Minnesota Legislature
SF 2361
1st Engrossment - 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; adding an informed consent provision for 1.19 abortion procedures; requiring reports; appropriating 1.20 money; amending Minnesota Statutes 2000, sections 1.21 13.46, subdivision 4; 13.461, subdivision 17; 13B.06, 1.22 subdivisions 4, 7; 15A.083, subdivision 4; 16A.06, by 1.23 adding a subdivision; 16A.87; 62A.095, subdivision 1; 1.24 62A.48, subdivision 4, by adding subdivisions; 1.25 62J.152, subdivision 8; 62J.451, subdivision 5; 1.26 62J.692, subdivision 7; 62J.694, subdivision 2; 1.27 62Q.19, subdivision 2; 62S.01, by adding subdivisions; 1.28 62S.26; 103I.101, subdivision 6; 103I.112; 103I.208, 1.29 subdivisions 1, 2; 103I.235, subdivision 1; 103I.525, 1.30 subdivisions 2, 6, 8, 9; 103I.531, subdivisions 2, 6, 1.31 8, 9; 103I.535, subdivisions 2, 6, 8, 9; 103I.541, 1.32 subdivisions 2b, 4, 5; 103I.545; 116L.11, subdivision 1.33 4; 116L.12, subdivisions 4, 5; 116L.13, subdivision 1; 1.34 121A.15, by adding subdivisions; 144.057; 144.0721, 1.35 subdivision 1; 144.1202, subdivision 4; 144.122; 1.36 144.1464; 144.148, subdivision 2; 144.1494, 1.37 subdivisions 1, 3, 4; 144.1496; 144.226, subdivision 1.38 4; 144.396, subdivision 7; 144.98, subdivision 3; 1.39 144A.071, subdivisions 1, 1a, 2, 4a; 144A.073, 1.40 subdivision 2; 145.881, subdivision 2; 145.882, 1.41 subdivision 7, by adding a subdivision; 145.885, 1.42 subdivision 2; 145.925, subdivision 1; 148.212; 1.43 148.263, subdivision 2; 148.284; 150A.10, by adding a 1.44 subdivision; 157.16, subdivision 3; 157.22; 214.001, 1.45 by adding a subdivision; 214.002, subdivision 1; 1.46 214.01, by adding a subdivision; 214.104; 241.272, 2.1 subdivision 6; 242.192; 245.462, subdivision 18, by 2.2 adding subdivisions; 245.466, subdivision 2; 245.470, 2.3 by adding a subdivision; 245.474, subdivision 2, by 2.4 adding a subdivision; 245.4871, subdivision 27, by 2.5 adding subdivisions; 245.4875, subdivision 2; 2.6 245.4876, subdivision 1, by adding a subdivision; 2.7 245.488, by adding a subdivision; 245.4885, 2.8 subdivision 1; 245.4886, subdivision 1; 245.98, by 2.9 adding a subdivision; 245.982; 245.99, subdivision 4; 2.10 245A.03, subdivision 2b; 245A.04, subdivisions 3, 3a, 2.11 3b, 3c, 3d; 245A.05; 245A.06; 245A.07; 245A.08; 2.12 245A.13, subdivisions 7, 8; 245A.16, subdivision 1; 2.13 245B.08, subdivision 3; 252.275, subdivision 4b; 2.14 253.28, by adding a subdivision; 253B.02, subdivision 2.15 10; 253B.03, subdivisions 5, 10, by adding a 2.16 subdivision; 253B.04, subdivisions 1, 1a, by adding a 2.17 subdivision; 253B.045, subdivision 6; 253B.05, 2.18 subdivision 1; 253B.07, subdivision 1; 253B.09, 2.19 subdivision 1; 253B.10, subdivision 4; 254B.03, 2.20 subdivision 1; 254B.09, by adding a subdivision; 2.21 256.01, subdivision 2, by adding a subdivision; 2.22 256.045, subdivisions 3, 3b, 4; 256.476, subdivisions 2.23 1, 2, 3, 4, 5, 8, by adding a subdivision; 256.741, 2.24 subdivisions 1, 5, 8; 256.955, subdivisions 2, 2a, 7, 2.25 by adding a subdivision; 256.9657, subdivision 2; 2.26 256.969, subdivision 3a, by adding a subdivision; 2.27 256.975, by adding subdivisions; 256.979, subdivisions 2.28 5, 6; 256.98, subdivision 8; 256B.02, subdivision 7; 2.29 256B.04, by adding a subdivision; 256B.055, 2.30 subdivision 3a; 256B.056, subdivisions 1a, 4, 4b; 2.31 256B.057, subdivisions 2, 9, by adding subdivisions; 2.32 256B.061; 256B.0625, subdivisions 7, 13, 13a, 17, 17a, 2.33 18a, 19a, 19c, 20, 30, 34, by adding subdivisions; 2.34 256B.0627, subdivisions 1, 2, 4, 5, 7, 8, 10, 11, by 2.35 adding subdivisions; 256B.0635, subdivisions 1, 2; 2.36 256B.0644; 256B.0911, subdivisions 1, 3, 5, 6, 7, by 2.37 adding subdivisions; 256B.0913, subdivisions 1, 2, 4, 2.38 5, 6, 7, 8, 9, 10, 11, 12, 13, 14; 256B.0915, 2.39 subdivisions 1d, 3, 5; 256B.0917, by adding a 2.40 subdivision; 256B.093, subdivision 3; 256B.431, 2.41 subdivision 2e, by adding subdivisions; 256B.433, 2.42 subdivision 3a; 256B.434, subdivision 4; 256B.49, by 2.43 adding subdivisions; 256B.5012, subdivision 3, by 2.44 adding subdivisions; 256B.69, subdivisions 4, 5c, 23, 2.45 by adding a subdivision; 256B.75; 256B.76; 256D.053, 2.46 subdivision 1; 256D.35, by adding subdivisions; 2.47 256D.425, subdivision 1; 256D.44, subdivision 5; 2.48 256I.05, subdivisions 1d, 1e, by adding a subdivision; 2.49 256J.08, subdivision 55a, by adding a subdivision; 2.50 256J.21, subdivision 2; 256J.24, subdivisions 2, 9, 2.51 10; 256J.31, subdivision 12; 256J.32, subdivision 4; 2.52 256J.37, subdivision 9; 256J.39, subdivision 2; 2.53 256J.42, subdivisions 1, 3, 4, 5; 256J.45, 2.54 subdivisions 1, 2; 256J.46, subdivision 1; 256J.48, 2.55 subdivision 1, by adding a subdivision; 256J.49, 2.56 subdivisions 2, 13, by adding a subdivision; 256J.50, 2.57 subdivisions 5, 10, by adding a subdivision; 256J.515; 2.58 256J.52, subdivisions 2, 3, 6; 256J.53, subdivisions 2.59 1, 2, 3; 256J.56; 256J.62, subdivisions 2a, 9; 2.60 256J.625; 256J.645; 256K.03, subdivisions 1, 5; 2.61 256K.07; 256L.01, subdivision 4; 256L.04, subdivision 2.62 2; 256L.05, subdivision 2; 256L.06, subdivision 3; 2.63 256L.07, subdivisions 1, 2, 3, by adding subdivisions; 2.64 256L.12, by adding a subdivision; 256L.15, 2.65 subdivisions 1, 2; 256L.16; 257.0725; 260C.201, 2.66 subdivision 1; 326.38; 393.07, by adding a 2.67 subdivision; 518.551, subdivision 13; 518.5513, 2.68 subdivision 5; 518.575, subdivision 1; 518.5851, by 2.69 adding a subdivision; 518.5853, by adding a 2.70 subdivision; 518.6111, subdivision 5; 518.6195; 2.71 518.64, subdivision 2; 518.641, subdivisions 1, 2, 3, 3.1 by adding a subdivision; 548.091, subdivision 1a; 3.2 609.115, subdivision 9; 611.23; 626.556, subdivisions 3.3 2, 10, 10b, 10d, 10e, 10f, 10i, 11, 12, by adding a 3.4 subdivision; 245.814, subdivision 1; 626.557, 3.5 subdivisions 3, 9d, 12b; 626.5572, subdivision 17; 3.6 626.559, subdivision 2; Laws 1998, chapter 404, 3.7 section 18, subdivision 4; Laws 1998, chapter 407, 3.8 article 8, section 9; Laws 1999, chapter 152, section 3.9 4; Laws 1999, chapter 216, article 1, section 13, 3.10 subdivision 4; Laws 1999, chapter 245, article 3, 3.11 section 45, as amended; Laws 1999, chapter 245, 3.12 article 4, section 110; Laws 1999, chapter 245, 3.13 article 10, section 10, as amended; Laws 2000, chapter 3.14 364, section 2; proposing coding for new law in 3.15 Minnesota Statutes, chapters 62Q; 62S; 116L; 144; 3.16 144A; 145; 214; 241; 244; 246; 256; 256B; 256J; 299A; 3.17 repealing Minnesota Statutes 2000, sections 16A.76; 3.18 116L.12, subdivisions 2, 7; 144.148, subdivision 8; 3.19 144A.16; 145.882, subdivisions 3, 4; 145.9245; 3.20 145.927; 256.01, subdivision 18; 256.476, subdivision 3.21 7; 256.955, subdivision 2b; 256B.0635, subdivision 3; 3.22 256B.0911, subdivisions 2, 2a, 4, 8, 9; 256B.0912; 3.23 256B.0913, subdivisions 3, 15a, 15b, 15c, 16; 3.24 256B.0915, subdivisions 3a, 3b, 3c; 256B.434, 3.25 subdivision 5; 256B.49, subdivisions 1, 2, 3, 4, 5, 6, 3.26 7, 8, 9, 10; 256D.066; 256E.06, subdivision 2b; 3.27 256J.08, subdivision 50a; 256J.12, subdivision 3; 3.28 256J.32, subdivision 7a; 256J.43; 256J.49, subdivision 3.29 11; 256J.53, subdivision 4; 256L.15, subdivision 3; 3.30 518.641, subdivisions 4, 5; Laws 1997, chapter 203, 3.31 article 9, section 21; Laws 1998, chapter 404, section 3.32 18, subdivision 4; Laws 1998, chapter 407, article 6, 3.33 section 111; Laws 2000, chapter 488, article 10, 3.34 section 28; Laws 2000, chapter 488, article 10, 3.35 section 30; Minnesota Rules, parts 4655.6810; 3.36 4655.6820; 4655.6830; 4658.1600; 4658.1605; 4658.1610; 3.37 4658.1690; 9505.2390; 9505.2395; 9505.2396; 9505.2400; 3.38 9505.2405; 9505.2410; 9505.2413; 9505.2415; 9505.2420; 3.39 9505.2425; 9505.2426; 9505.2430; 9505.2435; 9505.2440; 3.40 9505.2445; 9505.2450; 9505.2455; 9505.2458; 9505.2460; 3.41 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 3.42 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 3.43 9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 3.44 9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 3.45 9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 3.46 9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 3.47 9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 3.48 9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 3.49 9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 3.50 9505.3660; 9505.3670; 9546.0010; 9546.0020; 9546.0030; 3.51 9546.0040; 9546.0050; 9546.0060. 3.52 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.53 ARTICLE 1 3.54 DEPARTMENT OF HEALTH 3.55 Section 1. Minnesota Statutes 2000, section 62J.152, 3.56 subdivision 8, is amended to read: 3.57 Subd. 8. [REPEALER.] This section and sections 62J.15 and 3.58 62J.156 are repealed effective July 1,20012005. 3.59 Sec. 2. Minnesota Statutes 2000, section 62J.451, 3.60 subdivision 5, is amended to read: 3.61 Subd. 5. [HEALTH CARE ELECTRONIC DATA INTERCHANGE 4.1 SYSTEM.](a)The health data institute shall establish an 4.2 electronic data interchange system that electronically 4.3 transmits, collects, archives, and provides users of data with 4.4 the data necessary for their specific interests, in order to 4.5 promote a high quality, cost-effective, consumer-responsive 4.6 health care system. This public-private information system 4.7 shall be developed to make health care claims processing and 4.8 financial settlement transactions more efficient and to provide 4.9 an efficient, unobtrusive method for meeting the shared 4.10 electronic data interchange needs of consumers, group 4.11 purchasers, providers, and the state. 4.12(b) The health data institute shall operate the Minnesota4.13center for health care electronic data interchange established4.14in section 62J.57, and shall integrate the goals, objectives,4.15and activities of the center with those of the health data4.16institute's electronic data interchange system.4.17 Sec. 3. Minnesota Statutes 2000, section 103I.101, 4.18 subdivision 6, is amended to read: 4.19 Subd. 6. [FEES FOR VARIANCES.] The commissioner shall 4.20 charge a nonrefundable application fee of$120$150 to cover the 4.21 administrative cost of processing a request for a variance or 4.22 modification of rules adopted by the commissioner under this 4.23 chapter. 4.24 [EFFECTIVE DATE.] This section is effective July 1, 2002. 4.25 Sec. 4. Minnesota Statutes 2000, section 103I.112, is 4.26 amended to read: 4.27 103I.112 [FEE EXEMPTIONS FOR STATE AND LOCAL GOVERNMENT.] 4.28 (a) The commissioner of health may not charge fees required 4.29 under this chapter to a federal agency, state agency, or a local 4.30 unit of government or to a subcontractor performing work for the 4.31 state agency or local unit of government. 4.32 (b) "Local unit of government" means a statutory or home 4.33 rule charter city, town, county, or soil and water conservation 4.34 district, watershed district, an organization formed for the 4.35 joint exercise of powers under section 471.59, a board of health 4.36 or community health board, or other special purpose district or 5.1 authority with local jurisdiction in water and related land 5.2 resources management. 5.3 [EFFECTIVE DATE.] This section is effective July 1, 2002. 5.4 Sec. 5. Minnesota Statutes 2000, section 103I.208, 5.5 subdivision 1, is amended to read: 5.6 Subdivision 1. [WELL NOTIFICATION FEE.] The well 5.7 notification fee to be paid by a property owner is: 5.8 (1) for a new well,$120$150, which includes the state 5.9 core function fee; 5.10 (2) for a well sealing,$20$30 for each well, which 5.11 includes the state core function fee, except that for monitoring 5.12 wells constructed on a single property, having depths within a 5.13 25 foot range, and sealed within 48 hours of start of 5.14 construction, a single fee of$20$30; and 5.15 (3) for construction of a dewatering well,$120$150, which 5.16 includes the state core function fee, for each well except a 5.17 dewatering project comprising five or more wells shall be 5.18 assessed a single fee of$600$750 for the wells recorded on the 5.19 notification. 5.20 [EFFECTIVE DATE.] This section is effective July 1, 2002. 5.21 Sec. 6. Minnesota Statutes 2000, section 103I.208, 5.22 subdivision 2, is amended to read: 5.23 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 5.24 property owner is: 5.25 (1) for a well that is not in use under a maintenance 5.26 permit,$100$125 annually; 5.27 (2) for construction of a monitoring well,$120$150, which 5.28 includes the state core function fee; 5.29 (3) for a monitoring well that is unsealed under a 5.30 maintenance permit,$100$125 annually; 5.31 (4) for monitoring wells used as a leak detection device at 5.32 a single motor fuel retail outlet, a single petroleum bulk 5.33 storage site excluding tank farms, or a single agricultural 5.34 chemical facility site, the construction permit fee 5.35 is$120$150, which includes the state core function fee, per 5.36 site regardless of the number of wells constructed on the site, 6.1 and the annual fee for a maintenance permit for unsealed 6.2 monitoring wells is$100$125 per site regardless of the number 6.3 of monitoring wells located on site; 6.4 (5) for a groundwater thermal exchange device, in addition 6.5 to the notification fee for wells,$120$150, which includes the 6.6 state core function fee; 6.7 (6) for a vertical heat exchanger,$120$150; 6.8 (7) for a dewatering well that is unsealed under a 6.9 maintenance permit,$100$125 annually for each well, except a 6.10 dewatering project comprising more than five wells shall be 6.11 issued a single permit for$500$625 annually for wells recorded 6.12 on the permit; and 6.13 (8) for excavating holes for the purpose of installing 6.14 elevator shafts,$120$150 for each hole. 6.15 [EFFECTIVE DATE.] This section is effective July 1, 2002. 6.16 Sec. 7. Minnesota Statutes 2000, section 103I.235, 6.17 subdivision 1, is amended to read: 6.18 Subdivision 1. [DISCLOSURE OF WELLS TO BUYER.] (a) Before 6.19 signing an agreement to sell or transfer real property, the 6.20 seller must disclose in writing to the buyer information about 6.21 the status and location of all known wells on the property, by 6.22 delivering to the buyer either a statement by the seller that 6.23 the seller does not know of any wells on the property, or a 6.24 disclosure statement indicating the legal description and 6.25 county, and a map drawn from available information showing the 6.26 location of each well to the extent practicable. In the 6.27 disclosure statement, the seller must indicate, for each well, 6.28 whether the well is in use, not in use, or sealed. 6.29 (b) At the time of closing of the sale, the disclosure 6.30 statement information, name and mailing address of the buyer, 6.31 and the quartile, section, township, and range in which each 6.32 well is located must be provided on a well disclosure 6.33 certificate signed by the seller or a person authorized to act 6.34 on behalf of the seller. 6.35 (c) A well disclosure certificate need not be provided if 6.36 the seller does not know of any wells on the property and the 7.1 deed or other instrument of conveyance contains the statement: 7.2 "The Seller certifies that the Seller does not know of any wells 7.3 on the described real property." 7.4 (d) If a deed is given pursuant to a contract for deed, the 7.5 well disclosure certificate required by this subdivision shall 7.6 be signed by the buyer or a person authorized to act on behalf 7.7 of the buyer. If the buyer knows of no wells on the property, a 7.8 well disclosure certificate is not required if the following 7.9 statement appears on the deed followed by the signature of the 7.10 grantee or, if there is more than one grantee, the signature of 7.11 at least one of the grantees: "The Grantee certifies that the 7.12 Grantee does not know of any wells on the described real 7.13 property." The statement and signature of the grantee may be on 7.14 the front or back of the deed or on an attached sheet and an 7.15 acknowledgment of the statement by the grantee is not required 7.16 for the deed to be recordable. 7.17 (e) This subdivision does not apply to the sale, exchange, 7.18 or transfer of real property: 7.19 (1) that consists solely of a sale or transfer of severed 7.20 mineral interests; or 7.21 (2) that consists of an individual condominium unit as 7.22 described in chapters 515 and 515B. 7.23 (f) For an area owned in common under chapter 515 or 515B 7.24 the association or other responsible person must report to the 7.25 commissioner by July 1, 1992, the location and status of all 7.26 wells in the common area. The association or other responsible 7.27 person must notify the commissioner within 30 days of any change 7.28 in the reported status of wells. 7.29 (g) For real property sold by the state under section 7.30 92.67, the lessee at the time of the sale is responsible for 7.31 compliance with this subdivision. 7.32 (h) If the seller fails to provide a required well 7.33 disclosure certificate, the buyer, or a person authorized to act 7.34 on behalf of the buyer, may sign a well disclosure certificate 7.35 based on the information provided on the disclosure statement 7.36 required by this section or based on other available information. 8.1 (i) A county recorder or registrar of titles may not record 8.2 a deed or other instrument of conveyance dated after October 31, 8.3 1990, for which a certificate of value is required under section 8.4 272.115, or any deed or other instrument of conveyance dated 8.5 after October 31, 1990, from a governmental body exempt from the 8.6 payment of state deed tax, unless the deed or other instrument 8.7 of conveyance contains the statement made in accordance with 8.8 paragraph (c) or (d) or is accompanied by the well disclosure 8.9 certificate containing all the information required by paragraph 8.10 (b) or (d). The county recorder or registrar of titles must not 8.11 accept a certificate unless it contains all the required 8.12 information. The county recorder or registrar of titles shall 8.13 note on each deed or other instrument of conveyance accompanied 8.14 by a well disclosure certificate that the well disclosure 8.15 certificate was received. The notation must include the 8.16 statement "No wells on property" if the disclosure certificate 8.17 states there are no wells on the property. The well disclosure 8.18 certificate shall not be filed or recorded in the records 8.19 maintained by the county recorder or registrar of titles. After 8.20 noting "No wells on property" on the deed or other instrument of 8.21 conveyance, the county recorder or registrar of titles shall 8.22 destroy or return to the buyer the well disclosure certificate. 8.23 The county recorder or registrar of titles shall collect from 8.24 the buyer or the person seeking to record a deed or other 8.25 instrument of conveyance, a fee of$20$30 for receipt of a 8.26 completed well disclosure certificate. By the tenth day of each 8.27 month, the county recorder or registrar of titles shall transmit 8.28 the well disclosure certificates to the commissioner of health. 8.29 By the tenth day after the end of each calendar quarter, the 8.30 county recorder or registrar of titles shall transmit to the 8.31 commissioner of health$17.50$27.50 of the fee for each well 8.32 disclosure certificate received during the quarter. The 8.33 commissioner shall maintain the well disclosure certificate for 8.34 at least six years. The commissioner may store the certificate 8.35 as an electronic image. A copy of that image shall be as valid 8.36 as the original. 9.1 (j) No new well disclosure certificate is required under 9.2 this subdivision if the buyer or seller, or a person authorized 9.3 to act on behalf of the buyer or seller, certifies on the deed 9.4 or other instrument of conveyance that the status and number of 9.5 wells on the property have not changed since the last previously 9.6 filed well disclosure certificate. The following statement, if 9.7 followed by the signature of the person making the statement, is 9.8 sufficient to comply with the certification requirement of this 9.9 paragraph: "I am familiar with the property described in this 9.10 instrument and I certify that the status and number of wells on 9.11 the described real property have not changed since the last 9.12 previously filed well disclosure certificate." The 9.13 certification and signature may be on the front or back of the 9.14 deed or on an attached sheet and an acknowledgment of the 9.15 statement is not required for the deed or other instrument of 9.16 conveyance to be recordable. 9.17 (k) The commissioner in consultation with county recorders 9.18 shall prescribe the form for a well disclosure certificate and 9.19 provide well disclosure certificate forms to county recorders 9.20 and registrars of titles and other interested persons. 9.21 (l) Failure to comply with a requirement of this 9.22 subdivision does not impair: 9.23 (1) the validity of a deed or other instrument of 9.24 conveyance as between the parties to the deed or instrument or 9.25 as to any other person who otherwise would be bound by the deed 9.26 or instrument; or 9.27 (2) the record, as notice, of any deed or other instrument 9.28 of conveyance accepted for filing or recording contrary to the 9.29 provisions of this subdivision. 9.30 [EFFECTIVE DATE.] This section is effective July 1, 2002. 9.31 Sec. 8. Minnesota Statutes 2000, section 103I.525, 9.32 subdivision 2, is amended to read: 9.33 Subd. 2. [APPLICATION FEE.] The application fee for a well 9.34 contractor's license is$50$75. The commissioner may not act 9.35 on an application until the application fee is paid. 9.36 [EFFECTIVE DATE.] This section is effective July 1, 2002. 10.1 Sec. 9. Minnesota Statutes 2000, section 103I.525, 10.2 subdivision 6, is amended to read: 10.3 Subd. 6. [LICENSE FEE.] The fee for a well contractor's 10.4 license is $250, except the fee for an individual well 10.5 contractor's license is$50$75. 10.6 [EFFECTIVE DATE.] This section is effective July 1, 2002. 10.7 Sec. 10. Minnesota Statutes 2000, section 103I.525, 10.8 subdivision 8, is amended to read: 10.9 Subd. 8. [RENEWAL.] (a) A licensee must file an 10.10 application and a renewal application fee to renew the license 10.11 by the date stated in the license. 10.12 (b) The renewal application feeshall be set by the10.13commissioner under section 16A.1285for a well contractor's 10.14 license is $250. 10.15 (c) The renewal application must include information that 10.16 the applicant has met continuing education requirements 10.17 established by the commissioner by rule. 10.18 (d) At the time of the renewal, the commissioner must have 10.19 on file all properly completed well reports, well sealing 10.20 reports, reports of excavations to construct elevator shafts, 10.21 well permits, and well notifications for work conducted by the 10.22 licensee since the last license renewal. 10.23 [EFFECTIVE DATE.] This section is effective July 1, 2002. 10.24 Sec. 11. Minnesota Statutes 2000, section 103I.525, 10.25 subdivision 9, is amended to read: 10.26 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 10.27 to submit all information required for renewal in subdivision 8 10.28 or submits the application and information after the required 10.29 renewal date: 10.30 (1) the licensee must includean additionala late feeset10.31by the commissionerof $75; and 10.32 (2) the licensee may not conduct activities authorized by 10.33 the well contractor's license until the renewal application, 10.34 renewal application fee, late fee, and all other information 10.35 required in subdivision 8 are submitted. 10.36 [EFFECTIVE DATE.] This section is effective July 1, 2002. 11.1 Sec. 12. Minnesota Statutes 2000, section 103I.531, 11.2 subdivision 2, is amended to read: 11.3 Subd. 2. [APPLICATION FEE.] The application fee for a 11.4 limited well/boring contractor's license is$50$75. The 11.5 commissioner may not act on an application until the application 11.6 fee is paid. 11.7 [EFFECTIVE DATE.] This section is effective July 1, 2002. 11.8 Sec. 13. Minnesota Statutes 2000, section 103I.531, 11.9 subdivision 6, is amended to read: 11.10 Subd. 6. [LICENSE FEE.] The fee for a limited well/boring 11.11 contractor's license is$50$75. 11.12 [EFFECTIVE DATE.] This section is effective July 1, 2002. 11.13 Sec. 14. Minnesota Statutes 2000, section 103I.531, 11.14 subdivision 8, is amended to read: 11.15 Subd. 8. [RENEWAL.] (a) A person must file an application 11.16 and a renewal application fee to renew the limited well/boring 11.17 contractor's license by the date stated in the license. 11.18 (b) The renewal application feeshall be set by the11.19commissioner under section 16A.1285for a limited well/boring 11.20 contractor's license is $75. 11.21 (c) The renewal application must include information that 11.22 the applicant has met continuing education requirements 11.23 established by the commissioner by rule. 11.24 (d) At the time of the renewal, the commissioner must have 11.25 on file all properly completed well sealing reports, well 11.26 permits, vertical heat exchanger permits, and well notifications 11.27 for work conducted by the licensee since the last license 11.28 renewal. 11.29 [EFFECTIVE DATE.] This section is effective July 1, 2002. 11.30 Sec. 15. Minnesota Statutes 2000, section 103I.531, 11.31 subdivision 9, is amended to read: 11.32 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 11.33 to submit all information required for renewal in subdivision 8 11.34 or submits the application and information after the required 11.35 renewal date: 11.36 (1) the licensee must includean additionala late feeset12.1by the commissionerof $75; and 12.2 (2) the licensee may not conduct activities authorized by 12.3 the limited well/boring contractor's license until the renewal 12.4 application, renewal application fee, and late fee, and all 12.5 other information required in subdivision 8 are submitted. 12.6 [EFFECTIVE DATE.] This section is effective July 1, 2002. 12.7 Sec. 16. Minnesota Statutes 2000, section 103I.535, 12.8 subdivision 2, is amended to read: 12.9 Subd. 2. [APPLICATION FEE.] The application fee for an 12.10 elevator shaft contractor's license is$50$75. The 12.11 commissioner may not act on an application until the application 12.12 fee is paid. 12.13 [EFFECTIVE DATE.] This section is effective July 1, 2002. 12.14 Sec. 17. Minnesota Statutes 2000, section 103I.535, 12.15 subdivision 6, is amended to read: 12.16 Subd. 6. [LICENSE FEE.] The fee for an elevator shaft 12.17 contractor's license is$50$75. 12.18 [EFFECTIVE DATE.] This section is effective July 1, 2002. 12.19 Sec. 18. Minnesota Statutes 2000, section 103I.535, 12.20 subdivision 8, is amended to read: 12.21 Subd. 8. [RENEWAL.] (a) A person must file an application 12.22 and a renewal application fee to renew the license by the date 12.23 stated in the license. 12.24 (b) The renewal application feeshall be set by the12.25commissioner under section 16A.1285for an elevator shaft 12.26 contractor's license is $75. 12.27 (c) The renewal application must include information that 12.28 the applicant has met continuing education requirements 12.29 established by the commissioner by rule. 12.30 (d) At the time of renewal, the commissioner must have on 12.31 file all reports and permits for elevator shaft work conducted 12.32 by the licensee since the last license renewal. 12.33 [EFFECTIVE DATE.] This section is effective July 1, 2002. 12.34 Sec. 19. Minnesota Statutes 2000, section 103I.535, 12.35 subdivision 9, is amended to read: 12.36 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 13.1 to submit all information required for renewal in subdivision 8 13.2 or submits the application and information after the required 13.3 renewal date: 13.4 (1) the licensee must includean additionala late feeset13.5by the commissionerof $75; and 13.6 (2) the licensee may not conduct activities authorized by 13.7 the elevator shaft contractor's license until the renewal 13.8 application, renewal application fee, and late fee, and all 13.9 other information required in subdivision 8 are submitted. 13.10 [EFFECTIVE DATE.] This section is effective July 1, 2002. 13.11 Sec. 20. Minnesota Statutes 2000, section 103I.541, 13.12 subdivision 2b, is amended to read: 13.13 Subd. 2b. [APPLICATION FEE.] The application fee for a 13.14 monitoring well contractor registration is$50$75. The 13.15 commissioner may not act on an application until the application 13.16 fee is paid. 13.17 [EFFECTIVE DATE.] This section is effective July 1, 2002. 13.18 Sec. 21. Minnesota Statutes 2000, section 103I.541, 13.19 subdivision 4, is amended to read: 13.20 Subd. 4. [RENEWAL.] (a) A person must file an application 13.21 and a renewal application fee to renew the registration by the 13.22 date stated in the registration. 13.23 (b) The renewal application feeshall be set by the13.24commissioner under section 16A.1285for a monitoring well 13.25 contractor's registration is $75. 13.26 (c) The renewal application must include information that 13.27 the applicant has met continuing education requirements 13.28 established by the commissioner by rule. 13.29 (d) At the time of the renewal, the commissioner must have 13.30 on file all well reports, well sealing reports, well permits, 13.31 and notifications for work conducted by the registered person 13.32 since the last registration renewal. 13.33 [EFFECTIVE DATE.] This section is effective July 1, 2002. 13.34 Sec. 22. Minnesota Statutes 2000, section 103I.541, 13.35 subdivision 5, is amended to read: 13.36 Subd. 5. [INCOMPLETE OR LATE RENEWAL.] If a registered 14.1 person submits a renewal application after the required renewal 14.2 date: 14.3 (1) the registered person must includean additionala late 14.4 feeset by the commissionerof $75; and 14.5 (2) the registered person may not conduct activities 14.6 authorized by the monitoring well contractor's registration 14.7 until the renewal application, renewal application fee, late 14.8 fee, and all other information required in subdivision 4 are 14.9 submitted. 14.10 [EFFECTIVE DATE.] This section is effective July 1, 2002. 14.11 Sec. 23. Minnesota Statutes 2000, section 103I.545, is 14.12 amended to read: 14.13 103I.545 [REGISTRATION OF DRILLING MACHINES REQUIRED.] 14.14 Subdivision 1. [DRILLING MACHINE.] (a) A person may not 14.15 use a drilling machine such as a cable tool, rotary tool, hollow 14.16 rod tool, or auger for a drilling activity requiring a license 14.17 or registration under this chapter unless the drilling machine 14.18 is registered with the commissioner. 14.19 (b) A person must apply for the registration on forms 14.20 prescribed by the commissioner and submit a$50$75 registration 14.21 fee. 14.22 (c) A registration is valid for one year. 14.23 Subd. 2. [PUMP HOIST.] (a) A person may not use a machine 14.24 such as a pump hoist for an activity requiring a license or 14.25 registration under this chapter to repair wells or borings, seal 14.26 wells or borings, or install pumps unless the machine is 14.27 registered with the commissioner. 14.28 (b) A person must apply for the registration on forms 14.29 prescribed by the commissioner and submit a$50$75 registration 14.30 fee. 14.31 (c) A registration is valid for one year. 14.32 [EFFECTIVE DATE.] This section is effective July 1, 2002. 14.33 Sec. 24. Minnesota Statutes 2000, section 144.1202, 14.34 subdivision 4, is amended to read: 14.35 Subd. 4. [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 14.36 agreement entered into before August 2,20022003, must remain 15.1 in effect until terminated under the Atomic Energy Act of 1954, 15.2 United States Code, title 42, section 2021, paragraph (j). The 15.3 governor may not enter into an initial agreement with the 15.4 Nuclear Regulatory Commission after August 1,20022003. If an 15.5 agreement is not entered into by August 1,20022003, any rules 15.6 adopted under this section are repealed effective August 1,200215.7 2003. 15.8 (b) An agreement authorized under subdivision 1 must be 15.9 approved by law before it may be implemented. 15.10 Sec. 25. [144.1205] [RADIOACTIVE MATERIAL; SOURCE AND 15.11 SPECIAL NUCLEAR MATERIAL; FEES; INSPECTION.] 15.12 Subdivision 1. [APPLICATION AND LICENSE RENEWAL FEE.] When 15.13 a license is required for radioactive material or source or 15.14 special nuclear material by a rule adopted under section 15.15 144.1202, subdivision 2, an application fee according to 15.16 subdivision 4 must be paid upon initial application for a 15.17 license. The licensee must renew the license 60 days before the 15.18 expiration date of the license by paying a license renewal fee 15.19 equal to the application fee under subdivision 4. The 15.20 expiration date of a license is the date set by the United 15.21 States Nuclear Regulatory Commission before transfer of the 15.22 licensing program under section 144.1202 and thereafter as 15.23 specified by rule of the commissioner of health. 15.24 Subd. 2. [ANNUAL FEE.] A licensee must pay an annual fee 15.25 at least 60 days before the anniversary date of the issuance of 15.26 the license. The annual fee is an amount equal to 80 percent of 15.27 the application fee under subdivision 4, rounded to the nearest 15.28 whole dollar. 15.29 Subd. 3. [FEE CATEGORIES; INCORPORATION OF FEDERAL 15.30 LICENSING CATEGORIES.] (a) Fee categories under this section are 15.31 equivalent to the licensing categories used by the United States 15.32 Nuclear Regulatory Commission under Code of Federal Regulations, 15.33 title 10, parts 30 to 36, 39, 40, 70, 71, and 150, except as 15.34 provided in paragraph (b). 15.35 (b) The category of "Academic, small" is the type of 15.36 license required for the use of radioactive materials in a 16.1 teaching institution. Radioactive materials are limited to ten 16.2 radionuclides not to exceed a total activity amount of one curie. 16.3 Subd. 4. [APPLICATION FEE.] A licensee must pay an 16.4 application fee as follows: 16.5 Radioactive material, Application U.S. Nuclear Regulatory 16.6 source and fee Commission licensing 16.7 special material category as reference 16.9 Type A broadscope $20,000 Medical institution type A 16.10 Type B broadscope $15,000 Research and development 16.11 type B 16.12 Type C broadscope $10,000 Academic type C 16.13 Medical use $4,000 Medical 16.14 Medical institution 16.15 Medical private practice 16.16 Mobile nuclear 16.17 medical laboratory $4,000 Mobile medical laboratory 16.18 Medical special use 16.19 sealed sources $6,000 Teletherapy 16.20 High dose rate remote 16.21 afterloaders 16.22 Stereotactic 16.23 radiosurgery devices 16.24 In vitro testing $2,300 In vitro testing 16.25 laboratories 16.26 Measuring gauge, 16.27 sealed sources $2,000 Fixed gauges 16.28 Portable gauges 16.29 Analytical instruments 16.30 Measuring systems - other 16.31 Gas chromatographs $1,200 Gas chromatographs 16.32 Manufacturing and 16.33 distribution $14,700 Manufacturing and 16.34 distribution - other 16.35 Distribution only $8,800 Distribution of 16.36 radioactive material 17.1 for commercial use only 17.2 Other services $1,500 Other services 17.3 Nuclear medicine 17.4 pharmacy $4,100 Nuclear pharmacy 17.5 Waste disposal $9,400 Waste disposal service 17.6 prepackage 17.7 Waste disposal service 17.8 processing/repackage 17.9 Waste storage only $7,000 To receive and store 17.10 radioactive material waste 17.11 Industrial 17.12 radiography $8,400 Industrial radiography 17.13 fixed location 17.14 Industrial radiography 17.15 portable/temporary sites 17.16 Irradiator - 17.17 self-shielded $4,100 Irradiators self-shielded 17.18 less than 10,000 curies 17.19 Irradiator - 17.20 less than 10,000 Ci $7,500 Irradiators less than 17.21 10,000 curies 17.22 Irradiator - 17.23 more than 10,000 Ci $11,500 Irradiators greater than 17.24 10,000 curies 17.25 Research and 17.26 development, 17.27 no distribution $4,100 Research and development 17.28 Radioactive material 17.29 possession only $1,000 Byproduct possession only 17.30 Source material $1,000 Source material shielding 17.31 Special nuclear 17.32 material, less than 17.33 200 grams $1,000 Special nuclear material 17.34 plutonium-neutron sources 17.35 less than 200 grams 17.36 Pacemaker 18.1 manufacturing $1,000 Pacemaker byproduct 18.2 and/or special nuclear 18.3 material - medical 18.4 institution 18.5 General license 18.6 distribution $2,100 General license 18.7 distribution 18.8 General license 18.9 distribution, exempt $1,500 General license 18.10 distribution - 18.11 certain exempt items 18.12 Academic, small $1,000 Possession limit of ten 18.13 radionuclides, not to 18.14 exceed a total of one curie 18.15 of activity 18.16 Veterinary $2,000 Veterinary use 18.17 Well logging $5,000 Well logging 18.18 Subd. 5. [PENALTY FOR LATE PAYMENT.] An annual fee or a 18.19 license renewal fee submitted to the commissioner after the due 18.20 date specified by rule must be accompanied by an additional 18.21 amount equal to 25 percent of the fee due. 18.22 Subd. 6. [INSPECTIONS.] The commissioner of health shall 18.23 make periodic safety inspections of the radioactive material and 18.24 source and special nuclear material of a licensee. The 18.25 commissioner shall prescribe the frequency of safety inspections 18.26 by rule. 18.27 Subd. 7. [RECOVERY OF REINSPECTION COST.] If the 18.28 commissioner finds serious violations of public health standards 18.29 during an inspection under subdivision 6, the licensee must pay 18.30 all costs associated with subsequent reinspection of the 18.31 source. The costs shall be the actual costs incurred by the 18.32 commissioner and include, but are not limited to, labor, 18.33 transportation, per diem, materials, legal fees, testing, and 18.34 monitoring costs. 18.35 Subd. 8. [RECIPROCITY FEE.] A licensee submitting an 18.36 application for reciprocal recognition of a materials license 19.1 issued by another agreement state or the United States Nuclear 19.2 Regulatory Commission for a period of 180 days or less during a 19.3 calendar year must pay one-half of the application fee specified 19.4 under subdivision 4. For a period of 181 days or more, the 19.5 licensee must pay the entire application fee under subdivision 4. 19.6 Subd. 9. [FEES FOR LICENSE AMENDMENTS.] A licensee must 19.7 pay a fee to amend a license as follows: 19.8 (1) to amend a license requiring no license review 19.9 including, but not limited to, facility name change or removal 19.10 of a previously authorized user, no fee; 19.11 (2) to amend a license requiring review including, but not 19.12 limited to, addition of isotopes, procedure changes, new 19.13 authorized users, or a new radiation safety officer, $200; and 19.14 (3) to amend a license requiring review and a site visit 19.15 including, but not limited to, facility move or addition of 19.16 processes, $400. 19.17 [EFFECTIVE DATE.] This section is effective July 1, 2002. 19.18 Sec. 26. Minnesota Statutes 2000, section 144.122, is 19.19 amended to read: 19.20 144.122 [LICENSE, PERMIT, AND SURVEY FEES.] 19.21 (a) The state commissioner of health, by rule, may 19.22 prescribe reasonable procedures and fees for filing with the 19.23 commissioner as prescribed by statute and for the issuance of 19.24 original and renewal permits, licenses, registrations, and 19.25 certifications issued under authority of the commissioner. The 19.26 expiration dates of the various licenses, permits, 19.27 registrations, and certifications as prescribed by the rules 19.28 shall be plainly marked thereon. Fees may include application 19.29 and examination fees and a penalty fee for renewal applications 19.30 submitted after the expiration date of the previously issued 19.31 permit, license, registration, and certification. The 19.32 commissioner may also prescribe, by rule, reduced fees for 19.33 permits, licenses, registrations, and certifications when the 19.34 application therefor is submitted during the last three months 19.35 of the permit, license, registration, or certification period. 19.36 Fees proposed to be prescribed in the rules shall be first 20.1 approved by the department of finance. All fees proposed to be 20.2 prescribed in rules shall be reasonable. The fees shall be in 20.3 an amount so that the total fees collected by the commissioner 20.4 will, where practical, approximate the cost to the commissioner 20.5 in administering the program. All fees collected shall be 20.6 deposited in the state treasury and credited to the state 20.7 government special revenue fund unless otherwise specifically 20.8 appropriated by law for specific purposes. 20.9 (b) The commissioner may charge a fee for voluntary 20.10 certification of medical laboratories and environmental 20.11 laboratories, and for environmental and medical laboratory 20.12 services provided by the department, without complying with 20.13 paragraph (a) or chapter 14. Fees charged for environment and 20.14 medical laboratory services provided by the department must be 20.15 approximately equal to the costs of providing the services. 20.16 (c) The commissioner may develop a schedule of fees for 20.17 diagnostic evaluations conducted at clinics held by the services 20.18 for children with handicaps program. All receipts generated by 20.19 the program are annually appropriated to the commissioner for 20.20 use in the maternal and child health program. 20.21 (d) The commissioner, for fiscal years 1996 and beyond, 20.22 shall set license fees for hospitals and nursing homes that are 20.23 not boarding care homes at the following levels: 20.24 Joint Commission on Accreditation of Healthcare 20.25 Organizations (JCAHO hospitals)$1,01720.26 $7,055 20.27 Non-JCAHO hospitals$762 plus $34 per bed20.28 $4,680 plus $234 per bed 20.29 Nursing home $78 plus $19 per bed 20.30 For fiscal years 1996 and beyond, the commissioner shall 20.31 set license fees for outpatient surgical centers, boarding care 20.32 homes, and supervised living facilities at the following levels: 20.33 Outpatient surgical centers$51720.34 $1,512 20.35 Boarding care homes$78 plus $19 per bed20.36 $183 plus $91 per bed 21.1 Supervised living facilities$78 plus $19 per bed21.2 $183 plus $91 per bed. 21.3 (e) Unless prohibited by federal law, the commissioner of 21.4 health shall charge applicants the following fees to cover the 21.5 cost of any initial certification surveys required to determine 21.6 a provider's eligibility to participate in the Medicare or 21.7 Medicaid program: 21.8 Prospective payment surveys for $ 900 21.9 hospitals 21.11 Swing bed surveys for nursing homes $1,200 21.13 Psychiatric hospitals $1,400 21.15 Rural health facilities $1,100 21.17 Portable X-ray providers $ 500 21.19 Home health agencies $1,800 21.21 Outpatient therapy agencies $ 800 21.23 End stage renal dialysis providers $2,100 21.25 Independent therapists $ 800 21.27 Comprehensive rehabilitation $1,200 21.28 outpatient facilities 21.30 Hospice providers $1,700 21.32 Ambulatory surgical providers $1,800 21.34 Hospitals $4,200 21.36 Other provider categories or Actual surveyor costs: 21.37 additional resurveys required average surveyor cost x 21.38 to complete initial certification number of hours for the 21.39 survey process. 21.40 These fees shall be submitted at the time of the 21.41 application for federal certification and shall not be 21.42 refunded. All fees collected after the date that the imposition 21.43 of fees is not prohibited by federal law shall be deposited in 21.44 the state treasury and credited to the state government special 21.45 revenue fund. 21.46 Sec. 27. Minnesota Statutes 2000, section 144.1464, is 21.47 amended to read: 21.48 144.1464 [SUMMER HEALTH CARE INTERNS.] 21.49 Subdivision 1. [SUMMER INTERNSHIPS.] The commissioner of 21.50 health, through a contract with a nonprofit organization as 21.51 required by subdivision 4, shall award grants to hospitalsand, 22.1 clinics, nursing facilities, and home care providers to 22.2 establish a secondary and post-secondary summer health care 22.3 intern program. The purpose of the program is to expose 22.4 interested secondary and post-secondary pupils to various 22.5 careers within the health care profession. 22.6 Subd. 2. [CRITERIA.] (a) The commissioner, through the 22.7 organization under contract, shall award grants to 22.8 hospitalsand, clinics, nursing facilities, and home care 22.9 providers that agree to: 22.10 (1) provide secondary and post-secondary summer health care 22.11 interns with formal exposure to the health care profession; 22.12 (2) provide an orientation for the secondary and 22.13 post-secondary summer health care interns; 22.14 (3) pay one-half the costs of employing the secondary and 22.15 post-secondary summer health care intern, based on an overall22.16hourly wage that is at least the minimum wage but does not22.17exceed $6 an hour; 22.18 (4) interview and hire secondary and post-secondary pupils 22.19 for a minimum of six weeks and a maximum of 12 weeks; and 22.20 (5) employ at least one secondary student for each 22.21 post-secondary student employed, to the extent that there are 22.22 sufficient qualifying secondary student applicants. 22.23 (b) In order to be eligible to be hired as a secondary 22.24 summer health intern by a hospitalor, clinic, nursing facility, 22.25 or home care provider, a pupil must: 22.26 (1) intend to complete high school graduation requirements 22.27 and be between the junior and senior year of high school; and 22.28 (2) be from a school district in proximity to the facility;22.29and22.30(3) provide the facility with a letter of recommendation22.31from a health occupations or science educator. 22.32 (c) In order to be eligible to be hired as a post-secondary 22.33 summer health care intern by a hospital or clinic, a pupil must: 22.34 (1) intend to complete a health care training program or a 22.35 two-year or four-year degree program and be planning on 22.36 enrolling in or be enrolled in that training program or degree 23.1 program; and 23.2 (2) be enrolled in a Minnesota educational institution or 23.3 be a resident of the state of Minnesota; priority must be given 23.4 to applicants from a school district or an educational 23.5 institution in proximity to the facility; and23.6(3) provide the facility with a letter of recommendation23.7from a health occupations or science educator. 23.8 (d) Hospitalsand, clinics, nursing facilities, and home 23.9 care providers awarded grants may employ pupils as secondary and 23.10 post-secondary summer health care interns beginning on or after 23.11 June 15, 1993, if they agree to pay the intern, during the 23.12 period before disbursement of state grant money, with money 23.13 designated as the facility's 50 percent contribution towards 23.14 internship costs. 23.15 Subd. 3. [GRANTS.] The commissioner, through the 23.16 organization under contract, shall award separate grants to 23.17 hospitalsand, clinics, nursing facilities, and home care 23.18 providers meeting the requirements of subdivision 2. The grants 23.19 must be used to pay one-half of the costs of employing secondary 23.20 and post-secondary pupils in a hospitalor, clinic, nursing 23.21 facility, or home care setting during the course of the 23.22 program. No more than 50 percent of the participants may be 23.23 post-secondary students, unless the program does not receive 23.24 enough qualified secondary applicants per fiscal year. No more 23.25 than five pupils may be selected from any secondary or 23.26 post-secondary institution to participate in the program and no 23.27 more than one-half of the number of pupils selected may be from 23.28 the seven-county metropolitan area. 23.29 Subd. 4. [CONTRACT.] The commissioner shall contract with 23.30 a statewide, nonprofit organization representing facilities at 23.31 which secondary and post-secondary summer health care interns 23.32 will serve, to administer the grant program established by this 23.33 section. Grant funds that are not used in one fiscal year may 23.34 be carried over to the next fiscal year. The organization 23.35 awarded the grant shall provide the commissioner with any 23.36 information needed by the commissioner to evaluate the program, 24.1 in the form and at the times specified by the commissioner. 24.2 Sec. 28. Minnesota Statutes 2000, section 144.148, 24.3 subdivision 2, is amended to read: 24.4 Subd. 2. [PROGRAM.] The commissioner of health shall award 24.5 rural hospital capital improvement grants to eligible rural 24.6 hospitals. A grant shall not exceed$300,000$1,000,000 per 24.7 hospital. Prior to the receipt of any grant, the hospital must 24.8 certify to the commissioner that at least one-quarter of the 24.9 grant amount, which may include in-kind services, is available 24.10 for the same purposes from nonstate resources. 24.11 Sec. 29. Minnesota Statutes 2000, section 144.1494, 24.12 subdivision 1, is amended to read: 24.13 Subdivision 1. [CREATION OF ACCOUNT.]A rural physician24.14 Educationaccount isaccounts are established in the health care 24.15 access fund and the general fund. The commissioner shall use 24.16 money from the account to establish a loan forgiveness program 24.17 for medical residents agreeing to practice in designated rural 24.18 areas, as defined by the commissioner. Appropriations made 24.19 tothis accountthese accounts do not cancel and are available 24.20 until expended, except that at the end of each biennium the 24.21 commissioner shall cancel to the health care access fund or 24.22 general fund, as applicable, any remaining unobligated 24.23 balancein this accounts. 24.24 Sec. 30. Minnesota Statutes 2000, section 144.1494, 24.25 subdivision 3, is amended to read: 24.26 Subd. 3. [LOAN FORGIVENESS.]For each fiscal year after24.271995,The commissioner may accept up to1222 applicants a year 24.28 who are medical residents for participation in the loan 24.29 forgiveness program with payment for the first 12 applicants 24.30 accepted to be made out of the health care access fund education 24.31 account and payment for the remaining applicants accepted to be 24.32 made out of the general fund education account. The12 resident24.33 applicants may be in any year of residency training; however, 24.34 priority must be given to the following categories of residents 24.35 in descending order: third year residents, second year 24.36 residents, and first year residents. Applicants are responsible 25.1 for securing their own loans. Applicants chosen to participate 25.2 in the loan forgiveness program may designate for each year of 25.3 medical school, up to a maximum of four years, an agreed amount, 25.4 not to exceed $10,000, as a qualified loan. For each year that 25.5 a participant serves as a physician in a designated rural area, 25.6 up to a maximum of four years, the commissioner shall annually 25.7 pay an amount equal to one year of qualified loans. 25.8 Participants who move their practice from one designated rural 25.9 area to another remain eligible for loan repayment. In 25.10 addition, in any year that a resident participating in the loan 25.11 forgiveness program serves at least four weeks during a year of 25.12 residency substituting for a rural physician to temporarily 25.13 relieve the rural physician of rural practice commitments to 25.14 enable the rural physician to take a vacation, engage in 25.15 activities outside the practice area, or otherwise be relieved 25.16 of rural practice commitments, the participating resident may 25.17 designate up to an additional $2,000, above the $10,000 yearly 25.18 maximum. 25.19 Sec. 31. Minnesota Statutes 2000, section 144.1494, 25.20 subdivision 4, is amended to read: 25.21 Subd. 4. [PENALTY FOR NONFULFILLMENT.] If a participant 25.22 does not fulfill the required three-year minimum commitment of 25.23 service in a designated rural area, the commissioner shall 25.24 collect from the participant the amount paid under the loan 25.25 forgiveness program. The commissioner shall deposit themoney25.26collected in the rural physician education accountcollections 25.27 in the health care access fund or the general fund, as 25.28 applicable, to be credited to the accounts established in 25.29 subdivision 1. The commissioner shall allow waivers of all or 25.30 part of the money owed the commissioner if emergency 25.31 circumstances prevented fulfillment of the three-year service 25.32 commitment. 25.33 Sec. 32. Minnesota Statutes 2000, section 144.1496, is 25.34 amended to read: 25.35 144.1496 [NURSES IN NURSING HOMESOR, ICFMRS, OR HOME 25.36 HEALTH CARE AGENCIES.] 26.1 Subdivision 1. [CREATION OF THE ACCOUNT.]AnEducation 26.2accountaccounts in the health care access fundisand the 26.3 general fund are established for a loan forgiveness program for 26.4 nurses who agree to practice nursing in a nursing homeor, 26.5 intermediate care facility for persons with mental retardation 26.6 or related conditions, or home health care agency. Theaccount26.7consistsaccounts consist of money appropriated by the 26.8 legislature and repayments and penalties collected under 26.9 subdivision 4. Money from theaccountaccounts must be used for 26.10 a loan forgiveness program. 26.11 Subd. 2. [ELIGIBILITY.] To be eligible to participate in 26.12 the loan forgiveness program, a person enrolled in a program of 26.13 study designed to prepare the person to become a registered 26.14 nurse or licensed practical nurse must submit an application to 26.15 the commissioner before completion of a nursing education 26.16 program. A nurse who is selected to participate must sign a 26.17 contract to agree to serve a minimum one-year service obligation 26.18 providing nursing services in a licensed nursing homeor, 26.19 intermediate care facility for persons with mental retardation 26.20 or related conditions, or home health care agency, which shall 26.21 begin no later than March following completion of a nursing 26.22 program or loan forgiveness program selection. 26.23 Subd. 3. [LOAN FORGIVENESS.] The commissioner may accept 26.24 up toten177 applicants a year with payment for the first ten 26.25 applicants accepted to be made out of the health care access 26.26 fund education account and payment for the remaining applicants 26.27 accepted to be made out of the general fund education account. 26.28 Applicants are responsible for securing their own loans. For 26.29 each year of nursing education, for up to two years, applicants 26.30 accepted into the loan forgiveness program may designate an 26.31 agreed amount, not to exceed $3,000, as a qualified loan. For 26.32 each year that a participant practices nursing in a nursing home 26.33or, intermediate care facility for persons with mental 26.34 retardation or related conditions, or home health care agency, 26.35 up to a maximum of two years, the commissioner shall annually 26.36 repay an amount equal to one year of qualified loans. 27.1 Participants who move from one nursing homeor, intermediate 27.2 care facility for persons with mental retardation or related 27.3 conditions, or home health care agency to another remain 27.4 eligible for loan repayment. 27.5 Subd. 4. [PENALTY FOR NONFULFILLMENT.] If a participant 27.6 does not fulfill the service commitment required under 27.7 subdivision 3 for full repayment of all qualified loans, the 27.8 commissioner shall collect from the participant 100 percent of 27.9 any payments made for qualified loans and interest at a rate 27.10 established according to section 270.75. The commissioner shall 27.11 deposit the collections in the health care access fund or the 27.12 general fund, as applicable, to be credited to theaccount27.13 accounts established in subdivision 1. The commissioner may 27.14 grant a waiver of all or part of the money owed as a result of a 27.15 nonfulfillment penalty if emergency circumstances prevented 27.16 fulfillment of the required service commitment. 27.17 Subd. 5. [RULES.] The commissioner may adopt rules to 27.18 implement this section. 27.19 Sec. 33. [144.1499] [PROMOTION OF HEALTH CARE AND 27.20 LONG-TERM CARE CAREERS.] 27.21 The commissioner of health, in consultation with an 27.22 organization representing health care employers, long-term care 27.23 employers, and educational institutions, may make grants to 27.24 qualifying consortia as defined in section 116L.11, subdivision 27.25 4, for intergenerational programs to encourage middle and high 27.26 school students to work and volunteer in health care and 27.27 long-term care settings. To qualify for a grant under this 27.28 section, a consortium shall: 27.29 (1) develop a health and long-term care careers curriculum 27.30 that provides career exploration and training in national skill 27.31 standards for health care and long-term care and that is 27.32 consistent with Minnesota graduation standards and other related 27.33 requirements; 27.34 (2) offer programs for high school students that provide 27.35 training in health and long-term care careers with credits that 27.36 articulate into post-secondary programs; and 28.1 (3) provide technical support to the participating health 28.2 care and long-term care employer to enable the use of the 28.3 employer's facilities and programs for kindergarten to grade 12 28.4 health and long-term care careers education. 28.5 Sec. 34. [144.1501] [RURAL PHARMACISTS LOAN FORGIVENESS.] 28.6 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 28.7 section, the terms defined in this subdivision have the meanings 28.8 given them. 28.9 (b) "Designated rural area" means: 28.10 (1) an area in Minnesota outside the counties of Anoka, 28.11 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 28.12 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 28.13 and St. Cloud; or 28.14 (2) a municipal corporation, as defined under section 28.15 471.634, that is physically located, in whole or in part, in an 28.16 area defined as a designated rural area under clause (1). 28.17 Designated rural areas may be further defined by the 28.18 commissioner of health to reflect a shortage of pharmacists as 28.19 indicated by the ratio of pharmacists to population and the 28.20 distance to the next nearest pharmacy. 28.21 (c) "Qualifying educational loans" means government, 28.22 commercial, and foundation loans for actual costs paid for 28.23 tuition, reasonable education expenses, and reasonable living 28.24 expenses related to the graduate or undergraduate education of a 28.25 pharmacist. 28.26 Subd. 2. [CREATION OF ACCOUNT; LOAN FORGIVENESS 28.27 PROGRAM.] A rural pharmacist education account is established in 28.28 the general fund. The commissioner of health shall use money 28.29 from the account to establish a loan forgiveness program for 28.30 pharmacists who agree to practice in designated rural areas. 28.31 The commissioner may seek advice in establishing the program 28.32 from the pharmacists association, the University of Minnesota, 28.33 and other interested parties. 28.34 Subd. 3. [ELIGIBILITY.] To be eligible to participate in 28.35 the loan forgiveness program, a pharmacy student must submit an 28.36 application to the commissioner of health while attending a 29.1 program of study designed to prepare the individual to become a 29.2 licensed pharmacist. For fiscal year 2002, applicants may have 29.3 graduated from a pharmacy program in calendar year 2001. A 29.4 pharmacy student who is accepted into the loan forgiveness 29.5 program must sign a contract to agree to serve a minimum 29.6 three-year service obligation within a designated rural area, 29.7 which shall begin no later than March 31 of the first year 29.8 following completion of a pharmacy program or residency. If 29.9 fewer applications are submitted by pharmacy students than there 29.10 are participant slots available, the commissioner may consider 29.11 applications submitted by pharmacy program graduates who are 29.12 licensed pharmacists. Pharmacists selected for loan forgiveness 29.13 must comply with all terms and conditions of this section. 29.14 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 29.15 may accept up to 14 applicants per year for participation in the 29.16 loan forgiveness program. Applicants are responsible for 29.17 securing their own loans. The commissioner shall select 29.18 participants based on their suitability for rural practice, as 29.19 indicated by rural experience or training. The commissioner 29.20 shall give preference to applicants closest to completing their 29.21 training. For each year that a participant serves as a 29.22 pharmacist in a designated rural area as required under 29.23 subdivision 3, up to a maximum of four years, the commissioner 29.24 shall make annual disbursements directly to the participant 29.25 equivalent to $5,000 per year of service, not to exceed $20,000 29.26 or the balance of the qualifying educational loans, whichever is 29.27 less. Before receiving loan repayment disbursements and as 29.28 requested, the participant must complete and return to the 29.29 commissioner an affidavit of practice form provided by the 29.30 commissioner verifying that the participant is practicing as 29.31 required in an eligible area. The participant must provide the 29.32 commissioner with verification that the full amount of loan 29.33 repayment disbursement received by the participant has been 29.34 applied toward the qualifying educational loans. After each 29.35 disbursement, verification must be received by the commissioner 29.36 and approved before the next loan repayment disbursement is 30.1 made. Participants who move their practice from one designated 30.2 rural area to another remain eligible for loan repayment. 30.3 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 30.4 does not fulfill the service commitment under subdivision 3, the 30.5 commissioner of health shall collect from the participant 100 30.6 percent of any payments made for qualified educational loans and 30.7 interest at a rate established according to section 270.75. The 30.8 commissioner shall deposit the money collected in the rural 30.9 pharmacist education account established under subdivision 2. 30.10 Subd. 6. [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 30.11 service obligations cancel in the event of a participant's 30.12 death. The commissioner of health may waive or suspend payment 30.13 or service obligations in cases of total and permanent 30.14 disability or long-term temporary disability lasting for more 30.15 than two years. The commissioner shall evaluate all other 30.16 requests for suspension or waivers on a case-by-case basis and 30.17 may grant a waiver of all or part of the money owed as a result 30.18 of a nonfulfillment penalty if emergency circumstances prevented 30.19 fulfillment of the required service commitment. 30.20 Sec. 35. [144.1502] [DENTISTS LOAN FORGIVENESS.] 30.21 Subdivision 1. [DEFINITION.] For purposes of this section, 30.22 "qualifying educational loans" means government, commercial, and 30.23 foundation loans for actual costs paid for tuition, reasonable 30.24 education expenses, and reasonable living expenses related to 30.25 the graduate or undergraduate education of a dentist. 30.26 Subd. 2. [CREATION OF ACCOUNT; LOAN FORGIVENESS 30.27 PROGRAM.] A dentist education account is established in the 30.28 general fund. The commissioner of health shall use money from 30.29 the account to establish a loan forgiveness program for dentists 30.30 who agree to care for substantial numbers of state public 30.31 program participants and other low- to moderate-income uninsured 30.32 patients. 30.33 Subd. 3. [ELIGIBILITY.] To be eligible to participate in 30.34 the loan forgiveness program, a dental student must submit an 30.35 application to the commissioner of health while attending a 30.36 program of study designed to prepare the individual to become a 31.1 licensed dentist. For fiscal year 2002, applicants may have 31.2 graduated from a dentistry program in calendar year 2001. A 31.3 dental student who is accepted into the loan forgiveness program 31.4 must sign a contract to agree to serve a minimum three-year 31.5 service obligation during which at least 25 percent of the 31.6 dentist's yearly patient encounters are delivered to state 31.7 public program enrollees or patients receiving sliding fee 31.8 schedule discounts through a formal sliding fee schedule meeting 31.9 the standards established by the United States Department of 31.10 Health and Human Services under Code of Federal Regulations, 31.11 title 42, section 51, chapter 303. The service obligation shall 31.12 begin no later than March 31 of the first year following 31.13 completion of training. If fewer applications are submitted by 31.14 dental students than there are participant slots available, the 31.15 commissioner may consider applications submitted by dental 31.16 program graduates who are licensed dentists. Dentists selected 31.17 for loan forgiveness must comply with all terms and conditions 31.18 of this section. 31.19 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 31.20 may accept up to 14 applicants per year for participation in the 31.21 loan forgiveness program. Applicants are responsible for 31.22 securing their own loans. The commissioner shall select 31.23 participants based on their suitability for practice serving 31.24 public program patients, as indicated by experience or 31.25 training. The commissioner shall give preference to applicants 31.26 who have attended a Minnesota dentistry educational institution 31.27 and to applicants closest to completing their training. For 31.28 each year that a participant meets the service obligation 31.29 required under subdivision 3, up to a maximum of four years, the 31.30 commissioner shall make annual disbursements directly to the 31.31 participant equivalent to $10,000 per year of service, not to 31.32 exceed $40,000 or the balance of the qualifying educational 31.33 loans, whichever is less. Before receiving loan repayment 31.34 disbursements and as requested, the participant must complete 31.35 and return to the commissioner an affidavit of practice form 31.36 provided by the commissioner verifying that the participant is 32.1 practicing as required under subdivision 3. The participant 32.2 must provide the commissioner with verification that the full 32.3 amount of loan repayment disbursement received by the 32.4 participant has been applied toward the designated loans. After 32.5 each disbursement, verification must be received by the 32.6 commissioner and approved before the next loan repayment 32.7 disbursement is made. Participants who move their practice 32.8 remain eligible for loan repayment as long as they practice as 32.9 required under subdivision 3. 32.10 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 32.11 does not fulfill the service commitment under subdivision 3, the 32.12 commissioner of health shall collect from the participant 100 32.13 percent of any payments made for qualified educational loans and 32.14 interest at a rate established according to section 270.75. The 32.15 commissioner shall deposit the money collected in the dentist 32.16 education account established under subdivision 2. 32.17 Subd. 6. [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 32.18 service obligations cancel in the event of a participant's 32.19 death. The commissioner of health may waive or suspend payment 32.20 or service obligations in cases of total and permanent 32.21 disability or long-term temporary disability lasting for more 32.22 than two years. The commissioner shall evaluate all other 32.23 requests for suspension or waivers on a case-by-case basis and 32.24 may grant a waiver of all or part of the money owed as a result 32.25 of a nonfulfillment penalty if emergency circumstances prevented 32.26 fulfillment of the required service commitment. 32.27 Sec. 36. [144.1503] [RURAL MENTAL HEALTH PROFESSIONAL LOAN 32.28 FORGIVENESS.] 32.29 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 32.30 section, the terms defined in this subdivision have the meanings 32.31 given them. 32.32 (b) "Designated rural area" means: 32.33 (1) an area in Minnesota outside the counties of Anoka, 32.34 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 32.35 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 32.36 and St. Cloud; or 33.1 (2) a municipal corporation, as defined under section 33.2 471.634, that is physically located, in whole or in part, in an 33.3 area defined as a designated rural area under clause (1). 33.4 (c) "Mental health professional" means a psychologist, 33.5 clinical social worker, marriage and family therapist, or 33.6 psychiatric nurse. 33.7 (d) "Qualifying educational loans" means government, 33.8 commercial, and foundation loans for actual costs paid for 33.9 tuition, reasonable education expenses, and reasonable living 33.10 expenses related to the graduate or undergraduate education of a 33.11 mental health professional. 33.12 Subd. 2. [CREATION OF ACCOUNT; LOAN FORGIVENESS 33.13 PROGRAM.] A rural mental health professional education account 33.14 is established in the general fund. The commissioner of health 33.15 shall use money from the account to establish a loan forgiveness 33.16 program for mental health professionals who agree to practice in 33.17 designated rural areas. 33.18 Subd. 3. [ELIGIBILITY.] To be eligible to participate in 33.19 the loan forgiveness program, a mental health professional 33.20 student must submit an application to the commissioner of health 33.21 while attending a program of study designed to prepare the 33.22 individual to become a mental health professional. For fiscal 33.23 year 2002, applicants may have graduated from a mental health 33.24 professional educational program in calendar year 2001. A 33.25 mental health professional student who is accepted into the loan 33.26 forgiveness program must sign a contract to agree to serve a 33.27 minimum three-year service obligation within a designated rural 33.28 area, which shall begin no later than March 31 of the first year 33.29 following completion of a mental health professional educational 33.30 program. 33.31 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 33.32 may accept up to 12 applicants per year for participation in the 33.33 loan forgiveness program. Applicants are responsible for 33.34 securing their own loans. The commissioner shall select 33.35 participants based on their suitability for rural practice, as 33.36 indicated by rural experience or training. The commissioner 34.1 shall give preference to applicants who have attended a 34.2 Minnesota mental health professional educational institution and 34.3 to applicants closest to completing their training. For each 34.4 year that a participant serves as a mental health professional 34.5 in a designated rural area as required under subdivision 3, up 34.6 to a maximum of four years, the commissioner shall make annual 34.7 disbursements directly to the participant equivalent to $4,000 34.8 per year of service, not to exceed $16,000 or the balance of the 34.9 qualifying educational loans, whichever is less. Before 34.10 receiving loan repayment disbursements and as requested, the 34.11 participant must complete and return to the commissioner an 34.12 affidavit of practice form provided by the commissioner 34.13 verifying that the participant is practicing as required in an 34.14 eligible area. The participant must provide the commissioner 34.15 with verification that the full amount of loan repayment 34.16 disbursement received by the participant has been applied toward 34.17 the qualifying educational loans. After each disbursement, 34.18 verification must be received by the commissioner and approved 34.19 before the next loan repayment disbursement is made. 34.20 Participants who move their practice from one designated rural 34.21 area to another remain eligible for loan repayment. 34.22 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 34.23 does not fulfill the service commitment under subdivision 3, the 34.24 commissioner of health shall collect from the participant 100 34.25 percent of any payments made for qualified educational loans and 34.26 interest at a rate established according to section 270.75. The 34.27 commissioner shall deposit the money collected in the rural 34.28 mental health professional education account established under 34.29 subdivision 2. 34.30 Subd. 6. [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 34.31 service obligations cancel in the event of a participant's 34.32 death. The commissioner of health may waive or suspend payment 34.33 or service obligations in cases of total and permanent 34.34 disability or long-term temporary disability lasting for more 34.35 than two years. The commissioner shall evaluate all other 34.36 requests for suspension or waivers on a case-by-case basis and 35.1 may grant a waiver of all or part of the money owed as a result 35.2 of a nonfulfillment penalty if emergency circumstances prevented 35.3 fulfillment of the required service commitment. 35.4 Sec. 37. [144.1504] [RURAL HEALTH CARE TECHNICIANS LOAN 35.5 FORGIVENESS.] 35.6 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 35.7 section, the terms defined in this subdivision have the meanings 35.8 given them. 35.9 (b) "Clinical laboratory scientist" means a person who 35.10 performs and interprets results of medical tests that require 35.11 the exercise of independent judgment and responsibility, with 35.12 minimal supervision by the director or supervisor, in only those 35.13 specialties or subspecialties in which the person is qualified 35.14 by education, training, and experience and has demonstrated 35.15 ongoing competency by certification or other means. A clinical 35.16 laboratory scientist may also be called a medical technologist. 35.17 (c) "Clinical laboratory technician" means any person other 35.18 than a medical laboratory director, clinical laboratory 35.19 scientist, or trainee who functions under the supervision of a 35.20 medical laboratory director or clinical laboratory scientist and 35.21 performs diagnostic and analytical laboratory tests in only 35.22 those specialties or subspecialties in which the person is 35.23 qualified by education, training, and experience and has 35.24 demonstrated ongoing competency by certification or other 35.25 means. A clinical laboratory technician may also be called a 35.26 medical technician. 35.27 (d) "Designated rural area" means: 35.28 (1) an area in Minnesota outside the counties of Anoka, 35.29 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 35.30 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 35.31 and St. Cloud; or 35.32 (2) a municipal corporation, as defined under section 35.33 471.634, that is physically located, in whole or in part, in an 35.34 area defined as a designated rural area under clause (1). 35.35 (e) "Health care technician" means a clinical laboratory 35.36 scientist, clinical laboratory technician, radiologic 36.1 technologist, dental hygienist, dental assistant, or paramedic. 36.2 (f) "Paramedic" means a person certified under chapter 144E 36.3 by the emergency medical services regulatory board as an 36.4 emergency medical technician-paramedic. 36.5 (g) "Qualifying educational loans" means government, 36.6 commercial, and foundation loans for actual costs paid for 36.7 tuition, reasonable education expenses, and reasonable living 36.8 expenses related to the graduate or undergraduate education of a 36.9 health care technician. 36.10 (h) "Radiologic technologist" means a person, other than a 36.11 licensed physician, who has demonstrated competency by 36.12 certification, registration, or other means for administering 36.13 medical imaging or radiation therapy procedures to other persons 36.14 for medical purposes. Radiologic technologist includes, but is 36.15 not limited to, radiographers, radiation therapists, and nuclear 36.16 medicine technologists. 36.17 Subd. 2. [CREATION OF ACCOUNT; LOAN FORGIVENESS 36.18 PROGRAM.] A rural health care technician education account is 36.19 established in the general fund. The commissioner of health 36.20 shall use money from the account to establish a loan forgiveness 36.21 program for health care technicians who agree to practice in 36.22 designated rural areas. 36.23 Subd. 3. [ELIGIBILITY.] To be eligible to participate in 36.24 the loan forgiveness program, a health care technician student 36.25 must submit an application to the commissioner of health while 36.26 attending a program of study designed to prepare the individual 36.27 to become a health care technician. For fiscal year 2002, 36.28 applicants may have graduated from a health care technician 36.29 program in calendar year 2001. A health care technician student 36.30 who is accepted into the loan forgiveness program must sign a 36.31 contract to agree to serve a minimum one-year service obligation 36.32 within a designated rural area, which shall begin no later than 36.33 March 31 of the first year following completion of a health care 36.34 technician program. 36.35 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 36.36 may accept up to 30 applicants per year for participation in the 37.1 loan forgiveness program. Applicants are responsible for 37.2 securing their own loans. The commissioner shall select 37.3 participants based on their suitability for rural practice, as 37.4 indicated by rural experience or training. The commissioner 37.5 shall give preference to applicants who have attended a 37.6 Minnesota health care technician educational institution and to 37.7 applicants closest to completing their training. For each year 37.8 that a participant serves as a health care technician in a 37.9 designated rural area as required under subdivision 3, up to a 37.10 maximum of two years, the commissioner shall make annual 37.11 disbursements directly to the participant equivalent to $2,500 37.12 per year of service, not to exceed $5,000 or the balance of the 37.13 qualifying educational loans, whichever is less. Before 37.14 receiving loan repayment disbursements and as requested, the 37.15 participant must complete and return to the commissioner an 37.16 affidavit of practice form provided by the commissioner 37.17 verifying that the participant is practicing as required in an 37.18 eligible area. The participant must provide the commissioner 37.19 with verification that the full amount of loan repayment 37.20 disbursement received by the participant has been applied toward 37.21 the qualifying educational loans. After each disbursement, 37.22 verification must be received by the commissioner and approved 37.23 before the next loan repayment disbursement is made. 37.24 Participants who move their practice from one designated rural 37.25 area to another remain eligible for loan repayment. 37.26 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 37.27 does not fulfill the service commitment under subdivision 3, the 37.28 commissioner of health shall collect from the participant 100 37.29 percent of any payments made for qualified educational loans and 37.30 interest at a rate established according to section 270.75. The 37.31 commissioner shall deposit the money collected in the rural 37.32 health care technician education account established under 37.33 subdivision 2. 37.34 Subd. 6. [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 37.35 service obligations cancel in the event of a participant's 37.36 death. The commissioner of health may waive or suspend payment 38.1 or service obligations in cases of total and permanent 38.2 disability or long-term temporary disability lasting for more 38.3 than two years. The commissioner shall evaluate all other 38.4 requests for suspension or waivers on a case-by-case basis and 38.5 may grant a waiver of all or part of the money owed as a result 38.6 of a nonfulfillment penalty if emergency circumstances prevented 38.7 fulfillment of the required service commitment. 38.8 Sec. 38. Minnesota Statutes 2000, section 144.226, 38.9 subdivision 4, is amended to read: 38.10 Subd. 4. [VITAL RECORDS SURCHARGE.] In addition to any fee 38.11 prescribed under subdivision 1, there is a nonrefundable 38.12 surcharge of$3$2 for each certified and noncertified birth or 38.13 death record, and for a certification that the record cannot be 38.14 found. The local or state registrar shall forward this amount 38.15 to the state treasurer to be deposited into the state government 38.16 special revenue fund. This surcharge shall not be charged under 38.17 those circumstances in which no fee for a birth or death record 38.18 is permitted under subdivision 1, paragraph (a).This surcharge38.19requirement expires June 30, 2002.38.20 Sec. 39. [144.3805] [HEALTH STANDARDS.] 38.21 Subdivision 1. [CRITERIA.] When establishing or revising 38.22 safe drinking water standards, the commissioner of health shall 38.23 adopt standards that adequately protect children and adults with 38.24 a margin of safety that provides a reasonable certainty of no 38.25 harm to child and adult health, by taking into account the risk 38.26 of cancer and effects on each of the following health outcomes: 38.27 (1) general infant and child development; 38.28 (2) development of the brain and nervous system; 38.29 (3) respiratory function; 38.30 (4) immunologic suppression or hypersensitization; 38.31 (5) endocrine (hormonal) function; and 38.32 (6) any other important health outcomes identified by the 38.33 commissioner. 38.34 Subd. 2. [MARGIN OF SAFETY.] If there is insufficient 38.35 information to establish with reasonable certainty, for cancer 38.36 or any health outcome under subdivision 1, that child health 39.1 will not be harmed, the commissioner shall adopt a specific 39.2 margin of safety for that health outcome or risk that shall be 39.3 included in the overall margin of safety to protect human health. 39.4 Sec. 40. Minnesota Statutes 2000, section 144.396, 39.5 subdivision 7, is amended to read: 39.6 Subd. 7. [LOCAL PUBLIC HEALTH PROMOTION AND PROTECTION.] 39.7 The commissioner shall distribute the funds available under 39.8 section 144.395, subdivision 2, paragraph (c), clause (3) for 39.9 the following: 39.10 (1) to community health boards for local health promotion 39.11 and protection activities for local health initiatives other 39.12 than tobacco prevention aimed at high risk health behaviors 39.13 among youth. The commissioner shall distribute these funds to 39.14 the community health boards based on demographics and other 39.15 need-based factors relating to health; 39.16 (2) for activities that improve the health and learning 39.17 environment of school-aged children; and 39.18 (3) for competitive grants to public-private partnerships 39.19 focusing on the state school health issues identified by the 39.20 commissioner. 39.21 Sec. 41. Minnesota Statutes 2000, section 144.98, 39.22 subdivision 3, is amended to read: 39.23 Subd. 3. [FEES.] (a) An application for certification 39.24 under subdivision 1 must be accompanied by the biennial fee 39.25 specified in this subdivision. The fees are for: 39.26 (1) nonrefundable base certification fee,$500$1,200; and 39.27 (2) test category certification fees: 39.28 Test Category Certification Fee 39.29 Clean water program bacteriology$200$600 39.30 Safe drinking water program bacteriology $600 39.31 Clean water program inorganic chemistry,39.32fewer than four constituents$100$600 39.33 Safe drinking water program inorganic chemistry,39.34four or more constituents$300$600 39.35 Clean water program chemistry metals,39.36fewer than four constituents$200$800 40.1 Safe drinking water program chemistry metals,40.2four or more constituents$500$800 40.3 Resource conservation and recovery program 40.4 chemistry metals $800 40.5 Clean water program volatile organic compounds$600$1,200 40.6 Safe drinking water program 40.7 volatile organic compounds $1,200 40.8 Resource conservation and recovery program 40.9 volatile organic compounds $1,200 40.10 Underground storage tank program 40.11 volatile organic compounds $1,200 40.12 Clean water program other organic compounds$600$1,200 40.13 Safe drinking water program other organic compounds $1,200 40.14 Resource conservation and recovery program 40.15 other organic compounds $1,200 40.16 (b) The total biennial certification fee is the base fee 40.17 plus the applicable test category fees.The biennial40.18certification fee for a contract laboratory is 1.5 times the40.19total certification fee.40.20 (c) Laboratories located outside of this state that require 40.21 an on-site survey will be assessed an additional$1,200$2,500 40.22 fee. 40.23 (d) Fees must be set so that the total fees support the 40.24 laboratory certification program. Direct costs of the 40.25 certification service include program administration, 40.26 inspections, the agency's general support costs, and attorney 40.27 general costs attributable to the fee function. 40.28 (e) A change fee shall be assessed if a laboratory requests 40.29 additional analytes or methods at any time other than when 40.30 applying for or renewing its certification. The change fee is 40.31 equal to the test category certification fee for the analyte. 40.32 (f) A variance fee shall be assessed if a laboratory 40.33 requests and is granted a variance from a rule adopted under 40.34 this section. The variance fee is $500 per variance. 40.35 (g) Refunds or credits shall not be made for analytes or 40.36 methods requested but not approved. 41.1 (h) Certification of a laboratory shall not be awarded 41.2 until all fees are paid. 41.3 Sec. 42. [145.4241] [DEFINITIONS.] 41.4 Subdivision 1. [APPLICABILITY.] As used in sections 41.5 145.4241 to 145.4246, the following terms have the meaning given 41.6 them. 41.7 Subd. 2. [ABORTION.] "Abortion" includes an act, 41.8 procedure, or use of any instrument, medicine, or drug which is 41.9 supplied or prescribed for or administered to a woman known to 41.10 be pregnant with the intention to terminate the pregnancy with 41.11 an intention other than to increase the probability of live 41.12 birth, to preserve the life or health of the child after live 41.13 birth, or to remove a dead fetus. 41.14 Subd. 3. [ATTEMPT TO PERFORM AN ABORTION.] "Attempt to 41.15 perform an abortion" means an act, or an omission of a 41.16 statutorily required act, that, under the circumstances as the 41.17 actor believes them to be, constitutes a substantial step in a 41.18 course of conduct planned to culminate in the performance of an 41.19 abortion in Minnesota in violation of sections 145.4241 to 41.20 145.4246. 41.21 Subd. 4. [MEDICAL EMERGENCY.] "Medical emergency" means 41.22 any condition that, on the basis of the physician's good faith 41.23 clinical judgment, complicates the medical condition of a 41.24 pregnant female to the extent that: 41.25 (1) an immediate abortion of her pregnancy is necessary to 41.26 avert her death; or 41.27 (2) a 24-hour delay in performing an abortion creates a 41.28 serious risk of substantial injury or impairment of a major 41.29 bodily function. 41.30 Subd. 5. [PHYSICIAN.] "Physician" means a person licensed 41.31 under chapter 147. 41.32 Subd. 6. [PROBABLE GESTATIONAL AGE OF THE FETUS.] 41.33 "Probable gestational age of the fetus" means what will, in the 41.34 judgment of the physician, with reasonable probability, be the 41.35 gestational age of the fetus at the time the abortion is planned 41.36 to be performed. 42.1 Sec. 43. [145.4242] [INFORMED CONSENT.] 42.2 (a) No abortion shall be performed in this state except 42.3 with the voluntary and informed consent of the female upon whom 42.4 the abortion is to be performed. Except in the case of a 42.5 medical emergency, consent to an abortion is voluntary and 42.6 informed only if the female is told the following, by telephone 42.7 or in person, by the physician who is to perform the abortion, 42.8 the referring physician, a registered nurse, or a licensed 42.9 practical nurse, at least 24 hours prior to the abortion: 42.10 (1) the particular medical risks associated with the 42.11 particular abortion procedure to be employed including, when 42.12 medically accurate, the risks of infection, hemorrhage, breast 42.13 cancer, danger to subsequent pregnancies, and infertility; 42.14 (2) the probable gestational age of the fetus at the time 42.15 the abortion is to be performed; 42.16 (3) the medical risks associated with carrying to term; 42.17 (4) that medical assistance benefits may be available for 42.18 prenatal care, childbirth, and neonatal care; 42.19 (5) that the father is liable to assist in the support of 42.20 her child except under certain circumstances, even in instances 42.21 when the father has offered to pay for the abortion; 42.22 (6) the availability of a toll-free number and Web site 42.23 that can provide information on support services during 42.24 pregnancy and while the child is dependent and offer 42.25 alternatives to abortion; and 42.26 (7) that she has the right to review the printed materials 42.27 described in section 145.4243, and the printed materials are 42.28 available on the state Web site. 42.29 (b) The physician or the physician's agent shall orally 42.30 inform the female that the materials have been provided by the 42.31 state of Minnesota and that they describe the unborn child and 42.32 list agencies that offer alternatives to abortion. 42.33 (c) The physician or the physician's agent shall orally 42.34 inform the female of the Web site address and toll-free number. 42.35 (d) If the female chooses to view the materials, they shall 42.36 either be given to her at least 24 hours before the abortion or 43.1 mailed to her at least 72 hours before the abortion by first 43.2 class mail, or at the woman's request, by certified mail, 43.3 restricted delivery to addressee, which means the postal 43.4 employee may only deliver the mail to the addressee. The 43.5 envelope used by the physician shall not identify the name of 43.6 the physician or the physician's clinic or business. 43.7 (e) If a physical examination, tests, or the availability 43.8 of other information to the physician subsequently indicates, in 43.9 the medical judgment of the physician, a revision of the 43.10 information previously supplied to the patient, that revised 43.11 information may be communicated to the patient at any time prior 43.12 to the performance of the abortion. 43.13 Sec. 44. [145.4243] [PRINTED INFORMATION.] 43.14 Subdivision 1. [MATERIALS.] (a) Within 90 days after the 43.15 effective date of sections 145.4241 to 145.4246, the department 43.16 of health shall cause to be published, in English and in each 43.17 language that is the primary language of two percent or more of 43.18 the state's population, the printed materials described in 43.19 paragraphs (b) and (c) in such a way as to ensure that the 43.20 information is easily comprehensible. 43.21 (b) The materials must be designed to inform the female of 43.22 the probable anatomical and physiological characteristics of the 43.23 fetus at two-week gestational increments from the time when a 43.24 female can be known to be pregnant to full term, including any 43.25 relevant information on the possibility of the fetus' survival 43.26 and pictures or drawings representing the development of the 43.27 fetus at two-week gestational increments, provided that any such 43.28 pictures or drawings must contain the dimensions of the fetus 43.29 and must be realistic and appropriate for the stage of pregnancy 43.30 depicted. The materials must be objective, nonjudgmental, and 43.31 designed to convey only accurate scientific information about 43.32 the fetus at the various gestational ages. 43.33 (c) The materials must contain objective information 43.34 describing the methods of abortion procedures commonly employed, 43.35 the medical risks commonly associated with each procedure, the 43.36 possible detrimental psychological effects of abortion, and the 44.1 medical risks commonly associated with carrying a child to term. 44.2 Subd. 2. [TYPEFACE; AVAILABILITY.] The materials referred 44.3 to in this section must be printed in a typeface large enough to 44.4 be clearly legible. The materials required under this section 44.5 must be available from the department of health upon request and 44.6 in appropriate number to any person, facility, or hospital at no 44.7 cost. 44.8 Sec. 45. [145.4244] [PROCEDURE IN CASE OF MEDICAL 44.9 EMERGENCY.] 44.10 When a medical emergency compels the performance of an 44.11 abortion, the physician shall inform the female, prior to the 44.12 abortion if possible, of the medical indications supporting the 44.13 physician's judgment that an abortion is necessary to avert her 44.14 death or that a 24-hour delay in conformance with section 44.15 145.4242 creates a serious risk of substantial injury or 44.16 impairment of a major bodily function. 44.17 Sec. 46. [145.4245] [TOLL-FREE TELEPHONE NUMBER AND WEB 44.18 SITE.] 44.19 Subdivision 1. [RIGHT TO KNOW.] All pregnant women have 44.20 the right to know information about resources available to 44.21 assist them and their families. The commissioner of health 44.22 shall establish and maintain a statewide toll-free telephone 44.23 number available seven days a week to provide information and 44.24 referrals to local community resources to assist women and 44.25 families through pregnancy and childbirth and while the child is 44.26 dependent. 44.27 Subd. 2. [INFORMATION.] The toll-free telephone number 44.28 must provide information regarding community resources on the 44.29 following topics: 44.30 (1) information regarding avoiding unplanned pregnancies; 44.31 (2) prenatal care, including the need for an initial risk 44.32 screening and assessment; 44.33 (3) adoption; 44.34 (4) health education, including the importance of good 44.35 nutrition during pregnancy and the risks associated with alcohol 44.36 and tobacco use during pregnancy; 45.1 (5) available social services, including medical assistance 45.2 benefits for prenatal care, childbirth, and neonatal care; 45.3 (6) legal assistance in obtaining child support; and 45.4 (7) community support services and other resources to 45.5 enhance family strengths and reduce the possibility of family 45.6 violence. 45.7 Subd. 3. [WEB SITE.] The commissioner shall design and 45.8 maintain a secure Web site to provide the information described 45.9 under subdivision 2 and section 145.4243 with a minimum 45.10 resolution of 72 PPI. The Web site shall provide the toll-free 45.11 information and referral telephone number described under 45.12 subdivision 2. 45.13 Sec. 47. [145.4246] [ENFORCEMENT PENALTIES.] 45.14 Subdivision 1. [STANDING.] A person with standing may 45.15 maintain an action against the performance or attempted 45.16 performance of abortions in violation of section 145.4242. 45.17 Those with standing are: 45.18 (1) a woman upon whom an abortion in violation of section 45.19 145.4242 has been performed or attempted to be performed; and 45.20 (2) the parent of an unemancipated minor upon whom an 45.21 abortion in violation of section 145.4242 has been, is about to 45.22 be, or was attempted to be performed; and 45.23 (3) attorney general of the state of Minnesota. 45.24 Subd. 2. [INJUNCTIONS.] Parties bringing actions against 45.25 the performance or attempted performance of abortions in 45.26 violation of section 145.4242 may seek temporary restraining 45.27 orders, preliminary injunctions, and injunctions related only to 45.28 the physician or facility where the violation occurred in 45.29 accordance with the Rules of Civil Procedure. Persons with 45.30 standing must bring any actions within six months of the date of 45.31 the performed or attempted performance of abortions in violation 45.32 of section 145.4242. 45.33 Subd. 3. [CONTEMPT.] Any person knowingly violating the 45.34 terms of an injunction against the performance or attempted 45.35 performance of abortions in violation of section 145.4242 is 45.36 subject to civil contempt, and shall be fined no more than 46.1 $1,000 for the first violation, no more than $5,000 for the 46.2 second violation, no more than $10,000 for the third violation, 46.3 and for each successive violation an amount sufficient to deter 46.4 future violations. The fine shall be the exclusive penalty for 46.5 a violation. Each performance or attempted performance of 46.6 abortion in violation of section 145.4242 is a separate 46.7 violation. No fine shall be assessed against the woman on whom 46.8 an abortion is performed or attempted. 46.9 Subd. 4. [REALLOCATION OF THE FINE.] Any fines collected 46.10 under this section must be sent to a special account at the 46.11 Minnesota department of health to be used for materials cited in 46.12 section 145.4243. 46.13 Sec. 48. [145.4247] [CUMULATIVE RIGHTS.] 46.14 The provisions of sections 145.4241 to 145.4246 are 46.15 cumulative with existing law regarding an individual's right to 46.16 consent to medical treatment and shall not impair any existing 46.17 right any patient may have under the common law or statutes of 46.18 this state. 46.19 Sec. 49. [145.56] [SUICIDE PREVENTION.] 46.20 Subdivision 1. [SUICIDE PREVENTION PLAN.] The commissioner 46.21 of health shall refine, coordinate, and implement the state's 46.22 suicide prevention plan using an evidence-based, public health 46.23 approach focused on prevention, in collaboration with the 46.24 commissioner of human services; the commissioner of public 46.25 safety; the commissioner of children, families, and learning; 46.26 and appropriate agencies, organizations, and institutions in the 46.27 community. 46.28 Subd. 2. [COMMUNITY-BASED PROGRAMS.] (a) The commissioner 46.29 shall establish a grant program to fund: 46.30 (1) community-based programs to provide education, 46.31 outreach, and advocacy services to populations who may be at 46.32 risk for suicide; 46.33 (2) community-based programs that educate community helpers 46.34 and gatekeepers, such as family members, spiritual leaders, 46.35 coaches, and business owners, employers, and coworkers on how to 46.36 prevent suicide by encouraging help-seeking behaviors; 47.1 (3) community-based programs that educate populations at 47.2 risk for suicide and community helpers and gatekeepers that must 47.3 include information on the symptoms of depression and other 47.4 psychiatric illnesses, the warning signs of suicide, skills for 47.5 preventing suicides, and making or seeking effective referrals 47.6 to intervention and community resources; and 47.7 (4) community-based programs to provide evidence-based 47.8 suicide prevention and intervention education to school staff, 47.9 parents, and students in grades kindergarten through 12. 47.10 Subd. 3. [WORKPLACE AND PROFESSIONAL EDUCATION.] (a) The 47.11 commissioner shall promote the use of employee assistance and 47.12 workplace programs to support employees with depression and 47.13 other psychiatric illnesses and substance abuse disorders, and 47.14 refer them to services. The commissioner shall collaborate with 47.15 employer and professional associations, unions, and safety 47.16 councils. 47.17 (b) The commissioner shall provide training and technical 47.18 assistance to local public health and other community-based 47.19 professionals to provide for integrated implementation of best 47.20 practices for preventing suicide. 47.21 Subd. 4. [COLLECTION AND REPORTING SUICIDE DATA.] The 47.22 commissioner shall coordinate with federal, regional, local, and 47.23 other state agencies to collect, analyze, and annually issue a 47.24 public report on Minnesota-specific data on suicide and suicidal 47.25 behaviors. 47.26 Subd. 5. [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The 47.27 commissioner shall conduct periodic evaluations of the impact of 47.28 and outcomes from implementation of the state's suicide 47.29 prevention plan and each of the activities specified in this 47.30 section. Beginning July 1, 2004, and July 1 of each 47.31 even-numbered year thereafter, the commissioner shall report the 47.32 results of these evaluations to the chairs of the policy and 47.33 finance committees in the house and senate with jurisdiction 47.34 over health and human services issues. 47.35 Sec. 50. Minnesota Statutes 2000, section 145.881, 47.36 subdivision 2, is amended to read: 48.1 Subd. 2. [DUTIES.] The advisory task force shall meet on a 48.2 regular basis to perform the following duties: 48.3 (a) review and report on the health care needs of mothers 48.4 and children throughout the state of Minnesota; 48.5 (b) review and report on the type, frequency and impact of 48.6 maternal and child health care services provided to mothers and 48.7 children under existing maternal and child health care programs, 48.8 including programs administered by the commissioner of health; 48.9 (c) establish, review, and report to the commissioner a 48.10 list of program guidelines and criteria which the advisory task 48.11 force considers essential to providing an effective maternal and 48.12 child health care program to low income populations and high 48.13 risk persons and fulfilling the purposes defined in section 48.14 145.88; 48.15 (d) review staff recommendations of the department of 48.16 health regarding maternal and child health grant awards before 48.17 the awards are made; 48.18 (e) make recommendations to the commissioner for the use of 48.19 other federal and state funds available to meet maternal and 48.20 child health needs; 48.21 (f) make recommendations to the commissioner of health on 48.22 priorities for funding the following maternal and child health 48.23 services: (1) prenatal, delivery and postpartum care, (2) 48.24 comprehensive health care for children, especially from birth 48.25 through five years of age, (3) adolescent health services, (4) 48.26 family planning services, (5) preventive dental care, (6) 48.27 special services for chronically ill and handicapped children 48.28 and (7) any other services which promote the health of mothers 48.29 and children;and48.30 (g) make recommendations to the commissioner of health on 48.31 the process to distribute, award and administer the maternal and 48.32 child health block grant funds; and 48.33 (h) review the measures that are used to define the 48.34 variables of the funding distribution formula in section 48.35 145.882, subdivision 4a, every two years and make 48.36 recommendations to the commissioner of health for changes based 49.1 upon principles established by the advisory task force for this 49.2 purpose. 49.3 Sec. 51. Minnesota Statutes 2000, section 145.882, is 49.4 amended by adding a subdivision to read: 49.5 Subd. 4a. [ALLOCATION TO COMMUNITY HEALTH BOARDS.] (a) 49.6 Federal maternal and child health block grant money remaining 49.7 after distributions made under subdivision 2 and money 49.8 appropriated for allocation to community health boards must be 49.9 allocated according to paragraphs (b) to (d) to community health 49.10 boards as defined in section 145A.02, subdivision 5. 49.11 (b) All community health boards must receive 95 percent of 49.12 the funding awarded to them for the 1998-1999 funding cycle. If 49.13 the amount of state and federal funding available is less than 49.14 95 percent of the amount awarded to community health boards for 49.15 the 1998-1999 funding cycle, the available funding must be 49.16 apportioned to reflect a proportional decrease for each 49.17 recipient. 49.18 (c) The federal and state funding remaining after 49.19 distributions made under paragraph (b) must be allocated to each 49.20 community health board based on the following three variables: 49.21 (1) 25 percent based on the maternal and child population 49.22 in the area served by the community health board; 49.23 (2) 50 percent based on the following factors as determined 49.24 by averaging the data available for the three most current years: 49.25 (i) the proportion of infants in the area served by the 49.26 community health board whose weight at birth is less than 2,500 49.27 grams; 49.28 (ii) the proportion of mothers in the area served by the 49.29 community health board who received inadequate or no prenatal 49.30 care; 49.31 (iii) the proportion of births in the area served by the 49.32 community health board to women under age 19; and 49.33 (iv) the proportion of births in the area served by the 49.34 community health board to American Indians and women of color; 49.35 and 49.36 (3) 25 percent based on the income of the maternal and 50.1 child population in the area served by the community health 50.2 board. 50.3 (d) Each variable must be expressed as a city or county 50.4 score consisting of the city or county frequency of each 50.5 variable divided by the statewide frequency of the variable. A 50.6 total score for each city or county jurisdiction must be 50.7 computed by totaling the scores of the three variables. Each 50.8 community health board must be allocated an amount equal to the 50.9 total score obtained for the city, county, or counties in its 50.10 area multiplied by the amount of money available. 50.11 Sec. 52. Minnesota Statutes 2000, section 145.882, 50.12 subdivision 7, is amended to read: 50.13 Subd. 7. [USE OF BLOCK GRANT MONEY.] (a) Maternal and 50.14 child health block grant money allocated to a community health 50.15 board or community health services area under this section must 50.16 be used for qualified programs for high risk and low-income 50.17 individuals. Block grant money must be used for programs that: 50.18 (1) specifically address the highest risk populations, 50.19 particularly low-income and minority groups with a high rate of 50.20 infant mortality and children with low birth weight, by 50.21 providing services, including prepregnancy family planning 50.22 services, calculated to produce measurable decreases in infant 50.23 mortality rates, instances of children with low birth weight, 50.24 and medical complications associated with pregnancy and 50.25 childbirth, including infant mortality, low birth rates, and 50.26 medical complications arising from chemical abuse by a mother 50.27 during pregnancy; 50.28 (2) specifically target pregnant women whose age, medical 50.29 condition, maternal history, or chemical abuse substantially 50.30 increases the likelihood of complications associated with 50.31 pregnancy and childbirth or the birth of a child with an 50.32 illness, disability, or special medical needs; 50.33 (3) specifically address the health needs of young children 50.34 who have or are likely to have a chronic disease or disability 50.35 or special medical needs, including physical, neurological, 50.36 emotional, and developmental problems that arise from chemical 51.1 abuse by a mother during pregnancy; 51.2 (4) provide family planning and preventive medical care for 51.3 specifically identified target populations, such as minority and 51.4 low-income teenagers, in a manner calculated to decrease the 51.5 occurrence of inappropriate pregnancy and minimize the risk of 51.6 complications associated with pregnancy and childbirth; or 51.7 (5) specifically address the frequency and severity of 51.8 childhood injuries and other child and adolescent health 51.9 problems in high risk target populations by providing services 51.10 calculated to produce measurable decreases in mortality and 51.11 morbidity.However, money may be used for this purpose only if51.12the community health board's application includes program51.13components for the purposes in clauses (1) to (4) in the51.14proposed geographic service area and the total expenditure for51.15injury-related programs under this clause does not exceed ten51.16percent of the total allocation under subdivision 3.51.17(b) Maternal and child health block grant money may be used51.18for purposes other than the purposes listed in this subdivision51.19only under the following conditions:51.20(1) the community health board or community health services51.21area can demonstrate that existing programs fully address the51.22needs of the highest risk target populations described in this51.23subdivision; or51.24(2) the money is used to continue projects that received51.25funding before creation of the maternal and child health block51.26grant in 1981.51.27(c)(b) Projects that received funding before creation of 51.28 the maternal and child health block grant in 1981, must be51.29allocated at least the amount of maternal and child health51.30special project grant funds received in 1989, unless (1) the51.31local board of health provides equivalent alternative funding51.32for the project from another source; or (2) the local board of51.33health demonstrates that the need for the specific services51.34provided by the project has significantly decreased as a result51.35of changes in the demographic characteristics of the population,51.36or other factors that have a major impact on the demand for52.1services. If the amount of federal funding to the state for the52.2maternal and child health block grant is decreased, these52.3projects must receive a proportional decrease as required in52.4subdivision 1. Increases in allocation amounts to local boards52.5of health under subdivision 4 may be used to increase funding52.6levels for these projectsmay be continued at the discretion of 52.7 the community health board. 52.8 Sec. 53. Minnesota Statutes 2000, section 145.885, 52.9 subdivision 2, is amended to read: 52.10 Subd. 2. [ADDITIONAL REQUIREMENTS FOR COMMUNITY BOARDS OF 52.11 HEALTH.] Applications by community health boards as defined in 52.12 section 145A.02, subdivision 5, under section 145.882, 52.13 subdivision34a, must also contain a summary of the process 52.14 used to develop the local program, including evidence that the 52.15 community health board notified local public and private 52.16 providers of the availability of funding through the community 52.17 health board for maternal and child health services; a list of 52.18 all public and private agency requests for grants submitted to 52.19 the community health board indicating which requests were 52.20 included in the grant application; and an explanation of how 52.21 priorities were established for selecting the requests to be 52.22 included in the grant application. The community health board 52.23 shall include, with the grant application, a written statement 52.24 of the criteria to be applied to public and private agency 52.25 requests for funding. 52.26 Sec. 54. Minnesota Statutes 2000, section 145.925, 52.27 subdivision 1, is amended to read: 52.28 Subdivision 1. [ELIGIBLE ORGANIZATIONS; PURPOSE.] The 52.29 commissioner of health may make special grants to cities, 52.30 counties, groups of cities or counties, or nonprofit 52.31 corporations to provide prepregnancy family planning 52.32 services. No funds received under this section shall be used to 52.33 provide abortion services. 52.34 Sec. 55. [145.9263] [PROMOTING HEALTHY LIFESTYLES AMONG 52.35 YOUTH.] 52.36 Subdivision 1. [ESTABLISHMENT.] The commissioner shall 53.1 establish a grant program to promote healthy behavior among 53.2 youth. 53.3 Subd. 2. [LOCAL GRANTS.] The commissioner shall award 53.4 competitive grants to eligible applicants for projects and 53.5 initiatives directed at promoting healthy lifestyles such as 53.6 proper nutrition, the need for physical exercise, and the 53.7 avoidance of other unhealthy behaviors. The project areas for 53.8 grants include; 53.9 (1) after-school programs that focus on leadership, youth 53.10 mentoring and peer counseling, academic support, and 53.11 after-school enrichment; 53.12 (2) programs that provide education and support for youth 53.13 and parents that support healthy behaviors and self-sufficiency; 53.14 (3) youth development programs; or 53.15 (4) programs that focus on ethnic or cultural enrichment. 53.16 Subd. 3. [HIGH-RISK COMMUNITY YOUTH GRANTS.] (a) the 53.17 commissioner shall award grants to communities that have 53.18 significant risk factors for unhealthy youth behaviors and that 53.19 currently have in place youth development programs. 53.20 (b) To be eligible for a grant under this subdivision, an 53.21 applicant must be a tribal government or a community health 53.22 board as defined in section 145A.02. Applicants must submit 53.23 proposals to the commissioner. A proposal must specify the 53.24 strategies to be implemented. Strategies may include youth 53.25 mentoring programs, academic support programs, and parent 53.26 support and education programs. Applicants must demonstrate 53.27 that a proposed project: 53.28 (1) is research-based or based on proven effective 53.29 strategies; 53.30 (2) is designed to coordinate with related youth risk 53.31 behavior reduction activities; 53.32 (3) involves youth and parents in the project's development 53.33 and implementation; 53.34 (4) reflects racially and ethnically appropriate 53.35 approaches; and 53.36 (5) will be implemented through or with persons or 54.1 community-based organizations that reflect the race or ethnicity 54.2 of the population to be reached. 54.3 Subd. 4. [PUBLIC AWARENESS.] The commissioner shall 54.4 coordinate a public/private partnership to provide a statewide 54.5 outreach campaign directed at youth on the importance of a 54.6 healthy lifestyle and the health consequences of poor nutrition 54.7 and the lack of physical exercise in terms of obesity and other 54.8 health problems. The campaign shall include culturally specific 54.9 and community-based messages. 54.10 Subd. 5. [PROCESS.] (a) The commissioner, in consultation 54.11 with community partners, shall develop the criteria and 54.12 procedures to allocate the grants under this section. In 54.13 developing the criteria, the commissioner shall establish an 54.14 administrative cost limit for grant recipients. The outcomes 54.15 established under subdivision 6 must be specified to the grant 54.16 recipients receiving grants under this section at the time the 54.17 grant is awarded. The commissioner may require an applicant to 54.18 enter into a collaborative agreement with the local public 54.19 health entity. 54.20 (b) Eligible applicants may include, but are not limited 54.21 to, nonprofit organizations, community clinics, and social 54.22 service organizations. Applicants must submit proposals to the 54.23 commissioner. The proposals must specify the strategies to be 54.24 implemented and must take into account the need for a 54.25 coordinated local effort. 54.26 (c) The commissioner shall give priority to programs that: 54.27 (1) are designed to coordinate with related youth risk 54.28 behavior reduction activities; 54.29 (2) involve youth and parents in the development and 54.30 implementation; 54.31 (3) are implemented through or with community-based 54.32 organizations reflecting the race and ethnicity of the 54.33 population to be needed; and 54.34 (4) reflect racial and ethnic appropriate approaches. 54.35 Subd. 6. [MEASURABLE OUTCOMES.] The commissioner, in 54.36 consultation with other public and private nonprofit 55.1 organizations interested in youth development efforts, shall 55.2 establish measurable outcomes to determine the effectiveness of 55.3 the grants receiving funds under this section. 55.4 Subd. 7. [COORDINATION.] The commissioner shall coordinate 55.5 the projects and initiatives funded under this section with 55.6 other efforts at the local, state, and national level to avoid 55.7 duplication and promote complimentary efforts. 55.8 Subd. 8. [EVALUATION.] (a) Using the outcome measures 55.9 established in subdivision 6, the commissioner shall conduct a 55.10 biennial evaluation of the efforts funded under this section. 55.11 (b) Grant recipients shall cooperate with the commissioner 55.12 of health in the evaluation and provide the commissioner with 55.13 the information necessary to conduct the evaluation. 55.14 Subd. 9. [REPORT.] The commissioner shall submit biennial 55.15 reports to the legislature on the activities of the projects 55.16 funded under this section and the results of the biennial 55.17 evaluation. These reports are due by January 15 of every other 55.18 year, beginning in the year 2004. 55.19 Sec. 56. [145.9268] [COMMUNITY CLINIC GRANTS.] 55.20 Subdivision 1. [DEFINITION.] For purposes of this section, 55.21 "eligible community clinic" means: 55.22 (1) a clinic that provides services under conditions as 55.23 defined in Minnesota Rules, part 9505.0255, and utilizes a 55.24 sliding fee scale to determine eligibility for charity care; 55.25 (2) an Indian tribal government or Indian health service 55.26 unit; or 55.27 (3) a consortium of clinics comprised of entities under 55.28 clause (1) or (2). 55.29 Subd. 2. [GRANTS AUTHORIZED.] The commissioner of health 55.30 shall award grants to eligible community clinics to improve the 55.31 ongoing viability of Minnesota's clinic-based safety net 55.32 providers. Grants shall be awarded to support the capacity of 55.33 eligible community clinics to serve low-income populations, 55.34 reduce current or future uncompensated care burdens, or provide 55.35 for improved care delivery infrastructure. 55.36 Subd. 3. [ALLOCATION OF GRANTS.] (a) To receive a grant 56.1 under this section, an eligible community clinic must submit an 56.2 application to the commissioner of health by the deadline 56.3 established by the commissioner. A grant may be awarded upon 56.4 the signing of a grant contract. 56.5 (b) An application must be on a form and contain 56.6 information as specified by the commissioner but at a minimum 56.7 must contain: 56.8 (1) a description of the project for which grant funds will 56.9 be used; 56.10 (2) a description of the problem the proposed project will 56.11 address; and 56.12 (3) a description of achievable objectives, a workplan, and 56.13 a timeline for project completion. 56.14 (c) The commissioner shall review each application to 56.15 determine whether the application is complete and whether the 56.16 applicant and the project are eligible for a grant. In 56.17 evaluating applications according to paragraph (e), the 56.18 commissioner shall establish criteria including, but not limited 56.19 to: the priority level of the project; the applicant's 56.20 thoroughness and clarity in describing the problem; a 56.21 description of the applicant's proposed project; the manner in 56.22 which the applicant will demonstrate the effectiveness of the 56.23 project; and evidence of efficiencies and effectiveness gained 56.24 through collaborative efforts. The commissioner may also take 56.25 into account other relevant factors, including, but not limited 56.26 to, the percentage for which uninsured patients represent the 56.27 applicant's patient base. During application review, the 56.28 commissioner may request additional information about a proposed 56.29 project, including information on project cost. Failure to 56.30 provide the information requested disqualifies an applicant. 56.31 The commissioner has discretion over the number of grants 56.32 awarded. 56.33 (d) In determining which eligible community clinics will 56.34 receive grants under this section, the commissioner shall give 56.35 preference to those grant applications that show evidence of 56.36 collaboration with other eligible community clinics, hospitals, 57.1 health care providers, or community organizations. In addition, 57.2 the commissioner shall give priority, in declining order, to 57.3 grant applications for projects that: 57.4 (1) establish, update, or improve information, data 57.5 collection, or billing systems; 57.6 (2) procure, modernize, remodel, or replace equipment used 57.7 an the delivery of direct patient care at a clinic; 57.8 (3) provide improvements for care delivery, such as 57.9 increased translation and interpretation services; 57.10 (4) provide a direct offset to expenses incurred for 57.11 charity care services; or 57.12 (5) other projects determined by the commissioner to 57.13 improve the ability of applicants to provide care to the 57.14 vulnerable populations they serve. 57.15 Subd. 4. [EVALUATION.] The commissioner of health shall 57.16 evaluate the overall effectiveness of the grant program. The 57.17 commissioner shall collect progress reports to evaluate the 57.18 grant program from the eligible community clinics receiving 57.19 grants. 57.20 Sec. 57. [145.9269] [ELIMINATING HEALTH DISPARITIES.] 57.21 Subdivision 1. [STATE-COMMUNITY PARTNERSHIPS.] The 57.22 commissioner, in partnership with culturally based community 57.23 organizations; the Indian affairs council as defined in section 57.24 3.922; the council on affairs of Chicano/Latino people as 57.25 defined in section 3.9223; the council on Black Minnesotans as 57.26 defined in section 3.9225; the council on Asian-Pacific 57.27 Minnesotans as defined in section 3.9226; community health 57.28 boards; and tribal governments, shall develop and implement a 57.29 comprehensive coordinated plan to reduce health disparities 57.30 experienced by American Indians and communities of color in 57.31 infant mortality, breast and cervical cancer screening, 57.32 HIV/AIDS/STDs, immunizations, cardiovascular disease, diabetes, 57.33 injury, and violence. 57.34 Subd. 2. [MEASURABLE OUTCOMES.] The commissioner, in 57.35 consultation with community partners, shall establish measurable 57.36 outcomes to determine the effectiveness of the grants and other 58.1 activities receiving funds under this section in reducing health 58.2 disparities. The goal of the grants shall be to decrease by 58.3 one-half the ratio of American Indians and communities of color 58.4 specific health condition rates to white rates in the areas 58.5 identified in subdivision 1. 58.6 Subd. 3. [STATEWIDE ASSESSMENT.] The commissioner shall 58.7 enhance current data tools to assure a statewide assessment of 58.8 the risk behaviors associated with the areas identified in 58.9 subdivision 1. This statewide assessment must be used to 58.10 establish a baseline to measure the effect of activities funded 58.11 under this section. To the extent feasible, the commissioner of 58.12 health must conduct the assessment so that the results may be 58.13 compared to nationwide data. Data collected and used for 58.14 assessment must not identify an individual according to section 58.15 13.05, subdivision 7. 58.16 Subd. 4. [TECHNICAL ASSISTANCE.] The commissioner shall 58.17 provide the necessary expertise to community organizations to 58.18 ensure that submitted proposals are likely to be successful in 58.19 reducing health disparities. The commissioner shall provide 58.20 grant recipients with guidance and training on strategies 58.21 related to reducing the health disparities identified in this 58.22 section. The commissioner shall also provide grant recipients 58.23 with assistance in the development of evaluation of local 58.24 community activities. 58.25 Subd. 5. [PROCESS.] (a) The commissioner shall, in 58.26 consultation with community partners, develop the criteria and 58.27 procedures to allocate the grants under this section. In 58.28 developing the criteria, the commissioner shall establish an 58.29 administrative cost limit for grant recipients. The outcomes 58.30 established under subdivision 2 must be specified to the grant 58.31 recipients receiving grants under this section at the time the 58.32 grant is awarded. 58.33 (b) A grant recipient must coordinate the activities 58.34 related to reducing health disparities with other grant 58.35 recipients receiving funding under this section within the 58.36 recipient's service area. 59.1 Subd. 6. [COMMUNITY GRANT PROGRAM.] (a) The commissioner 59.2 shall award grants to eligible applicants for local or regional 59.3 projects and initiatives directed at reducing health 59.4 disparities. Grant proposals must address one or more of the 59.5 following priority areas: 59.6 (1) decreasing racial and ethnic disparities in infant 59.7 mortality rates; 59.8 (2) decreasing racial and ethnic disparities in morbidity 59.9 and mortality rates relating to breast and cervical cancer; 59.10 (3) decreasing racial and ethnic disparities in morbidity 59.11 and mortality rates relating to HIV/AIDS/STDs; 59.12 (4) increasing adult and child immunization rates in racial 59.13 and ethnic populations; 59.14 (5) decreasing racial and ethnic disparities in morbidity 59.15 and mortality rates relating to cardiovascular disease; 59.16 (6) decreasing racial and ethnic disparities in morbidity 59.17 and mortality rates relating to diabetes; and 59.18 (7) decreasing racial and ethnic disparities in morbidity 59.19 and mortality rates relating to injury or violence. 59.20 (b) The commissioner may award up to 20 percent of the 59.21 funds available as planning grants. Planning grant proposals 59.22 must be used to address such areas as community assessment, 59.23 determining community priority areas, coordination activities, 59.24 and development of community-supported strategies. 59.25 (c) Eligible applicants may include, but are not limited 59.26 to, faith-based organizations, social service organizations, 59.27 community nonprofit organizations, and community clinics. 59.28 Applicants must submit proposals to the commissioner and must 59.29 demonstrate partnerships with local public health. The 59.30 proposals must specify the strategies to be implemented to 59.31 reduce one or more of the project areas listed under subdivision 59.32 6, paragraph (a), and must be targeted to achieve the outcomes 59.33 established in subdivision 2. 59.34 (d) The commissioner must give priority to applicants who 59.35 demonstrate that the proposed project or initiative: 59.36 (1) is supported by the community the applicant will be 60.1 serving; 60.2 (2) is research based or based on promising strategies; 60.3 (3) is designed to compliment other related community 60.4 activities; 60.5 (4) utilizes strategies that positively impacts more than 60.6 one priority area; and 60.7 (5) is implemented through or with community-based 60.8 organizations that reflect the race or ethnicity of the 60.9 population to be reached. 60.10 Subd. 7. [LOCAL PUBLIC HEALTH.] The commissioner shall 60.11 award grants to community health boards for local health 60.12 promotion and protection activities aimed at reducing maternal 60.13 and child health disparities between whites and American Indians 60.14 and populations of color. Local public health must submit 60.15 proposals to the commissioner and must demonstrate partnerships 60.16 with culturally based community organizations or with tribal 60.17 governments. The commissioner shall distribute these funds to 60.18 community health boards according to the formula in section 60.19 145.882, subdivision 4. 60.20 Subd. 8. [TRIBAL GOVERNMENTS.] The commissioner shall 60.21 award grants to American Indian tribal governments for 60.22 implementation of community interventions to reduce health 60.23 disparities for the project areas listed under subdivision 6, 60.24 paragraph (a), and must be targeted to achieve the outcomes 60.25 established in subdivision 2. Tribal governments must submit 60.26 proposals to the commissioner and must demonstrate partnerships 60.27 with local public health. The distribution formula shall be 60.28 determined by the commissioner, in consultation with the tribal 60.29 governments. 60.30 Subd. 9. [REFUGEE AND IMMIGRANT HEALTH.] The commissioner 60.31 shall distribute funds to community health boards for health 60.32 screening and follow-up services for foreign-born persons. 60.33 Distribution shall be based on the following criteria: 60.34 (1) cases of pulmonary tuberculosis; 60.35 (2) cases of extrapulmonary tuberculosis; 60.36 (3) the number of months providing directly observed 61.1 therapy to cases of uninsured tuberculosis or extrapulmonary 61.2 tuberculosis; and 61.3 (4) the number of new refugees in the service area within 61.4 the fiscal year. 61.5 The commissioner, in cooperation with the affected local public 61.6 health departments, shall determine reimbursement rates within 61.7 the given appropriations. 61.8 Subd. 10. [COORDINATION.] The commissioner shall 61.9 coordinate the projects and initiatives funded under this 61.10 section with other efforts at the local, state, or national 61.11 level to avoid duplication of effort and promote complimentary 61.12 efforts. 61.13 Subd. 11. [EVALUATION.] Using the outcome measures 61.14 established in subdivision 2, the commissioner shall conduct a 61.15 biennial evaluation of the community grants program, community 61.16 health board activities, and tribal government activities funded 61.17 under this section. Grant recipients, tribal governments, and 61.18 community health boards shall cooperate with the commissioner in 61.19 the evaluation and provide the commissioner with the information 61.20 necessary to conduct the evaluation. 61.21 Subd. 12. [REPORT.] The commissioner shall submit a 61.22 biennial report to the legislature on the local community 61.23 projects, tribal government, and community health board 61.24 prevention activities funded under this section. These reports 61.25 must include information on grant recipients, activities that 61.26 were conducted using grant funds, evaluation data and outcome 61.27 measures, if available. These reports are due by January 15 of 61.28 every other year, beginning in the year 2004. 61.29 Sec. 58. Minnesota Statutes 2000, section 157.16, 61.30 subdivision 3, is amended to read: 61.31 Subd. 3. [ESTABLISHMENT FEES; DEFINITIONS.] (a) The 61.32 following fees are required for food and beverage service 61.33 establishments, hotels, motels, lodging establishments, and 61.34 resorts licensed under this chapter. Food and beverage service 61.35 establishments must pay the highest applicable fee under 61.36 paragraph (e), clause (1), (2), (3), or (4), and establishments 62.1 serving alcohol must pay the highest applicable fee under 62.2 paragraph (e), clause (6) or (7). The license fee for new 62.3 operators previously licensed under this chapter for the same 62.4 calendar year is one-half of the appropriate annual license fee, 62.5 plus any penalty that may be required. The license fee for 62.6 operators opening on or after October 1 is one-half of the 62.7 appropriate annual license fee, plus any penalty that may be 62.8 required. 62.9 (b) All food and beverage service establishments, except 62.10 special event food stands, and all hotels, motels, lodging 62.11 establishments, and resorts shall pay an annual base fee of 62.12$100$145. 62.13 (c) A special event food stand shall pay a flat fee 62.14 of$30$35 annually. "Special event food stand" means a fee 62.15 category where food is prepared or served in conjunction with 62.16 celebrations, county fairs, or special events from a special 62.17 event food stand as defined in section 157.15. 62.18 (d) In addition to the base fee in paragraph (b), each food 62.19 and beverage service establishment, other than a special event 62.20 food stand, and each hotel, motel, lodging establishment, and 62.21 resort shall pay an additional annual fee for each fee category 62.22 as specified in this paragraph: 62.23 (1) Limited food menu selection,$30$40. "Limited food 62.24 menu selection" means a fee category that provides one or more 62.25 of the following: 62.26 (i) prepackaged food that receives heat treatment and is 62.27 served in the package; 62.28 (ii) frozen pizza that is heated and served; 62.29 (iii) a continental breakfast such as rolls, coffee, juice, 62.30 milk, and cold cereal; 62.31 (iv) soft drinks, coffee, or nonalcoholic beverages; or 62.32 (v) cleaning for eating, drinking, or cooking utensils, 62.33 when the only food served is prepared off site. 62.34 (2) Small establishment, including boarding establishments, 62.35$55$75. "Small establishment" means a fee category that has no 62.36 salad bar and meets one or more of the following: 63.1 (i) possesses food service equipment that consists of no 63.2 more than a deep fat fryer, a grill, two hot holding containers, 63.3 and one or more microwave ovens; 63.4 (ii) serves dipped ice cream or soft serve frozen desserts; 63.5 (iii) serves breakfast in an owner-occupied bed and 63.6 breakfast establishment; 63.7 (iv) is a boarding establishment; or 63.8 (v) meets the equipment criteria in clause (3), item (i) or 63.9 (ii), and has a maximum patron seating capacity of not more than 63.10 50. 63.11 (3) Medium establishment,$150$210. "Medium establishment" 63.12 means a fee category that meets one or more of the following: 63.13 (i) possesses food service equipment that includes a range, 63.14 oven, steam table, salad bar, or salad preparation area; 63.15 (ii) possesses food service equipment that includes more 63.16 than one deep fat fryer, one grill, or two hot holding 63.17 containers; or 63.18 (iii) is an establishment where food is prepared at one 63.19 location and served at one or more separate locations. 63.20 Establishments meeting criteria in clause (2), item (v), 63.21 are not included in this fee category. 63.22 (4) Large establishment,$250$350. "Large establishment" 63.23 means either: 63.24 (i) a fee category that (A) meets the criteria in clause 63.25 (3), items (i) or (ii), for a medium establishment, (B) seats 63.26 more than 175 people, and (C) offers the full menu selection an 63.27 average of five or more days a week during the weeks of 63.28 operation; or 63.29 (ii) a fee category that (A) meets the criteria in clause 63.30 (3), item (iii), for a medium establishment, and (B) prepares 63.31 and serves 500 or more meals per day. 63.32 (5) Other food and beverage service, including food carts, 63.33 mobile food units, seasonal temporary food stands, and seasonal 63.34 permanent food stands,$30$40. 63.35 (6) Beer or wine table service,$30$40. "Beer or wine 63.36 table service" means a fee category where the only alcoholic 64.1 beverage service is beer or wine, served to customers seated at 64.2 tables. 64.3 (7) Alcoholic beverage service, other than beer or wine 64.4 table service,$75$105. 64.5 "Alcohol beverage service, other than beer or wine table 64.6 service" means a fee category where alcoholic mixed drinks are 64.7 served or where beer or wine are served from a bar. 64.8 (8) Lodging per sleeping accommodation unit,$4$6, 64.9 including hotels, motels, lodging establishments, and resorts, 64.10 up to a maximum of$400$600. "Lodging per sleeping 64.11 accommodation unit" means a fee category including the number of 64.12 guest rooms, cottages, or other rental units of a hotel, motel, 64.13 lodging establishment, or resort; or the number of beds in a 64.14 dormitory. 64.15 (9) First public swimming pool,$100$140; each additional 64.16 public swimming pool,$50$80. "Public swimming pool" means a 64.17 fee category that has the meaning given in Minnesota Rules, part 64.18 4717.0250, subpart 8. 64.19 (10) First spa,$50$80; each additional spa,$25$40. 64.20 "Spa pool" means a fee category that has the meaning given in 64.21 Minnesota Rules, part 4717.0250, subpart 9. 64.22 (11) Private sewer or water,$30$40. "Individual private 64.23 water" means a fee category with a water supply other than a 64.24 community public water supply as defined in Minnesota Rules, 64.25 chapter 4720. "Individual private sewer" means a fee category 64.26 with an individual sewage treatment system which uses subsurface 64.27 treatment and disposal. 64.28 (e)A fee is not required for a food and beverage service64.29establishment operated by a school as defined in sections64.30120A.05, subdivisions 9, 11, 13, and 17 and 120A.22.64.31(f)A fee of $150 for review of the construction plans must 64.32 accompany the initial license application for food and beverage 64.33 service establishments, hotels, motels, lodging establishments, 64.34 or resorts. 64.35(g)(f) When existing food and beverage service 64.36 establishments, hotels, motels, lodging establishments, or 65.1 resorts are extensively remodeled, a fee of $150 must be 65.2 submitted with the remodeling plans. 65.3(h)(g) Seasonal temporary food stands and special event 65.4 food stands are not required to submit construction or 65.5 remodeling plans for review. 65.6 Sec. 59. Minnesota Statutes 2000, section 157.22, is 65.7 amended to read: 65.8 157.22 [EXEMPTIONS.] 65.9 This chapter shall not be construed to apply to: 65.10 (1) interstate carriers under the supervision of the United 65.11 States Department of Health and Human Services; 65.12 (2) any building constructed and primarily used for 65.13 religious worship; 65.14 (3) any building owned, operated, and used by a college or 65.15 university in accordance with health regulations promulgated by 65.16 the college or university under chapter 14; 65.17 (4) any person, firm, or corporation whose principal mode 65.18 of business is licensed under sections 28A.04 and 28A.05, is 65.19 exempt at that premises from licensure as a food or beverage 65.20 establishment; provided that the holding of any license pursuant 65.21 to sections 28A.04 and 28A.05 shall not exempt any person, firm, 65.22 or corporation from the applicable provisions of this chapter or 65.23 the rules of the state commissioner of health relating to food 65.24 and beverage service establishments; 65.25 (5) family day care homes and group family day care homes 65.26 governed by sections 245A.01 to 245A.16; 65.27 (6) nonprofit senior citizen centers for the sale of 65.28 home-baked goods;and65.29 (7) food not prepared at an establishment and brought in by 65.30 individuals attending a potluck event for consumption at the 65.31 potluck event. An organization sponsoring a potluck event under 65.32 this clause may advertise the potluck event to the public 65.33 through any means. Individuals who are not members of an 65.34 organization sponsoring a potluck event under this clause may 65.35 attend the potluck event and consume the food at the event. 65.36 Licensed food establishments cannot be sponsors of potluck 66.1 events. Potluck event food shall not be brought into a licensed 66.2 food establishment kitchen; and 66.3 (8) a home school in which a child is provided instruction 66.4 at home. 66.5 Sec. 60. Minnesota Statutes 2000, section 326.38, is 66.6 amended to read: 66.7 326.38 [LOCAL REGULATIONS.] 66.8 Any city having a system of waterworks or sewerage, or any 66.9 town in which reside over 5,000 people exclusive of any 66.10 statutory cities located therein, or the metropolitan airports 66.11 commission, may, by ordinance, adopt local regulations providing 66.12 for plumbing permits, bonds, approval of plans, and inspections 66.13 of plumbing, which regulations are not in conflict with the 66.14 plumbing standards on the same subject prescribed by the state 66.15 commissioner of health. No city or such town shall prohibit 66.16 plumbers licensed by the state commissioner of health from 66.17 engaging in or working at the business, except cities and 66.18 statutory cities which, prior to April 21, 1933, by ordinance 66.19 required the licensing of plumbers. Any city by ordinance may 66.20 prescribe regulations, reasonable standards, and inspections and 66.21 grant permits to any person, firm, or corporation engaged in the 66.22 business of installing water softeners, who is not licensed as a 66.23 master plumber or journeyman plumber by the state commissioner 66.24 of health, to connect water softening and water filtering 66.25 equipment to private residence water distribution systems, where 66.26 provision has been previously made therefor and openings left 66.27 for that purpose or by use of cold water connections to a 66.28 domestic water heater; where it is not necessary to rearrange, 66.29 make any extension or alteration of, or addition to any pipe, 66.30 fixture or plumbing connected with the water system except to 66.31 connect the water softener, and provided the connections so made 66.32 comply with minimum standards prescribed by the state 66.33 commissioner of health. 66.34 Sec. 61. [MEDICATIONS DISPENSED IN SCHOOLS STUDY.] 66.35 (a) The commissioner of health, in consultation with the 66.36 board of nursing, shall study the relationship between the Nurse 67.1 Practice Act, Minnesota Statutes, sections 148.171 to 148.285; 67.2 and 121A.22, which specifies the administration of medications 67.3 in schools and the activities authorized under these sections, 67.4 including the administration of prescription and nonprescription 67.5 medications and medications needed by students to manage a 67.6 chronic illness. The commissioner shall also make 67.7 recommendations on necessary statutory changes needed to promote 67.8 student health and safety in relation to administering 67.9 medications in schools and addressing the changing health needs 67.10 of students. 67.11 (b) The commissioner shall convene a work group to assist 67.12 in the study and recommendations. The work group shall consist 67.13 of representatives of the commissioner of human services; the 67.14 commissioner of children, families, and learning; the board of 67.15 nursing; the board of teaching; school nurses; parents; school 67.16 administrators; school board associations; the American Academy 67.17 of Pediatrics; and the Minnesota Nurse's Association. 67.18 (c) The commissioner shall submit these recommendations and 67.19 any recommended statutory changes to the legislature by January 67.20 15, 2002. 67.21 Sec. 62. [REPEALER.] 67.22 Minnesota Statutes 2000, sections 144.148, subdivision 8; 67.23 145.882, subdivisions 3 and 4; and 145.927, are repealed. 67.24 ARTICLE 2 67.25 HEALTH CARE 67.26 Section 1. Minnesota Statutes 2000, section 16A.87, is 67.27 amended to read: 67.28 16A.87 [TOBACCO SETTLEMENT FUND.] 67.29 Subdivision 1. [ESTABLISHMENT; PURPOSE.] The tobacco 67.30 settlement fund is established as a clearing account in the 67.31 state treasury. 67.32 Subd. 2. [DEPOSIT OF MONEY.] The commissioner shall credit 67.33 to the tobacco settlement fund the tobacco settlement payments 67.34 received by the state on September 5, 1998, January 4, 1999, 67.35 January 3, 2000,andJanuary 2, 2001, January 2, 2002, and 67.36 January 2, 2003, as a result of the settlement of the lawsuit 68.1 styled as State v. Philip Morris Inc., No. C1-94-8565 (Minnesota 68.2 District Court, Second Judicial District). 68.3 Subd. 3. [APPROPRIATION.] (a) Of the amounts credited to 68.4 the fund prior to June 30, 2001, 61 percent is appropriated for 68.5 transfer to the tobacco use prevention and local public health 68.6 endowment fund created in section 144.395 and 39 percent is 68.7 appropriated for transfer to the medical education endowment 68.8 fund created in section 62J.694. 68.9 (b) The entire amount credited to the fund from the 68.10 payments made on January 2, 2002, and on January 2, 2003, are 68.11 appropriated for transfer to the children's health care 68.12 endowment fund created in section 256.952. 68.13 Subd. 4. [SUNSET.] The tobacco settlement fund expires 68.14 June 30, 2015. 68.15 Sec. 2. Minnesota Statutes 2000, section 62A.095, 68.16 subdivision 1, is amended to read: 68.17 Subdivision 1. [APPLICABILITY.] (a) No health plan shall 68.18 be offered, sold, or issued to a resident of this state, or to 68.19 cover a resident of this state, unless the health plan complies 68.20 with subdivision 2. 68.21 (b) Health plans providing benefits under health care 68.22 programs administered by the commissioner of human services are 68.23 not subject to the limits described in subdivision 2 but are 68.24 subject to the right of subrogation provisions under section 68.25 256B.37 and the lien provisions under section 256.015; 256B.042; 68.26 256D.03, subdivision 8; or 256L.03, subdivision 6. 68.27 Sec. 3. Minnesota Statutes 2000, section 62J.692, 68.28 subdivision 7, is amended to read: 68.29 Subd. 7. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 68.30 SERVICES.] (a) The amount transferred according to section 68.31 256B.69, subdivision 5c, paragraph (a), clause (3), shall be 68.32 distributed to the University of Minnesota academic health 68.33 center. 68.34 (b) The amount transferred according to section 256B.69, 68.35 subdivision 5c, paragraph (a), clause (4), shall be distributed 68.36 to the Hennepin county medical center. 69.1 (c) The amount transferred according to section 256B.69, 69.2 subdivision 5c, paragraph (a), clause (2), shall be distributed 69.3 by the commissioner to clinical medical education programs that 69.4 meet the qualifications of subdivision 3 based on a distribution 69.5 formula that reflects a summation of two factors: 69.6 (1) an education factor, which is determined by the total 69.7 number of eligible trainee FTEs and the total statewide average 69.8 costs per trainee, by type of trainee, in each clinical medical 69.9 education program; and 69.10 (2) a public program volume factor, which is determined by 69.11 the total volume of public program revenue received by each 69.12 training site as a percentage of all public program revenue 69.13 received by all training sites in the fund pool created under 69.14 this subdivision. 69.15 In this formula, the education factor shall be weighted at 69.16 50 percent and the public program volume factor shall be 69.17 weighted at 50 percent. 69.18(b)(d) Public program revenue for the formula in paragraph 69.19(a)(c) shall include revenue from medical assistance, prepaid 69.20 medical assistance, general assistance medical care, and prepaid 69.21 general assistance medical care. 69.22(c)Training sites that receive no public program revenue 69.23 shall be ineligible for funds available underthis69.24subdivisionparagraph (c). 69.25 Sec. 4. Minnesota Statutes 2000, section 62J.694, 69.26 subdivision 2, is amended to read: 69.27 Subd. 2. [EXPENDITURES.] (a) Up to five percent of the 69.28 fair market value of the fund is appropriated for medical 69.29 education activities in the state of Minnesota. The 69.30 appropriations are to be transferred quarterly for the purposes 69.31 identified in the following paragraphs. 69.32 (b) For fiscal year 2000, 70 percent of the appropriation 69.33 in paragraph (a) is for transfer to the board of regents for the 69.34 instructional costs of health professional programs at the 69.35 academic health center and affiliated teaching institutions, and 69.36 30 percent of the appropriation is for transfer to the 70.1 commissioner of health to be distributed for medical education 70.2 under section 62J.692. 70.3 (c) For fiscal year 2001, 49 percent of the appropriation 70.4 in paragraph (a) is for transfer to the board of regents for the 70.5 instructional costs of health professional programs at the 70.6 academic health center and affiliated teaching institutions, and 70.7 51 percent is for transfer to the commissioner of health to be 70.8 distributed for medical education under section 62J.692. 70.9 (d) For fiscal year 2002, and each year thereafter, 42 70.10 percent of the appropriation in paragraph (a)may be70.11appropriated by another law for the instructional costs of70.12health professional programs at publicly funded academic health70.13centers and affiliated teaching institutionsis for transfer to 70.14 the commissioner of human services to be used to increase the 70.15 capitation payments under section 256B.69, and 58 percent is for 70.16 transfer to the commissioner of health to be distributed for 70.17 medical education under section 62J.692. 70.18 (e) A maximum of $150,000 of each annual appropriation to 70.19 the commissioner of health in paragraph (d) may be used by the 70.20 commissioner for administrative expenses associated with 70.21 implementing section 62J.692. 70.22 Sec. 5. Minnesota Statutes 2000, section 62Q.19, 70.23 subdivision 2, is amended to read: 70.24 Subd. 2. [APPLICATION.] (a) Any provider may apply to the 70.25 commissioner for designation as an essential community provider 70.26 by submitting an application form developed by the 70.27 commissioner. Except as provided in paragraph (d), applications 70.28 must be accepted within two years after the effective date of 70.29 the rules adopted by the commissioner to implement this section. 70.30 (b) Each application submitted must be accompanied by an 70.31 application fee in an amount determined by the commissioner. 70.32 The fee shall be no more than what is needed to cover the 70.33 administrative costs of processing the application. 70.34 (c) The name, address, contact person, and the date by 70.35 which the commissioner's decision is expected to be made shall 70.36 be classified as public data under section 13.41. All other 71.1 information contained in the application form shall be 71.2 classified as private data under section 13.41 until the 71.3 application has been approved, approved as modified, or denied 71.4 by the commissioner. Once the decision has been made, all 71.5 information shall be classified as public data unless the 71.6 applicant designates and the commissioner determines that the 71.7 information contains trade secret information. 71.8 (d) The commissioner shall accept an application for 71.9 designation as an essential community provider until June 30, 71.10 2001, from: 71.11 (1) one applicant that is a nonprofit community health care 71.12 facility, certified as a medical assistance provider effective 71.13 April 1, 1998, that provides culturally competent health care to 71.14 an underserved Southeast Asian immigrant and refugee population 71.15 residing in the immediate neighborhood of the facility; 71.16 (2) one applicant that is a nonprofit home health care 71.17 provider, certified as a Medicare and a medical assistance 71.18 provider that provides culturally competent home health care 71.19 services to a low-income culturally diverse population; 71.20 (3) up to five applicants that are nonprofit community 71.21 mental health centers certified as medical assistance providers 71.22 that provide mental health services to children with serious 71.23 emotional disturbance and their families or to adults with 71.24 serious and persistent mental illness; and 71.25 (4) one applicant that is a nonprofit provider certified as 71.26 a medical assistance provider that provides mental health, child 71.27 development, and family services to children with physical and 71.28 mental health disorders and their families. 71.29 (e) The commissioner shall accept applications for 71.30 designation as an essential community provider until June 30, 71.31 2002, from an alternative school authorized under sections 71.32 123A.05 to 123A.08 or under section 124D.68 and a charter school 71.33 authorized under section 124D.10. For these schools, the 71.34 essential community provider designation applies for mental 71.35 health services delivered by a licensed health care or social 71.36 services practitioner to a child currently enrolled in the 72.1 school. 72.2 Sec. 6. [145.495] [HEALTH CARE SAFETY NET ENDOWMENT FUND.] 72.3 Subdivision 1. [CREATION.] The health care safety net 72.4 endowment fund is created in the state treasury. The state 72.5 board of investment shall invest the fund under section 11A.24. 72.6 All earnings of the fund must be credited to the fund. The 72.7 principal of the fund must be maintained inviolate, except that 72.8 the principal may be used to make expenditures from the fund for 72.9 the purposes specified in this section. 72.10 Subd. 2. [EXPENDITURES.] (a) For fiscal year 2003, and 72.11 each year thereafter, up to five percent of the average of the 72.12 fair market values of the fund for the preceding 12 months is 72.13 appropriated for the purposes identified in clauses (1) to (4): 72.14 (1) 26.7 percent is appropriated to the commissioner of 72.15 health to distributed as grants to community clinics in 72.16 accordance in section 145.928; 72.17 (2) 26.7 percent is appropriated to the commissioner of 72.18 commerce to be paid to the Minnesota comprehensive health 72.19 association for the exclusive purpose of reducing the 72.20 association's operating deficit assessment for the year; 72.21 (3) 33.3 percent is appropriated to the commissioner of 72.22 health to be distributed as rural hospital capital improvement 72.23 grants in accordance with section 144.148; and 72.24 (4) 13.3 percent is appropriated to the commissioner of 72.25 human services to be distributed as dental access grants in 72.26 accordance with section 256B.53. If the amount appropriated is 72.27 not used within that fiscal year for dental access grants, the 72.28 commissioner of finance shall transfer the remaining amount to 72.29 the commissioner of health to be added to the amount to be 72.30 distributed as rural hospital capital improvement grants for the 72.31 next fiscal year. 72.32 Subd. 3. [ENDOWMENT FUND NOT TO SUPPLANT EXISTING 72.33 FUNDS.] Appropriations from the fund must not be used as a 72.34 substitute for traditional sources of funding for health care 72.35 programs. Any local political subdivision of the state 72.36 receiving money under this section must ensure that existing 73.1 local financial efforts remain in place. 73.2 Subd. 4. [HEALTH CARE SAFETY NET ENDOWMENT FUND.] 73.3 If the health care safety net endowment fund created under 73.4 subdivision 1 is repealed, the commissioner of finance shall 73.5 transfer the principal and any remaining interest to the health 73.6 care access fund. 73.7 Sec. 7. Minnesota Statutes 2000, section 150A.10, is 73.8 amended by adding a subdivision to read: 73.9 Subd. 1a. [LIMITED AUTHORIZATION FOR DENTAL 73.10 HYGIENISTS.] (a) Notwithstanding subdivision 1, a dental 73.11 hygienist licensed under this chapter may be employed or 73.12 retained by a health care facility to perform dental hygiene 73.13 services described under paragraph (b) without the patient first 73.14 being examined by a licensed dentist if the dental hygienist: 73.15 (1) has two years practical clinical experience with a 73.16 licensed dentist within the preceding five years; and 73.17 (2) has entered into a collaborative agreement with a 73.18 licensed dentist that designates authorization for the services 73.19 provided by the dental hygienist. 73.20 (b) The dental hygiene services authorized to be performed 73.21 by a dental hygienist under this subdivision are limited to 73.22 removal of deposits and stains from the surfaces of the teeth, 73.23 application of topical preventive or prophylactic agents, 73.24 polishing and smoothing restorations, and performance of root 73.25 planing and soft-tissue curettage. The dental hygienist shall 73.26 not place pit and fissure sealants, unless the patient has been 73.27 recently examined and the treatment planned by a licensed 73.28 dentist. The dental hygienist shall not perform injections of 73.29 anesthetic agents or the administration of nitrous oxide unless 73.30 under the indirect supervision of a licensed dentist. The 73.31 performance of dental hygiene services in a health care facility 73.32 is limited to patients, students, and residents of the 73.33 facility. A dental hygienist must refer patients to a licensed 73.34 dentist for dental diagnosis, treatment planning, and dental 73.35 treatment. 73.36 (c) A collaborating dentist must be licensed under this 74.1 chapter and may enter into a collaborative agreement with more 74.2 than one dental hygienist. The collaborative agreement must be 74.3 maintained by the dentist and the dental hygienist and must be 74.4 made available to the board upon request. 74.5 (d) For the purposes of this subdivision, a "health care 74.6 facility" is limited to a hospital; nursing home; home health 74.7 agency; group home serving the elderly, disabled, or juveniles; 74.8 state-operated facility licensed by the commissioner of human 74.9 services or the commissioner of corrections; and federal, state, 74.10 or local public health facility, community clinic, or tribal 74.11 clinic. 74.12 (e) For purposes of this subdivision, "a collaborative 74.13 agreement" means an agreement with a licensed dentist who 74.14 authorizes and accepts responsibility for the services performed 74.15 by the dental hygienist. The services authorized under this 74.16 subdivision and the collaborative agreement may be performed 74.17 without the presence of a licensed dentist and may be performed 74.18 at a location other than the usual place of practice of the 74.19 dentist or dental hygienist and without a dentist's diagnosis 74.20 and treatment plan. 74.21 Sec. 8. Minnesota Statutes 2000, section 256.01, 74.22 subdivision 2, is amended to read: 74.23 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 74.24 section 241.021, subdivision 2, the commissioner of human 74.25 services shall: 74.26 (1) Administer and supervise all forms of public assistance 74.27 provided for by state law and other welfare activities or 74.28 services as are vested in the commissioner. Administration and 74.29 supervision of human services activities or services includes, 74.30 but is not limited to, assuring timely and accurate distribution 74.31 of benefits, completeness of service, and quality program 74.32 management. In addition to administering and supervising human 74.33 services activities vested by law in the department, the 74.34 commissioner shall have the authority to: 74.35 (a) require county agency participation in training and 74.36 technical assistance programs to promote compliance with 75.1 statutes, rules, federal laws, regulations, and policies 75.2 governing human services; 75.3 (b) monitor, on an ongoing basis, the performance of county 75.4 agencies in the operation and administration of human services, 75.5 enforce compliance with statutes, rules, federal laws, 75.6 regulations, and policies governing welfare services and promote 75.7 excellence of administration and program operation; 75.8 (c) develop a quality control program or other monitoring 75.9 program to review county performance and accuracy of benefit 75.10 determinations; 75.11 (d) require county agencies to make an adjustment to the 75.12 public assistance benefits issued to any individual consistent 75.13 with federal law and regulation and state law and rule and to 75.14 issue or recover benefits as appropriate; 75.15 (e) delay or deny payment of all or part of the state and 75.16 federal share of benefits and administrative reimbursement 75.17 according to the procedures set forth in section 256.017; 75.18 (f) make contracts with and grants to public and private 75.19 agencies and organizations, both profit and nonprofit, and 75.20 individuals, using appropriated funds; and 75.21 (g) enter into contractual agreements with federally 75.22 recognized Indian tribes with a reservation in Minnesota to the 75.23 extent necessary for the tribe to operate a federally approved 75.24 family assistance program or any other program under the 75.25 supervision of the commissioner. The commissioner shall consult 75.26 with the affected county or counties in the contractual 75.27 agreement negotiations, if the county or counties wish to be 75.28 included, in order to avoid the duplication of county and tribal 75.29 assistance program services. The commissioner may establish 75.30 necessary accounts for the purposes of receiving and disbursing 75.31 funds as necessary for the operation of the programs. 75.32 (2) Inform county agencies, on a timely basis, of changes 75.33 in statute, rule, federal law, regulation, and policy necessary 75.34 to county agency administration of the programs. 75.35 (3) Administer and supervise all child welfare activities; 75.36 promote the enforcement of laws protecting handicapped, 76.1 dependent, neglected and delinquent children, and children born 76.2 to mothers who were not married to the children's fathers at the 76.3 times of the conception nor at the births of the children; 76.4 license and supervise child-caring and child-placing agencies 76.5 and institutions; supervise the care of children in boarding and 76.6 foster homes or in private institutions; and generally perform 76.7 all functions relating to the field of child welfare now vested 76.8 in the state board of control. 76.9 (4) Administer and supervise all noninstitutional service 76.10 to handicapped persons, including those who are visually 76.11 impaired, hearing impaired, or physically impaired or otherwise 76.12 handicapped. The commissioner may provide and contract for the 76.13 care and treatment of qualified indigent children in facilities 76.14 other than those located and available at state hospitals when 76.15 it is not feasible to provide the service in state hospitals. 76.16 (5) Assist and actively cooperate with other departments, 76.17 agencies and institutions, local, state, and federal, by 76.18 performing services in conformity with the purposes of Laws 76.19 1939, chapter 431. 76.20 (6) Act as the agent of and cooperate with the federal 76.21 government in matters of mutual concern relative to and in 76.22 conformity with the provisions of Laws 1939, chapter 431, 76.23 including the administration of any federal funds granted to the 76.24 state to aid in the performance of any functions of the 76.25 commissioner as specified in Laws 1939, chapter 431, and 76.26 including the promulgation of rules making uniformly available 76.27 medical care benefits to all recipients of public assistance, at 76.28 such times as the federal government increases its participation 76.29 in assistance expenditures for medical care to recipients of 76.30 public assistance, the cost thereof to be borne in the same 76.31 proportion as are grants of aid to said recipients. 76.32 (7) Establish and maintain any administrative units 76.33 reasonably necessary for the performance of administrative 76.34 functions common to all divisions of the department. 76.35 (8) Act as designated guardian of both the estate and the 76.36 person of all the wards of the state of Minnesota, whether by 77.1 operation of law or by an order of court, without any further 77.2 act or proceeding whatever, except as to persons committed as 77.3 mentally retarded. For children under the guardianship of the 77.4 commissioner whose interests would be best served by adoptive 77.5 placement, the commissioner may contract with a licensed 77.6 child-placing agency to provide adoption services. A contract 77.7 with a licensed child-placing agency must be designed to 77.8 supplement existing county efforts and may not replace existing 77.9 county programs, unless the replacement is agreed to by the 77.10 county board and the appropriate exclusive bargaining 77.11 representative or the commissioner has evidence that child 77.12 placements of the county continue to be substantially below that 77.13 of other counties. Funds encumbered and obligated under an 77.14 agreement for a specific child shall remain available until the 77.15 terms of the agreement are fulfilled or the agreement is 77.16 terminated. 77.17 (9) Act as coordinating referral and informational center 77.18 on requests for service for newly arrived immigrants coming to 77.19 Minnesota. 77.20 (10) The specific enumeration of powers and duties as 77.21 hereinabove set forth shall in no way be construed to be a 77.22 limitation upon the general transfer of powers herein contained. 77.23 (11) Establish county, regional, or statewide schedules of 77.24 maximum fees and charges which may be paid by county agencies 77.25 for medical, dental, surgical, hospital, nursing and nursing 77.26 home care and medicine and medical supplies under all programs 77.27 of medical care provided by the state and for congregate living 77.28 care under the income maintenance programs. 77.29 (12) Have the authority to conduct and administer 77.30 experimental projects to test methods and procedures of 77.31 administering assistance and services to recipients or potential 77.32 recipients of public welfare. To carry out such experimental 77.33 projects, it is further provided that the commissioner of human 77.34 services is authorized to waive the enforcement of existing 77.35 specific statutory program requirements, rules, and standards in 77.36 one or more counties. The order establishing the waiver shall 78.1 provide alternative methods and procedures of administration, 78.2 shall not be in conflict with the basic purposes, coverage, or 78.3 benefits provided by law, and in no event shall the duration of 78.4 a project exceed four years. It is further provided that no 78.5 order establishing an experimental project as authorized by the 78.6 provisions of this section shall become effective until the 78.7 following conditions have been met: 78.8 (a) The secretary of health and human services of the 78.9 United States has agreed, for the same project, to waive state 78.10 plan requirements relative to statewide uniformity. 78.11 (b) A comprehensive plan, including estimated project 78.12 costs, shall be approved by the legislative advisory commission 78.13 and filed with the commissioner of administration. 78.14 (13) According to federal requirements, establish 78.15 procedures to be followed by local welfare boards in creating 78.16 citizen advisory committees, including procedures for selection 78.17 of committee members. 78.18 (14) Allocate federal fiscal disallowances or sanctions 78.19 which are based on quality control error rates for the aid to 78.20 families with dependent children program formerly codified in 78.21 sections 256.72 to 256.87, medical assistance, or food stamp 78.22 program in the following manner: 78.23 (a) One-half of the total amount of the disallowance shall 78.24 be borne by the county boards responsible for administering the 78.25 programs. For the medical assistance and the AFDC program 78.26 formerly codified in sections 256.72 to 256.87, disallowances 78.27 shall be shared by each county board in the same proportion as 78.28 that county's expenditures for the sanctioned program are to the 78.29 total of all counties' expenditures for the AFDC program 78.30 formerly codified in sections 256.72 to 256.87, and medical 78.31 assistance programs. For the food stamp program, sanctions 78.32 shall be shared by each county board, with 50 percent of the 78.33 sanction being distributed to each county in the same proportion 78.34 as that county's administrative costs for food stamps are to the 78.35 total of all food stamp administrative costs for all counties, 78.36 and 50 percent of the sanctions being distributed to each county 79.1 in the same proportion as that county's value of food stamp 79.2 benefits issued are to the total of all benefits issued for all 79.3 counties. Each county shall pay its share of the disallowance 79.4 to the state of Minnesota. When a county fails to pay the 79.5 amount due hereunder, the commissioner may deduct the amount 79.6 from reimbursement otherwise due the county, or the attorney 79.7 general, upon the request of the commissioner, may institute 79.8 civil action to recover the amount due. 79.9 (b) Notwithstanding the provisions of paragraph (a), if the 79.10 disallowance results from knowing noncompliance by one or more 79.11 counties with a specific program instruction, and that knowing 79.12 noncompliance is a matter of official county board record, the 79.13 commissioner may require payment or recover from the county or 79.14 counties, in the manner prescribed in paragraph (a), an amount 79.15 equal to the portion of the total disallowance which resulted 79.16 from the noncompliance, and may distribute the balance of the 79.17 disallowance according to paragraph (a). 79.18 (15) Develop and implement special projects that maximize 79.19 reimbursements and result in the recovery of money to the 79.20 state. For the purpose of recovering state money, the 79.21 commissioner may enter into contracts with third parties. Any 79.22 recoveries that result from projects or contracts entered into 79.23 under this paragraph shall be deposited in the state treasury 79.24 and credited to a special account until the balance in the 79.25 account reaches $1,000,000. When the balance in the account 79.26 exceeds $1,000,000, the excess shall be transferred and credited 79.27 to the general fund. All money in the account is appropriated 79.28 to the commissioner for the purposes of this paragraph. 79.29 (16) Have the authority to make direct payments to 79.30 facilities providing shelter to women and their children 79.31 according to section 256D.05, subdivision 3. Upon the written 79.32 request of a shelter facility that has been denied payments 79.33 under section 256D.05, subdivision 3, the commissioner shall 79.34 review all relevant evidence and make a determination within 30 79.35 days of the request for review regarding issuance of direct 79.36 payments to the shelter facility. Failure to act within 30 days 80.1 shall be considered a determination not to issue direct payments. 80.2 (17) Have the authority to establish and enforce the 80.3 following county reporting requirements: 80.4 (a) The commissioner shall establish fiscal and statistical 80.5 reporting requirements necessary to account for the expenditure 80.6 of funds allocated to counties for human services programs. 80.7 When establishing financial and statistical reporting 80.8 requirements, the commissioner shall evaluate all reports, in 80.9 consultation with the counties, to determine if the reports can 80.10 be simplified or the number of reports can be reduced. 80.11 (b) The county board shall submit monthly or quarterly 80.12 reports to the department as required by the commissioner. 80.13 Monthly reports are due no later than 15 working days after the 80.14 end of the month. Quarterly reports are due no later than 30 80.15 calendar days after the end of the quarter, unless the 80.16 commissioner determines that the deadline must be shortened to 80.17 20 calendar days to avoid jeopardizing compliance with federal 80.18 deadlines or risking a loss of federal funding. Only reports 80.19 that are complete, legible, and in the required format shall be 80.20 accepted by the commissioner. 80.21 (c) If the required reports are not received by the 80.22 deadlines established in clause (b), the commissioner may delay 80.23 payments and withhold funds from the county board until the next 80.24 reporting period. When the report is needed to account for the 80.25 use of federal funds and the late report results in a reduction 80.26 in federal funding, the commissioner shall withhold from the 80.27 county boards with late reports an amount equal to the reduction 80.28 in federal funding until full federal funding is received. 80.29 (d) A county board that submits reports that are late, 80.30 illegible, incomplete, or not in the required format for two out 80.31 of three consecutive reporting periods is considered 80.32 noncompliant. When a county board is found to be noncompliant, 80.33 the commissioner shall notify the county board of the reason the 80.34 county board is considered noncompliant and request that the 80.35 county board develop a corrective action plan stating how the 80.36 county board plans to correct the problem. The corrective 81.1 action plan must be submitted to the commissioner within 45 days 81.2 after the date the county board received notice of noncompliance. 81.3 (e) The final deadline for fiscal reports or amendments to 81.4 fiscal reports is one year after the date the report was 81.5 originally due. If the commissioner does not receive a report 81.6 by the final deadline, the county board forfeits the funding 81.7 associated with the report for that reporting period and the 81.8 county board must repay any funds associated with the report 81.9 received for that reporting period. 81.10 (f) The commissioner may not delay payments, withhold 81.11 funds, or require repayment under paragraph (c) or (e) if the 81.12 county demonstrates that the commissioner failed to provide 81.13 appropriate forms, guidelines, and technical assistance to 81.14 enable the county to comply with the requirements. If the 81.15 county board disagrees with an action taken by the commissioner 81.16 under paragraph (c) or (e), the county board may appeal the 81.17 action according to sections 14.57 to 14.69. 81.18 (g) Counties subject to withholding of funds under 81.19 paragraph (c) or forfeiture or repayment of funds under 81.20 paragraph (e) shall not reduce or withhold benefits or services 81.21 to clients to cover costs incurred due to actions taken by the 81.22 commissioner under paragraph (c) or (e). 81.23 (18) Allocate federal fiscal disallowances or sanctions for 81.24 audit exceptions when federal fiscal disallowances or sanctions 81.25 are based on a statewide random sample for the foster care 81.26 program under title IV-E of the Social Security Act, United 81.27 States Code, title 42, in direct proportion to each county's 81.28 title IV-E foster care maintenance claim for that period. 81.29 (19) Be responsible for ensuring the detection, prevention, 81.30 investigation, and resolution of fraudulent activities or 81.31 behavior by applicants, recipients, and other participants in 81.32 the human services programs administered by the department. 81.33 (20) Require county agencies to identify overpayments, 81.34 establish claims, and utilize all available and cost-beneficial 81.35 methodologies to collect and recover these overpayments in the 81.36 human services programs administered by the department. 82.1 (21) Have the authority to administer a drug rebate program 82.2 for drugs purchased pursuant to the prescription drug program 82.3 established under section 256.955 after the beneficiary's 82.4 satisfaction of any deductible established in the program. The 82.5 commissioner shall require a rebate agreement from all 82.6 manufacturers of covered drugs as defined in section 256B.0625, 82.7 subdivision 13. Rebate agreements for prescription drugs 82.8 delivered on or after July 1, 2002, must include rebates for 82.9 individuals covered under the prescription drug program who are 82.10 under 65 years of age. For each drug, the amount of the rebate 82.11 shall be equal to the basic rebate as defined for purposes of 82.12 the federal rebate program in United States Code, title 42, 82.13 section 1396r-8(c)(1). This basic rebate shall be applied to 82.14 single-source and multiple-source drugs. The manufacturers must 82.15 provide full payment within 30 days of receipt of the state 82.16 invoice for the rebate within the terms and conditions used for 82.17 the federal rebate program established pursuant to section 1927 82.18 of title XIX of the Social Security Act. The manufacturers must 82.19 provide the commissioner with any information necessary to 82.20 verify the rebate determined per drug. The rebate program shall 82.21 utilize the terms and conditions used for the federal rebate 82.22 program established pursuant to section 1927 of title XIX of the 82.23 Social Security Act. 82.24 (22) Have the authority to administer the federal drug 82.25 rebate program for drugs purchased under the medical assistance 82.26 program as allowed by section 1927 of title XIX of the Social 82.27 Security Act and according to the terms and conditions of 82.28 section 1927. Rebates shall be collected for all drugs that 82.29 have been dispensed or administered in an outpatient setting and 82.30 that are from manufacturers who have signed a rebate agreement 82.31 with the United States Department of Health and Human Services. 82.32(22)(23) Operate the department's communication systems 82.33 account established in Laws 1993, First Special Session chapter 82.34 1, article 1, section 2, subdivision 2, to manage shared 82.35 communication costs necessary for the operation of the programs 82.36 the commissioner supervises. A communications account may also 83.1 be established for each regional treatment center which operates 83.2 communications systems. Each account must be used to manage 83.3 shared communication costs necessary for the operations of the 83.4 programs the commissioner supervises. The commissioner may 83.5 distribute the costs of operating and maintaining communication 83.6 systems to participants in a manner that reflects actual usage. 83.7 Costs may include acquisition, licensing, insurance, 83.8 maintenance, repair, staff time and other costs as determined by 83.9 the commissioner. Nonprofit organizations and state, county, 83.10 and local government agencies involved in the operation of 83.11 programs the commissioner supervises may participate in the use 83.12 of the department's communications technology and share in the 83.13 cost of operation. The commissioner may accept on behalf of the 83.14 state any gift, bequest, devise or personal property of any 83.15 kind, or money tendered to the state for any lawful purpose 83.16 pertaining to the communication activities of the department. 83.17 Any money received for this purpose must be deposited in the 83.18 department's communication systems accounts. Money collected by 83.19 the commissioner for the use of communication systems must be 83.20 deposited in the state communication systems account and is 83.21 appropriated to the commissioner for purposes of this section. 83.22(23)(24) Receive any federal matching money that is made 83.23 available through the medical assistance program for the 83.24 consumer satisfaction survey. Any federal money received for 83.25 the survey is appropriated to the commissioner for this 83.26 purpose. The commissioner may expend the federal money received 83.27 for the consumer satisfaction survey in either year of the 83.28 biennium. 83.29(24)(25) Incorporate cost reimbursement claims from First 83.30 Call Minnesota and Greater Twin Cities United Way into the 83.31 federal cost reimbursement claiming processes of the department 83.32 according to federal law, rule, and regulations. Any 83.33 reimbursement received is appropriated to the commissioner and 83.34 shall be disbursed to First Call Minnesota and Greater Twin 83.35 Cities United Way according to normal department payment 83.36 schedules. 84.1(25)(26) Develop recommended standards for foster care 84.2 homes that address the components of specialized therapeutic 84.3 services to be provided by foster care homes with those services. 84.4 Sec. 9. [256.952] [CHILDREN'S HEALTH CARE ENDOWMENT FUND.] 84.5 Subdivision 1. [CREATION.] The children's health care 84.6 endowment fund is created in the state treasury. The state 84.7 board of investment shall invest the fund under section 11A.24. 84.8 All earnings of the fund must be credited to the fund. The 84.9 principal of the fund must be maintained inviolate, except that 84.10 the principal may be used to make expenditures from the fund for 84.11 the purposes specified in this section. 84.12 Subd. 2. [EXPENDITURES.] (a) For fiscal year 2003, up to 84.13 five percent of the average of the fair market values of the 84.14 fund for the preceding six months is appropriated to the 84.15 commissioner of human services to provide coverage for 84.16 low-income children in the MinnesotaCare program. 84.17 (b) For fiscal year 2004 and each year thereafter, up to 84.18 five percent of the average of the fair market values of the 84.19 fund for the preceding 12 months is appropriated to the 84.20 commissioner of human services to provide coverage for 84.21 low-income children in the MinnesotaCare program. 84.22 Sec. 10. Minnesota Statutes 2000, section 256.955, 84.23 subdivision 2, is amended to read: 84.24 Subd. 2. [DEFINITIONS.] (a) For purposes of this section, 84.25 the following definitions apply. 84.26 (b) "Health plan" has the meaning provided in section 84.27 62Q.01, subdivision 3. 84.28 (c) "Health plan company" has the meaning provided in 84.29 section 62Q.01, subdivision 4. 84.30 (d) "Qualified individual" means an individual who meets 84.31 the requirements described in subdivision 2aor 2b, and: 84.32 (1) who is not determined eligible for medical assistance 84.33 according to section 256B.0575, who is not determined eligible 84.34 for medical assistance or general assistance medical care 84.35 without a spenddown, or who is not enrolled in MinnesotaCare; 84.36 (2) is not enrolled in prescription drug coverage under a 85.1 health plan; 85.2 (3) is not enrolled in prescription drug coverage under a 85.3 Medicare supplement plan, as defined in sections 62A.31 to 85.4 62A.44, or policies, contracts, or certificates that supplement 85.5 Medicare issued by health maintenance organizations or those 85.6 policies, contracts, or certificates governed by section 1833 or 85.7 1876 of the federal Social Security Act, United States Code, 85.8 title 42, section 1395, et seq., as amended; 85.9 (4) has not had coverage described in clauses (2) and (3) 85.10 for at least four months prior to application for the program; 85.11 and 85.12 (5) is a permanent resident of Minnesota as defined in 85.13 section 256L.09. 85.14 (e) For purposes of clauses (2) and (3), prescription drug 85.15 coverage does not include: 85.16 (1) a Medicare risk product that provides prescription drug 85.17 coverage of less than $450 per year; or 85.18 (2) a Medicare cost product that provides prescription drug 85.19 coverage that provides a maximum benefit on brand name drugs of 85.20 nor more than $500 per year. 85.21 [EFFECTIVE DATE.] This section is effective January 1, 2002. 85.22 Sec. 11. Minnesota Statutes 2000, section 256.955, 85.23 subdivision 2a, is amended to read: 85.24 Subd. 2a. [ELIGIBILITY.] An individual satisfying the 85.25 following requirements and the requirements described in 85.26 subdivision 2, paragraph (d), is eligible for the prescription 85.27 drug program: 85.28 (1) isat least 65 years of age or older; and85.29(2) is eligible asaqualifiedMedicarebeneficiary85.30according to section 256B.057, subdivision 3 or 3a, or is85.31eligible under section 256B.057, subdivision 3 or 3a, and is85.32also eligible for medical assistance or general assistance85.33medical care with a spenddown as defined in section 256B.056,85.34subdivision 5enrollee whose assets are no more than $10,000 for 85.35 a single individual and $18,000 for a married couple or family 85.36 of two or more, using the asset methodology for aged, blind, or 86.1 disabled individuals specified in section 256B.056, subdivision 86.2 1a; and 86.3 (2) has a household income that does not exceed 150 percent 86.4 of the federal poverty guidelines, using the income methodology 86.5 for aged, blind, or disabled individuals specified in section 86.6 256B.056, subdivision 1a. 86.7 [EFFECTIVE DATE.] This section is effective January 1, 2002. 86.8 Sec. 12. Minnesota Statutes 2000, section 256.955, 86.9 subdivision 7, is amended to read: 86.10 Subd. 7. [COST SHARING.] Program enrollees must satisfy 86.11 a$420 annualmonthly deductible, based upon expenditures for 86.12 prescription drugs, to be paid in $35 monthly increments. The 86.13 monthly deductible must be calculated by the commissioner based 86.14 upon the household income of the enrollee expressed as a 86.15 percentage of the federal poverty guidelines, using the 86.16 following sliding scale: 86.17 Household Income Monthly Deductible 86.18 of Enrollee 86.19 not more than 120 percent $35 86.20 more than 120 percent 86.21 but not more than 125 percent $43 86.22 more than 125 percent 86.23 but not more than 130 percent $52 86.24 more than 130 percent 86.25 but not more than 135 percent $60 86.26 more than 135 percent 86.27 but not more than 140 percent $68 86.28 more than 140 percent 86.29 but not more than 145 percent $77 86.30 more than 145 percent 86.31 but not more than 150 percent $85 86.32 [EFFECTIVE DATE.] This section is effective January 1, 2002. 86.33 Sec. 13. Minnesota Statutes 2000, section 256.955, is 86.34 amended by adding a subdivision to read: 86.35 Subd. 10. [DEDICATED ACCOUNT.] (a) The Minnesota 86.36 prescription drug dedicated account is established in the state 87.1 treasury. The commissioner of finance shall credit to the 87.2 account all rebates paid under section 256.01, subdivision 1, 87.3 clause (21), any appropriations designated for the prescription 87.4 drug program and any federal funds received by the state to 87.5 implement a senior prescription drug program. The commissioner 87.6 of finance shall ensure that account money is invested under 87.7 section 11A.25. All money earned by the account must be 87.8 credited to the account. 87.9 (b) Money in the account is appropriated to the 87.10 commissioner of human services for the prescription drug program. 87.11 [EFFECTIVE DATE.] This section is effective July 1, 2001. 87.12 Sec. 14. [256.956] [PURCHASING ALLIANCE STOP-LOSS FUND.] 87.13 Subdivision 1. [DEFINITIONS.] For purposes of this 87.14 section, the following definitions apply: 87.15 (a) "Commissioner" means the commissioner of human services. 87.16 (b) "Health plan" means a policy, contract, or certificate 87.17 issued by a health plan company to a qualifying purchasing 87.18 alliance. Any health plan issued to the members of a qualifying 87.19 purchasing alliance must meet the requirements of chapter 62L. 87.20 (c) "Health plan company" means: 87.21 (1) a health carrier as defined under section 62A.011, 87.22 subdivision 2; 87.23 (2) a community integrated service network operating under 87.24 chapter 62N; or 87.25 (3) an accountable provider network operating under chapter 87.26 62T. 87.27 (d) "Qualifying employer" means an employer who: 87.28 (1) is a member of a qualifying purchasing alliance; 87.29 (2) has at least one employee but no more than ten 87.30 employees or is a sole proprietor or farmer; 87.31 (3) did not offer employer-subsidized health care coverage 87.32 to its employees for at least 12 months prior to joining the 87.33 purchasing alliance; and 87.34 (4) is offering health coverage through the purchasing 87.35 alliance to all employees who work at least 20 hours per week 87.36 unless the employee is eligible for Medicare. 88.1 For purposes of this subdivision, "employer-subsidized health 88.2 coverage" means health coverage for which the employer pays at 88.3 least 50 percent of the cost of coverage for the employee. 88.4 (e) "Qualifying enrollee" means an employee of a qualifying 88.5 employer or the employee's dependent covered by a health plan. 88.6 (f) "Qualifying purchasing alliance" means a purchasing 88.7 alliance as defined in section 62T.01, subdivision 2, that: 88.8 (1) meets the requirements of chapter 62T; 88.9 (2) services a geographic area located in outstate 88.10 Minnesota, excluding the city of Duluth; and 88.11 (3) is organized and operating before May 1, 2001. 88.12 The criteria used by the qualifying purchasing alliance for 88.13 membership must be approved by the commissioner of health. A 88.14 qualifying purchasing alliance may begin enrolling qualifying 88.15 employers after July 1, 2001, with enrollment ending by December 88.16 31, 2003. 88.17 Subd. 2. [CREATION OF ACCOUNT.] A purchasing alliance 88.18 stop-loss fund account is established in the general fund. The 88.19 commissioner shall use the money to establish a stop-loss fund 88.20 from which a health plan company may receive reimbursement for 88.21 claims paid for qualifying enrollees. The account consists of 88.22 money appropriated by the legislature. Money from the account 88.23 must be used for the stop-loss fund. 88.24 Subd. 3. [REIMBURSEMENT.] (a) A health plan company may 88.25 receive reimbursement from the fund for 90 percent of the 88.26 portion of the claim that exceeds $30,000 but not of the portion 88.27 that exceeds $100,000 in a calendar year for a qualifying 88.28 enrollee. 88.29 (b) Claims shall be reported and funds shall be distributed 88.30 on a calendar-year basis. Claims shall be eligible for 88.31 reimbursement only for the calendar year in which the claims 88.32 were paid. 88.33 (c) Once claims paid on behalf of a qualifying enrollee 88.34 reach $100,000 in a given calendar year, no further claims may 88.35 be submitted for reimbursement on behalf of that enrollee in 88.36 that calendar year. 89.1 Subd. 4. [REQUEST PROCESS.] (a) Each health plan company 89.2 must submit a request for reimbursement from the fund on a form 89.3 prescribed by the commissioner. Requests for payment must be 89.4 submitted no later than April 1 following the end of the 89.5 calendar year for which the reimbursement request is being made, 89.6 beginning April 1, 2002. 89.7 (b) The commissioner may require a health plan company to 89.8 submit claims data as needed in connection with the 89.9 reimbursement request. 89.10 Subd. 5. [DISTRIBUTION.] (a) The commissioner shall 89.11 calculate the total claims reimbursement amount for all 89.12 qualifying health plan companies for the calendar year for which 89.13 claims are being reported and shall distribute the stop-loss 89.14 funds on an annual basis. 89.15 (b) In the event that the total amount requested for 89.16 reimbursement by the health plan companies for a calendar year 89.17 exceeds the funds available for distribution for claims paid by 89.18 all health plan companies during the same calendar year, the 89.19 commissioner shall provide for the pro rata distribution of the 89.20 available funds. Each health plan company shall be eligible to 89.21 receive only a proportionate amount of the available funds as 89.22 the health plan company's total eligible claims paid compares to 89.23 the total eligible claims paid by all health plan companies. 89.24 (c) In the event that funds available for distribution for 89.25 claims paid by all health plan companies during a calendar year 89.26 exceed the total amount requested for reimbursement by all 89.27 health plan companies during the same calendar year, any excess 89.28 funds shall be reallocated for distribution in the next calendar 89.29 year. 89.30 Subd. 6. [DATA.] Upon the request of the commissioner, 89.31 each health plan company shall furnish such data as the 89.32 commissioner deems necessary to administer the fund. The 89.33 commissioner may require that such data be submitted on a per 89.34 enrollee, aggregate, or categorical basis. Any data submitted 89.35 under this section shall be classified as private data or 89.36 nonpublic data as defined in section 13.02. 90.1 Subd. 7. [DELEGATION.] The commissioner may delegate any 90.2 or all of the commissioner's administrative duties to another 90.3 state agency or to a private contractor. 90.4 Subd. 8. [REPORT.] The commissioner of commerce, in 90.5 consultation with the office of rural health and the qualifying 90.6 purchasing alliances, shall evaluate the extent to which the 90.7 purchasing alliance stop-loss fund increases the availability of 90.8 employer-subsidized health care coverage for residents residing 90.9 in the geographic areas served by the qualifying purchasing 90.10 alliances. A preliminary report must be submitted to the 90.11 legislature by February 15, 2003, and a final report must be 90.12 submitted by February 15, 2004. 90.13 Subd. 9. [SUNSET.] This section shall expire January 1, 90.14 2005. 90.15 Sec. 15. [256.958] [RETIRED DENTIST PROGRAM.] 90.16 Subdivision 1. [PROGRAM.] The commissioner of human 90.17 services shall establish a program to reimburse a retired 90.18 dentist for the dentist's license fee and for the reasonable 90.19 cost of malpractice insurance compared to other dentists in the 90.20 community in exchange for the dentist providing 100 hours of 90.21 dental services on a volunteer basis within a 12-month period at 90.22 a community dental clinic or a dental training clinic located at 90.23 a Minnesota state college or university. 90.24 Subd. 2. [DOCUMENTATION.] Upon completion of the required 90.25 hours, the retired dentist shall submit to the commissioner the 90.26 following: 90.27 (1) documentation of the service provided; 90.28 (2) the cost of malpractice insurance for the 12-month 90.29 period; and 90.30 (3) the cost of the license. 90.31 Subd. 3. [REIMBURSEMENT.] Upon receipt of the information 90.32 described in subdivision 2, the commissioner shall provide 90.33 reimbursement to the retired dentist for the cost of malpractice 90.34 insurance for the previous 12-month period and the cost of the 90.35 license. 90.36 Sec. 16. [256.959] [DENTAL PRACTICE DONATION PROGRAM.] 91.1 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 91.2 services shall establish a dental practice donation program that 91.3 coordinates the donation of a qualifying dental practice to a 91.4 qualified charitable organization and assists in locating a 91.5 dentist licensed under chapter 150A who wishes to maintain the 91.6 dental practice. 91.7 Subd. 2. [QUALIFYING DENTAL PRACTICE.] To qualify for the 91.8 dental practice donation program, a dental practice must meet 91.9 the following requirements: 91.10 (1) the dental practice must be owned by the donating 91.11 dentist; 91.12 (2) the dental practice must be located in a designated 91.13 underserved area of the state as defined by the commissioner; 91.14 and 91.15 (3) the practice must be equipped with the basic dental 91.16 equipment necessary to maintain a dental practice as determined 91.17 by the commissioner. 91.18 Subd. 3. [COORDINATION.] The commissioner shall establish 91.19 a procedure for dentists to donate their dental practices to a 91.20 qualified charitable organization. The commissioner shall 91.21 authorize a practice for donation only if it meets the 91.22 requirements of subdivision 2 and there is a licensed dentist 91.23 who is interested in entering into an agreement as described in 91.24 subdivision 4. Upon donation of the practice, the commissioner 91.25 shall provide the donating dentist with a statement verifying 91.26 that a donation of the practice was made to a qualifying 91.27 charitable organization for purposes of state and federal income 91.28 tax returns. 91.29 Subd. 4. [DONATED DENTAL PRACTICE AGREEMENT.] (a) A 91.30 dentist accepting the donated practice must enter into an 91.31 agreement with the qualified charitable organization to maintain 91.32 the dental practice for a minimum of five years at the donated 91.33 practice site and to provide services to underserved populations 91.34 up to a preagreed percentage of patients served. 91.35 (b) The agreement must include the terms for the recovery 91.36 of the donated dental practice if the dentist accepting the 92.1 practice does not fulfill the service commitment required under 92.2 this subdivision. 92.3 (c) Any costs associated with operating the dental practice 92.4 during the service commitment time period are the financial 92.5 responsibility of the dentist accepting the practice. 92.6 Sec. 17. Minnesota Statutes 2000, section 256.9657, 92.7 subdivision 2, is amended to read: 92.8 Subd. 2. [HOSPITAL SURCHARGE.] (a) Effective October 1, 92.9 1992, each Minnesota hospital except facilities of the federal 92.10 Indian Health Service and regional treatment centers shall pay 92.11 to the medical assistance account a surcharge equal to 1.4 92.12 percent of net patient revenues excluding net Medicare revenues 92.13 reported by that provider to the health care cost information 92.14 system according to the schedule in subdivision 4. 92.15 (b) Effective July 1, 1994, the surcharge under paragraph 92.16 (a) is increased to 1.56 percent. 92.17 (c) Notwithstanding the Medicare cost finding and allowable 92.18 cost principles, the hospital surcharge is not an allowable cost 92.19 for purposes of rate setting under sections 256.9685 to 256.9695. 92.20 Sec. 18. Minnesota Statutes 2000, section 256.969, is 92.21 amended by adding a subdivision to read: 92.22 Subd. 26. [GREATER MINNESOTA PAYMENT ADJUSTMENT AFTER JUNE 92.23 30, 2001.] (a) For admissions occurring after June 30, 2001, the 92.24 commissioner shall pay fee-for-service inpatient admissions for 92.25 the diagnosis-related groups specified in paragraph (b) at 92.26 hospitals located outside of the seven-county metropolitan area 92.27 at the higher of: 92.28 (1) the hospital's current payment rate for the diagnostic 92.29 category to which the diagnosis-related group belongs, exclusive 92.30 of disproportionate population adjustments received under 92.31 subdivision 9 and hospital payment adjustments received under 92.32 subdivision 23; or 92.33 (2) 90 percent of the average payment rate for that 92.34 diagnostic category for hospitals located within the 92.35 seven-county metropolitan area, exclusive of disproportionate 92.36 population adjustments received under subdivision 9 and hospital 93.1 payment adjustments received under subdivisions 20 and 23. 93.2 (b) The payment increases provided in paragraph (a) apply 93.3 to the following diagnosis-related groups, as they fall within 93.4 the diagnostic categories: 93.5 (1) 370 cesarean section with complicating diagnosis; 93.6 (2) 371 cesarean section without complicating diagnosis; 93.7 (3) 372 vaginal delivery with complicating diagnosis; 93.8 (4) 373 vaginal delivery without complicating diagnosis; 93.9 (5) 386 extreme immaturity and respiratory distress 93.10 syndrome, neonate; 93.11 (6) 388 full-term neonates with other problems; 93.12 (7) 390 prematurity without major problems; 93.13 (8) 391 normal newborn; 93.14 (9) 385 neonate, died or transferred to another acute care 93.15 facility; 93.16 (10) 425 acute adjustment reaction and psychosocial 93.17 dysfunction; 93.18 (11) 430 psychoses; 93.19 (12) 431 childhood mental disorders; and 93.20 (13) 164-167 appendectomy. 93.21 Sec. 19. Minnesota Statutes 2000, section 256B.02, 93.22 subdivision 7, is amended to read: 93.23 Subd. 7. "Vendor of medical care" means any person or 93.24 persons furnishing, within the scope of the vendor's respective 93.25 license, any or all of the following goods or services: 93.26 medical, surgical, hospital, optical, visual, dental and nursing 93.27 services; drugs and medical supplies; appliances; laboratory, 93.28 diagnostic, and therapeutic services; nursing home and 93.29 convalescent care; screening and health assessment services 93.30 provided by public health nurses as defined in section 145A.02, 93.31 subdivision 18; health care services provided at the residence 93.32 of the patient if the services are performed by a public health 93.33 nurse and the nurse indicates in a statement submitted under 93.34 oath that the services were actually provided; oral language 93.35 interpreter services for persons of limited English proficiency 93.36 when necessary to access health care; and such other medical 94.1 services or supplies provided or prescribed by persons 94.2 authorized by state law to give such services and supplies. The 94.3 term includes, but is not limited to, directors and officers of 94.4 corporations or members of partnerships who, either individually 94.5 or jointly with another or others, have the legal control, 94.6 supervision, or responsibility of submitting claims for 94.7 reimbursement to the medical assistance program. The term only 94.8 includes directors and officers of corporations who personally 94.9 receive a portion of the distributed assets upon liquidation or 94.10 dissolution, and their liability is limited to the portion of 94.11 the claim that bears the same proportion to the total claim as 94.12 their share of the distributed assets bears to the total 94.13 distributed assets. 94.14 Sec. 20. Minnesota Statutes 2000, section 256B.04, is 94.15 amended by adding a subdivision to read: 94.16 Subd. 1b. [ADMINISTRATIVE SERVICES.] Notwithstanding 94.17 subdivision 1, the commissioner may contract with federally 94.18 recognized Indian tribes with a reservation in Minnesota for the 94.19 provision of early and periodic screening, diagnosis, and 94.20 treatment administrative services for American Indian children, 94.21 in accordance with the Code of Federal Regulations, title 42, 94.22 section 441, subpart B, and Minnesota Rules, part 9505.1693, 94.23 when the tribe chooses to provide such services. For purposes 94.24 of this subdivision, "American Indian" has the meaning given to 94.25 persons to whom services will be provided in the Code of Federal 94.26 Regulations, title 42, section 36.12. Notwithstanding Minnesota 94.27 Rules, part 9505.1748, subpart 1, the commissioner, the local 94.28 agency, and the tribe may contract with any entity for the 94.29 provision of early and periodic screening, diagnosis, and 94.30 treatment administrative services. 94.31 Sec. 21. Minnesota Statutes 2000, section 256B.055, 94.32 subdivision 3a, is amended to read: 94.33 Subd. 3a. [MFIP-S FAMILIES;FAMILIES ELIGIBLE UNDER PRIOR 94.34 AFDC RULES.] (a)Beginning January 1, 1998, or on the date that94.35MFIP-S is implemented in counties, medical assistance may be94.36paid for a person receiving public assistance under the MFIP-S95.1program.Beginning July 1, 2002, medical assistance may be paid 95.2 for a person who would have been eligible, but for excess income 95.3 or assets, under the state's AFDC plan in effect as of July 16, 95.4 1996, with the base AFDC standard increased according to section 95.5 256B.056, subdivision 4. 95.6 (b) BeginningJanuary 1, 1998,July 1, 2002, medical 95.7 assistance may be paid for a person who would have been eligible 95.8 for public assistance under the income andresourceassets 95.9 standards, or who would have been eligible but for excess income95.10or assets,under the state's AFDC plan in effect as of July 16, 95.11 1996,as required by the Personal Responsibility and Work95.12Opportunity Reconciliation Act of 1996 (PRWORA), Public Law95.13Number 104-193with the base AFDC rate increased according to 95.14 section 256B.056, subdivision 4. 95.15 [EFFECTIVE DATE.] This section is effective July 1, 2002. 95.16 Sec. 22. Minnesota Statutes 2000, section 256B.056, 95.17 subdivision 1a, is amended to read: 95.18 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 95.19 specifically required by state law or rule or federal law or 95.20 regulation, the methodologies used in counting income and assets 95.21 to determine eligibility for medical assistance for persons 95.22 whose eligibility category is based on blindness, disability, or 95.23 age of 65 or more years, the methodologies for the supplemental 95.24 security income program shall be used. For children eligible 95.25 for home and community-based waiver services whose eligibility 95.26 for medical assistance is determined without regard to parental 95.27 income, or for children eligible under section 256B.055, 95.28 subdivision 12, child support payments, including any payments 95.29 made by an obligor in satisfaction of or in addition to a 95.30 temporary or permanent order for child support, and social 95.31 security payments, are not counted as income. For families and 95.32 children, which includes all other eligibility categories, the 95.33 methodologies under the state's AFDC plan in effect as of July 95.34 16, 1996, as required by the Personal Responsibility and Work 95.35 Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 95.36 Number 104-193, shall be used. Effective upon federal approval, 96.1 in-kind contributions to, and payments made on behalf of, a 96.2 recipient, by an obligor, in satisfaction of or in addition to a 96.3 temporary or permanent order for child support or maintenance, 96.4 shall be considered income to the recipient. For these 96.5 purposes, a "methodology" does not include an asset or income 96.6 standard, or accounting method, or method of determining 96.7 effective dates. 96.8 [EFFECTIVE DATE.] This section is effective July 1, 2001, 96.9 or the date upon which federal rules published in the Federal 96.10 Register at 66FR2316 become effective, whichever is later. 96.11 Sec. 23. Minnesota Statutes 2000, section 256B.056, 96.12 subdivision 4, is amended to read: 96.13 Subd. 4. [INCOME.] To be eligible for medical assistance, 96.14 a person eligible under section 256B.055, subdivision 7, not 96.15 receiving supplemental security income program payments, and 96.16 families and children may have an income up to 133-1/3 percent 96.17 of the AFDC income standard in effect under the July 16, 1996, 96.18 AFDC state plan. Effective July 1, 2000, the base AFDC standard 96.19 in effect on July 16, 1996, shall be increased by three percent. 96.20 Effective July 1, 2001, or the date upon which federal rules 96.21 published in the Federal Register at 66FR2316 become effective, 96.22 whichever is later, the income limit for a person eligible under 96.23 this subdivision shall be increased by 3.2 percent. Effective 96.24 January 1, 2000, and each successive January, recipients of 96.25 supplemental security income may have an income up to the 96.26 supplemental security income standard in effect on that date. 96.27 In computing income to determine eligibility of persons who are 96.28 not residents of long-term care facilities, the commissioner 96.29 shall disregard increases in income as required by Public Law 96.30 Numbers 94-566, section 503; 99-272; and 99-509. Veterans aid 96.31 and attendance benefits and Veterans Administration unusual 96.32 medical expense payments are considered income to the recipient. 96.33 Sec. 24. Minnesota Statutes 2000, section 256B.056, 96.34 subdivision 4b, is amended to read: 96.35 Subd. 4b. [INCOME VERIFICATION.] The local agency shall 96.36 not require a monthly income verification form for a recipient 97.1 who is a resident of a long-term care facility and who has 97.2 monthly earned income of $80 or less. The commissioner or 97.3 county agency shall use electronic verification as the primary 97.4 method of income verification. If there is a discrepancy in the 97.5 electronic verification, an individual may be required to submit 97.6 additional verification. 97.7 Sec. 25. Minnesota Statutes 2000, section 256B.057, 97.8 subdivision 2, is amended to read: 97.9 Subd. 2. [CHILDREN.] A childonetwo throughfive18 years 97.10 of age in a family whose countable income islessno greater 97.11 than133185 percent of the federal poverty guidelines for the 97.12 same family size, is eligible for medical assistance.A child97.13six through 18 years of age, who was born after September 30,97.141983, in a family whose countable income is less than 10097.15percent of the federal poverty guidelines for the same family97.16size is eligible for medical assistance.Countable income means 97.17 gross income minus child support paid according to a court order 97.18 and dependent care costs deducted from income under the state's 97.19 AFDC plan in effect as of July 16, 1996. 97.20 [EFFECTIVE DATE.] This section is effective July 1, 2002. 97.21 Sec. 26. Minnesota Statutes 2000, section 256B.057, 97.22 subdivision 9, is amended to read: 97.23 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 97.24 assistance may be paid for a person who is employed and who: 97.25 (1) meets the definition of disabled under the supplemental 97.26 security income program; 97.27 (2) is at least 16 but less than 65 years of age; 97.28 (3) meets the asset limits in paragraph (b); and 97.29 (4) pays a premium, if required, under paragraph (c). 97.30 Any spousal income or assets shall be disregarded for purposes 97.31 of eligibility and premium determinations. 97.32 After the month of enrollment, a person enrolled in medical 97.33 assistance under this subdivision who is temporarily unable to 97.34 work and without receipt of earned income due to a medical 97.35 condition, as verified by a physician, or who has involuntarily 97.36 left employment may retain eligibility for up to four calendar 98.1 months. 98.2 (b) For purposes of determining eligibility under this 98.3 subdivision, a person's assets must not exceed $20,000, 98.4 excluding: 98.5 (1) all assets excluded under section 256B.056; 98.6 (2) retirement accounts, including individual accounts, 98.7 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 98.8 (3) medical expense accounts set up through the person's 98.9 employer. 98.10 (c) A person whose earned and unearned income is equal to 98.11 or greaterthan 200than 100 percent of federal poverty 98.12 guidelines for the applicable family size must pay a premium to 98.13 be eligible for medical assistance under this subdivision. The 98.14 premium shall beequal to ten percent of the person's gross98.15earned and unearned income above 200 percent of federal poverty98.16guidelines for the applicable family size up to the cost of98.17coveragebased on the person's gross earned and unearned income 98.18 and the applicable family size using a sliding fee scale 98.19 established by the commissioner, which begins at one percent of 98.20 income at 100 percent of the federal poverty guidelines and 98.21 increases to 7.5 percent of income for those with incomes at or 98.22 above 300 percent of the federal poverty guidelines. Annual 98.23 adjustments in the premium schedule based upon changes in the 98.24 federal poverty guidelines shall be effective for premiums due 98.25 in June of each year. 98.26 (d) A person's eligibility and premium shall be determined 98.27 by the local county agency. Premiums must be paid to the 98.28 commissioner. All premiums are dedicated to the commissioner. 98.29 (e) Any required premium shall be determined at application 98.30 and redetermined annually at recertification or when a change in 98.31 income or family size occurs. 98.32 (f) Premium payment is due upon notification from the 98.33 commissioner of the premium amount required. Premiums may be 98.34 paid in installments at the discretion of the commissioner. 98.35 (g) Nonpayment of the premium shall result in denial or 98.36 termination of medical assistance unless the person demonstrates 99.1 good cause for nonpayment. Good cause exists if the 99.2 requirements specified in Minnesota Rules, part 9506.0040, 99.3 subpart 7, items B to D, are met. Nonpayment shall include 99.4 payment with a returned, refused, or dishonored instrument. The 99.5 commissioner may require a guaranteed form of payment as the 99.6 only means to replace a returned, refused, or dishonored 99.7 instrument. 99.8 [EFFECTIVE DATE.] This section is effective September 1, 99.9 2001. 99.10 Sec. 27. Minnesota Statutes 2000, section 256B.057, is 99.11 amended by adding a subdivision to read: 99.12 Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 99.13 CERVICAL CANCER.] (a) Medical assistance may be paid for a 99.14 person who: 99.15 (1) has been screened for breast or cervical cancer under 99.16 the centers for disease control and prevention's national breast 99.17 and cervical cancer early detection program established under 99.18 United States Code, title 42, sections 300k et seq.; 99.19 (2) according to the person's treating health professional, 99.20 needs treatment, including diagnostic services necessary to 99.21 determine the extent and proper course of treatment, for breast 99.22 or cervical cancer, including precancerous conditions and early 99.23 stage cancer; 99.24 (3) is under age 65; 99.25 (4) is not otherwise eligible for medical assistance under 99.26 United States Code, title 42, section 1396(a)(10)(A)(i); and 99.27 (5) is not otherwise covered under creditable coverage, as 99.28 defined under United States Code, title 42, section 300gg(c). 99.29 (b) Medical assistance provided for an eligible person 99.30 under this subdivision shall be limited to services provided 99.31 during the period that the person receives treatment for breast 99.32 or cervical cancer. 99.33 (c) A person meeting the criteria in paragraph (a) is 99.34 eligible for medical assistance without meeting the eligibility 99.35 criteria relating to income and assets in section 256B.056, 99.36 subdivisions 1a to 5b. 100.1 Sec. 28. Minnesota Statutes 2000, section 256B.057, is 100.2 amended by adding a subdivision to read: 100.3 Subd. 11. [AGED, BLIND, OR DISABLED.] (a) To be eligible 100.4 for medical assistance, a person eligible under section 100.5 256B.055, subdivision 7, 7a, or 12, may have an income up to 100 100.6 percent of the federal poverty guidelines. 100.7 (b) 100.8 In computing income to determine eligibility of persons who 100.9 are not residents of long-term care facilities, the commissioner 100.10 shall disregard increases in income as required by Public Law 100.11 Numbers 94-566, section 503; 99-272; and 99-509. Veterans aid 100.12 and attendance benefits and Veterans Administration unusual 100.13 medical expense payments are considered income to the recipient. 100.14 Sec. 29. Minnesota Statutes 2000, section 256B.061, is 100.15 amended to read: 100.16 256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 100.17 (a) If any individual has been determined to be eligible 100.18 for medical assistance, it will be made available for care and 100.19 services included under the plan and furnished in or after the 100.20 third month before the month in which the individual made 100.21 application for such assistance, if such individual was, or upon 100.22 application would have been, eligible for medical assistance at 100.23 the time the care and services were furnished. The commissioner 100.24 may limit, restrict, or suspend the eligibility of an individual 100.25 for up to one year upon that individual's conviction of a 100.26 criminal offense related to application for or receipt of 100.27 medical assistance benefits. 100.28 (b) On the basis of information provided on the completed 100.29 application, an applicant who meets the following criteria shall 100.30 be determined eligible beginning in the month of application: 100.31 (1)whose gross income is less than 90 percent of the100.32applicable income standard;100.33(2)whose total liquid assets are less than 90 percent of 100.34 the asset limit; 100.35(3)(2) does not reside in a long-term care facility; and 100.36(4)(3) meets all other eligibility requirements. 101.1 The applicant must provide all required verifications within 30 101.2 days' notice of the eligibility determination or eligibility 101.3 shall be terminated. 101.4 (c) Under this chapter and chapter 256D within the limits 101.5 of the appropriation made available for this purpose, the 101.6 commissioner shall develop and implement a pilot project 101.7 establishing presumptive eligibility for children under age 19 101.8 with family income at or below the medical assistance 101.9 guidelines. The commissioner shall select locations such as 101.10 provider offices, hospitals, clinics, and schools where 101.11 presumptive eligibility for medical assistance shall be 101.12 determined on site by a trained staff person. The commissioner 101.13 shall expand presumptive eligibility effective July 1, 2002, by 101.14 selecting additional locations. The entity determining 101.15 presumptive eligibility for a child must notify the parent or 101.16 caretaker at the time of the determination and provide the 101.17 parent or caretaker with an application form, and within five 101.18 working days after the date of the presumptive eligibility 101.19 determination must notify the commissioner. The presumptive 101.20 eligibility period ends on the earlier of the date a child is 101.21 found to be eligible for medical assistance, or the last day of 101.22 the month after the month of the presumptive eligibility 101.23 determination if no application for medical assistance has been 101.24 filed for that child. 101.25 Sec. 30. Minnesota Statutes 2000, section 256B.0625, is 101.26 amended by adding a subdivision to read: 101.27 Subd. 5a. [AUTISM BEHAVIOR THERAPY CLINICAL SUPERVISION 101.28 SERVICES.] (a) Medical assistance covers autism behavior therapy 101.29 clinical supervision services. Autism behavior therapy clinical 101.30 supervision services shall be reimbursed at the same rate as 101.31 services provided by a mental health professional. 101.32 (b) Providers enrolled in medical assistance to provide 101.33 this service or related autism behavior therapy services are not 101.34 required to hold a contract with a county board, as specified in 101.35 Minnesota Rules, part 9505.0324, subpart 2. 101.36 [EFFECTIVE DATE.] This section is effective January 1, 2003. 102.1 Sec. 31. Minnesota Statutes 2000, section 256B.0625, 102.2 subdivision 13, is amended to read: 102.3 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 102.4 except for fertility drugs when specifically used to enhance 102.5 fertility, if prescribed by a licensed practitioner and 102.6 dispensed by a licensed pharmacist, by a physician enrolled in 102.7 the medical assistance program as a dispensing physician, or by 102.8 a physician or a nurse practitioner employed by or under 102.9 contract with a community health board as defined in section 102.10 145A.02, subdivision 5, for the purposes of communicable disease 102.11 control. The commissioner, after receiving recommendations from 102.12 professional medical associations and professional pharmacist 102.13 associations, shall designate a formulary committee to advise 102.14 the commissioner on the names of drugs for which payment is 102.15 made, recommend a system for reimbursing providers on a set fee 102.16 or charge basis rather than the present system, and develop 102.17 methods encouraging use of generic drugs when they are less 102.18 expensive and equally effective as trademark drugs. The 102.19 formulary committee shall consist of nine members, four of whom 102.20 shall be physicians who are not employed by the department of 102.21 human services, and a majority of whose practice is for persons 102.22 paying privately or through health insurance, three of whom 102.23 shall be pharmacists who are not employed by the department of 102.24 human services, and a majority of whose practice is for persons 102.25 paying privately or through health insurance, a consumer 102.26 representative, and a nursing home representative. Committee 102.27 members shall serve three-year terms and shall serve without 102.28 compensation. Members may be reappointed once. 102.29 (b) The commissioner shall establish a drug formulary. Its 102.30 establishment and publication shall not be subject to the 102.31 requirements of the Administrative Procedure Act, but the 102.32 formulary committee shall review and comment on the formulary 102.33 contents. The formulary committee shall review and recommend 102.34 drugs which require prior authorization. The formulary 102.35 committee may recommend drugs for prior authorization directly 102.36 to the commissioner, as long as opportunity for public input is 103.1 provided. Prior authorization may be requested by the 103.2 commissioner based on medical and clinical criteria before 103.3 certain drugs are eligible for payment. Before a drug may be 103.4 considered for prior authorization at the request of the 103.5 commissioner: 103.6 (1) the drug formulary committee must develop criteria to 103.7 be used for identifying drugs; the development of these criteria 103.8 is not subject to the requirements of chapter 14, but the 103.9 formulary committee shall provide opportunity for public input 103.10 in developing criteria; 103.11 (2) the drug formulary committee must hold a public forum 103.12 and receive public comment for an additional 15 days; and 103.13 (3) the commissioner must provide information to the 103.14 formulary committee on the impact that placing the drug on prior 103.15 authorization will have on the quality of patient care and 103.16 information regarding whether the drug is subject to clinical 103.17 abuse or misuse. Prior authorization may be required by the 103.18 commissioner before certain formulary drugs are eligible for 103.19 payment. The formulary shall not include: 103.20 (i) drugs or products for which there is no federal 103.21 funding; 103.22 (ii) over-the-counter drugs, except for antacids, 103.23 acetaminophen, family planning products, aspirin, insulin, 103.24 products for the treatment of lice, vitamins for adults with 103.25 documented vitamin deficiencies, vitamins for children under the 103.26 age of seven and pregnant or nursing women, and any other 103.27 over-the-counter drug identified by the commissioner, in 103.28 consultation with the drug formulary committee, as necessary, 103.29 appropriate, and cost-effective for the treatment of certain 103.30 specified chronic diseases, conditions or disorders, and this 103.31 determination shall not be subject to the requirements of 103.32 chapter 14; 103.33 (iii) anorectics, except that medically necessary 103.34 anorectics shall be covered for a recipient previously diagnosed 103.35 as having pickwickian syndrome and currently diagnosed as having 103.36 diabetes and being morbidly obese; 104.1 (iv) drugs for which medical value has not been 104.2 established; and 104.3 (v) drugs from manufacturers who have not signed a rebate 104.4 agreement with the Department of Health and Human Services 104.5 pursuant to section 1927 of title XIX of the Social Security Act. 104.6 The commissioner shall publish conditions for prohibiting 104.7 payment for specific drugs after considering the formulary 104.8 committee's recommendations. An honorarium of $100 per meeting 104.9 and reimbursement for mileage shall be paid to each committee 104.10 member in attendance. 104.11 (c) The basis for determining the amount of payment shall 104.12 be the lower of the actual acquisition costs of the drugs plus a 104.13 fixed dispensing fee; the maximum allowable cost set by the 104.14 federal government or by the commissioner plus the fixed 104.15 dispensing fee; or the usual and customary price charged to the 104.16 public. The pharmacy dispensing fee shall be $3.65, except that 104.17 the dispensing fee for intravenous solutions which must be 104.18 compounded by the pharmacist shall be $8 per bag, $14 per bag 104.19 for cancer chemotherapy products, and $30 per bag for total 104.20 parenteral nutritional products dispensed in one liter 104.21 quantities, or $44 per bag for total parenteral nutritional 104.22 products dispensed in quantities greater than one liter. Actual 104.23 acquisition cost includes quantity and other special discounts 104.24 except time and cash discounts. The actual acquisition cost of 104.25 a drug shall be estimated by the commissioner, at average 104.26 wholesale price minus nine percent, except that where a drug has 104.27 had its wholesale price reduced as a result of the actions of 104.28 the National Association of Medicaid Fraud Control Units, the 104.29 estimated actual acquisition cost shall be the reduced average 104.30 wholesale price, without the nine percent deduction. The 104.31 maximum allowable cost of a multisource drug may be set by the 104.32 commissioner and it shall be comparable to, but no higher than, 104.33 the maximum amount paid by other third-party payors in this 104.34 state who have maximum allowable cost programs. The 104.35 commissioner shall set maximum allowable costs for multisource 104.36 drugs that are not on the federal upper limit list as described 105.1 in United States Code, title 42, chapter 7, section 1396r-8(e), 105.2 the Social Security Act, and Code of Federal Regulations, title 105.3 42, part 447, section 447.332. Establishment of the amount of 105.4 payment for drugs shall not be subject to the requirements of 105.5 the Administrative Procedure Act. An additional dispensing fee 105.6 of $.30 may be added to the dispensing fee paid to pharmacists 105.7 for legend drug prescriptions dispensed to residents of 105.8 long-term care facilities when a unit dose blister card system, 105.9 approved by the department, is used. Under this type of 105.10 dispensing system, the pharmacist must dispense a 30-day supply 105.11 of drug. The National Drug Code (NDC) from the drug container 105.12 used to fill the blister card must be identified on the claim to 105.13 the department. The unit dose blister card containing the drug 105.14 must meet the packaging standards set forth in Minnesota Rules, 105.15 part 6800.2700, that govern the return of unused drugs to the 105.16 pharmacy for reuse. The pharmacy provider will be required to 105.17 credit the department for the actual acquisition cost of all 105.18 unused drugs that are eligible for reuse. Over-the-counter 105.19 medications must be dispensed in the manufacturer's unopened 105.20 package. The commissioner may permit the drug clozapine to be 105.21 dispensed in a quantity that is less than a 30-day supply. 105.22 Whenever a generically equivalent product is available, payment 105.23 shall be on the basis of the actual acquisition cost of the 105.24 generic drug, unless the prescriber specifically indicates 105.25 "dispense as written - brand necessary" on the prescription as 105.26 required by section 151.21, subdivision 2. 105.27 (d) For purposes of this subdivision, "multisource drugs" 105.28 means covered outpatient drugs, excluding innovator multisource 105.29 drugs for which there are two or more drug products, which: 105.30 (1) are related as therapeutically equivalent under the 105.31 Food and Drug Administration's most recent publication of 105.32 "Approved Drug Products with Therapeutic Equivalence 105.33 Evaluations"; 105.34 (2) are pharmaceutically equivalent and bioequivalent as 105.35 determined by the Food and Drug Administration; and 105.36 (3) are sold or marketed in Minnesota. 106.1 "Innovator multisource drug" means a multisource drug that was 106.2 originally marketed under an original new drug application 106.3 approved by the Food and Drug Administration. 106.4 (e) The basis for determining the amount of payment for 106.5 drugs administered in an outpatient setting shall be the lower 106.6 of the usual and customary cost submitted by the provider; the 106.7 average wholesale price minus five percent; or the maximum 106.8 allowable cost set by the federal government under United States 106.9 Code, title 42, chapter 7, section 1396r-8(e) and Code of 106.10 Federal Regulations, title 42, section 447.332, or by the 106.11 commissioner under paragraph (c). 106.12 Sec. 32. Minnesota Statutes 2000, section 256B.0625, 106.13 subdivision 13a, is amended to read: 106.14 Subd. 13a. [DRUG UTILIZATION REVIEW BOARD.] A nine-member 106.15 drug utilization review board is established. The board is 106.16 comprised of at least three but no more than four licensed 106.17 physicians actively engaged in the practice of medicine in 106.18 Minnesota; at least three licensed pharmacists actively engaged 106.19 in the practice of pharmacy in Minnesota; and one consumer 106.20 representative; the remainder to be made up of health care 106.21 professionals who are licensed in their field and have 106.22 recognized knowledge in the clinically appropriate prescribing, 106.23 dispensing, and monitoring of covered outpatient drugs. The 106.24 board shall be staffed by an employee of the department who 106.25 shall serve as an ex officio nonvoting member of the board. The 106.26 members of the board shall be appointed by the commissioner and 106.27 shall serve three-year terms. The members shall be selected 106.28 from lists submitted by professional associations. The 106.29 commissioner shall appoint the initial members of the board for 106.30 terms expiring as follows: three members for terms expiring 106.31 June 30, 1996; three members for terms expiring June 30, 1997; 106.32 and three members for terms expiring June 30, 1998. Members may 106.33 be reappointed once. The board shall annually elect a chair 106.34 from among the members. 106.35 The commissioner shall, with the advice of the board: 106.36 (1) implement a medical assistance retrospective and 107.1 prospective drug utilization review program as required by 107.2 United States Code, title 42, section 1396r-8(g)(3); 107.3 (2) develop and implement the predetermined criteria and 107.4 practice parameters for appropriate prescribing to be used in 107.5 retrospective and prospective drug utilization review; 107.6 (3) develop, select, implement, and assess interventions 107.7 for physicians, pharmacists, and patients that are educational 107.8 and not punitive in nature; 107.9 (4) establish a grievance and appeals process for 107.10 physicians and pharmacists under this section; 107.11 (5) publish and disseminate educational information to 107.12 physicians and pharmacists regarding the board and the review 107.13 program; 107.14 (6) adopt and implement procedures designed to ensure the 107.15 confidentiality of any information collected, stored, retrieved, 107.16 assessed, or analyzed by the board, staff to the board, or 107.17 contractors to the review program that identifies individual 107.18 physicians, pharmacists, or recipients; 107.19 (7) establish and implement an ongoing process to (i) 107.20 receive public comment regarding drug utilization review 107.21 criteria and standards, and (ii) consider the comments along 107.22 with other scientific and clinical information in order to 107.23 revise criteria and standards on a timely basis; and 107.24 (8) adopt any rules necessary to carry out this section. 107.25 The board may establish advisory committees. The 107.26 commissioner may contract with appropriate organizations to 107.27 assist the board in carrying out the board's duties. The 107.28 commissioner may enter into contracts for services to develop 107.29 and implement a retrospective and prospective review program. 107.30 The board shall report to the commissioner annually on the 107.31 date the Drug Utilization Review Annual Report is due to the 107.32 Health Care Financing Administration. This report is to cover 107.33 the preceding federal fiscal year. The commissioner shall make 107.34 the report available to the public upon request. The report 107.35 must include information on the activities of the board and the 107.36 program; the effectiveness of implemented interventions; 108.1 administrative costs; and any fiscal impact resulting from the 108.2 program. An honorarium of$50$100 per meeting and 108.3 reimbursement for mileage shall be paid to each board member in 108.4 attendance. 108.5 Sec. 33. Minnesota Statutes 2000, section 256B.0625, 108.6 subdivision 17, is amended to read: 108.7 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 108.8 covers transportation costs incurred solely for obtaining 108.9 emergency medical care or transportation costs incurred by 108.10 nonambulatory persons in obtaining emergency or nonemergency 108.11 medical care when paid directly to an ambulance company, common 108.12 carrier, or other recognized providers of transportation 108.13 services. For the purpose of this subdivision, a person who is 108.14 incapable of transport by taxicab or bus shall be considered to 108.15 be nonambulatory. 108.16 (b) Medical assistance covers special transportation, as 108.17 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 108.18 if the provider receives and maintains a current physician's 108.19 order by the recipient's attending physician certifying that the 108.20 recipient has a physical or mental impairment that would 108.21 prohibit the recipient from safely accessing and using a bus, 108.22 taxi, other commercial transportation, or private automobile. 108.23 Special transportation includes driver-assisted service to 108.24 eligible individuals. Driver-assisted service includes 108.25 passenger pickup at and return to the individual's residence or 108.26 place of business, assistance with admittance of the individual 108.27 to the medical facility, and assistance in passenger securement 108.28 or in securing of wheelchairs or stretchers in the vehicle. The 108.29 commissioner shall establish maximum medical assistance 108.30 reimbursement rates for special transportation services for 108.31 persons who need a wheelchairliftaccessible van or 108.32stretcher-equippedstretcher-accessible vehicle and for those 108.33 who do not need a wheelchairliftaccessible van or 108.34stretcher-equippedstretcher-accessible vehicle. The average of 108.35 these two rates per trip must not exceed $15 for the base rate 108.36 and$1.20$1.30 per mile. Special transportation provided to 109.1 nonambulatory persons who do not need a wheelchairlift109.2 accessible van orstretcher-equippedstretcher-accessible 109.3 vehicle, may be reimbursed at a lower rate than special 109.4 transportation provided to persons who need a wheelchairlift109.5 accessible van orstretcher-equippedstretcher-accessible 109.6 vehicle. 109.7 [EFFECTIVE DATE.] This section is effective July 1, 2001. 109.8 Sec. 34. Minnesota Statutes 2000, section 256B.0625, 109.9 subdivision 17a, is amended to read: 109.10 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 109.11 services rendered on or after July 1,19992001, medical 109.12 assistance payments for ambulance services shall beincreased by109.13five percentpaid at the Medicare reimbursement rate or at the 109.14 medical assistance payment rate in effect on July 1, 2000, 109.15 whichever is greater. 109.16 Sec. 35. Minnesota Statutes 2000, section 256B.0625, 109.17 subdivision 18a, is amended to read: 109.18 Subd. 18a. [PAYMENT FOR MEALS AND LODGINGACCESS TO 109.19 MEDICAL SERVICES.] (a) Medical assistance reimbursement for 109.20 meals for persons traveling to receive medical care may not 109.21 exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner. 109.22 (b) Medical assistance reimbursement for lodging for 109.23 persons traveling to receive medical care may not exceed $50 per 109.24 day unless prior authorized by the local agency. 109.25 (c) Medical assistance direct mileage reimbursement to the 109.26 eligible person or the eligible person's driver may not exceed 109.27 20 cents per mile. 109.28 (d) Medical assistance covers oral language interpreter 109.29 services when provided by an enrolled health care provider 109.30 during the course of providing a direct, person-to-person 109.31 covered health care service to an enrolled recipient with 109.32 limited English proficiency. 109.33 Sec. 36. Minnesota Statutes 2000, section 256B.0625, 109.34 subdivision 30, is amended to read: 109.35 Subd. 30. [OTHER CLINIC SERVICES.] (a) Medical assistance 109.36 covers rural health clinic services, federally qualified health 110.1 center services, nonprofit community health clinic services, 110.2 public health clinic services, and the services of a clinic 110.3 meeting the criteria established in rule by the commissioner. 110.4 Rural health clinic services and federally qualified health 110.5 center services mean services defined in United States Code, 110.6 title 42, section 1396d(a)(2)(B) and (C). Payment for rural 110.7 health clinic and federally qualified health center services 110.8 shall be made according to applicable federal law and regulation. 110.9 (b) A federally qualified health center that is beginning 110.10 initial operation shall submit an estimate of budgeted costs and 110.11 visits for the initial reporting period in the form and detail 110.12 required by the commissioner. A federally qualified health 110.13 center that is already in operation shall submit an initial 110.14 report using actual costs and visits for the initial reporting 110.15 period. Within 90 days of the end of its reporting period, a 110.16 federally qualified health center shall submit, in the form and 110.17 detail required by the commissioner, a report of its operations, 110.18 including allowable costs actually incurred for the period and 110.19 the actual number of visits for services furnished during the 110.20 period, and other information required by the commissioner. 110.21 Federally qualified health centers that file Medicare cost 110.22 reports shall provide the commissioner with a copy of the most 110.23 recent Medicare cost report filed with the Medicare program 110.24 intermediary for the reporting year which support the costs 110.25 claimed on their cost report to the state. 110.26 (c) In order to continue cost-based payment under the 110.27 medical assistance program according to paragraphs (a) and (b), 110.28 a federally qualified health center or rural health clinic must 110.29 apply for designation as an essential community provider within 110.30 six months of final adoption of rules by the department of 110.31 health according to section 62Q.19, subdivision 7. For those 110.32 federally qualified health centers and rural health clinics that 110.33 have applied for essential community provider status within the 110.34 six-month time prescribed, medical assistance payments will 110.35 continue to be made according to paragraphs (a) and (b) for the 110.36 first three years after application. For federally qualified 111.1 health centers and rural health clinics that either do not apply 111.2 within the time specified above or who have had essential 111.3 community provider status for three years, medical assistance 111.4 payments for health services provided by these entities shall be 111.5 according to the same rates and conditions applicable to the 111.6 same service provided by health care providers that are not 111.7 federally qualified health centers or rural health clinics. 111.8 (d) Effective July 1, 1999, the provisions of paragraph (c) 111.9 requiring a federally qualified health center or a rural health 111.10 clinic to make application for an essential community provider 111.11 designation in order to have cost-based payments made according 111.12 to paragraphs (a) and (b) no longer apply. 111.13 (e) Effective January 1, 2000, payments made according to 111.14 paragraphs (a) and (b) shall be limited to the cost phase-out 111.15 schedule of the Balanced Budget Act of 1997. 111.16 (f) Effective January 1, 2001, each federally qualified 111.17 health center and rural health clinic may elect to be paid 111.18 either under the prospective payment system established in 111.19 United States Code, title 42, section 1396a, (a) or under an 111.20 alternative payment methodology consistent with the requirements 111.21 of United States Code, title 42, section 1392a, (a) and approved 111.22 by the Health Care Financing Administration. The alternative 111.23 payment methodology shall be 100 percent of cost as determined 111.24 according to Medicare cost principles. 111.25 Sec. 37. Minnesota Statutes 2000, section 256B.0625, 111.26 subdivision 34, is amended to read: 111.27 Subd. 34. [INDIAN HEALTH SERVICES FACILITIES.] Medical 111.28 assistance payments to facilities of the Indian health service 111.29 and facilities operated by a tribe or tribal organization under 111.30 funding authorized by United States Code, title 25, sections 111.31 450f to 450n, or title III of the Indian Self-Determination and 111.32 Education Assistance Act, Public Law Number 93-638, for 111.33 enrollees who are eligible for federal financial participation, 111.34 shall be at the option of the facility in accordance with the 111.35 rate published by the United States Assistant Secretary for 111.36 Health under the authority of United States Code, title 42, 112.1 sections 248(a) and 249(b). General assistance medical care 112.2 payments to facilities of the Indian health services and 112.3 facilities operated by a tribe or tribal organization for the 112.4 provision of outpatient medical care services billed after June 112.5 30, 1990, must be in accordance with the general assistance 112.6 medical care rates paid for the same services when provided in a 112.7 facility other than a facility of the Indian health service or a 112.8 facility operated by a tribe or tribal 112.9 organization. MinnesotaCare payments for enrollees who are not 112.10 eligible for federal financial participation at facilities of 112.11 the Indian health service and facilities operated by a tribe or 112.12 tribal organization for the provision of outpatient medical 112.13 services must be in accordance with the medical assistance rates 112.14 paid for the same services when provided in a facility other 112.15 than a facility of the Indian health service or a facility 112.16 operated by a tribe or tribal organization. 112.17 [EFFECTIVE DATE.] This section shall be effective the day 112.18 following final enactment. 112.19 Sec. 38. Minnesota Statutes 2000, section 256B.0625, is 112.20 amended by adding a subdivision to read: 112.21 Subd. 43. [TARGETED CASE MANAGEMENT SERVICES.] Medical 112.22 assistance covers case management services for vulnerable adults 112.23 and persons with developmental disabilities not receiving home 112.24 and community-based waiver services. 112.25 Sec. 39. Minnesota Statutes 2000, section 256B.0625, is 112.26 amended by adding a subdivision to read: 112.27 Subd. 44. [TARGETED CASE MANAGEMENT SERVICE FOR CHILDREN 112.28 UNDER THE AGE OF 19.] Medical assistance, subject to federal 112.29 approval, covers targeted case management services in accordance 112.30 with section 256B.0948 for children under the age of 19 who have 112.31 had at least one previous birth. 112.32 Sec. 40. Minnesota Statutes 2000, section 256B.0635, 112.33 subdivision 1, is amended to read: 112.34 Subdivision 1. [INCREASED EMPLOYMENT.]Beginning January112.351, 1998(a) Until June 30, 2002, medical assistance may be paid 112.36 for persons who received MFIP-S or medical assistance for 113.1 families and children in at least three of six months preceding 113.2 the month in which the person became ineligible for MFIP-S or 113.3 medical assistance, if the ineligibility was due to an increase 113.4 in hours of employment or employment income or due to the loss 113.5 of an earned income disregard. In addition, to receive 113.6 continued assistance under this section, persons who received 113.7 medical assistance for families and children but did not receive 113.8 MFIP-S must have had income less than or equal to the assistance 113.9 standard for their family size under the state's AFDC plan in 113.10 effect as of July 16, 1996,as required by the Personal113.11Responsibility and Work Opportunity Reconciliation Act of 1996113.12(PRWORA), Public Law Number 104-193,increased according to 113.13 section 256B.056, subdivision 4, at the time medical assistance 113.14 eligibility began. A person who is eligible for extended 113.15 medical assistance is entitled tosix12 months of assistance 113.16 without reapplication, unless the assistance unit ceases to 113.17 include a dependent child. For a person under 21 years of113.18age, except medical assistance may not be discontinued for that 113.19 dependent child under 21 years of age within thesix-month113.20 12-month period of extended eligibility until it has been 113.21 determined that the person is not otherwise eligible for medical 113.22 assistance.Medical assistance may be continued for an113.23additional six months if the person meets all requirements for113.24the additional six months, according to title XIX of the Social113.25Security Act, as amended by section 303 of the Family Support113.26Act of 1988, Public Law Number 100-485.113.27 (b) Beginning July 1, 2002, medical assistance for families 113.28 and children may be paid for persons who were eligible under 113.29 section 256B.055, subdivision 3a, paragraph (b), in at least 113.30 three of six months preceding the month in which the person 113.31 became ineligible under that section if the ineligibility was 113.32 due to an increase in hours of employment or employment income 113.33 or due to the loss of an earned income disregard. A person who 113.34 is eligible for extended medical assistance is entitled to 12 113.35 months of assistance without reapplication, unless the 113.36 assistance unit ceases to include a dependent child, except 114.1 medical assistance may not be discontinued for that dependent 114.2 child under 21 years of age within the 12-month period of 114.3 extended eligibility until it has been determined that the 114.4 person is not otherwise eligible for medical assistance. 114.5 [EFFECTIVE DATE.] This section is effective July 1, 2001. 114.6 Sec. 41. Minnesota Statutes 2000, section 256B.0635, 114.7 subdivision 2, is amended to read: 114.8 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.]Beginning114.9January 1, 1998(a) Until June 30, 2002, medical assistance may 114.10 be paid for persons who received MFIP-S or medical assistance 114.11 for families and children in at least three of the six months 114.12 preceding the month in which the person became ineligible for 114.13 MFIP-S or medical assistance, if the ineligibility was the 114.14 result of the collection of child or spousal support under part 114.15 D of title IV of the Social Security Act. In addition, to 114.16 receive continued assistance under this section, persons who 114.17 received medical assistance for families and children but did 114.18 not receive MFIP-S must have had income less than or equal to 114.19 the assistance standard for their family size under the state's 114.20 AFDC plan in effect as of July 16, 1996,as required by the114.21Personal Responsibility and Work Opportunity Reconciliation Act114.22of 1996 (PRWORA), Public Law Number 104-193increased according 114.23 to section 256B.056, subdivision 4, at the time medical 114.24 assistance eligibility began. A person who is eligible for 114.25 extended medical assistance under this subdivision is entitled 114.26 to four months of assistance without reapplication, unless the 114.27 assistance unit ceases to include a dependent child. For a114.28person under 21 years of age, except medical assistance may not 114.29 be discontinued for that dependent child under 21 years of age 114.30 within the four-month period of extended eligibility until it 114.31 has been determined that the person is not otherwise eligible 114.32 for medical assistance. 114.33 (b) Beginning July 1, 2002, medical assistance for families 114.34 and children may be paid for persons who were eligible under 114.35 section 256B.055, subdivision 3a, paragraph (b), in at least 114.36 three of the six months preceding the month in which the person 115.1 became ineligible under that section if the ineligibility was 115.2 the result of the collection of child or spousal support under 115.3 part D of title IV of the Social Security Act. A person who is 115.4 eligible for extended medical assistance under this subdivision 115.5 is entitled to four months of assistance without reapplication, 115.6 unless the assistance unit ceases to include a dependent child, 115.7 except medical assistance may not be discontinued for that 115.8 dependent child under 21 years of age within the four-month 115.9 period of extended eligibility until it has been determined that 115.10 the person is not otherwise eligible for medical assistance. 115.11 [EFFECTIVE DATE.] This section is effective July 1, 2001. 115.12 Sec. 42. [256B.0637] [PRESUMPTIVE ELIGIBILITY FOR CERTAIN 115.13 PERSONS NEEDING TREATMENT FOR BREAST OR CERVICAL CANCER.] 115.14 Medical assistance is available during a presumptive 115.15 eligibility period for persons who meet the criteria in section 115.16 256B.057, subdivision 10. For purposes of this section, the 115.17 presumptive eligibility period begins on the date on which an 115.18 entity designated by the commissioner determines based on 115.19 preliminary information that the person meets the criteria in 115.20 section 256B.057, subdivision 10. The presumptive eligibility 115.21 period ends on the day on which a determination is made as to 115.22 the person's eligibility, except that if an application is not 115.23 submitted by the last day of the month following the month 115.24 during which the determination based on preliminary information 115.25 is made, the presumptive eligibility period ends on that last 115.26 day of the month. 115.27 Sec. 43. Minnesota Statutes 2000, section 256B.0644, is 115.28 amended to read: 115.29 256B.0644 [PARTICIPATION REQUIRED FOR REIMBURSEMENT UNDER 115.30 OTHER STATE HEALTH CARE PROGRAMS.] 115.31 A vendor of medical care, as defined in section 256B.02, 115.32 subdivision 7, and a health maintenance organization, as defined 115.33 in chapter 62D, must participate as a provider or contractor in 115.34 the medical assistance program, general assistance medical care 115.35 program, and MinnesotaCare as a condition of participating as a 115.36 provider in health insurance plans and programs or contractor 116.1 for state employees established under section 43A.18, the public 116.2 employees insurance program under section 43A.316, for health 116.3 insurance plans offered to local statutory or home rule charter 116.4 city, county, and school district employees, the workers' 116.5 compensation system under section 176.135, and insurance plans 116.6 provided through the Minnesota comprehensive health association 116.7 under sections 62E.01 to 62E.19. The limitations on insurance 116.8 plans offered to local government employees shall not be 116.9 applicable in geographic areas where provider participation is 116.10 limited by managed care contracts with the department of human 116.11 services. For providers other than health maintenance 116.12 organizations, participation in the medical assistance program 116.13 means that (1) the provider accepts new medical assistance, 116.14 general assistance medical care, and MinnesotaCare patients or 116.15 (2) at least 20 percent of the provider's patients are covered 116.16 by medical assistance, general assistance medical care, and 116.17 MinnesotaCare as their primary source of coverage. Patients 116.18 seen on a volunteer basis by the provider at a location other 116.19 than the provider's usual place of practice may be considered in 116.20 meeting this participation requirement. The commissioner shall 116.21 establish participation requirements for health maintenance 116.22 organizations. The commissioner shall provide lists of 116.23 participating medical assistance providers on a quarterly basis 116.24 to the commissioner of employee relations, the commissioner of 116.25 labor and industry, and the commissioner of commerce. Each of 116.26 the commissioners shall develop and implement procedures to 116.27 exclude as participating providers in the program or programs 116.28 under their jurisdiction those providers who do not participate 116.29 in the medical assistance program. The commissioner of employee 116.30 relations shall implement this section through contracts with 116.31 participating health and dental carriers. 116.32 Sec. 44. Minnesota Statutes 2000, section 256B.0913, 116.33 subdivision 12, is amended to read: 116.34 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 116.35 all 180-day eligible clients to help pay for the cost of 116.36 participating in the program. The amount of the premium for the 117.1 alternative care client shall be determined as follows: 117.2 (1) when the alternative care client's income less 117.3 recurring and predictable medical expenses is greater than the 117.4 medical assistance income standard but less than 150 percent of 117.5 the federal poverty guideline, and total assets are less than 117.6 $10,000, the fee is zero; 117.7 (2) when the alternative care client's income less 117.8 recurring and predictable medical expenses is greater than 150 117.9 percent of the federal poverty guideline, and total assets are 117.10 less than $10,000, the fee is 25 percent of the cost of 117.11 alternative care services or the difference between 150 percent 117.12 of the federal poverty guideline and the client's income less 117.13 recurring and predictable medical expenses, whichever is less; 117.14 and 117.15 (3) when the alternative care client's total assets are 117.16 greater than $10,000, the fee is 25 percent of the cost of 117.17 alternative care services. 117.18 For married persons, total assets are defined as the total 117.19 marital assets less the estimated community spouse asset 117.20 allowance, under section 256B.059, if applicable. For married 117.21 persons, total income is defined as the client's income less the 117.22 monthly spousal allotment, under section 256B.058. 117.23 All alternative care services except case management shall 117.24 be included in the estimated costs for the purpose of 117.25 determining 25 percent of the costs. 117.26 The monthly premium shall be calculated based on the cost 117.27 of the first full month of alternative care services and shall 117.28 continue unaltered until the next reassessment is completed or 117.29 at the end of 12 months, whichever comes first. Premiums are 117.30 due and payable each month alternative care services are 117.31 received unless the actual cost of the services is less than the 117.32 premium. 117.33 (b) The fee shall be waived by the commissioner when: 117.34 (1) a person who is residing in a nursing facility is 117.35 receiving case management only; 117.36 (2) a person is applying for medical assistance; 118.1 (3) a married couple is requesting an asset assessment 118.2 under the spousal impoverishment provisions; 118.3 (4) a person is a medical assistance recipient, but has 118.4 been approved for alternative care-funded assisted living 118.5 services; 118.6 (5) a person is found eligible for alternative care, but is 118.7 not yet receiving alternative care services; or 118.8 (6) a person's fee under paragraph (a) is less than $25. 118.9 (c) The county agency must record in the state's receivable 118.10 system the client's assessed premium amount or the reason the 118.11 premium has been waived. The commissioner will bill and collect 118.12 the premium from the clientand forward the amounts collected to118.13the commissioner in the manner and at the times prescribed by118.14the commissioner. Money collected must be deposited in the 118.15 general fund and is appropriated to the commissioner for the 118.16 alternative care program. The client must supply the county 118.17 with the client's social security number at the time of 118.18 application.If a client fails or refuses to pay the premium118.19due,The county shall supply the commissioner with the client's 118.20 social security number and other information the commissioner 118.21 requires to collect the premium from the client. The 118.22 commissioner shall collect unpaid premiums using the Revenue 118.23 Recapture Act in chapter 270A and other methods available to the 118.24 commissioner. The commissioner may require counties to inform 118.25 clients of the collection procedures that may be used by the 118.26 state if a premium is not paid. This paragraph does not apply 118.27 to alternative care pilot projects authorized in Laws 1993, 118.28 First Special Session chapter 1, article 5, section 133, if a 118.29 county operating under the pilot project reports the following 118.30 dollar amounts to the commissioner quarterly: 118.31 (1) total premiums billed to clients; 118.32 (2) total collections of premiums billed; and 118.33 (3) balance of premiums owed by clients. 118.34 If a county does not adhere to these reporting requirements, the 118.35 commissioner may terminate the billing, collecting, and 118.36 remitting portions of the pilot project and require the county 119.1 involved to operate under the procedures set forth in this 119.2 paragraph. 119.3 (d) The commissioner shall begin to adopt emergency or 119.4 permanent rules governing client premiums within 30 days after 119.5 July 1, 1991, including criteria for determining when services 119.6 to a client must be terminated due to failure to pay a premium. 119.7 Sec. 45. Minnesota Statutes 2000, section 256B.0913, 119.8 subdivision 14, is amended to read: 119.9 Subd. 14. [REIMBURSEMENT AND RATE ADJUSTMENTS.] (a) 119.10 Reimbursement for expenditures for the alternative care services 119.11 as approved by the client's case manager shall be through the 119.12 invoice processing procedures of the department's Medicaid 119.13 Management Information System (MMIS). To receive reimbursement, 119.14 the county or vendor must submit invoices within 12 months 119.15 following the date of service. The county agency and its 119.16 vendors under contract shall not be reimbursed for services 119.17 which exceed the county allocation. 119.18 (b)If a county collects less than 50 percent of the client119.19premiums due under subdivision 12, the commissioner may withhold119.20up to three percent of the county's final alternative care119.21program allocation determined under subdivisions 10 and 11.119.22(c)The county shall negotiate individual rates with 119.23 vendors and may be reimbursed for actual costs up to the greater 119.24 of the county's current approved rate or 60 percent of the 119.25 maximum rate in fiscal year 1994 and 65 percent of the maximum 119.26 rate in fiscal year 1995 for each alternative care service. 119.27 Notwithstanding any other rule or statutory provision to the 119.28 contrary, the commissioner shall not be authorized to increase 119.29 rates by an annual inflation factor, unless so authorized by the 119.30 legislature. 119.31(d)(c) On July 1, 1993, the commissioner shall increase 119.32 the maximum rate for home delivered meals to $4.50 per meal. 119.33 Sec. 46. [256B.0924] [TARGETED CASE MANAGEMENT SERVICES 119.34 FOR VULNERABLE ADULTS AND PERSONS WITH DEVELOPMENTAL 119.35 DISABILITIES.] 119.36 Subdivision 1. [PURPOSE.] The state recognizes that 120.1 targeted case management services can decrease the need for more 120.2 costly services such as multiple emergency room visits or 120.3 hospitalizations by linking eligible individuals with less 120.4 costly services available in the community. 120.5 Subd. 2. [DEFINITIONS.] For purposes of this section, the 120.6 following terms have the meanings given: 120.7 (a) "Targeted case management" means services which will 120.8 assist medical assistance eligible persons to gain access to 120.9 needed medical, social, educational, and other services. 120.10 Targeted case management does not include therapy, treatment, 120.11 legal, or outreach services. 120.12 (b) "Targeted case management for adults" means activities 120.13 that coordinate and link social and other services designed to 120.14 help eligible persons gain access to needed protective services, 120.15 social, health care, mental health, habilitative, educational, 120.16 vocational, recreational, advocacy, legal, chemical, health, and 120.17 other related services. 120.18 Subd. 3. [ELIGIBILITY.] Persons are eligible to receive 120.19 targeted case management services under this section if the 120.20 requirements in paragraphs (a) and (b) are met. 120.21 (a) The person must be assessed and determined by the local 120.22 county agency to: 120.23 (1) be age 18 or older; 120.24 (2) be receiving medical assistance; 120.25 (3) have significant functional limitations; and 120.26 (4) be in need of service coordination to attain or 120.27 maintain living in an integrated community setting. 120.28 (b) The person must be a vulnerable adult in need of adult 120.29 protection as defined in section 626.5572, or is an adult with 120.30 mental retardation as defined in section 252A.02, subdivision 2, 120.31 or a related condition as defined in section 252.27, subdivision 120.32 1a, and is not receiving home and community-based waiver 120.33 services. 120.34 Subd. 4. [TARGETED CASE MANAGEMENT SERVICE 120.35 ACTIVITIES.] (a) For persons with mental retardation or a 120.36 related condition, targeted case management services must meet 121.1 the provisions of section 256B.092. 121.2 (b) For persons not eligible as a person with mental 121.3 retardation or a related condition, targeted case management 121.4 service activities include: 121.5 (1) an assessment of the person's need for targeted case 121.6 management services; 121.7 (2) the development of a written personal service plan; 121.8 (3) a regular review and revision of the written personal 121.9 service plan with the recipient and the recipient's legal 121.10 representative, and others as identified by the recipient, to 121.11 ensure access to necessary services and supports identified in 121.12 the plan; 121.13 (4) effective communication with the recipient and the 121.14 recipient's legal representative and others identified by the 121.15 recipient; 121.16 (5) coordination of referrals for needed services with 121.17 qualified providers; 121.18 (6) coordination and monitoring of the overall service 121.19 delivery to ensure the quality and effectiveness of services; 121.20 (7) assistance to the recipient and the recipient's legal 121.21 representative to help make an informed choice of services; 121.22 (8) advocating on behalf of the recipient when service 121.23 barriers are encountered or referring the recipient and the 121.24 recipient's legal representative to an independent advocate; 121.25 (9) monitoring and evaluating services identified in the 121.26 personal service plan to ensure personal outcomes are met and to 121.27 ensure satisfaction with services and service delivery; 121.28 (10) conducting face-to-face monitoring with the recipient 121.29 at least twice a year; 121.30 (11) completing and maintain necessary documentation that 121.31 supports verifies the activities in this section; 121.32 (12) coordinating with the medical assistance facility 121.33 discharge planner in the 180-day period prior to the recipient's 121.34 discharge into the community; and 121.35 (13) a personal service plan developed and reviewed at 121.36 least annually with the recipient and the recipient's legal 122.1 representative. The personal service plan must be revised when 122.2 there is a change in the recipient's status. The personal 122.3 service plan must identify: 122.4 (i) the desired personal short and long-term outcomes; 122.5 (ii) the recipient's preferences for services and supports, 122.6 including development of a person-centered plan if requested; 122.7 and 122.8 (iii) formal and informal services and supports based on 122.9 areas of assessment, such as: social, health, mental health, 122.10 residence, family, educational and vocational, safety, legal, 122.11 self-determination, financial, and chemical health as determined 122.12 by the recipient and the recipient's legal representative and 122.13 the recipient's support network. 122.14 Subd. 5. [PROVIDER STANDARDS.] County boards or providers 122.15 who contract with the county are eligible to receive medical 122.16 assistance reimbursement for adult targeted case management 122.17 services. To qualify as a provider of targeted case management 122.18 services the vendor must: 122.19 (1) have demonstrated the capacity and experience to 122.20 provide the activities of case management services defined in 122.21 subdivision 4; 122.22 (2) be able to coordinate and link community resources 122.23 needed by the recipient; 122.24 (3) have the administrative capacity and experience to 122.25 serve the eligible population in providing services and to 122.26 ensure quality of services under state and federal requirements; 122.27 (4) have a financial management system that provides 122.28 accurate documentation of services and costs under state and 122.29 federal requirements; 122.30 (5) have the capacity to document and maintain individual 122.31 case records complying with state and federal requirements; 122.32 (6) coordinate with county social service agencies 122.33 responsible for planning for community social services under 122.34 chapters 256E and 256F; conducting adult protective 122.35 investigations under section 626.557, and conducting prepetition 122.36 screenings for commitments under section 253B.07; 123.1 (7) coordinate with health care providers to ensure access 123.2 to necessary health care services; 123.3 (8) have a procedure in place that notifies the recipient 123.4 and the recipient's legal representative of any conflict of 123.5 interest if the contracted targeted case management service 123.6 provider also provides the recipient's services and supports and 123.7 provides information on all potential conflicts of interest and 123.8 obtains the recipient's informed consent and provides the 123.9 recipient with alternatives; and 123.10 (9) have demonstrated the capacity to achieve the following 123.11 performance outcomes: access, quality, and consumer 123.12 satisfaction. 123.13 Subd. 6. [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 123.14 Medical assistance and MinnesotaCare payment for targeted case 123.15 management shall be made on a monthly basis. In order to 123.16 receive payment for an eligible adult, the provider must 123.17 document at least one contact per month and not more than two 123.18 consecutive months without a face-to-face contact with the adult 123.19 or the adult's legal representative. 123.20 (b) Payment for targeted case management provided by county 123.21 staff under this subdivision shall be based on the monthly rate 123.22 methodology under section 256B.094, subdivision 6, paragraph 123.23 (b), calculated as one combined average rate together with adult 123.24 mental health case management under section 256B.0625, 123.25 subdivision 20. Billing and payment must identify the 123.26 recipient's primary population group to allow tracking of 123.27 revenues. 123.28 (c) Payment for targeted case management provided by 123.29 county-contracted vendors shall be based on a monthly rate 123.30 negotiated by the host county. The negotiated rate must not 123.31 exceed the rate charged by the vendor for the same service to 123.32 other payers. If the service is provided by a team of 123.33 contracted vendors, the county may negotiate a team rate with a 123.34 vendor who is a member of the team. The team shall determine 123.35 how to distribute the rate among its members. No reimbursement 123.36 received by contracted vendors shall be returned to the county, 124.1 except to reimburse the county for advance funding provided by 124.2 the county to the vendor. 124.3 (d) If the service is provided by a team that includes 124.4 contracted vendors and county staff, the costs for county staff 124.5 participation on the team shall be included in the rate for 124.6 county-provided services. In this case, the contracted vendor 124.7 and the county may each receive separate payment for services 124.8 provided by each entity in the same month. In order to prevent 124.9 duplication of services, the county must document, in the 124.10 recipient's file, the need for team targeted case management and 124.11 a description of the different roles of the team members. 124.12 (e) Notwithstanding section 256B.19, subdivision 1, the 124.13 nonfederal share of costs for targeted case management shall be 124.14 provided by the recipient's county of responsibility, as defined 124.15 in sections 256G.01 to 256G.12, from sources other than federal 124.16 funds or funds used to match other federal funds. 124.17 (f) The commissioner may suspend, reduce, or terminate 124.18 reimbursement to a provider that does not meet the reporting or 124.19 other requirements of this section. The county of 124.20 responsibility, as defined in sections 256G.01 to 256G.12, is 124.21 responsible for any federal disallowances. The county may share 124.22 this responsibility with its contracted vendors. 124.23 (g) The commissioner shall set aside five percent of the 124.24 federal funds received under this section for use in reimbursing 124.25 the state for costs of developing and implementing this section. 124.26 (h) Notwithstanding section 256.025, subdivision 2, 124.27 payments to counties for targeted case management expenditures 124.28 under this section shall only be made from federal earnings from 124.29 services provided under this section. Payments to contracted 124.30 vendors shall include both the federal earnings and the county 124.31 share. 124.32 (i) Notwithstanding section 256B.041, county payments for 124.33 the cost of case management services provided by county staff 124.34 shall not be made to the state treasurer. For the purposes of 124.35 targeted case management services provided by county staff under 124.36 this section, the centralized disbursement of payments to 125.1 counties under section 256B.041 consists only of federal 125.2 earnings from services provided under this section. 125.3 (j) If the recipient is a resident of a nursing facility, 125.4 intermediate care facility, or hospital, and the recipient's 125.5 institutional care is paid by medical assistance, payment for 125.6 targeted case management services under this subdivision is 125.7 limited to the last 180 days of the recipient's residency in 125.8 that facility and may not exceed more than six months in a 125.9 calendar year. 125.10 (k) Payment for targeted case management services under 125.11 this subdivision shall not duplicate payments made under other 125.12 program authorities for the same purpose. 125.13 (l) Any growth in targeted case management services and 125.14 cost increases under this section shall be the responsibility of 125.15 the counties. 125.16 Subd. 7. [IMPLEMENTATION AND EVALUATION.] The commissioner 125.17 of human services in consultation with county boards shall 125.18 establish a program to accomplish the provisions of subdivisions 125.19 1 to 6. The commissioner in consultation with county boards 125.20 shall establish performance measures to evaluate the 125.21 effectiveness of the targeted case management services. If a 125.22 county fails to meet agreed upon performance measures, the 125.23 commissioner may authorize contracted providers other than the 125.24 county. Providers contracted by the commissioner shall also be 125.25 subject to the standards in subdivision 6. 125.26 Sec. 47. [256B.0948] [TARGETED CASE MANAGEMENT SERVICES 125.27 FOR CHILDREN UNDER THE AGE OF 19.] 125.28 Subdivision 1. [ELIGIBILITY.] An eligible recipient must: 125.29 (1) be under the age of 19; 125.30 (2) be enrolled in medical assistance or MinnesotaCare; 125.31 (3) have had at least one previous birth; and 125.32 (4) not receiving any other form of targeted case 125.33 management or case management through home and community-based 125.34 waiver services. 125.35 Subd. 2. [SCOPE.] "Targeted case management services" 125.36 means the coordination or implementation of social, health, 126.1 educational, counseling, or other services designed to ensure 126.2 continued social support to the recipient to prevent or delay a 126.3 subsequent pregnancy. 126.4 Subd. 3. [ELIGIBLE SERVICES.] (a) Case management services 126.5 include: 126.6 (1) assessing the recipient's need for medical, social, 126.7 educational, and other related services; 126.8 (2) coordinating health, social, educational, and 126.9 vocational needs with community-based services and programs; 126.10 (3) providing counseling services, including mentoring, 126.11 academic support, after-school enrichment, and healthy lifestyle 126.12 practices; 126.13 (4) monitoring the needs of the recipient on a regular 126.14 basis to ensure continued support; and 126.15 (5) promoting positive parenting. 126.16 (b) These services shall be provided to the recipient on a 126.17 one-to-one basis, in the recipient's home, community setting, or 126.18 in groups. 126.19 (c) Payment shall be made on a monthly basis. In order to 126.20 receive payment, a provider must document at least a 126.21 face-to-face contact with the recipient. 126.22 Subd. 4. [INDIVIDUAL SUPPORT PLAN.] Providers must develop 126.23 and implement an individual support plan for each recipient. 126.24 The plan must include concrete, measurable goals to be achieved 126.25 and specific objectives directed toward the achievement of each 126.26 goal. The plan must indicate how collaboration with other 126.27 services will occur. 126.28 Subd. 5. [TARGET POPULATION.] The commissioner shall 126.29 contract with qualified case managers to provide targeted case 126.30 management services. The contract will further define the 126.31 target population, covered case management services, payment 126.32 rates, and provider qualifications to ensure that annual 126.33 spending, including related administrative costs for the 126.34 nonfederal share of the cost is within the amount appropriated 126.35 for this purpose. 126.36 [EFFECTIVE DATE.] This section is effective on January 1, 127.1 2002, or upon federal approval, whichever is later. 127.2 Sec. 48. [256B.195] [ADDITIONAL INTERGOVERNMENTAL 127.3 TRANSFERS; HOSPITAL PAYMENTS.] 127.4 Subdivision 1. [FEDERAL APPROVAL REQUIRED.] Section 127.5 256.969, subdivision 26, and this section are contingent on 127.6 federal approval of the intergovernmental transfers and payments 127.7 to safety net hospitals authorized under this section. 127.8 Subd. 2. [PAYMENTS FROM GOVERNMENTAL HOSPITALS.] In 127.9 addition to any payment required under section 256B.19, 127.10 effective July 15, 2001, the following government entities shall 127.11 make the payments indicated before noon on the 15th of each 127.12 month: 127.13 (1) Hennepin county, $1,883,000; and 127.14 (2) Ramsey county, $696,450. 127.15 These sums shall be part of the designated governmental unit's 127.16 portion of the nonfederal share of medical assistance costs. 127.17 Subd. 3. [PAYMENTS TO CERTAIN SAFETY NET HOSPITALS.] (a) 127.18 Effective July 15, 2001, the commissioner shall make the 127.19 following payments to the hospitals indicated after noon on the 127.20 15th of each month: 127.21 (1) to Hennepin county medical center, $3,218,000, of which 127.22 $1,883,000 is to offset the amount of the transfer under 127.23 subdivision 2 and $1,335,000 is to increase payments for medical 127.24 assistance admissions; and 127.25 (2) to Regions hospital, $1,190,250, of which $696,450 is 127.26 to offset the amount of the transfer under subdivision 2 and 127.27 $493,800 is to increase payments for medical assistance 127.28 admissions. 127.29 (b) This section and section 256.969, subdivision 26, shall 127.30 apply to fee-for-service payments only and shall not increase 127.31 capitation payments or payments made based on average rates. 127.32 (c) Medical assistance rate or payment changes required to 127.33 obtain federal financial participation under section 62J.692, 127.34 subdivision 8, shall precede the determination of 127.35 intergovernmental transfer amounts determined in this 127.36 subdivision. Participation in the intergovernmental transfer 128.1 program shall not result in the offset of any health care 128.2 provider's receipt of medical assistance payment increases other 128.3 than limits on rates and payments. 128.4 Subd. 4. [ADJUSTMENTS PERMITTED.] (a) The commissioner may 128.5 adjust the intergovernmental transfers under subdivision 2 and 128.6 the hospital payments under subdivision 3, after consultation 128.7 with the nonstate government entities named in this section, 128.8 based on the commissioner's determination of Medicare upper 128.9 payment limits and hospital-specific limitations on 128.10 disproportionate share payments. 128.11 (b) The ratio of medical assistance payments specified in 128.12 subdivision 3 to the intergovernmental transfers specified in 128.13 subdivision 2 shall not be reduced below 170 percent unless a 128.14 further reduction is required to preserve state budget 128.15 neutrality. 128.16 (c) If the federal rules regarding the establishment of the 128.17 150 percent upper payment limit for certain nonstate public 128.18 hospitals are rescinded, or if the upper payment limit is 128.19 otherwise reduced to 100 percent, the ratio of intergovernmental 128.20 transfers and medical assistance payments among the 128.21 participating entities named in this section shall be adjusted 128.22 based on the proportion of medical assistance inpatient hospital 128.23 admissions from the third previous rate year provided by each 128.24 participating hospital, and paragraph (b) shall not apply. 128.25 Subd. 5. [INCLUSION OF FAIRVIEW UNIVERSITY MEDICAL 128.26 CENTER.] Upon federal approval of the inclusion of Fairview 128.27 university medical center in the nonstate government category, 128.28 the commissioner shall establish an intergovernmental transfer 128.29 with the University of Minnesota in an amount determined by the 128.30 commissioner based on the increase in the Medicare upper payment 128.31 limit due solely to the inclusion of Fairview university medical 128.32 center as a nonstate government hospital and the amount 128.33 available under the hospital specific disproportionate share 128.34 limit. All of the proceeds of the transfer shall be used to 128.35 increase payments to Fairview university medical center for 128.36 medical assistance admissions. From this payment, Fairview 129.1 university medical center shall pay to the University of 129.2 Minnesota the cost of the transfer on the same day the payment 129.3 is received. 129.4 Sec. 49. [256B.53] [DENTAL ACCESS GRANTS.] 129.5 (a) The commissioner shall award grants to community 129.6 clinics or other nonprofit community organizations, political 129.7 subdivisions, professional associations, or other organizations 129.8 that demonstrate the ability to provide dental services 129.9 effectively to public program recipients. Grants may be used to 129.10 fund the costs related to coordinating access for recipients, 129.11 developing and implementing patient care criteria, upgrading or 129.12 establishing new facilities, acquiring furnishings or equipment, 129.13 recruiting new providers, or other development costs that will 129.14 improve access to dental care in a region. 129.15 (b) In awarding grants, the commissioner shall give 129.16 priority to applicants that plan to serve areas of the state in 129.17 which the number of dental providers is not currently sufficient 129.18 to meet the needs of recipients of public programs or uninsured 129.19 individuals. The commissioner shall consider the following in 129.20 awarding the grants: 129.21 (1) potential to successfully increase access to an 129.22 underserved population; 129.23 (2) the long-term viability of the project to improve 129.24 access beyond the period of initial funding; 129.25 (3) the efficiency in the use of the funding; and 129.26 (4) the experience of the applicants in providing services 129.27 to the target population. 129.28 (c) The commissioner shall consider grants for the 129.29 following: 129.30 (1) implementation of new programs or continued expansion 129.31 of current access programs that have demonstrated success in 129.32 providing dental services in underserved areas; 129.33 (2) a program for mobile or other types of outreach dental 129.34 clinics in underserved geographic areas; 129.35 (3) a program for school-based dental clinics in schools 129.36 with high numbers of children receiving medical assistance; 130.1 (4) a program testing new models of care that are sensitive 130.2 to the cultural needs of the recipients; 130.3 (5) a program creating new educational campaigns that 130.4 inform individuals of the importance of good oral health and the 130.5 link between dental disease and overall health status; 130.6 (6) a program that organizes a network of volunteer 130.7 dentists to provide dental services to public program recipients 130.8 or uninsured individuals; and 130.9 (7) a program that tests new delivery models by creating 130.10 partnerships between local providers and county public health 130.11 agencies. 130.12 (d) The commissioner shall evaluate the effects of the 130.13 dental access initiatives funded through the dental access 130.14 grants and submit a report to the legislature by January 15, 130.15 2003. 130.16 Sec. 50. [256B.55] [DENTAL ACCESS ADVISORY COMMITTEE.] 130.17 Subdivision 1. [ESTABLISHMENT.] The commissioner shall 130.18 establish a dental access advisory committee to monitor the 130.19 purchasing, administration, and coverage of dental care services 130.20 for the public health care programs to ensure dental care access 130.21 and quality for public program recipients. 130.22 Subd. 2. [MEMBERSHIP.] (a) The membership of the advisory 130.23 committee shall include, but is not limited to, representatives 130.24 of dentists, including a dentist practicing in the seven-county 130.25 metropolitan area and a dentist practicing outside the 130.26 seven-county metropolitan area; oral surgeons; pediatric 130.27 dentists; dental hygienists; community clinics; client advocacy 130.28 groups; public health; health service plans; the University of 130.29 Minnesota school of dentistry and the department of pediatrics; 130.30 and the commissioner of health. 130.31 (b) The advisory committee is governed by section 15.059 130.32 for membership terms and removal of members. 130.33 Subd. 3. [DUTIES.] The advisory committee shall provide 130.34 recommendations on the following: 130.35 (1) how to reduce the administrative burden governing 130.36 dental care coverage policies in order to promote administrative 131.1 simplification, including prior authorization, coverage limits, 131.2 and co-payment collections; 131.3 (2) developing and implementing an action plan to improve 131.4 the oral health of children and persons with special needs in 131.5 the state; 131.6 (3) exploring alternative ways of purchasing and improving 131.7 access to dental services; 131.8 (4) developing ways to foster greater responsibility among 131.9 health care program recipients in seeking and obtaining dental 131.10 care, including initiatives to keep dental appointments and 131.11 comply with dental care plans; 131.12 (5) exploring innovative ways for dental providers to 131.13 schedule public program patients in order to reduce or minimize 131.14 the effect of appointment no shows; 131.15 (6) exploring ways to meet the barriers that may be present 131.16 in providing dental services to health care program recipients 131.17 such as language, culture, disability, and lack of 131.18 transportation; and 131.19 (7) exploring the possibility of pediatricians, family 131.20 physicians, and nurse practitioners providing basic oral health 131.21 screenings and basic preventive dental services. 131.22 Subd. 4. [REPORT.] The commissioner shall submit a report 131.23 by February 1, 2002, and by February 1, 2003, summarizing the 131.24 activities and recommendations of the advisory committee. 131.25 Subd. 5. [SUNSET.] Notwithstanding section 15.059, 131.26 subdivision 5, this section expires June 30, 2003. 131.27 Sec. 51. Minnesota Statutes 2000, section 256B.69, 131.28 subdivision 4, is amended to read: 131.29 Subd. 4. [LIMITATION OF CHOICE.] (a) The commissioner 131.30 shall develop criteria to determine when limitation of choice 131.31 may be implemented in the experimental counties. The criteria 131.32 shall ensure that all eligible individuals in the county have 131.33 continuing access to the full range of medical assistance 131.34 services as specified in subdivision 6. 131.35 (b) The commissioner shall exempt the following persons 131.36 from participation in the project, in addition to those who do 132.1 not meet the criteria for limitation of choice: 132.2 (1) persons eligible for medical assistance according to 132.3 section 256B.055, subdivision 1; 132.4 (2) persons eligible for medical assistance due to 132.5 blindness or disability as determined by the social security 132.6 administration or the state medical review team, unless: 132.7 (i) they are 65 years of age or older,; or 132.8 (ii) they reside in Itasca county or they reside in a 132.9 county in which the commissioner conducts a pilot project under 132.10 a waiver granted pursuant to section 1115 of the Social Security 132.11 Act; 132.12 (3) recipients who currently have private coverage through 132.13 a health maintenance organization; 132.14 (4) recipients who are eligible for medical assistance by 132.15 spending down excess income for medical expenses other than the 132.16 nursing facility per diem expense; 132.17 (5) recipients who receive benefits under the Refugee 132.18 Assistance Program, established under United States Code, title 132.19 8, section 1522(e); 132.20 (6) children who are both determined to be severely 132.21 emotionally disturbed and receiving case management services 132.22 according to section 256B.0625, subdivision 20;and132.23 (7) adults who are both determined to be seriously and 132.24 persistently mentally ill and received case management services 132.25 according to section 256B.0625, subdivision 20; and 132.26 (8) persons eligible for medical assistance according to 132.27 section 256B.057, subdivision 10. 132.28 Children under age 21 who are in foster placement may enroll in 132.29 the project on an elective basis. Individuals excluded under 132.30 clauses (6) and (7) may choose to enroll on an elective basis. 132.31 (c) When a child enrolled with a demonstration provider has 132.32 been identified as receiving mental health services in an 132.33 alternative school, the alternative school shall notify the 132.34 commissioner and the child's county of financial 132.35 responsibility. The commissioner, in coordination with the 132.36 county, shall determine whether the child qualifies under 133.1 paragraph (b) for exclusion from participation in the 133.2 demonstration project. If the child qualifies, the county shall 133.3 contact the child's parent or guardian and offer the option for 133.4 the child to be excluded from the demonstration project. 133.5 (d) The commissioner may allow persons with a one-month 133.6 spenddown who are otherwise eligible to enroll to voluntarily 133.7 enroll or remain enrolled, if they elect to prepay their monthly 133.8 spenddown to the state. 133.9 (e)Beginning on or after July 1, 1997,The commissioner 133.10 may require those individuals to enroll in the prepaid medical 133.11 assistance program who otherwise would have been excluded 133.12 under paragraph (b), clauses (1)and, (3), and (8), and under 133.13 Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L. 133.14 (f) Before limitation of choice is implemented, eligible 133.15 individuals shall be notified and after notification, shall be 133.16 allowed to choose only among demonstration providers. The 133.17 commissioner may assign an individual with private coverage 133.18 through a health maintenance organization, to the same health 133.19 maintenance organization for medical assistance coverage, if the 133.20 health maintenance organization is under contract for medical 133.21 assistance in the individual's county of residence. After 133.22 initially choosing a provider, the recipient is allowed to 133.23 change that choice only at specified times as allowed by the 133.24 commissioner. If a demonstration provider ends participation in 133.25 the project for any reason, a recipient enrolled with that 133.26 provider must select a new provider but may change providers 133.27 without cause once more within the first 60 days after 133.28 enrollment with the second provider. 133.29 [EFFECTIVE DATE.] Paragraph (c) of this section is 133.30 effective the day following final enactment. 133.31 Sec. 52. Minnesota Statutes 2000, section 256B.69, 133.32 subdivision 5c, is amended to read: 133.33 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) 133.34 Beginning in January 1999 and each year thereafter: 133.35 (1) the commissioner of human services shall transfer an 133.36 amount equal to the reduction in the prepaid medical assistance 134.1 and prepaid general assistance medical care payments resulting 134.2 from clause (2), excluding nursing facility and elderly waiver 134.3 payments and demonstration projects operating under subdivision 134.4 23, and an amount totaling the amount identified in clauses (3) 134.5 and (4) to the medical education and research fund established 134.6 under section 62J.692; 134.7 (2) until January 1, 2002, the county medical assistance 134.8 and general assistance medical care capitation base rate prior 134.9 to plan specific adjustments and after the regional rate 134.10 adjustments under section 256B.69, subdivision 5b, shall be 134.11 reduced 6.3 percent for Hennepin county, two percent for the 134.12 remaining metropolitan counties, and no reduction for 134.13 nonmetropolitan Minnesota counties; and after January 1, 2002, 134.14 the county medical assistance and general assistance medical 134.15 care capitation base rate prior to plan specific adjustments 134.16 shall be reduced 6.3 percent for Hennepin county, two percent 134.17 for the remaining metropolitan counties, and 1.6 percent for 134.18 nonmetropolitan Minnesota counties;and134.19 (3) effective July 1, 2001, the amount transferred under 134.20 section 62J.694, subdivision 2, paragraph (d), to increase the 134.21 capitation rates plus any federal matching funds; 134.22 (4) effective July 1, 2001, $600,000 from the capitation 134.23 rates paid under this section plus any federal matching funds on 134.24 this amount; and 134.25 (5) the amount calculated under clause (1) shall not be 134.26 adjusted for subsequent changes to the capitation payments for 134.27 periods already paid. 134.28 (b) This subdivision shall be effective upon approval of a 134.29 federal waiver which allows federal financial participation in 134.30 the medical education and research fund. 134.31 Sec. 53. Minnesota Statutes 2000, section 256B.69, is 134.32 amended by adding a subdivision to read: 134.33 Subd. 6c. [DENTAL SERVICES DEMONSTRATION PROJECT.] The 134.34 commissioner shall establish a dental services demonstration 134.35 project in Crow Wing, Todd, Morrison, Wadena, and Cass counties 134.36 for provision of dental services to medical assistance, general 135.1 assistance medical care, and MinnesotaCare recipients. The 135.2 commissioner may contract on a prospective per capita payment 135.3 basis for these dental services with an organization licensed 135.4 under chapter 62C, 62D, or 62N in accordance with section 135.5 256B.037 or may establish and administer a fee-for-service 135.6 system for the reimbursement of dental services. 135.7 Sec. 54. Minnesota Statutes 2000, section 256B.69, 135.8 subdivision 23, is amended to read: 135.9 Subd. 23. [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES; 135.10 ELDERLY AND DISABLED PERSONS.] (a) The commissioner may 135.11 implement demonstration projects to create alternative 135.12 integrated delivery systems for acute and long-term care 135.13 services to elderly persons and persons with disabilities as 135.14 defined in section 256B.77, subdivision 7a, that provide 135.15 increased coordination, improve access to quality services, and 135.16 mitigate future cost increases. The commissioner may seek 135.17 federal authority to combine Medicare and Medicaid capitation 135.18 payments for the purpose of such demonstrations. Medicare funds 135.19 and services shall be administered according to the terms and 135.20 conditions of the federal waiver and demonstration provisions. 135.21 For the purpose of administering medical assistance funds, 135.22 demonstrations under this subdivision are subject to 135.23 subdivisions 1 to 22. The provisions of Minnesota Rules, parts 135.24 9500.1450 to 9500.1464, apply to these demonstrations, with the 135.25 exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, 135.26 subpart 1, items B and C, which do not apply to persons 135.27 enrolling in demonstrations under this section. An initial open 135.28 enrollment period may be provided. Persons who disenroll from 135.29 demonstrations under this subdivision remain subject to 135.30 Minnesota Rules, parts 9500.1450 to 9500.1464. When a person is 135.31 enrolled in a health plan under these demonstrations and the 135.32 health plan's participation is subsequently terminated for any 135.33 reason, the person shall be provided an opportunity to select a 135.34 new health plan and shall have the right to change health plans 135.35 within the first 60 days of enrollment in the second health 135.36 plan. Persons required to participate in health plans under 136.1 this section who fail to make a choice of health plan shall not 136.2 be randomly assigned to health plans under these demonstrations. 136.3 Notwithstanding section 256L.12, subdivision 5, and Minnesota 136.4 Rules, part 9505.5220, subpart 1, item A, if adopted, for the 136.5 purpose of demonstrations under this subdivision, the 136.6 commissioner may contract with managed care organizations, 136.7 including counties, to serve only elderly persons eligible for 136.8 medical assistance, elderly and disabled persons, or disabled 136.9 persons only. For persons with primary diagnoses of mental 136.10 retardation or a related condition, serious and persistent 136.11 mental illness, or serious emotional disturbance, the 136.12 commissioner must ensure that the county authority has approved 136.13 the demonstration and contracting design. Enrollment in these 136.14 projects for persons with disabilities shall be voluntaryuntil136.15July 1, 2001. The commissioner shall not implement any 136.16 demonstration project under this subdivision for persons with 136.17 primary diagnoses of mental retardation or a related condition, 136.18 serious and persistent mental illness, or serious emotional 136.19 disturbance, without approval of the county board of the county 136.20 in which the demonstration is being implemented. 136.21 Before implementation of a demonstration project for 136.22 disabled persons, the commissioner must provide information to 136.23 appropriate committees of the house of representatives and 136.24 senate and must involve representatives of affected disability 136.25 groups in the design of the demonstration projects. 136.26 (b) A nursing facility reimbursed under the alternative 136.27 reimbursement methodology in section 256B.434 may, in 136.28 collaboration with a hospital, clinic, or other health care 136.29 entity provide services under paragraph (a). The commissioner 136.30 shall amend the state plan and seek any federal waivers 136.31 necessary to implement this paragraph. 136.32 Sec. 55. Minnesota Statutes 2000, section 256B.75, is 136.33 amended to read: 136.34 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 136.35 (a) For outpatient hospital facility fee payments for 136.36 services rendered on or after October 1, 1992, the commissioner 137.1 of human services shall pay the lower of (1) submitted charge, 137.2 or (2) 32 percent above the rate in effect on June 30, 1992, 137.3 except for those services for which there is a federal maximum 137.4 allowable payment. Effective for services rendered on or after 137.5 January 1, 2000, payment rates for nonsurgical outpatient 137.6 hospital facility fees and emergency room facility fees shall be 137.7 increased by eight percent over the rates in effect on December 137.8 31, 1999, except for those services for which there is a federal 137.9 maximum allowable payment. Services for which there is a 137.10 federal maximum allowable payment shall be paid at the lower of 137.11 (1) submitted charge, or (2) the federal maximum allowable 137.12 payment. Total aggregate payment for outpatient hospital 137.13 facility fee services shall not exceed the Medicare upper 137.14 limit. If it is determined that a provision of this section 137.15 conflicts with existing or future requirements of the United 137.16 States government with respect to federal financial 137.17 participation in medical assistance, the federal requirements 137.18 prevail. The commissioner may, in the aggregate, prospectively 137.19 reduce payment rates to avoid reduced federal financial 137.20 participation resulting from rates that are in excess of the 137.21 Medicare upper limitations. 137.22 (b) Notwithstanding paragraph (a), payment for outpatient, 137.23 emergency, and ambulatory surgery hospital facility fee services 137.24 for critical access hospitals designated under section 144.1483, 137.25 clause (11), shall be paid on a cost-based payment system that 137.26 is based on the cost-finding methods and allowable costs of the 137.27 Medicare program. 137.28 (c) Effective for services provided on or after July 1, 137.29 2002, rates that are based on the Medicare outpatient 137.30 prospective payment system shall be replaced by a budget neutral 137.31 prospective payment system that is derived using medical 137.32 assistance data. The commissioner shall provide a proposal to 137.33 the 2002 legislature to define and implement this provision. 137.34 Sec. 56. Minnesota Statutes 2000, section 256B.76, is 137.35 amended to read: 137.36 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 138.1 (a) Effective for services rendered on or after October 1, 138.2 1992, the commissioner shall make payments for physician 138.3 services as follows: 138.4 (1) payment for level one Health Care Finance 138.5 Administration's common procedural coding system (HCPCS) codes 138.6 titled "office and other outpatient services," "preventive 138.7 medicine new and established patient," "delivery, antepartum, 138.8 and postpartum care," "critical care,"Caesareancesarean 138.9 delivery and pharmacologic management provided to psychiatric 138.10 patients, and HCPCS level three codes for enhanced services for 138.11 prenatal high risk, shall be paid at the lower of (i) submitted 138.12 charges, or (ii) 25 percent above the rate in effect on June 30, 138.13 1992. If the rate on any procedure code within these categories 138.14 is different than the rate that would have been paid under the 138.15 methodology in section 256B.74, subdivision 2, then the larger 138.16 rate shall be paid; 138.17 (2) payments for all other services shall be paid at the 138.18 lower of (i) submitted charges, or (ii) 15.4 percent above the 138.19 rate in effect on June 30, 1992; 138.20 (3) all physician rates shall be converted from the 50th 138.21 percentile of 1982 to the 50th percentile of 1989, less the 138.22 percent in aggregate necessary to equal the above increases 138.23 except that payment rates for home health agency services shall 138.24 be the rates in effect on September 30, 1992; 138.25 (4) effective for services rendered on or after January 1, 138.26 2000, payment rates for physician and professional services 138.27 shall be increased by three percent over the rates in effect on 138.28 December 31, 1999, except for home health agency and family 138.29 planning agency services; and 138.30 (5) the increases in clause (4) shall be implemented 138.31 January 1, 2000, for managed care. 138.32 (b) Effective for services rendered on or after October 1, 138.33 1992, the commissioner shall make payments for dental services 138.34 as follows: 138.35 (1) dental services shall be paid at the lower of (i) 138.36 submitted charges, or (ii) 25 percent above the rate in effect 139.1 on June 30, 1992; 139.2 (2) dental rates shall be converted from the 50th 139.3 percentile of 1982 to the 50th percentile of 1989, less the 139.4 percent in aggregate necessary to equal the above increases; 139.5 (3) effective for services rendered on or after January 1, 139.6 2000, payment rates for dental services shall be increased by 139.7 three percent over the rates in effect on December 31, 1999; 139.8 (4)the commissioner shall award grants to community139.9clinics or other nonprofit community organizations, political139.10subdivisions, professional associations, or other organizations139.11that demonstrate the ability to provide dental services139.12effectively to public program recipients. Grants may be used to139.13fund the costs related to coordinating access for recipients,139.14developing and implementing patient care criteria, upgrading or139.15establishing new facilities, acquiring furnishings or equipment,139.16recruiting new providers, or other development costs that will139.17improve access to dental care in a region. In awarding grants,139.18the commissioner shall give priority to applicants that plan to139.19serve areas of the state in which the number of dental providers139.20is not currently sufficient to meet the needs of recipients of139.21public programs or uninsured individuals. The commissioner139.22shall consider the following in awarding the grants: (i)139.23potential to successfully increase access to an underserved139.24population; (ii) the ability to raise matching funds; (iii) the139.25long-term viability of the project to improve access beyond the139.26period of initial funding; (iv) the efficiency in the use of the139.27funding; and (v) the experience of the proposers in providing139.28services to the target population.139.29The commissioner shall monitor the grants and may terminate139.30a grant if the grantee does not increase dental access for139.31public program recipients. The commissioner shall consider139.32grants for the following:139.33(i) implementation of new programs or continued expansion139.34of current access programs that have demonstrated success in139.35providing dental services in underserved areas;139.36(ii) a pilot program for utilizing hygienists outside of a140.1traditional dental office to provide dental hygiene services;140.2and140.3(iii) a program that organizes a network of volunteer140.4dentists, establishes a system to refer eligible individuals to140.5volunteer dentists, and through that network provides donated140.6dental care services to public program recipients or uninsured140.7individuals.140.8(5)beginning October 1, 1999, the payment for tooth 140.9 sealants and fluoride treatments shall be the lower of (i) 140.10 submitted charge, or (ii) 80 percent of median 1997 charges;and140.11(6)(5) the increases listed in clauses (3) and(5)(4) 140.12 shall be implemented January 1, 2000, for managed care; 140.13 (6) effective for services provided on or after January 1, 140.14 2002, payment for diagnostic examinations and dental x-rays 140.15 provided to children under age 21 shall be the lower of: 140.16 (i) the submitted charge; or 140.17 (ii) 70 percent of median 1999 charges; and 140.18 (7) a dental provider shall be reimbursed for the dental 140.19 services actually provided to a patient when the dental work 140.20 scheduled requires more than one appointment and the patient 140.21 fails to keep the subsequent appointment or appointments. 140.22 (c) Effective for dental services provided on or after 140.23 January 1, 2002, the commissioner may increase reimbursement to 140.24 dentists or dental clinics designated by the commissioner as 140.25 critical access providers. The commissioner may increase 140.26 reimbursement to a critical access provider by up to 30 percent 140.27 more than would otherwise be paid to that provider. In 140.28 determining critical access provider status, the commissioner 140.29 shall review: 140.30 (1) the utilization rate for dental services by Minnesota 140.31 health care program patients in the service area; 140.32 (2) the level of service provided to Minnesota health care 140.33 program patients by the dentist or dental clinic; and 140.34 (3) whether the level of services provided by the dentist 140.35 or clinic is critical to maintaining an adequate level of access 140.36 for patients in the service area. 141.1 If no provider in a service area is designated a critical access 141.2 provider upon review, the commissioner may designate a dentist 141.3 or dental clinic as a critical access provider if the dentist or 141.4 clinic is willing to provide care to Minnesota health care 141.5 program patients at a level that significantly increases access 141.6 to dental care within the service area. The commissioner shall 141.7 adjust payments to prepaid health plans to reflect increased 141.8 reimbursement to critical access providers under this paragraph 141.9 effective January 1, 2002. 141.10 (d) An entity that operates both a Medicare certified 141.11 comprehensive outpatient rehabilitation facility and a facility 141.12 which was certified prior to January 1, 1993, that is licensed 141.13 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 141.14 whom at least 33 percent of the clients receiving rehabilitation 141.15 services and mental health services in the most recent calendar 141.16 year are medical assistance recipients, shall be reimbursed by 141.17 the commissioner for rehabilitation services and mental health 141.18 services at rates that are 38 percent greater than the maximum 141.19 reimbursement rate allowed under paragraph (a), clause (2), when 141.20 those services are (1) provided within the comprehensive 141.21 outpatient rehabilitation facility and (2) provided to residents 141.22 of nursing facilities owned by the entity. 141.23 Sec. 57. [256B.78] [MEDICAL ASSISTANCE DEMONSTRATION 141.24 PROJECT FOR FAMILY PLANNING SERVICES.] 141.25 (a) The commissioner of human services shall establish a 141.26 medical assistance demonstration project to determine whether 141.27 improved access to coverage of prepregnancy family planning 141.28 services reduces medical assistance and MFIP costs. 141.29 (b) This section is effective upon federal approval of the 141.30 demonstration project. 141.31 Sec. 58. [256B.79] [HEALTH CARE PREVENTIVE SERVICES POOL.] 141.32 The commissioner of human services shall create an 141.33 uncompensated care pool to reimburse community clinics and other 141.34 health care providers that provide initial health care 141.35 screenings and preventive care services to children who are 141.36 uninsured. The commissioner shall establish a process for 142.1 clinics to apply for reimbursement. As a condition of receiving 142.2 payment from this pool, the clinic or provider must offer 142.3 services ranging from providing information up to on-site 142.4 enrollment. 142.5 Sec. 59. Minnesota Statutes 2000, section 256J.31, 142.6 subdivision 12, is amended to read: 142.7 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 142.8 participant who is not in vendor payment status may discontinue 142.9 receipt of the cash assistance portion of the MFIP assistance 142.10 grant and retain eligibility for child care assistance under 142.11 section 119B.05and for medical assistance under sections142.12256B.055, subdivision 3a, and 256B.0635. For the months a 142.13 participant chooses to discontinue the receipt of the cash 142.14 portion of the MFIP grant, the assistance unit accrues months of 142.15 eligibility to be applied toward eligibility for child care 142.16 under section 119B.05and for medical assistance under sections142.17256B.055, subdivision 3a, and 256B.0635. 142.18 [EFFECTIVE DATE.] This section is effective July 1, 2002. 142.19 Sec. 60. Minnesota Statutes 2000, section 256K.03, 142.20 subdivision 1, is amended to read: 142.21 Subdivision 1. [NOTIFICATION OF PROGRAM.] Except for the 142.22 provisions in this section, the provisions for the MFIP 142.23 application process shall be followed. Within two days after 142.24 receipt of a completed combined application form, the county 142.25 agency must refer to the provider the applicant who meets the 142.26 conditions under section 256K.02, and notify the applicant in 142.27 writing of the program including the following provisions: 142.28 (1) notification that, as part of the application process, 142.29 applicants are required to attend orientation, to be followed 142.30 immediately by a job search; 142.31 (2) the program provider, the date, time, and location of 142.32 the scheduled program orientation; 142.33 (3) the procedures for qualifying for and receiving 142.34 benefits under the program; 142.35 (4) the immediate availability of supportive services, 142.36 including, but not limited to, child care, transportation, 143.1medical assistance,and other work-related aid; and 143.2 (5) the rights, responsibilities, and obligations of 143.3 participants in the program, including, but not limited to, the 143.4 grounds for exemptions and deferrals, the consequences for 143.5 refusing or failing to participate fully, and the appeal process. 143.6 [EFFECTIVE DATE.] This section is effective July 1, 2002. 143.7 Sec. 61. Minnesota Statutes 2000, section 256K.07, is 143.8 amended to read: 143.9 256K.07 [ELIGIBILITY FOR FOOD STAMPS, MEDICAL ASSISTANCE,143.10 AND CHILD CARE.] 143.11 The participant shall be treated as an MFIP recipient for 143.12 food stamps, medical assistance,and child care eligibility 143.13 purposes. The participant who leaves the program as a result of 143.14 increased earnings from employment shall be eligible for 143.15transitional medical assistance andchild care without regard to 143.16 MFIP receipt in three of the six months preceding ineligibility. 143.17 [EFFECTIVE DATE.] This section is effective July 1, 2002. 143.18 Sec. 62. Minnesota Statutes 2000, section 256L.01, 143.19 subdivision 4, is amended to read: 143.20 Subd. 4. [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] (a) 143.21 "Gross individual or gross family income" forfarm andnonfarm 143.22 self-employed means income calculated using as the baseline the 143.23 adjusted gross income reported on the applicant's federal income 143.24 tax form for the previous year and adding back in reported 143.25 depreciation, carryover loss, and net operating loss amounts 143.26 that apply to the business in which the family is currently 143.27 engaged. 143.28 (b) "Gross individual or gross family income" for farm 143.29 self-employed means income calculated using as the baseline the 143.30 adjusted gross income reported on the applicant's federal income 143.31 tax form for the previous year and adding back in reported 143.32 depreciation amounts that apply to the business in which the 143.33 family is currently engaged. 143.34 (c) Applicants shall report the most recent financial 143.35 situation of the family if it has changed from the period of 143.36 time covered by the federal income tax form. The report may be 144.1 in the form of percentage increase or decrease. 144.2 [EFFECTIVE DATE.] This section is effective July 1, 2001, 144.3 or upon receipt of federal approval, whichever is later. 144.4 Sec. 63. Minnesota Statutes 2000, section 256L.04, 144.5 subdivision 2, is amended to read: 144.6 Subd. 2. [COOPERATION IN ESTABLISHING THIRD-PARTY 144.7 LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 144.8 eligible for MinnesotaCare, individuals and families must 144.9 cooperate with the state agency to identify potentially liable 144.10 third-party payers and assist the state in obtaining third-party 144.11 payments. "Cooperation" includes, but is not limited to, 144.12 identifying any third party who may be liable for care and 144.13 services provided under MinnesotaCare to the enrollee, providing 144.14 relevant information to assist the state in pursuing a 144.15 potentially liable third party, and completing forms necessary 144.16 to recover third-party payments. For a child through age 18 144.17 whose gross family income is equal to or less than 225 percent 144.18 of the federal poverty guidelines, cooperation also includes 144.19 providing information about a group health plan in which the 144.20 child is enrolled or eligible to enroll. If the health plan is 144.21 determined cost-effective by the state agency and premiums are 144.22 paid by the state or local agency or there is no cost to the 144.23 enrollee, the MinnesotaCare enrollee must enroll or remain 144.24 enrolled in the group health plan, and the commissioner may 144.25 exempt the enrollee from the requirements of section 256L.12. 144.26 For purposes of this subdivision, coverage provided by the 144.27 Minnesota comprehensive health association under chapter 62E 144.28 shall not be considered group health plan coverage or 144.29 cost-effective by the state and local agency. 144.30 (b) A parent, guardian, relative caretaker, or child 144.31 enrolled in the MinnesotaCare program must cooperate with the 144.32 department of human services and the local agency in 144.33 establishing the paternity of an enrolled child and in obtaining 144.34 medical care support and payments for the child and any other 144.35 person for whom the person can legally assign rights, in 144.36 accordance with applicable laws and rules governing the medical 145.1 assistance program. A child shall not be ineligible for or 145.2 disenrolled from the MinnesotaCare program solely because the 145.3 child's parent, relative caretaker, or guardian fails to 145.4 cooperate in establishing paternity or obtaining medical support. 145.5 [EFFECTIVE DATE.] This section is effective July 1, 2002. 145.6 Sec. 64. Minnesota Statutes 2000, section 256L.05, 145.7 subdivision 2, is amended to read: 145.8 Subd. 2. [COMMISSIONER'S DUTIES.] The commissionershall145.9use individuals' social security numbers as identifiers for145.10purposes of administering the plan and conduct data matches to145.11verify income. Applicants shall submit evidence of individual145.12and family income, earned and unearned, such as the most recent145.13income tax return, wage slips, or other documentation that is145.14determined by the commissioner as necessary to verify income145.15eligibilityor county agency shall use electronic verification 145.16 as the primary method of income verification. If there is a 145.17 discrepancy in the electronic verification, an individual may be 145.18 required to submit additional verification. In addition, the 145.19 commissioner shall perform random audits to verify reported 145.20 income and eligibility. The commissioner may execute data 145.21 sharing arrangements with the department of revenue and any 145.22 other governmental agency in order to perform income 145.23 verification related to eligibility and premium payment under 145.24 the MinnesotaCare program. 145.25 Sec. 65. Minnesota Statutes 2000, section 256L.06, 145.26 subdivision 3, is amended to read: 145.27 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 145.28 Premiums are dedicated to the commissioner for MinnesotaCare. 145.29 (b) The commissioner shall develop and implement procedures 145.30 to: (1) require enrollees to report changes in income; (2) 145.31 adjust sliding scale premium payments, based upon changes in 145.32 enrollee income; and (3) disenroll enrollees from MinnesotaCare 145.33 for failure to pay required premiums. Failure to pay includes 145.34 payment with a dishonored check, a returned automatic bank 145.35 withdrawal, or a refused credit card or debit card payment. The 145.36 commissioner may demand a guaranteed form of payment, including 146.1 a cashier's check or a money order, as the only means to replace 146.2 a dishonored, returned, or refused payment. 146.3 (c) Premiums are calculated on a calendar month basis and 146.4 may be paid on a monthly, quarterly, or annual basis, with the 146.5 first payment due upon notice from the commissioner of the 146.6 premium amount required. The commissioner shall inform 146.7 applicants and enrollees of these premium payment options. 146.8 Premium payment is required before enrollment is complete and to 146.9 maintain eligibility in MinnesotaCare. 146.10 (d) Nonpayment of the premium will result in disenrollment 146.11 from the planwithin one calendar month after the due date146.12 effective for the calendar month for which the premium was due. 146.13 Persons disenrolled for nonpayment or who voluntarily terminate 146.14 coverage from the program may not reenroll until four calendar 146.15 months have elapsed. Persons disenrolled for nonpayment who pay 146.16 all past due premiums as well as current premiums due, including 146.17 premiums due for the period of disenrollment, within 20 days of 146.18 disenrollment, shall be reenrolled retroactively to the first 146.19 day of disenrollment. Persons disenrolled for nonpayment or who 146.20 voluntarily terminate coverage from the program may not reenroll 146.21 for four calendar months unless the person demonstrates good 146.22 cause for nonpayment. Good cause does not exist if a person 146.23 chooses to pay other family expenses instead of the premium. 146.24 The commissioner shall define good cause in rule. 146.25 [EFFECTIVE DATE.] This section is effective July 1, 2002. 146.26 Sec. 66. Minnesota Statutes 2000, section 256L.07, 146.27 subdivision 1, is amended to read: 146.28 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 146.29 enrolled in the original children's health plan as of September 146.30 30, 1992, and children who enrolled in the MinnesotaCare program 146.31 after September 30, 1992, pursuant to Laws 1992, chapter 549, 146.32 article 4, section 17, who have maintained continuous coverage 146.33 in the MinnesotaCare program or medical assistance; and children 146.34 under two; pregnant women; and children through age 18 who have 146.35 family gross incomes that are equal to or less than150225 146.36 percent of the federal poverty guidelines are eligible without 147.1 meeting the requirements ofsubdivision 2, as long as they147.2maintain continuous coverage in the MinnesotaCare program or147.3medical assistance. Children who apply for MinnesotaCare on or147.4after the implementation date of the employer-subsidized health147.5coverage program as described in Laws 1998, chapter 407, article147.65, section 45, who have family gross incomes that are equal to147.7or less than 150 percent of the federal poverty guidelines, must147.8meet the requirements of subdivision 2 to be eligible for147.9MinnesotaCaresubdivisions 2 and 3. 147.10 (b) Families enrolled in MinnesotaCare under section 147.11 256L.04, subdivision 1, whose income increases above 275 percent 147.12 of the federal poverty guidelines, are no longer eligible for 147.13 the program and shall be disenrolled by the commissioner. 147.14 Individuals enrolled in MinnesotaCare under section 256L.04, 147.15 subdivision 7, whose income increases above 175 percent of the 147.16 federal poverty guidelines are no longer eligible for the 147.17 program and shall be disenrolled by the commissioner. For 147.18 persons disenrolled under this subdivision, MinnesotaCare 147.19 coverage terminates the last day of the calendar month following 147.20 the month in which the commissioner determines that the income 147.21 of a family or individual exceeds program income limits. 147.22 (c) Notwithstanding paragraph (b), individuals and families 147.23 may remain enrolled in MinnesotaCare if ten percent of their 147.24 annual income is less than the annual premium for a policy with 147.25 a $500 deductible available through the Minnesota comprehensive 147.26 health association. Individuals and families who are no longer 147.27 eligible for MinnesotaCare under this subdivision shall be given 147.28 an 18-month notice period from the date that ineligibility is 147.29 determined before disenrollment. 147.30 [EFFECTIVE DATE.] This section is effective July 1, 2002. 147.31 Sec. 67. Minnesota Statutes 2000, section 256L.07, 147.32 subdivision 2, is amended to read: 147.33 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 147.34 COVERAGE.] (a) To be eligible, a family or individual must not 147.35 have access to subsidized health coverage through an employer 147.36 and must not have had access to employer-subsidized coverage 148.1 through a current employer for 18 months prior to application or 148.2 reapplication. A family or individual whose employer-subsidized 148.3 coverage is lost due to an employer terminating health care 148.4 coverage as an employee benefit during the previous 18 months is 148.5 not eligible. 148.6 (b) This subdivision does not apply to a family or 148.7 individual who was enrolled in MinnesotaCare within six months 148.8 or less of reapplication and who no longer has 148.9 employer-subsidized coverage due to the employer terminating 148.10 health care coverage as an employee benefit. 148.11 (c) For purposes of thisrequirementsubdivision, 148.12 subsidized health coverage means health coverage for which the 148.13 employer pays at least5060 percent of the cost of coverage for 148.14 the employee or dependent, or a higher percentage as specified 148.15 by the commissioner. Children are eligible for 148.16 employer-subsidized coverage through either parent, including 148.17 the noncustodial parent. The commissioner must treat employer 148.18 contributions to Internal Revenue Code Section 125 plans and any 148.19 other employer benefits intended to pay health care costs as 148.20 qualified employer subsidies toward the cost of health coverage 148.21 for employees for purposes of this subdivision. 148.22 Sec. 68. Minnesota Statutes 2000, section 256L.07, 148.23 subdivision 3, is amended to read: 148.24 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 148.25 individuals enrolled in the MinnesotaCare program must have no 148.26 health coverage while enrolled or for at least four months prior 148.27 to application and renewal.Children enrolled in the original148.28children's health plan and children in families with income148.29equal to or less than 150 percent of the federal poverty148.30guidelines, who have other health insurance, are eligible if the148.31coverage:148.32(1) lacks two or more of the following:148.33(i) basic hospital insurance;148.34(ii) medical-surgical insurance;148.35(iii) prescription drug coverage;148.36(iv) dental coverage; or149.1(v) vision coverage;149.2(2) requires a deductible of $100 or more per person per149.3year; or149.4(3) lacks coverage because the child has exceeded the149.5maximum coverage for a particular diagnosis or the policy149.6excludes a particular diagnosis.149.7 The commissioner may change this eligibility criterion for 149.8 sliding scale premiums in order to remain within the limits of 149.9 available appropriations. The requirement of no health coverage 149.10 does not apply to newborns. 149.11 (b) Medical assistance, general assistance medical care, 149.12 and civilian health and medical program of the uniformed 149.13 service, CHAMPUS, are not considered insurance or health 149.14 coverage for purposes of the four-month requirement described in 149.15 this subdivision. 149.16 (c) For purposes of this subdivision, Medicare Part A or B 149.17 coverage under title XVIII of the Social Security Act, United 149.18 States Code, title 42, sections 1395c to 1395w-4, is considered 149.19 health coverage. An applicant or enrollee may not refuse 149.20 Medicare coverage to establish eligibility for MinnesotaCare. 149.21 (d) Applicants who were recipients of medical assistance or 149.22 general assistance medical care within one month of application 149.23 must meet the provisions of this subdivision and subdivision 2. 149.24 [EFFECTIVE DATE.] This section is effective July 1, 2002. 149.25 Sec. 69. Minnesota Statutes 2000, section 256L.07, is 149.26 amended by adding a subdivision to read: 149.27 Subd. 5. [EXEMPTION FOR PERSONS WITH CONTINUATION 149.28 COVERAGE.] (a) Families with children and individuals who apply 149.29 for the MinnesotaCare program upon termination from continuation 149.30 coverage required under federal or state law are exempt from the 149.31 requirements of subdivision 3. 149.32 (b) For purposes of paragraph (a), "termination from 149.33 continuation coverage" means involuntary termination for any 149.34 reason, other than premium nonpayment by the family or 149.35 individual, including termination due to reaching the end of the 149.36 maximum period for continuation coverage required under federal 150.1 or state law. 150.2 Sec. 70. Minnesota Statutes 2000, section 256L.07, is 150.3 amended by adding a subdivision to read: 150.4 Subd. 6. [EXEMPTION FOR PERSONS LOSING COVERAGE AS A 150.5 DEPENDENT.] Individuals who apply for the MinnesotaCare program 150.6 upon termination of other health coverage due to loss of status 150.7 as a dependent are exempt from the requirements of subdivision 3. 150.8 Sec. 71. Minnesota Statutes 2000, section 256L.12, is 150.9 amended by adding a subdivision to read: 150.10 Subd. 11. [AMERICAN INDIAN ENROLLEES.] For American Indian 150.11 enrollees, MinnesotaCare shall cover health care services 150.12 provided at Indian Health Service facilities and facilities 150.13 operated by a tribe or tribal organization under funding 150.14 authorized by United States Code, title 25, sections 450f to 150.15 450n, or title III of the Indian Self-Determination and 150.16 Education Assistance Act, Public Law Number 93-638, if those 150.17 services would otherwise be covered under section 256L.03. 150.18 Payments for services provided under this subdivision shall be 150.19 made on a fee-for-service basis, and may, at the option of the 150.20 tribe or tribal organization, be made at the rates authorized 150.21 under sections 256.969, subdivision 16, and 256B.0625, 150.22 subdivision 34, for those MinnesotaCare enrollees eligible for 150.23 coverage at medical assistance rates. For purposes of this 150.24 subdivision, "American Indian" has the meaning given to persons 150.25 to whom services will be provided in the Code of Federal 150.26 Regulations, title 42, section 36.12. 150.27 Sec. 72. Minnesota Statutes 2000, section 256L.15, 150.28 subdivision 1, is amended to read: 150.29 Subdivision 1. [PREMIUM DETERMINATION.] (a) Except as 150.30 provided in paragraph (b), families with children and 150.31 individuals shall pay a premium determined according to a 150.32 sliding fee based on a percentage of the family's gross family 150.33 income. 150.34 (b) Children in households with family income equal to or 150.35 less than 225 percent of the federal poverty guidelines and the 150.36 parents and relative caretakers of children under the age of 21 151.1 in households with family income equal to or less than 120 151.2 percent of the federal poverty guidelines are exempt from paying 151.3 a premium. Pregnant women and children under age two are exempt 151.4 from the provisions of section 256L.06, subdivision 3, paragraph 151.5 (b), clause (3), requiring disenrollment for failure to pay 151.6 premiums. For pregnant women, this exemption continues until 151.7 the first day of the month following the 60th day postpartum. 151.8 Women who remain enrolled during pregnancy or the postpartum 151.9 period, despite nonpayment of premiums, shall be disenrolled on 151.10 the first of the month following the 60th day postpartum for the 151.11 penalty period that otherwise applies under section 256L.06, 151.12 unless they begin paying premiums. 151.13 Sec. 73. Minnesota Statutes 2000, section 256L.15, 151.14 subdivision 2, is amended to read: 151.15 Subd. 2. [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 151.16 GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 151.17 establish a sliding fee scale to determine the percentage of 151.18 gross individual or family income that households at different 151.19 income levels must pay to obtain coverage through the 151.20 MinnesotaCare program. The sliding fee scale must be based on 151.21 the enrollee's gross individual or family income. The sliding 151.22 fee scale must contain separate tables based on enrollment of 151.23 one, two, or three or more persons. For single adults and 151.24 families without children, the sliding fee scale begins with a 151.25 premium of 1.5 percent of grossindividual orfamily incomefor151.26individuals or families with incomes below the limits for the151.27medical assistance program for families and children in effect151.28on January 1, 1999,and proceeds through the following evenly 151.29 spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 151.30 percent. For families with children, the sliding fee scale 151.31 begins with a premium of 1.5 percent of gross family income with 151.32 incomes below the children in effect on January 1, 1999, and 151.33 proceeds through following evenly spaced steps: 1.8, 2.3, 3.1, 151.34 and 5.0 percent. These percentages are matched to evenly spaced 151.35 income steps ranging from the medical assistance income limit 151.36 for families and children in effect on January 1, 1999, to 275 152.1 percent of the federal poverty guidelines for the applicable 152.2 family size, up to a family size of five. The sliding fee scale 152.3 for a family of five must be used for families of more than five. 152.4 The sliding fee scale and percentages are not subject to the 152.5 provisions of chapter 14. If a family or individual reports 152.6 increased income after enrollment, premiums shall not be 152.7 adjusted until eligibility renewal. 152.8 (b) Enrolled individuals and families whose gross annual 152.9 income increases above 275 percent of the federal poverty 152.10 guideline shall pay the maximum premium. The maximum premium is 152.11 defined as a base charge for one, two, or three or more 152.12 enrollees so that if all MinnesotaCare cases paid the maximum 152.13 premium, the total revenue would equal the total cost of 152.14 MinnesotaCare medical coverage and administration. In this 152.15 calculation, administrative costs shall be assumed to equal ten 152.16 percent of the total. The costs of medical coverage for 152.17 pregnant women and children under age two and the enrollees in 152.18 these groups shall be excluded from the total. The maximum 152.19 premium for two enrollees shall be twice the maximum premium for 152.20 one, and the maximum premium for three or more enrollees shall 152.21 be three times the maximum premium for one. 152.22 Sec. 74. Minnesota Statutes 2000, section 256L.16, is 152.23 amended to read: 152.24 256L.16 [PAYMENT RATES; SERVICES FOR FAMILIES AND CHILDREN 152.25 UNDER THE MINNESOTACARE HEALTH CARE REFORM WAIVER.] 152.26 Section 256L.11, subdivision 2, shall not apply to services 152.27 provided tochildrenfamilies with children who are eligibleto152.28receive expanded servicesaccording to section256L.03,152.29subdivision 1a256L.04, subdivision 1a. 152.30 Sec. 75. Laws 1999, chapter 245, article 4, section 110, 152.31 is amended to read: 152.32 Sec. 110. [PROGRAMS FOR SENIOR CITIZENS.] 152.33 The commissioner of human services shall study the 152.34 eligibility criteria of and benefits provided to persons age 65 152.35 and over through the array of cash assistance and health care 152.36 programs administered by the department, and the extent to which 153.1 these programs can be combined, simplified, or coordinated to 153.2 reduce administrative costs and improve access. The 153.3 commissioner shall also study potential barriers to enrollment 153.4 for low-income seniors who would otherwise deplete resources 153.5 necessary to maintain independent community living. At a 153.6 minimum, the study must include an evaluation of asset 153.7 requirements and enrollment sites. The commissioner shall 153.8 report study findings and recommendations to the legislature by 153.9June 30, 2001January 15, 2002. 153.10 Sec. 76. [EXPAND DENTAL AUXILIARY PERSONNEL; 153.11 FOREIGN-TRAINED DENTISTS; DENTAL CLINICS.] 153.12 Subdivision 1. [DEVELOPMENT.] (a) The board of dentistry, 153.13 in consultation with the University of Minnesota school of 153.14 dentistry, the Minnesota state colleges and universities that 153.15 offer a dental auxiliary training program, the commissioner of 153.16 health, and licensed dentists and dental auxiliaries practicing 153.17 in private practice and at community clinics, shall develop new 153.18 expanded duties for registered dental assistants and dental 153.19 hygienists. The new duties must be performed under direct or 153.20 indirect supervision of a licensed dentist and must include 153.21 selected technical dental services. These expanded duties must 153.22 be limited to reversible procedures, including, but not be 153.23 limited to, placement, contouring, and adjustment of amalgam, 153.24 composite, glass ionomer, and temporary restoration; pit and 153.25 fissure sealants; and the adaptation and cementation of 153.26 stainless steel crowns for primary teeth. These expanded duties 153.27 shall not include or imply a diagnosis or treatment plan, nor 153.28 include prescribing medications, cutting hard or soft tissue, or 153.29 any direct patient care in which formal training has not been 153.30 completed. The board shall establish a standard of practice and 153.31 necessary educational qualifications for certification to 153.32 perform the new duties. 153.33 (b) The board shall make recommendations to amend Minnesota 153.34 Statutes, chapter 150A, to permit a foreign-trained dentist to 153.35 practice as a dental hygienist or as a registered dental 153.36 assistant. 154.1 (c) The board shall submit the proposed changes to 154.2 Minnesota Statutes, chapter 150A, to the legislature by January 154.3 15, 2002. 154.4 Subd. 2. [DENTAL CLINICS.] The commissioner of health, in 154.5 consultation with the Minnesota state colleges and universities, 154.6 shall determine the capital improvements needed to establish 154.7 community-based dental clinics at state colleges and 154.8 universities to be used as training sites and as public 154.9 community-based dental clinics for public program recipients 154.10 during times when the school is not in session and the clinic is 154.11 not in use. The commissioner shall submit the necessary capital 154.12 improvement costs for start-up equipment and necessary 154.13 infrastructure as part of the 2002 legislative capital budget 154.14 requests. 154.15 Sec. 77. [FEDERAL WAIVER REQUEST.] 154.16 The commissioner of human services shall seek federal 154.17 approval to expand the medical assistance program to provide 154.18 access to discounted prices for prescription drugs to Medicare 154.19 beneficiaries with no prescription drug coverage. Individuals 154.20 in this expanded coverage group shall receive a discount for 154.21 prescription drugs equal to the average rebate paid to the 154.22 medical assistance program by pharmaceutical manufacturers. 154.23 Upon receipt of the waiver, the commissioner shall submit a 154.24 proposal to the legislature for implementation of this expansion 154.25 to individuals with income at or below 200 percent of the 154.26 federal poverty guidelines. 154.27 Sec. 78. [HEALTH STATUS IMPROVEMENT GRANTS.] 154.28 The commissioner of human services shall award grants to 154.29 improve the quality of health care services provided to 154.30 children. Priority shall be given to grant applications that: 154.31 (1) develop "best practices guidelines" for primary and 154.32 preventative health care services to all children in Minnesota, 154.33 regardless of payor; 154.34 (2) design and implement community-based education and 154.35 evaluation programs for physicians and other direct care 154.36 providers to implement best practice guidelines; and 155.1 (3) reduce disparities in access to health care services 155.2 and in health status of Minnesota children. 155.3 Sec. 79. [NOTICE OF PREMIUM CHANGES IN THE EMPLOYED 155.4 PERSONS WITH DISABILITIES PROGRAM.] 155.5 The commissioner of human services shall provide notice to 155.6 all medical assistance recipients receiving coverage through the 155.7 employed persons with disabilities program under Minnesota 155.8 Statutes, section 256B.057, subdivision 9, of the first new 155.9 premium schedule in effect on September 1, 2001, at least two 155.10 months before the month in which the first new premium is due. 155.11 Sec. 80. [REPEALER.] 155.12 (a) Minnesota Statutes 2000, section 16A.76, is repealed 155.13 effective July 1, 2001. 155.14 (b) Minnesota Statutes 2000, section 256.955, subdivision 155.15 2b, is repealed effective January 1, 2002. 155.16 (c) Minnesota Statutes 2000, sections 256B.0635, 155.17 subdivision 3; and 256L.15, subdivision 3, are repealed 155.18 effective July 1, 2002. 155.19 ARTICLE 3 155.20 CONTINUING CARE 155.21 Section 1. Minnesota Statutes 2000, section 245A.13, 155.22 subdivision 7, is amended to read: 155.23 Subd. 7. [RATE RECOMMENDATION.] The commissioner of human 155.24 services may review rates of a residential program participating 155.25 in the medical assistance program which is in receivership and 155.26 that has needs or deficiencies documented by the department of 155.27 health or the department of human services. If the commissioner 155.28 of human services determines that a review of the rate 155.29 established undersection 256B.501sections 256B.5012 and 155.30 256B.5013 is needed, the commissioner shall: 155.31 (1) review the order or determination that cites the 155.32 deficiencies or needs; and 155.33 (2) determine the need for additional staff, additional 155.34 annual hours by type of employee, and additional consultants, 155.35 services, supplies, equipment, repairs, or capital assets 155.36 necessary to satisfy the needs or deficiencies. 156.1 Sec. 2. Minnesota Statutes 2000, section 245A.13, 156.2 subdivision 8, is amended to read: 156.3 Subd. 8. [ADJUSTMENT TO THE RATE.] Upon review of rates 156.4 under subdivision 7, the commissioner may adjust the residential 156.5 program's payment rate. The commissioner shall review the 156.6 circumstances, together with the residentialprogram cost report156.7 program's most recent income and expense report, to determine 156.8 whether or not the deficiencies or needs can be corrected or met 156.9 by reallocating residential program staff, costs, revenues, 156.10 or any other resources includinganyinvestments, efficiency156.11incentives, or allowances. If the commissioner determines that 156.12 any deficiency cannot be corrected or the need cannot be met 156.13 with the payment rate currently being paid, the commissioner 156.14 shall determine the payment rate adjustment by dividing the 156.15 additional annual costs established during the commissioner's 156.16 review by the residential program's actual resident days from 156.17 the most recentdesk-audited costincome and expense report or 156.18 the estimated resident days in the projected receivership 156.19 period. The payment rate adjustmentmust meet the conditions in156.20Minnesota Rules, parts 9553.0010 to 9553.0080, andremains in 156.21 effect during the period of the receivership or until another 156.22 date set by the commissioner. Upon the subsequent sale, 156.23 closure, or transfer of the residential program, the 156.24 commissioner may recover amounts that were paid as payment rate 156.25 adjustments under this subdivision. This recovery shall be 156.26 determined through a review of actual costs and resident days in 156.27 the receivership period. The costs the commissioner finds to be 156.28 allowable shall be divided by the actual resident days for the 156.29 receivership period. This rate shall be compared to the rate 156.30 paid throughout the receivership period, with the difference 156.31 multiplied by resident days, being the amount to be repaid to 156.32 the commissioner. Allowable costs shall be determined by the 156.33 commissioner as those ordinary, necessary, and related to 156.34 resident care by prudent and cost-conscious management. The 156.35 buyer or transferee shall repay this amount to the commissioner 156.36 within 60 days after the commissioner notifies the buyer or 157.1 transferee of the obligation to repay. This provision does not 157.2 limit the liability of the seller to the commissioner pursuant 157.3 to section 256B.0641. 157.4 Sec. 3. Minnesota Statutes 2000, section 252.275, 157.5 subdivision 4b, is amended to read: 157.6 Subd. 4b. [GUARANTEED FLOOR.] Each countywith an original157.7allocation for the preceding year that is equal to or less than157.8the guaranteed floor minimum index shall have a guaranteed floor157.9equal to its original allocation for the preceding year. Each157.10county with an original allocation for the preceding year that157.11is greater than the guaranteed floor minimum indexshall have a 157.12 guaranteed floor equal to the lesser of clause (1) or (2): 157.13 (1) the county's original allocation for the preceding 157.14 year; or 157.15 (2) 70 percent of the county's reported expenditures 157.16 eligible for reimbursement during the 12 months ending on June 157.17 30 of the preceding calendar year. 157.18For calendar year 1993, the guaranteed floor minimum index157.19shall be $20,000. For each subsequent year, the index shall be157.20adjusted by the projected change in the average value in the157.21United States Department of Labor Bureau of Labor Statistics157.22consumer price index (all urban) for that year.157.23 Notwithstanding this subdivision, no county shall be 157.24 allocated a guaranteed floor of less than $1,000. 157.25 When the amount of funds available for allocation is less 157.26 than the amount available in the previous year, each county's 157.27 previous year allocation shall be reduced in proportion to the 157.28 reduction in the statewide funding, to establish each county's 157.29 guaranteed floor. 157.30 Sec. 4. Minnesota Statutes 2000, section 254B.03, 157.31 subdivision 1, is amended to read: 157.32 Subdivision 1. [LOCAL AGENCY DUTIES.] (a) Every local 157.33 agency shall provide chemical dependency services to persons 157.34 residing within its jurisdiction who meet criteria established 157.35 by the commissioner for placement in a chemical dependency 157.36 residential or nonresidential treatment service. Chemical 158.1 dependency money must be administered by the local agencies 158.2 according to law and rules adopted by the commissioner under 158.3 sections 14.001 to 14.69. 158.4 (b) In order to contain costs, the county board shall, with 158.5 the approval of the commissioner of human services, select 158.6 eligible vendors of chemical dependency services who can provide 158.7 economical and appropriate treatment. Unless the local agency 158.8 is a social services department directly administered by a 158.9 county or human services board, the local agency shall not be an 158.10 eligible vendor under section 254B.05. The commissioner may 158.11 approve proposals from county boards to provide services in an 158.12 economical manner or to control utilization, with safeguards to 158.13 ensure that necessary services are provided. If a county 158.14 implements a demonstration or experimental medical services 158.15 funding plan, the commissioner shall transfer the money as 158.16 appropriate. If a county selects a vendor located in another 158.17 state, the county shall ensure that the vendor is in compliance 158.18 with the rules governing licensure of programs located in the 158.19 state. 158.20 (c) The calendar year19982002 rate for vendors may not 158.21 increase more thanthree3.5 percent above the rate approved in 158.22 effect on January 1,19972001. The calendar year19992003 158.23 rate for vendors may not increase more thanthree3.5 percent 158.24 above the rate in effect on January 1,19982002. 158.25 (d) A culturally specific vendor that provides assessments 158.26 under a variance under Minnesota Rules, part 9530.6610, shall be 158.27 allowed to provide assessment services to persons not covered by 158.28 the variance. 158.29 Sec. 5. Minnesota Statutes 2000, section 254B.09, is 158.30 amended by adding a subdivision to read: 158.31 Subd. 8. [PAYMENTS TO IMPROVE SERVICES TO AMERICAN 158.32 INDIANS.] The commissioner may set rates for chemical dependency 158.33 services according to the American Indian Health Improvement 158.34 Act, Public Law Number 94-437, for eligible vendors. These 158.35 rates shall supersede rates set in county purchase of service 158.36 agreements when payments are made on behalf of clients eligible 159.1 according to Public Law Number 94-437. 159.2 Sec. 6. Minnesota Statutes 2000, section 256.01, is 159.3 amended by adding a subdivision to read: 159.4 Subd. 19. [GRANTS FOR CASE MANAGEMENT SERVICES TO PERSONS 159.5 WITH HIV OR AIDS.] The commissioner may award grants to eligible 159.6 vendors for the development, implementation, and evaluation of 159.7 case management services for individuals infected with the human 159.8 immunodeficiency virus. HIV/AIDs case management services will 159.9 be provided to increase access to cost effective health care 159.10 services, to reduce the risk of HIV transmission, to ensure that 159.11 basic client needs are met, and to increase client access to 159.12 needed community supports or services. 159.13 Sec. 7. Minnesota Statutes 2000, section 256.476, 159.14 subdivision 1, is amended to read: 159.15 Subdivision 1. [PURPOSE AND GOALS.] The commissioner of 159.16 human services shall establish a consumer support grant 159.17 programto assistfor individuals with functional limitations 159.18 and their familiesin purchasing and securing supports which the159.19individuals need to live as independently and productively in159.20the community as possiblewho wish to purchase and secure their 159.21 own supports. The commissioner and local agencies shall jointly 159.22 develop an implementation plan which must include a way to 159.23 resolve the issues related to county liability. The program 159.24 shall: 159.25 (1) make support grants available to individuals or 159.26 families as an effective alternative to existing programs and 159.27 services, such as the developmental disability family support 159.28 program,the alternative care program,personal care attendant 159.29 services, home health aide services, and private duty nursing 159.30facilityservices; 159.31 (2) provide consumers more control, flexibility, and 159.32 responsibility overthe needed supportstheir services and 159.33 supports; 159.34 (3) promote local program management and decision making; 159.35 and 159.36 (4) encourage the use of informal and typical community 160.1 supports. 160.2 Sec. 8. Minnesota Statutes 2000, section 256.476, 160.3 subdivision 2, is amended to read: 160.4 Subd. 2. [DEFINITIONS.] For purposes of this section, the 160.5 following terms have the meanings given them: 160.6 (a) "County board" means the county board of commissioners 160.7 for the county of financial responsibility as defined in section 160.8 256G.02, subdivision 4, or its designated representative. When 160.9 a human services board has been established under sections 160.10 402.01 to 402.10, it shall be considered the county board for 160.11 the purposes of this section. 160.12 (b) "Family" means the person's birth parents, adoptive 160.13 parents or stepparents, siblings or stepsiblings, children or 160.14 stepchildren, grandparents, grandchildren, niece, nephew, aunt, 160.15 uncle, or spouse. For the purposes of this section, a family 160.16 member is at least 18 years of age. 160.17 (c) "Functional limitations" means the long-term inability 160.18 to perform an activity or task in one or more areas of major 160.19 life activity, including self-care, understanding and use of 160.20 language, learning, mobility, self-direction, and capacity for 160.21 independent living. For the purpose of this section, the 160.22 inability to perform an activity or task results from a mental, 160.23 emotional, psychological, sensory, or physical disability, 160.24 condition, or illness. 160.25 (d) "Informed choice" means a voluntary decision made by 160.26 the person or the person's legal representative, after becoming 160.27 familiarized with the alternatives to: 160.28 (1) select a preferred alternative from a number of 160.29 feasible alternatives; 160.30 (2) select an alternative which may be developed in the 160.31 future; and 160.32 (3) refuse any or all alternatives. 160.33 (e) "Local agency" means the local agency authorized by the 160.34 county board to carry out the provisions of this section. 160.35 (f) "Person" or "persons" means a person or persons meeting 160.36 the eligibility criteria in subdivision 3. 161.1 (g) "Authorized representative" means an individual 161.2 designated by the person or their legal representative to act on 161.3 their behalf. This individual may be a family member, guardian, 161.4 representative payee, or other individual designated by the 161.5 person or their legal representative, if any, to assist in 161.6 purchasing and arranging for supports. For the purposes of this 161.7 section, an authorized representative is at least 18 years of 161.8 age. 161.9 (h) "Screening" means the screening of a person's service 161.10 needs under sections 256B.0911 and 256B.092. 161.11 (i) "Supports" means services, care, aids,home161.12 environmental modifications, or assistance purchased by the 161.13 person or the person's family. Examples of supports include 161.14 respite care, assistance with daily living, andadaptive aids161.15 assistive technology. For the purpose of this section, 161.16 notwithstanding the provisions of section 144A.43, supports 161.17 purchased under the consumer support program are not considered 161.18 home care services. 161.19 (j) "Program of origination" means the program the 161.20 individual transferred from when approved for the consumer 161.21 support grant program. 161.22 Sec. 9. Minnesota Statutes 2000, section 256.476, 161.23 subdivision 3, is amended to read: 161.24 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 161.25 is eligible to apply for a consumer support grant if the person 161.26 meets all of the following criteria: 161.27 (1) the person is eligible for and has been approved to 161.28 receive services under medical assistance as determined under 161.29 sections 256B.055 and 256B.056or the person is eligible for and161.30has been approved to receive services under alternative care161.31services as determined under section 256B.0913or the person has 161.32 been approved to receive a grant under the developmental 161.33 disability family support program under section 252.32; 161.34 (2) the person is able to direct and purchase the person's 161.35 own care and supports, or the person has a family member, legal 161.36 representative, or other authorized representative who can 162.1 purchase and arrange supports on the person's behalf; 162.2 (3) the person has functional limitations, requires ongoing 162.3 supports to live in the community, and is at risk of or would 162.4 continue institutionalization without such supports; and 162.5 (4) the person will live in a home. For the purpose of 162.6 this section, "home" means the person's own home or home of a 162.7 person's family member. These homes are natural home settings 162.8 and are not licensed by the department of health or human 162.9 services. 162.10 (b) Persons may not concurrently receive a consumer support 162.11 grant if they are: 162.12 (1) receiving home and community-based services under 162.13 United States Code, title 42, section 1396h(c); personal care 162.14 attendant and home health aide services under section 256B.0625; 162.15 a developmental disability family support grant; or alternative 162.16 care services under section 256B.0913; or 162.17 (2) residing in an institutional or congregate care setting. 162.18 (c) A person or person's family receiving a consumer 162.19 support grant shall not be charged a fee or premium by a local 162.20 agency for participating in the program. 162.21 (d) The commissioner may limit the participation ofnursing162.22facility residents, residents of intermediate care facilities162.23for persons with mental retardation, and therecipients of 162.24 services from federal waiver programs in the consumer support 162.25 grant program if the participation of these individuals will 162.26 result in an increase in the cost to the state. 162.27 (e) The commissioner shall establish a budgeted 162.28 appropriation each fiscal year for the consumer support grant 162.29 program. The number of individuals participating in the program 162.30 will be adjusted so the total amount allocated to counties does 162.31 not exceed the amount of the budgeted appropriation. The 162.32 budgeted appropriation will be adjusted annually to accommodate 162.33 changes in demand for the consumer support grants. 162.34 Sec. 10. Minnesota Statutes 2000, section 256.476, 162.35 subdivision 4, is amended to read: 162.36 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 163.1 county board may choose to participate in the consumer support 163.2 grant program. If a county board chooses to participate in the 163.3 program, the local agency shall establish written procedures and 163.4 criteria to determine the amount and use of support grants. 163.5 These procedures must include, at least, the availability of 163.6 respite care, assistance with daily living, and adaptive aids. 163.7 The local agency may establish monthly or annual maximum amounts 163.8 for grants and procedures where exceptional resources may be 163.9 required to meet the health and safety needs of the person on a 163.10 time-limited basis, however, the total amount awarded to each 163.11 individual may not exceed the limits established in subdivision 163.12 5, paragraph (f). 163.13 (b) Support grants to a person or a person's family will be 163.14 provided through a monthly subsidy payment and be in the form of 163.15 cash, voucher, or direct county payment to vendor. Support 163.16 grant amounts must be determined by the local agency. Each 163.17 service and item purchased with a support grant must meet all of 163.18 the following criteria: 163.19 (1) it must be over and above the normal cost of caring for 163.20 the person if the person did not have functional limitations; 163.21 (2) it must be directly attributable to the person's 163.22 functional limitations; 163.23 (3) it must enable the person or the person's family to 163.24 delay or prevent out-of-home placement of the person; and 163.25 (4) it must be consistent with the needs identified in the 163.26 service plan, when applicable. 163.27 (c) Items and services purchased with support grants must 163.28 be those for which there are no other public or private funds 163.29 available to the person or the person's family. Fees assessed 163.30 to the person or the person's family for health and human 163.31 services are not reimbursable through the grant. 163.32 (d) In approving or denying applications, the local agency 163.33 shall consider the following factors: 163.34 (1) the extent and areas of the person's functional 163.35 limitations; 163.36 (2) the degree of need in the home environment for 164.1 additional support; and 164.2 (3) the potential effectiveness of the grant to maintain 164.3 and support the person in the family environment or the person's 164.4 own home. 164.5 (e) At the time of application to the program or screening 164.6 for other services, the person or the person's family shall be 164.7 provided sufficient information to ensure an informed choice of 164.8 alternatives by the person, the person's legal representative, 164.9 if any, or the person's family. The application shall be made 164.10 to the local agency and shall specify the needs of the person 164.11 and family, the form and amount of grant requested, the items 164.12 and services to be reimbursed, and evidence of eligibility for 164.13 medical assistanceor alternative care program. 164.14 (f) Upon approval of an application by the local agency and 164.15 agreement on a support plan for the person or person's family, 164.16 the local agency shall make grants to the person or the person's 164.17 family. The grant shall be in an amount for the direct costs of 164.18 the services or supports outlined in the service agreement. 164.19 (g) Reimbursable costs shall not include costs for 164.20 resources already available, such as special education classes, 164.21 day training and habilitation, case management, other services 164.22 to which the person is entitled, medical costs covered by 164.23 insurance or other health programs, or other resources usually 164.24 available at no cost to the person or the person's family. 164.25 (h) The state of Minnesota, the county boards participating 164.26 in the consumer support grant program, or the agencies acting on 164.27 behalf of the county boards in the implementation and 164.28 administration of the consumer support grant program shall not 164.29 be liable for damages, injuries, or liabilities sustained 164.30 through the purchase of support by the individual, the 164.31 individual's family, or the authorized representative under this 164.32 section with funds received through the consumer support grant 164.33 program. Liabilities include but are not limited to: workers' 164.34 compensation liability, the Federal Insurance Contributions Act 164.35 (FICA), or the Federal Unemployment Tax Act (FUTA). For 164.36 purposes of this section, participating county boards and 165.1 agencies acting on behalf of county boards are exempt from the 165.2 provisions of section 268.04. 165.3 Sec. 11. Minnesota Statutes 2000, section 256.476, 165.4 subdivision 5, is amended to read: 165.5 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 165.6 For the purpose of transferring persons to the consumer support 165.7 grant program from specific programs or services, such as the 165.8 developmental disability family support program andalternative165.9care program,personal careattendantassistant services, home 165.10 health aide services, ornursing facilityprivate duty nursing 165.11 services, the amount of funds transferred by the commissioner 165.12 between the developmental disability family support program 165.13 account,the alternative care account,the medical assistance 165.14 account, or the consumer support grant account shall be based on 165.15 each county's participation in transferring persons to the 165.16 consumer support grant program from those programs and services. 165.17 (b) At the beginning of each fiscal year, county 165.18 allocations for consumer support grants shall be based on: 165.19 (1) the number of persons to whom the county board expects 165.20 to provide consumer supports grants; 165.21 (2) their eligibility for current program and services; 165.22 (3) the amount of nonfederal dollars expended on those 165.23 individuals for those programs and servicesor, in situations165.24where an individual is unable to obtain the support needed from165.25the program of origination due to the unavailability of service165.26providers at the time or the location where the supports are165.27needed, the allocation will be based on the county's best165.28estimate of the nonfederal dollars that would have been expended165.29if the services had been available; and 165.30 (4) projected dates when persons will start receiving 165.31 grants. County allocations shall be adjusted periodically by 165.32 the commissioner based on the actual transfer of persons or 165.33 service openings, and the nonfederal dollars associated with 165.34 those persons or service openings, to the consumer support grant 165.35 program. 165.36 (c) The amount of funds transferred by the commissioner 166.1 fromthe alternative care account andthe medical assistance 166.2 account for an individual may be changed if it is determined by 166.3 the county or its agent that the individual's need for support 166.4 has changed. 166.5 (d) The authority to utilize funds transferred to the 166.6 consumer support grant account for the purposes of implementing 166.7 and administering the consumer support grant program will not be 166.8 limited or constrained by the spending authority provided to the 166.9 program of origination. 166.10 (e) The commissionershallmay use up to five percent of 166.11 each county's allocation, as adjusted, for payments to that 166.12 county for administrative expenses, to be paid as a 166.13 proportionate addition to reported direct service expenditures. 166.14 (f)Except as provided in this paragraph,The county 166.15 allocation for each individual or individual's family cannot 166.16 exceed80 percent ofthe total nonfederal dollars expended on 166.17 the individual by the program of originationexcept for the166.18developmental disabilities family support grant program which166.19can be approved up to 100 percent of the nonfederal dollars and166.20in situations as described in paragraph (b), clause (3). In166.21situations where exceptional need exists or the individual's166.22need for support increases, up to 100 percent of the nonfederal166.23dollars expended may be allocated to the county. Allocations166.24that exceed 80 percent of the nonfederal dollars expended on the166.25individual by the program of origination must be approved by the166.26commissioner. The remainder of the amount expended on the166.27individual by the program of origination will be used in the166.28following proportions: half will be made available to the166.29consumer support grant program and participating counties for166.30consumer training, resource development, and other costs, and166.31half will be returned to the state general fund. 166.32 (g) The commissioner may recover, suspend, or withhold 166.33 payments if the county board, local agency, or grantee does not 166.34 comply with the requirements of this section. 166.35 (h) Grant funds unexpended by consumers shall return to the 166.36 state once a year. The annual return of unexpended grant funds 167.1 shall occur in the quarter following the end of the state fiscal 167.2 year. 167.3 Sec. 12. Minnesota Statutes 2000, section 256.476, 167.4 subdivision 8, is amended to read: 167.5 Subd. 8. [COMMISSIONER RESPONSIBILITIES.] The commissioner 167.6 shall: 167.7 (1) transfer and allocate funds pursuant to this section; 167.8 (2) determine allocations based on projected and actual 167.9 local agency use; 167.10 (3) monitor and oversee overall program spending; 167.11 (4) evaluate the effectiveness of the program; 167.12 (5) provide training and technical assistance for local 167.13 agencies and consumers to help identify potential applicants to 167.14 the program; and 167.15 (6) develop guidelines for local agency program 167.16 administration and consumer information; and167.17(7) apply for a federal waiver or take any other action167.18necessary to maximize federal funding for the program by167.19September 1, 1999. 167.20 Sec. 13. Minnesota Statutes 2000, section 256.476, is 167.21 amended by adding a subdivision to read: 167.22 Subd. 11. [CONSUMER SUPPORT GRANT PROGRAM AFTER JULY 1, 167.23 2001.] (a) Effective July 1, 2001, upon approval of the 1115 167.24 federal waiver for consumer-directed home care in section 167.25 256B.0627, subdivision 13, the consumer support grant program 167.26 shall be limited to 200 persons. 167.27 (b) If federal approval delays implementation of the 1115 167.28 waiver or it is denied, additional individuals may receive 167.29 consumer support grants according to subdivision 5. The 167.30 statewide average of medical assistance expenditures for 167.31 recipients receiving those services during the most recent 167.32 fiscal year will be used to determine the maximum allowable 167.33 grant award. 167.34 (c) Persons receiving consumer support grants prior to July 167.35 1, 2001, may continue to receive a grant amount established 167.36 prior to July 1, 2001. 168.1 Sec. 14. Minnesota Statutes 2000, section 256B.0625, 168.2 subdivision 7, is amended to read: 168.3 Subd. 7. [PRIVATE DUTY NURSING.] Medical assistance covers 168.4 private duty nursing services in a recipient's home. Recipients 168.5 who are authorized to receive private duty nursing services in 168.6 their home may use approved hours outside of the home during 168.7 hours when normal life activities take them outside of their 168.8 homeand when, without the provision of private duty nursing,168.9their health and safety would be jeopardized. To use private 168.10 duty nursing services at school, the recipient or responsible 168.11 party must provide written authorization in the care plan 168.12 identifying the chosen provider and the daily amount of services 168.13 to be used at school. Medical assistance does not cover private 168.14 duty nursing services for residents of a hospital, nursing 168.15 facility, intermediate care facility, or a health care facility 168.16 licensed by the commissioner of health, except as authorized in 168.17 section 256B.64 for ventilator-dependent recipients in hospitals 168.18 or unless a resident who is otherwise eligible is on leave from 168.19 the facility and the facility either pays for the private duty 168.20 nursing services or forgoes the facility per diem for the leave 168.21 days that private duty nursing services are used. Total hours 168.22 of service and payment allowed for services outside the home 168.23 cannot exceed that which is otherwise allowed in an in-home 168.24 setting according to section 256B.0627. All private duty 168.25 nursing services must be provided according to the limits 168.26 established under section 256B.0627. Private duty nursing 168.27 services may not be reimbursed if the nurse is thespouse of the168.28recipient or the parent orfoster care provider of a recipient 168.29 who is under age 18, or the recipient's legal guardian. 168.30 Sec. 15. Minnesota Statutes 2000, section 256B.0625, 168.31 subdivision 19a, is amended to read: 168.32 Subd. 19a. [PERSONAL CARE ASSISTANT SERVICES.] Medical 168.33 assistance covers personal care assistant services in a 168.34 recipient's home. To qualify for personal care assistant 168.35 services, recipients or responsible parties must be able to 168.36 identify the recipient's needs, direct and evaluate task 169.1 accomplishment, and provide for health and safety. Approved 169.2 hours may be used outside the home when normal life activities 169.3 take them outside the homeand when, without the provision of169.4personal care, their health and safety would be jeopardized. To 169.5 use personal care assistant services at school, the recipient or 169.6 responsible party must provide written authorization in the care 169.7 plan identifying the chosen provider and the daily amount of 169.8 services to be used at school. Total hours for services, 169.9 whether actually performed inside or outside the recipient's 169.10 home, cannot exceed that which is otherwise allowed for personal 169.11 care assistant services in an in-home setting according to 169.12 section 256B.0627. Medical assistance does not cover personal 169.13 care assistant services for residents of a hospital, nursing 169.14 facility, intermediate care facility, health care facility 169.15 licensed by the commissioner of health, or unless a resident who 169.16 is otherwise eligible is on leave from the facility and the 169.17 facility either pays for the personal care assistant services or 169.18 forgoes the facility per diem for the leave days that personal 169.19 care assistant services are used. All personal care assistant 169.20 services must be provided according to section 256B.0627. 169.21 Personal care assistant services may not be reimbursed if the 169.22 personal care assistant is the spouse or legal guardian of the 169.23 recipient or the parent of a recipient under age 18, or the 169.24 responsible party or the foster care provider of a recipient who 169.25 cannot direct the recipient's own care unless, in the case of a 169.26 foster care provider, a county or state case manager visits the 169.27 recipient as needed, but not less than every six months, to 169.28 monitor the health and safety of the recipient and to ensure the 169.29 goals of the care plan are met. Parents of adult recipients, 169.30 adult children of the recipient or adult siblings of the 169.31 recipient may be reimbursed for personal care assistant services 169.32if they are not the recipient's legal guardian and, if they are 169.33 granted a waiver under section 256B.0627.Until July 1, 2001,169.34andNotwithstanding the provisions of section 256B.0627, 169.35 subdivision 4, paragraph (b), clause (4), the noncorporate legal 169.36 guardian or conservator of an adult, who is not the responsible 170.1 party and not the personal care provider organization, may be 170.2 granted a hardship waiver under section 256B.0627, to be 170.3 reimbursed to provide personal care assistant services to the 170.4 recipient, and shall not be considered to have a service 170.5 provider interest for purposes of participation on the screening 170.6 team under section 256B.092, subdivision 7. 170.7 Sec. 16. Minnesota Statutes 2000, section 256B.0625, 170.8 subdivision 19c, is amended to read: 170.9 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 170.10 personal care assistant services provided by an individual who 170.11 is qualified to provide the services according to subdivision 170.12 19a and section 256B.0627, where the services are prescribed by 170.13 a physician in accordance with a plan of treatment and are 170.14 supervised by the recipientunder the fiscal agent option170.15according to section 256B.0627, subdivision 10,or a qualified 170.16 professional. "Qualified professional" means a mental health 170.17 professional as defined in section 245.462, subdivision 18, or 170.18 245.4871, subdivision 27; or a registered nurse as defined in 170.19 sections 148.171 to 148.285. As part of the assessment, the 170.20 county public health nurse willconsult withassist the 170.21 recipient or responsible partyandto identify the most 170.22 appropriate person to provide supervision of the personal care 170.23 assistant. The qualified professional shall perform the duties 170.24 described in Minnesota Rules, part 9505.0335, subpart 4. 170.25 Sec. 17. Minnesota Statutes 2000, section 256B.0625, 170.26 subdivision 20, is amended to read: 170.27 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 170.28 extent authorized by rule of the state agency, medical 170.29 assistance covers case management services to persons with 170.30 serious and persistent mental illness and children with severe 170.31 emotional disturbance. Services provided under this section 170.32 must meet the relevant standards in sections 245.461 to 170.33 245.4888, the Comprehensive Adult and Children's Mental Health 170.34 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 170.35 9505.0322, excluding subpart 10. 170.36 (b) Entities meeting program standards set out in rules 171.1 governing family community support services as defined in 171.2 section 245.4871, subdivision 17, are eligible for medical 171.3 assistance reimbursement for case management services for 171.4 children with severe emotional disturbance when these services 171.5 meet the program standards in Minnesota Rules, parts 9520.0900 171.6 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 171.7 (c) Medical assistance and MinnesotaCare payment for mental 171.8 health case management shall be made on a monthly basis. In 171.9 order to receive payment for an eligible child, the provider 171.10 must document at least a face-to-face contact with the child, 171.11 the child's parents, or the child's legal representative. To 171.12 receive payment for an eligible adult, the provider must 171.13 document: 171.14 (1) at least a face-to-face contact with the adult or the 171.15 adult's legal representative; or 171.16 (2) at least a telephone contact with the adult or the 171.17 adult's legal representative and document a face-to-face contact 171.18 with the adult or the adult's legal representative within the 171.19 preceding two months. 171.20 (d) Payment for mental health case management provided by 171.21 county or state staff shall be based on the monthly rate 171.22 methodology under section 256B.094, subdivision 6, paragraph 171.23 (b), with separate rates calculated for child welfare and mental 171.24 health, and within mental health, separate rates for children 171.25 and adults. 171.26 (e) Payment for mental health case management provided by 171.27 county-contracted vendors shall be based on a monthly rate 171.28 negotiated by the host county. The negotiated rate must not 171.29 exceed the rate charged by the vendor for the same service to 171.30 other payers. If the service is provided by a team of 171.31 contracted vendors, the county may negotiate a team rate with a 171.32 vendor who is a member of the team. The team shall determine 171.33 how to distribute the rate among its members. No reimbursement 171.34 received by contracted vendors shall be returned to the county, 171.35 except to reimburse the county for advance funding provided by 171.36 the county to the vendor. 172.1 (f) If the service is provided by a team which includes 172.2 contracted vendors and county or state staff, the costs for 172.3 county or state staff participation in the team shall be 172.4 included in the rate for county-provided services. In this 172.5 case, the contracted vendor and the county may each receive 172.6 separate payment for services provided by each entity in the 172.7 same month. In order to prevent duplication of services, the 172.8 county must document, in the recipient's file, the need for team 172.9 case management and a description of the roles of the team 172.10 members. 172.11 (g) The commissioner shall calculate the nonfederal share 172.12 of actual medical assistance and general assistance medical care 172.13 payments for each county, based on the higher of calendar year 172.14 1995 or 1996, by service date, project that amount forward to 172.15 1999, and transfer one-half of the result from medical 172.16 assistance and general assistance medical care to each county's 172.17 mental health grants under sections 245.4886 and 256E.12 for 172.18 calendar year 1999. The annualized minimum amount added to each 172.19 county's mental health grant shall be $3,000 per year for 172.20 children and $5,000 per year for adults. The commissioner may 172.21 reduce the statewide growth factor in order to fund these 172.22 minimums. The annualized total amount transferred shall become 172.23 part of the base for future mental health grants for each county. 172.24 (h) Any net increase in revenue to the county as a result 172.25 of the change in this section must be used to provide expanded 172.26 mental health services as defined in sections 245.461 to 172.27 245.4888, the Comprehensive Adult and Children's Mental Health 172.28 Acts, excluding inpatient and residential treatment. For 172.29 adults, increased revenue may also be used for services and 172.30 consumer supports which are part of adult mental health projects 172.31 approved under Laws 1997, chapter 203, article 7, section 25. 172.32 For children, increased revenue may also be used for respite 172.33 care and nonresidential individualized rehabilitation services 172.34 as defined in section 245.492, subdivisions 17 and 23. 172.35 "Increased revenue" has the meaning given in Minnesota Rules, 172.36 part 9520.0903, subpart 3. 173.1 (i) Notwithstanding section 256B.19, subdivision 1, the 173.2 nonfederal share of costs for mental health case management 173.3 shall be provided by the recipient's county of responsibility, 173.4 as defined in sections 256G.01 to 256G.12, from sources other 173.5 than federal funds or funds used to match other federal funds. 173.6 (j) The commissioner may suspend, reduce, or terminate the 173.7 reimbursement to a provider that does not meet the reporting or 173.8 other requirements of this section. The county of 173.9 responsibility, as defined in sections 256G.01 to 256G.12, is 173.10 responsible for any federal disallowances. The county may share 173.11 this responsibility with its contracted vendors. 173.12 (k) The commissioner shall set aside a portion of the 173.13 federal funds earned under this section to repay the special 173.14 revenue maximization account under section 256.01, subdivision 173.15 2, clause (15). The repayment is limited to: 173.16 (1) the costs of developing and implementing this section; 173.17 and 173.18 (2) programming the information systems. 173.19 (l) Notwithstanding section 256.025, subdivision 2, 173.20 payments to counties for case management expenditures under this 173.21 section shall only be made from federal earnings from services 173.22 provided under this section. Payments to contracted vendors 173.23 shall include both the federal earnings and the county share. 173.24 (m) Notwithstanding section 256B.041, county payments for 173.25 the cost of mental health case management services provided by 173.26 county or state staff shall not be made to the state treasurer. 173.27 For the purposes of mental health case management services 173.28 provided by county or state staff under this section, the 173.29 centralized disbursement of payments to counties under section 173.30 256B.041 consists only of federal earnings from services 173.31 provided under this section. 173.32 (n) Case management services under this subdivision do not 173.33 include therapy, treatment, legal, or outreach services. 173.34 (o) If the recipient is a resident of a nursing facility, 173.35 intermediate care facility, or hospital, and the recipient's 173.36 institutional care is paid by medical assistance, payment for 174.1 case management services under this subdivision is limited to 174.2 the last30180 days of the recipient's residency in that 174.3 facility and may not exceed more thantwosix months in a 174.4 calendar year. 174.5 (p) Payment for case management services under this 174.6 subdivision shall not duplicate payments made under other 174.7 program authorities for the same purpose. 174.8 (q) By July 1, 2000, the commissioner shall evaluate the 174.9 effectiveness of the changes required by this section, including 174.10 changes in number of persons receiving mental health case 174.11 management, changes in hours of service per person, and changes 174.12 in caseload size. 174.13 (r) For each calendar year beginning with the calendar year 174.14 2001, the annualized amount of state funds for each county 174.15 determined under paragraph (g) shall be adjusted by the county's 174.16 percentage change in the average number of clients per month who 174.17 received case management under this section during the fiscal 174.18 year that ended six months prior to the calendar year in 174.19 question, in comparison to the prior fiscal year. 174.20 (s) For counties receiving the minimum allocation of $3,000 174.21 or $5,000 described in paragraph (g), the adjustment in 174.22 paragraph (r) shall be determined so that the county receives 174.23 the higher of the following amounts: 174.24 (1) a continuation of the minimum allocation in paragraph 174.25 (g); or 174.26 (2) an amount based on that county's average number of 174.27 clients per month who received case management under this 174.28 section during the fiscal year that ended six months prior to 174.29 the calendar year in question, in comparison to the prior fiscal 174.30 year, times the average statewide grant per person per month for 174.31 counties not receiving the minimum allocation. 174.32 (t) The adjustments in paragraphs (r) and (s) shall be 174.33 calculated separately for children and adults. 174.34 Sec. 18. Minnesota Statutes 2000, section 256B.0625, is 174.35 amended by adding a subdivision to read: 174.36 Subd. 43. [TARGETED CASE MANAGEMENT.] For purposes of 175.1 subdivisions 43a to 43h, the following terms have the meanings 175.2 given them: 175.3 (1) "home care service recipients" means those individuals 175.4 receiving the following services under section 256B.0627: 175.5 skilled nursing visits, home health aide visits, private duty 175.6 nursing, personal care assistants, or therapies provided through 175.7 a home health agency; 175.8 (2) "home care targeted case management" means the 175.9 provision of targeted case management services for the purpose 175.10 of assisting home care service recipients to gain access to 175.11 needed services and supports so that they may remain in the 175.12 community; 175.13 (3) "institutions" means hospitals, consistent with Code of 175.14 Federal Regulations, title 42, section 440.10; regional 175.15 treatment center inpatient services, consistent with section 175.16 245.474; nursing facilities; and intermediate care facilities 175.17 for persons with mental retardation; 175.18 (4) "relocation targeted case management" means the 175.19 provision of targeted case management services for the purpose 175.20 of assisting recipients to gain access to needed services and 175.21 supports if they choose to move from an institution to the 175.22 community. Relocation targeted case management may be provided 175.23 during the last 180 consecutive days of an eligible recipient's 175.24 institutional stay; and 175.25 (5) "targeted case management" means case management 175.26 services provided to help recipients gain access to needed 175.27 medical, social, educational, and other services and supports. 175.28 Sec. 19. Minnesota Statutes 2000, section 256B.0625, is 175.29 amended by adding a subdivision to read: 175.30 Subd. 43a. [ELIGIBILITY.] The following persons are 175.31 eligible for relocation targeted case management or home 175.32 care-targeted case management: 175.33 (1) medical assistance eligible persons residing in 175.34 institutions who choose to move into the community are eligible 175.35 for relocation targeted case management services; and 175.36 (2) medical assistance eligible persons receiving home care 176.1 services, who are not eligible for any other medical assistance 176.2 reimbursable case management service, are eligible for home 176.3 care-targeted case management services beginning January 1, 2003. 176.4 Sec. 20. Minnesota Statutes 2000, section 256B.0625, is 176.5 amended by adding a subdivision to read: 176.6 Subd. 43b. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 176.7 QUALIFICATIONS.] The following qualifications and certification 176.8 standards must be met by providers of relocation targeted case 176.9 management: 176.10 (a) The commissioner must certify each provider or 176.11 relocation targeted case management before enrollment. The 176.12 certification process shall examine the provider's ability to 176.13 meet the requirements in this subdivision and other federal and 176.14 state requirements of this service. A certified relocation 176.15 targeted case management provider may subcontract with another 176.16 provider to deliver relocation targeted case management 176.17 services. Subcontracted providers must demonstrate the ability 176.18 to provide the services outlined in subdivision 43d. 176.19 (b) A relocation targeted case management provider is an 176.20 enrolled medical assistance provider who is determined by the 176.21 commissioner to have all of the following characteristics: 176.22 (1) the legal authority to provide public welfare under 176.23 sections 393.01, subdivision 7; and 393.07; or a federally 176.24 recognized Indian tribe; 176.25 (2) the demonstrated capacity and experience to provide the 176.26 components of case management to coordinate and link community 176.27 resources needed by the eligible population; 176.28 (3) the administrative capacity and experience to serve the 176.29 target population for whom it will provide services and ensure 176.30 quality of services under state and federal requirements; 176.31 (4) the legal authority to provide complete investigative 176.32 and protective services under section 626.556, subdivision 10; 176.33 and child welfare and foster care services under section 393.07, 176.34 subdivisions 1 and 2; or a federally recognized Indian tribe; 176.35 (5) a financial management system that provides accurate 176.36 documentation of services and costs under state and federal 177.1 requirements; and 177.2 (6) the capacity to document and maintain individual case 177.3 records under state and federal requirements. 177.4 A provider of targeted case management under subdivision 20 may 177.5 be deemed a certified provider of relocation targeted case 177.6 management. 177.7 Sec. 21. Minnesota Statutes 2000, section 256B.0625, is 177.8 amended by adding a subdivision to read: 177.9 Subd. 43c. [HOME CARE TARGETED CASE MANAGEMENT PROVIDER 177.10 QUALIFICATIONS.] The following qualifications and certification 177.11 standards must be met by providers of home care targeted case 177.12 management. 177.13 (a) The commissioner must certify each provider of home 177.14 care targeted case management before enrollment. The 177.15 certification process shall examine the provider's ability to 177.16 meet the requirements in this subdivision and other state and 177.17 federal requirements of this service. 177.18 (b) A home care targeted case management provider is an 177.19 enrolled medical assistance provider who has a minimum of a 177.20 bachelor's degree, a license in a health or human services 177.21 field, and is determined by the commissioner to have all of the 177.22 following characteristics: 177.23 (1) the demonstrated capacity and experience to provide the 177.24 components of case management to coordinate and link community 177.25 resources needed by the eligible population; 177.26 (2) the administrative capacity and experience to serve the 177.27 target population for whom it will provide services and ensure 177.28 quality of services under state and federal requirements; 177.29 (3) a financial management system that provides accurate 177.30 documentation of services and costs under state and federal 177.31 requirements; 177.32 (4) the capacity to document and maintain individual case 177.33 records under state and federal requirements; and 177.34 (5) the capacity to coordinate with county administrative 177.35 functions. 177.36 Sec. 22. Minnesota Statutes 2000, section 256B.0625, is 178.1 amended by adding a subdivision to read: 178.2 Subd. 43d. [ELIGIBLE SERVICES.] Services eligible for 178.3 medical assistance reimbursement as targeted case management 178.4 include: 178.5 (1) assessment of the recipient's need for targeted case 178.6 management services; 178.7 (2) development, completion, and regular review of a 178.8 written individual service plan, which is based upon the 178.9 assessment of the recipient's needs and choices, and which will 178.10 ensure access to medical, social, educational, and other related 178.11 services and supports; 178.12 (3) routine contact or communication with the recipient, 178.13 the recipient's family, primary caregiver, legal representative, 178.14 substitute care provider, service providers, or other relevant 178.15 persons identified as necessary to the development or 178.16 implementation of the goals of the individual service plan; 178.17 (4) coordinating referrals for, and the provision of, case 178.18 management services for the recipient with appropriate service 178.19 providers, consistent with section 1902(a)(23) of the Social 178.20 Security Act; 178.21 (5) coordinating and monitoring the overall service 178.22 delivery to ensure quality of services, appropriateness, and 178.23 continued need; 178.24 (6) completing and maintaining necessary documentation that 178.25 supports and verifies the activities in this subdivision; 178.26 (7) traveling to conduct a visit with the recipient or 178.27 other relevant person necessary to develop or implement the 178.28 goals of the individual service plan; and 178.29 (8) coordinating with the institution discharge planner in 178.30 the 180-day period before the recipient's discharge. 178.31 Sec. 23. Minnesota Statutes 2000, section 256B.0625, is 178.32 amended by adding a subdivision to read: 178.33 Subd. 43e. [TIMELINES.] The following timelines must be 178.34 met for assigning a case manager: 178.35 (1) for relocation targeted case management, an eligible 178.36 recipient must be assigned a case manager who visits the person 179.1 within 20 working days of requesting one from their county of 179.2 financial responsibility as determined under chapter 256G. If a 179.3 county agency does not provide case management services as 179.4 required, the recipient may, after written notice to the county 179.5 agency, obtain targeted-relocation case management services from 179.6 a home care targeted case management provider under this 179.7 subdivision; and 179.8 (2) for home care targeted case management, an eligible 179.9 recipient must be assigned a case manager within 20 working days 179.10 of requesting one from a home care targeted case management 179.11 provider, as defined in subdivision 43c. 179.12 Sec. 24. Minnesota Statutes 2000, section 256B.0625, is 179.13 amended by adding a subdivision to read: 179.14 Subd. 43f. [EVALUATION.] The commissioner shall evaluate 179.15 the delivery of targeted case management, including, but not 179.16 limited to, access to case management services, consumer 179.17 satisfaction with case management services, and quality of case 179.18 management services. 179.19 Sec. 25. Minnesota Statutes 2000, section 256B.0625, is 179.20 amended by adding a subdivision to read: 179.21 Subd. 43g. [CONTACT DOCUMENTATION.] The case manager must 179.22 document each face-to-face and telephone contact with the 179.23 recipient and others involved in the recipient's individual 179.24 service plan. 179.25 Sec. 26. Minnesota Statutes 2000, section 256B.0625, is 179.26 amended by adding a subdivision to read: 179.27 Subd. 43h. [PAYMENT RATES.] The commissioner shall set 179.28 payment rates for targeted case management under this 179.29 subdivision. Case managers may bill according to the following 179.30 criteria: 179.31 (1) for relocation targeted case management, case managers 179.32 may bill for direct case management activities, including 179.33 face-to-face and telephone contacts, in the 180 days preceding 179.34 an eligible recipient's discharge from an institution; 179.35 (2) for home care targeted case management, case managers 179.36 may bill for direct case management activities, including 180.1 face-to-face and telephone contacts; and 180.2 (3) billings for targeted case management services under 180.3 this subdivision shall not duplicate payments made under other 180.4 program authorities for the same purpose. 180.5 Sec. 27. Minnesota Statutes 2000, section 256B.0627, 180.6 subdivision 1, is amended to read: 180.7 Subdivision 1. [DEFINITION.] (a) "Activities of daily 180.8 living" includes eating, toileting, grooming, dressing, bathing, 180.9 transferring, mobility, and positioning. 180.10 (b) "Assessment" means a review and evaluation of a 180.11 recipient's need for home care services conducted in person. 180.12 Assessments for private duty nursing shall be conducted by a 180.13 registered private duty nurse. Assessments for home health 180.14 agency services shall be conducted by a home health agency 180.15 nurse. Assessments for personal care assistant services shall 180.16 be conducted by the county public health nurse or a certified 180.17 public health nurse under contract with the county. A 180.18 face-to-face assessment must include: documentation of health 180.19 status, determination of need, evaluation of service 180.20 effectiveness, identification of appropriate services, service 180.21 plan development or modification, coordination of services, 180.22 referrals and follow-up to appropriate payers and community 180.23 resources, completion of required reports, recommendation of 180.24 service authorization, and consumer education. Once the need 180.25 for personal care assistant services is determined under this 180.26 section, the county public health nurse or certified public 180.27 health nurse under contract with the county is responsible for 180.28 communicating this recommendation to the commissioner and the 180.29 recipient. A face-to-face assessment for personal 180.30 care assistant services is conducted on those recipients who 180.31 have never had a county public health nurse assessment. A 180.32 face-to-face assessment must occur at least annually or when 180.33 there is a significant change in the recipient's condition or 180.34 when there is a change in the need for personal care assistant 180.35 services. A service update may substitute for the annual 180.36 face-to-face assessment when there is not a significant change 181.1 in recipient condition or a change in the need for personal care 181.2 assistant service. A service update or review for temporary 181.3 increase includes a review of initial baseline data, evaluation 181.4 of service effectiveness, redetermination of service need, 181.5 modification of service plan and appropriate referrals, update 181.6 of initial forms, obtaining service authorization, and on going 181.7 consumer education. Assessments for medical assistance home 181.8 care services for mental retardation or related conditions and 181.9 alternative care services for developmentally disabled home and 181.10 community-based waivered recipients may be conducted by the 181.11 county public health nurse to ensure coordination and avoid 181.12 duplication. Assessments must be completed on forms provided by 181.13 the commissioner within 30 days of a request for home care 181.14 services by a recipient or responsible party. 181.15(b)(c) "Care plan" means a written description of personal 181.16 care assistant services developed by the qualified 181.17 professional or the recipient's physician with the recipient or 181.18 responsible party to be used by the personal care assistant with 181.19 a copy provided to the recipient or responsible party. 181.20 (d) "Complex and regular private duty nursing care" means: 181.21 (1) complex care is private duty nursing provided to 181.22 recipients who are ventilator dependent or for whom a physician 181.23 has certified that were it not for private duty nursing the 181.24 recipient would meet the criteria for inpatient hospital 181.25 intensive care unit (ICU) level of care; and 181.26 (2) regular care is private duty nursing provided to all 181.27 other recipients. 181.28 (e) "Health-related functions" means functions that can be 181.29 delegated or assigned by a licensed health care professional 181.30 under state law to be performed by a personal care attendant. 181.31(c)(f) "Home care services" means a health service, 181.32 determined by the commissioner as medically necessary, that is 181.33 ordered by a physician and documented in a service plan that is 181.34 reviewed by the physician at least once every6260 days for the 181.35 provision of home health services, or private duty nursing, or 181.36 at least once every 365 days for personal care. Home care 182.1 services are provided to the recipient at the recipient's 182.2 residence that is a place other than a hospital or long-term 182.3 care facility or as specified in section 256B.0625. 182.4 (g) "Instrumental activities of daily living" includes meal 182.5 planning and preparation, managing finances, shopping for food, 182.6 clothing, and other essential items, performing essential 182.7 household chores, communication by telephone and other media, 182.8 and getting around and participating in the community. 182.9(d)(h) "Medically necessary" has the meaning given in 182.10 Minnesota Rules, parts 9505.0170 to 9505.0475. 182.11(e)(i) "Personal care assistant" means a person who: 182.12 (1) is at least 18 years old, except for persons 16 to 18 182.13 years of age who participated in a related school-based job 182.14 training program or have completed a certified home health aide 182.15 competency evaluation; 182.16 (2) is able to effectively communicate with the recipient 182.17 and personal care provider organization; 182.18 (3) effective July 1, 1996, has completed one of the 182.19 training requirements as specified in Minnesota Rules, part 182.20 9505.0335, subpart 3, items A to D; 182.21 (4) has the ability to, and provides covered personal 182.22 care assistant services according to the recipient's care plan, 182.23 responds appropriately to recipient needs, and reports changes 182.24 in the recipient's condition to the supervising qualified 182.25 professional or physician; 182.26 (5) is not a consumer of personal care assistant services; 182.27 and 182.28 (6) is subject to criminal background checks and procedures 182.29 specified in section 245A.04. 182.30(f)(j) "Personal care provider organization" means an 182.31 organization enrolled to provide personal care assistant 182.32 services under the medical assistance program that complies with 182.33 the following: (1) owners who have a five percent interest or 182.34 more, and managerial officials are subject to a background study 182.35 as provided in section 245A.04. This applies to currently 182.36 enrolled personal care provider organizations and those agencies 183.1 seeking enrollment as a personal care provider organization. An 183.2 organization will be barred from enrollment if an owner or 183.3 managerial official of the organization has been convicted of a 183.4 crime specified in section 245A.04, or a comparable crime in 183.5 another jurisdiction, unless the owner or managerial official 183.6 meets the reconsideration criteria specified in section 245A.04; 183.7 (2) the organization must maintain a surety bond and liability 183.8 insurance throughout the duration of enrollment and provides 183.9 proof thereof. The insurer must notify the department of human 183.10 services of the cancellation or lapse of policy; and (3) the 183.11 organization must maintain documentation of services as 183.12 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 183.13 as evidence of compliance with personal care assistant training 183.14 requirements. 183.15(g)(k) "Responsible party" means an individual residing 183.16 with a recipient of personal care assistant services who is 183.17 capable of providing the supportive care necessary to assist the 183.18 recipient to live in the community, is at least 18 years old, 183.19 and is not a personal care assistant. Responsible parties who 183.20 are parents of minors or guardians of minors or incapacitated 183.21 persons may delegate the responsibility to another adult during 183.22 a temporary absence of at least 24 hours but not more than six 183.23 months. The person delegated as a responsible party must be 183.24 able to meet the definition of responsible party, except that 183.25 the delegated responsible party is required to reside with the 183.26 recipient only while serving as the responsible party. Foster 183.27 care license holders may be designated the responsible party for 183.28 residents of the foster care home if case management is provided 183.29 as required in section 256B.0625, subdivision 19a. For persons 183.30 who, as of April 1, 1992, are sharing personal care assistant 183.31 services in order to obtain the availability of 24-hour 183.32 coverage, an employee of the personal care provider organization 183.33 may be designated as the responsible party if case management is 183.34 provided as required in section 256B.0625, subdivision 19a. 183.35(h)(l) "Service plan" means a written description of the 183.36 services needed based on the assessment developed by the nurse 184.1 who conducts the assessment together with the recipient or 184.2 responsible party. The service plan shall include a description 184.3 of the covered home care services, frequency and duration of 184.4 services, and expected outcomes and goals. The recipient and 184.5 the provider chosen by the recipient or responsible party must 184.6 be given a copy of the completed service plan within 30 calendar 184.7 days of the request for home care services by the recipient or 184.8 responsible party. 184.9(i)(m) "Skilled nurse visits" are provided in a 184.10 recipient's residence under a plan of care or service plan that 184.11 specifies a level of care which the nurse is qualified to 184.12 provide. These services are: 184.13 (1) nursing services according to the written plan of care 184.14 or service plan and accepted standards of medical and nursing 184.15 practice in accordance with chapter 148; 184.16 (2) services which due to the recipient's medical condition 184.17 may only be safely and effectively provided by a registered 184.18 nurse or a licensed practical nurse; 184.19 (3) assessments performed only by a registered nurse; and 184.20 (4) teaching and training the recipient, the recipient's 184.21 family, or other caregivers requiring the skills of a registered 184.22 nurse or licensed practical nurse. 184.23 (n) "Telehomecare" means the use of telecommunications 184.24 technology by a home health care professional to deliver home 184.25 health care services, within the professional's scope of 184.26 practice, to a patient located at a site other than the site 184.27 where the practitioner is located. 184.28 [EFFECTIVE DATE.] Paragraph (d) of this section is 184.29 effective January 1, 2003. 184.30 Sec. 28. Minnesota Statutes 2000, section 256B.0627, 184.31 subdivision 2, is amended to read: 184.32 Subd. 2. [SERVICES COVERED.] Home care services covered 184.33 under this section include: 184.34 (1) nursing services under section 256B.0625, subdivision 184.35 6a; 184.36 (2) private duty nursing services under section 256B.0625, 185.1 subdivision 7; 185.2 (3) home healthaideservices under section 256B.0625, 185.3 subdivision 6a; 185.4 (4) personal care assistant services under section 185.5 256B.0625, subdivision 19a; 185.6 (5) supervision of personal care assistant services 185.7 provided by a qualified professional under section 256B.0625, 185.8 subdivision 19a; 185.9 (6)consultingqualified professional of personal care 185.10 assistant services under the fiscalagentintermediary option as 185.11 specified in subdivision 10; 185.12 (7) face-to-face assessments by county public health nurses 185.13 for services under section 256B.0625, subdivision 19a; and 185.14 (8) service updates and review of temporary increases for 185.15 personal care assistant services by the county public health 185.16 nurse for services under section 256B.0625, subdivision 19a. 185.17 Sec. 29. Minnesota Statutes 2000, section 256B.0627, 185.18 subdivision 4, is amended to read: 185.19 Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The 185.20 personal care assistant services that are eligible for payment 185.21 arethe following:services and supports furnished to an 185.22 individual, as needed, to assist in accomplishing activities of 185.23 daily living; instrumental activities of daily living; 185.24 health-related functions through hands-on assistance, 185.25 supervision, and cueing; and redirection and intervention for 185.26 behavior including observation and monitoring. 185.27 (b) Payment for services will be made within the limits 185.28 approved using the prior authorized process established in 185.29 subdivision 5. 185.30 (c) The amount and type of services authorized shall be 185.31 based on an assessment of the recipient's needs in these areas: 185.32 (1) bowel and bladder care; 185.33 (2) skin care to maintain the health of the skin; 185.34 (3) repetitive maintenance range of motion, muscle 185.35 strengthening exercises, and other tasks specific to maintaining 185.36 a recipient's optimal level of function; 186.1 (4) respiratory assistance; 186.2 (5) transfers and ambulation; 186.3 (6) bathing, grooming, and hairwashing necessary for 186.4 personal hygiene; 186.5 (7) turning and positioning; 186.6 (8) assistance with furnishing medication that is 186.7 self-administered; 186.8 (9) application and maintenance of prosthetics and 186.9 orthotics; 186.10 (10) cleaning medical equipment; 186.11 (11) dressing or undressing; 186.12 (12) assistance with eating and meal preparation and 186.13 necessary grocery shopping; 186.14 (13) accompanying a recipient to obtain medical diagnosis 186.15 or treatment; 186.16 (14) assisting, monitoring, or prompting the recipient to 186.17 complete the services in clauses (1) to (13); 186.18 (15) redirection, monitoring, and observation that are 186.19 medically necessary and an integral part of completing the 186.20 personal care assistant services described in clauses (1) to 186.21 (14); 186.22 (16) redirection and intervention for behavior, including 186.23 observation and monitoring; 186.24 (17) interventions for seizure disorders, including 186.25 monitoring and observation if the recipient has had a seizure 186.26 that requires intervention within the past three months; 186.27 (18) tracheostomy suctioning using a clean procedure if the 186.28 procedure is properly delegated by a registered nurse. Before 186.29 this procedure can be delegated to a personal care assistant, a 186.30 registered nurse must determine that the tracheostomy suctioning 186.31 can be accomplished utilizing a clean rather than a sterile 186.32 procedure and must ensure that the personal care assistant has 186.33 been taught the proper procedure; and 186.34 (19) incidental household services that are an integral 186.35 part of a personal care service described in clauses (1) to (18). 186.36 For purposes of this subdivision, monitoring and observation 187.1 means watching for outward visible signs that are likely to 187.2 occur and for which there is a covered personal care service or 187.3 an appropriate personal care intervention. For purposes of this 187.4 subdivision, a clean procedure refers to a procedure that 187.5 reduces the numbers of microorganisms or prevents or reduces the 187.6 transmission of microorganisms from one person or place to 187.7 another. A clean procedure may be used beginning 14 days after 187.8 insertion. 187.9(b)(d) The personal care assistant services that are not 187.10 eligible for payment are the following: 187.11 (1) services not ordered by the physician; 187.12 (2) assessments by personal care assistant provider 187.13 organizations or by independently enrolled registered nurses; 187.14 (3) services that are not in the service plan; 187.15 (4) services provided by the recipient's spouse, legal 187.16 guardian for an adult or child recipient, or parent of a 187.17 recipient under age 18; 187.18 (5) services provided by a foster care provider of a 187.19 recipient who cannot direct the recipient's own care, unless 187.20 monitored by a county or state case manager under section 187.21 256B.0625, subdivision 19a; 187.22 (6) services provided by the residential or program license 187.23 holder in a residence for more than four persons; 187.24 (7) services that are the responsibility of a residential 187.25 or program license holder under the terms of a service agreement 187.26 and administrative rules; 187.27 (8)sterile procedures;187.28(9)injections of fluids into veins, muscles, or skin; 187.29(10)(9) services provided by parents of adult recipients, 187.30 adult children, or siblings of the recipient, unless these 187.31 relatives meet one of the following hardship criteria and the 187.32 commissioner waives this requirement: 187.33 (i) the relative resigns from a part-time or full-time job 187.34 to provide personal care for the recipient; 187.35 (ii) the relative goes from a full-time to a part-time job 187.36 with less compensation to provide personal care for the 188.1 recipient; 188.2 (iii) the relative takes a leave of absence without pay to 188.3 provide personal care for the recipient; 188.4 (iv) the relative incurs substantial expenses by providing 188.5 personal care for the recipient; or 188.6 (v) because of labor conditions, special language needs, or 188.7 intermittent hours of care needed, the relative is needed in 188.8 order to provide an adequate number of qualified personal care 188.9 assistants to meet the medical needs of the recipient; 188.10(11)(10) homemaker services that are not an integral part 188.11 of a personal care assistant services; 188.12(12)(11) home maintenance, or chore services; 188.13(13)(12) services not specified under paragraph (a); and 188.14(14)(13) services not authorized by the commissioner or 188.15 the commissioner's designee. 188.16 (e) The recipient or responsible party may choose to 188.17 supervise the personal care assistant or to have a qualified 188.18 professional, as defined in section 256B.0625, subdivision 19c, 188.19 provide the supervision. As required under section 256B.0625, 188.20 subdivision 19c, the county public health nurse, as a part of 188.21 the assessment, will consult with the recipient or responsible 188.22 party to identify the most appropriate person to provide 188.23 supervision of the personal care assistant. Health-related 188.24 delegated tasks performed by the personal care assistant will be 188.25 under the supervision of a qualified professional or the 188.26 direction of the recipient's physician. If the recipient has a 188.27 qualified professional, Minnesota Rules, part 9505.0335, subpart 188.28 4, applies. 188.29 Sec. 30. Minnesota Statutes 2000, section 256B.0627, 188.30 subdivision 5, is amended to read: 188.31 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 188.32 payments for home care services shall be limited according to 188.33 this subdivision. 188.34 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 188.35 recipient may receive the following home care services during a 188.36 calendar year: 189.1 (1) up to two face-to-face assessments to determine a 189.2 recipient's need for personal care assistant services; 189.3 (2) one service update done to determine a recipient's need 189.4 for personal care assistant services; and 189.5 (3) up tofivenine skilled nurse visits. 189.6 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 189.7 services above the limits in paragraph (a) must receive the 189.8 commissioner's prior authorization, except when: 189.9 (1) the home care services were required to treat an 189.10 emergency medical condition that if not immediately treated 189.11 could cause a recipient serious physical or mental disability, 189.12 continuation of severe pain, or death. The provider must 189.13 request retroactive authorization no later than five working 189.14 days after giving the initial service. The provider must be 189.15 able to substantiate the emergency by documentation such as 189.16 reports, notes, and admission or discharge histories; 189.17 (2) the home care services were provided on or after the 189.18 date on which the recipient's eligibility began, but before the 189.19 date on which the recipient was notified that the case was 189.20 opened. Authorization will be considered if the request is 189.21 submitted by the provider within 20 working days of the date the 189.22 recipient was notified that the case was opened; 189.23 (3) a third-party payor for home care services has denied 189.24 or adjusted a payment. Authorization requests must be submitted 189.25 by the provider within 20 working days of the notice of denial 189.26 or adjustment. A copy of the notice must be included with the 189.27 request; 189.28 (4) the commissioner has determined that a county or state 189.29 human services agency has made an error; or 189.30 (5) the professional nurse determines an immediate need for 189.31 up to 40 skilled nursing or home health aide visits per calendar 189.32 year and submits a request for authorization within 20 working 189.33 days of the initial service date, and medical assistance is 189.34 determined to be the appropriate payer. 189.35 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 189.36 authorization will be evaluated according to the same criteria 190.1 applied to prior authorization requests. 190.2 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 190.3 section 256B.0627, subdivision 1, paragraph (a), shall be 190.4 conducted initially, and at least annually thereafter, in person 190.5 with the recipient and result in a completed service plan using 190.6 forms specified by the commissioner. Within 30 days of 190.7 recipient or responsible party request for home care services, 190.8 the assessment, the service plan, and other information 190.9 necessary to determine medical necessity such as diagnostic or 190.10 testing information, social or medical histories, and hospital 190.11 or facility discharge summaries shall be submitted to the 190.12 commissioner. For personal care assistant services: 190.13 (1) The amount and type of service authorized based upon 190.14 the assessment and service plan will follow the recipient if the 190.15 recipient chooses to change providers. 190.16 (2) If the recipient's medical need changes, the 190.17 recipient's provider may assess the need for a change in service 190.18 authorization and request the change from the county public 190.19 health nurse. Within 30 days of the request, the public health 190.20 nurse will determine whether to request the change in services 190.21 based upon the provider assessment, or conduct a home visit to 190.22 assess the need and determine whether the change is appropriate. 190.23 (3) To continue to receive personal care assistant services 190.24 after the first year, the recipient or the responsible party, in 190.25 conjunction with the public health nurse, may complete a service 190.26 update on forms developed by the commissioner according to 190.27 criteria and procedures in subdivision 1. 190.28 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 190.29 commissioner's designee, shall review the assessment, service 190.30 update, request for temporary services, service plan, and any 190.31 additional information that is submitted. The commissioner 190.32 shall, within 30 days after receiving a complete request, 190.33 assessment, and service plan, authorize home care services as 190.34 follows: 190.35 (1) [HOME HEALTH SERVICES.] All home health services 190.36 provided by alicensed nurse or ahome health aide must be prior 191.1 authorized by the commissioner or the commissioner's designee. 191.2 Prior authorization must be based on medical necessity and 191.3 cost-effectiveness when compared with other care options. When 191.4 home health services are used in combination with personal care 191.5 and private duty nursing, the cost of all home care services 191.6 shall be considered for cost-effectiveness. The commissioner 191.7 shall limitnurse andhome health aide visits to no more than 191.8 one visiteachper day. The commissioner, or the commissioner's 191.9 designee, may authorize up to two skilled nurse visits per day. 191.10 (2) [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal 191.11 care assistant services and supervision by a qualified 191.12 professional, if requested by the recipient, must be prior 191.13 authorized by the commissioner or the commissioner's designee 191.14 except for the assessments established in paragraph (a). The 191.15 amount of personal care assistant services authorized must be 191.16 based on the recipient's home care rating. A child may not be 191.17 found to be dependent in an activity of daily living if because 191.18 of the child's age an adult would either perform the activity 191.19 for the child or assist the child with the activity and the 191.20 amount of assistance needed is similar to the assistance 191.21 appropriate for a typical child of the same age. Based on 191.22 medical necessity, the commissioner may authorize: 191.23 (A) up to two times the average number of direct care hours 191.24 provided in nursing facilities for the recipient's comparable 191.25 case mix level; or 191.26 (B) up to three times the average number of direct care 191.27 hours provided in nursing facilities for recipients who have 191.28 complex medical needs or are dependent in at least seven 191.29 activities of daily living and need physical assistance with 191.30 eating or have a neurological diagnosis; or 191.31 (C) up to 60 percent of the average reimbursement rate, as 191.32 of July 1, 1991, for care provided in a regional treatment 191.33 center for recipients who have Level I behavior, plus any 191.34 inflation adjustment as provided by the legislature for personal 191.35 care service; or 191.36 (D) up to the amount the commissioner would pay, as of July 192.1 1, 1991, plus any inflation adjustment provided for home care 192.2 services, for care provided in a regional treatment center for 192.3 recipients referred to the commissioner by a regional treatment 192.4 center preadmission evaluation team. For purposes of this 192.5 clause, home care services means all services provided in the 192.6 home or community that would be included in the payment to a 192.7 regional treatment center; or 192.8 (E) up to the amount medical assistance would reimburse for 192.9 facility care for recipients referred to the commissioner by a 192.10 preadmission screening team established under section 256B.0911 192.11 or 256B.092; and 192.12 (F) a reasonable amount of time for the provision of 192.13 supervision by a qualified professional of personal 192.14 care assistant services, if a qualified professional is 192.15 requested by the recipient or responsible party. 192.16 (ii) The number of direct care hours shall be determined 192.17 according to the annual cost report submitted to the department 192.18 by nursing facilities. The average number of direct care hours, 192.19 as established by May 1, 1992, shall be calculated and 192.20 incorporated into the home care limits on July 1, 1992. These 192.21 limits shall be calculated to the nearest quarter hour. 192.22 (iii) The home care rating shall be determined by the 192.23 commissioner or the commissioner's designee based on information 192.24 submitted to the commissioner by the county public health nurse 192.25 on forms specified by the commissioner. The home care rating 192.26 shall be a combination of current assessment tools developed 192.27 under sections 256B.0911 and 256B.501 with an addition for 192.28 seizure activity that will assess the frequency and severity of 192.29 seizure activity and with adjustments, additions, and 192.30 clarifications that are necessary to reflect the needs and 192.31 conditions of recipients who need home care including children 192.32 and adults under 65 years of age. The commissioner shall 192.33 establish these forms and protocols under this section and shall 192.34 use an advisory group, including representatives of recipients, 192.35 providers, and counties, for consultation in establishing and 192.36 revising the forms and protocols. 193.1 (iv) A recipient shall qualify as having complex medical 193.2 needs if the care required is difficult to perform and because 193.3 of recipient's medical condition requires more time than 193.4 community-based standards allow or requires more skill than 193.5 would ordinarily be required and the recipient needs or has one 193.6 or more of the following: 193.7 (A) daily tube feedings; 193.8 (B) daily parenteral therapy; 193.9 (C) wound or decubiti care; 193.10 (D) postural drainage, percussion, nebulizer treatments, 193.11 suctioning, tracheotomy care, oxygen, mechanical ventilation; 193.12 (E) catheterization; 193.13 (F) ostomy care; 193.14 (G) quadriplegia; or 193.15 (H) other comparable medical conditions or treatments the 193.16 commissioner determines would otherwise require institutional 193.17 care. 193.18 (v) A recipient shall qualify as having Level I behavior if 193.19 there is reasonable supporting evidence that the recipient 193.20 exhibits, or that without supervision, observation, or 193.21 redirection would exhibit, one or more of the following 193.22 behaviors that cause, or have the potential to cause: 193.23 (A) injury to the recipient's own body; 193.24 (B) physical injury to other people; or 193.25 (C) destruction of property. 193.26 (vi) Time authorized for personal care relating to Level I 193.27 behavior in subclause (v), items (A) to (C), shall be based on 193.28 the predictability, frequency, and amount of intervention 193.29 required. 193.30 (vii) A recipient shall qualify as having Level II behavior 193.31 if the recipient exhibits on a daily basis one or more of the 193.32 following behaviors that interfere with the completion of 193.33 personal care assistant services under subdivision 4, paragraph 193.34 (a): 193.35 (A) unusual or repetitive habits; 193.36 (B) withdrawn behavior; or 194.1 (C) offensive behavior. 194.2 (viii) A recipient with a home care rating of Level II 194.3 behavior in subclause (vii), items (A) to (C), shall be rated as 194.4 comparable to a recipient with complex medical needs under 194.5 subclause (iv). If a recipient has both complex medical needs 194.6 and Level II behavior, the home care rating shall be the next 194.7 complex category up to the maximum rating under subclause (i), 194.8 item (B). 194.9 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 194.10 nursing services shall be prior authorized by the commissioner 194.11 or the commissioner's designee. Prior authorization for private 194.12 duty nursing services shall be based on medical necessity and 194.13 cost-effectiveness when compared with alternative care options. 194.14 The commissioner may authorize medically necessary private duty 194.15 nursing services in quarter-hour units when: 194.16 (i) the recipient requires more individual and continuous 194.17 care than can be provided during a nurse visit; or 194.18 (ii) the cares are outside of the scope of services that 194.19 can be provided by a home health aide or personal care assistant. 194.20 The commissioner may authorize: 194.21 (A) up to two times the average amount of direct care hours 194.22 provided in nursing facilities statewide for case mix 194.23 classification "K" as established by the annual cost report 194.24 submitted to the department by nursing facilities in May 1992; 194.25 (B) private duty nursing in combination with other home 194.26 care services up to the total cost allowed under clause (2); 194.27 (C) up to 16 hours per day if the recipient requires more 194.28 nursing than the maximum number of direct care hours as 194.29 established in item (A) and the recipient meets the hospital 194.30 admission criteria established under Minnesota Rules, parts 194.319505.05009505.0501 to 9505.0540. 194.32 The commissioner may authorize up to 16 hours per day of 194.33 medically necessary private duty nursing services or up to 24 194.34 hours per day of medically necessary private duty nursing 194.35 services until such time as the commissioner is able to make a 194.36 determination of eligibility for recipients who are 195.1 cooperatively applying for home care services under the 195.2 community alternative care program developed under section 195.3 256B.49, or until it is determined by the appropriate regulatory 195.4 agency that a health benefit plan is or is not required to pay 195.5 for appropriate medically necessary health care services. 195.6 Recipients or their representatives must cooperatively assist 195.7 the commissioner in obtaining this determination. Recipients 195.8 who are eligible for the community alternative care program may 195.9 not receive more hours of nursing under this section than would 195.10 otherwise be authorized under section 256B.49. 195.11 Beginning January 1, 2003, private duty nursing services 195.12 shall be authorized for complex and regular care according to 195.13 section 256B.0627. 195.14 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 195.15 ventilator-dependent, the monthly medical assistance 195.16 authorization for home care services shall not exceed what the 195.17 commissioner would pay for care at the highest cost hospital 195.18 designated as a long-term hospital under the Medicare program. 195.19 For purposes of this clause, home care services means all 195.20 services provided in the home that would be included in the 195.21 payment for care at the long-term hospital. 195.22 "Ventilator-dependent" means an individual who receives 195.23 mechanical ventilation for life support at least six hours per 195.24 day and is expected to be or has been dependent for at least 30 195.25 consecutive days. 195.26 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 195.27 or the commissioner's designee shall determine the time period 195.28 for which a prior authorization shall be effective. If the 195.29 recipient continues to require home care services beyond the 195.30 duration of the prior authorization, the home care provider must 195.31 request a new prior authorization. Under no circumstances, 195.32 other than the exceptions in paragraph (b), shall a prior 195.33 authorization be valid prior to the date the commissioner 195.34 receives the request or for more than 12 months. A recipient 195.35 who appeals a reduction in previously authorized home care 195.36 services may continue previously authorized services, other than 196.1 temporary services under paragraph (h), pending an appeal under 196.2 section 256.045. The commissioner must provide a detailed 196.3 explanation of why the authorized services are reduced in amount 196.4 from those requested by the home care provider. 196.5 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 196.6 the commissioner's designee shall determine the medical 196.7 necessity of home care services, the level of caregiver 196.8 according to subdivision 2, and the institutional comparison 196.9 according to this subdivision, the cost-effectiveness of 196.10 services, and the amount, scope, and duration of home care 196.11 services reimbursable by medical assistance, based on the 196.12 assessment, primary payer coverage determination information as 196.13 required, the service plan, the recipient's age, the cost of 196.14 services, the recipient's medical condition, and diagnosis or 196.15 disability. The commissioner may publish additional criteria 196.16 for determining medical necessity according to section 256B.04. 196.17 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 196.18 The agency nurse, the independently enrolled private duty nurse, 196.19 or county public health nurse may request a temporary 196.20 authorization for home care services by telephone. The 196.21 commissioner may approve a temporary level of home care services 196.22 based on the assessment, and service or care plan information, 196.23 and primary payer coverage determination information as required. 196.24 Authorization for a temporary level of home care services 196.25 including nurse supervision is limited to the time specified by 196.26 the commissioner, but shall not exceed 45 days, unless extended 196.27 because the county public health nurse has not completed the 196.28 required assessment and service plan, or the commissioner's 196.29 determination has not been made. The level of services 196.30 authorized under this provision shall have no bearing on a 196.31 future prior authorization. 196.32 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 196.33 Home care services provided in an adult or child foster care 196.34 setting must receive prior authorization by the department 196.35 according to the limits established in paragraph (a). 196.36 The commissioner may not authorize: 197.1 (1) home care services that are the responsibility of the 197.2 foster care provider under the terms of the foster care 197.3 placement agreement and administrative rules; 197.4 (2) personal care assistant services when the foster care 197.5 license holder is also the personal care provider or personal 197.6 care assistant unless the recipient can direct the recipient's 197.7 own care, or case management is provided as required in section 197.8 256B.0625, subdivision 19a; 197.9 (3) personal care assistant services when the responsible 197.10 party is an employee of, or under contract with, or has any 197.11 direct or indirect financial relationship with the personal care 197.12 provider or personal care assistant, unless case management is 197.13 provided as required in section 256B.0625, subdivision 19a; or 197.14 (4) personal care assistant and private duty nursing 197.15 services when the number of foster care residents is greater 197.16 than four unless the county responsible for the recipient's 197.17 foster placement made the placement prior to April 1, 1992, 197.18 requests that personal care assistant and private duty nursing 197.19 services be provided, and case management is provided as 197.20 required in section 256B.0625, subdivision 19a. 197.21 Sec. 31. Minnesota Statutes 2000, section 256B.0627, 197.22 subdivision 7, is amended to read: 197.23 Subd. 7. [NONCOVERED HOME CARE SERVICES.] The following 197.24 home care services are not eligible for payment under medical 197.25 assistance: 197.26 (1) skilled nurse visits for the sole purpose of 197.27 supervision of the home health aide; 197.28 (2) a skilled nursing visit: 197.29 (i) only for the purpose of monitoring medication 197.30 compliance with an established medication program for a 197.31 recipient; or 197.32 (ii) to administer or assist with medication 197.33 administration, including injections, prefilling syringes for 197.34 injections, or oral medication set-up of an adult recipient, 197.35 when as determined and documented by the registered nurse, the 197.36 need can be met by an available pharmacy or the recipient is 198.1 physically and mentally able to self-administer or prefill a 198.2 medication; 198.3 (3) home care services to a recipient who is eligible for 198.4 covered servicesincluding hospice, if elected by the recipient,198.5 under the Medicare program or any other insurance held by the 198.6 recipient; 198.7 (4) services to other members of the recipient's household; 198.8 (5) a visit made by a skilled nurse solely to train other 198.9 home health agency workers; 198.10 (6) any home care service included in the daily rate of the 198.11 community-based residential facility where the recipient is 198.12 residing; 198.13 (7) nursing and rehabilitation therapy services that are 198.14 reasonably accessible to a recipient outside the recipient's 198.15 place of residence, excluding the assessment, counseling and 198.16 education, and personal assistant care; 198.17 (8) any home health agency service, excluding personal care 198.18 assistant services and private duty nursing services, which are 198.19 performed in a place other than the recipient's residence; and 198.20 (9) Medicare evaluation or administrative nursing visits on 198.21 dual-eligible recipients that do not qualify for Medicare visit 198.22 billing. 198.23 Sec. 32. Minnesota Statutes 2000, section 256B.0627, 198.24 subdivision 8, is amended to read: 198.25 Subd. 8. [SHARED PERSONAL CARE ASSISTANT SERVICES.] (a) 198.26 Medical assistance payments for shared personal care assistance 198.27 services shall be limited according to this subdivision. 198.28 (b) Recipients of personal care assistant services may 198.29 share staff and the commissioner shall provide a rate system for 198.30 shared personal care assistant services. For two persons 198.31 sharing services, the rate paid to a provider shall not exceed 198.32 1-1/2 times the rate paid for serving a single individual, and 198.33 for three persons sharing services, the rate paid to a provider 198.34 shall not exceed twice the rate paid for serving a single 198.35 individual. These rates apply only to situations in which all 198.36 recipients were present and received shared services on the date 199.1 for which the service is billed. No more than three persons may 199.2 receive shared services from a personal care assistant in a 199.3 single setting. 199.4 (c) Shared service is the provision of personal 199.5 care assistant services by a personal care assistant to two or 199.6 three recipients at the same time and in the same setting. For 199.7 the purposes of this subdivision, "setting" means: 199.8 (1) the home or foster care home of one of the individual 199.9 recipients; or 199.10 (2) a child care program in which all recipients served by 199.11 one personal care assistant are participating, which is licensed 199.12 under chapter 245A or operated by a local school district or 199.13 private school; or 199.14 (3) outside the home or foster care home of one of the 199.15 recipients when normal life activities take the recipients 199.16 outside the home. 199.17 The provisions of this subdivision do not apply when a 199.18 personal care assistant is caring for multiple recipients in 199.19 more than one setting. 199.20 (d) The recipient or the recipient's responsible party, in 199.21 conjunction with the county public health nurse, shall determine: 199.22 (1) whether shared personal care assistant services is an 199.23 appropriate option based on the individual needs and preferences 199.24 of the recipient; and 199.25 (2) the amount of shared services allocated as part of the 199.26 overall authorization of personal care assistant services. 199.27 The recipient or the responsible party, in conjunction with 199.28 the supervising qualified professional, if a qualified 199.29 professional is requested by any one of the recipients or 199.30 responsible parties, shall arrange the setting and grouping of 199.31 shared services based on the individual needs and preferences of 199.32 the recipients. Decisions on the selection of recipients to 199.33 share services must be based on the ages of the recipients, 199.34 compatibility, and coordination of their care needs. 199.35 (e) The following items must be considered by the recipient 199.36 or the responsible party and the supervising qualified 200.1 professional, if a qualified professional has been requested by 200.2 any one of the recipients or responsible parties, and documented 200.3 in the recipient's health service record: 200.4 (1) the additional qualifications needed by the personal 200.5 care assistant to provide care to several recipients in the same 200.6 setting; 200.7 (2) the additional training and supervision needed by the 200.8 personal care assistant to ensure that the needs of the 200.9 recipient are met appropriately and safely. The provider must 200.10 provide on-site supervision by a qualified professional within 200.11 the first 14 days of shared services, and monthly thereafter, if 200.12 supervision by a qualified provider has been requested by any 200.13 one of the recipients or responsible parties; 200.14 (3) the setting in which the shared services will be 200.15 provided; 200.16 (4) the ongoing monitoring and evaluation of the 200.17 effectiveness and appropriateness of the service and process 200.18 used to make changes in service or setting; and 200.19 (5) a contingency plan which accounts for absence of the 200.20 recipient in a shared services setting due to illness or other 200.21 circumstances and staffing contingencies. 200.22 (f) The provider must offer the recipient or the 200.23 responsible party the option of shared or one-on-one personal 200.24 care assistant services. The recipient or the responsible party 200.25 can withdraw from participating in a shared services arrangement 200.26 at any time. 200.27 (g) In addition to documentation requirements under 200.28 Minnesota Rules, part 9505.2175, a personal care provider must 200.29 meet documentation requirements for shared personal care 200.30 assistant services and must document the following in the health 200.31 service record for each individual recipient sharing services: 200.32 (1) permission by the recipient or the recipient's 200.33 responsible party, if any, for the maximum number of shared 200.34 services hours per week chosen by the recipient; 200.35 (2) permission by the recipient or the recipient's 200.36 responsible party, if any, for personal care assistant services 201.1 provided outside the recipient's residence; 201.2 (3) permission by the recipient or the recipient's 201.3 responsible party, if any, for others to receive shared services 201.4 in the recipient's residence; 201.5 (4) revocation by the recipient or the recipient's 201.6 responsible party, if any, of the shared service authorization, 201.7 or the shared service to be provided to others in the 201.8 recipient's residence, or the shared service to be provided 201.9 outside the recipient's residence; 201.10 (5) supervision of the shared personal care assistant 201.11 services by the qualified professional, if a qualified 201.12 professional is requested by one of the recipients or 201.13 responsible parties, including the date, time of day, number of 201.14 hours spent supervising the provision of shared services, 201.15 whether the supervision was face-to-face or another method of 201.16 supervision, changes in the recipient's condition, shared 201.17 services scheduling issues and recommendations; 201.18 (6) documentation by the qualified professional, if a 201.19 qualified professional is requested by one of the recipients or 201.20 responsible parties, of telephone calls or other discussions 201.21 with the personal care assistant regarding services being 201.22 provided to the recipient who has requested the supervision; and 201.23 (7) daily documentation of the shared services provided by 201.24 each identified personal care assistant including: 201.25 (i) the names of each recipient receiving shared services 201.26 together; 201.27 (ii) the setting for the shared services, including the 201.28 starting and ending times that the recipient received shared 201.29 services; and 201.30 (iii) notes by the personal care assistant regarding 201.31 changes in the recipient's condition, problems that may arise 201.32 from the sharing of services, scheduling issues, care issues, 201.33 and other notes as required by the qualified professional, if a 201.34 qualified professional is requested by one of the recipients or 201.35 responsible parties. 201.36 (h) Unless otherwise provided in this subdivision, all 202.1 other statutory and regulatory provisions relating to personal 202.2 care assistant services apply to shared services. 202.3 (i) In the event that supervision by a qualified 202.4 professional has been requested by one or more recipients, but 202.5 not by all of the recipients, the supervision duties of the 202.6 qualified professional shall be limited to only those recipients 202.7 who have requested the supervision. 202.8 Nothing in this subdivision shall be construed to reduce 202.9 the total number of hours authorized for an individual recipient. 202.10 Sec. 33. Minnesota Statutes 2000, section 256B.0627, 202.11 subdivision 10, is amended to read: 202.12 Subd. 10. [FISCALAGENTINTERMEDIARY OPTION AVAILABLE FOR 202.13 PERSONAL CARE ASSISTANT SERVICES.] (a)"Fiscal agent option" is202.14an option that allows the recipient to:202.15(1) use a fiscal agent instead of a personal care provider202.16organization;202.17(2) supervise the personal care assistant; and202.18(3) use a consulting professional.202.19 The commissioner may allow a recipient of personal care 202.20 assistant services to use a fiscalagentintermediary to assist 202.21 the recipient in paying and accounting for medically necessary 202.22 covered personal care assistant services authorized in 202.23 subdivision 4 and within the payment parameters of subdivision 202.24 5. Unless otherwise provided in this subdivision, all other 202.25 statutory and regulatory provisions relating to personal care 202.26 assistant services apply to a recipient using the fiscalagent202.27 intermediary option. 202.28 (b) The recipient or responsible party shall: 202.29 (1)hire, and terminate the personal care assistant and202.30consulting professional, with the fiscal agentrecruit, hire, 202.31 and terminate a qualified professional, if a qualified 202.32 professional is requested by the recipient or responsible party; 202.33 (2)recruit the personal care assistant and consulting202.34professional and orient and train the personal care assistant in202.35areas that do not require professional delegation as determined202.36by the county public health nurseverify and document the 203.1 credentials of the qualified professional, if a qualified 203.2 professional is requested by the recipient or responsible party; 203.3 (3)supervise and evaluate the personal care assistant in203.4areas that do not require professional delegation as determined203.5in the assessment;203.6(4) cooperate with a consultingdevelop a service plan 203.7 based on physician orders and public health nurse assessment 203.8 with the assistance of a qualified professionaland implement203.9recommendations pertaining to the health and safety of the203.10recipient, if a qualified professional is requested by the 203.11 recipient or responsible party, that addresses the health and 203.12 safety of the recipient; 203.13(5) hire a qualified professional to train and supervise203.14the performance of delegated tasks done by(4) recruit, hire, 203.15 and terminate the personal care assistant; 203.16(6) monitor services and verify in writing the hours worked203.17by the personal care assistant and the consulting(5) orient and 203.18 train the personal care assistant with assistance as needed from 203.19 the qualified professional; 203.20(7) develop and revise a care plan with assistance from a203.21consulting(6) supervise and evaluate the personal care 203.22 assistant with assistance as needed from the recipient's 203.23 physician or the qualified professional; 203.24(8) verify and document the credentials of the consulting203.25 (7) monitor and verify in writing and report to the fiscal 203.26 intermediary the number of hours worked by the personal care 203.27 assistant and the qualified professional; and 203.28(9)(8) enter into a written agreement, as specified in 203.29 paragraph (f). 203.30 (c) The duties of the fiscalagentintermediary shall be to: 203.31 (1) bill the medical assistance program for personal care 203.32 assistant andconsultingqualified professional services; 203.33 (2) request and secure background checks on personal care 203.34 assistants andconsultingqualified professionals according to 203.35 section 245A.04; 203.36 (3) pay the personal care assistant andconsulting204.1 qualified professional based on actual hours of services 204.2 provided; 204.3 (4) withhold and pay all applicable federal and state 204.4 taxes; 204.5 (5) verify anddocumentkeep records hours worked by the 204.6 personal care assistant andconsultingqualified professional; 204.7 (6) make the arrangements and pay unemployment insurance, 204.8 taxes, workers' compensation, liability insurance, and other 204.9 benefits, if any; 204.10 (7) enroll in the medical assistance program as a fiscal 204.11agentintermediary; and 204.12 (8) enter into a written agreement as specified in 204.13 paragraph (f) before services are provided. 204.14 (d) The fiscalagentintermediary: 204.15 (1) may not be related to the recipient,consulting204.16 qualified professional, or the personal care assistant; 204.17 (2) must ensure arm's length transactions with the 204.18 recipient and personal care assistant; and 204.19 (3) shall be considered a joint employer of the personal 204.20 care assistant andconsultingqualified professional to the 204.21 extent specified in this section. 204.22 The fiscalagentintermediary or owners of the entity that 204.23 provides fiscalagentintermediary services under this 204.24 subdivision must pass a criminal background check as required in 204.25 section 256B.0627, subdivision 1, paragraph (e). 204.26 (e) If the recipient or responsible party requests a 204.27 qualified professional, theconsultingqualified professional 204.28 providing assistance to the recipient shall meet the 204.29 qualifications specified in section 256B.0625, subdivision 19c. 204.30 Theconsultingqualified professional shall assist the recipient 204.31 in developing and revising a plan to meet the 204.32 recipient'sassessedneeds,and supervise the performance of204.33delegated tasks, as determined by the public health nurseas 204.34 assessed by the public health nurse. In performing this 204.35 function, theconsultingqualified professional must visit the 204.36 recipient in the recipient's home at least once annually. 205.1 Theconsultingqualified professional must reportto the local205.2county public health nurse concerns relating to the health and205.3safety of the recipient, andany suspected abuse, neglect, or 205.4 financial exploitation of the recipient to the appropriate 205.5 authorities. 205.6 (f) The fiscalagentintermediary, recipient or responsible 205.7 party, personal care assistant, andconsultingqualified 205.8 professional shall enter into a written agreement before 205.9 services are started. The agreement shall include: 205.10 (1) the duties of the recipient, qualified professional, 205.11 personal care assistant, and fiscal agent based on paragraphs 205.12 (a) to (e); 205.13 (2) the salary and benefits for the personal care assistant 205.14 andthose providing professional consultationthe qualified 205.15 professional; 205.16 (3) the administrative fee of the fiscalagentintermediary 205.17 and services paid for with that fee, including background check 205.18 fees; 205.19 (4) procedures to respond to billing or payment complaints; 205.20 and 205.21 (5) procedures for hiring and terminating the personal care 205.22 assistant andthose providing professional consultationthe 205.23 qualified professional. 205.24 (g) The rates paid for personal care assistant services, 205.25 qualified professionalassistanceservices, and fiscalagency205.26 intermediary services under this subdivision shall be the same 205.27 rates paid for personal care assistant services and qualified 205.28 professional services under subdivision 2 respectively. Except 205.29 for the administrative fee of the fiscalagentintermediary 205.30 specified in paragraph (f), the remainder of the rates paid to 205.31 the fiscalagentintermediary must be used to pay for the salary 205.32 and benefits for the personal care assistant orthose providing205.33professional consultationthe qualified professional. 205.34 (h) As part of the assessment defined in subdivision 1, the 205.35 following conditions must be met to use or continue use of a 205.36 fiscalagentintermediary: 206.1 (1) the recipient must be able to direct the recipient's 206.2 own care, or the responsible party for the recipient must be 206.3 readily available to direct the care of the personal care 206.4 assistant; 206.5 (2) the recipient or responsible party must be 206.6 knowledgeable of the health care needs of the recipient and be 206.7 able to effectively communicate those needs; 206.8 (3) a face-to-face assessment must be conducted by the 206.9 local county public health nurse at least annually, or when 206.10 there is a significant change in the recipient's condition or 206.11 change in the need for personal care assistant services. The206.12county public health nurse shall determine the services that206.13require professional delegation, if any, and the amount and206.14frequency of related supervision; 206.15 (4) the recipient cannot select the shared services option 206.16 as specified in subdivision 8; and 206.17 (5) parties must be in compliance with the written 206.18 agreement specified in paragraph (f). 206.19 (i) The commissioner shall deny, revoke, or suspend the 206.20 authorization to use the fiscalagentintermediary option if: 206.21 (1) it has been determined by theconsultingqualified 206.22 professional or local county public health nurse that the use of 206.23 this option jeopardizes the recipient's health and safety; 206.24 (2) the parties have failed to comply with the written 206.25 agreement specified in paragraph (f); or 206.26 (3) the use of the option has led to abusive or fraudulent 206.27 billing for personal care assistant services. 206.28 The recipient or responsible party may appeal the 206.29 commissioner's action according to section 256.045. The denial, 206.30 revocation, or suspension to use the fiscalagentintermediary 206.31 option shall not affect the recipient's authorized level of 206.32 personal care assistant services as determined in subdivision 5. 206.33 Sec. 34. Minnesota Statutes 2000, section 256B.0627, 206.34 subdivision 11, is amended to read: 206.35 Subd. 11. [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 206.36 Medical assistance payments for shared private duty nursing 207.1 services by a private duty nurse shall be limited according to 207.2 this subdivision. For the purposes of this section, "private 207.3 duty nursing agency" means an agency licensed under chapter 144A 207.4 to provide private duty nursing services. 207.5 (b) Recipients of private duty nursing services may share 207.6 nursing staff and the commissioner shall provide a rate 207.7 methodology for shared private duty nursing. For two persons 207.8 sharing nursing care, the rate paid to a provider shall not 207.9 exceed 1.5 times thenonwaiveredregular private duty nursing 207.10 rates paid for serving a single individualwho is not ventilator207.11dependent,by a registered nurse or licensed practical nurse. 207.12 These rates apply only to situations in which both recipients 207.13 are present and receive shared private duty nursing care on the 207.14 date for which the service is billed. No more than two persons 207.15 may receive shared private duty nursing services from a private 207.16 duty nurse in a single setting. 207.17 (c) Shared private duty nursing care is the provision of 207.18 nursing services by a private duty nurse to two recipients at 207.19 the same time and in the same setting. For the purposes of this 207.20 subdivision, "setting" means: 207.21 (1) the home or foster care home of one of the individual 207.22 recipients; or 207.23 (2) a child care program licensed under chapter 245A or 207.24 operated by a local school district or private school; or 207.25 (3) an adult day care service licensed under chapter 245A; 207.26 or 207.27 (4) outside the home or foster care home of one of the 207.28 recipients when normal life activities take the recipients 207.29 outside the home. 207.30 This subdivision does not apply when a private duty nurse 207.31 is caring for multiple recipients in more than one setting. 207.32 (d) The recipient or the recipient's legal representative, 207.33 and the recipient's physician, in conjunction with the home 207.34 health care agency, shall determine: 207.35 (1) whether shared private duty nursing care is an 207.36 appropriate option based on the individual needs and preferences 208.1 of the recipient; and 208.2 (2) the amount of shared private duty nursing services 208.3 authorized as part of the overall authorization of nursing 208.4 services. 208.5 (e) The recipient or the recipient's legal representative, 208.6 in conjunction with the private duty nursing agency, shall 208.7 approve the setting, grouping, and arrangement of shared private 208.8 duty nursing care based on the individual needs and preferences 208.9 of the recipients. Decisions on the selection of recipients to 208.10 share services must be based on the ages of the recipients, 208.11 compatibility, and coordination of their care needs. 208.12 (f) The following items must be considered by the recipient 208.13 or the recipient's legal representative and the private duty 208.14 nursing agency, and documented in the recipient's health service 208.15 record: 208.16 (1) the additional training needed by the private duty 208.17 nurse to provide care to two recipients in the same setting and 208.18 to ensure that the needs of the recipients are met appropriately 208.19 and safely; 208.20 (2) the setting in which the shared private duty nursing 208.21 care will be provided; 208.22 (3) the ongoing monitoring and evaluation of the 208.23 effectiveness and appropriateness of the service and process 208.24 used to make changes in service or setting; 208.25 (4) a contingency plan which accounts for absence of the 208.26 recipient in a shared private duty nursing setting due to 208.27 illness or other circumstances; 208.28 (5) staffing backup contingencies in the event of employee 208.29 illness or absence; and 208.30 (6) arrangements for additional assistance to respond to 208.31 urgent or emergency care needs of the recipients. 208.32 (g) The provider must offer the recipient or responsible 208.33 party the option of shared or one-on-one private duty nursing 208.34 services. The recipient or responsible party can withdraw from 208.35 participating in a shared service arrangement at any time. 208.36 (h) The private duty nursing agency must document the 209.1 following in the health service record for each individual 209.2 recipient sharing private duty nursing care: 209.3 (1) permission by the recipient or the recipient's legal 209.4 representative for the maximum number of shared nursing care 209.5 hours per week chosen by the recipient; 209.6 (2) permission by the recipient or the recipient's legal 209.7 representative for shared private duty nursing services provided 209.8 outside the recipient's residence; 209.9 (3) permission by the recipient or the recipient's legal 209.10 representative for others to receive shared private duty nursing 209.11 services in the recipient's residence; 209.12 (4) revocation by the recipient or the recipient's legal 209.13 representative of the shared private duty nursing care 209.14 authorization, or the shared care to be provided to others in 209.15 the recipient's residence, or the shared private duty nursing 209.16 services to be provided outside the recipient's residence; and 209.17 (5) daily documentation of the shared private duty nursing 209.18 services provided by each identified private duty nurse, 209.19 including: 209.20 (i) the names of each recipient receiving shared private 209.21 duty nursing services together; 209.22 (ii) the setting for the shared services, including the 209.23 starting and ending times that the recipient received shared 209.24 private duty nursing care; and 209.25 (iii) notes by the private duty nurse regarding changes in 209.26 the recipient's condition, problems that may arise from the 209.27 sharing of private duty nursing services, and scheduling and 209.28 care issues. 209.29 (i) Unless otherwise provided in this subdivision, all 209.30 other statutory and regulatory provisions relating to private 209.31 duty nursing services apply to shared private duty nursing 209.32 services. 209.33 Nothing in this subdivision shall be construed to reduce 209.34 the total number of private duty nursing hours authorized for an 209.35 individual recipient under subdivision 5. 209.36 Sec. 35. Minnesota Statutes 2000, section 256B.0627, is 210.1 amended by adding a subdivision to read: 210.2 Subd. 13. [CONSUMER-DIRECTED HOME CARE DEMONSTRATION 210.3 PROJECT.] (a) Upon the receipt of federal waiver authority, the 210.4 commissioner shall implement a consumer-directed home care 210.5 demonstration project. The consumer-directed home care 210.6 demonstration project must demonstrate and evaluate the outcomes 210.7 of a consumer-directed service delivery alternative to improve 210.8 access, increase consumer control and accountability over 210.9 available resources, and enable the use of supports that are 210.10 more individualized and cost-effective for eligible medical 210.11 assistance recipients receiving certain medical assistance home 210.12 care services. The consumer-directed home care demonstration 210.13 project will be administered locally by county agencies, tribal 210.14 governments, or administrative entities under contract with the 210.15 state in regions where counties choose not to provide this 210.16 service. 210.17 (b) Grant awards for persons who have been receiving 210.18 medical assistance covered personal care, home health aide, or 210.19 private duty nursing services for a period of 12 consecutive 210.20 months or more prior to enrollment in the consumer-directed home 210.21 care demonstration project will be established on a case-by-case 210.22 basis using historical service expenditure data. An average 210.23 monthly expenditure for each continuing enrollee will be 210.24 calculated based on historical expenditures made on behalf of 210.25 the enrollee for personal care, home health aide, or private 210.26 duty nursing services during the 12 month period directly prior 210.27 to enrollment in the project. The grant award will equal 90 210.28 percent of the average monthly expenditure. 210.29 (c) Grant awards for project enrollees who have been 210.30 receiving medical assistance covered personal care, home health 210.31 aide, or private duty nursing services for a period of less than 210.32 12 consecutive months prior to project enrollment will be 210.33 calculated on a case-by-case basis using the service 210.34 authorization in place at the time of enrollment. The total 210.35 number of units of personal care, home health aide, or private 210.36 duty nursing services the enrollee has been authorized to 211.1 receive will be converted to the total cost of the authorized 211.2 services in a given month using the statewide average service 211.3 payment rates. To determine an estimated monthly expenditure, 211.4 the total authorized monthly personal care, home health aide or 211.5 private duty nursing service costs will be reduced by a 211.6 percentage rate equivalent to the difference between the 211.7 statewide average service authorization and the statewide 211.8 average utilization rate for each of the services by medical 211.9 assistance eligibles during the most recent fiscal year for 211.10 which 12 months of data is available. The grant award will 211.11 equal 90 percent of the estimated monthly expenditure. 211.12 Sec. 36. Minnesota Statutes 2000, section 256B.0627, is 211.13 amended by adding a subdivision to read: 211.14 Subd. 14. [TELEHOMECARE; SKILLED NURSE VISITS.] Medical 211.15 assistance covers skilled nurse visits according to section 211.16 256B.0625, subdivision 6a, provided via telehomecare, for 211.17 services which do not require hands-on care between the home 211.18 care nurse and recipient. The provision of telehomecare must be 211.19 made via live, two-way interactive audiovisual technology and 211.20 may be augmented by utilizing store-and-forward technologies. 211.21 Store-and-forward technology includes telehomecare services that 211.22 do not occur in real time via synchronous transmissions, and 211.23 that do not require a face-to-face encounter with the recipient 211.24 for all or any part of any such telehomecare visit. A 211.25 communication between the home care nurse and recipient that 211.26 consists solely of a telephone conversation, facsimile, 211.27 electronic mail, or a consultation between two health care 211.28 practitioners, is not to be considered a telehomecare visit. 211.29 Multiple daily skilled nurse visits provided via telehomecare 211.30 are allowed. Coverage of telehomecare is limited to two visits 211.31 per day. All skilled nurse visits provided via telehomecare 211.32 must be prior authorized by the commissioner or the 211.33 commissioner's designee and will be covered at the same 211.34 allowable rate as skilled nurse visits provided in-person. 211.35 Sec. 37. Minnesota Statutes 2000, section 256B.0627, is 211.36 amended by adding a subdivision to read: 212.1 Subd. 15. [THERAPIES THROUGH HOME HEALTH AGENCIES.] (a) 212.2 [PHYSICAL THERAPY.] Medical assistance covers physical therapy 212.3 and related services, including specialized maintenance 212.4 therapy. Services provided by a physical therapy assistant 212.5 shall be reimbursed at the same rate as services performed by a 212.6 physical therapist when the services of the physical therapy 212.7 assistant are provided under the direction of a physical 212.8 therapist who is on the premises. Services provided by a 212.9 physical therapy assistant that are provided under the direction 212.10 of a physical therapist who is not on the premises shall be 212.11 reimbursed at 65 percent of the physical therapist rate. 212.12 Direction of the physical therapy assistant must be provided by 212.13 the physical therapist as described in Minnesota Rules, part 212.14 9505.0390, subpart 1, item B. The physical therapist and 212.15 physical therapist assistant may not both bill for services 212.16 provided to a recipient on the same day. 212.17 (b) [OCCUPATIONAL THERAPY.] Medical assistance covers 212.18 occupational therapy and related services, including specialized 212.19 maintenance therapy. Services provided by an occupational 212.20 therapy assistant shall be reimbursed at the same rate as 212.21 services performed by an occupational therapist when the 212.22 services of the occupational therapy assistant are provided 212.23 under the direction of the occupational therapist who is on the 212.24 premises. Services provided by an occupational therapy 212.25 assistant under the direction of an occupational therapist who 212.26 is not on the premises shall be reimbursed at 65 percent of the 212.27 occupational therapist rate. Direction of the occupational 212.28 therapy assistant must be provided by the occupational therapist 212.29 as described in Minnesota Rules, part 9505.0390, subpart 1, item 212.30 B. The occupational therapist and occupational therapist 212.31 assistant may not both bill for services provided to a recipient 212.32 on the same day. 212.33 Sec. 38. Minnesota Statutes 2000, section 256B.0627, is 212.34 amended by adding a subdivision to read: 212.35 Subd. 16. [HARDSHIP CRITERIA; PRIVATE DUTY NURSING.] (a) 212.36 Payment is allowed for extraordinary services that require 213.1 specialized nursing skills and are provided by parents of minor 213.2 children, spouses, and legal guardians who are providing private 213.3 duty nursing care under the following conditions: 213.4 (1) the provision of these services is not legally required 213.5 of the parents, spouses, or legal guardians; 213.6 (2) the services are necessary to prevent hospitalization 213.7 of the recipient; and 213.8 (3) the recipient is eligible for state plan home care or a 213.9 home and community-based waiver and one of the following 213.10 hardship criteria are met: 213.11 (i) the parent, spouse, or legal guardian resigns from a 213.12 part-time or full-time job to provide nursing care for the 213.13 recipient; or 213.14 (ii) the parent, spouse, or legal guardian goes from a 213.15 full-time to a part-time job with less compensation to provide 213.16 nursing care for the recipient; or 213.17 (iii) the parent, spouse, or legal guardian takes a leave 213.18 of absence without pay to provide nursing care for the 213.19 recipient; or 213.20 (iv) because of labor conditions, special language needs, 213.21 or intermittent hours of care needed, the parent, spouse, or 213.22 legal guardian is needed in order to provide adequate private 213.23 duty nursing services to meet the medical needs of the recipient. 213.24 (b) Private duty nursing may be provided by a parent, 213.25 spouse, or legal guardian who is a nurse licensed in Minnesota. 213.26 Private duty nursing services provided by a parent, spouse, or 213.27 legal guardian cannot be used in lieu of nursing services 213.28 covered and available under liable third-party payors, including 213.29 Medicare. The private duty nursing provided by a parent, 213.30 spouse, or legal guardian must be included in the service plan. 213.31 Authorized skilled nursing services provided by the parent, 213.32 spouse, or legal guardian may not exceed 50 percent of the total 213.33 approved nursing hours, or eight hours per day, whichever is 213.34 less, up to a maximum of 40 hours per week. Nothing in this 213.35 subdivision precludes the parent's, spouse's, or legal 213.36 guardian's obligation of assuming the nonreimbursed family 214.1 responsibilities of emergency backup caregiver and primary 214.2 caregiver. 214.3 (c) A parent or a spouse may not be paid to provide private 214.4 duty nursing care if the parent or spouse fails to pass a 214.5 criminal background check according to section 245A.04, or if it 214.6 has been determined by the home health agency, the case manager, 214.7 or the physician that the private duty nursing care provided by 214.8 the parent, spouse, or legal guardian is unsafe. 214.9 Sec. 39. Minnesota Statutes 2000, section 256B.0627, is 214.10 amended by adding a subdivision to read: 214.11 Subd. 17. [QUALITY ASSURANCE PLAN FOR PERSONAL CARE 214.12 ASSISTANT SERVICES.] The commissioner shall establish a quality 214.13 assurance plan for personal care assistant services that 214.14 includes: 214.15 (1) performance-based provider agreements; 214.16 (2) meaningful consumer input, which may include consumer 214.17 surveys, that measure the extent to which participants receive 214.18 the services and supports described in the individual plan and 214.19 participant satisfaction with such services and supports; 214.20 (3) ongoing monitoring of the health and well-being of 214.21 consumers; and 214.22 (4) an ongoing public process for development, 214.23 implementation, and review of the quality assurance plan. 214.24 Sec. 40. Minnesota Statutes 2000, section 256B.0911, is 214.25 amended by adding a subdivision to read: 214.26 Subd. 4a. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 214.27 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 214.28 ensure that individuals with disabilities or chronic illness are 214.29 served in the most integrated setting appropriate to their needs 214.30 and have the necessary information to make informed choices 214.31 about home and community-based service options. 214.32 (b) Individuals under 65 years of age who are admitted to a 214.33 nursing facility from a hospital must be screened prior to 214.34 admission as outlined in subdivision 4. 214.35 (c) Individuals under 65 years of age who are admitted to 214.36 nursing facilities with only a telephone screening must receive 215.1 a face-to-face assessment from the long-term care consultation 215.2 team member of the county in which the facility is located or 215.3 from the recipient's county case manager within 20 working days 215.4 of admission. 215.5 (d) At the face-to-face assessment, the long-term care 215.6 consultation team member or county case manager must perform the 215.7 activities required under subdivision 3. 215.8 (e) For individuals under 21 years of age, the screening or 215.9 assessment which recommends nursing facility admission must be 215.10 approved by the commissioner before the individual is admitted 215.11 to the nursing facility. 215.12 (f) In the event that an individual under 65 years of age 215.13 is admitted to a nursing facility on an emergency basis, the 215.14 county must be notified of the admission on the next working 215.15 day, and a face-to-face assessment as described in paragraph (c) 215.16 must be conducted within 20 working days of admission. 215.17 (g) At the face-to-face assessment, the long-term care 215.18 consultation team member or the case manager must present 215.19 information about home and community-based options so the 215.20 individual can make informed choices. If the individual chooses 215.21 home and community-based services, the long-term care 215.22 consultation team member or case manager must complete a written 215.23 relocation plan within 20 working days of the visit. The plan 215.24 shall describe the services needed to move out of the facility 215.25 and a timeline for the move which is designed to ensure a smooth 215.26 transition to the individual's home and community. 215.27 (h) An individual under 65 years of age residing in a 215.28 nursing facility shall receive a face-to-face assessment at 215.29 least every 12 months to review the person's service choices and 215.30 available alternatives unless the individual indicates, in 215.31 writing, that annual visits are not desired. In this case, the 215.32 individual must receive a face-to-face assessment at least once 215.33 every 36 months for the same purposes. 215.34 (i) Notwithstanding the provisions of subdivision 6, the 215.35 commissioner may pay county agencies directly for face-to-face 215.36 assessments for individuals who are eligible for medical 216.1 assistance, under 65 years of age, and being considered for 216.2 placement or residing in a nursing facility. 216.3 Sec. 41. Minnesota Statutes 2000, section 256B.093, 216.4 subdivision 3, is amended to read: 216.5 Subd. 3. [TRAUMATIC BRAIN INJURY PROGRAM DUTIES.] The 216.6 department shall fund administrative case management under this 216.7 subdivision using medical assistance administrative funds. The 216.8 traumatic brain injury program duties include: 216.9 (1) recommending to the commissioner in consultation with 216.10 the medical review agent according to Minnesota Rules, parts 216.11 9505.0500 to 9505.0540, the approval or denial of medical 216.12 assistance funds to pay for out-of-state placements for 216.13 traumatic brain injury services and in-state traumatic brain 216.14 injury services provided by designated Medicare long-term care 216.15 hospitals; 216.16 (2) coordinating the traumatic brain injury home and 216.17 community-based waiver; 216.18 (3)approving traumatic brain injury waiver eligibility or216.19care plans or both;216.20(4)providing ongoing technical assistance and consultation 216.21 to county and facility case managers to facilitate care plan 216.22 development for appropriate, accessible, and cost-effective 216.23 medical assistance services; 216.24(5)(4) providing technical assistance to promote statewide 216.25 development of appropriate, accessible, and cost-effective 216.26 medical assistance services and related policy; 216.27(6)(5) providing training and outreach to facilitate 216.28 access to appropriate home and community-based services to 216.29 prevent institutionalization; 216.30(7)(6) facilitating appropriate admissions, continued stay 216.31 review, discharges, and utilization review for neurobehavioral 216.32 hospitals and other specialized institutions; 216.33(8)(7) providing technical assistance on the use of prior 216.34 authorization of home care services and coordination of these 216.35 services with other medical assistance services; 216.36(9)(8) developing a system for identification of nursing 217.1 facility and hospital residents with traumatic brain injury to 217.2 assist in long-term planning for medical assistance services. 217.3 Factors will include, but are not limited to, number of 217.4 individuals served, length of stay, services received, and 217.5 barriers to community placement; and 217.6(10)(9) providing information, referral, and case 217.7 consultation to access medical assistance services for 217.8 recipients without a county or facility case manager. Direct 217.9 access to this assistance may be limited due to the structure of 217.10 the program. 217.11 Sec. 42. Minnesota Statutes 2000, section 256B.49, is 217.12 amended by adding a subdivision to read: 217.13 Subd. 11. [AUTHORITY.] (a) The commissioner is authorized 217.14 to apply for home and community-based service waivers, as 217.15 authorized under section 1915(c) of the Social Security Act to 217.16 serve persons under the age of 65 who are determined to require 217.17 the level of care provided in a nursing home and persons who 217.18 require the level of care provided in a hospital. The 217.19 commissioner shall apply for the home and community-based 217.20 waivers in order to: (i) promote the support of persons with 217.21 disabilities in the most integrated settings; (ii) expand the 217.22 availability of services for persons who are eligible for 217.23 medical assistance; (iii) promote cost-effective options to 217.24 institutional care; and (iv) obtain federal financial 217.25 participation. 217.26 (b) The provision of waivered services to medical 217.27 assistance recipients with disabilities shall comply with the 217.28 requirements outlined in the federally approved applications for 217.29 home and community-based services and subsequent amendments, 217.30 including provision of services according to a service plan 217.31 designated to meet the needs of the individual. For purposes of 217.32 this section, the approved home and community-based application 217.33 is considered the necessary federal requirement. 217.34 (c) The commissioner shall seek approval, as authorized 217.35 under section 1915(c) of the Social Security Act, to allow 217.36 medical assistance eligibility under this section for children 218.1 under age 21 without deeming of parental income or assets. 218.2 (d) The commissioner shall seek approval, as authorized 218.3 under section 1915(c) of the Social Security Act, to allow 218.4 medical assistance eligibility under this section for 218.5 individuals under age 65 without deeming the spouse's income or 218.6 assets. 218.7 (e) Prior to submitting to the federal government any 218.8 proposed changes or amendments to federally approved 218.9 applications for home and community-based services, the 218.10 commissioner shall notify interested persons serving on 218.11 departmental advisory groups and task forces and persons who 218.12 have requested to be notified. 218.13 Sec. 43. Minnesota Statutes 2000, section 256B.49, is 218.14 amended by adding a subdivision to read: 218.15 Subd. 12. [INFORMED CHOICE.] Persons who are determined 218.16 likely to require the level of care provided in a nursing 218.17 facility or hospital shall be informed of the home and 218.18 community-based support alternatives to the provision of 218.19 inpatient hospital services or nursing facility services. Each 218.20 person must be given the choice of either institutional or home 218.21 and community-based services using the provisions described in 218.22 section 256B.77, subdivision 2, paragraph (p). 218.23 Sec. 44. Minnesota Statutes 2000, section 256B.49, is 218.24 amended by adding a subdivision to read: 218.25 Subd. 13. [CASE MANAGEMENT.] (a) Each recipient of a home 218.26 and community-based waiver shall be provided case management 218.27 services by qualified vendors as described in the federally 218.28 approved waiver application. The case management service 218.29 activities provided will include: 218.30 (1) assessing the needs of the individual within 20 working 218.31 days of a recipient's request; 218.32 (2) developing the written individual service plan within 218.33 ten working days after the assessment is completed; 218.34 (3) informing the recipient or the recipient's legal 218.35 guardian or conservator of service options; 218.36 (4) assisting the recipient in the identification of 219.1 potential service providers; 219.2 (5) assisting the recipient to access services; 219.3 (6) coordinating, evaluating, and monitoring of the 219.4 services identified in the service plan; 219.5 (7) completing the annual reviews of the service plan; and 219.6 (8) informing the recipient or legal representative of the 219.7 right to have assessments completed and service plans developed 219.8 within specified time periods, and to appeal county action or 219.9 inaction under section 256.045, subdivision 3. 219.10 (b) The case manager may delegate certain aspects of the 219.11 case management service activities to another individual 219.12 provided there is oversight by the case manager. The case 219.13 manager may not delegate those aspects which require 219.14 professional judgment including assessments, reassessments, and 219.15 care plan development. 219.16 Sec. 45. Minnesota Statutes 2000, section 256B.49, is 219.17 amended by adding a subdivision to read: 219.18 Subd. 14. [ASSESSMENT AND REASSESSMENT.] (a) Assessments 219.19 of each recipient's strengths, informal support systems, and 219.20 need for services shall be completed within 20 working days of 219.21 the recipient's request. Reassessment of each recipient's 219.22 strengths, support systems, and need for services shall be 219.23 conducted at least every 12 months and at other times when there 219.24 has been a significant change in the recipient's functioning. 219.25 (b) Persons with mental retardation or a related condition 219.26 who apply for services under the nursing facility level waiver 219.27 programs shall be screened for the appropriate level of care 219.28 according to section 256B.092. 219.29 (c) Recipients who are found eligible for home and 219.30 community-based services under this section before their 65th 219.31 birthday may remain eligible for these services after their 65th 219.32 birthday if they continue to meet all other eligibility factors. 219.33 Sec. 46. Minnesota Statutes 2000, section 256B.49, is 219.34 amended by adding a subdivision to read: 219.35 Subd. 15. [INDIVIDUALIZED SERVICE PLAN.] Each recipient of 219.36 home and community-based waivered services shall be provided a 220.1 copy of the written service plan which: 220.2 (1) is developed and signed by the recipient within ten 220.3 working days of the completion of the assessment; 220.4 (2) meets the assessed needs of the recipient; 220.5 (3) reasonably ensures the health and safety of the 220.6 recipient; 220.7 (4) promotes independence; 220.8 (5) allows for services to be provided in the most 220.9 integrated settings; and 220.10 (6) provides for an informed choice, as defined in section 220.11 256B.77, subdivision 2, paragraph (p), of service and support 220.12 providers. 220.13 Sec. 47. Minnesota Statutes 2000, section 256B.49, is 220.14 amended by adding a subdivision to read: 220.15 Subd. 16. [SERVICES AND SUPPORTS.] Services and supports 220.16 included in the home and community-based waivers for persons 220.17 with disabilities shall meet the requirements set out in United 220.18 States Code, title 42, section 1396n. The services and 220.19 supports, which are offered as alternatives to institutional 220.20 care, shall promote consumer choice, community inclusion, 220.21 self-sufficiency, and self-determination. Beginning January 1, 220.22 2003, the commissioner shall simplify and improve access to home 220.23 and community-based services, to the extent possible, through 220.24 the establishment of a common service menu that is available to 220.25 eligible recipients regardless of age, disability type, or 220.26 waiver program. Consumer-directed community support services 220.27 shall be offered as an option to all persons eligible for 220.28 services under subdivision 11 by January 1, 2002. Services and 220.29 supports shall be arranged and provided consistent with 220.30 individualized written plans of care for eligible waiver 220.31 recipients. 220.32 Sec. 48. Minnesota Statutes 2000, section 256B.49, is 220.33 amended by adding a subdivision to read: 220.34 Subd. 17. [COST OF SERVICES AND SUPPORTS.] (a) The 220.35 commissioner shall ensure that the average per capita 220.36 expenditures estimated in any fiscal year for home and 221.1 community-based waiver recipients does not exceed the average 221.2 per capita expenditures that would have been made to provide 221.3 institutional services for recipients in the absence of the 221.4 waiver. 221.5 (b) The commissioner shall implement on January 1, 2002, 221.6 one or more aggregate, need-based methods for allocating to 221.7 local agencies the home and community-based waivered service 221.8 resources available to support recipients with disabilities in 221.9 need of the level of care provided in a nursing facility or a 221.10 hospital. The commissioner shall allocate resources to single 221.11 counties and county partnerships in a manner that reflects 221.12 consideration of: 221.13 (1) an incentive-based payment process for achieving 221.14 outcomes; 221.15 (2) the need for a state-level risk pool; 221.16 (3) the need for retention of management responsibility at 221.17 the state agency level; and 221.18 (4) a phase-in strategy as appropriate. 221.19 (c) Until the allocation methods described in paragraph (b) 221.20 are implemented, the annual allowable reimbursement level of 221.21 home and community-based waiver services shall be the greater of: 221.22 (1) the statewide average payment amount which the 221.23 recipient is assigned under the waiver reimbursement system in 221.24 place on June 30, 2001, modified by the percentage of any 221.25 provider rate increase appropriated for home and community-based 221.26 services; or 221.27 (2) an amount approved by the commissioner based on the 221.28 recipient's extraordinary needs that cannot be met within the 221.29 current allowable reimbursement level. The increased 221.30 reimbursement level must be necessary to allow the recipient to 221.31 be discharged from an institution or to prevent imminent 221.32 placement in an institution. The additional reimbursement may 221.33 be used to secure environmental modifications; assistive 221.34 technology and equipment; and increased costs for supervision, 221.35 training, and support services necessary to address the 221.36 recipient's extraordinary needs. The commissioner may approve 222.1 an increased reimbursement level for up to one year of the 222.2 recipient's relocation from an institution or up to six months 222.3 of a determination that a current waiver recipient is at 222.4 imminent risk of being placed in an institution. 222.5 (d) Beginning January 1, 2003, medically necessary private 222.6 duty nursing services will be authorized under this section as 222.7 complex and regular care according to section 256B.0627. The 222.8 rate established by the commissioner for registered nurse or 222.9 licensed practical nurse services under any home and 222.10 community-based waiver as of January 1, 2001, shall not be 222.11 reduced. 222.12 Sec. 49. Minnesota Statutes 2000, section 256B.49, is 222.13 amended by adding a subdivision to read: 222.14 Subd. 18. [PAYMENTS.] The commissioner shall reimburse 222.15 approved vendors from the medical assistance account for the 222.16 costs of providing home and community-based services to eligible 222.17 recipients using the invoice processing procedures of the 222.18 Medicaid management information system (MMIS). Recipients will 222.19 be screened and authorized for services according to the 222.20 federally approved waiver application and its subsequent 222.21 amendments. 222.22 Sec. 50. Minnesota Statutes 2000, section 256B.49, is 222.23 amended by adding a subdivision to read: 222.24 Subd. 19. [HEALTH AND WELFARE.] The commissioner of human 222.25 services shall take the necessary safeguards to protect the 222.26 health and welfare of individuals provided services under the 222.27 waiver. 222.28 Sec. 51. Minnesota Statutes 2000, section 256D.35, is 222.29 amended by adding a subdivision to read: 222.30 Subd. 11a. [INSTITUTION.] "Institution" means a hospital, 222.31 consistent with Code of Federal Regulations, title 42, section 222.32 440.10; regional treatment center inpatient services, consistent 222.33 with section 245.474; a nursing facility; and an intermediate 222.34 care facility for persons with mental retardation. 222.35 Sec. 52. Minnesota Statutes 2000, section 256D.35, is 222.36 amended by adding a subdivision to read: 223.1 Subd. 18a. [SHELTER COSTS.] "Shelter costs" means rent, 223.2 manufactured home lot rentals; monthly principal, interest, 223.3 insurance premiums, and property taxes due for mortgages or 223.4 contract for deed costs; costs for utilities, including heating, 223.5 cooling, electricity, water, and sewerage; garbage collection 223.6 fees; and the basic service fee for one telephone. 223.7 Sec. 53. Minnesota Statutes 2000, section 256D.44, 223.8 subdivision 5, is amended to read: 223.9 Subd. 5. [SPECIAL NEEDS.] In addition to the state 223.10 standards of assistance established in subdivisions 1 to 4, 223.11 payments are allowed for the following special needs of 223.12 recipients of Minnesota supplemental aid who are not residents 223.13 of a nursing home, a regional treatment center, or a group 223.14 residential housing facility. 223.15 (a) The county agency shall pay a monthly allowance for 223.16 medically prescribed diets payable under the Minnesota family 223.17 investment program if the cost of those additional dietary needs 223.18 cannot be met through some other maintenance benefit. 223.19 (b) Payment for nonrecurring special needs must be allowed 223.20 for necessary home repairs or necessary repairs or replacement 223.21 of household furniture and appliances using the payment standard 223.22 of the AFDC program in effect on July 16, 1996, for these 223.23 expenses, as long as other funding sources are not available. 223.24 (c) A fee for guardian or conservator service is allowed at 223.25 a reasonable rate negotiated by the county or approved by the 223.26 court. This rate shall not exceed five percent of the 223.27 assistance unit's gross monthly income up to a maximum of $100 223.28 per month. If the guardian or conservator is a member of the 223.29 county agency staff, no fee is allowed. 223.30 (d) The county agency shall continue to pay a monthly 223.31 allowance of $68 for restaurant meals for a person who was 223.32 receiving a restaurant meal allowance on June 1, 1990, and who 223.33 eats two or more meals in a restaurant daily. The allowance 223.34 must continue until the person has not received Minnesota 223.35 supplemental aid for one full calendar month or until the 223.36 person's living arrangement changes and the person no longer 224.1 meets the criteria for the restaurant meal allowance, whichever 224.2 occurs first. 224.3 (e) A fee of ten percent of the recipient's gross income or 224.4 $25, whichever is less, is allowed for representative payee 224.5 services provided by an agency that meets the requirements under 224.6 SSI regulations to charge a fee for representative payee 224.7 services. This special need is available to all recipients of 224.8 Minnesota supplemental aid regardless of their living 224.9 arrangement. 224.10 (f) Notwithstanding the language in this subdivision, an 224.11 amount equal to the maximum allotment authorized by the federal 224.12 Food Stamp Program for a single individual which is in effect on 224.13 the first day of January of the previous year will be added to 224.14 the standards of assistance established in subdivisions 1 to 4 224.15 for individuals under the age of 65 who are relocating from an 224.16 institution and who are shelter needy. An eligible individual 224.17 who receives this benefit prior to age 65 may continue to 224.18 receive the benefit after the age of 65. 224.19 "Shelter needy" means that the assistance unit incurs 224.20 monthly shelter costs that exceed 40 percent of the assistance 224.21 unit's gross income before the application of this special needs 224.22 standard. "Gross income" for the purposes of this section is 224.23 the applicant's or recipient's income as defined in section 224.24 256D.35, subdivision 10, or the standard specified in 224.25 subdivision 3, whichever is greater. A recipient of a federal 224.26 or state housing subsidy, that limits shelter costs to a 224.27 percentage of gross income, shall not be considered shelter 224.28 needy for purposes of this paragraph. 224.29 Sec. 54. [SEMI-INDEPENDENT LIVING SERVICES (SILS) STUDY.] 224.30 The commissioner of human services, in consultation with 224.31 county representatives and other interested persons, shall 224.32 develop recommendations revising the funding methodology for 224.33 SILS as defined in Minnesota Statutes, section 252.275, 224.34 subdivisions 3, 4, 4b, and 4c, and report by January 15, 2002, 224.35 to the chair of the house of representatives health and human 224.36 services finance committee and the chair of the senate health, 225.1 human services and corrections budget division. 225.2 Sec. 55. [WAIVER REQUEST REGARDING SPOUSAL INCOME.] 225.3 By September 1, 2001, the commissioner of human services 225.4 shall seek federal approval to allow recipients of home and 225.5 community-based waivers authorized under Minnesota Statutes, 225.6 section 256B.49, to choose either a waiver of deeming of spousal 225.7 income or the spousal impoverishment protections authorized 225.8 under United States Code, title 42, section 1396r-5, with the 225.9 addition of the group residential housing rate set according to 225.10 Minnesota Statutes, section 256I.03, subdivision 5, to the 225.11 personal needs allowance authorized by Minnesota Statutes, 225.12 section 256B.0575. 225.13 Sec. 56. [GRANTS TO PROVIDE BRAIN INJURY SUPPORT.] 225.14 Subdivision 1. [GRANTS.] Within the limits of the 225.15 appropriations made specifically for this purpose, the 225.16 commissioner of health shall make grants of up to $300,000 to 225.17 nonprofit corporations to continue a pilot project that provides 225.18 information, connects to community resources, and provides 225.19 support and problem solving on an ongoing basis to individuals 225.20 with traumatic brain injuries. 225.21 Subd. 2. [REPORT.] The commissioner shall prepare a report 225.22 identifying the results of the pilot project and making 225.23 recommendations on continuation of the project. The report must 225.24 be forwarded to the legislature no later than January 15, 2004. 225.25 Sec. 57. [REPEALER.] 225.26 (a) Minnesota Statutes 2000, sections 145.9245; 256.476, 225.27 subdivision 7; 256B.0912; 256B.0915, subdivisions 3a, 3b, and 225.28 3c; 256B.49, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10, are 225.29 repealed. 225.30 (b) Minnesota Rules, parts 9505.2455; 9505.2458; 9505.2460; 225.31 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 225.32 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 225.33 9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 225.34 9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 225.35 9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 225.36 9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 226.1 9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 226.2 9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 226.3 9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 226.4 9505.3660; and 9505.3670, are repealed. 226.5 ARTICLE 4 226.6 CONSUMER INFORMATION AND ASSISTANCE 226.7 AND COMMUNITY-BASED CARE 226.8 Section 1. Minnesota Statutes 2000, section 256.975, is 226.9 amended by adding a subdivision to read: 226.10 Subd. 7. [CONSUMER INFORMATION AND ASSISTANCE; SENIOR 226.11 LINKAGE.] (a) The Minnesota board on aging shall operate a 226.12 statewide information and assistance service to aid older 226.13 Minnesotans and their families in making informed choices about 226.14 long-term care options and health care benefits. Language 226.15 services to persons with limited English language skills must be 226.16 made available. The service, known as Senior LinkAge Line, must 226.17 be available during business hours through a statewide toll-free 226.18 number and must also be available through the Internet. 226.19 (b) The service must assist older adults, caregivers, and 226.20 providers in accessing information about choices in long-term 226.21 care services that are purchased through private providers or 226.22 available through public options. The service must: 226.23 (1) develop a comprehensive database that includes detailed 226.24 listings in both consumer- and provider-oriented formats; 226.25 (2) make the database accessible on the Internet and 226.26 through other telecommunication and media-related tools; 226.27 (3) link callers to interactive long-term care screening 226.28 tools and making these tools available through the Internet by 226.29 integrating the tools with the database; 226.30 (4) develop community education materials with a focus on 226.31 planning for long-term care and evaluating independent living, 226.32 housing, and service options; 226.33 (5) conduct an outreach campaign to assist older adults and 226.34 their caregivers in finding information on the Internet and 226.35 through other means of communication; 226.36 (6) implement a messaging system for overflow callers and 227.1 respond to these callers by the next business day; 227.2 (7) link callers with county human services and other 227.3 providers to receive more in-depth assistance and consultation 227.4 related to long-term care options; and 227.5 (8) link callers with quality profiles for nursing 227.6 facilities and other providers developed by the commissioner of 227.7 human services. 227.8 Sec. 2. [256.9754] [COMMUNITY SERVICES DEVELOPMENT GRANTS 227.9 PROGRAM.] 227.10 Subdivision 1. [DEFINITIONS.] For purposes of this 227.11 section, the following terms have the meanings given. 227.12 (a) "Community" means a town, township, city, or targeted 227.13 neighborhood within a city, or a consortium of towns, townships, 227.14 cities, or targeted neighborhoods within cities. 227.15 (b) "Older adult services" means any services available 227.16 under the elderly waiver program or alternative care grant 227.17 program; nursing facility services; transportation services; 227.18 respite services; and other community-based services identified 227.19 as necessary either to maintain lifestyle choices for older 227.20 Minnesotans or to promote independence. 227.21 (c) "Older adult" refers to individuals 65 years of age and 227.22 older. 227.23 Subd. 2. [CREATION.] The community services development 227.24 grants program is created under the administration of the 227.25 commissioner of human services. 227.26 Subd. 3. [PROVISION OF GRANTS.] The commissioner shall 227.27 make grants available to communities, providers of older adult 227.28 services identified in subdivision 1, or to a consortium of 227.29 providers of older adult services, to establish new older adult 227.30 services. Grants may be provided for capital and other costs 227.31 including, but not limited to, start-up and training costs, 227.32 equipment, and supplies related to the establishment of new 227.33 older adult services or other residential or service 227.34 alternatives to nursing facility care. Grants may also be made 227.35 to renovate current buildings, provide transportation services, 227.36 or expand state-funded programs in the area. 228.1 Subd. 4. [ELIGIBILITY.] Grants may be awarded only to 228.2 communities and providers or to a consortium of providers that 228.3 have a local match of 50 percent of the costs for the project in 228.4 the form of donations, local tax dollars, in-kind donations, or 228.5 other local match. 228.6 Sec. 3. Minnesota Statutes 2000, section 256B.0911, 228.7 subdivision 1, is amended to read: 228.8 Subdivision 1. [PURPOSE AND GOAL.] (a) The purpose ofthe228.9preadmission screening programlong-term care consultation 228.10 services is to assist persons with long-term or chronic care 228.11 needs in making long-term care decisions and selecting options 228.12 that meet their needs and reflect their preferences. The 228.13 availability of, and access to, information and other types of 228.14 assistance is also intended to prevent or delay certified 228.15 nursing facility placementsby assessing applicants and228.16residents and offering cost-effective alternatives appropriate228.17for the person's needsand to provide transition assistance 228.18 after admission. Further, the goal ofthe programthese 228.19 services is to contain costs associated with unnecessary 228.20 certified nursing facility admissions. The commissioners of 228.21 human services and health shall seek to maximize use of 228.22 available federal and state funds and establish the broadest 228.23 program possible within the funding available. 228.24 (b) These services must be coordinated with services 228.25 provided under sections 256.975, subdivision 7, and 256.9772, 228.26 and with services provided by other public and private agencies 228.27 in the community to offer a variety of cost-effective 228.28 alternatives to persons with disabilities and elderly persons. 228.29 The county agency providing long-term care consultation services 228.30 shall encourage the use of volunteers from families, religious 228.31 organizations, social clubs, and similar civic and service 228.32 organizations to provide community-based services. 228.33 Sec. 4. Minnesota Statutes 2000, section 256B.0911, is 228.34 amended by adding a subdivision to read: 228.35 Subd. 1a. [DEFINITIONS.] For purposes of this section, the 228.36 following definitions apply: 229.1 (a) "Long-term care consultation services" means: 229.2 (1) providing information and education to the general 229.3 public regarding availability of the services authorized under 229.4 this section; 229.5 (2) an intake process that provides access to the services 229.6 described in this section; 229.7 (3) assessment of the health, psychological, and social 229.8 needs of referred individuals; 229.9 (4) assistance in identifying services needed to maintain 229.10 an individual in the least restrictive environment; 229.11 (5) providing recommendations on cost-effective community 229.12 services that are available to the individual; 229.13 (6) development of an individual's community support plan; 229.14 (7) providing information regarding eligibility for 229.15 Minnesota health care programs; 229.16 (8) preadmission screening to determine the need for a 229.17 nursing facility level of care; 229.18 (9) preliminary determination of Minnesota health care 229.19 programs eligibility for individuals who need a nursing facility 229.20 level of care, with appropriate referrals for final 229.21 determination; 229.22 (10) providing recommendations for nursing facility 229.23 placement when there are no cost-effective community services 229.24 available; and 229.25 (11) assistance to transition people back to community 229.26 settings after facility admission. 229.27 (b) "Minnesota health care programs" means the medical 229.28 assistance program under chapter 256B, the alternative care 229.29 program under section 256B.0913, and the prescription drug 229.30 program under section 256.955. 229.31 Sec. 5. Minnesota Statutes 2000, section 256B.0911, 229.32 subdivision 3, is amended to read: 229.33 Subd. 3. [PERSONS RESPONSIBLE FOR CONDUCTING THE229.34PREADMISSION SCREENINGLONG-TERM CARE CONSULTATION TEAM.] (a) A 229.35local screeninglong-term care consultation team shall be 229.36 established by the county board of commissioners. Each local 230.1screeningconsultation team shall consist ofscreeners who are a230.2 at least one social worker andaat least one public health 230.3 nurse from their respective county agencies. The board may 230.4 designate public health or social services as the lead agency 230.5 for long-term care consultation services. If a county does not 230.6 have a public health nurse available, it may request approval 230.7 from the commissioner to assign a county registered nurse with 230.8 at least one year experience in home care to participate on the 230.9 team.The screening team members must confer regarding the most230.10appropriate care for each individual screened.Two or more 230.11 counties may collaborate to establish a joint localscreening230.12 consultation team or teams. 230.13 (b)In assessing a person's needs, screeners shall have a230.14physician available for consultation and shall consider the230.15assessment of the individual's attending physician, if any. The230.16individual's physician shall be included if the physician230.17chooses to participate. Other personnel may be included on the230.18team as deemed appropriate by the county agencies.The team is 230.19 responsible for providing long-term care consultation services 230.20 to all persons located in the county who request the services, 230.21 regardless of eligibility for Minnesota health care programs. 230.22 Sec. 6. Minnesota Statutes 2000, section 256B.0911, is 230.23 amended by adding a subdivision to read: 230.24 Subd. 3a. [ASSESSMENT AND SUPPORT PLANNING.] (a) Persons 230.25 requesting assessment, services planning, or other assistance 230.26 intended to support community-based living must be visited by a 230.27 long-term care consultation team within ten working days after 230.28 the date on which an assessment was requested or recommended. 230.29 Assessments must be conducted according to paragraphs (b) to (g). 230.30 (b) The county may utilize a team of either the social 230.31 worker or public health nurse, or both, to conduct the 230.32 assessment in a face-to-face interview. The consultation team 230.33 members must confer regarding the most appropriate care for each 230.34 individual screened or assessed. 230.35 (c) The long-term care consultation team must assess the 230.36 health and social needs of the person, using an assessment form 231.1 provided by the commissioner. 231.2 (d) The team must conduct the assessment in a face-to-face 231.3 interview with the person being assessed and the person's legal 231.4 representative, if applicable. 231.5 (e) The team must provide the person, or the person's legal 231.6 representative, with written recommendations for facility- or 231.7 community-based services. The team must document that the most 231.8 cost-effective alternatives available were offered to the 231.9 individual. For purposes of this requirement, "cost-effective 231.10 alternatives" means community services and living arrangements 231.11 that cost the same as or less than nursing facility care. 231.12 (f) If the person chooses to use community-based services, 231.13 the team must provide the person or the person's legal 231.14 representative with a written community support plan, regardless 231.15 of whether the individual is eligible for Minnesota health care 231.16 programs. The person may request assistance in developing a 231.17 community support plan without participating in a complete 231.18 assessment. 231.19 (g) The team must give the person receiving assessment or 231.20 support planning, or the person's legal representative, 231.21 materials supplied by the commissioner containing the following 231.22 information: 231.23 (1) the purpose of preadmission screening and assessment; 231.24 (2) information about Minnesota health care programs; 231.25 (3) the person's freedom to accept or reject the 231.26 recommendations of the team; 231.27 (4) the person's right to confidentiality under the 231.28 Minnesota Government Data Practices Act, chapter 13; and 231.29 (5) the person's right to appeal the decision regarding the 231.30 need for nursing facility level of care or the county's final 231.31 decisions regarding public programs eligibility according to 231.32 section 256.045, subdivision 3. 231.33 Sec. 7. Minnesota Statutes 2000, section 256B.0911, is 231.34 amended by adding a subdivision to read: 231.35 Subd. 3b. [TRANSITION ASSISTANCE.] (a) A long-term care 231.36 consultation team shall provide assistance to persons residing 232.1 in a nursing facility, hospital, regional treatment center, or 232.2 intermediate care facility for persons with mental retardation 232.3 who request or are referred for assistance. Transition 232.4 assistance must include assessment, community support plan 232.5 development, referrals to Minnesota health care programs, and 232.6 referrals to programs that provide assistance with housing. 232.7 (b) The county shall develop transition processes with 232.8 institutional social workers and discharge planners to ensure 232.9 that: 232.10 (1) persons admitted to facilities receive information 232.11 about transition assistance that is available; 232.12 (2) the assessment is completed for persons within ten 232.13 working days of the date of request or recommendation for 232.14 assessment; and 232.15 (3) there is a plan for transition and follow-up for the 232.16 individual's return to the community. The plan must require 232.17 notification of other local agencies when a person who may 232.18 require assistance is screened by one county for admission to a 232.19 facility located in another county. 232.20 (c) If a person who is eligible for a Minnesota health care 232.21 program is admitted to a nursing facility, the nursing facility 232.22 must include a consultation team member or the case manager in 232.23 the discharge planning process. 232.24 Sec. 8. Minnesota Statutes 2000, section 256B.0911, is 232.25 amended by adding a subdivision to read: 232.26 Subd. 3c. [ACCESS DEMONSTRATIONS.] (a) The commissioner 232.27 shall establish demonstration projects that are intended to 232.28 target critical areas for improvement in long-term care 232.29 consultation services, and to organize resources in a more 232.30 efficient, effective, and preferred way. The demonstrations may 232.31 include: 232.32 (1) development and implementation of strategies to 232.33 increase the number of people who leave nursing facilities, 232.34 hospitals, regional treatment centers, and intermediate care 232.35 facilities for persons with mental retardation and return to 232.36 community living, based on demonstration proposals that: 233.1 (i) focus on transitional planning between care settings; 233.2 (ii) engage a variety of providers and care settings; 233.3 (iii) include participants from both greater Minnesota and 233.4 metro communities; 233.5 (iv) emphasize regional or other cooperative approaches; 233.6 and 233.7 (v) identify potential obstacles to individuals returning 233.8 to community settings and propose recommendations to address 233.9 those obstacles and ways to improve the identification of people 233.10 who need transitional assistance; 233.11 (2) improved access to and expansion of the availability of 233.12 long-term care consultation services, and improved integration 233.13 of these services with other local activities designed to 233.14 support people in community living; 233.15 (3) identification of activities that increase public 233.16 awareness of and information about the various forms of 233.17 long-term care assistance available, and develop and implement 233.18 replicable training efforts; and 233.19 (4) selection of sites based on outcome and other 233.20 performance criteria outlined in an application process. 233.21 Projects can be single-county or multicounty managed. Project 233.22 budgets may include payments to increase the amount of and 233.23 encourage innovation in the development of transitional services 233.24 within demonstration sites. Payments for increased assessments, 233.25 support plan development, and other activities, as approved in 233.26 the budget proposal for selected project sites, shall be 233.27 incorporated into the reimbursement for long-term care 233.28 consultation services as described in subdivision 6. Projected 233.29 transition assessments included as part of selected 233.30 demonstration sites shall be calculated at the rate for county 233.31 case management services. 233.32 (b) The commissioner of human services shall submit a 233.33 report to the legislature describing demonstration models, 233.34 implementation activities, and projected outcomes by February 233.35 15, 2002. A final report on the performance of the models and 233.36 recommendations for strategies to address relocation or 234.1 transitional assistance shall be completed by December 15, 2003. 234.2 Sec. 9. Minnesota Statutes 2000, section 256B.0911, is 234.3 amended by adding a subdivision to read: 234.4 Subd. 4a. [PREADMISSION SCREENING ACTIVITIES RELATED TO 234.5 NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid 234.6 certified nursing facilities, including certified boarding care 234.7 facilities, must be screened prior to admission regardless of 234.8 income, assets, or funding sources for nursing facility care, 234.9 except as described in subdivision 4b. The purpose of the 234.10 screening is to determine the need for nursing facility level of 234.11 care as described in paragraph (d) and to complete activities 234.12 required under federal law related to mental illness and mental 234.13 retardation as outlined in paragraph (b). 234.14 (b) A person who has a diagnosis or possible diagnosis of 234.15 mental illness, mental retardation, or a related condition must 234.16 receive a preadmission screening before admission regardless of 234.17 the exemptions outlined in subdivision 4b, paragraph (b), to 234.18 identify the need for further evaluation and specialized 234.19 services, unless the admission prior to screening is authorized 234.20 by the local mental health authority or the local developmental 234.21 disabilities case manager, or unless authorized by the county 234.22 agency according to Public Law Number 100-508. 234.23 The following criteria apply to the preadmission screening: 234.24 (1) the county must use forms and criteria developed by the 234.25 commissioner to identify persons who require referral for 234.26 further evaluation and determination of the need for specialized 234.27 services; and 234.28 (2) the evaluation and determination of the need for 234.29 specialized services must be done by: 234.30 (i) a qualified independent mental health professional, for 234.31 persons with a primary or secondary diagnosis of a serious 234.32 mental illness; or 234.33 (ii) a qualified mental retardation professional, for 234.34 persons with a primary or secondary diagnosis of mental 234.35 retardation or related conditions. For purposes of this 234.36 requirement, a qualified mental retardation professional must 235.1 meet the standards for a qualified mental retardation 235.2 professional under Code of Federal Regulations, title 42, 235.3 section 483.430. 235.4 (c) The local county mental health authority or the state 235.5 mental retardation authority under Public Law Numbers 100-203 235.6 and 101-508 may prohibit admission to a nursing facility if the 235.7 individual does not meet the nursing facility level of care 235.8 criteria or needs specialized services as defined in Public Law 235.9 Numbers 100-203 and 101-508. For purposes of this section, 235.10 "specialized services" for a person with mental retardation or a 235.11 related condition means active treatment as that term is defined 235.12 under Code of Federal Regulations, title 42, section 483.440 235.13 (a)(1). 235.14 (d) The determination of the need for nursing facility 235.15 level of care must be made according to criteria developed by 235.16 the commissioner. In assessing a person's needs, consultation 235.17 team members shall have a physician available for consultation 235.18 and shall consider the assessment of the individual's attending 235.19 physician, if any. The individual's physician must be included 235.20 if the physician chooses to participate. Other personnel may be 235.21 included on the team as deemed appropriate by the county. 235.22 Sec. 10. Minnesota Statutes 2000, section 256B.0911, is 235.23 amended by adding a subdivision to read: 235.24 Subd. 4b. [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 235.25 Exemptions from the federal screening requirements outlined in 235.26 subdivision 4a, paragraphs (b) and (c), are limited to: 235.27 (1) a person who, having entered an acute care facility 235.28 from a certified nursing facility, is returning to a certified 235.29 nursing facility; and 235.30 (2) a person transferring from one certified nursing 235.31 facility in Minnesota to another certified nursing facility in 235.32 Minnesota. 235.33 (b) Persons who are exempt from preadmission screening for 235.34 purposes of level of care determination include: 235.35 (1) persons described in paragraph (a); 235.36 (2) an individual who has a contractual right to have 236.1 nursing facility care paid for indefinitely by the veterans' 236.2 administration; 236.3 (3) an individual enrolled in a demonstration project under 236.4 section 256B.69, subdivision 8, at the time of application to a 236.5 nursing facility; 236.6 (4) an individual currently being served under the 236.7 alternative care program or under a home and community-based 236.8 services waiver authorized under section 1915(c) of the federal 236.9 Social Security Act; and 236.10 (5) individuals admitted to a certified nursing facility 236.11 for a short-term stay, which is expected to be 14 days or less 236.12 in duration based upon a physician's certification, and who have 236.13 been assessed and approved for nursing facility admission within 236.14 the previous six months. This exemption applies only if the 236.15 consultation team member determines at the time of the initial 236.16 assessment of the six-month period that it is appropriate to use 236.17 the nursing facility for short-term stays and that there is an 236.18 adequate plan of care for return to the home or community-based 236.19 setting. If a stay exceeds 14 days, the individual must be 236.20 referred no later than the first county working day following 236.21 the 14th resident day for a screening, which must be completed 236.22 within five working days of the referral. The payment 236.23 limitations in subdivision 7 apply to an individual found at 236.24 screening to not meet the level of care criteria for admission 236.25 to a certified nursing facility. 236.26 (c) Persons admitted to a Medicaid-certified nursing 236.27 facility from the community on an emergency basis as described 236.28 in paragraph (d) or from an acute care facility on a nonworking 236.29 day must be screened the first working day after admission. 236.30 (d) Emergency admission to a nursing facility prior to 236.31 screening is permitted when all of the following conditions are 236.32 met: 236.33 (1) a person is admitted from the community to a certified 236.34 nursing or certified boarding care facility during county 236.35 nonworking hours; 236.36 (2) a physician has determined that delaying admission 237.1 until preadmission screening is completed would adversely affect 237.2 the person's health and safety; 237.3 (3) there is a recent precipitating event that precludes 237.4 the client from living safely in the community, such as 237.5 sustaining an injury, sudden onset of acute illness, or a 237.6 caregiver's inability to continue to provide care; 237.7 (4) the attending physician has authorized the emergency 237.8 placement and has documented the reason that the emergency 237.9 placement is recommended; and 237.10 (5) the county is contacted on the first working day 237.11 following the emergency admission. 237.12 Transfer of a patient from an acute care hospital to a nursing 237.13 facility is not considered an emergency except for a person who 237.14 has received hospital services in the following situations: 237.15 hospital admission for observation, care in an emergency room 237.16 without hospital admission, or following hospital 24-hour bed 237.17 care. 237.18 Sec. 11. Minnesota Statutes 2000, section 256B.0911, is 237.19 amended by adding a subdivision to read: 237.20 Subd. 4c. [SCREENING REQUIREMENTS.] (a) A person may be 237.21 screened for nursing facility admission by telephone or in a 237.22 face-to-face screening interview. Consultation team members 237.23 shall identify each individual's needs using the following 237.24 categories: 237.25 (1) the person needs no face-to-face screening interview to 237.26 determine the need for nursing facility level of care based on 237.27 information obtained from other health care professionals; 237.28 (2) the person needs an immediate face-to-face screening 237.29 interview to determine the need for nursing facility level of 237.30 care and complete activities required under subdivision 4a; or 237.31 (3) the person may be exempt from screening requirements as 237.32 outlined in subdivision 4b, but will need transitional 237.33 assistance after admission or in-person follow-along after a 237.34 return home. 237.35 (b) Persons admitted on a nonemergency basis to a 237.36 Medicaid-certified nursing facility must be screened prior to 238.1 admission. 238.2 (c) The long-term care consultation team shall recommend a 238.3 case mix classification for persons admitted to a certified 238.4 nursing facility when sufficient information is received to make 238.5 that classification. The nursing facility is authorized to 238.6 conduct all case mix assessments for persons who have been 238.7 screened prior to admission for whom the county did not 238.8 recommend a case mix classification. The nursing facility is 238.9 authorized to conduct all case mix assessments for persons 238.10 admitted to the facility prior to a preadmission screening. The 238.11 county retains the responsibility of distributing appropriate 238.12 case mix forms to the nursing facility. 238.13 (d) The county screening or intake activity must include 238.14 processes to identify persons who may require transition 238.15 assistance as described in subdivision 3b. 238.16 Sec. 12. Minnesota Statutes 2000, section 256B.0911, 238.17 subdivision 5, is amended to read: 238.18 Subd. 5. [SIMPLIFICATION OF FORMSADMINISTRATIVE 238.19 ACTIVITY.] The commissioner shall minimize the number of forms 238.20 required in thepreadmission screening processprovision of 238.21 long-term care consultation services and shall limit the 238.22 screening document to items necessary forcarecommunity support 238.23 plan approval, reimbursement, program planning, evaluation, and 238.24 policy development. 238.25 Sec. 13. Minnesota Statutes 2000, section 256B.0911, 238.26 subdivision 6, is amended to read: 238.27 Subd. 6. [PAYMENT FORPREADMISSION SCREENINGLONG-TERM 238.28 CARE CONSULTATION SERVICES.] (a) The totalscreeningpayment for 238.29 each county must be paid monthly by certified nursing facilities 238.30 in the county. The monthly amount to be paid by each nursing 238.31 facility for each fiscal year must be determined by dividing the 238.32 county's annual allocation forscreeningslong-term care 238.33 consultation services by 12 to determine the monthly payment and 238.34 allocating the monthly payment to each nursing facility based on 238.35 the number of licensed beds in the nursing facility. Payments 238.36 to counties in which there is no certified nursing facility must 239.1 be made by increasing the payment rate of the two facilities 239.2 located nearest to the county seat. 239.3 (b) The commissioner shall include the total annual payment 239.4for screeningdetermined under paragraph (a) for each nursing 239.5 facility reimbursed under section 256B.431 or 256B.434 according 239.6 to section 256B.431, subdivision 2b, paragraph (g), or 256B.435. 239.7 (c) In the event of the layaway, delicensure and 239.8 decertification, or removal from layaway of 25 percent or more 239.9 of the beds in a facility, the commissioner may adjust the per 239.10 diem payment amount in paragraph (b) and may adjust the monthly 239.11 payment amount in paragraph (a). The effective date of an 239.12 adjustment made under this paragraph shall be on or after the 239.13 first day of the month following the effective date of the 239.14 layaway, delicensure and decertification, or removal from 239.15 layaway. 239.16 (d) Payments forscreening activitieslong-term care 239.17 consultation services are available to the county or counties to 239.18 cover staff salaries and expenses to provide thescreening239.19functionservices described in subdivision 1a. Thelead agency239.20 county shall employ, or contract with other agencies to employ, 239.21 within the limits of available funding, sufficient personnel 239.22 toconduct the preadmission screening activityprovide long-term 239.23 care consultation services while meeting the state's long-term 239.24 care outcomes and objectives as defined in section 256B.0917, 239.25 subdivision 1. Thelocal agencycounty shall be accountable for 239.26 meeting local objectives as approved by the commissioner in the 239.27 CSSA biennial plan. 239.28(d)(e) Notwithstanding section 256B.0641, overpayments 239.29 attributable to payment of the screening costs under the medical 239.30 assistance program may not be recovered from a facility. 239.31(e)(f) The commissioner of human services shall amend the 239.32 Minnesota medical assistance plan to include reimbursement for 239.33 the localscreeningconsultation teams. 239.34 (g) The county may bill, as case management services, 239.35 assessments, support planning, and follow-along provided to 239.36 persons determined to be eligible for case management under 240.1 Minnesota health care programs. No individual or family member 240.2 shall be charged for an initial assessment or initial support 240.3 plan development provided under subdivision 3a or 3b. 240.4 Sec. 14. Minnesota Statutes 2000, section 256B.0911, 240.5 subdivision 7, is amended to read: 240.6 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 240.7 (a) Medical assistance reimbursement for nursing facilities 240.8 shall be authorized for a medical assistance recipient only if a 240.9 preadmission screening has been conducted prior to admission or 240.10 thelocalcountyagencyhas authorized an exemption. Medical 240.11 assistance reimbursement for nursing facilities shall not be 240.12 provided for any recipient who the local screener has determined 240.13 does not meet the level of care criteria for nursing facility 240.14 placement or, if indicated, has not had a level IIPASARROBRA 240.15 evaluation as required under the federal Omnibus Budget 240.16 Reconciliation Act of 1987 completed unless an admission for a 240.17 recipient with mental illness is approved by the local mental 240.18 health authority or an admission for a recipient with mental 240.19 retardation or related condition is approved by the state mental 240.20 retardation authority. 240.21 (b) The nursing facility must not bill a person who is not 240.22 a medical assistance recipient for resident days that preceded 240.23 the date of completion of screening activities as required under 240.24 subdivisions 4a, 4b, and 4c. The nursing facility must include 240.25 unreimbursed resident days in the nursing facility resident day 240.26 totals reported to the commissioner. 240.27 (c) The commissioner shall make a request to the health 240.28 care financing administration for a waiver allowingscreening240.29 team approval of Medicaid payments for certified nursing 240.30 facility care. An individual has a choice and makes the final 240.31 decision between nursing facility placement and community 240.32 placement after the screening team's recommendation, except as 240.33 provided inparagraphs (b) and (c)subdivision 4a, paragraph (c). 240.34(c) The local county mental health authority or the state240.35mental retardation authority under Public Law Numbers 100-203240.36and 101-508 may prohibit admission to a nursing facility, if the241.1individual does not meet the nursing facility level of care241.2criteria or needs specialized services as defined in Public Law241.3Numbers 100-203 and 101-508. For purposes of this section,241.4"specialized services" for a person with mental retardation or a241.5related condition means "active treatment" as that term is241.6defined in Code of Federal Regulations, title 42, section241.7483.440(a)(1).241.8(e) Appeals from the screening team's recommendation or the241.9county agency's final decision shall be made according to241.10section 256.045, subdivision 3.241.11 Sec. 15. Minnesota Statutes 2000, section 256B.0913, 241.12 subdivision 1, is amended to read: 241.13 Subdivision 1. [PURPOSE AND GOALS.] The purpose of the 241.14 alternative care program is to provide funding foror access to241.15 home and community-based services forfrailelderly persons, in 241.16 order to limit nursing facility placements. The program is 241.17 designed to supportfrailelderly persons in their desire to 241.18 remain in the community as independently and as long as possible 241.19 and to support informal caregivers in their efforts to provide 241.20 care forfrailelderly people. Further, the goals of the 241.21 program are: 241.22 (1) to contain medical assistance expenditures byproviding241.23 funding care in the communityat a cost the same or less than241.24nursing facility costs; and 241.25 (2) to maintain the moratorium on new construction of 241.26 nursing home beds. 241.27 Sec. 16. Minnesota Statutes 2000, section 256B.0913, 241.28 subdivision 2, is amended to read: 241.29 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 241.30 services are available toall frail olderMinnesotans. This241.31includes:241.32(1) persons who are receiving medical assistance and served241.33under the medical assistance program or the Medicaid waiver241.34program;241.35(2) personsage 65 or older who are not eligible for 241.36 medical assistance without a spenddown or waiver obligation but 242.1 who would be eligible for medical assistance within 180 days of 242.2 admission to a nursing facility andserved undersubject to 242.3 subdivisions 4 to 13; and242.4(3) persons who are paying for their services out-of-pocket. 242.5 Sec. 17. Minnesota Statutes 2000, section 256B.0913, 242.6 subdivision 4, is amended to read: 242.7 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 242.8 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 242.9 under the alternative care program is available to persons who 242.10 meet the following criteria: 242.11 (1) the person has beenscreened by the county screening242.12team or, if previously screened and served under the alternative242.13care program, assessed by the local county social worker or242.14public health nursedetermined by a community assessment under 242.15 section 256B.0911, to be a person who would require the level of 242.16 care provided in a nursing facility, but for the provision of 242.17 services under the alternative care program; 242.18 (2) the person is age 65 or older; 242.19 (3) the person would befinanciallyeligible for medical 242.20 assistance within 180 days of admission to a nursing facility; 242.21 (4) the personmeets the asset transfer requirements ofis 242.22 not ineligible for the medical assistance program due to an 242.23 asset transfer penalty; 242.24 (5)the screening team would recommend nursing facility242.25admission or continued stay for the person if alternative care242.26services were not available;242.27(6)the person needs services that are notavailable at242.28that time in the countyfunded through othercounty,state,or 242.29 federal fundingsources; and 242.30(7)(6) the monthly cost of the alternative care services 242.31 funded by the program for this person does not exceed 75 percent 242.32 of the statewideaverage monthly medical assistance payment for242.33nursing facility care at the individual's case mix242.34classificationweighted average monthly nursing facility rate of 242.35 the case mix resident class to which the individual alternative 242.36 care client would be assigned under Minnesota Rules, parts 243.1 9549.0050 to 9549.0059, less the recipient's maintenance needs 243.2 allowance as described in section 256B.0915, subdivision 1d, 243.3 paragraph (a), until the first day of the state fiscal year in 243.4 which the resident assessment system, under section 256B.437, 243.5 for nursing home rate determination is implemented. Effective 243.6 on the first day of the state fiscal year in which a resident 243.7 assessment system, under section 256B.437, for nursing home rate 243.8 determination is implemented and the first day of each 243.9 subsequent state fiscal year, the monthly cost of alternative 243.10 care services for this person shall not exceed the alternative 243.11 care monthly cap for the case mix resident class to which the 243.12 alternative care client would be assigned under Minnesota Rules, 243.13 parts 9549.0050 to 9549.0059, which was in effect on the last 243.14 day of the previous state fiscal year, and adjusted by the 243.15 greater of any legislatively adopted home and community-based 243.16 services cost-of-living percentage increase or any legislatively 243.17 adopted statewide percent rate increase for nursing facilities. 243.18 This monthly limit does not prohibit the alternative care client 243.19 from payment for additional services, but in no case may the 243.20 cost of additional services purchased under this section exceed 243.21 the difference between the client's monthly service limit 243.22 defined under section 256B.0915, subdivision 3, and the 243.23 alternative care program monthly service limit defined in this 243.24 paragraph. If medical supplies and equipment oradaptations243.25 environmental modifications are or will be purchased for an 243.26 alternative care services recipient, the costs may be prorated 243.27 on a monthly basisthroughout the year in which they are243.28purchasedfor up to 12 consecutive months beginning with the 243.29 month of purchase. If the monthly cost of a recipient's other 243.30 alternative care services exceeds the monthly limit established 243.31 in this paragraph, the annual cost of the alternative care 243.32 services shall be determined. In this event, the annual cost of 243.33 alternative care services shall not exceed 12 times the monthly 243.34 limitcalculateddescribed in this paragraph. 243.35 (b)Individuals who meet the criteria in paragraph (a) and243.36who have been approved for alternative care funding are called244.1180-day eligible clients.244.2(c) The statewide average payment for nursing facility care244.3is the statewide average monthly nursing facility rate in effect244.4on July 1 of the fiscal year in which the cost is incurred, less244.5the statewide average monthly income of nursing facility244.6residents who are age 65 or older and who are medical assistance244.7recipients in the month of March of the previous fiscal year.244.8This monthly limit does not prohibit the 180-day eligible client244.9from paying for additional services needed or desired.244.10(d) In determining the total costs of alternative care244.11services for one month, the costs of all services funded by the244.12alternative care program, including supplies and equipment, must244.13be included.244.14(e)Alternative care funding under this subdivision is not 244.15 available for a person who is a medical assistance recipient or 244.16 who would be eligible for medical assistance without a 244.17 spenddown, unless authorized by the commissioneror waiver 244.18 obligation. A person whose initial application for medical 244.19 assistance is being processed may be served under the 244.20 alternative care program for a period up to 60 days. If the 244.21 individual is found to be eligible for medical assistance,the244.22county must billmedical assistance must be billed for services 244.23 payable under the federally approved elderly waiver plan and 244.24 delivered from the date the individual was found eligible 244.25 forservices reimbursable underthe federally approved elderly 244.26 waiverprogramplan. Notwithstanding this provision, upon 244.27 federal approval, alternative care funds may not be used to pay 244.28 for any service the cost of which is payable by medical 244.29 assistance or which is used by a recipient to meet a medical 244.30 assistance income spenddown or waiver obligation. 244.31(f)(c) Alternative care funding is not available for a 244.32 person who resides in a licensed nursing homeor, certified 244.33 boarding care home, hospital, or intermediate care facility, 244.34 except for case management services which arebeingprovided in 244.35 support of the discharge planning process to a nursing home 244.36 resident or certified boarding care home resident who is 245.1 ineligible for case management funded by medical assistance. 245.2 Sec. 18. Minnesota Statutes 2000, section 256B.0913, 245.3 subdivision 5, is amended to read: 245.4 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 245.5 Alternative care funding may be used for payment of costs of: 245.6 (1) adult foster care; 245.7 (2) adult day care; 245.8 (3) home health aide; 245.9 (4) homemaker services; 245.10 (5) personal care; 245.11 (6) case management; 245.12 (7) respite care; 245.13 (8) assisted living; 245.14 (9) residential care services; 245.15 (10) care-related supplies and equipment; 245.16 (11) meals delivered to the home; 245.17 (12) transportation; 245.18 (13) skilled nursing; 245.19 (14) chore services; 245.20 (15) companion services; 245.21 (16) nutrition services; 245.22 (17) training for direct informal caregivers; 245.23 (18) telemedicine devices to monitor recipients in their 245.24 own homes as an alternative to hospital care, nursing home care, 245.25 or home visits;and245.26 (19) "other services"includingincludes discretionary 245.27 funds and direct cash payments to clients,approved by the245.28county agencyfollowing approval by the commissioner, subject to 245.29 the provisions of paragraph(m)(j). Total annual payments for " 245.30 other services" for all clients within a county may not exceed 245.31 either ten percent of that county's annual alternative care 245.32 program base allocation or $5,000, whichever is greater. In no 245.33 case shall this amount exceed the county's total annual 245.34 alternative care program base allocation; and 245.35 (20) environmental modifications. 245.36 (b) The county agency must ensure that the funds are not 246.1 usedonly to supplement and notto supplant services available 246.2 through other public assistance or services programs. 246.3 (c) Unless specified in statute, the service definitions 246.4 and standards for alternative care services shall be the same as 246.5 the service definitions and standardsdefinedspecified in the 246.6 federally approved elderly waiver plan. Except for the county 246.7 agencies' approval of direct cash payments to clients as 246.8 described in paragraph (j) or for a provider of supplies and 246.9 equipment when the monthly cost of the supplies and equipment is 246.10 less than $250, persons or agencies must be employed by or under 246.11 a contract with the county agency or the public health nursing 246.12 agency of the local board of health in order to receive funding 246.13 under the alternative care program. Supplies and equipment may 246.14 be purchased from a vendor not certified to participate in the 246.15 Medicaid program if the cost for the item is less than that of a 246.16 Medicaid vendor. 246.17 (d) The adult foster care rate shall be considered a 246.18 difficulty of care payment and shall not include room and 246.19 board. The adult foster caredailyrate shall be negotiated 246.20 between the county agency and the foster care provider.The246.21rate established under this section shall not exceed 75 percent246.22of the state average monthly nursing home payment for the case246.23mix classification to which the individual receiving foster care246.24is assigned, and it must allow for other alternative care246.25services to be authorized by the case manager.The alternative 246.26 care payment for the foster care service in combination with the 246.27 payment for other alternative care services, including case 246.28 management, must not exceed the limit specified in subdivision 246.29 4, paragraph (a), clause (6). 246.30 (e) Personal care servicesmay be provided by a personal246.31care provider organization.must meet the service standards 246.32 defined in the federally approved elderly waiver plan, except 246.33 that a county agency may contract with a client's relativeof246.34the clientwho meets the relative hardship waiver requirement as 246.35 defined in section 256B.0627, subdivision 4, paragraph (b), 246.36 clause (10), to provide personal care services, but must ensure247.1nursingif the county agency ensures supervision of this service 247.2 by a registered nurse or mental health practitioner.Covered247.3personal care services defined in section 256B.0627, subdivision247.44, must meet applicable standards in Minnesota Rules, part247.59505.0335.247.6 (f)A county may use alternative care funds to purchase247.7medical supplies and equipment without prior approval from the247.8commissioner when: (1) there is no other funding source; (2)247.9the supplies and equipment are specified in the individual's247.10care plan as medically necessary to enable the individual to247.11remain in the community according to the criteria in Minnesota247.12Rules, part 9505.0210, item A; and (3) the supplies and247.13equipment represent an effective and appropriate use of247.14alternative care funds. A county may use alternative care funds247.15to purchase supplies and equipment from a non-Medicaid certified247.16vendor if the cost for the items is less than that of a Medicaid247.17vendor. A county is not required to contract with a provider of247.18supplies and equipment if the monthly cost of the supplies and247.19equipment is less than $250.247.20(g)For purposes of this section, residential care services 247.21 are services which are provided to individuals living in 247.22 residential care homes. Residential care homes are currently 247.23 licensed as board and lodging establishments and are registered 247.24 with the department of health as providing special 247.25 services under section 157.17 and are not subject to 247.26 registration under chapter 144D. Residential care services are 247.27 defined as "supportive services" and "health-related services." 247.28 "Supportive services" means the provision of up to 24-hour 247.29 supervision and oversight. Supportive services includes: (1) 247.30 transportation, when provided by the residential carecenter247.31 home only; (2) socialization, when socialization is part of the 247.32 plan of care, has specific goals and outcomes established, and 247.33 is not diversional or recreational in nature; (3) assisting 247.34 clients in setting up meetings and appointments; (4) assisting 247.35 clients in setting up medical and social services; (5) providing 247.36 assistance with personal laundry, such as carrying the client's 248.1 laundry to the laundry room. Assistance with personal laundry 248.2 does not include any laundry, such as bed linen, that is 248.3 included in the room and board rate. "Health-related services" 248.4 are limited to minimal assistance with dressing, grooming, and 248.5 bathing and providing reminders to residents to take medications 248.6 that are self-administered or providing storage for medications, 248.7 if requested. Individuals receiving residential care services 248.8 cannot receive homemaking services funded under this section. 248.9(h)(g) For the purposes of this section, "assisted living" 248.10 refers to supportive services provided by a single vendor to 248.11 clients who reside in the same apartment building of three or 248.12 more units which are not subject to registration under chapter 248.13 144D and are licensed by the department of health as a class A 248.14 home care provider or a class E home care provider. Assisted 248.15 living services are defined as up to 24-hour supervision, and 248.16 oversight, supportive services as defined in clause (1), 248.17 individualized home care aide tasks as defined in clause (2), 248.18 and individualized home management tasks as defined in clause 248.19 (3) provided to residents of a residential center living in 248.20 their units or apartments with a full kitchen and bathroom. A 248.21 full kitchen includes a stove, oven, refrigerator, food 248.22 preparation counter space, and a kitchen utensil storage 248.23 compartment. Assisted living services must be provided by the 248.24 management of the residential center or by providers under 248.25 contract with the management or with the county. 248.26 (1) Supportive services include: 248.27 (i) socialization, when socialization is part of the plan 248.28 of care, has specific goals and outcomes established, and is not 248.29 diversional or recreational in nature; 248.30 (ii) assisting clients in setting up meetings and 248.31 appointments; and 248.32 (iii) providing transportation, when provided by the 248.33 residential center only. 248.34Individuals receiving assisted living services will not248.35receive both assisted living services and homemaking services.248.36Individualized means services are chosen and designed249.1specifically for each resident's needs, rather than provided or249.2offered to all residents regardless of their illnesses,249.3disabilities, or physical conditions.249.4 (2) Home care aide tasks means: 249.5 (i) preparing modified diets, such as diabetic or low 249.6 sodium diets; 249.7 (ii) reminding residents to take regularly scheduled 249.8 medications or to perform exercises; 249.9 (iii) household chores in the presence of technically 249.10 sophisticated medical equipment or episodes of acute illness or 249.11 infectious disease; 249.12 (iv) household chores when the resident's care requires the 249.13 prevention of exposure to infectious disease or containment of 249.14 infectious disease; and 249.15 (v) assisting with dressing, oral hygiene, hair care, 249.16 grooming, and bathing, if the resident is ambulatory, and if the 249.17 resident has no serious acute illness or infectious disease. 249.18 Oral hygiene means care of teeth, gums, and oral prosthetic 249.19 devices. 249.20 (3) Home management tasks means: 249.21 (i) housekeeping; 249.22 (ii) laundry; 249.23 (iii) preparation of regular snacks and meals; and 249.24 (iv) shopping. 249.25 Individuals receiving assisted living services shall not 249.26 receive both assisted living services and homemaking services. 249.27 Individualized means services are chosen and designed 249.28 specifically for each resident's needs, rather than provided or 249.29 offered to all residents regardless of their illnesses, 249.30 disabilities, or physical conditions. Assisted living services 249.31 as defined in this section shall not be authorized in boarding 249.32 and lodging establishments licensed according to sections 249.33 157.011 and 157.15 to 157.22. 249.34(i)(h) For establishments registered under chapter 144D, 249.35 assisted living services under this section means either the 249.36 services describedand licensedin paragraph (g) and delivered 250.1 by a class E home care provider licensed by the department of 250.2 health or the services described under section 144A.4605 and 250.3 delivered by an assisted living home care provider or a class A 250.4 home care provider licensed by the commissioner of health. 250.5(j) For the purposes of this section, reimbursement(i) 250.6 Payment for assisted living services and residential care 250.7 services shall be a monthly rate negotiated and authorized by 250.8 the county agency based on an individualized service plan for 250.9 each resident and may not cover direct rent or food costs.The250.10rate250.11 (1) The individualized monthly negotiated payment for 250.12 assisted living services as described in paragraph (g) or (h), 250.13 and residential care services as described in paragraph (f), 250.14 shall not exceed the nonfederal share in effect on July 1 of the 250.15 state fiscal year for which the rate limit is being calculated 250.16 of the greater of either the statewide or any of the geographic 250.17 groups' weighted average monthlymedical assistancenursing 250.18 facility payment rate of the case mix resident class to which 250.19 the180-dayalternative care eligible client would be assigned 250.20 under Minnesota Rules, parts 9549.0050 to 9549.0059,unless the250.21 less the maintenance needs allowance as described in section 250.22 256B.0915, subdivision 1d, paragraph (a), until the first day of 250.23 the state fiscal year in which a resident assessment system, 250.24 under section 256B.437, of nursing home rate determination is 250.25 implemented. Effective on the first day of the state fiscal 250.26 year in which a resident assessment system, under section 250.27 256B.437, of nursing home rate determination is implemented and 250.28 the first day of each subsequent state fiscal year, the 250.29 individualized monthly negotiated payment for the services 250.30 described in this clause shall not exceed the limit described in 250.31 this clause which was in effect on the last day of the previous 250.32 state fiscal year and which has been adjusted by the greater of 250.33 any legislatively adopted home and community-based services 250.34 cost-of-living percentage increase or any legislatively adopted 250.35 statewide percent rate increase for nursing facilities. 250.36 (2) The individualized monthly negotiated payment for 251.1 assisted living servicesare provided by a home caredescribed 251.2 under section 144A.4605 and delivered by a provider licensed by 251.3 the department of health as a class A home care provider or an 251.4 assisted living home care provider andareprovided in a 251.5 building that is registered as a housing with services 251.6 establishment under chapter 144D and that provides 24-hour 251.7 supervision in combination with the payment for other 251.8 alternative care services, including case management, must not 251.9 exceed the limit specified in subdivision 4, paragraph (a), 251.10 clause (6). 251.11(k) For purposes of this section, companion services are251.12defined as nonmedical care, supervision and oversight, provided251.13to a functionally impaired adult. Companions may assist the251.14individual with such tasks as meal preparation, laundry and251.15shopping, but do not perform these activities as discrete251.16services. The provision of companion services does not entail251.17hands-on medical care. Providers may also perform light251.18housekeeping tasks which are incidental to the care and251.19supervision of the recipient. This service must be approved by251.20the case manager as part of the care plan. Companion services251.21must be provided by individuals or organizations who are under251.22contract with the local agency to provide the service. Any251.23person related to the waiver recipient by blood, marriage or251.24adoption cannot be reimbursed under this service. Persons251.25providing companion services will be monitored by the case251.26manager.251.27(l) For purposes of this section, training for direct251.28informal caregivers is defined as a classroom or home course of251.29instruction which may include: transfer and lifting skills,251.30nutrition, personal and physical cares, home safety in a home251.31environment, stress reduction and management, behavioral251.32management, long-term care decision making, care coordination251.33and family dynamics. The training is provided to an informal251.34unpaid caregiver of a 180-day eligible client which enables the251.35caregiver to deliver care in a home setting with high levels of251.36quality. The training must be approved by the case manager as252.1part of the individual care plan. Individuals, agencies, and252.2educational facilities which provide caregiver training and252.3education will be monitored by the case manager.252.4(m)(j) A county agency may make payment from their 252.5 alternative care program allocation for "other services" 252.6provided to an alternative care program recipient if those252.7services prevent, shorten, or delay institutionalization. These252.8services maywhich include use of "discretionary funds" for 252.9 services that are not otherwise defined in this section and 252.10 direct cash payments to therecipientclient for the purpose of 252.11 purchasing therecipient'sservices. The following provisions 252.12 apply to payments under this paragraph: 252.13 (1) a cash payment to a client under this provision cannot 252.14 exceed 80 percent of the monthly payment limit for that client 252.15 as specified in subdivision 4, paragraph (a), clause(7)(6); 252.16 (2) a county may not approve any cash payment for a client 252.17 who meets either of the following: 252.18 (i) has been assessed as having a dependency in 252.19 orientation, unless the client has an authorized 252.20 representativeunder section 256.476, subdivision 2, paragraph252.21(g), or for a client who. An "authorized representative" means 252.22 an individual who is at least 18 years of age and is designated 252.23 by the person or the person's legal representative to act on the 252.24 person's behalf. This individual may be a family member, 252.25 guardian, representative payee, or other individual designated 252.26 by the person or the person's legal representative, if any, to 252.27 assist in purchasing and arranging for supports; or 252.28 (ii) is concurrently receiving adult foster care, 252.29 residential care, or assisted living services; 252.30 (3)any service approved under this section must be a252.31service which meets the purpose and goals of the program as252.32listed in subdivision 1;252.33(4) cash payments must also meet the criteria of and are252.34governed by the procedures and liability protection established252.35in section 256.476, subdivision 4, paragraphs (b) through (h),252.36and recipients of cash grants must meet the requirements in253.1section 256.476, subdivision 10; andcash payments to a person 253.2 or a person's family will be provided through a monthly payment 253.3 and be in the form of cash, voucher, or direct county payment to 253.4 a vendor. Fees or premiums assessed to the person for 253.5 eligibility for health and human services are not reimbursable 253.6 through this service option. Services and goods purchased 253.7 through cash payments must be identified in the person's 253.8 individualized care plan and must meet all of the following 253.9 criteria: 253.10 (i) they must be over and above the normal cost of caring 253.11 for the person if the person did not have functional 253.12 limitations; 253.13 (ii) they must be directly attributable to the person's 253.14 functional limitations; 253.15 (iii) they must have the potential to be effective at 253.16 meeting the goals of the program; 253.17 (iv) they must be consistent with the needs identified in 253.18 the individualized service plan. The service plan shall specify 253.19 the needs of the person and family, the form and amount of 253.20 payment, the items and services to be reimbursed, and the 253.21 arrangements for management of the individual grant; and 253.22 (v) the person, the person's family, or the legal 253.23 representative shall be provided sufficient information to 253.24 ensure an informed choice of alternatives. The local agency 253.25 shall document this information in the person's care plan, 253.26 including the type and level of expenditures to be reimbursed; 253.27 (4) the county, lead agency under contract, or tribal 253.28 government under contract to administer the alternative care 253.29 program shall not be liable for damages, injuries, or 253.30 liabilities sustained through the purchase of direct supports or 253.31 goods by the person, the person's family, or the authorized 253.32 representative with funds received through the cash payments 253.33 under this section. Liabilities include, but are not limited 253.34 to, workers' compensation, the Federal Insurance Contributions 253.35 Act (FICA), or the Federal Unemployment Tax Act (FUTA); 253.36 (5) persons receiving grants under this section shall have 254.1 the following responsibilities: 254.2 (i) spend the grant money in a manner consistent with their 254.3 individualized service plan with the local agency; 254.4 (ii) notify the local agency of any necessary changes in 254.5 the grant-expenditures; 254.6 (iii) arrange and pay for supports; and 254.7 (iv) inform the local agency of areas where they have 254.8 experienced difficulty securing or maintaining supports; and 254.9(5)(6) the county shall report client outcomes, services, 254.10 and costs under this paragraph in a manner prescribed by the 254.11 commissioner. 254.12 (k) Upon implementation of direct cash payments to clients 254.13 under this section, any person determined eligible for the 254.14 alternative care program who chooses a cash payment approved by 254.15 the county agency shall receive the cash payment under this 254.16 section and not under section 256.476 unless the person was 254.17 receiving a consumer support grant under section 256.476 before 254.18 implementation of direct cash payments under this section. 254.19 Sec. 19. Minnesota Statutes 2000, section 256B.0913, 254.20 subdivision 6, is amended to read: 254.21 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] The 254.22 alternative care program is administered by the county agency. 254.23 This agency is the lead agency responsible for the local 254.24 administration of the alternative care program as described in 254.25 this section. However, it may contract with the public health 254.26 nursing service to be the lead agency. The commissioner may 254.27 contract with federally recognized Indian tribes with a 254.28 reservation in Minnesota to serve as the lead agency responsible 254.29 for the local administration of the alternative care program as 254.30 described in the contract. 254.31 Sec. 20. Minnesota Statutes 2000, section 256B.0913, 254.32 subdivision 7, is amended to read: 254.33 Subd. 7. [CASE MANAGEMENT.] Providers of case management 254.34 services for persons receiving services funded by the 254.35 alternative care program must meet the qualification 254.36 requirements and standards specified in section 256B.0915, 255.1 subdivision 1b. The case manager mustensure the health and255.2safety of the individual client andnot approve alternative care 255.3 funding for a client in any setting in which the case manager 255.4 cannot reasonably ensure the client's health and safety. The 255.5 case manager is responsible for the cost-effectiveness of the 255.6 alternative care individual care plan and must not approve any 255.7 care plan in which the cost of services funded by alternative 255.8 care and client contributions exceeds the limit specified in 255.9 section 256B.0915, subdivision 3, paragraph (b). The county may 255.10 allow a case manager employed by the county to delegate certain 255.11 aspects of the case management activity to another individual 255.12 employed by the county provided there is oversight of the 255.13 individual by the case manager. The case manager may not 255.14 delegate those aspects which require professional judgment 255.15 including assessments, reassessments, and care plan development. 255.16 Sec. 21. Minnesota Statutes 2000, section 256B.0913, 255.17 subdivision 8, is amended to read: 255.18 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 255.19 case manager shall implement the plan of care for each180-day255.20eligiblealternative care client and ensure that a client's 255.21 service needs and eligibility are reassessed at least every 12 255.22 months. The plan shall include any services prescribed by the 255.23 individual's attending physician as necessary to allow the 255.24 individual to remain in a community setting. In developing the 255.25 individual's care plan, the case manager should include the use 255.26 of volunteers from families and neighbors, religious 255.27 organizations, social clubs, and civic and service organizations 255.28 to support the formal home care services. The county shall be 255.29 held harmless for damages or injuries sustained through the use 255.30 of volunteers under this subdivision including workers' 255.31 compensation liability.The lead agency shall provide255.32documentation to the commissioner verifying that the255.33individual's alternative care is not available at that time255.34through any other public assistance or service program.The 255.35 lead agency shall provide documentation in each individual's 255.36 plan of care and, if requested, to the commissioner that the 256.1 most cost-effective alternatives available have been offered to 256.2 the individual and that the individual was free to choose among 256.3 available qualified providers, both public and private. The 256.4 case manager must give the individual a ten-day written notice 256.5 of any decrease in or termination of alternative care services. 256.6 (b) If the county administering alternative care services 256.7 is different than the county of financial responsibility, the 256.8 care plan may be implemented without the approval of the county 256.9 of financial responsibility. 256.10 Sec. 22. Minnesota Statutes 2000, section 256B.0913, 256.11 subdivision 9, is amended to read: 256.12 Subd. 9. [CONTRACTING PROVISIONS FOR PROVIDERS.]The lead256.13agency shall document to the commissioner that the agency made256.14reasonable efforts to inform potential providers of the256.15anticipated need for services under the alternative care program256.16or waiver programs under sections 256B.0915 and 256B.49,256.17including a minimum of 14 days' written advance notice of the256.18opportunity to be selected as a service provider and an annual256.19public meeting with providers to explain and review the criteria256.20for selection. The lead agency shall also document to the256.21commissioner that the agency allowed potential providers an256.22opportunity to be selected to contract with the county agency.256.23Funds reimbursed to counties under this subdivisionAlternative 256.24 care funds paid to service providers are subject to audit by the 256.25 commissioner for fiscal and utilization control. 256.26 The lead agency must select providers for contracts or 256.27 agreements using the following criteria and other criteria 256.28 established by the county: 256.29 (1) the need for the particular services offered by the 256.30 provider; 256.31 (2) the population to be served, including the number of 256.32 clients, the length of time services will be provided, and the 256.33 medical condition of clients; 256.34 (3) the geographic area to be served; 256.35 (4) quality assurance methods, including appropriate 256.36 licensure, certification, or standards, and supervision of 257.1 employees when needed; 257.2 (5) rates for each service and unit of service exclusive of 257.3 county administrative costs; 257.4 (6) evaluation of services previously delivered by the 257.5 provider; and 257.6 (7) contract or agreement conditions, including billing 257.7 requirements, cancellation, and indemnification. 257.8 The county must evaluate its own agency services under the 257.9 criteria established for other providers.The county shall257.10provide a written statement of the reasons for not selecting257.11providers.257.12 Sec. 23. Minnesota Statutes 2000, section 256B.0913, 257.13 subdivision 10, is amended to read: 257.14 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 257.15 appropriation for fiscal years 1992 and beyond shall cover 257.16 only180-dayalternative care eligible clients. Prior to July 1 257.17 of each year, the commissioner shall allocate to county agencies 257.18 the state funds available for alternative care for persons 257.19 eligible under subdivision 2. 257.20 (b)Prior to July 1 of each year, the commissioner shall257.21allocate to county agencies the state funds available for257.22alternative care for persons eligible under subdivision 2. The257.23allocation for fiscal year 1992 shall be calculated using a base257.24that is adjusted to exclude the medical assistance share of257.25alternative care expenditures. The adjusted base is calculated257.26by multiplying each county's allocation for fiscal year 1991 by257.27the percentage of county alternative care expenditures for257.28180-day eligible clients. The percentage is determined based on257.29expenditures for services rendered in fiscal year 1989 or257.30calendar year 1989, whichever is greater.The adjusted base for 257.31 each county is the county's current fiscal year base allocation 257.32 plus any targeted funds approved during the current fiscal 257.33 year. Calculations for paragraphs (c) and (d) are to be made as 257.34 follows: for each county, the determination of alternative care 257.35 program expenditures shall be based on payments for services 257.36 rendered from April 1 through March 31 in the base year, to the 258.1 extent that claims have been submitted and paid by June 1 of 258.2 that year. 258.3 (c) If thecountyalternative care program expendituresfor258.4180-day eligible clientsas defined in paragraph (b) are 95 258.5 percent or more ofitsthe county's adjusted base allocation, 258.6 the allocation for the next fiscal year is 100 percent of the 258.7 adjusted base, plus inflation to the extent that inflation is 258.8 included in the state budget. 258.9 (d) If thecountyalternative care program expendituresfor258.10180-day eligible clientsas defined in paragraph (b) are less 258.11 than 95 percent ofitsthe county's adjusted base allocation, 258.12 the allocation for the next fiscal year is the adjusted base 258.13 allocation less the amount of unspent funds below the 95 percent 258.14 level. 258.15 (e)For fiscal year 1992 only, a county may receive an258.16increased allocation if annualized service costs for the month258.17of May 1991 for 180-day eligible clients are greater than the258.18allocation otherwise determined. A county may apply for this258.19increase by reporting projected expenditures for May to the258.20commissioner by June 1, 1991. The amount of the allocation may258.21exceed the amount calculated in paragraph (b). The projected258.22expenditures for May must be based on actual 180-day eligible258.23client caseload and the individual cost of clients' care plans.258.24If a county does not report its expenditures for May, the amount258.25in paragraph (c) or (d) shall be used.258.26(f) Calculations for paragraphs (c) and (d) are to be made258.27as follows: for each county, the determination of expenditures258.28shall be based on payments for services rendered from April 1258.29through March 31 in the base year, to the extent that claims258.30have been submitted by June 1 of that year. Calculations for258.31paragraphs (c) and (d) must also include the funds transferred258.32to the consumer support grant program for clients who have258.33transferred to that program from April 1 through March 31 in the258.34base year.258.35(g) For the biennium ending June 30, 2001, the allocation258.36of state funds to county agencies shall be calculated as259.1described in paragraphs (c) and (d).If the annual legislative 259.2 appropriation for the alternative care program is inadequate to 259.3 fund the combined county allocations forfiscal year 2000 or259.42001a biennium, the commissioner shall distribute to each 259.5 county the entire annual appropriation as that county's 259.6 percentage of the computed base as calculated inparagraph259.7(f)paragraphs (c) and (d). 259.8 Sec. 24. Minnesota Statutes 2000, section 256B.0913, 259.9 subdivision 11, is amended to read: 259.10 Subd. 11. [TARGETED FUNDING.] (a) The purpose of targeted 259.11 funding is to make additional money available to counties with 259.12 the greatest need. Targeted funds are not intended to be 259.13 distributed equitably among all counties, but rather, allocated 259.14 to those with long-term care strategies that meet state goals. 259.15 (b) The funds available for targeted funding shall be the 259.16 total appropriation for each fiscal year minus county 259.17 allocations determined under subdivision 10 as adjusted for any 259.18 inflation increases provided in appropriations for the biennium. 259.19 (c) The commissioner shall allocate targeted funds to 259.20 counties that demonstrate to the satisfaction of the 259.21 commissioner that they have developed feasible plans to increase 259.22 alternative care spending. In making targeted funding 259.23 allocations, the commissioner shall use the following priorities: 259.24 (1) counties that received a lower allocation in fiscal 259.25 year 1991 than in fiscal year 1990. Counties remain in this 259.26 priority until they have been restored to their fiscal year 1990 259.27 level plus inflation; 259.28 (2) counties that sustain a base allocation reduction for 259.29 failure to spend 95 percent of the allocation if they 259.30 demonstrate that the base reduction should be restored; 259.31 (3) counties that propose projects to divert community 259.32 residents from nursing home placement or convert nursing home 259.33 residents to community living; and 259.34 (4) counties that can otherwise justify program growth by 259.35 demonstrating the existence of waiting lists, demographically 259.36 justified needs, or other unmet needs. 260.1 (d) Counties that would receive targeted funds according to 260.2 paragraph (c) must demonstrate to the commissioner's 260.3 satisfaction that the funds would be appropriately spent by 260.4 showing how the funds would be used to further the state's 260.5 alternative care goals as described in subdivision 1, and that 260.6 the county has the administrative and service delivery 260.7 capability to use them. 260.8 (e) The commissioner shall request applicationsby June 1260.9each year, for county agencies to applyfor targeted funds by 260.10 November 1 of each year. The counties selected for targeted 260.11 funds shall be notified of the amount of their additional 260.12 fundingby August 1 of each year. Targeted funds allocated to a 260.13 county agency in one year shall be treated as part of the 260.14 county's base allocation for that year in determining 260.15 allocations for subsequent years. No reallocations between 260.16 counties shall be made. 260.17(f) The allocation for each year after fiscal year 1992260.18shall be determined using the previous fiscal year's allocation,260.19including any targeted funds, as the base and then applying the260.20criteria under subdivision 10, paragraphs (c), (d), and (f), to260.21the current year's expenditures.260.22 Sec. 25. Minnesota Statutes 2000, section 256B.0913, 260.23 subdivision 12, is amended to read: 260.24 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 260.25 all180-dayalternative care eligible clients to help pay for 260.26 the cost of participating in the program. The amount of the 260.27 premium for the alternative care client shall be determined as 260.28 follows: 260.29 (1) when the alternative care client's income less 260.30 recurring and predictable medical expenses is greater than the 260.31medical assistance income standardrecipient's maintenance needs 260.32 allowance as defined in section 256B.0915, subdivision 1d, 260.33 paragraph (a), but less than 150 percent of the federal poverty 260.34 guideline effective on July 1 of the state fiscal year in which 260.35 the premium is being computed, and total assets are less than 260.36 $10,000, the fee is zero; 261.1 (2) when the alternative care client's income less 261.2 recurring and predictable medical expenses is greater than 150 261.3 percent of the federal poverty guideline effective on July 1 of 261.4 the state fiscal year in which the premium is being computed, 261.5 and total assets are less than $10,000, the fee is 25 percent of 261.6 the cost of alternative care services or the difference between 261.7 150 percent of the federal poverty guideline effective on July 1 261.8 of the state fiscal year in which the premium is being computed 261.9 and the client's income less recurring and predictable medical 261.10 expenses, whichever is less; and 261.11 (3) when the alternative care client's total assets are 261.12 greater than $10,000, the fee is 25 percent of the cost of 261.13 alternative care services. 261.14 For married persons, total assets are defined as the total 261.15 marital assets less the estimated community spouse asset 261.16 allowance, under section 256B.059, if applicable. For married 261.17 persons, total income is defined as the client's income less the 261.18 monthly spousal allotment, under section 256B.058. 261.19 All alternative care services except case management shall 261.20 be included in the estimated costs for the purpose of 261.21 determining 25 percent of the costs. 261.22 The monthly premium shall be calculated based on the cost 261.23 of the first full month of alternative care services and shall 261.24 continue unaltered until the next reassessment is completed or 261.25 at the end of 12 months, whichever comes first. Premiums are 261.26 due and payable each month alternative care services are 261.27 received unless the actual cost of the services is less than the 261.28 premium. 261.29 (b) The fee shall be waived by the commissioner when: 261.30 (1) a person who is residing in a nursing facility is 261.31 receiving case management only; 261.32 (2) a person is applying for medical assistance; 261.33 (3) a married couple is requesting an asset assessment 261.34 under the spousal impoverishment provisions; 261.35 (4)a person is a medical assistance recipient, but has261.36been approved for alternative care-funded assisted living262.1services;262.2(5)a person is found eligible for alternative care, but is 262.3 not yet receiving alternative care services; or 262.4(6)(5) a person's fee under paragraph (a) is less than $25. 262.5 (c) The county agency must collect the premium from the 262.6 client and forward the amounts collected to the commissioner in 262.7 the manner and at the times prescribed by the commissioner. 262.8 Money collected must be deposited in the general fund and is 262.9 appropriated to the commissioner for the alternative care 262.10 program. The client must supply the county with the client's 262.11 social security number at the time of application. If a client 262.12 fails or refuses to pay the premium due, the county shall supply 262.13 the commissioner with the client's social security number and 262.14 other information the commissioner requires to collect the 262.15 premium from the client. The commissioner shall collect unpaid 262.16 premiums using the Revenue Recapture Act in chapter 270A and 262.17 other methods available to the commissioner. The commissioner 262.18 may require counties to inform clients of the collection 262.19 procedures that may be used by the state if a premium is not 262.20 paid. 262.21 (d) The commissioner shall begin to adopt emergency or 262.22 permanent rules governing client premiums within 30 days after 262.23 July 1, 1991, including criteria for determining when services 262.24 to a client must be terminated due to failure to pay a premium. 262.25 Sec. 26. Minnesota Statutes 2000, section 256B.0913, 262.26 subdivision 13, is amended to read: 262.27 Subd. 13. [COUNTY BIENNIAL PLAN.] The county biennial plan 262.28 forthe preadmission screening programlong-term care 262.29 consultation services under section 256B.0911, the alternative 262.30 care program under this section, and waivers for the elderly 262.31 under section 256B.0915,and waivers for the disabled under262.32section 256B.49,shall be incorporated into the biennial 262.33 Community Social Services Act plan and shall meet the 262.34 regulations and timelines of that plan.This county biennial262.35plan shall include:262.36(1) information on the administration of the preadmission263.1screening program;263.2(2) information on the administration of the home and263.3community-based services waivers for the elderly under section263.4256B.0915, and for the disabled under section 256B.49; and263.5(3) information on the administration of the alternative263.6care program.263.7 Sec. 27. Minnesota Statutes 2000, section 256B.0913, 263.8 subdivision 14, is amended to read: 263.9 Subd. 14. [REIMBURSEMENTPAYMENT AND RATE ADJUSTMENTS.] (a) 263.10ReimbursementPayment forexpenditures for theprovided 263.11 alternative care services as approved by the client's case 263.12 manager shall be through the invoice processing procedures of 263.13 the department's Medicaid Management Information System (MMIS). 263.14 To receivereimbursementpayment, the county or vendor must 263.15 submit invoices within 12 months following the date of service. 263.16 The county agency and its vendors under contract shall not be 263.17 reimbursed for services which exceed the county allocation. 263.18 (b) If a county collects less than 50 percent of the client 263.19 premiums due under subdivision 12, the commissioner may withhold 263.20 up to three percent of the county's final alternative care 263.21 program allocation determined under subdivisions 10 and 11. 263.22 (c) The county shall negotiate individual rates with 263.23 vendors and maybe reimbursedauthorize service payment for 263.24 actual costs up tothe greater ofthe county's current approved 263.25 rateor 60 percent of the maximum rate in fiscal year 1994 and263.2665 percent of the maximum rate in fiscal year 1995 for each263.27alternative care service. Notwithstanding any other rule or 263.28 statutory provision to the contrary, the commissioner shall not 263.29 be authorized to increase rates by an annual inflation factor, 263.30 unless so authorized by the legislature. 263.31 (d)On July 1, 1993, the commissioner shall increase the263.32maximum rate for home delivered meals to $4.50 per mealTo 263.33 improve access to community services and eliminate payment 263.34 disparities between the alternative care program and the elderly 263.35 waiver program, the commissioner shall establish statewide 263.36 maximum service rate limits and eliminate county-specific 264.1 service rate limits. 264.2 (1) Effective July 1, 2001, for service rate limits, except 264.3 those in subdivision 5, paragraphs (d) and (i), the rate limit 264.4 for each service shall be the greater of the alternative care 264.5 statewide maximum rate or the elderly waiver statewide maximum 264.6 rate. 264.7 (2) Counties may negotiate individual service rates with 264.8 vendors for actual costs up to the statewide maximum service 264.9 rate limit. 264.10 Sec. 28. Minnesota Statutes 2000, section 256B.0915, 264.11 subdivision 1d, is amended to read: 264.12 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 264.13 RESOURCES FOR ELDERLY WAIVER.](a)Notwithstanding the 264.14 provisions of section 256B.056, the commissioner shall make the 264.15 following amendment to the medical assistance elderly waiver 264.16 program effective July 1, 1999, or upon federal approval, 264.17 whichever is later. 264.18 A recipient's maintenance needs will be an amount equal to 264.19 the Minnesota supplemental aid equivalent rate as defined in 264.20 section 256I.03, subdivision 5, plus the medical assistance 264.21 personal needs allowance as defined in section 256B.35, 264.22 subdivision 1, paragraph (a), when applying posteligibility 264.23 treatment of income rules to the gross income of elderly waiver 264.24 recipients, except for individuals whose income is in excess of 264.25 the special income standard according to Code of Federal 264.26 Regulations, title 42, section 435.236. Recipient maintenance 264.27 needs shall be adjusted under this provision each July 1. 264.28(b) The commissioner of human services shall secure264.29approval of additional elderly waiver slots sufficient to serve264.30persons who will qualify under the revised income standard264.31described in paragraph (a) before implementing section264.32256B.0913, subdivision 16.264.33(c) In implementing this subdivision, the commissioner264.34shall consider allowing persons who would otherwise be eligible264.35for the alternative care program but would qualify for the264.36elderly waiver with a spenddown to remain on the alternative265.1care program.265.2 Sec. 29. Minnesota Statutes 2000, section 256B.0915, 265.3 subdivision 3, is amended to read: 265.4 Subd. 3. [LIMITS OF CASES, RATES,REIMBURSEMENTPAYMENTS, 265.5 AND FORECASTING.] (a) The number of medical assistance waiver 265.6 recipients that a county may serve must be allocated according 265.7 to the number of medical assistance waiver cases open on July 1 265.8 of each fiscal year. Additional recipients may be served with 265.9 the approval of the commissioner. 265.10 (b) The monthly limit for the cost of waivered services to 265.11 an individual elderly waiver client shall be thestatewide265.12average paymentweighted average monthly nursing facility rate 265.13 of the case mix resident class to which the elderly waiver 265.14 client would be assigned underthe medical assistance case mix265.15reimbursement system.Minnesota Rules, parts 9549.0050 to 265.16 9549.0059, less the recipient's maintenance needs allowance as 265.17 described in subdivision 1d, paragraph (a), until the first day 265.18 of the state fiscal year in which the resident assessment system 265.19 as described in section 256B.437 for nursing home rate 265.20 determination is implemented. Effective on the first day of the 265.21 state fiscal year in which the resident assessment system as 265.22 described in section 256B.437 for nursing home rate 265.23 determination is implemented and the first day of each 265.24 subsequent state fiscal year, the monthly limit for the cost of 265.25 waivered services to an individual elderly waiver client shall 265.26 be the rate of the case mix resident class to which the waiver 265.27 client would be assigned under Minnesota Rules, parts 9549.0050 265.28 to 9549.0059, in effect on the last day of the previous state 265.29 fiscal year, adjusted by the greater of any legislatively 265.30 adopted home and community-based services cost-of-living 265.31 percentage increase or any legislatively adopted statewide 265.32 percent rate increase for nursing facilities. 265.33 (c) If extended medical supplies and equipment or 265.34adaptationsenvironmental modifications are or will be purchased 265.35 for an elderly waiverservices recipient, theclient, the costs 265.36 may be proratedon a monthly basis throughout the year in which266.1they are purchasedfor up to 12 consecutive months beginning 266.2 with the month of purchase. If the monthly cost of a 266.3 recipient'sotherwaivered services exceeds the monthly limit 266.4 established inthisparagraph (b), the annual cost oftheall 266.5 waivered services shall be determined. In this event, the 266.6 annual cost of all waivered services shall not exceed 12 times 266.7 the monthly limitcalculated in this paragraph. The statewide266.8average payment rate is calculated by determining the statewide266.9average monthly nursing home rate, effective July 1 of the266.10fiscal year in which the cost is incurred, less the statewide266.11average monthly income of nursing home residents who are age 65266.12or older, and who are medical assistance recipients in the month266.13of March of the previous state fiscal year. The annual cost266.14divided by 12 of elderly or disabled waivered servicesof 266.15 waivered services as described in paragraph (b). 266.16 (d) For a person who is a nursing facility resident at the 266.17 time of requesting a determination of eligibility for elderlyor266.18disabledwaivered servicesshall be the greater of the monthly266.19payment for: (i), a monthly conversion limit for the cost of 266.20 elderly waivered services may be requested. The monthly 266.21 conversion limit for the cost of elderly waiver services shall 266.22 be the resident class assigned under Minnesota Rules, parts 266.23 9549.0050 to 9549.0059, for that resident in the nursing 266.24 facility where the resident currently resides; or (ii) the266.25statewide average payment of the case mix resident class to266.26which the resident would be assigned under the medical266.27assistance case mix reimbursement system, provided thatuntil 266.28 July 1 of the state fiscal year in which the resident assessment 266.29 system as described in section 256B.437 for nursing home rate 266.30 determination is implemented. Effective on July 1 of the state 266.31 fiscal year in which the resident assessment system as described 266.32 in section 256B.437 for nursing home rate determination is 266.33 implemented, the monthly conversion limit for the cost of 266.34 elderly waiver services shall be the per diem nursing facility 266.35 rate as determined by the resident assessment system as 266.36 described in section 256B.437 for that resident in the nursing 267.1 facility where the resident currently resides multiplied by 365 267.2 and divided by 12, less the recipient's maintenance needs 267.3 allowance as described in subdivision 1d. The limit under this 267.4 clause only applies to persons discharged from a nursing 267.5 facility after a minimum 30-day stay and found eligible for 267.6 waivered services on or after July 1, 1997. The following costs 267.7 must be included in determining the total monthly costs for the 267.8 waiver client: 267.9 (1) cost of all waivered services, including extended 267.10 medical supplies and equipment and environmental modifications; 267.11 and 267.12 (2) cost of skilled nursing, home health aide, and personal 267.13 care services reimbursable by medical assistance. 267.14(c)(e) Medical assistance funding for skilled nursing 267.15 services, private duty nursing, home health aide, and personal 267.16 care services for waiver recipients must be approved by the case 267.17 manager and included in the individual care plan. 267.18(d) For both the elderly waiver and the nursing facility267.19disabled waiver, a county may purchase extended supplies and267.20equipment without prior approval from the commissioner when267.21there is no other funding source and the supplies and equipment267.22are specified in the individual's care plan as medically267.23necessary to enable the individual to remain in the community267.24according to the criteria in Minnesota Rules, part 9505.0210,267.25items A and B.(f) A county is not required to contract with a 267.26 provider of supplies and equipment if the monthly cost of the 267.27 supplies and equipment is less than $250. 267.28(e)(g) The adult foster caredailyratefor the elderly267.29and disabled waiversshall be considered a difficulty of care 267.30 payment and shall not include room and board. The adult foster 267.31 care service rate shall be negotiated between the county agency 267.32 and the foster care provider.The rate established under this267.33section shall not exceed the state average monthly nursing home267.34payment for the case mix classification to which the individual267.35receiving foster care is assigned; the rate must allow for other267.36waiver and medical assistance home care services to be268.1authorized by the case manager.The elderly waiver payment for 268.2 the foster care service in combination with the payment for all 268.3 other elderly waiver services, including case management, must 268.4 not exceed the limit specified in paragraph (b). 268.5(f) The assisted living and residential care service rates268.6for elderly and community alternatives for disabled individuals268.7(CADI) waivers shall be made to the vendor as a monthly rate268.8negotiated with the county agency based on an individualized268.9service plan for each resident. The rate shall not exceed the268.10nonfederal share of the greater of either the statewide or any268.11of the geographic groups' weighted average monthly medical268.12assistance nursing facility payment rate of the case mix268.13resident class to which the elderly or disabled client would be268.14assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,268.15unless the services are provided by a home care provider268.16licensed by the department of health and are provided in a268.17building that is registered as a housing with services268.18establishment under chapter 144D and that provides 24-hour268.19supervision. For alternative care assisted living projects268.20established under Laws 1988, chapter 689, article 2, section268.21256, monthly rates may not exceed 65 percent of the greater of268.22either the statewide or any of the geographic groups' weighted268.23average monthly medical assistance nursing facility payment rate268.24for the case mix resident class to which the elderly or disabled268.25client would be assigned under Minnesota Rules, parts 9549.0050268.26to 9549.0059. The rate may not cover direct rent or food costs.268.27 (h) Payment for assisted living service shall be a monthly 268.28 rate negotiated and authorized by the county agency based on an 268.29 individualized service plan for each resident and may not cover 268.30 direct rent or food costs. 268.31 (1) The individualized monthly negotiated payment for 268.32 assisted living services as described in section 256B.0913, 268.33 subdivision 5, paragraph (g) or (h), and residential care 268.34 services as described in section 256B.0913, subdivision 5, 268.35 paragraph (f), shall not exceed the nonfederal share, in effect 268.36 on July 1 of the state fiscal year for which the rate limit is 269.1 being calculated, of the greater of either the statewide or any 269.2 of the geographic groups' weighted average monthly nursing 269.3 facility rate of the case mix resident class to which the 269.4 elderly waiver eligible client would be assigned under Minnesota 269.5 Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 269.6 allowance as described in subdivision 1d, paragraph (a), until 269.7 the July 1 of the state fiscal year in which the resident 269.8 assessment system as described in section 256B.437 for nursing 269.9 home rate determination is implemented. Effective on July 1 of 269.10 the state fiscal year in which the resident assessment system as 269.11 described in section 256B.437 for nursing home rate 269.12 determination is implemented and July 1 of each subsequent state 269.13 fiscal year, the individualized monthly negotiated payment for 269.14 the services described in this clause shall not exceed the limit 269.15 described in this clause which was in effect on June 30 of the 269.16 previous state fiscal year and which has been adjusted by the 269.17 greater of any legislatively adopted home and community-based 269.18 services cost-of-living percentage increase or any legislatively 269.19 adopted statewide percent rate increase for nursing facilities. 269.20 (2) The individualized monthly negotiated payment for 269.21 assisted living services described in section 144A.4605 and 269.22 delivered by a provider licensed by the department of health as 269.23 a Class A home care provider or an assisted living home care 269.24 provider and provided in a building that is registered as a 269.25 housing with services establishment under chapter 144D and that 269.26 provides 24-hour supervision in combination with the payment for 269.27 other elderly waiver services, including case management, must 269.28 not exceed the limit specified in paragraph (b). 269.29(g)(i) The county shall negotiate individual service rates 269.30 with vendors and maybe reimbursedauthorize payment for actual 269.31 costs up to thegreater of thecounty's current approved rateor269.3260 percent of the maximum rate in fiscal year 1994 and 65269.33percent of the maximum rate in fiscal year 1995 for each service269.34within each program. Persons or agencies must be employed by or 269.35 under a contract with the county agency or the public health 269.36 nursing agency of the local board of health in order to receive 270.1 funding under the elderly waiver program, except as a provider 270.2 of supplies and equipment when the monthly cost of the supplies 270.3 and equipment is less than $250. 270.4(h) On July 1, 1993, the commissioner shall increase the270.5maximum rate for home-delivered meals to $4.50 per meal.270.6(i)(j) Reimbursement for the medical assistance recipients 270.7 under the approved waiver shall be made from the medical 270.8 assistance account through the invoice processing procedures of 270.9 the department's Medicaid Management Information System (MMIS), 270.10 only with the approval of the client's case manager. The budget 270.11 for the state share of the Medicaid expenditures shall be 270.12 forecasted with the medical assistance budget, and shall be 270.13 consistent with the approved waiver. 270.14 (k) To improve access to community services and eliminate 270.15 payment disparities between the alternative care program and the 270.16 elderly waiver, the commissioner shall establish statewide 270.17 maximum service rate limits and eliminate county-specific 270.18 service rate limits. 270.19 (1) Effective July 1, 2001, for service rate limits, except 270.20 those described or defined in paragraphs (g) and (h), the rate 270.21 limit for each service shall be the greater of the alternative 270.22 care statewide maximum rate or the elderly waiver statewide 270.23 maximum rate. 270.24 (2) Counties may negotiate individual service rates with 270.25 vendors for actual costs up to the statewide maximum service 270.26 rate limit. 270.27(j)(l) Beginning July 1, 1991, the state shall reimburse 270.28 counties according to the payment schedule in section 256.025 270.29 for the county share of costs incurred under this subdivision on 270.30 or after January 1, 1991, for individuals who are receiving 270.31 medical assistance. 270.32(k) For the community alternatives for disabled individuals270.33waiver, and nursing facility disabled waivers, county may use270.34waiver funds for the cost of minor adaptations to a client's270.35residence or vehicle without prior approval from the270.36commissioner if there is no other source of funding and the271.1adaptation:271.2(1) is necessary to avoid institutionalization;271.3(2) has no utility apart from the needs of the client; and271.4(3) meets the criteria in Minnesota Rules, part 9505.0210,271.5items A and B.271.6For purposes of this subdivision, "residence" means the client's271.7own home, the client's family residence, or a family foster271.8home. For purposes of this subdivision, "vehicle" means the271.9client's vehicle, the client's family vehicle, or the client's271.10family foster home vehicle.271.11(l) The commissioner shall establish a maximum rate unit271.12for baths provided by an adult day care provider that are not271.13included in the provider's contractual daily or hourly rate.271.14This maximum rate must equal the home health aide extended rate271.15and shall be paid for baths provided to clients served under the271.16elderly and disabled waivers.271.17 Sec. 30. Minnesota Statutes 2000, section 256B.0915, 271.18 subdivision 5, is amended to read: 271.19 Subd. 5. [REASSESSMENTS FOR WAIVER CLIENTS.] A 271.20 reassessment of a client served under the elderlyor disabled271.21 waiver must be conducted at least every 12 months and at other 271.22 times when the case manager determines that there has been 271.23 significant change in the client's functioning. This may 271.24 include instances where the client is discharged from the 271.25 hospital. 271.26 Sec. 31. Minnesota Statutes 2000, section 256B.0917, is 271.27 amended by adding a subdivision to read: 271.28 Subd. 13. [COMMUNITY SERVICE GRANTS.] The commissioner 271.29 shall award contracts for grants to public and private nonprofit 271.30 agencies to establish services that strengthen a community's 271.31 ability to provide a system of home and community-based services 271.32 for elderly persons. The commissioner shall use a request for 271.33 proposal process. Communities that have a planned closure of a 271.34 nursing facility approved under section 256B.437 shall be given 271.35 preference for grants. The commissioner shall consider grants 271.36 for: 272.1 (1) caregiver support and respite care projects under 272.2 subdivision 6; 272.3 (2) on-site coordination under section 256.9731; 272.4 (3) the living-at-home/block nurse grant under subdivisions 272.5 7 to 10; and 272.6 (4) services identified as needed for community transition. 272.7 Sec. 32. [RESPITE CARE.] 272.8 The Minnesota board on aging shall present recommendations 272.9 to the legislature by February 1, 2002, on the provision of 272.10 in-home and out-of-home respite care services on a sliding scale 272.11 basis under the federal Older Americans Act. 272.12 Sec. 33. [REPEALER.] 272.13 (a) Minnesota Statutes 2000, sections 256B.0911, 272.14 subdivisions 2, 2a, 4, 8, and 9; 256B.0913, subdivisions 3, 15a, 272.15 15b, 15c, and 16; and 256B.0915, subdivisions 3a, 3b, and 3c, 272.16 are repealed. 272.17 (b) Minnesota Rules, parts 9505.2390; 9505.2395; 9505.2396; 272.18 9505.2400; 9505.2405; 9505.2410; 9505.2413; 9505.2415; 272.19 9505.2420; 9505.2425; 9505.2426; 9505.2430; 9505.2435; 272.20 9505.2440; 9505.2445; 9505.2450; 9505.2455; 9505.2458; 272.21 9505.2460; 9505.2465; 9505.2470; 9505.2473; 9505.2475; 272.22 9505.2480; 9505.2485; 9505.2486; 9505.2490; 9505.2495; 272.23 9505.2496; and 9505.2500, are repealed. 272.24 ARTICLE 5 272.25 LONG-TERM CARE SYSTEM REFORM AND REIMBURSEMENT 272.26 Section 1. Minnesota Statutes 2000, section 144.0721, 272.27 subdivision 1, is amended to read: 272.28 Subdivision 1. [APPROPRIATENESS AND QUALITY.] Until the 272.29 date of implementation of the revised case mix system based on 272.30 the minimum data set, the commissioner of health shall assess 272.31 the appropriateness and quality of care and services furnished 272.32 to private paying residents in nursing homes and boarding care 272.33 homes that are certified for participation in the medical 272.34 assistance program under United States Code, title 42, sections 272.35 1396-1396p. These assessments shall be conducted until the date 272.36 of implementation of the revised case mix system based on the 273.1 minimum data set, in accordance with section 144.072, with the 273.2 exception of provisions requiring recommendations for changes in 273.3 the level of care provided to the private paying residents. 273.4 Sec. 2. [144.0724] [RESIDENT REIMBURSEMENT 273.5 CLASSIFICATION.] 273.6 Subdivision 1. [RESIDENT REIMBURSEMENT 273.7 CLASSIFICATIONS.] The commissioner of health shall establish 273.8 resident reimbursement classifications based upon the 273.9 assessments of residents of nursing homes and boarding care 273.10 homes conducted under this section and according to section 273.11 256B.438. The reimbursement classifications established under 273.12 this section shall be implemented after June 30, 2002, but no 273.13 later than January 1, 2003. 273.14 Subd. 2. [DEFINITIONS.] For purposes of this section, the 273.15 following terms have the meanings given. 273.16 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 273.17 date" means the last day of the minimum data set observation 273.18 period. The date sets the designated endpoint of the common 273.19 observation period, and all minimum data set items refer back in 273.20 time from that point. 273.21 (b) [CASE MIX INDEX.] "Case mix index" means the weighting 273.22 factors assigned to the RUG-III classifications. 273.23 (c) [INDEX MAXIMIZATION.] "Index maximization" means 273.24 classifying a resident who could be assigned to more than one 273.25 category, to the category with the highest case mix index. 273.26 (d) [MINIMUM DATA SET.] "Minimum data set" means the 273.27 assessment instrument specified by the Health Care Financing 273.28 Administration and designated by the Minnesota department of 273.29 health. 273.30 (e) [REPRESENTATIVE.] "Representative" means a person who 273.31 is the resident's guardian or conservator, the person authorized 273.32 to pay the nursing home expenses of the resident, a 273.33 representative of the nursing home ombudsman's office whose 273.34 assistance has been requested, or any other individual 273.35 designated by the resident. 273.36 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 274.1 utilization groups" or "RUG" means the system for grouping a 274.2 nursing facility's residents according to their clinical and 274.3 functional status identified in data supplied by the facility's 274.4 minimum data set. 274.5 Subd. 3. [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] (a) 274.6 Resident reimbursement classifications shall be based on the 274.7 minimum data set, version 2.0 assessment instrument, or its 274.8 successor version mandated by the Health Care Financing 274.9 Administration that nursing facilities are required to complete 274.10 for all residents. The commissioner of health shall establish 274.11 resident classes according to the 34 group, resource utilization 274.12 groups, version III or RUG-III model. Resident classes must be 274.13 established based on the individual items on the minimum data 274.14 set and must be completed according to the facility manual for 274.15 case mix classification issued by the Minnesota department of 274.16 health. The facility manual for case mix classification shall 274.17 be drafted by the Minnesota department of health and presented 274.18 to the chairs of health and human services legislative 274.19 committees by December 31, 2001. 274.20 (b) Each resident must be classified based on the 274.21 information from the minimum data set according to general 274.22 domains in clauses (1) to (7): 274.23 (1) extensive services where a resident requires 274.24 intravenous feeding or medications, suctioning, tracheostomy 274.25 care, or is on a ventilator or respirator; 274.26 (2) rehabilitation where a resident requires physical, 274.27 occupational, or speech therapy; 274.28 (3) special care where a resident has cerebral palsy; 274.29 quadriplegia; multiple sclerosis; pressure ulcers; fever with 274.30 vomiting, weight loss, or dehydration; tube feeding and aphasia; 274.31 or is receiving radiation therapy; 274.32 (4) clinically complex status where a resident has burns, 274.33 coma, septicemia, pneumonia, internal bleeding, chemotherapy, 274.34 wounds, kidney failure, urinary tract infections, oxygen, or 274.35 transfusions; 274.36 (5) impaired cognition where a resident has poor cognitive 275.1 performance; 275.2 (6) behavior problems where a resident exhibits wandering, 275.3 has hallucinations, or is physically or verbally abusive toward 275.4 others, unless the resident's other condition would place the 275.5 resident in other categories; and 275.6 (7) reduced physical functioning where a resident has no 275.7 special clinical conditions. 275.8 (c) The commissioner of health shall establish resident 275.9 classification according to a 34 group model based on the 275.10 information on the minimum data set and within the general 275.11 domains listed in paragraph (b), clauses (1) to (7). Detailed 275.12 descriptions of each resource utilization group shall be defined 275.13 in the facility manual for case mix classification issued by the 275.14 Minnesota department of health. The 34 groups are described as 275.15 follows: 275.16 (1) SE3: requires four or five extensive services; 275.17 (2) SE2: requires two or three extensive services; 275.18 (3) SE1: requires one extensive service; 275.19 (4) RAD: requires rehabilitation services and is dependent 275.20 in activity of daily living (ADL) at a count of 17 or 18; 275.21 (5) RAC: requires rehabilitation services and ADL count is 275.22 14 to 16; 275.23 (6) RAB: requires rehabilitation services and ADL count is 275.24 ten to 13; 275.25 (7) RAA: requires rehabilitation services and ADL count is 275.26 four to nine; 275.27 (8) SSC: requires special care and ADL count is 17 or 18; 275.28 (9) SSB: requires special care and ADL count is 15 or 16; 275.29 (10) SSA: requires special care and ADL count is seven to 275.30 14; 275.31 (11) CC2: clinically complex with depression and ADL count 275.32 is 17 or 18; 275.33 (12) CC1: clinically complex with no depression and ADL 275.34 count is 17 or 18; 275.35 (13) CB2: clinically complex with depression and ADL count 275.36 is 12 to 16; 276.1 (14) CB1: clinically complex with no depression and ADL 276.2 count is 12 to 16; 276.3 (15) CA2: clinically complex with depression and ADL count 276.4 is four to 11; 276.5 (16) CA1: clinically complex with no depression and ADL 276.6 count is four to 11; 276.7 (17) IB2: impaired cognition with nursing rehabilitation 276.8 and ADL count is six to ten; 276.9 (18) IB1: impaired cognition with no nursing 276.10 rehabilitation and ADL count is six to ten; 276.11 (19) IA2: impaired cognition with nursing rehabilitation 276.12 and ADL count is four or five; 276.13 (20) IA1: impaired cognition with no nursing 276.14 rehabilitation and ADL count is four or five; 276.15 (21) BB2: behavior problems with nursing rehabilitation 276.16 and ADL count is six to ten; 276.17 (22) BB1: behavior problems with no nursing rehabilitation 276.18 and ADL count is six to ten; 276.19 (23) BA2: behavior problems with nursing rehabilitation 276.20 and ADL count is four to five; 276.21 (24) BA1: behavior problems with no nursing rehabilitation 276.22 and ADL count is four to five; 276.23 (25) PE2: reduced physical functioning with nursing 276.24 rehabilitation and ADL count is 16 to 18; 276.25 (26) PE1: reduced physical functioning with no nursing 276.26 rehabilitation and ADL count is 16 to 18; 276.27 (27) PD2: reduced physical functioning with nursing 276.28 rehabilitation and ADL count is 11 to 15; 276.29 (28) PD1: reduced physical functioning with no nursing 276.30 rehabilitation and ADL count is 11 to 15; 276.31 (29) PC2: reduced physical functioning with nursing 276.32 rehabilitation and ADL count is nine or ten; 276.33 (30) PC1: reduced physical functioning with no nursing 276.34 rehabilitation and ADL count is nine or ten; 276.35 (31) PB2: reduced physical functioning with nursing 276.36 rehabilitation and ADL count is six to eight; 277.1 (32) PB1: reduced physical functioning with no nursing 277.2 rehabilitation and ADL count is six to eight; 277.3 (33) PA2: reduced physical functioning with nursing 277.4 rehabilitation and ADL count is four or five; and 277.5 (34) PA1: reduced physical functioning with no nursing 277.6 rehabilitation and ADL count is four or five. 277.7 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) A facility 277.8 must conduct and electronically submit to the commissioner of 277.9 health case mix assessments that conform with the assessment 277.10 schedule defined by the Code of Federal Regulations, title 42, 277.11 section 483.20, and published by the United States Department of 277.12 Health and Human Services, Health Care Financing Administration, 277.13 in the Long Term Care Assessment Instrument User's Manual, 277.14 version 2.0, October 1995, and subsequent clarifications made in 277.15 the Long-Term Care Assessment Instrument Questions and Answers, 277.16 version 2.0, August 1996. The commissioner of health may 277.17 substitute successor manuals or question and answer documents 277.18 published by the United States Department of Health and Human 277.19 Services, Health Care Financing Administration, to replace or 277.20 supplement the current version of the manual or document. 277.21 (b) The assessments used to determine a case mix 277.22 classification for reimbursement include the following: 277.23 (1) a new admission assessment must be completed by day 14 277.24 following admission; 277.25 (2) an annual assessment must be completed within 366 days 277.26 of the last comprehensive assessment; 277.27 (3) a significant change assessment must be completed 277.28 within 14 days of the identification of a significant change; 277.29 and 277.30 (4) the second quarterly assessment following either a new 277.31 admission assessment, an annual assessment, or a significant 277.32 change assessment. Each quarterly assessment must be completed 277.33 within 92 days of the previous assessment. 277.34 Subd. 5. [SHORT STAYS.] (a) A facility must submit to the 277.35 commissioner of health an initial admission assessment for all 277.36 residents who stay in the facility less than 14 days. 278.1 (b) Notwithstanding the admission assessment requirements 278.2 of paragraph (a), a facility may elect to accept a default rate 278.3 with a case mix index of 1.0 for all facility residents who stay 278.4 less than 14 days in lieu of submitting an initial assessment. 278.5 Facilities may make this election to be effective on the day of 278.6 implementation of the revised case mix system. 278.7 (c) After implementation of the revised case mix system, 278.8 nursing facilities must elect one of the options described in 278.9 paragraphs (a) and (b) on the annual report to the commissioner 278.10 of human services filed for each report year ending September 278.11 30. The election shall be effective on the following July 1. 278.12 (d) For residents who are admitted or readmitted and leave 278.13 the facility on a frequent basis and for whom readmission is 278.14 expected, the resident may be discharged on an extended leave 278.15 status. This status does not require reassessment each time the 278.16 resident returns to the facility unless a significant change in 278.17 the resident's status has occurred since the last assessment. 278.18 The case mix classification for these residents is determined by 278.19 the facility election made in paragraphs (a) and (b). 278.20 Subd. 6. [PENALTIES FOR LATE OR NONSUBMISSION.] A facility 278.21 that fails to complete or submit an assessment for a RUG-III 278.22 classification within seven days of the time requirements in 278.23 subdivisions 4 and 5 is subject to a reduced rate for that 278.24 resident. The reduced rate shall be the lowest rate for that 278.25 facility. The reduced rate is effective on the day of admission 278.26 for new admission assessments or on the day that the assessment 278.27 was due for all other assessments and continues in effect until 278.28 the first day of the month following the date of submission of 278.29 the resident's assessment. 278.30 Subd. 7. [NOTICE OF RESIDENT REIMBURSEMENT 278.31 CLASSIFICATION.] (a) A facility must elect between the options 278.32 in paragraphs (1) and (2) to provide notice to a resident of the 278.33 resident's case mix classification. 278.34 (1) The commissioner of health shall provide to a nursing 278.35 facility a notice for each resident of the reimbursement 278.36 classification established under subdivision 1. The notice must 279.1 inform the resident of the classification that was assigned, the 279.2 opportunity to review the documentation supporting the 279.3 classification, the opportunity to obtain clarification from the 279.4 commissioner, and the opportunity to request a reconsideration 279.5 of the classification. The commissioner must send notice of 279.6 resident classification by first class mail. A nursing facility 279.7 is responsible for the distribution of the notice to each 279.8 resident, to the person responsible for the payment of the 279.9 resident's nursing home expenses, or to another person 279.10 designated by the resident. This notice must be distributed 279.11 within three working days after the facility's receipt of the 279.12 notice from the commissioner of health. 279.13 (2) A facility may choose to provide a classification 279.14 notice, as prescribed by the commissioner of health, to a 279.15 resident upon receipt of the confirmation of the case mix 279.16 classification calculated by a facility or a corrected case mix 279.17 classification as indicated on the final validation report from 279.18 the commissioner. A nursing facility is responsible for the 279.19 distribution of the notice to each resident, to the person 279.20 responsible for the payment of the resident's nursing home 279.21 expenses, or to another person designated by the resident. This 279.22 notice must be distributed within three working days after the 279.23 facility's receipt of the validation report from the 279.24 commissioner. If a facility elects this option, the 279.25 commissioner of health shall provide the facility with a list of 279.26 residents and their case mix classifications as determined by 279.27 the commissioner. A nursing facility may make this election to 279.28 be effective on the day of implementation of the revised case 279.29 mix system. 279.30 (3) After implementation of the revised case mix system, a 279.31 nursing facility shall elect a notice of resident reimbursement 279.32 classification procedure as described in paragraph (1) or (2) on 279.33 the annual report to the commissioner of human services filed 279.34 for each report year ending September 30. The election will be 279.35 effective the following July 1. 279.36 (b) If a facility submits a correction to an assessment 280.1 conducted under subdivision 3 that results in a change in case 280.2 mix classification, the facility shall give written notice to 280.3 the resident or the resident's representative about the item 280.4 that was corrected and the reason for the correction. The 280.5 notice of corrected assessment may be provided at the same time 280.6 that the resident or resident's representative is provided the 280.7 resident's corrected notice of classification. 280.8 Subd. 8. [REQUEST FOR RECONSIDERATION OF RESIDENT 280.9 CLASSIFICATIONS.] (a) The resident, or resident's 280.10 representative, or the nursing facility or boarding care home 280.11 may request that the commissioner of health reconsider the 280.12 assigned reimbursement classification. The request for 280.13 reconsideration must be submitted in writing to the commissioner 280.14 within 30 days of the day the resident or the resident's 280.15 representative receives the resident classification notice. The 280.16 request for reconsideration must include the name of the 280.17 resident, the name and address of the facility in which the 280.18 resident resides, the reasons for the reconsideration, the 280.19 requested classification changes, and documentation supporting 280.20 the requested classification. The documentation accompanying 280.21 the reconsideration request is limited to documentation which 280.22 establishes that the needs of the resident at the time of the 280.23 assessment justify a classification which is different than the 280.24 classification established by the commissioner of health. 280.25 (b) Upon request, the nursing facility must give the 280.26 resident or the resident's representative a copy of the 280.27 assessment form and the other documentation that was given to 280.28 the commissioner of health to support the assessment findings. 280.29 The nursing facility shall also provide access to and a copy of 280.30 other information from the resident's record that has been 280.31 requested by or on behalf of the resident to support a 280.32 resident's reconsideration request. A copy of any requested 280.33 material must be provided within three working days of receipt 280.34 of a written request for the information. If a facility fails 280.35 to provide the material within this time, it is subject to the 280.36 issuance of a correction order and penalty assessment under 281.1 sections 144.653 and 144A.10. Notwithstanding those sections, 281.2 any correction order issued under this subdivision must require 281.3 that the nursing facility immediately comply with the request 281.4 for information and that as of the date of the issuance of the 281.5 correction order, the facility shall forfeit to the state a $100 281.6 fine for the first day of noncompliance, and an increase in the 281.7 $100 fine by $50 increments for each day the noncompliance 281.8 continues. 281.9 (c) In addition to the information required under 281.10 paragraphs (a) and (b), a reconsideration request from a nursing 281.11 facility must contain the following information: (i) the date 281.12 the reimbursement classification notices were received by the 281.13 facility; (ii) the date the classification notices were 281.14 distributed to the resident or the resident's representative; 281.15 and (iii) a copy of a notice sent to the resident or to the 281.16 resident's representative. This notice must inform the resident 281.17 or the resident's representative that a reconsideration of the 281.18 resident's classification is being requested, the reason for the 281.19 request, that the resident's rate will change if the request is 281.20 approved by the commissioner, the extent of the change, that 281.21 copies of the facility's request and supporting documentation 281.22 are available for review, and that the resident also has the 281.23 right to request a reconsideration. If the facility fails to 281.24 provide the required information with the reconsideration 281.25 request, the request must be denied, and the facility may not 281.26 make further reconsideration requests on that specific 281.27 reimbursement classification. 281.28 (d) Reconsideration by the commissioner must be made by 281.29 individuals not involved in reviewing the assessment, audit, or 281.30 reconsideration that established the disputed classification. 281.31 The reconsideration must be based upon the initial assessment 281.32 and upon the information provided to the commissioner under 281.33 paragraphs (a) and (b). If necessary for evaluating the 281.34 reconsideration request, the commissioner may conduct on-site 281.35 reviews. Within 15 working days of receiving the request for 281.36 reconsideration, the commissioner shall affirm or modify the 282.1 original resident classification. The original classification 282.2 must be modified if the commissioner determines that the 282.3 assessment resulting in the classification did not accurately 282.4 reflect the needs or assessment characteristics of the resident 282.5 at the time of the assessment. The resident and the nursing 282.6 facility or boarding care home shall be notified within five 282.7 working days after the decision is made. A decision by the 282.8 commissioner under this subdivision is the final administrative 282.9 decision of the agency for the party requesting reconsideration. 282.10 (e) The resident classification established by the 282.11 commissioner shall be the classification that applies to the 282.12 resident while the request for reconsideration is pending. 282.13 (f) The commissioner may request additional documentation 282.14 regarding a reconsideration necessary to make an accurate 282.15 reconsideration determination. 282.16 Subd. 9. [AUDIT AUTHORITY.] (a) The commissioner shall 282.17 audit the accuracy of resident assessments performed under 282.18 section 256B.438 through desk audits, on-site review of 282.19 residents and their records, and interviews with staff and 282.20 families. The commissioner shall reclassify a resident if the 282.21 commissioner determines that the resident was incorrectly 282.22 classified. 282.23 (b) The commissioner is authorized to conduct on-site 282.24 audits on an unannounced basis. 282.25 (c) A facility must grant the commissioner access to 282.26 examine the medical records relating to the resident assessments 282.27 selected for audit under this subdivision. The commissioner may 282.28 also observe and speak to facility staff and residents. 282.29 (d) The commissioner shall consider documentation under the 282.30 time frames for coding items on the minimum data set as set out 282.31 in the Resident Assessment Instrument Manual published by the 282.32 Health Care Financing Administration. 282.33 (e) The commissioner shall develop an audit selection 282.34 procedure that includes the following factors: 282.35 (1) The commissioner may target facilities that demonstrate 282.36 an atypical pattern of scoring minimum data set items, 283.1 nonsubmission of assessments, late submission of assessments, or 283.2 a previous history of audit changes of greater than 35 percent. 283.3 The commissioner shall select at least 20 percent of the most 283.4 current assessments submitted to the state for audit. Audits of 283.5 assessments selected in the targeted facilities must focus on 283.6 the factors leading to the audit. If the number of targeted 283.7 assessments selected does not meet the threshold of 20 percent 283.8 of the facility residents, then a stratified sample of the 283.9 remainder of assessments shall be drawn to meet the quota. If 283.10 the total change exceeds 35 percent, the commissioner may 283.11 conduct an expanded audit up to 100 percent of the remaining 283.12 current assessments. 283.13 (2) Facilities that are not a part of the targeted group 283.14 shall be placed in a general pool from which facilities will be 283.15 selected on a random basis for audit. Every facility shall be 283.16 audited annually. If a facility has two successive audits in 283.17 which the percentage of change is five percent or less and the 283.18 facility has not been the subject of a targeted audit in the 283.19 past 36 months, the facility may be audited biannually. A 283.20 stratified sample of 15 percent of the most current assessments 283.21 shall be selected for audit. If more than 20 percent of the 283.22 RUGS-III classifications after the audit are changed, the audit 283.23 shall be expanded to a second 15 percent sample. If the total 283.24 change between the first and second samples exceed 35 percent, 283.25 the commissioner may expand the audit to all of the remaining 283.26 assessments. 283.27 (3) If a facility qualifies for an expanded audit, the 283.28 commissioner may audit the facility again within six months. If 283.29 a facility has two expanded audits within a 24-month period, 283.30 that facility will be audited at least every six months for the 283.31 next 18 months. 283.32 (4) The commissioner may conduct special audits if the 283.33 commissioner determines that circumstances exist that could 283.34 alter or affect the validity of case mix classifications of 283.35 residents. These circumstances include, but are not limited to, 283.36 the following: 284.1 (i) frequent changes in the administration or management of 284.2 the facility; 284.3 (ii) an unusually high percentage of residents in a 284.4 specific case mix classification; 284.5 (iii) a high frequency in the number of reconsideration 284.6 requests received from a facility; 284.7 (iv) frequent adjustments of case mix classifications as 284.8 the result of reconsiderations or audits; 284.9 (v) a criminal indictment alleging provider fraud; or 284.10 (vi) other similar factors that relate to a facility's 284.11 ability to conduct accurate assessments. 284.12 (f) Within 15 working days of completing the audit process, 284.13 the commissioner shall mail the written results of the audit to 284.14 the facility, along with a written notice for each resident 284.15 affected to be forwarded by the facility. The notice must 284.16 contain the resident's classification and a statement informing 284.17 the resident, the resident's authorized representative, and the 284.18 facility of their right to review the commissioner's documents 284.19 supporting the classification and to request a reconsideration 284.20 of the classification. This notice must also include the 284.21 address and telephone number of the area nursing home ombudsman. 284.22 Subd. 10. [TRANSITION.] After implementation of this 284.23 section, reconsiderations requested for classifications made 284.24 under section 144.0722, subdivision 1, shall be determined under 284.25 section 144.0722, subdivision 3. 284.26 Sec. 3. Minnesota Statutes 2000, section 144A.071, 284.27 subdivision 1, is amended to read: 284.28 Subdivision 1. [FINDINGS.] The legislature declares that a 284.29 moratorium on the licensure and medical assistance certification 284.30 of new nursing home beds and construction projects that 284.31 exceed$750,000$1,000,000 is necessary to control nursing home 284.32 expenditure growth and enable the state to meet the needs of its 284.33 elderly by providing high quality services in the most 284.34 appropriate manner along a continuum of care. 284.35 Sec. 4. Minnesota Statutes 2000, section 144A.071, 284.36 subdivision 1a, is amended to read: 285.1 Subd. 1a. [DEFINITIONS.] For purposes of sections 144A.071 285.2 to 144A.073, the following terms have the meanings given them: 285.3 (a) "attached fixtures" has the meaning given in Minnesota 285.4 Rules, part 9549.0020, subpart 6. 285.5 (b) "buildings" has the meaning given in Minnesota Rules, 285.6 part 9549.0020, subpart 7. 285.7 (c) "capital assets" has the meaning given in section 285.8 256B.421, subdivision 16. 285.9 (d) "commenced construction" means that all of the 285.10 following conditions were met: the final working drawings and 285.11 specifications were approved by the commissioner of health; the 285.12 construction contracts were let; a timely construction schedule 285.13 was developed, stipulating dates for beginning, achieving 285.14 various stages, and completing construction; and all zoning and 285.15 building permits were applied for. 285.16 (e) "completion date" means the date on which a certificate 285.17 of occupancy is issued for a construction project, or if a 285.18 certificate of occupancy is not required, the date on which the 285.19 construction project is available for facility use. 285.20 (f) "construction" means any erection, building, 285.21 alteration, reconstruction, modernization, or improvement 285.22 necessary to comply with the nursing home licensure rules. 285.23 (g) "construction project" means: 285.24 (1) a capital asset addition to, or replacement of a 285.25 nursing home or certified boarding care home that results in new 285.26 space or the remodeling of or renovations to existing facility 285.27 space; 285.28 (2) the remodeling or renovation of existing facility space 285.29 the use of which is modified as a result of the project 285.30 described in clause (1). This existing space and the project 285.31 described in clause (1) must be used for the functions as 285.32 designated on the construction plans on completion of the 285.33 project described in clause (1) for a period of not less than 24 285.34 months; or 285.35 (3) capital asset additions or replacements that are 285.36 completed within 12 months before or after the completion date 286.1 of the project described in clause (1). 286.2 (h) "new licensed" or "new certified beds" means: 286.3 (1) newly constructed beds in a facility or the 286.4 construction of a new facility that would increase the total 286.5 number of licensed nursing home beds or certified boarding care 286.6 or nursing home beds in the state; or 286.7 (2) newly licensed nursing home beds or newly certified 286.8 boarding care or nursing home beds that result from remodeling 286.9 of the facility that involves relocation of beds but does not 286.10 result in an increase in the total number of beds, except when 286.11 the project involves the upgrade of boarding care beds to 286.12 nursing home beds, as defined in section 144A.073, subdivision 286.13 1. "Remodeling" includes any of the type of conversion, 286.14 renovation, replacement, or upgrading projects as defined in 286.15 section 144A.073, subdivision 1. 286.16 (i) "project construction costs" means the cost of the 286.17 facility capital asset additions, replacements, renovations, or 286.18 remodeling projects, construction site preparation costs, and 286.19 related soft costs. Project construction costsalsoinclude the 286.20 cost of any remodeling or renovation of existing facility space 286.21 which is modified as a result of the construction 286.22 project. Project construction costs also includes the cost of 286.23 new technology implemented as part of the construction project. 286.24 (j) "technology" means information systems or devices that 286.25 make documentation, charting, and staff time more efficient or 286.26 encourage and allow for care through alternative settings 286.27 including, but not limited to, touch screens, monitors, 286.28 hand-helds, swipe cards, motion detectors, pagers, telemedicine, 286.29 medication dispensers, and equipment to monitor vital signs and 286.30 self-injections, and to observe skin and other conditions. 286.31 Sec. 5. Minnesota Statutes 2000, section 144A.071, 286.32 subdivision 2, is amended to read: 286.33 Subd. 2. [MORATORIUM.] The commissioner of health, in 286.34 coordination with the commissioner of human services, shall deny 286.35 each request for new licensed or certified nursing home or 286.36 certified boarding care beds except as provided in subdivision 3 287.1 or 4a, or section 144A.073. "Certified bed" means a nursing 287.2 home bed or a boarding care bed certified by the commissioner of 287.3 health for the purposes of the medical assistance program, under 287.4 United States Code, title 42, sections 1396 et seq. 287.5 The commissioner of human services, in coordination with 287.6 the commissioner of health, shall deny any request to issue a 287.7 license under section 252.28 and chapter 245A to a nursing home 287.8 or boarding care home, if that license would result in an 287.9 increase in the medical assistance reimbursement amount. 287.10 In addition, the commissioner of health must not approve 287.11 any construction project whose cost exceeds$750,000$1,000,000, 287.12 unless: 287.13 (a) any construction costs exceeding$750,000$1,000,000 287.14 are not added to the facility's appraised value and are not 287.15 included in the facility's payment rate for reimbursement under 287.16 the medical assistance program; or 287.17 (b) the project: 287.18 (1) has been approved through the process described in 287.19 section 144A.073; 287.20 (2) meets an exception in subdivision 3 or 4a; 287.21 (3) is necessary to correct violations of state or federal 287.22 law issued by the commissioner of health; 287.23 (4) is necessary to repair or replace a portion of the 287.24 facility that was damaged by fire, lightning, groundshifts, or 287.25 other such hazards, including environmental hazards, provided 287.26 that the provisions of subdivision 4a, clause (a), are met; 287.27 (5) as of May 1, 1992, the facility has submitted to the 287.28 commissioner of health written documentation evidencing that the 287.29 facility meets the "commenced construction" definition as 287.30 specified in subdivision 1a, clause (d), or that substantial 287.31 steps have been taken prior to April 1, 1992, relating to the 287.32 construction project. "Substantial steps" require that the 287.33 facility has made arrangements with outside parties relating to 287.34 the construction project and include the hiring of an architect 287.35 or construction firm, submission of preliminary plans to the 287.36 department of health or documentation from a financial 288.1 institution that financing arrangements for the construction 288.2 project have been made; or 288.3 (6) is being proposed by a licensed nursing facility that 288.4 is not certified to participate in the medical assistance 288.5 program and will not result in new licensed or certified beds. 288.6 Prior to the final plan approval of any construction 288.7 project, the commissioner of health shall be provided with an 288.8 itemized cost estimate for the project construction costs. If a 288.9 construction project is anticipated to be completed in phases, 288.10 the total estimated cost of all phases of the project shall be 288.11 submitted to the commissioner and shall be considered as one 288.12 construction project. Once the construction project is 288.13 completed and prior to the final clearance by the commissioner, 288.14 the total project construction costs for the construction 288.15 project shall be submitted to the commissioner. If the final 288.16 project construction cost exceeds the dollar threshold in this 288.17 subdivision, the commissioner of human services shall not 288.18 recognize any of the project construction costs or the related 288.19 financing costs in excess of this threshold in establishing the 288.20 facility's property-related payment rate. 288.21 The dollar thresholds for construction projects are as 288.22 follows: for construction projects other than those authorized 288.23 in clauses (1) to (6), the dollar threshold 288.24 is$750,000$1,000,000. For projects authorized after July 1, 288.25 1993, under clause (1), the dollar threshold is the cost 288.26 estimate submitted with a proposal for an exception under 288.27 section 144A.073, plus inflation as calculated according to 288.28 section 256B.431, subdivision 3f, paragraph (a). For projects 288.29 authorized under clauses (2) to (4), the dollar threshold is the 288.30 itemized estimate project construction costs submitted to the 288.31 commissioner of health at the time of final plan approval, plus 288.32 inflation as calculated according to section 256B.431, 288.33 subdivision 3f, paragraph (a). 288.34 The commissioner of health shall adopt rules to implement 288.35 this section or to amend the emergency rules for granting 288.36 exceptions to the moratorium on nursing homes under section 289.1 144A.073. 289.2 Sec. 6. Minnesota Statutes 2000, section 144A.071, 289.3 subdivision 4a, is amended to read: 289.4 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 289.5 best interest of the state to ensure that nursing homes and 289.6 boarding care homes continue to meet the physical plant 289.7 licensing and certification requirements by permitting certain 289.8 construction projects. Facilities should be maintained in 289.9 condition to satisfy the physical and emotional needs of 289.10 residents while allowing the state to maintain control over 289.11 nursing home expenditure growth. 289.12 The commissioner of health in coordination with the 289.13 commissioner of human services, may approve the renovation, 289.14 replacement, upgrading, or relocation of a nursing home or 289.15 boarding care home, under the following conditions: 289.16 (a) to license or certify beds in a new facility 289.17 constructed to replace a facility or to make repairs in an 289.18 existing facility that was destroyed or damaged after June 30, 289.19 1987, by fire, lightning, or other hazard provided: 289.20 (i) destruction was not caused by the intentional act of or 289.21 at the direction of a controlling person of the facility; 289.22 (ii) at the time the facility was destroyed or damaged the 289.23 controlling persons of the facility maintained insurance 289.24 coverage for the type of hazard that occurred in an amount that 289.25 a reasonable person would conclude was adequate; 289.26 (iii) the net proceeds from an insurance settlement for the 289.27 damages caused by the hazard are applied to the cost of the new 289.28 facility or repairs; 289.29 (iv) the new facility is constructed on the same site as 289.30 the destroyed facility or on another site subject to the 289.31 restrictions in section 144A.073, subdivision 5; 289.32 (v) the number of licensed and certified beds in the new 289.33 facility does not exceed the number of licensed and certified 289.34 beds in the destroyed facility; and 289.35 (vi) the commissioner determines that the replacement beds 289.36 are needed to prevent an inadequate supply of beds. 290.1 Project construction costs incurred for repairs authorized under 290.2 this clause shall not be considered in the dollar threshold 290.3 amount defined in subdivision 2; 290.4 (b) to license or certify beds that are moved from one 290.5 location to another within a nursing home facility, provided the 290.6 total costs of remodeling performed in conjunction with the 290.7 relocation of beds does not exceed$750,000$1,000,000; 290.8 (c) to license or certify beds in a project recommended for 290.9 approval under section 144A.073; 290.10 (d) to license or certify beds that are moved from an 290.11 existing state nursing home to a different state facility, 290.12 provided there is no net increase in the number of state nursing 290.13 home beds; 290.14 (e) to certify and license as nursing home beds boarding 290.15 care beds in a certified boarding care facility if the beds meet 290.16 the standards for nursing home licensure, or in a facility that 290.17 was granted an exception to the moratorium under section 290.18 144A.073, and if the cost of any remodeling of the facility does 290.19 not exceed$750,000$1,000,000. If boarding care beds are 290.20 licensed as nursing home beds, the number of boarding care beds 290.21 in the facility must not increase beyond the number remaining at 290.22 the time of the upgrade in licensure. The provisions contained 290.23 in section 144A.073 regarding the upgrading of the facilities do 290.24 not apply to facilities that satisfy these requirements; 290.25 (f) to license and certify up to 40 beds transferred from 290.26 an existing facility owned and operated by the Amherst H. Wilder 290.27 Foundation in the city of St. Paul to a new unit at the same 290.28 location as the existing facility that will serve persons with 290.29 Alzheimer's disease and other related disorders. The transfer 290.30 of beds may occur gradually or in stages, provided the total 290.31 number of beds transferred does not exceed 40. At the time of 290.32 licensure and certification of a bed or beds in the new unit, 290.33 the commissioner of health shall delicense and decertify the 290.34 same number of beds in the existing facility. As a condition of 290.35 receiving a license or certification under this clause, the 290.36 facility must make a written commitment to the commissioner of 291.1 human services that it will not seek to receive an increase in 291.2 its property-related payment rate as a result of the transfers 291.3 allowed under this paragraph; 291.4 (g) to license and certify nursing home beds to replace 291.5 currently licensed and certified boarding care beds which may be 291.6 located either in a remodeled or renovated boarding care or 291.7 nursing home facility or in a remodeled, renovated, newly 291.8 constructed, or replacement nursing home facility within the 291.9 identifiable complex of health care facilities in which the 291.10 currently licensed boarding care beds are presently located, 291.11 provided that the number of boarding care beds in the facility 291.12 or complex are decreased by the number to be licensed as nursing 291.13 home beds and further provided that, if the total costs of new 291.14 construction, replacement, remodeling, or renovation exceed ten 291.15 percent of the appraised value of the facility or $200,000, 291.16 whichever is less, the facility makes a written commitment to 291.17 the commissioner of human services that it will not seek to 291.18 receive an increase in its property-related payment rate by 291.19 reason of the new construction, replacement, remodeling, or 291.20 renovation. The provisions contained in section 144A.073 291.21 regarding the upgrading of facilities do not apply to facilities 291.22 that satisfy these requirements; 291.23 (h) to license as a nursing home and certify as a nursing 291.24 facility a facility that is licensed as a boarding care facility 291.25 but not certified under the medical assistance program, but only 291.26 if the commissioner of human services certifies to the 291.27 commissioner of health that licensing the facility as a nursing 291.28 home and certifying the facility as a nursing facility will 291.29 result in a net annual savings to the state general fund of 291.30 $200,000 or more; 291.31 (i) to certify, after September 30, 1992, and prior to July 291.32 1, 1993, existing nursing home beds in a facility that was 291.33 licensed and in operation prior to January 1, 1992; 291.34 (j) to license and certify new nursing home beds to replace 291.35 beds in a facility acquired by the Minneapolis community 291.36 development agency as part of redevelopment activities in a city 292.1 of the first class, provided the new facility is located within 292.2 three miles of the site of the old facility. Operating and 292.3 property costs for the new facility must be determined and 292.4 allowed under section 256B.431 or 256B.434; 292.5 (k) to license and certify up to 20 new nursing home beds 292.6 in a community-operated hospital and attached convalescent and 292.7 nursing care facility with 40 beds on April 21, 1991, that 292.8 suspended operation of the hospital in April 1986. The 292.9 commissioner of human services shall provide the facility with 292.10 the same per diem property-related payment rate for each 292.11 additional licensed and certified bed as it will receive for its 292.12 existing 40 beds; 292.13 (l) to license or certify beds in renovation, replacement, 292.14 or upgrading projects as defined in section 144A.073, 292.15 subdivision 1, so long as the cumulative total costs of the 292.16 facility's remodeling projects do not 292.17 exceed$750,000$1,000,000; 292.18 (m) to license and certify beds that are moved from one 292.19 location to another for the purposes of converting up to five 292.20 four-bed wards to single or double occupancy rooms in a nursing 292.21 home that, as of January 1, 1993, was county-owned and had a 292.22 licensed capacity of 115 beds; 292.23 (n) to allow a facility that on April 16, 1993, was a 292.24 106-bed licensed and certified nursing facility located in 292.25 Minneapolis to layaway all of its licensed and certified nursing 292.26 home beds. These beds may be relicensed and recertified in a 292.27 newly-constructed teaching nursing home facility affiliated with 292.28 a teaching hospital upon approval by the legislature. The 292.29 proposal must be developed in consultation with the interagency 292.30 committee on long-term care planning. The beds on layaway 292.31 status shall have the same status as voluntarily delicensed and 292.32 decertified beds, except that beds on layaway status remain 292.33 subject to the surcharge in section 256.9657. This layaway 292.34 provision expires July 1, 1998; 292.35 (o) to allow a project which will be completed in 292.36 conjunction with an approved moratorium exception project for a 293.1 nursing home in southern Cass county and which is directly 293.2 related to that portion of the facility that must be repaired, 293.3 renovated, or replaced, to correct an emergency plumbing problem 293.4 for which a state correction order has been issued and which 293.5 must be corrected by August 31, 1993; 293.6 (p) to allow a facility that on April 16, 1993, was a 293.7 368-bed licensed and certified nursing facility located in 293.8 Minneapolis to layaway, upon 30 days prior written notice to the 293.9 commissioner, up to 30 of the facility's licensed and certified 293.10 beds by converting three-bed wards to single or double 293.11 occupancy. Beds on layaway status shall have the same status as 293.12 voluntarily delicensed and decertified beds except that beds on 293.13 layaway status remain subject to the surcharge in section 293.14 256.9657, remain subject to the license application and renewal 293.15 fees under section 144A.07 and shall be subject to a $100 per 293.16 bed reactivation fee. In addition, at any time within three 293.17 years of the effective date of the layaway, the beds on layaway 293.18 status may be: 293.19 (1) relicensed and recertified upon relocation and 293.20 reactivation of some or all of the beds to an existing licensed 293.21 and certified facility or facilities located in Pine River, 293.22 Brainerd, or International Falls; provided that the total 293.23 project construction costs related to the relocation of beds 293.24 from layaway status for any facility receiving relocated beds 293.25 may not exceed the dollar threshold provided in subdivision 2 293.26 unless the construction project has been approved through the 293.27 moratorium exception process under section 144A.073; 293.28 (2) relicensed and recertified, upon reactivation of some 293.29 or all of the beds within the facility which placed the beds in 293.30 layaway status, if the commissioner has determined a need for 293.31 the reactivation of the beds on layaway status. 293.32 The property-related payment rate of a facility placing 293.33 beds on layaway status must be adjusted by the incremental 293.34 change in its rental per diem after recalculating the rental per 293.35 diem as provided in section 256B.431, subdivision 3a, paragraph 293.36 (c). The property-related payment rate for a facility 294.1 relicensing and recertifying beds from layaway status must be 294.2 adjusted by the incremental change in its rental per diem after 294.3 recalculating its rental per diem using the number of beds after 294.4 the relicensing to establish the facility's capacity day 294.5 divisor, which shall be effective the first day of the month 294.6 following the month in which the relicensing and recertification 294.7 became effective. Any beds remaining on layaway status more 294.8 than three years after the date the layaway status became 294.9 effective must be removed from layaway status and immediately 294.10 delicensed and decertified; 294.11 (q) to license and certify beds in a renovation and 294.12 remodeling project to convert 12 four-bed wards into 24 two-bed 294.13 rooms, expand space, and add improvements in a nursing home 294.14 that, as of January 1, 1994, met the following conditions: the 294.15 nursing home was located in Ramsey county; had a licensed 294.16 capacity of 154 beds; and had been ranked among the top 15 294.17 applicants by the 1993 moratorium exceptions advisory review 294.18 panel. The total project construction cost estimate for this 294.19 project must not exceed the cost estimate submitted in 294.20 connection with the 1993 moratorium exception process; 294.21 (r) to license and certify up to 117 beds that are 294.22 relocated from a licensed and certified 138-bed nursing facility 294.23 located in St. Paul to a hospital with 130 licensed hospital 294.24 beds located in South St. Paul, provided that the nursing 294.25 facility and hospital are owned by the same or a related 294.26 organization and that prior to the date the relocation is 294.27 completed the hospital ceases operation of its inpatient 294.28 hospital services at that hospital. After relocation, the 294.29 nursing facility's status under section 256B.431, subdivision 294.30 2j, shall be the same as it was prior to relocation. The 294.31 nursing facility's property-related payment rate resulting from 294.32 the project authorized in this paragraph shall become effective 294.33 no earlier than April 1, 1996. For purposes of calculating the 294.34 incremental change in the facility's rental per diem resulting 294.35 from this project, the allowable appraised value of the nursing 294.36 facility portion of the existing health care facility physical 295.1 plant prior to the renovation and relocation may not exceed 295.2 $2,490,000; 295.3 (s) to license and certify two beds in a facility to 295.4 replace beds that were voluntarily delicensed and decertified on 295.5 June 28, 1991; 295.6 (t) to allow 16 licensed and certified beds located on July 295.7 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 295.8 facility in Minneapolis, notwithstanding the licensure and 295.9 certification after July 1, 1995, of the Minneapolis facility as 295.10 a 147-bed nursing home facility after completion of a 295.11 construction project approved in 1993 under section 144A.073, to 295.12 be laid away upon 30 days' prior written notice to the 295.13 commissioner. Beds on layaway status shall have the same status 295.14 as voluntarily delicensed or decertified beds except that they 295.15 shall remain subject to the surcharge in section 256.9657. The 295.16 16 beds on layaway status may be relicensed as nursing home beds 295.17 and recertified at any time within five years of the effective 295.18 date of the layaway upon relocation of some or all of the beds 295.19 to a licensed and certified facility located in Watertown, 295.20 provided that the total project construction costs related to 295.21 the relocation of beds from layaway status for the Watertown 295.22 facility may not exceed the dollar threshold provided in 295.23 subdivision 2 unless the construction project has been approved 295.24 through the moratorium exception process under section 144A.073. 295.25 The property-related payment rate of the facility placing 295.26 beds on layaway status must be adjusted by the incremental 295.27 change in its rental per diem after recalculating the rental per 295.28 diem as provided in section 256B.431, subdivision 3a, paragraph 295.29 (c). The property-related payment rate for the facility 295.30 relicensing and recertifying beds from layaway status must be 295.31 adjusted by the incremental change in its rental per diem after 295.32 recalculating its rental per diem using the number of beds after 295.33 the relicensing to establish the facility's capacity day 295.34 divisor, which shall be effective the first day of the month 295.35 following the month in which the relicensing and recertification 295.36 became effective. Any beds remaining on layaway status more 296.1 than five years after the date the layaway status became 296.2 effective must be removed from layaway status and immediately 296.3 delicensed and decertified; 296.4 (u) to license and certify beds that are moved within an 296.5 existing area of a facility or to a newly constructed addition 296.6 which is built for the purpose of eliminating three- and 296.7 four-bed rooms and adding space for dining, lounge areas, 296.8 bathing rooms, and ancillary service areas in a nursing home 296.9 that, as of January 1, 1995, was located in Fridley and had a 296.10 licensed capacity of 129 beds; 296.11 (v) to relocate 36 beds in Crow Wing county and four beds 296.12 from Hennepin county to a 160-bed facility in Crow Wing county, 296.13 provided all the affected beds are under common ownership; 296.14 (w) to license and certify a total replacement project of 296.15 up to 49 beds located in Norman county that are relocated from a 296.16 nursing home destroyed by flood and whose residents were 296.17 relocated to other nursing homes. The operating cost payment 296.18 rates for the new nursing facility shall be determined based on 296.19 the interim and settle-up payment provisions of Minnesota Rules, 296.20 part 9549.0057, and the reimbursement provisions of section 296.21 256B.431, except that subdivision 26, paragraphs (a) and (b), 296.22 shall not apply until the second rate year after the settle-up 296.23 cost report is filed. Property-related reimbursement rates 296.24 shall be determined under section 256B.431, taking into account 296.25 any federal or state flood-related loans or grants provided to 296.26 the facility; 296.27 (x) to license and certify a total replacement project of 296.28 up to 129 beds located in Polk county that are relocated from a 296.29 nursing home destroyed by flood and whose residents were 296.30 relocated to other nursing homes. The operating cost payment 296.31 rates for the new nursing facility shall be determined based on 296.32 the interim and settle-up payment provisions of Minnesota Rules, 296.33 part 9549.0057, and the reimbursement provisions of section 296.34 256B.431, except that subdivision 26, paragraphs (a) and (b), 296.35 shall not apply until the second rate year after the settle-up 296.36 cost report is filed. Property-related reimbursement rates 297.1 shall be determined under section 256B.431, taking into account 297.2 any federal or state flood-related loans or grants provided to 297.3 the facility; 297.4 (y) to license and certify beds in a renovation and 297.5 remodeling project to convert 13 three-bed wards into 13 two-bed 297.6 rooms and 13 single-bed rooms, expand space, and add 297.7 improvements in a nursing home that, as of January 1, 1994, met 297.8 the following conditions: the nursing home was located in 297.9 Ramsey county, was not owned by a hospital corporation, had a 297.10 licensed capacity of 64 beds, and had been ranked among the top 297.11 15 applicants by the 1993 moratorium exceptions advisory review 297.12 panel. The total project construction cost estimate for this 297.13 project must not exceed the cost estimate submitted in 297.14 connection with the 1993 moratorium exception process; 297.15 (z) to license and certify up to 150 nursing home beds to 297.16 replace an existing 285 bed nursing facility located in St. 297.17 Paul. The replacement project shall include both the renovation 297.18 of existing buildings and the construction of new facilities at 297.19 the existing site. The reduction in the licensed capacity of 297.20 the existing facility shall occur during the construction 297.21 project as beds are taken out of service due to the construction 297.22 process. Prior to the start of the construction process, the 297.23 facility shall provide written information to the commissioner 297.24 of health describing the process for bed reduction, plans for 297.25 the relocation of residents, and the estimated construction 297.26 schedule. The relocation of residents shall be in accordance 297.27 with the provisions of law and rule; 297.28 (aa) to allow the commissioner of human services to license 297.29 an additional 36 beds to provide residential services for the 297.30 physically handicapped under Minnesota Rules, parts 9570.2000 to 297.31 9570.3400, in a 198-bed nursing home located in Red Wing, 297.32 provided that the total number of licensed and certified beds at 297.33 the facility does not increase; 297.34 (bb) to license and certify a new facility in St. Louis 297.35 county with 44 beds constructed to replace an existing facility 297.36 in St. Louis county with 31 beds, which has resident rooms on 298.1 two separate floors and an antiquated elevator that creates 298.2 safety concerns for residents and prevents nonambulatory 298.3 residents from residing on the second floor. The project shall 298.4 include the elimination of three- and four-bed rooms; 298.5 (cc) to license and certify four beds in a 16-bed certified 298.6 boarding care home in Minneapolis to replace beds that were 298.7 voluntarily delicensed and decertified on or before March 31, 298.8 1992. The licensure and certification is conditional upon the 298.9 facility periodically assessing and adjusting its resident mix 298.10 and other factors which may contribute to a potential 298.11 institution for mental disease declaration. The commissioner of 298.12 human services shall retain the authority to audit the facility 298.13 at any time and shall require the facility to comply with any 298.14 requirements necessary to prevent an institution for mental 298.15 disease declaration, including delicensure and decertification 298.16 of beds, if necessary;or298.17 (dd) to license and certify 72 beds in an existing facility 298.18 in Mille Lacs county with 80 beds as part of a renovation 298.19 project. The renovation must include construction of an 298.20 addition to accommodate ten residents with beginning and 298.21 midstage dementia in a self-contained living unit; creation of 298.22 three resident households where dining, activities, and support 298.23 spaces are located near resident living quarters; designation of 298.24 four beds for rehabilitation in a self-contained area; 298.25 designation of 30 private rooms; and other improvements; 298.26 (ee) to license and certify beds in a facility that has 298.27 undergone replacement or remodeling as part of a planned closure 298.28 under section 256B.437; 298.29 (ff) to transfer up to 98 beds of a 129 licensed bed 298.30 facility located in Anoka county that, as of March 25, 2001, is 298.31 in the active process of closing, to a 122 licensed bed 298.32 nonprofit nursing facility located in the city of Columbia 298.33 Heights, or its affiliate. The transfer is effective when the 298.34 receiving facility notifies the commissioner in writing of the 298.35 number of beds accepted. The commissioner shall place all 298.36 transferred beds on layaway status held in the name of the 299.1 receiving facility. The layaway adjustment provisions of 299.2 section 256B.431, subdivision 30, do not apply to this layaway. 299.3 The receiving facility may only remove the beds from layaway for 299.4 recertification and relicensure at the receiving facility's 299.5 current site, or at a newly constructed facility located in 299.6 Anoka county. The receiving facility must receive statutory 299.7 authorization before removing the beds from layaway status; 299.8 (gg) to license and certify up to 120 new nursing facility 299.9 beds to replace beds in a facility in Anoka county, which was 299.10 licensed for 98 beds as of July 1, 2000, provided the new 299.11 facility is located within four miles of the existing facility 299.12 and is in Anoka county. Operating and property rates will be 299.13 determined and allowed under section 256B.431 and Minnesota 299.14 Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 299.15 256B.435. The provisions of section 256B.431, subdivision 26, 299.16 paragraphs (a) and (b), do not apply until the second rate year 299.17 following settle-up; or 299.18 (hh) to license and certify a total replacement project of 299.19 up to 124 beds located in Wilkin county that are in need of 299.20 relocation from a nursing home substantially destroyed by 299.21 flood. The operating cost payment rates for the new nursing 299.22 facility shall be determined based on the interim and settle-up 299.23 payment provisions of Minnesota Rules, part 9549.0057, and the 299.24 reimbursement provisions of section 256B.431, except that 299.25 section 256B.431, subdivision 26, paragraphs (a) and (b), shall 299.26 not apply until the second rate year after the settle-up cost 299.27 report is filed. Property-related reimbursement rates shall be 299.28 determined under section 256B.431, taking into account any 299.29 federal or state flood-related loans or grants provided to the 299.30 facility. 299.31 Sec. 7. Minnesota Statutes 2000, section 144A.073, 299.32 subdivision 2, is amended to read: 299.33 Subd. 2. [REQUEST FOR PROPOSALS.] At the authorization by 299.34 the legislature of additional medical assistance expenditures 299.35 for exceptions to the moratorium on nursing homes, the 299.36 interagency committee shall publish in the State Register a 300.1 request for proposals for nursing home projects to be licensed 300.2 or certified under section 144A.071, subdivision 4a, clause 300.3 (c). The public notice of this funding and the request for 300.4 proposals must specify how the approval criteria will be 300.5 prioritized by the advisory review panel, the interagency 300.6 long-term care planning committee, and the commissioner. The 300.7 notice must describe the information that must accompany a 300.8 request and state that proposals must be submitted to the 300.9 interagency committee within 90 days of the date of 300.10 publication. The notice must include the amount of the 300.11 legislative appropriation available for the additional costs to 300.12 the medical assistance program of projects approved under this 300.13 section. If no money is appropriated for a year, the 300.14 interagency committee shall publish a notice to that effect, and 300.15 no proposals shall be requested. If money is appropriated, the 300.16 interagency committee shall initiate the application and review 300.17 process described in this section at least twice each biennium 300.18 and up to four times each biennium, according to dates 300.19 established by rule. Authorized funds shall be allocated 300.20 proportionally to the number of processes. Funds not encumbered 300.21 by an earlier process within a biennium shall carry forward to 300.22 subsequent iterations of the process.Authorization for300.23expenditures does not carry forward into the following300.24biennium.To be considered for approval, a proposal must 300.25 include the following information: 300.26 (1) whether the request is for renovation, replacement, 300.27 upgrading, conversion, or relocation; 300.28 (2) a description of the problem the project is designed to 300.29 address; 300.30 (3) a description of the proposed project; 300.31 (4) an analysis of projected costs of the nursing facility 300.32 proposal, which are not required to exceed the cost threshold 300.33 referred to in section 144A.071, subdivision 1, to be considered 300.34 under this section, including initial construction and 300.35 remodeling costs; site preparation costs; technology costs; 300.36 financing costs, including the current estimated long-term 301.1 financing costs of the proposal, which consists of estimates of 301.2 the amount and sources of money, reserves if required under the 301.3 proposed funding mechanism, annual payments schedule, interest 301.4 rates, length of term, closing costs and fees, insurance costs, 301.5 and any completed marketing study or underwriting review; and 301.6 estimated operating costs during the first two years after 301.7 completion of the project; 301.8 (5) for proposals involving replacement of all or part of a 301.9 facility, the proposed location of the replacement facility and 301.10 an estimate of the cost of addressing the problem through 301.11 renovation; 301.12 (6) for proposals involving renovation, an estimate of the 301.13 cost of addressing the problem through replacement; 301.14 (7) the proposed timetable for commencing construction and 301.15 completing the project; 301.16 (8) a statement of any licensure or certification issues, 301.17 such as certification survey deficiencies; 301.18 (9) the proposed relocation plan for current residents if 301.19 beds are to be closed so that the department of human services 301.20 can estimate the total costs of a proposal; and 301.21 (10) other information required by permanent rule of the 301.22 commissioner of health in accordance with subdivisions 4 and 8. 301.23 Sec. 8. [144A.161] [NURSING FACILITY RESIDENT RELOCATION.] 301.24 Subdivision 1. [DEFINITIONS.] The definitions in this 301.25 subdivision apply to subdivisions 2 to 10. 301.26 (a) "Closure" means the cessation of operations of a 301.27 nursing home and the delicensure and decertification of all beds 301.28 within the facility. 301.29 (b) "Curtailment," "reduction," or "change" refers to any 301.30 change in operations which would result in or encourage the 301.31 relocation of residents. 301.32 (c) "Facility" means a nursing home licensed pursuant to 301.33 this chapter, or a certified boarding care home licensed 301.34 pursuant to sections 144.50 to 144.56. 301.35 (d) "Licensee" means the owner of the facility or the 301.36 owner's designee or the commissioner of health for a facility in 302.1 receivership. 302.2 (e) "Local agency" means the county or multicounty social 302.3 service agency authorized under sections 393.01 and 393.07, as 302.4 the agency responsible for providing social services for the 302.5 county in which the nursing home is located. 302.6 (f) "Plan" means a process developed under subdivision 3, 302.7 paragraph (b), for the closure, curtailment, reduction, or 302.8 change in operations in a facility and the subsequent relocation 302.9 of residents. 302.10 (g) "Relocation" means the discharge of a resident and 302.11 movement of the resident to another facility or living 302.12 arrangement as a result of the closing, curtailment, reduction, 302.13 or change in operations of a nursing home or boarding care home. 302.14 Subd. 2. [INITIAL NOTICE FROM LICENSEE.] (a) The licensee 302.15 of the facility shall notify the following parties in writing 302.16 when there is an intent to close, curtail, reduce, or change 302.17 operations or services which would result in or encourage the 302.18 relocation of residents: the commissioner of health, the 302.19 commissioner of human services, the local agency, the office of 302.20 ombudsman for older Minnesotans, and the ombudsman for mental 302.21 health/mental retardation. 302.22 (b) The written notice shall include the names, telephone 302.23 numbers, facsimile numbers, and e-mail addresses of the persons 302.24 responsible for coordinating the licensee's efforts in the 302.25 planning process, and the number of residents potentially 302.26 affected by the closure, curtailment, reduction, or change in 302.27 operations. 302.28 Subd. 3. [PLANNING PROCESS.] (a) The local agency shall, 302.29 within five working days of receiving initial notice of the 302.30 licensee's intent to close, curtail, reduce, or change 302.31 operations, provide the licensee and all parties identified in 302.32 subdivision 2, paragraph (a), with the names, telephone numbers, 302.33 facsimile numbers, and e-mail addresses of those persons 302.34 responsible for coordinating local agency efforts in the 302.35 planning process. 302.36 (b) The licensee shall convene a meeting with the local 303.1 agency to jointly develop a plan regarding the closure, 303.2 curtailment, or change in facility operations. The licensee 303.3 shall notify representatives of the departments of health and 303.4 human services of the date, time, and location of the meeting so 303.5 that representatives from the departments may attend. The 303.6 licensee must allow a minimum of 28 days for this planning 303.7 process from the day of the initial notice. However, the plan 303.8 may be finalized on an earlier schedule agreed to by all 303.9 parties. To the extent practicable, consistent with 303.10 requirements to protect the safety and health of residents, the 303.11 commissioner may authorize the planning process under this 303.12 subdivision to occur concurrent with the 60 day notice required 303.13 under subdivision 5, paragraph (e). The plan shall: 303.14 (1) identify the expected date of closure, curtailment, 303.15 reduction, or change in operations; 303.16 (2) outline the process for public notification of the 303.17 closure, curtailment, reduction, or change in operations; 303.18 (3) identify and make efforts to include other stakeholders 303.19 in the planning process; 303.20 (4) outline the process to ensure 60-day advance written 303.21 notice to residents, family members, and designated 303.22 representatives; 303.23 (5) present an aggregate description of the resident 303.24 population remaining to be relocated and their needs; 303.25 (6) outline the individual resident assessment process to 303.26 be utilized; 303.27 (7) identify an inventory of available relocation options, 303.28 including home and community-based services; 303.29 (8) identify a timeline for submission of the list 303.30 identified in subdivision 5, paragraph (h); and 303.31 (9) identify a schedule for the timely completion of each 303.32 element of the plan. 303.33 Subd. 4. [RESPONSIBILITIES OF LICENSEE FOR RESIDENT 303.34 RELOCATIONS.] The licensee shall provide for the safe, orderly, 303.35 and appropriate relocation of residents. The licensee and 303.36 facility staff shall cooperate with representatives from the 304.1 local agency, the department of health, the department of human 304.2 services, the office of ombudsman for older Minnesotans, and 304.3 ombudsman for mental health/mental retardation, in planning for 304.4 and implementing the relocation of residents. The discharge and 304.5 relocation of residents must comply with all applicable state 304.6 and federal requirements. 304.7 Subd. 5. [RESPONSIBILITIES PRIOR TO RELOCATION.] (a) The 304.8 licensee shall provide an initial notice as described in 304.9 subdivision 2, when there is an intent to close, curtail, 304.10 reduce, or change in operations which would result in or 304.11 encourage the relocation of residents. 304.12 (b) The licensee shall establish an interdisciplinary team 304.13 responsible for coordinating and implementing the plan as 304.14 outlined in subdivision 3, paragraph (b). The interdisciplinary 304.15 team shall include representatives from the local agency, the 304.16 office of ombudsman for older Minnesotans, facility staff that 304.17 provide direct care services to the residents, and facility 304.18 administration. 304.19 (c) The licensee shall provide a list to the local agency 304.20 that includes the following information on each resident to be 304.21 relocated: 304.22 (1) the resident's name; 304.23 (2) date of birth; 304.24 (3) social security number; 304.25 (4) medical assistance identification number; 304.26 (5) all diagnoses; and 304.27 (6) the name and contact information for the resident's 304.28 family or other designated representative. 304.29 (d) The licensee shall consult with the local agency on the 304.30 availability and development of available resources, and on the 304.31 resident relocation process. 304.32 (e) At least 60 days before the proposed date of closing, 304.33 curtailment, reduction, or change in operations as agreed to in 304.34 the plan, the licensee shall send a written notice of closure, 304.35 curtailment, reduction, or change in operations to each resident 304.36 being relocated, the resident's family member or designated 305.1 representative, and the resident's attending physician. The 305.2 notice must include the following: 305.3 (1) the date of the proposed closure, curtailment, 305.4 reduction, or change in operations; 305.5 (2) the name, address, telephone number, facsimile number, 305.6 and e-mail address of the individual or individuals in the 305.7 facility responsible for providing assistance and information; 305.8 (3) notification of upcoming meetings for residents, 305.9 families and designated representatives, and resident and family 305.10 councils to discuss the relocation of residents; 305.11 (4) the name, address, and telephone number of the local 305.12 agency contact person; 305.13 (5) the name, address, and telephone number of the office 305.14 of ombudsman for older Minnesotans and the ombudsman for mental 305.15 health/mental retardation; and 305.16 (6) a notice of resident rights during discharge and 305.17 relocation, in a form approved by the office of ombudsman for 305.18 older Minnesotans. 305.19 The notice must comply with all applicable state and 305.20 federal requirements for notice of transfer or discharge of 305.21 nursing home residents. 305.22 (f) The licensee shall request the attending physician 305.23 provide or arrange for the release of medical information needed 305.24 to update resident medical records and prepare all required 305.25 forms and discharge summaries. 305.26 (g) The licensee shall provide sufficient preparation to 305.27 residents to ensure safe, orderly and appropriate discharge, and 305.28 relocation. The licensee shall assist residents in finding 305.29 placements that respond to personal preferences, such as desired 305.30 geographic location. 305.31 (h) The licensee shall prepare a resource list with several 305.32 relocation options for each resident. The list must contain the 305.33 following information for each relocation option, when 305.34 applicable: 305.35 (1) the name, address, and telephone and facsimile numbers 305.36 of each facility with appropriate, available beds or services; 306.1 (2) the certification level of the available beds; 306.2 (3) the types of services available; 306.3 (4) the name, address, and telephone and facsimile numbers 306.4 of appropriate available home and community-based placements, 306.5 services and settings, or other options for individuals with 306.6 special needs. 306.7 The list shall be made available to residents and their families 306.8 or designated representatives, and upon request to the office of 306.9 ombudsman for older Minnesotans and ombudsman for mental 306.10 health/mental retardation, and the local agency. 306.11 (i) Following the establishment of the plan under 306.12 subdivision 3, paragraph (b), the licensee shall conduct 306.13 meetings with residents, families and designated 306.14 representatives, and resident and family councils to notify them 306.15 of the process for resident relocation. Representatives from 306.16 the local county social services agency, the office of ombudsman 306.17 for older Minnesotans, the ombudsman for mental health and 306.18 mental retardation, the commissioner of health, and the 306.19 commissioner of human services shall receive advance notice of 306.20 the meetings. 306.21 (j) The licensee shall assist residents desiring to make 306.22 site visits to facilities with available beds or other 306.23 appropriate living options to which the resident may relocate, 306.24 unless it is medically inadvisable, as documented by the 306.25 attending physician in the resident's care record. The licensee 306.26 shall provide transportation for site visits to facilities or 306.27 other living options within a 50-mile radius to which the 306.28 resident may relocate. The licensee shall provide available 306.29 written materials to residents on a potential new facility or 306.30 living option. 306.31 (k) The licensee shall complete an inventory of resident 306.32 personal possessions and provide a copy of the final inventory 306.33 to the resident and the resident's designated representative 306.34 prior to relocation. The licensee shall be responsible for the 306.35 transfer of the resident's possessions for all relocations 306.36 within a 50-mile radius of the facility. The licensee shall 307.1 complete the transfer of resident possessions in a timely 307.2 manner, but no later than the date of the actual physical 307.3 relocation of the resident. 307.4 (l) The licensee shall complete a final accounting of 307.5 personal funds held in trust by the facility and provide a copy 307.6 of this accounting to the resident and the resident's family or 307.7 the resident's designated representative. The licensee shall be 307.8 responsible for the transfer of all personal funds held in trust 307.9 by the facility. The licensee shall complete the transfer of 307.10 all personal funds in a timely manner. 307.11 (m) The licensee shall assist residents with the transfer 307.12 and reconnection of service for telephones or other personal 307.13 communication devices or services. The licensee shall pay the 307.14 costs associated with reestablishing service for telephones or 307.15 other personal communication devices or services, such as 307.16 connection fees or other one-time charges. The transfer or 307.17 reconnection of personal communication devices or services shall 307.18 be completed in a timely manner. 307.19 (n) The licensee shall provide the resident, the resident's 307.20 family or designated representative, and the resident's 307.21 attending physician final written notice prior to the relocation 307.22 of the resident. The notice must: 307.23 (1) be provided seven days prior to the actual relocation, 307.24 unless the resident agrees to waive the right to advance notice; 307.25 and 307.26 (2) identify the date of the anticipated relocation and the 307.27 destination to which the resident is being relocated. 307.28 (o) The licensee shall provide the receiving facility or 307.29 other health, housing, or care entity with complete and accurate 307.30 resident records including information on family members, 307.31 designated representatives, guardians, social service 307.32 caseworkers, or other contact information. These records must 307.33 also include all information necessary to provide appropriate 307.34 medical care and social services. This includes, but is not 307.35 limited to, information on preadmission screening, Level I and 307.36 Level II screening, Minimum Data Set (MDS) and all other 308.1 assessments, resident diagnoses, social, behavioral, and 308.2 medication information. 308.3 Subd. 6. [RESPONSIBILITIES OF THE LICENSEE DURING 308.4 RELOCATION.] (a) The licensee shall arrange for the safe 308.5 transport of residents to the new facility or placement. 308.6 (b) The licensee must ensure that there is no disruption in 308.7 the provision of meals, medications, or treatments of the 308.8 resident during the relocation process. 308.9 (c) Beginning the week following development of the initial 308.10 relocation plan, the licensee shall submit biweekly status 308.11 reports to the commissioners of the department of health and the 308.12 department of human services or their designees, and to the 308.13 local agency. The initial status report must identify: 308.14 (1) the relocation plan developed; 308.15 (2) the interdisciplinary team members; and 308.16 (3) the number of residents to be relocated. 308.17 (d) Subsequent status reports must identify: 308.18 (1) any modifications to the plan; 308.19 (2) any change of interdisciplinary team members; 308.20 (3) the number of residents relocated; 308.21 (4) the destination to which residents have been relocated; 308.22 (5) the number of residents remaining to be relocated; and 308.23 (6) issues or problems encountered during the process and 308.24 resolution of these issues. 308.25 Subd. 7. [RESPONSIBILITIES OF THE LICENSEE FOLLOWING 308.26 RELOCATION.] The licensee shall retain or make arrangements for 308.27 the retention of all remaining resident records, for the period 308.28 required by law. The licensee shall provide the department of 308.29 health access to these records. The licensee shall notify the 308.30 department of health of the location of any resident records 308.31 that have not been transferred to the new facility or other 308.32 health care entity. 308.33 Subd. 8. [RESPONSIBILITIES OF THE LOCAL AGENCY.] (a) The 308.34 local agency shall participate in the meeting as outlined in 308.35 subdivision 3, paragraph (b), to develop a relocation plan. 308.36 (b) The local agency shall designate a representative to 309.1 the interdisciplinary team established by the licensee 309.2 responsible for coordinating the relocation efforts. 309.3 (c) The local agency shall serve as a resource in the 309.4 relocation process. 309.5 (d) Concurrent with the notice sent to residents from the 309.6 licensee as provided in subdivision 5, paragraph (e), the local 309.7 agency shall provide written notice to residents, family, or 309.8 designated representatives describing: 309.9 (1) the county's role in the relocation process and in the 309.10 follow-up to relocations; 309.11 (2) a local agency contact name, address, and telephone 309.12 number; and 309.13 (3) the name, address, and telephone number of the office 309.14 of ombudsman for older Minnesotans and the ombudsman for mental 309.15 health/mental retardation. 309.16 (e) The local agency designee shall meet with appropriate 309.17 facility staff to coordinate any assistance in the relocation 309.18 process. This coordination shall include participating in group 309.19 meetings with residents, families, and designated 309.20 representatives to explain the relocation process. 309.21 (f) The local agency shall monitor compliance with all 309.22 components of the plan. If the licensee is not in compliance, 309.23 the local agency shall notify the commissioners of the 309.24 department of health and the department of human services. 309.25 (g) The local agency shall report to the commissioners of 309.26 health and human services any relocations that endanger the 309.27 health, safety, or well-being of residents. The local agency 309.28 shall pursue remedies to protect the resident during the 309.29 relocation process, including, but not limited to, assisting the 309.30 resident with filing an appeal of transfer or discharge, 309.31 notification of all appropriate licensing boards and agencies, 309.32 and other remedies available to the county under section 309.33 626.557, subdivision 10. 309.34 (h) A member of the local agency staff shall visit 309.35 residents relocated within one hundred miles of the county 309.36 within 30 days after the relocation. Local agency staff shall 310.1 interview the resident and family or designated representative, 310.2 observe the resident on site, and review and discuss pertinent 310.3 medical or social records with facility staff to: 310.4 (1) assess the adjustment of the resident to the new 310.5 placement; 310.6 (2) recommend services or methods to meet any special needs 310.7 of the resident; and 310.8 (3) identify residents at risk. 310.9 (i) The local agency shall have the authority to conduct 310.10 subsequent follow-up visits in cases where the adjustment of the 310.11 resident to the new placement is in question. 310.12 (j) Within 60 days of the completion of the follow-up 310.13 visits, the local agency shall submit a written summary of the 310.14 follow-up work to the department of health and the department of 310.15 human services, in a manner approved by the commissioners. 310.16 (k) The local agency shall submit to the department of 310.17 health and the department of human services a report of any 310.18 issues that may require further review or monitoring. 310.19 (l) The local agency shall be responsible for the safe and 310.20 orderly relocation of residents in cases where an emergent need 310.21 arises or when the licensee has abrogated its responsibilities 310.22 under the plan. 310.23 Subd. 9. [FUNDING.] The commissioner of human services 310.24 shall negotiate with the local agency to determine an amount of 310.25 administrative funding within appropriations specified for this 310.26 purpose to make available to the local agency for the costs of 310.27 work related to the relocation process in accordance with 310.28 section 256B.437, subdivision 9. 310.29 Subd. 10. [PENALTIES.] According to sections 144.653 and 310.30 144A.10, the licensee shall be subject to correction orders and 310.31 civil monetary penalties of up to $500 per day for each 310.32 violation of this statute. 310.33 Sec. 9. [144A.1888] [REUSE OF FACILITIES.] 310.34 Notwithstanding any local ordinance related to development, 310.35 planning, or zoning to the contrary, the conversion or reuse of 310.36 a nursing home that closes or that curtails, reduces, or changes 311.1 operations shall be considered a conforming use permitted under 311.2 local law, provided that the facility is converted to another 311.3 long-term care service approved by a regional planning group 311.4 under section 256B.437 that serves a smaller number of persons 311.5 than the number of persons served before the closure or 311.6 curtailment, reduction, or change in operations. 311.7 Sec. 10. Minnesota Statutes 2000, section 256B.431, 311.8 subdivision 2e, is amended to read: 311.9 Subd. 2e. [CONTRACTS FOR SERVICES FOR VENTILATOR-DEPENDENT 311.10 PERSONS.] The commissioner may contract with a nursing facility 311.11 eligible to receive medical assistance payments to provide 311.12 services to a ventilator-dependent person identified by the 311.13 commissioner according to criteria developed by the 311.14 commissioner, including: 311.15 (1) nursing facility care has been recommended for the 311.16 person by a preadmission screening team; 311.17 (2)the person has been assessed at case mix classification311.18K;311.19(3)the person has been hospitalizedfor at least six311.20monthsand no longer requires inpatient acute care hospital 311.21 services; and 311.22(4)(3) the commissioner has determined that necessary 311.23 services for the person cannot be provided under existing 311.24 nursing facility rates. 311.25 The commissioner may issue a request for proposals to 311.26 provide services to a ventilator-dependent person to nursing 311.27 facilities eligible to receive medical assistance payments and 311.28 shall select nursing facilities from among respondents according 311.29 to criteria developed by the commissioner, including: 311.30 (1) the cost-effectiveness and appropriateness of services; 311.31 (2) the nursing facility's compliance with federal and 311.32 state licensing and certification standards; and 311.33 (3) the proximity of the nursing facility to a 311.34 ventilator-dependent person identified by the commissioner who 311.35 requires nursing facility placement. 311.36 The commissioner may negotiate an adjustment to the 312.1 operating cost payment rate for a nursing facility selected by 312.2 the commissioner from among respondents to the request for 312.3 proposals. The negotiated adjustment must reflect only the 312.4 actual additional cost of meeting the specialized care needs of 312.5 a ventilator-dependent person identified by the commissioner for 312.6 whom necessary services cannot be provided under existing 312.7 nursing facility rates and which are not otherwise covered under 312.8 Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to 312.9 9505.0475. For persons who are initially admitted to a nursing 312.10 facility before July 1, 2001, and have their payment rate under 312.11 this subdivision negotiated after July 1, 2001, the negotiated 312.12 payment rate must not exceed 200 percent of the highest multiple 312.13 bedroom payment rate fora Minnesota nursingthe facility, as 312.14 initially established by the commissioner for the rate year for 312.15 case mix classification K. For persons initially admitted to a 312.16 nursing facility on or after July 1, 2001, the negotiated 312.17 payment rate must not exceed 300 percent of the facility's 312.18 multiple bedroom payment rate for case mix classification K. 312.19 The negotiated adjustment shall not affect the payment rate 312.20 charged to private paying residents under the provisions of 312.21 section 256B.48, subdivision 1. 312.22 Sec. 11. Minnesota Statutes 2000, section 256B.431, is 312.23 amended by adding a subdivision to read: 312.24 Subd. 31. [NURSING FACILITY RATE INCREASES BEGINNING JULY 312.25 1, 2001, AND JULY 1, 2002.] (a) For the rate years beginning 312.26 July 1, 2001, and July 1, 2002, the commissioner shall make 312.27 available to each nursing facility reimbursed under this section 312.28 or section 256B.434 an adjustment of 3.0 percent to the total 312.29 operating payment rates in effect on June 30, 2001, and June 30, 312.30 2002, respectively. The operating payment rate in effect on 312.31 June 30, 2001, must include the adjustment in subdivision 2i, 312.32 paragraph (c). The adjustment must be used to increase the 312.33 wages of all employees except management fees, the 312.34 administrator, and central office staff and to pay associated 312.35 costs for FICA, the Medicare tax, workers' compensation 312.36 premiums, and federal and state unemployment insurance. 313.1 Money received by a facility as a result of the additional 313.2 rate increase provided under this paragraph must be used only 313.3 for wage increases implemented on or after July 1, 2001, or July 313.4 1, 2002, respectively, and must not be used for wage increases 313.5 implemented prior to those dates. 313.6 (b) Nursing facilities may apply for the wage-related 313.7 payment rate adjustment calculated under paragraph (a). The 313.8 application must be made to the commissioner and contain a plan 313.9 by which the nursing facility will distribute the payment rate 313.10 adjustment to employees of the nursing facility. For nursing 313.11 facilities in which the employees are represented by an 313.12 exclusive bargaining representative, an agreement negotiated and 313.13 agreed to by the employer and the exclusive bargaining 313.14 representative constitutes the plan. A negotiated agreement may 313.15 constitute the plan only if the agreement is finalized after the 313.16 date of enactment of all increases for the rate year. The 313.17 commissioner shall review the plan to ensure that the 313.18 wage-related payment rate adjustment per diem is used as 313.19 provided in paragraph (a). To be eligible, a facility must 313.20 submit its plan for the wage distribution by December 31 each 313.21 year. If a facility's plan for wage distribution is effective 313.22 for its employees after July 1 of the year that the funds are 313.23 available, the payment rate adjustment per diem is effective the 313.24 same date as its plan. 313.25 (c) A hospital-attached nursing facility may include costs 313.26 in their distribution plan for wages and wage-related costs of 313.27 employees in the organization's shared services departments, 313.28 provided that: 313.29 (1) the nursing facility and the hospital share common 313.30 ownership; and 313.31 (2) adjustments for hospital services using the 313.32 diagnostic-related grouping payment rates per admission under 313.33 medical assistance or Medicare are less than three percent 313.34 during the 12 months prior to the effective date of this 313.35 increase. 313.36 If a hospital-attached facility meets the qualifications in 314.1 this paragraph, the difference between the rate increase 314.2 approved for nursing facility services and the rate increase 314.3 approved for hospital services may be permitted as a 314.4 distribution in the hospital-attached facility's plan regardless 314.5 of whether the use of those funds is shown as being attributable 314.6 to employee hours worked in the nursing facility or employee 314.7 hours worked in the hospital. 314.8 For the purposes of this paragraph, a hospital-attached 314.9 nursing facility is one that meets the definition under 314.10 subdivision 2j, or, in the case of a facility reimbursed under 314.11 section 256B.434, met this definition at the time their last 314.12 payment rate was established under Minnesota Rules, parts 314.13 9549.0010 to 9549.0080, and this section. 314.14 (d) A copy of the approved distribution plan must be made 314.15 available to all employees by giving each employee a copy or by 314.16 posting it in an area of the nursing facility to which all 314.17 employees have access. If an employee does not receive the wage 314.18 adjustment described in the facility's approved plan and is 314.19 unable to resolve the problem with the facility's management or 314.20 through the employee's union representative, the employee may 314.21 contact the commissioner at an address or telephone number 314.22 provided by the commissioner and included in the approved plan. 314.23 (e) Notwithstanding section 256B.48, subdivision 1, clause 314.24 (a), upon the request of a nursing facility, the commissioner 314.25 may authorize the facility to raise per diem rates for 314.26 private-pay residents on July 1 by the amount anticipated to be 314.27 required upon implementation of the wage-related increase 314.28 available under this subdivision. The commissioner shall 314.29 require any amounts collected under this paragraph to be placed 314.30 in an escrow account until the medical assistance rate is 314.31 finalized. The commissioner shall conduct audits as necessary 314.32 to ensure that: 314.33 (1) the amounts collected are retained in escrow until 314.34 medical assistance rates are increased to reflect the 314.35 wage-related adjustment; and 314.36 (2) any amounts collected from private-pay residents in 315.1 excess of the final medical assistance wage-related rate 315.2 increase are repaid to the private-pay residents with interest 315.3 at the rate used by the commissioner of revenue for the late 315.4 payment of taxes and in effect on the date the distribution plan 315.5 is approved by the commissioner of human services. 315.6 (f) For the rate year beginning July 1, 2001, the 315.7 commissioner shall make available to each nursing facility that 315.8 is reimbursed under this section or section 256B.434 and had 35 315.9 or fewer admissions during calendar year 2000 an adjustment of 315.10 1.0 percent to the total operating payment rates in effect on 315.11 June 30, 2001. 315.12 The operating payment rate in effect on June 30, 2001, must 315.13 include the adjustment in subdivision 2i, paragraph (c). 315.14 Sec. 12. Minnesota Statutes 2000, section 256B.431, is 315.15 amended by adding a subdivision to read: 315.16 Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 315.17 years beginning on or after July 1, 2001, the total payment rate 315.18 for a facility reimbursed under this section, section 256B.434, 315.19 or any other section for the first 90 paid days after admission 315.20 shall be: 315.21 (1) for the first 30 paid days, the rate shall be 120 315.22 percent of the facility's medical assistance rate for each case 315.23 mix class; and 315.24 (2) for the next 60 paid days after the first 30 paid days, 315.25 the rate shall be 110 percent of the facility's medical 315.26 assistance rate for each case mix class. 315.27 (b) Beginning with the 91st paid day after admission, the 315.28 payment rate shall be the rate otherwise determined under this 315.29 section, section 256B.434, or any other section. 315.30 Sec. 13. Minnesota Statutes 2000, section 256B.431, is 315.31 amended by adding a subdivision to read: 315.32 Subd. 34. [STAGED REDUCTION IN RATE DISPARITIES.] (a) The 315.33 commissioner, by June 30, 2001, shall provide each nursing 315.34 facility with information on how its per diem operating payment 315.35 rates for each case mix category compare to the median per diem 315.36 rates for facilities in geographic group three, as determined 316.1 under Minnesota Rules, part 9549.0052. 316.2 (b) The commissioner shall provide nursing facilities 316.3 reimbursed under this section or section 256B.434 with the 316.4 following staged rate increases, for each case mix category 316.5 operating payment per diem that is below the median for 316.6 facilities in geographic group three: 316.7 (1) effective July 1, 2001, the commissioner shall allow 316.8 increases in the total operating payment per diems for each 316.9 facility of up to 38 percent of the difference between that 316.10 facility's operating payment rate in effect on June 30, 2001, 316.11 for each case mix category and 85 percent of the median payment 316.12 rate in effect on June 30, 2001, for that category for 316.13 facilities in geographic group three; 316.14 (2) effective July 1, 2002, the commissioner shall allow 316.15 increases in the total operating payment per diems for each 316.16 facility by 38 percent of the difference between that facility's 316.17 operating payment rate in effect on June 30, 2002, for each case 316.18 mix category and 85 percent of the median payment rate in effect 316.19 on June 30, 2002, for that category for facilities in geographic 316.20 group three; and 316.21 (3) effective July 1, 2003, the commissioner shall allow 316.22 increases in the total operating payment per diems for each 316.23 facility by 24 percent of the difference between that facility's 316.24 operating payment rate in effect on June 30, 2003, for each case 316.25 mix category and 100 percent of the median payment rate in 316.26 effect on June 30, 2003, for each case mix category for 316.27 facilities in geographic group three. 316.28 (c) In order to receive the rate increases provided in 316.29 paragraph (b), facilities must apply to the commissioner. A 316.30 facility must submit an application for each rate increase by 316.31 December 31 of the calendar year in which the increase is 316.32 allowed, using a form provided by the commissioner. The 316.33 application must include a plan for use of the rate increase and 316.34 any other information deemed necessary by the commissioner to 316.35 determine the amount of an increase that will be allowed. The 316.36 commissioner shall deny a request for a rate increase, or reduce 317.1 the rate increase provided, if the commissioner determines that 317.2 the proposed plan for using the rate increase is not an approved 317.3 use of funding under Minnesota Rules, parts 9549.0010 to 317.4 9549.0080. A facility whose request has been denied or reduced 317.5 may reapply for a rate increase. Rate increases approved by the 317.6 commissioner shall be effective on the first day of the month 317.7 following the month which the application was received by the 317.8 commissioner, but not before July 1 of the year in which it is 317.9 allowed. 317.10 (d) A facility must make a copy of the approved application 317.11 available to residents, their designated representatives, and 317.12 employees, by posting it in an area of the facility to which 317.13 these individuals have access, or by providing these individuals 317.14 with copies. 317.15 [EFFECTIVE DATE.] This section is effective the day 317.16 following final enactment. 317.17 Sec. 14. Minnesota Statutes 2000, section 256B.433, 317.18 subdivision 3a, is amended to read: 317.19 Subd. 3a. [EXEMPTION FROM REQUIREMENT FOR SEPARATE THERAPY 317.20 BILLING.] The provisions of subdivision 3 do not apply to 317.21 nursing facilities that are reimbursed according to the 317.22 provisions of section 256B.431and are located in a county317.23participating in the prepaid medical assistance program. 317.24 Nursing facilities that are reimbursed according to the 317.25 provisions of section 256B.434 and are located in a county 317.26 participating in the prepaid medical assistance program are 317.27 exempt from the maximum therapy rent revenue provisions of 317.28 subdivision 3, paragraph (c). 317.29 [EFFECTIVE DATE.] This section is effective the day 317.30 following final enactment. 317.31 Sec. 15. Minnesota Statutes 2000, section 256B.434, 317.32 subdivision 4, is amended to read: 317.33 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 317.34 nursing facilities which have their payment rates determined 317.35 under this section rather than section 256B.431, the 317.36 commissioner shall establish a rate under this subdivision. The 318.1 nursing facility must enter into a written contract with the 318.2 commissioner. 318.3 (b) A nursing facility's case mix payment rate for the 318.4 first rate year of a facility's contract under this section is 318.5 the payment rate the facility would have received under section 318.6 256B.431. 318.7 (c) A nursing facility's case mix payment rates for the 318.8 second and subsequent years of a facility's contract under this 318.9 section are the previous rate year's contract payment rates plus 318.10 an inflation adjustment. The index for the inflation adjustment 318.11 must be based on the change in the Consumer Price Index-All 318.12 Items (United States City average) (CPI-U) forecasted by Data 318.13 Resources, Inc., as forecasted in the fourth quarter of the 318.14 calendar year preceding the rate year. The inflation adjustment 318.15 must be based on the 12-month period from the midpoint of the 318.16 previous rate year to the midpoint of the rate year for which 318.17 the rate is being determined. For the rate years beginning on 318.18 July 1, 1999,andJuly 1, 2000, July 1, 2001, and July 1, 2002, 318.19 this paragraph shall apply only to the property-related payment 318.20 rate. In determining the amount of the property-related payment 318.21 rate adjustment under this paragraph, the commissioner shall 318.22 determine the proportion of the facility's rates that are 318.23 property-related based on the facility's most recent cost report. 318.24 (d) The commissioner shall develop additional 318.25 incentive-based payments of up to five percent above the 318.26 standard contract rate for achieving outcomes specified in each 318.27 contract. The specified facility-specific outcomes must be 318.28 measurable and approved by the commissioner. The commissioner 318.29 may establish, for each contract, various levels of achievement 318.30 within an outcome. After the outcomes have been specified the 318.31 commissioner shall assign various levels of payment associated 318.32 with achieving the outcome. Any incentive-based payment cancels 318.33 if there is a termination of the contract. In establishing the 318.34 specified outcomes and related criteria the commissioner shall 318.35 consider the following state policy objectives: 318.36 (1) improved cost effectiveness and quality of life as 319.1 measured by improved clinical outcomes; 319.2 (2) successful diversion or discharge to community 319.3 alternatives; 319.4 (3) decreased acute care costs; 319.5 (4) improved consumer satisfaction; 319.6 (5) the achievement of quality; or 319.7 (6) any additional outcomes proposed by a nursing facility 319.8 that the commissioner finds desirable. 319.9 Sec. 16. [256B.437] [NURSING FACILITY VOLUNTARY CLOSURES 319.10 AND PLANNING AND DEVELOPMENT OF COMMUNITY-BASED ALTERNATIVES.] 319.11 Subdivision 1. [DEFINITIONS.] (a) The definitions in this 319.12 subdivision apply to subdivisions 2 to 9. 319.13 (b) "Closure" means the cessation of operations of a 319.14 nursing facility and delicensure and decertification of all beds 319.15 within the facility. 319.16 (c) "Closure plan" means a plan to close a nursing facility 319.17 and reallocate a portion of the resulting savings to provide 319.18 planned closure rate adjustments at other facilities. 319.19 (d) "Commencement of closure" means the date on which 319.20 residents and designated representatives are notified of a 319.21 planned closure in accordance with section 144A.161, subdivision 319.22 5, paragraph (e), as part of an approved closure plan. 319.23 (e) "Completion of closure" means the date on which the 319.24 final resident of the nursing facility designated for closure in 319.25 an approved closure plan is discharged from the facility. 319.26 (f) "Partial closure" means the delicensure and 319.27 decertification of a portion of the beds within the facility. 319.28 (g) "Planned closure rate adjustment" means an increase in 319.29 a nursing facility's operating rates resulting from a planned 319.30 closure or a planned partial closure of another facility. 319.31 Subd. 2. [REGIONAL LONG-TERM CARE PLANNING AND 319.32 DEVELOPMENT.] (a) The commissioner of human services shall 319.33 establish a process to adjust the capacity and distribution of 319.34 long-term care services to equalize the supply and demand for 319.35 different types of services. The process must include community 319.36 and regional planning, expansion or establishment of needed 320.1 services, and voluntary nursing facility closures. 320.2 (b) The commissioner shall issue a request for proposals to 320.3 contract with regional long-term care planning groups. At least 320.4 one of the planning groups must be an American Indian long-term 320.5 care planning group. Each group must: 320.6 (1) consist of county health and social services agencies, 320.7 consumers, housing agencies, a representative of nursing 320.8 facilities, a representative of home and community-based 320.9 services providers, a union representative, and area agencies on 320.10 aging in the geographic area; and 320.11 (2) serve an area that has at least 2,000 people who are 85 320.12 years of age or older. American Indian long-term care planning 320.13 groups are exempt from this requirement. 320.14 In awarding contracts, the commissioner shall give preference to 320.15 groups that represent an entire area agency on aging region 320.16 where there is not already a planning and development group 320.17 established under section 256B.0917. An area not included in a 320.18 proposal must be included in a group convened by the area agency 320.19 on aging of that planning and service area through a contract 320.20 negotiated by the commissioner. 320.21 (c) Each regional long-term care planning group shall: 320.22 (1) conduct a detailed assessment of the region's long-term 320.23 care services system. This assessment must be completed within 320.24 90 days of the contract award and must evaluate the adequacy of 320.25 nursing facility beds and the impact of potential nursing 320.26 facility closures. The commissioner of health and the 320.27 commissioner of human services, as appropriate, shall provide 320.28 data to the group on nursing facility bed distribution, 320.29 housing-with-service options, the closure of nursing facilities 320.30 in the planning area that occur outside of the planned closure 320.31 process, the approval of planned closures in the planning area, 320.32 the addition of new community long-term care services in the 320.33 area, the closure of existing community long-term care services 320.34 in the area, and other available data; 320.35 (2) plan options for increasing community capacity to 320.36 provide more home and community-based services to reduce 321.1 reliance on nursing facility services; 321.2 (3) develop community services alternatives to ensure that 321.3 sufficient community-based services are available to meet 321.4 demand; 321.5 (4) assist a nursing facility in the development of a 321.6 proposal to the commissioner for voluntary bed closures under 321.7 this section; 321.8 (5) monitor the success of alternatives to nursing facility 321.9 care that are developed that meet the needs of communities; 321.10 (6) respond to requests from the commissioner for 321.11 information about long-term care planning and development 321.12 activities in the region; and 321.13 (7) review and comment on nursing facility proposals 321.14 submitted under this section. 321.15 Subd. 2a. [PLANNING AND DEVELOPMENT OF COMMUNITY-BASED 321.16 SERVICES.] (a) The purpose of this subdivision is to promote the 321.17 planning and development of community-based services prior to 321.18 the transitioning or closure of nursing facilities. This 321.19 process will support early intervention, advocacy, and consumer 321.20 protection while providing incentives for the nursing facilities 321.21 to transition to meet community needs. 321.22 (b) The commissioner shall establish a process to support 321.23 and facilitate expansion of community-based services under the 321.24 county-administered alternative care program and the elderly 321.25 waiver program. The process shall utilize community assessments 321.26 and planning developed for the community health services plan 321.27 and plan update and for the Community Social Services Act plan. 321.28 (c) The plan shall include recommendations for development 321.29 of community-based services, and both planning and 321.30 implementation shall be implemented within the amount of funding 321.31 made available to the county board for these purposes. 321.32 (d) The plan, within the funding allocated, shall: 321.33 (1) identify the need for services for all residents in 321.34 each community within the county based on demographic and 321.35 caseload information; 321.36 (2) involve providers, consumers, cities, townships, and 322.1 businesses in the planning process; 322.2 (3) address the need for all alternative care and elderly 322.3 waiver services for eligible recipients; 322.4 (4) assess the need for other supportive services such as 322.5 transit, housing, and workforce and economic development; 322.6 (5) estimate the cost and timelines for development; and 322.7 (6) coordinate with the county mental health plan, the 322.8 community health services plan, and community social services 322.9 plan. 322.10 (e) The county board shall cooperate in planning and 322.11 implementation with any county having a nursing facility that 322.12 includes their county in the immediate service area within the 322.13 funding allocated for these purposes. 322.14 (f) The commissioner of health, in cooperation with the 322.15 commissioner of human services and county boards, shall jointly 322.16 report to the legislature by January 15 of each year regarding 322.17 the development of community-based services, transition or 322.18 closure of nursing facilities, and consumer outcomes achieved. 322.19 Subd. 3. [APPLICATIONS FOR PLANNED CLOSURE OF NURSING 322.20 FACILITIES.] (a) By July 15, 2001, the commissioner of human 322.21 services shall implement and announce a program for closure or 322.22 partial closure of nursing facilities. The announcement must 322.23 specify: 322.24 (1) the criteria in subdivision 4 that will be used by the 322.25 commissioner to approve or reject applications; 322.26 (2) the information that must accompany an application; and 322.27 (3) that applications may combine planned closure rate 322.28 adjustments with moratorium exception funding, in which case a 322.29 single application may serve both purposes. 322.30 Between August 1, 2001, and June 30, 2003, the commissioner may 322.31 approve planned closures of up to 5,140 nursing facility beds, 322.32 less the number of licensed beds in facilities that close during 322.33 the same time period without approved closure plans or that have 322.34 notified the commissioner of health of their intent to close 322.35 without an approved closure plan. 322.36 (b) A facility or facilities reimbursed under section 323.1 256B.431 or 256B.434 with a closure plan approved by the 323.2 commissioner under subdivision 6 may assign a planned closure 323.3 rate adjustment to another facility or facilities that are not 323.4 closing or in the case of a partial closure, to itself. A 323.5 facility may also elect to have a planned closure rate 323.6 adjustment shared equally by the five nursing facilities with 323.7 the lowest total operating payment rates in the state 323.8 development region designated under section 462.385, in which 323.9 the facility that is closing is located. The planned closure 323.10 rate adjustment must be calculated under subdivision 7. 323.11 Facilities that close without a closure plan, or whose closure 323.12 plan is not approved by the commissioner, are not eligible to 323.13 assign a planned closure rate adjustment under subdivision 7. 323.14 The commissioner shall calculate the amount the facility would 323.15 have been eligible to assign under subdivision 7, and shall use 323.16 this amount to provide equal rate adjustments to the five 323.17 nursing facilities with the lowest total operating payment rates 323.18 in the state development region designated under section 323.19 462.385, in which the facility that closed is located. 323.20 (c) To be considered for approval, an application must 323.21 include: 323.22 (1) a description of the proposed closure plan, which must 323.23 include identification of the facility or facilities to receive 323.24 a planned closure rate adjustment and the amount and timing of a 323.25 planned closure rate adjustment proposed for each facility; 323.26 (2) the proposed timetable for any proposed closure, 323.27 including the proposed dates for announcement to residents, 323.28 commencement of closure, and completion of closure; 323.29 (3) the proposed relocation plan for current residents of 323.30 any facility designated for closure. The proposed relocation 323.31 plan must be designed to comply with all applicable state and 323.32 federal statutes and regulations, including, but not limited to, 323.33 section 144A.161; 323.34 (4) a description of the relationship between the nursing 323.35 facility that is proposed for closure and the nursing facility 323.36 or facilities proposed to receive the planned closure rate 324.1 adjustment. If these facilities are not under common ownership, 324.2 copies of any contracts, purchase agreements, or other documents 324.3 establishing a relationship or proposed relationship must be 324.4 provided; 324.5 (5) documentation, in a format approved by the 324.6 commissioner, that all the nursing facilities receiving a 324.7 planned closure rate adjustment under the plan have accepted 324.8 joint and several liability for recovery of overpayments under 324.9 section 256B.0641, subdivision 2, for the facilities designated 324.10 for closure under the plan; and 324.11 (6) comments by the affected regional planning and 324.12 development groups on the facility proposal. 324.13 (d) The application must address the criteria listed in 324.14 subdivision 4. 324.15 Subd. 4. [CRITERIA FOR REVIEW OF APPLICATION.] In 324.16 reviewing and approving closure proposals, the commissioner 324.17 shall consider, but not be limited to, the following criteria: 324.18 (1) improved quality of care and quality of life for 324.19 consumers; 324.20 (2) closure of a nursing facility that has a poor physical 324.21 plant; 324.22 (3) the existence of excess nursing facility beds, measured 324.23 in terms of beds per thousand persons aged 85 or older. The 324.24 excess must be measured in reference to: 324.25 (i) the county in which the facility is located; 324.26 (ii) the county and all contiguous counties; 324.27 (iii) the region in which the facility is located; or 324.28 (iv) the facility's service area; 324.29 the facility shall indicate in its application the service area 324.30 it believes is appropriate for this measurement. A facility in 324.31 a county that is in the lowest quartile of counties with 324.32 reference to beds per thousand persons aged 85 or older is not 324.33 in an area of excess capacity; 324.34 (4) low-occupancy rates, provided that the unoccupied beds 324.35 are not the result of a personnel shortage. In analyzing 324.36 occupancy rates, the commissioner shall examine waiting lists in 325.1 the applicant facility and at facilities in the surrounding 325.2 area, as determined under clause (3); 325.3 (5) evidence of coordination between the community planning 325.4 process and the facility application; 325.5 (6) proposed usage of funds available from a planned 325.6 closure rate adjustment for care-related purposes; 325.7 (7) innovative use planned for the closed facility's 325.8 physical plant; 325.9 (8) evidence that the proposal serves the interests of the 325.10 state; and 325.11 (9) evidence of other factors that affect the viability of 325.12 the facility, including excessive nursing pool costs. 325.13 Subd. 5. [CERTIFICATION.] Upon receipt of an application 325.14 for planned closure, the commissioner of human services shall 325.15 provide a copy of the application to the commissioner of 325.16 health. The commissioner of health shall certify to the 325.17 commissioner of human services within 14 days whether the 325.18 application, if implemented, will satisfy the requirements of 325.19 section 144A.161. The commissioner of human services shall 325.20 reject all applications for which the commissioner of health 325.21 fails to make the certification required under this subdivision 325.22 within 14 days. 325.23 Subd. 6. [REVIEW AND APPROVAL OF APPLICATIONS.] (a) The 325.24 commissioner of human services, in consultation with the 325.25 commissioner of health, shall approve or disapprove an 325.26 application within 30 days after receiving it. 325.27 (b) The commissioner shall not approve an application that 325.28 results in a closure, curtailment, reduction, or change of 325.29 operations combined with the establishment of new long-term care 325.30 facilities or services offered in the existing facilities or in 325.31 new facilities provided by the same corporation, agency, or 325.32 individual, unless: 325.33 (1) the employees at the time of the closure, curtailment, 325.34 reduction, or change of operations are given by seniority the 325.35 first priority for hiring into positions for which they are 325.36 qualified in the new facility or service; and 326.1 (2) the exclusive bargaining representative at the time of 326.2 the closure, curtailment, reduction, or change of operations is 326.3 recognized as the exclusive bargaining representative for the 326.4 new long-term care facilities or services. 326.5 (c) Approval of a planned closure expires 18 months after 326.6 approval by the commissioner of human services, unless 326.7 commencement of closure has begun. 326.8 (d) The commissioner of human services may change any 326.9 provision of the application to which the applicant, the 326.10 regional planning group, and the commissioner agree. 326.11 Subd. 7. [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 326.12 commissioner of human services shall calculate the amount of the 326.13 planned closure rate adjustment available under subdivision 3, 326.14 paragraph (b), for up to 5,140 beds according to clauses (1) to 326.15 (4): 326.16 (1) the amount available is the net reduction of nursing 326.17 facility beds multiplied by $2,080; 326.18 (2) the total number of beds in the nursing facility or 326.19 facilities receiving the planned closure rate adjustment must be 326.20 identified; 326.21 (3) capacity days are determined by multiplying the number 326.22 determined under clause (2) by 365; and 326.23 (4) the planned closure rate adjustment is the amount 326.24 available in clause (1), divided by capacity days determined 326.25 under clause (3). 326.26 (b) A planned closure rate adjustment under this section is 326.27 effective on the first day of the month following completion of 326.28 closure of the facility designated for closure in the 326.29 application and becomes part of the nursing facility's total 326.30 operating payment rate. 326.31 (c) Applicants may use the planned closure rate adjustment 326.32 to allow for a property payment for a new nursing facility or an 326.33 addition to an existing nursing facility. Applications approved 326.34 under this subdivision are exempt from other requirements for 326.35 moratorium exceptions under section 144A.073, subdivisions 2 and 326.36 3. 327.1 (d) Upon the request of a closing facility, the 327.2 commissioner must allow the facility a closure rate adjustment 327.3 equal to a 50 percent payment rate increase to reimburse 327.4 relocation costs or other costs related to facility closure. 327.5 This rate increase is effective on the date the facility's 327.6 occupancy decreases to 90 percent of capacity days after the 327.7 written notice of closure is distributed under section 144A.161, 327.8 subdivision 5, and shall remain in effect for a period of up to 327.9 60 days. The commissioner shall delay the implementation of the 327.10 planned closure rate adjustments to offset the cost of this rate 327.11 adjustment. 327.12 Subd. 8. [OTHER RATE ADJUSTMENTS.] Facilities subject to 327.13 this section remain eligible for any applicable rate adjustments 327.14 provided under section 256B.431, 256B.434, or any other section. 327.15 Subd. 9. [COUNTY COSTS.] The commissioner of human 327.16 services may allocate up to $400 total state and federal funds 327.17 per nursing facility bed that is closing, within the limits of 327.18 the appropriation specified for this purpose, to be used for 327.19 relocation costs incurred by counties for planned closures under 327.20 this section or resident relocation under section 144A.161. To 327.21 be eligible for this allocation, a county in which a nursing 327.22 facility closes must provide to the commissioner a detailed 327.23 statement in a form provided by the commissioner of additional 327.24 costs, not to exceed $400 per bed closed, that are directly 327.25 incurred related to the county's required role in the relocation 327.26 process. 327.27 [EFFECTIVE DATE.] This section is effective the day 327.28 following final enactment. 327.29 Sec. 17. [256B.438] [IMPLEMENTATION OF A CASE MIX SYSTEM 327.30 FOR NURSING FACILITIES BASED ON THE MINIMUM DATA SET.] 327.31 Subdivision 1. [SCOPE.] This section establishes the 327.32 method and criteria used to determine resident reimbursement 327.33 classifications based upon the assessments of residents of 327.34 nursing homes and boarding care homes whose payment rates are 327.35 established under section 256B.431, 256B.434, or 256B.435. 327.36 Resident reimbursement classifications shall be established 328.1 according to the 34 group, resource utilization groups, version 328.2 III or RUG-III model as described in section 144.0724. 328.3 Reimbursement classifications established under this section 328.4 shall be implemented after June 30, 2002, but no later than 328.5 January 1, 2003. 328.6 Subd. 2. [DEFINITIONS.] For purposes of this section, the 328.7 following terms have the meanings given. 328.8 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 328.9 date" has the meaning given in section 144.0724, subdivision 2, 328.10 paragraph (a). 328.11 (b) [CASE MIX INDEX.] "Case mix index" has the meaning 328.12 given in section 144.0724, subdivision 2, paragraph (b). 328.13 (c) [INDEX MAXIMIZATION.] "Index maximization" has the 328.14 meaning given in section 144.0724, subdivision 2, paragraph (c). 328.15 (d) [MINIMUM DATA SET.] "Minimum data set" has the meaning 328.16 given in section 144.0724, subdivision 2, paragraph (d). 328.17 (e) [REPRESENTATIVE.] "Representative" has the meaning 328.18 given in section 144.0724, subdivision 2, paragraph (e). 328.19 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 328.20 utilization groups" or "RUG" has the meaning given in section 328.21 144.0724, subdivision 2, paragraph (f). 328.22 Subd. 3. [CASE MIX INDICES.] (a) The commissioner of human 328.23 services shall assign a case mix index to each resident class 328.24 based on the Health Care Financing Administration's staff time 328.25 measurement study and adjusted for Minnesota-specific wage 328.26 indices. The case mix indices assigned to each resident class 328.27 shall be published in the Minnesota State Register at least 120 328.28 days prior to the implementation of the 34 group, RUG-III 328.29 resident classification system. 328.30 (b) An index maximization approach shall be used to 328.31 classify residents. 328.32 (c) After implementation of the revised case mix system, 328.33 the commissioner of human services may annually rebase case mix 328.34 indices and base rates using more current data on average wage 328.35 rates and staff time measurement studies. This rebasing shall 328.36 be calculated under subdivision 7, paragraph (b). The 329.1 commissioner shall publish in the Minnesota State Register 329.2 adjusted case mix indices at least 45 days prior to the 329.3 effective date of the adjusted case mix indices. 329.4 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) Nursing 329.5 facilities shall conduct and submit case mix assessments 329.6 according to the schedule established by the commissioner of 329.7 health under section 144.0724, subdivisions 4 and 5. 329.8 (b) The resident reimbursement classifications established 329.9 under section 144.0724, subdivision 3, shall be effective the 329.10 day of admission for new admission assessments. The effective 329.11 date for significant change assessments shall be the assessment 329.12 reference date. The effective date for annual and second 329.13 quarterly assessments shall be the first day of the month 329.14 following assessment reference date. 329.15 Subd. 5. [NOTICE OF RESIDENT REIMBURSEMENT 329.16 CLASSIFICATION.] Nursing facilities shall provide notice to a 329.17 resident of the resident's case mix classification according to 329.18 procedures established by the commissioner of health under 329.19 section 144.0724, subdivision 7. 329.20 Subd. 6. [RECONSIDERATION OF RESIDENT CLASSIFICATION.] Any 329.21 request for reconsideration of a resident classification must be 329.22 made under section 144.0724, subdivision 8. 329.23 Subd. 7. [RATE DETERMINATION UPON TRANSITION TO RUG-III 329.24 PAYMENT RATES.] (a) The commissioner of human services shall 329.25 determine payment rates at the time of transition to the RUG 329.26 based payment model in a facility-specific, budget-neutral 329.27 manner. The case mix indices as defined in subdivision 3 shall 329.28 be used to allocate the case mix adjusted component of total 329.29 payment across all case mix groups. To transition from the 329.30 current calculation methodology to the RUG based methodology, 329.31 the commissioner of health shall report to the commissioner of 329.32 human services the resident days classified according to the 329.33 categories defined in subdivision 3 for the 12-month reporting 329.34 period ending September 30, 2001, for each nursing facility. 329.35 The commissioner of human services shall use this data to 329.36 compute the standardized days for the reporting period under the 330.1 RUG system. 330.2 (b) The commissioner of human services shall determine the 330.3 case mix adjusted component of the rate as follows: 330.4 (1) determine the case mix portion of the 11 case mix rates 330.5 in effect on June 30, 2002, or the 34 case mix rates in effect 330.6 on or after June 30, 2003; 330.7 (2) multiply each amount in clause (1) by the number of 330.8 resident days assigned to each group for the reporting period 330.9 ending September 30, 2001, or the most recent year for which 330.10 data is available; 330.11 (3) compute the sum of the amounts in clause (2); 330.12 (4) determine the total RUG standardized days for the 330.13 reporting period ending September 30, 2001, or the most recent 330.14 year for which data is available using the new indices 330.15 calculated under subdivision 3, paragraph (c); 330.16 (5) divide the amount in clause (3) by the amount in clause 330.17 (4) which shall be the average case mix adjusted component of 330.18 the rate under the RUG method; and 330.19 (6) multiply this average rate by the case mix weight in 330.20 subdivision 3 for each RUG group. 330.21 (c) The noncase mix component will be allocated to each RUG 330.22 group as a constant amount to determine the transition payment 330.23 rate. Any other rate adjustments that are effective on or after 330.24 July 1, 2002, shall be applied to the transition rates 330.25 determined under this section. 330.26 Sec. 18. [256B.439] [LONG-TERM CARE QUALITY PROFILES.] 330.27 Subdivision 1. [DEVELOPMENT AND IMPLEMENTATION OF QUALITY 330.28 PROFILES.] (a) The commissioner of human services shall develop 330.29 and implement a quality profile system for nursing facilities 330.30 and, beginning not later than July 1, 2003, other providers of 330.31 long-term care services. The system must be developed and 330.32 implemented to the extent possible without the collection of 330.33 significant amounts of new data. The system must not duplicate 330.34 the requirements of section 256B.5011, 256B.5012, or 256B.5013. 330.35 The system must be designed to provide information on quality: 330.36 (1) to consumers and their families to facilitate informed 331.1 choices of service providers; 331.2 (2) to providers to enable them to measure the results of 331.3 their quality improvement efforts and compare quality 331.4 achievements with other service providers; and 331.5 (3) to public and private purchasers of long-term care 331.6 services to enable them to purchase high-quality care. 331.7 (b) The system must be developed in consultation with the 331.8 long-term care task force and representatives of consumers, 331.9 providers, and labor unions. Within the limits of available 331.10 appropriations, the commissioner may employ consultants to 331.11 assist with this project. 331.12 Subd. 2. [QUALITY MEASUREMENT TOOLS.] The commissioner of 331.13 human services shall identify and apply existing quality 331.14 measurement tools to: 331.15 (1) emphasize quality of care and its relationship to 331.16 quality of life; and 331.17 (2) address the needs of various users of long-term care 331.18 services, including, but not limited to, short-stay residents, 331.19 persons with behavioral problems, persons with dementia, and 331.20 persons who are members of minority groups. 331.21 The tools must be identified and applied, to the extent 331.22 possible, without requiring providers to supply information 331.23 beyond current state and federal requirements. 331.24 Subd. 3. [CONSUMER SURVEYS.] Following identification of 331.25 the quality measurement tool, the commissioner of human services 331.26 shall conduct surveys of long-term care service consumers to 331.27 develop quality profiles of providers. To the extent possible, 331.28 surveys must be conducted face-to-face by state employees or 331.29 contractors. At the discretion of the commissioner, surveys may 331.30 be conducted by telephone or by provider staff. Surveys must be 331.31 conducted periodically to update quality profiles of individual 331.32 service providers. 331.33 Subd. 4. [DISSEMINATION OF QUALITY PROFILES.] By July 1, 331.34 2002, the commissioner of human services shall implement a 331.35 system to disseminate the quality profiles developed from 331.36 consumer surveys using the quality measurement tools. Profiles 332.1 must be disseminated to consumers, providers, and purchasers of 332.2 long-term care services through all feasible printed and 332.3 electronic outlets. The commissioner shall conduct a public 332.4 awareness campaign to inform potential users regarding profile 332.5 contents and potential uses. 332.6 Sec. 19. Minnesota Statutes 2000, section 256B.5012, 332.7 subdivision 3, is amended to read: 332.8 Subd. 3. [PROPERTY PAYMENT RATE.] (a) The property payment 332.9 rate effective October 1, 2000, is based on the facility's 332.10 modified property payment rate in effect on September 30, 2000. 332.11 The modified property payment rate is the actual property 332.12 payment rate exclusive of the effect of gains or losses on 332.13 disposal of capital assets or adjustments for excess 332.14 depreciation claims. Effective October 1, 2000, a facility 332.15 minimum property rate of $8.13 shall be applied to all existing 332.16 ICF/MR facilities. Facilities with a modified property payment 332.17 rate effective September 30, 2000, which is below the minimum 332.18 property rate shall receive an increase effective October 1, 332.19 2000, equal to the difference between the minimum property 332.20 payment rate and the modified property payment rate in effect as 332.21 of September 30, 2000. Facilities with a modified property 332.22 payment rate at or above the minimum property payment rate 332.23 effective September 30, 2000, shall receive the modified 332.24 property payment rate effective October 1, 2000. 332.25 (b)Within the limits of appropriations specifically for332.26this purpose,Facility property payment rates shall be increased 332.27 annually for inflation, effective January 1, 2002. The increase 332.28 shall be based on each facility's property payment rate in 332.29 effect on September 30, 2000. Modified property payment rates 332.30 effective September 30, 2000, shall be arrayed from highest to 332.31 lowest before applying the minimum property payment rate in 332.32 paragraph (a). For modified property payment rates at the 90th 332.33 percentile or above, the annual inflation increase shall be 332.34 zero. For modified property payment rates below the 90th 332.35 percentile but equal to or above the 75th percentile, the annual 332.36 inflation increase shall be one percent. For modified property 333.1 payment rates below the 75th percentile, the annual inflation 333.2 increase shall be two percent. 333.3 Sec. 20. Minnesota Statutes 2000, section 256B.5012, is 333.4 amended by adding a subdivision to read: 333.5 Subd. 4. [ICF/MR RATE INCREASES BEGINNING JULY 1, 2001, 333.6 AND JULY 1, 2002.] (a) For the rate years beginning July 1, 333.7 2001, and July 1, 2002, the commissioner shall make available to 333.8 each facility reimbursed under this section an adjustment to the 333.9 total operating payment rate of 3.5 percent. Of this 333.10 adjustment, 3.0 percentage points must be used to provide an 333.11 employee wage increase as provided under paragraph (b) and 0.5 333.12 percentage points must be used for operating costs. 333.13 (b) The adjustment under this paragraph must be used to 333.14 increase the wages of all employees except administrative and 333.15 central office employees and to pay associated costs for FICA, 333.16 the Medicare tax, workers' compensation premiums, and federal 333.17 and state unemployment insurance, provided that this increase 333.18 must be used only for wage increases implemented on or after the 333.19 first day of the rate year and must not be used for wage 333.20 increases implemented prior to that date. 333.21 (c) For each facility, the commissioner shall make 333.22 available an adjustment using the percentage specified in 333.23 paragraph (a) multiplied by the total payment rate, excluding 333.24 the property-related payment rate, in effect on the preceding 333.25 June 30. The total payment rate shall include the adjustment 333.26 provided in section 256B.501, subdivision 12. 333.27 (d) A facility whose payment rates are governed by closure 333.28 agreements, receivership agreements, or Minnesota Rules, part 333.29 9553.0075, is not eligible for an adjustment otherwise granted 333.30 under this subdivision. 333.31 (e) A facility may apply for the wage-related payment rate 333.32 adjustment provided under paragraph (b). The application must 333.33 be made to the commissioner and contain a plan by which the 333.34 facility will distribute the wage-related portion of the payment 333.35 rate adjustment to employees of the facility. For facilities in 333.36 which the employees are represented by an exclusive bargaining 334.1 representative, an agreement negotiated and agreed to by the 334.2 employer and the exclusive bargaining representative constitutes 334.3 the plan. A negotiated agreement may constitute the plan only 334.4 if the agreement is finalized after the date of enactment of all 334.5 rate increases for the rate year. The commissioner shall review 334.6 the plan to ensure that the payment rate adjustment per diem is 334.7 used as provided in this subdivision. To be eligible, a 334.8 facility must submit its plan by March 31, 2002, and March 31, 334.9 2003, respectively. If a facility's plan is effective for its 334.10 employees after the first day of the applicable rate year that 334.11 the funds are available, the payment rate adjustment per diem is 334.12 effective the same date as its plan. 334.13 (f) A copy of the approved distribution plan must be made 334.14 available to all employees by giving each employee a copy or by 334.15 posting it in an area of the facility to which all employees 334.16 have access. If an employee does not receive the wage 334.17 adjustment described in the facility's approved plan and is 334.18 unable to resolve the problem with the facility's management or 334.19 through the employee's union representative, the employee may 334.20 contact the commissioner at an address or telephone number 334.21 provided by the commissioner and included in the approved plan. 334.22 Sec. 21. Minnesota Statutes 2000, section 626.557, 334.23 subdivision 12b, is amended to read: 334.24 Subd. 12b. [DATA MANAGEMENT.] (a) [COUNTY DATA.] In 334.25 performing any of the duties of this section as a lead agency, 334.26 the county social service agency shall maintain appropriate 334.27 records. Data collected by the county social service agency 334.28 under this section are welfare data under section 13.46. 334.29 Notwithstanding section 13.46, subdivision 1, paragraph (a), 334.30 data under this paragraph that are inactive investigative data 334.31 on an individual who is a vendor of services are private data on 334.32 individuals, as defined in section 13.02. The identity of the 334.33 reporter may only be disclosed as provided in paragraph (c). 334.34 Data maintained by the common entry point are confidential 334.35 data on individuals or protected nonpublic data as defined in 334.36 section 13.02. Notwithstanding section 138.163, the common 335.1 entry point shall destroy data three calendar years after date 335.2 of receipt. 335.3 (b) [LEAD AGENCY DATA.] The commissioners of health and 335.4 human services shall prepare an investigation memorandum for 335.5 each report alleging maltreatment investigated under this 335.6 section. During an investigation by the commissioner of health 335.7 or the commissioner of human services, data collected under this 335.8 section are confidential data on individuals or protected 335.9 nonpublic data as defined in section 13.02. Upon completion of 335.10 the investigation, the data are classified as provided in 335.11 clauses (1) to (3) and paragraph (c). 335.12 (1) The investigation memorandum must contain the following 335.13 data, which are public: 335.14 (i) the name of the facility investigated; 335.15 (ii) a statement of the nature of the alleged maltreatment; 335.16 (iii) pertinent information obtained from medical or other 335.17 records reviewed; 335.18 (iv) the identity of the investigator; 335.19 (v) a summary of the investigation's findings; 335.20 (vi) statement of whether the report was found to be 335.21 substantiated, inconclusive, false, or that no determination 335.22 will be made; 335.23 (vii) a statement of any action taken by the facility; 335.24 (viii) a statement of any action taken by the lead agency; 335.25 and 335.26 (ix) when a lead agency's determination has substantiated 335.27 maltreatment, a statement of whether an individual, individuals, 335.28 or a facility were responsible for the substantiated 335.29 maltreatment, if known. 335.30 The investigation memorandum must be written in a manner 335.31 which protects the identity of the reporter and of the 335.32 vulnerable adult and may not contain the names or, to the extent 335.33 possible, data on individuals or private data listed in clause 335.34 (2). 335.35 (2) Data on individuals collected and maintained in the 335.36 investigation memorandum are private data, including: 336.1 (i) the name of the vulnerable adult; 336.2 (ii) the identity of the individual alleged to be the 336.3 perpetrator; 336.4 (iii) the identity of the individual substantiated as the 336.5 perpetrator; and 336.6 (iv) the identity of all individuals interviewed as part of 336.7 the investigation. 336.8 (3) Other data on individuals maintained as part of an 336.9 investigation under this section are private data on individuals 336.10 upon completion of the investigation. 336.11 (c) [IDENTITY OF REPORTER.] The subject of the report may 336.12 compel disclosure of the name of the reporter only with the 336.13 consent of the reporter or upon a written finding by a court 336.14 that the report was false and there is evidence that the report 336.15 was made in bad faith. This subdivision does not alter 336.16 disclosure responsibilities or obligations under the rules of 336.17 criminal procedure, except that where the identity of the 336.18 reporter is relevant to a criminal prosecution, the district 336.19 court shall do an in-camera review prior to determining whether 336.20 to order disclosure of the identity of the reporter. 336.21 (d) [DESTRUCTION OF DATA.] Notwithstanding section 336.22 138.163, data maintained under this section by the commissioners 336.23 of health and human services must be destroyed under the 336.24 following schedule: 336.25 (1) data from reports determined to be false, two years 336.26 after the finding was made; 336.27 (2) data from reports determined to be inconclusive, four 336.28 years after the finding was made; 336.29 (3) data from reports determined to be substantiated, seven 336.30 years after the finding was made; and 336.31 (4) data from reports which were not investigated by a lead 336.32 agency and for which there is no final disposition, two years 336.33 from the date of the report. 336.34 (e) [SUMMARY OF REPORTS.] The commissioners of health and 336.35 human services shall each annuallyprepare a summary ofreport 336.36 to the legislature and the governor on the number and type of 337.1 reports of alleged maltreatment involving licensed facilities 337.2 reported under this section, the number of those requiring 337.3 investigation under this section, and the resolution of those 337.4 investigations. The report shall identify: 337.5 (1) whether and where backlogs of cases result in a failure 337.6 to conform with statutory time frames; 337.7 (2) where adequate coverage requires additional 337.8 appropriations and staffing; and 337.9 (3) any other trends that affect the safety of vulnerable 337.10 adults. 337.11 (f) [RECORD RETENTION POLICY.] Each lead agency must have 337.12 a record retention policy. 337.13 (g) [EXCHANGE OF INFORMATION.] Lead agencies, prosecuting 337.14 authorities, and law enforcement agencies may exchange not 337.15 public data, as defined in section 13.02, if the agency or 337.16 authority requesting the data determines that the data are 337.17 pertinent and necessary to the requesting agency in initiating, 337.18 furthering, or completing an investigation under this section. 337.19 Data collected under this section must be made available to 337.20 prosecuting authorities and law enforcement officials, local 337.21 county agencies, and licensing agencies investigating the 337.22 alleged maltreatment under this section. The lead agency shall 337.23 exchange not public data with the vulnerable adult maltreatment 337.24 review panel established in section 256.021 if the data are 337.25 pertinent and necessary for a review requested under that 337.26 section. Upon completion of the review, not public data 337.27 received by the review panel must be returned to the lead agency. 337.28 (h) [COMPLETION TIME.] Each lead agency shall keep records 337.29 of the length of time it takes to complete its investigations. 337.30 (i) [NOTIFICATION OF OTHER AFFECTED PARTIES.] A lead 337.31 agency may notify other affected parties and their authorized 337.32 representative if the agency has reason to believe maltreatment 337.33 has occurred and determines the information will safeguard the 337.34 well-being of the affected parties or dispel widespread rumor or 337.35 unrest in the affected facility. 337.36 (j) [FEDERAL REQUIREMENTS.] Under any notification 338.1 provision of this section, where federal law specifically 338.2 prohibits the disclosure of patient identifying information, a 338.3 lead agency may not provide any notice unless the vulnerable 338.4 adult has consented to disclosure in a manner which conforms to 338.5 federal requirements. 338.6 Sec. 22. Laws 1999, chapter 245, article 3, section 45, as 338.7 amended by Laws 2000, chapter 312, section 3, is amended to read: 338.8 Sec. 45. [STATE LICENSURE CONFLICTS WITH FEDERAL 338.9 REGULATIONS.] 338.10 (a) Notwithstanding the provisions of Minnesota Rules, part 338.11 4658.0520, an incontinent resident must be checked according to 338.12 a specific time interval written in the resident's care plan. 338.13 The resident's attending physician must authorize in writing any 338.14 interval longer than two hours unless the resident, if 338.15 competent, or a family member or legally appointed conservator, 338.16 guardian, or health care agent of a resident who is not 338.17 competent, agrees in writing to waive physician involvement in 338.18 determining this interval. 338.19 (b) This section expires July 1,20012003. 338.20 Sec. 23. Laws 2000, chapter 364, section 2, is amended to 338.21 read: 338.22 Sec. 2. [MORATORIUM EXCEPTION PROCESS.] 338.23 Forfiscal yearthe biennium beginning July 1,20002001, 338.24 when approving nursing home moratorium exception projects under 338.25 Minnesota Statutes, section 144A.073, the commissioner of health 338.26 shall give priority toproposalsa proposal to build a 338.27 replacementfacilitiesfacility in the city of Anoka or within 338.28 ten miles of the city of Anoka. 338.29 Sec. 24. [DEVELOPMENT OF NEW NURSING FACILITY 338.30 REIMBURSEMENT SYSTEM.] 338.31 (a) The commissioner of human services shall develop and 338.32 report to the legislature by January 15, 2003, a system to 338.33 replace the current nursing facility reimbursement system 338.34 established under Minnesota Statutes, sections 256B.431, 338.35 256B.434, and 256B.435. 338.36 (b) The system must be developed in consultation with the 339.1 long-term care task force and with representatives of consumers, 339.2 providers, and labor unions. Within the limits of available 339.3 appropriations, the commissioner may employ consultants to 339.4 assist with this project. 339.5 (c) The new reimbursement system must: 339.6 (1) provide incentives to enhance quality of life and 339.7 quality of care; 339.8 (2) recognize cost differences in the care of different 339.9 types of populations, including subacute care and dementia care; 339.10 (3) establish rates that are sufficient without being 339.11 excessive; 339.12 (4) be affordable for the state and for private-pay 339.13 residents; 339.14 (5) be sensitive to changing conditions in the long-term 339.15 care environment; 339.16 (6) avoid creating access problems related to insufficient 339.17 funding; 339.18 (7) allow providers maximum flexibility in their business 339.19 operations; and 339.20 (8) recognize the need for capital investment to improve 339.21 physical plants. 339.22 (d) Notwithstanding Minnesota Statutes, section 256B.435, 339.23 the commissioner must not implement a performance-based 339.24 contracting system for nursing facilities prior to July 1, 2003. 339.25 The commissioner shall continue to reimburse nursing facilities 339.26 under Minnesota Statutes, section 256B.431 or 256B.434, until 339.27 otherwise directed by law. 339.28 Sec. 25. [MINIMUM STAFFING STANDARDS REPORT.] 339.29 By January 15, 2002, the commissioner of health and the 339.30 commissioner of human services shall report to the legislature 339.31 on whether they should translate the minimum nurse staffing 339.32 requirement in Minnesota Statutes, section 144A.04, subdivision 339.33 7, paragraph (a), upon the transition to the RUG-III 339.34 classification system, or whether they should establish 339.35 different time-based standards, and how to accomplish either. 339.36 Sec. 26. [TIME MOTION STUDY.] 340.1 (a) The commissioner of human services shall conduct a time 340.2 motion study to determine the amount of time devoted to the care 340.3 of high-need nursing facility residents, including, but not 340.4 limited to, persons with Alzheimer's disease and other 340.5 dementias, persons with multiple sclerosis, and persons with 340.6 mental illness. 340.7 (b) The commissioner shall report the results of the study 340.8 to the legislature by January 15, 2003, with an analysis of 340.9 whether these costs are adequately reimbursed under the current 340.10 reimbursement system and with recommendations for adjusting 340.11 nursing facility reimbursement rates as necessary to account for 340.12 these costs. 340.13 Sec. 27. [PROVIDER RATE INCREASES.] 340.14 (a) The commissioner of human services shall increase 340.15 reimbursement rates by 3.5 percent each year of the biennium for 340.16 the providers listed in paragraph (b). The increases are 340.17 effective for services rendered on or after July 1 of each year. 340.18 (b) The rate increases described in this section must be 340.19 provided to home and community-based waivered services for: 340.20 (1) persons with mental retardation or related conditions 340.21 under Minnesota Statutes, section 256B.501; 340.22 (2) home and community-based waivered services for the 340.23 elderly under Minnesota Statutes, section 256B.0915; 340.24 (3) waivered services under community alternatives for 340.25 disabled individuals under Minnesota Statutes, section 256B.49; 340.26 (4) community alternative care waivered services under 340.27 Minnesota Statutes, section 256B.49; 340.28 (5) traumatic brain injury waivered services under 340.29 Minnesota Statutes, section 256B.49; 340.30 (6) nursing services and home health services under 340.31 Minnesota Statutes, section 256B.0625, subdivision 6a; 340.32 (7) personal care services and nursing supervision of 340.33 personal care services under Minnesota Statutes, section 340.34 256B.0625, subdivision 19a; 340.35 (8) private duty nursing services under Minnesota Statutes, 340.36 section 256B.0625, subdivision 7; 341.1 (9) day training and habilitation services for adults with 341.2 mental retardation or related conditions under Minnesota 341.3 Statutes, sections 252.40 to 252.46; 341.4 (10) alternative care services under Minnesota Statutes, 341.5 section 256B.0913; 341.6 (11) adult residential program grants under Minnesota 341.7 Rules, parts 9535.2000 to 9535.3000; 341.8 (12) adult and family community support grants under 341.9 Minnesota Rules, parts 9535.1700 to 9535.1760; 341.10 (13) the group residential housing supplementary service 341.11 rate under Minnesota Statutes, section 256I.05, subdivision 1a; 341.12 (14) adult mental health integrated fund grants under 341.13 Minnesota Statutes, section 245.4661; 341.14 (15) semi-independent living services under Minnesota 341.15 Statutes, section 252.275, including SILS funding under county 341.16 social services grants formerly funded under Minnesota Statutes, 341.17 chapter 256I; 341.18 (16) community support services for deaf and 341.19 hard-of-hearing adults with mental illness who use or wish to 341.20 use sign language as their primary means of communication; and 341.21 (17) living skills training programs for persons with 341.22 intractable epilepsy who need assistance in the transition to 341.23 independent living. 341.24 (c) Providers that receive a rate increase under this 341.25 section shall use 0.5 percentage points of the additional 341.26 revenue for operating cost increases and 3.0 percentage points 341.27 of the additional revenue to increase wages for all employees 341.28 other than the administrator and central office staff and to pay 341.29 associated costs for FICA, the Medicare tax, workers' 341.30 compensation premiums, and federal and state unemployment 341.31 insurance. For public employees, the portion of this increase 341.32 reserved to increase wages for certain staff is available and 341.33 pay rates shall be increased only to the extent that they comply 341.34 with laws governing public employees collective bargaining. 341.35 Money received by a provider for pay increases under this 341.36 section must be used only for wage increases implemented on or 342.1 after the first day of the state fiscal year in which the 342.2 increase is available and must not be used for wage increases 342.3 implemented prior to that date. 342.4 (d) A copy of the provider's plan for complying with 342.5 paragraph (c) must be made available to all employees by giving 342.6 each employee a copy or by posting it in an area of the 342.7 provider's operation to which all employees have access. If an 342.8 employee does not receive the wage adjustment described in the 342.9 plan and is unable to resolve the problem with the provider, the 342.10 employee may contact the employee's union representative. If 342.11 the employee is not covered by a collective bargaining 342.12 agreement, the employee may contact the commissioner at a phone 342.13 number provided by the commissioner and included in the 342.14 provider's plan. 342.15 Sec. 28. [REGULATORY FLEXIBILITY.] 342.16 (a) By July 1, 2001, the commissioners of health and human 342.17 services shall: 342.18 (1) develop a summary of federal nursing facility and 342.19 community long-term care regulations that hamper state 342.20 flexibility and place burdens on the goal of achieving 342.21 high-quality care and optimum outcomes for consumers of 342.22 services; and 342.23 (2) share this summary with the legislature, other states, 342.24 national groups that advocate for state interests with Congress, 342.25 and the Minnesota congressional delegation. 342.26 (b) The commissioners shall conduct ongoing follow-up with 342.27 the entities to which this summary is provided and with the 342.28 health care financing administration to achieve maximum 342.29 regulatory flexibility, including the possibility of pilot 342.30 projects to demonstrate regulatory flexibility on less than a 342.31 statewide basis. 342.32 [EFFECTIVE DATE.] This section is effective the day 342.33 following final enactment. 342.34 Sec. 29. [REPORT.] 342.35 By January 15, 2003, the commissioner of health and the 342.36 commissioner of human services shall report to the senate health 343.1 and family security committee and the house health and human 343.2 services policy committee on the number of closures that have 343.3 taken place under this article, alternatives to nursing facility 343.4 care that have been developed, any problems with access to 343.5 long-term care services that have resulted, and any 343.6 recommendations for continuation of the regional long-term care 343.7 planning process and the closure process after June 30, 2003. 343.8 Sec. 30. [REVISOR INSTRUCTION.] 343.9 The revisor of statutes shall delete any reference to 343.10 Minnesota Statutes, section 144A.16, in Minnesota Statutes and 343.11 Minnesota Rules. 343.12 Sec. 31. [REPEALER.] 343.13 (a) Minnesota Statutes 2000, sections 144A.16; and 343.14 256B.434, subdivision 5, are repealed. 343.15 (b) Minnesota Rules, parts 4655.6810; 4655.6820; 4655.6830; 343.16 4658.1600; 4658.1605; 4658.1610; 4658.1690; 9546.0010; 343.17 9546.0020; 9546.0030; 9546.0040; 9546.0050; and 9546.0060, are 343.18 repealed. 343.19 ARTICLE 6 343.20 WORKFORCE RECRUITMENT AND RETENTION 343.21 Section 1. Minnesota Statutes 2000, section 116L.11, 343.22 subdivision 4, is amended to read: 343.23 Subd. 4. [QUALIFYING CONSORTIUM.] "Qualifying consortium" 343.24 means an entity thatmay includeincludes a public or private 343.25 institution of higher education, work force center, county,and 343.26 oneor moreeligibleemployers, but must include a public or343.27private institution of higher education and one or more eligible343.28employersemployer. 343.29 Sec. 2. Minnesota Statutes 2000, section 116L.12, 343.30 subdivision 4, is amended to read: 343.31 Subd. 4. [GRANTS.] Within the limits of available 343.32 appropriations, the board shall make grants not to exceed 343.33 $400,000 each to qualifying consortia to operate local, 343.34 regional, or statewide training and retention programs. Grants 343.35 may be made from TANF funds, general fund appropriations, and 343.36 any other funding sources available to the board, provided the 344.1 requirements of those funding sources are satisfied. Grant 344.2 awards must establish specific, measurable outcomes and 344.3 timelines for achieving those outcomes. 344.4 Sec. 3. Minnesota Statutes 2000, section 116L.12, 344.5 subdivision 5, is amended to read: 344.6 Subd. 5. [LOCAL MATCH REQUIREMENTS.] A consortium must 344.7provide at least a 50 percent match from local resources for344.8money appropriated under this section. The local match344.9requirement must be satisfied on an overall program basis but344.10need not be satisfied for each particular client. The local344.11match requirement may be reduced for consortia that include a344.12relatively large number of small employers whose financial344.13contribution has been reduced in accordance with section 116L.15.344.14In-kind services and expenditures under section 116L.13,344.15subdivision 2, may be used to meet this local match344.16requirement. The grant application must specify the financial344.17contribution from each member of the consortiumsatisfy the 344.18 match requirements established in section 116L.02, paragraph (a). 344.19 Sec. 4. Minnesota Statutes 2000, section 116L.13, 344.20 subdivision 1, is amended to read: 344.21 Subdivision 1. [MARKETING AND RECRUITMENT.] A qualifying 344.22 consortium must implement a marketing and outreach strategy to 344.23 recruit into the health care and human services fields persons 344.24 from one or more of the potential employee target groups. 344.25 Recruitment strategies must include: 344.26 (1) a screening process to evaluate whether potential 344.27 employees may be disqualified as the result of a required 344.28 background check or are otherwise unlikely to succeed in the 344.29 position for which they are being recruited; and 344.30 (2) a process for modifying course work to meet the 344.31 training needs of non-English-speaking persons, when appropriate. 344.32 Sec. 5. [116L.146] [EXPEDITED GRANT PROCESS.] 344.33 (a) The board may authorize grants not to exceed $50,000 344.34 each through an expedited grant approval process to: 344.35 (1) eligible employers to provide training programs for up 344.36 to 50 workers; or 345.1 (2) a public or private institution of higher education to: 345.2 (i) do predevelopment or curriculum development for 345.3 training programs prior to submission for program funding under 345.4 section 116L.12; 345.5 (ii) convert an existing curriculum for distance learning 345.6 through interactive television or other communication methods; 345.7 or 345.8 (iii) enable a training program to be offered when it would 345.9 otherwise be canceled due to an enrollment shortfall of one or 345.10 two students when the program is offered in a health-related 345.11 field with a documented worker shortage and is part of a 345.12 training program not exceeding two years in length. 345.13 (b) The board shall develop application procedures and 345.14 evaluation policies for grants made under this section. 345.15 Sec. 6. [256.956] [LONG-TERM CARE EMPLOYEE HEALTH 345.16 INSURANCE ASSISTANCE PROGRAM.] 345.17 Subdivision 1. [DEFINITIONS.] (a) For the purpose of this 345.18 section, the definitions have the meanings given them. 345.19 (b) "Commissioner" means the commissioner of human services. 345.20 (c) "Dependent" means an unmarried child who is under the 345.21 age of 19 years. For the purpose of this definition, a 345.22 dependent includes a child for whom an eligible employee or an 345.23 eligible employee's spouse has been appointed legal guardian or 345.24 an adopted child as defined under section 62A.27. A dependent 345.25 does not include: 345.26 (1) a child of an eligible employee who is eligible for 345.27 health coverage through medical assistance without a spenddown 345.28 or through an employer-subsidized health plan where an employer 345.29 other than the employer of the eligible employee pays at least 345.30 50 percent of the cost of coverage for the child; or 345.31 (2) a child of an eligible employee who is excluded from 345.32 coverage under title XXI of the Social Security Act, United 345.33 States Code, title 42, section 1397aa et seq. 345.34 (d) "Eligible employee" means an individual employed for at 345.35 least 20 hours by an employer in a position other than as an 345.36 administrator or in the central office. An "employee" does not 346.1 include an individual who: 346.2 (1) works on a temporary or substitute basis; 346.3 (2) is hired as an independent contractor; or 346.4 (3) is a state employee. 346.5 (e) "Employer" means any of the following: 346.6 (1) a nursing facility reimbursed under section 256B.431 or 346.7 256B.434; 346.8 (2) a facility reimbursed under sections 256B.501 and 346.9 256B.5011 and Laws 1993, First Special Session chapter 1, 346.10 article 4, section 11; or 346.11 (3) a provider who meets the following requirements: 346.12 (i) provides home and community-based waivered services for 346.13 persons with mental retardation or related conditions under 346.14 section 256B.501; home and community-based waivered services for 346.15 the elderly under section 256B.0915; waivered services under 346.16 community alternatives for disabled individuals under section 346.17 256B.49; community alternative care waivered services under 346.18 section 256B.49; traumatic brain injury waivered services under 346.19 section 256B.49; nursing services and home health services under 346.20 section 256B.0625, subdivision 6a; personal care services and 346.21 nursing supervision of personal care services under section 346.22 256B.0625, subdivision 19a; private duty nursing services under 346.23 section 256B.0625, subdivision 7; day training and habilitation 346.24 services for adults with mental retardation or related 346.25 conditions under sections 252.40 to 252.46; alternative care 346.26 services under section 256B.0913; adult residential program 346.27 grants under Minnesota Rules, parts 9535.2000 to 9535.3000; 346.28 adult and family community support grants under Minnesota Rules, 346.29 parts 9535.1700 to 9535.1760; semi-independent living services 346.30 under section 252.275, including SILS funding under county 346.31 social services grants formerly funded under chapter 256I; 346.32 community support services for deaf and hard-of-hearing adults 346.33 with mental illness who use or wish to use sign language as 346.34 their primary means of communication; or living skills training 346.35 programs for persons with intractable epilepsy who need 346.36 assistance in the transition to independent living; and 347.1 (ii) the revenue received by the provider from medical 347.2 assistance that equals or exceeds 20 percent of the total 347.3 revenue received by the provider from all payment sources. 347.4 Employer includes both for-profit and nonprofit entities. 347.5 (f) "Program" means the long-term care employee health 347.6 insurance assistance program. 347.7 Subd. 2. [PROGRAM.] (a) The commissioner shall establish 347.8 and administer the long-term care employee health insurance 347.9 assistance program to provide the advantages of pooling for the 347.10 purchase of health coverage for long-term care employers. 347.11 (b) The commissioner shall solicit bids from health 347.12 maintenance organizations licensed under chapter 62D to provide 347.13 health coverage to the dependents of eligible employees. Health 347.14 maintenance organizations shall submit proposals in good faith 347.15 that meet the requirements of the request for proposal from the 347.16 commissioner, provided that the requirements can reasonably be 347.17 met by the health maintenance organization. Coverage shall be 347.18 offered on a guaranteed-issue and renewal basis. No health 347.19 maintenance organization is required to provide coverage to an 347.20 eligible employee's dependent who does not reside within the 347.21 health maintenance organization's approved service area. 347.22 (c) The commissioner shall, consistent with the provisions 347.23 of this section, determine coverage options, premium 347.24 arrangements, contractual arrangements, and all other matters 347.25 necessary to administer the program. 347.26 (d) The commissioner may extend the program to include 347.27 coverage for the eligible employee and noneligible employee. 347.28 The cost of coverage for these employees shall be the 347.29 responsibility of the employer or employee. In determining 347.30 whether to extend the program to include coverage for the 347.31 employees, the commissioner shall evaluate the feasibility of 347.32 the state establishing a stop-loss insurance fund for the 347.33 purpose of lowering the cost of premiums for the employees. 347.34 (e) The commissioner shall consult with representatives of 347.35 the long-term care industry on issues related to the 347.36 administration of the program. 348.1 Subd. 3. [EMPLOYER REQUIREMENTS.] (a) All employers may 348.2 participate in the program subject to the requirements of this 348.3 section. The commissioner shall establish procedures for an 348.4 employer to apply for coverage through this program. These 348.5 procedures may include requiring eligible employees to provide 348.6 relevant financial information to determine the eligibility of 348.7 their dependents. 348.8 (b) A participating employer must offer dependent coverage 348.9 to all employees. For purposes of this paragraph, dependent 348.10 includes the children excluded under subdivision 1, paragraph 348.11 (c). 348.12 (c) The participating employer must provide to the 348.13 commissioner any employee information deemed necessary by the 348.14 commissioner to determine eligibility and premium payments and 348.15 must notify the commissioner upon a change in an employee's or 348.16 an employee's dependent's eligibility. 348.17 (d) The initial term of the employer's coverage must be for 348.18 at least one year but may be made automatically renewable from 348.19 term to term in the absence of notice of termination by either 348.20 the employer or the commissioner. 348.21 Subd. 4. [INDIVIDUAL ELIGIBILITY.] (a) The commissioner 348.22 may require a probationary period for new employees of no more 348.23 than 90 days before the dependents of a new employee become 348.24 eligible for coverage through the program. 348.25 (b) A participating employer may elect to offer coverage 348.26 through the program to: 348.27 (1) the eligible and noneligible employees, if the program 348.28 is extended by the commissioner to include these individuals; 348.29 (2) children of eligible and noneligible employees who are 348.30 under the age of 25 years and who are full-time students; and 348.31 (3) the spouses of eligible and noneligible employees. 348.32 The cost of coverage for the individuals described in this 348.33 paragraph, the dependents of noneligible employees, and any 348.34 child of an eligible or noneligible employee who is not 348.35 considered a dependent in accordance with subdivision 1, 348.36 paragraph (c), shall be the responsibility of the employer or 349.1 employee. 349.2 (c) The commissioner may require a certain percentage of 349.3 participation of the individuals described in paragraph (b) 349.4 before coverage can be offered through the program. 349.5 Subd. 5. [COVERAGE.] (a) The health plan offered must meet 349.6 all applicable requirements of chapters 62A and 62D and sections 349.7 62J.71 to 62J.73; 62M.01 to 62M.16; 62Q.1055; 62Q.106; 62Q.12; 349.8 62Q.135; 62Q.14; 62Q.145; 62Q.19; 62Q.23; 62Q.43; 62Q.47; 62Q.52 349.9 to 62Q.58; and 62Q.68 to 62Q.73. 349.10 (b) The health plan offered must meet all underwriting 349.11 requirements of chapter 62L and must provide periodic open 349.12 enrollments for eligible employees where a choice in coverage 349.13 exists. 349.14 (c) The commissioner shall establish the benefits to be 349.15 provided under this program in accordance with the following: 349.16 (1) the benefits provided must comply with title XXI of the 349.17 Social Security Act, United States Code, title 42, section 349.18 1397aa et seq., and be at least equivalent to the lowest 349.19 benchmark allowable under title XXI; 349.20 (2) preventive and restorative dental services must be 349.21 included; and 349.22 (3) except for a $20 copay per visit for emergency care, 349.23 there shall be no deductibles, copayments, or coinsurance 349.24 requirements. 349.25 (d) The health plan requirements described in paragraph (c) 349.26 apply only to coverage offered to the dependents of eligible 349.27 employees. 349.28 Subd. 6. [PREMIUMS.] (a) The commissioner shall determine 349.29 premium rates and rating methods for the coverage offered 349.30 through the program. 349.31 (b) The commissioner shall pay the premiums for the 349.32 dependents of eligible employees directly to the health 349.33 maintenance organization. 349.34 (c) Payment of any remaining premiums must be collected by 349.35 the participating employer and paid directly to the health 349.36 maintenance organization. 350.1 (d) Any premiums paid by the state under this section are 350.2 not subject to taxes or surcharges imposed under chapter 297I, 350.3 chapter 295, or section 256.9657 and shall be excluded when 350.4 determining a health maintenance organization's total premium 350.5 under section 62E.11. 350.6 [EFFECTIVE DATE.] This section is effective January 15, 350.7 2003, or upon federal approval of a federal waiver to receive 350.8 enhanced matching funds under the state's children's health 350.9 insurance program, whichever occurs latest. 350.10 Sec. 7. Minnesota Statutes 2000, section 256B.431, is 350.11 amended by adding a subdivision to read: 350.12 Subd. 33. [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN 350.13 ENGLISH AS A SECOND LANGUAGE.] (a) For the rate year beginning 350.14 July 1, 2001, the commissioner shall provide to each nursing 350.15 facility reimbursed under this section, section 256B.434, or any 350.16 other section an adjustment of 25 cents to the total operating 350.17 payment rate to be used: 350.18 (1) for employee scholarships that satisfy the following 350.19 requirements: 350.20 (i) scholarships are available to all employees who work an 350.21 average of at least 20 hours per week at the facility except the 350.22 administrator, department supervisors, registered nurses, and 350.23 licensed practical nurses; and 350.24 (ii) the course of study is expected to lead to employment 350.25 in a health-related career, including medical care interpreter 350.26 services and social work; and 350.27 (2) to provide job-related training on the job site in 350.28 English as a second language. 350.29 (b) A facility receiving a rate adjustment under this 350.30 subdivision must report to the commissioner on a form supplied 350.31 by the commissioner the following information: the amount 350.32 received from this rate adjustment; the amount used for training 350.33 in English as a second language; the number of persons receiving 350.34 the training; the name of the person or entity providing the 350.35 training; and for each scholarship recipient, the name of the 350.36 recipient, the amount awarded, the educational institution 351.1 attended, the nature of the educational program, and the program 351.2 completion date. 351.3 (c) Amounts spent by a facility for scholarships or for 351.4 training in English as a second language that satisfy the 351.5 requirements of this subdivision shall be included in the 351.6 facility's total payment rates for the purposes of determining 351.7 future rates under this section, section 256B.434, or any other 351.8 section. 351.9 Sec. 8. Minnesota Statutes 2000, section 256B.5012, is 351.10 amended by adding a subdivision to read: 351.11 Subd. 5. [EMPLOYEE SCHOLARSHIP COSTS.] (a) For the rate 351.12 year beginning July 1, 2001, the commissioner shall provide to 351.13 each facility reimbursed under this section an adjustment of 25 351.14 cents to the total payment rate to be used: 351.15 (1) for employee scholarships that satisfy the following 351.16 requirements: 351.17 (i) scholarships are available to all employees who work an 351.18 average of at least 20 hours per week at the facility except the 351.19 administrator, department supervisors, registered nurses, and 351.20 licensed practical nurses; and 351.21 (ii) the course of study is expected to lead to employment 351.22 in a health-related career, including medical care interpreter 351.23 services and social work; and 351.24 (2) to provide job-related training on the job site in 351.25 English as a second language. 351.26 (b) A facility receiving a rate adjustment under this 351.27 subdivision must report to the commissioner on a form supplied 351.28 by the commissioner the following information: the amount 351.29 received from this rate adjustment; the amount used for training 351.30 in English as a second language; the number of persons receiving 351.31 the training; the name of the person or entity providing the 351.32 training; and for each scholarship recipient, the name of the 351.33 recipient, the amount awarded, the educational institution 351.34 attended, the nature of the educational program, and the program 351.35 completion date. 351.36 (c) Amounts spent by a facility for scholarships or for 352.1 training in English as a second language that satisfy the 352.2 requirements of this subdivision shall be included in the 352.3 facility's total payment rates for the purposes of determining 352.4 future rates under this section or any other section. 352.5 Sec. 9. Minnesota Statutes 2000, section 256L.07, 352.6 subdivision 2, is amended to read: 352.7 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 352.8 COVERAGE.] (a) To be eligible, a family or individual must not 352.9 have access to subsidized health coverage through an employer 352.10 and must not have had access to employer-subsidized coverage 352.11 through a current employer for 18 months prior to application or 352.12 reapplication. A family or individual whose employer-subsidized 352.13 coverage is lost due to an employer terminating health care 352.14 coverage as an employee benefit during the previous 18 months is 352.15 not eligible. 352.16 (b) For purposes of this requirement, subsidized health 352.17 coverage means health coverage for which the employer pays at 352.18 least 50 percent of the cost of coverage for the employee or 352.19 dependent, or a higher percentage as specified by the 352.20 commissioner. Children are eligible for employer-subsidized 352.21 coverage through either parent, including the noncustodial 352.22 parent. Children who are eligible for coverage under the 352.23 long-term care employee health insurance assistance program 352.24 established under section 256.956 are considered to have access 352.25 to subsidized health coverage under this subdivision. The 352.26 commissioner must treat employer contributions to Internal 352.27 Revenue Code Section 125 plans and any other employer benefits 352.28 intended to pay health care costs as qualified employer 352.29 subsidies toward the cost of health coverage for employees for 352.30 purposes of this subdivision. 352.31 [EFFECTIVE DATE.] This section is effective upon 352.32 implementation of Minnesota Statutes, section 256.956. 352.33 Sec. 10. [EMPLOYEE SCHOLARSHIP COSTS.] 352.34 (a) The commissioner of human services shall increase 352.35 reimbursement rates by .25 percent for the providers listed in 352.36 paragraph (d), effective for services rendered on or after July 353.1 1, 2001, to be used: 353.2 (1) for employee scholarships that satisfy the following 353.3 requirements: 353.4 (i) scholarships are available to all employees who work an 353.5 average of at least 20 hours per week at the facility except the 353.6 administrator, department supervisors, registered nurses, and 353.7 licensed practical nurses; and 353.8 (ii) the course of study is expected to lead to employment 353.9 in a health-related career, including medical care interpreter 353.10 services and social work; and 353.11 (2) to provide job-related training on the job site in 353.12 English as a second language. 353.13 (b) A provider receiving a rate adjustment under this 353.14 subdivision must report to the commissioner on a form supplied 353.15 by the commissioner the following information: the amount 353.16 received from this rate adjustment; the amount used for training 353.17 in English as a second language; the number of persons receiving 353.18 the training; the name of the person or entity providing the 353.19 training; and for each scholarship recipient, the name of the 353.20 recipient, the amount awarded, the educational institution 353.21 attended, the nature of the educational program, and the program 353.22 completion date. 353.23 (c) Amounts spent by a provider for scholarships or for 353.24 training in English as a second language that satisfy the 353.25 requirements of this section shall be included in the provider's 353.26 total payment rates for the purposes of determining future rates. 353.27 (d) The rate increases described in this section shall be 353.28 provided to home and community-based waivered services for 353.29 persons with mental retardation or related conditions under 353.30 Minnesota Statutes, section 256B.501; home and community-based 353.31 waivered services for the elderly under Minnesota Statutes, 353.32 section 256B.0915; waivered services under community 353.33 alternatives for disabled individuals under Minnesota Statutes, 353.34 section 256B.49; community alternative care waivered services 353.35 under Minnesota Statutes, section 256B.49; traumatic brain 353.36 injury waivered services under Minnesota Statutes, section 354.1 256B.49; nursing services and home health services under 354.2 Minnesota Statutes, section 256B.0625, subdivision 6a; personal 354.3 care services and nursing supervision of personal care services 354.4 under Minnesota Statutes, section 256B.0625, subdivision 19a; 354.5 private duty nursing services under Minnesota Statutes, section 354.6 256B.0625, subdivision 7; day training and habilitation services 354.7 for adults with mental retardation or related conditions under 354.8 Minnesota Statutes, sections 252.40 to 252.46; alternative care 354.9 services under Minnesota Statutes, section 256B.0913; adult 354.10 residential program grants under Minnesota Rules, parts 354.11 9535.2000 to 9535.3000; adult and family community support 354.12 grants under Minnesota Rules, parts 9535.1700 to 9535.1760; the 354.13 group residential housing supplementary service rate under 354.14 section 256I.05, subdivision 1a; adult mental health integrated 354.15 fund grants under Minnesota Statutes, section 245.4661; and 354.16 semi-independent living services under Minnesota Statutes, 354.17 section 252.275. 354.18 Sec. 11. [CHIP WAIVER.] 354.19 The commissioner of human services shall seek all waivers 354.20 necessary to obtain enhanced matching funds under the state 354.21 children's health insurance program established as title XXI of 354.22 the Social Security Act, United States Code, title 42, section 354.23 1397aa et seq. 354.24 [EFFECTIVE DATE.] This section is effective the day 354.25 following final enactment. 354.26 Sec. 12. [S-CHIP ALLOTMENT.] Upon implementation of 354.27 section 256.956, the commissioner shall claim eligible 354.28 expenditures against Minnesota's available funding under the 354.29 state children's health insurance program in the following order: 354.30 (1) expenditures made according to Minnesota Statutes, 354.31 section 256B.057, subdivision 8; 354.32 (2) expenditures for outreach and other state or local 354.33 expenditures that are authorized to be claimed under Laws 1998, 354.34 chapter 407, article 5, section 46; 354.35 (3) expenditures under the long-term care employee health 354.36 insurance assistance program; and 355.1 (4) expenditures that may be eligible for matching funds 355.2 under S-CHIP that otherwise may be claimed as Medicaid 355.3 expenditures. 355.4 [EFFECTIVE DATE.] This section is effective the day 355.5 following final enactment. 355.6 Sec. 13. [REPEALER.] 355.7 Minnesota Statutes 2000, section 116L.12, subdivisions 2 355.8 and 7, are repealed. 355.9 ARTICLE 7 355.10 REGULATION OF SUPPLEMENTAL 355.11 NURSING SERVICES AGENCIES 355.12 Section 1. Minnesota Statutes 2000, section 144.057, is 355.13 amended to read: 355.14 144.057 [BACKGROUND STUDIES ON LICENSEES AND SUPPLEMENTAL 355.15 NURSING SERVICES AGENCY PERSONNEL.] 355.16 Subdivision 1. [BACKGROUND STUDIES REQUIRED.] The 355.17 commissioner of health shall contract with the commissioner of 355.18 human services to conduct background studies of: 355.19 (1) individuals providing services which have direct 355.20 contact, as defined under section 245A.04, subdivision 3, with 355.21 patients and residents in hospitals, boarding care homes, 355.22 outpatient surgical centers licensed under sections 144.50 to 355.23 144.58; nursing homes and home care agencies licensed under 355.24 chapter 144A; residential care homes licensed under chapter 355.25 144B, and board and lodging establishments that are registered 355.26 to provide supportive or health supervision services under 355.27 section 157.17;and355.28 (2) beginning July 1, 1999, all other employees in nursing 355.29 homes licensed under chapter 144A, and boarding care homes 355.30 licensed under sections 144.50 to 144.58. A disqualification of 355.31 an individual in this section shall disqualify the individual 355.32 from positions allowing direct contact or access to patients or 355.33 residents receiving services; 355.34 (3) individuals employed by a supplemental nursing services 355.35 agency, as defined under section 144A.70, who are providing 355.36 services in health care facilities; and 356.1 (4) controlling persons of a supplemental nursing services 356.2 agency, as defined under section 144A.70. 356.3 If a facility or program is licensed by the department of 356.4 human services and subject to the background study provisions of 356.5 chapter 245A and is also licensed by the department of health, 356.6 the department of human services is solely responsible for the 356.7 background studies of individuals in the jointly licensed 356.8 programs. 356.9 Subd. 2. [RESPONSIBILITIES OF DEPARTMENT OF HUMAN 356.10 SERVICES.] The department of human services shall conduct the 356.11 background studies required by subdivision 1 in compliance with 356.12 the provisions of chapter 245A and Minnesota Rules, parts 356.13 9543.3000 to 9543.3090. For the purpose of this section, the 356.14 term "residential program" shall include all facilities 356.15 described in subdivision 1. The department of human services 356.16 shall provide necessary forms and instructions, shall conduct 356.17 the necessary background studies of individuals, and shall 356.18 provide notification of the results of the studies to the 356.19 facilities, supplemental nursing services agencies, individuals, 356.20 and the commissioner of health. Individuals shall be 356.21 disqualified under the provisions of chapter 245A and Minnesota 356.22 Rules, parts 9543.3000 to 9543.3090. If an individual is 356.23 disqualified, the department of human services shall notify the 356.24 facility, the supplemental nursing services agency, and the 356.25 individual and shall inform the individual of the right to 356.26 request a reconsideration of the disqualification by submitting 356.27 the request to the department of health. 356.28 Subd. 3. [RECONSIDERATIONS.] The commissioner of health 356.29 shall review and decide reconsideration requests, including the 356.30 granting of variances, in accordance with the procedures and 356.31 criteria contained in chapter 245A and Minnesota Rules, parts 356.32 9543.3000 to 9543.3090. The commissioner's decision shall be 356.33 provided to the individual and to the department of human 356.34 services. The commissioner's decision to grant or deny a 356.35 reconsideration of disqualification is the final administrative 356.36 agency action. 357.1 Subd. 4. [RESPONSIBILITIES OF FACILITIES AND AGENCIES.] 357.2 Facilities and agencies described in subdivision 1 shall be 357.3 responsible for cooperating with the departments in implementing 357.4 the provisions of this section. The responsibilities imposed on 357.5 applicants and licensees under chapter 245A and Minnesota Rules, 357.6 parts 9543.3000 to 9543.3090, shall apply to these 357.7 facilities and supplemental nursing services agencies. The 357.8 provision of section 245A.04, subdivision 3, paragraph (e), 357.9 shall apply to applicants, licensees, registrants, or an 357.10 individual's refusal to cooperate with the completion of the 357.11 background studies. Supplemental nursing services agencies 357.12 subject to the registration requirements in section 144A.71 must 357.13 maintain records verifying compliance with the background study 357.14 requirements under this section. 357.15 Sec. 2. [144A.70] [REGISTRATION OF SUPPLEMENTAL NURSING 357.16 SERVICES AGENCIES; DEFINITIONS.] 357.17 Subdivision 1. [SCOPE.] As used in sections 144A.70 to 357.18 144A.74, the terms defined in this section have the meanings 357.19 given them. 357.20 Subd. 2. [COMMISSIONER.] "Commissioner" means the 357.21 commissioner of health. 357.22 Subd. 3. [CONTROLLING PERSON.] "Controlling person" means 357.23 a business entity, officer, program administrator, or director 357.24 whose responsibilities include the direction of the management 357.25 or policies of a supplemental nursing services agency. 357.26 Controlling person also means an individual who, directly or 357.27 indirectly, beneficially owns an interest in a corporation, 357.28 partnership, or other business association that is a controlling 357.29 person. 357.30 Subd. 4. [HEALTH CARE FACILITY.] "Health care facility" 357.31 means a hospital, boarding care home, or outpatient surgical 357.32 center licensed under sections 144.50 to 144.58; a nursing home 357.33 or home care agency licensed under chapter 144A; a housing with 357.34 services establishment registered under chapter 144D; or a board 357.35 and lodging establishment that is registered to provide 357.36 supportive or health supervision services under section 157.17. 358.1 Subd. 5. [PERSON.] "Person" includes an individual, firm, 358.2 corporation, partnership, or association. 358.3 Subd. 6. [SUPPLEMENTAL NURSING SERVICES 358.4 AGENCY.] "Supplemental nursing services agency" means a person, 358.5 firm, corporation, partnership, or association engaged for hire 358.6 in the business of providing or procuring temporary employment 358.7 in health care facilities for nurses, nursing assistants, nurse 358.8 aides, and orderlies. Supplemental nursing services agency does 358.9 not include an individual who only engages in providing the 358.10 individual's services on a temporary basis to health care 358.11 facilities. Supplemental nursing services agency also does not 358.12 include any nursing service agency that is limited to providing 358.13 temporary nursing personnel solely to one or more health care 358.14 facilities owned or operated by the same person, firm, 358.15 corporation, or partnership. 358.16 Sec. 3. [144A.71] [SUPPLEMENTAL NURSING SERVICES AGENCY 358.17 REGISTRATION.] 358.18 Subdivision 1. [DUTY TO REGISTER.] A person who operates a 358.19 supplemental nursing services agency shall register the agency 358.20 with the commissioner. Each separate location of the business 358.21 of a supplemental nursing services agency shall register the 358.22 agency with the commissioner. Each separate location of the 358.23 business of a supplemental nursing services agency shall have a 358.24 separate registration. 358.25 Subd. 2. [APPLICATION INFORMATION AND FEE.] The 358.26 commissioner shall establish forms and procedures for processing 358.27 each supplemental nursing services agency registration 358.28 application. An application for a supplemental nursing services 358.29 agency registration must include at least the following: 358.30 (1) the names and addresses of the owner or owners of the 358.31 supplemental nursing services agency; 358.32 (2) if the owner is a corporation, copies of its articles 358.33 of incorporation and current bylaws, together with the names and 358.34 addresses of its officers and directors; 358.35 (3) any other relevant information that the commissioner 358.36 determines is necessary to properly evaluate an application for 359.1 registration; and 359.2 (4) the annual registration fee for a supplemental nursing 359.3 services agency, which is $891. 359.4 Subd. 3. [REGISTRATION NOT TRANSFERABLE.] A registration 359.5 issued by the commissioner according to this section is 359.6 effective for a period of one year from the date of its issuance 359.7 unless the registration is revoked or suspended under section 359.8 144A.72, subdivision 2, or unless the supplemental nursing 359.9 services agency is sold or ownership or management is 359.10 transferred. When a supplemental nursing services agency is 359.11 sold or ownership or management is transferred, the registration 359.12 of the agency must be voided and the new owner or operator may 359.13 apply for a new registration. 359.14 Sec. 4. [144A.72] [REGISTRATION REQUIREMENTS; PENALTIES.] 359.15 Subdivision 1. [MINIMUM CRITERIA.] The commissioner shall 359.16 require that, as a condition of registration: 359.17 (1) the supplemental nursing services agency shall document 359.18 that each temporary employee provided to health care facilities 359.19 currently meets the minimum licensing, training, and continuing 359.20 education standards for the position in which the employee will 359.21 be working; 359.22 (2) the supplemental nursing services agency shall comply 359.23 with all pertinent requirements relating to the health and other 359.24 qualifications of personnel employed in health care facilities; 359.25 (3) the supplemental nursing services agency must not 359.26 restrict in any manner the employment opportunities of its 359.27 employees; 359.28 (4) the supplemental nursing services agency, when 359.29 supplying temporary employees to a health care facility, and 359.30 when requested by the facility to do so, shall agree that at 359.31 least 30 percent of the total personnel hours supplied are 359.32 during night, holiday, or weekend shifts; 359.33 (5) the supplemental nursing services agency shall carry 359.34 medical malpractice insurance to insure against the loss, 359.35 damage, or expense incident to a claim arising out of the death 359.36 or injury of any person as the result of negligence or 360.1 malpractice in the provision of health care services by the 360.2 supplemental nursing services agency or by any employee of the 360.3 agency; and 360.4 (6) the supplemental nursing services agency must not, in 360.5 any contract with any employee or health care facility, require 360.6 the payment of liquidated damages, employment fees, or other 360.7 compensation should the employee be hired as a permanent 360.8 employee of a health care facility. 360.9 Subd. 2. [PENALTIES.] A pattern of failure to comply with 360.10 this section shall subject the supplemental nursing services 360.11 agency to revocation or nonrenewal of its registration. 360.12 Violations of section 144A.74 are subject to a fine equal to 200 360.13 percent of the amount billed or received in excess of the 360.14 maximum permitted under that section. 360.15 Sec. 5. [144A.73] [COMPLAINT SYSTEM.] 360.16 The commissioner shall establish a system for reporting 360.17 complaints against a supplemental nursing services agency or its 360.18 employees. Complaints may be made by any member of the public. 360.19 Written complaints must be forwarded to the employer of each 360.20 person against whom a complaint is made. The employer shall 360.21 promptly report to the commissioner any corrective action taken. 360.22 Sec. 6. [144A.74] [MAXIMUM CHARGES.] 360.23 A supplemental nursing services agency must not bill or 360.24 receive payments from a health care facility at a rate higher 360.25 than 150 percent of the average wage rate by employee 360.26 classification as identified by the commissioner of economic 360.27 security. The maximum rate must include all charges for 360.28 administrative fees, contract fees, or other special charges in 360.29 addition to the hourly rates for the temporary nursing pool 360.30 personnel supplied to a nursing home. 360.31 Sec. 7. [256B.039] [REPORTING OF SUPPLEMENTAL NURSING 360.32 SERVICES AGENCY USE.] 360.33 Beginning March 1, 2002, the commissioner shall to report 360.34 to the legislature annually on the use of supplemental nursing 360.35 services, including the number of hours worked by supplemental 360.36 nursing services agency personnel and payments to supplemental 361.1 nursing services agencies. 361.2 ARTICLE 8 361.3 LONG-TERM CARE INSURANCE 361.4 Section 1. Minnesota Statutes 2000, section 62A.48, 361.5 subdivision 4, is amended to read: 361.6 Subd. 4. [LOSS RATIO.] The anticipated loss ratio for 361.7 long-term care policies must not be less than 65 percent for 361.8 policies issued on a group basis or 60 percent for policies 361.9 issued on an individual or mass-market basis. This subdivision 361.10 does not apply to policies issued on or after January 1, 2002, 361.11 that comply with sections 62S.021 and 62S.081. 361.12 [EFFECTIVE DATE.] This section is effective the day 361.13 following final enactment. 361.14 Sec. 2. Minnesota Statutes 2000, section 62A.48, is 361.15 amended by adding a subdivision to read: 361.16 Subd. 10. [REGULATION OF PREMIUMS AND PREMIUM 361.17 INCREASES.] Policies issued under sections 62A.46 to 62A.56 on 361.18 or after January 1, 2002, must comply with sections 62S.021, 361.19 62S.081, 62S.265, and 62S.266 to the same extent as policies 361.20 issued under chapter 62S. 361.21 [EFFECTIVE DATE.] This section is effective the day 361.22 following final enactment. 361.23 Sec. 3. Minnesota Statutes 2000, section 62A.48, is 361.24 amended by adding a subdivision to read: 361.25 Subd. 11. [NONFORFEITURE BENEFITS.] Policies issued under 361.26 sections 62A.46 to 62A.56 on or after January 1, 2002, must 361.27 comply with section 62S.02, subdivision 2, to the same extent as 361.28 policies issued under chapter 62S. 361.29 [EFFECTIVE DATE.] This section is effective the day 361.30 following final enactment. 361.31 Sec. 4. Minnesota Statutes 2000, section 62S.01, is 361.32 amended by adding a subdivision to read: 361.33 Subd. 13a. [EXCEPTIONAL INCREASE.] (a) "Exceptional 361.34 increase" means only those premium rate increases filed by an 361.35 insurer as exceptional for which the commissioner determines 361.36 that the need for the premium rate increase is justified due to 362.1 changes in laws or rules applicable to long-term care coverage 362.2 in this state, or due to increased and unexpected utilization 362.3 that affects the majority of insurers of similar products. 362.4 (b) Except as provided in section 62S.265, exceptional 362.5 increases are subject to the same requirements as other premium 362.6 rate schedule increases. The commissioner may request a review 362.7 by an independent actuary or a professional actuarial body of 362.8 the basis for a request that an increase be considered an 362.9 exceptional increase. The commissioner, in determining that the 362.10 necessary basis for an exceptional increase exists, shall also 362.11 determine any potential offsets to higher claims costs. 362.12 [EFFECTIVE DATE.] This section is effective the day 362.13 following final enactment. 362.14 Sec. 5. Minnesota Statutes 2000, section 62S.01, is 362.15 amended by adding a subdivision to read: 362.16 Subd. 17a. [INCIDENTAL.] "Incidental," as used in section 362.17 62S.265, subdivision 10, means that the value of the long-term 362.18 care benefits provided is less than ten percent of the total 362.19 value of the benefits provided over the life of the policy. 362.20 These values must be measured as of the date of issue. 362.21 [EFFECTIVE DATE.] This section is effective the day 362.22 following final enactment. 362.23 Sec. 6. Minnesota Statutes 2000, section 62S.01, is 362.24 amended by adding a subdivision to read: 362.25 Subd. 23a. [QUALIFIED ACTUARY.] "Qualified actuary" means 362.26 a member in good standing of the American Academy of Actuaries. 362.27 [EFFECTIVE DATE.] This section is effective the day 362.28 following final enactment. 362.29 Sec. 7. Minnesota Statutes 2000, section 62S.01, is 362.30 amended by adding a subdivision to read: 362.31 Subd. 25a. [SIMILAR POLICY FORMS.] "Similar policy forms" 362.32 means all of the long-term care insurance policies and 362.33 certificates issued by an insurer in the same long-term care 362.34 benefit classification as the policy form being considered. 362.35 Certificates of groups that meet the definition in section 362.36 62S.01, subdivision 15, clause (1), are not considered similar 363.1 to certificates or policies otherwise issued as long-term care 363.2 insurance, but are similar to other comparable certificates with 363.3 the same long-term care benefit classifications. For purposes 363.4 of determining similar policy forms, long-term care benefit 363.5 classifications are defined as follows: institutional long-term 363.6 care benefits only, noninstitutional long-term care benefits 363.7 only, or comprehensive long-term care benefits. 363.8 [EFFECTIVE DATE.] This section is effective the day 363.9 following final enactment. 363.10 Sec. 8. [62S.021] [LONG-TERM CARE INSURANCE; INITIAL 363.11 FILING.] 363.12 Subdivision 1. [APPLICABILITY.] This section applies to 363.13 any long-term care policy issued in this state on or after 363.14 January 1, 2002, under this chapter or sections 62A.46 to 62A.56. 363.15 Subd. 2. [REQUIRED SUBMISSION TO COMMISSIONER.] An insurer 363.16 shall provide the following information to the commissioner 30 363.17 days prior to making a long-term care insurance form available 363.18 for sale: 363.19 (1) a copy of the disclosure documents required in section 363.20 62S.081; and 363.21 (2) an actuarial certification consisting of at least the 363.22 following: 363.23 (i) a statement that the initial premium rate schedule is 363.24 sufficient to cover anticipated costs under moderately adverse 363.25 experience and that the premium rate schedule is reasonably 363.26 expected to be sustainable over the life of the form with no 363.27 future premium increases anticipated; 363.28 (ii) a statement that the policy design and coverage 363.29 provided have been reviewed and taken into consideration; 363.30 (iii) a statement that the underwriting and claims 363.31 adjudication processes have been reviewed and taken into 363.32 consideration; and 363.33 (iv) a complete description of the basis for contract 363.34 reserves that are anticipated to be held under the form, to 363.35 include: 363.36 (A) sufficient detail or sample calculations provided so as 364.1 to have a complete depiction of the reserve amounts to be held; 364.2 (B) a statement that the assumptions used for reserves 364.3 contain reasonable margins for adverse experience; 364.4 (C) a statement that the net valuation premium for renewal 364.5 years does not increase, except for attained age rating where 364.6 permitted; 364.7 (D) a statement that the difference between the gross 364.8 premium and the net valuation premium for renewal years is 364.9 sufficient to cover expected renewal expenses, or if such a 364.10 statement cannot be made, a complete description of the 364.11 situations in which this does not occur. An aggregate 364.12 distribution of anticipated issues may be used as long as the 364.13 underlying gross premiums maintain a reasonably consistent 364.14 relationship. If the gross premiums for certain age groups 364.15 appear to be inconsistent with this requirement, the 364.16 commissioner may request a demonstration under item (i) based on 364.17 a standard age distribution; and 364.18 (E) either a statement that the premium rate schedule is 364.19 not less than the premium rate schedule for existing similar 364.20 policy forms also available from the insurer except for 364.21 reasonable differences attributable to benefits, or a comparison 364.22 of the premium schedules for similar policy forms that are 364.23 currently available from the insurer with an explanation of the 364.24 differences. 364.25 Subd. 3. [ACTUARIAL DEMONSTRATION.] The commissioner may 364.26 request an actuarial demonstration that benefits are reasonable 364.27 in relation to premiums. The actuarial demonstration must 364.28 include either premium and claim experience on similar policy 364.29 forms, adjusted for any premium or benefit differences, relevant 364.30 and credible data from other studies, or both. If the 364.31 commissioner asks for additional information under this 364.32 subdivision, the 30-day time limit in subdivision 2 does not 364.33 include the time during which the insurer is preparing the 364.34 requested information. 364.35 [EFFECTIVE DATE.] This section is effective the day 364.36 following final enactment. 365.1 Sec. 9. [62S.081] [REQUIRED DISCLOSURE OF RATING PRACTICES 365.2 TO CONSUMERS.] 365.3 Subdivision 1. [APPLICATION.] This section applies as 365.4 follows: 365.5 (a) Except as provided in paragraph (b), this section 365.6 applies to any long-term care policy or certificate issued in 365.7 this state on or after January 1, 2002. 365.8 (b) For certificates issued on or after the effective date 365.9 of this section under a policy of group long-term care insurance 365.10 as defined in section 62S.01, subdivision 15, that was in force 365.11 on the effective date of this section, this section applies on 365.12 the policy anniversary following June 30, 2002. 365.13 Subd. 2. [REQUIRED DISCLOSURES.] Other than policies for 365.14 which no applicable premium rate or rate schedule increases can 365.15 be made, insurers shall provide all of the information listed in 365.16 this subdivision to the applicant at the time of application or 365.17 enrollment, unless the method of application does not allow for 365.18 delivery at that time; in this case, an insurer shall provide 365.19 all of the information listed in this subdivision to the 365.20 applicant no later than at the time of delivery of the policy or 365.21 certificate: 365.22 (1) a statement that the policy may be subject to rate 365.23 increases in the future; 365.24 (2) an explanation of potential future premium rate 365.25 revisions and the policyholder's or certificate holder's option 365.26 in the event of a premium rate revision; 365.27 (3) the premium rate or rate schedules applicable to the 365.28 applicant that will be in effect until a request is made for an 365.29 increase; 365.30 (4) a general explanation of applying premium rate or rate 365.31 schedule adjustments that must include: 365.32 (i) a description of when premium rate or rate schedule 365.33 adjustments will be effective, for example the next anniversary 365.34 date or the next billing date; and 365.35 (ii) the right to a revised premium rate or rate schedule 365.36 as provided in clause (3) if the premium rate or rate schedule 366.1 is changed; and 366.2 (5)(i) information regarding each premium rate increase on 366.3 this policy form or similar policy forms over the past ten years 366.4 for this state or any other state that, at a minimum, identifies: 366.5 (A) the policy forms for which premium rates have been 366.6 increased; 366.7 (B) the calendar years when the form was available for 366.8 purchase; and 366.9 (C) the amount or percent of each increase. The percentage 366.10 may be expressed as a percentage of the premium rate prior to 366.11 the increase and may also be expressed as minimum and maximum 366.12 percentages if the rate increase is variable by rating 366.13 characteristics; 366.14 (ii) the insurer may, in a fair manner, provide additional 366.15 explanatory information related to the rate increases; 366.16 (iii) an insurer has the right to exclude from the 366.17 disclosure premium rate increases that apply only to blocks of 366.18 business acquired from other nonaffiliated insurers or the 366.19 long-term care policies acquired from other nonaffiliated 366.20 insurers when those increases occurred prior to the acquisition; 366.21 (iv) if an acquiring insurer files for a rate increase on a 366.22 long-term care policy form acquired from nonaffiliated insurers 366.23 or a block of policy forms acquired from nonaffiliated insurers 366.24 on or before the later of the effective date of this section, or 366.25 the end of a 24-month period following the acquisition of the 366.26 block of policies, the acquiring insurer may exclude that rate 366.27 increase from the disclosure. However, the nonaffiliated 366.28 selling company must include the disclosure of that rate 366.29 increase according to item (i); and 366.30 (v) if the acquiring insurer in item (iv) files for a 366.31 subsequent rate increase, even within the 24-month period, on 366.32 the same policy form acquired from nonaffiliated insurers or 366.33 block of policy forms acquired from nonaffiliated insurers 366.34 referenced in item (iv), the acquiring insurer shall make all 366.35 disclosures required by this subdivision, including disclosure 366.36 of the earlier rate increase referenced in item (iv). 367.1 Subd. 3. [ACKNOWLEDGMENT.] An applicant shall sign an 367.2 acknowledgment at the time of application, unless the method of 367.3 application does not allow for signature at that time, that the 367.4 insurer made the disclosure required under subdivision 2. If, 367.5 due to the method of application, the applicant cannot sign an 367.6 acknowledgment at the time of application, the applicant shall 367.7 sign no later than at the time of delivery of the policy or 367.8 certificate. 367.9 Subd. 4. [FORMS.] An insurer shall use the forms in 367.10 Appendices B and F of the Long-term Care Insurance Model 367.11 Regulation adopted by the National Association of Insurance 367.12 Commissioners to comply with the requirements of subdivisions 1 367.13 and 2. 367.14 Subd. 5. [NOTICE OF INCREASE.] An insurer shall provide 367.15 notice of an upcoming premium rate schedule increase, after the 367.16 increase has been approved by the commissioner, to all 367.17 policyholders or certificate holders, if applicable, at least 45 367.18 days prior to the implementation of the premium rate schedule 367.19 increase by the insurer. The notice must include the 367.20 information required by subdivision 2 when the rate increase is 367.21 implemented. 367.22 [EFFECTIVE DATE.] This section is effective the day 367.23 following final enactment. 367.24 Sec. 10. Minnesota Statutes 2000, section 62S.26, is 367.25 amended to read: 367.26 62S.26 [LOSS RATIO.] 367.27 (a) The minimum loss ratio must be at least 60 percent, 367.28 calculated in a manner which provides for adequate reserving of 367.29 the long-term care insurance risk. In evaluating the expected 367.30 loss ratio, the commissioner shall give consideration to all 367.31 relevant factors, including: 367.32 (1) statistical credibility of incurred claims experience 367.33 and earned premiums; 367.34 (2) the period for which rates are computed to provide 367.35 coverage; 367.36 (3) experienced and projected trends; 368.1 (4) concentration of experience within early policy 368.2 duration; 368.3 (5) expected claim fluctuation; 368.4 (6) experience refunds, adjustments, or dividends; 368.5 (7) renewability features; 368.6 (8) all appropriate expense factors; 368.7 (9) interest; 368.8 (10) experimental nature of the coverage; 368.9 (11) policy reserves; 368.10 (12) mix of business by risk classification; and 368.11 (13) product features such as long elimination periods, 368.12 high deductibles, and high maximum limits. 368.13 (b) This section does not apply to policies or certificates 368.14 that are subject to sections 62S.021, 62S.081, and 62S.265, and 368.15 that comply with those sections. 368.16 [EFFECTIVE DATE.] This section is effective the day 368.17 following final enactment. 368.18 Sec. 11. [62S.265] [PREMIUM RATE SCHEDULE INCREASES.] 368.19 Subdivision 1. [APPLICABILITY.] (a) Except as provided in 368.20 paragraph (b), this section applies to any long-term care policy 368.21 or certificate issued in this state on or after January 1, 2002, 368.22 under this chapter or sections 62A.46 to 62A.56. 368.23 (b) For certificates issued on or after the effective date 368.24 of this section under a group long-term care insurance policy as 368.25 defined in section 62S.01, subdivision 15, issued under this 368.26 chapter, that was in force on the effective date of this 368.27 section, this section applies on the policy anniversary 368.28 following June 30, 2002. 368.29 Subd. 2. [NOTICE.] An insurer shall file a requested 368.30 premium rate schedule increase, including an exceptional 368.31 increase, to the commissioner for prior approval at least 60 368.32 days prior to the notice to the policyholders and shall include: 368.33 (1) all information required by section 62S.081; 368.34 (2) certification by a qualified actuary that: 368.35 (i) if the requested premium rate schedule increase is 368.36 implemented and the underlying assumptions, which reflect 369.1 moderately adverse conditions, are realized, no further premium 369.2 rate schedule increases are anticipated; and 369.3 (ii) the premium rate filing complies with this section; 369.4 (3) an actuarial memorandum justifying the rate schedule 369.5 change request that includes: 369.6 (i) lifetime projections of earned premiums and incurred 369.7 claims based on the filed premium rate schedule increase and the 369.8 method and assumptions used in determining the projected values, 369.9 including reflection of any assumptions that deviate from those 369.10 used for pricing other forms currently available for sale; 369.11 (A) annual values for the five years preceding and the 369.12 three years following the valuation date must be provided 369.13 separately; 369.14 (B) the projections must include the development of the 369.15 lifetime loss ratio, unless the rate increase is an exceptional 369.16 increase; 369.17 (C) the projections must demonstrate compliance with 369.18 subdivision 3; and 369.19 (D) for exceptional increases, the projected experience 369.20 must be limited to the increases in claims expenses attributable 369.21 to the approved reasons for the exceptional increase and, if the 369.22 commissioner determines that offsets to higher claim costs may 369.23 exist, the insurer shall use appropriate net projected 369.24 experience; 369.25 (ii) disclosure of how reserves have been incorporated in 369.26 this rate increase whenever the rate increase will trigger 369.27 contingent benefit upon lapse; 369.28 (iii) disclosure of the analysis performed to determine why 369.29 a rate adjustment is necessary, which pricing assumptions were 369.30 not realized and why, and what other actions taken by the 369.31 company have been relied upon by the actuary; 369.32 (iv) a statement that policy design, underwriting, and 369.33 claims adjudication practices have been taken into 369.34 consideration; and 369.35 (v) if it is necessary to maintain consistent premium rates 369.36 for new certificates and certificates receiving a rate increase, 370.1 the insurer shall file composite rates reflecting projections of 370.2 new certificates; 370.3 (4) a statement that renewal premium rate schedules are not 370.4 greater than new business premium rate schedules except for 370.5 differences attributable to benefits, unless sufficient 370.6 justification is provided to the commissioner; and 370.7 (5) sufficient information for review and approval of the 370.8 premium rate schedule increase by the commissioner. 370.9 Subd. 3. [REQUIREMENTS PERTAINING TO RATE INCREASES.] All 370.10 premium rate schedule increases must be determined according to 370.11 the following requirements: 370.12 (1) exceptional increases must provide that 70 percent of 370.13 the present value of projected additional premiums from the 370.14 exceptional increase will be returned to policyholders in 370.15 benefits; 370.16 (2) premium rate schedule increases must be calculated so 370.17 that the sum of the accumulated value of incurred claims, 370.18 without the inclusion of active life reserves, and the present 370.19 value of future projected incurred claims, without the inclusion 370.20 of active life reserves, will not be less than the sum of the 370.21 following: 370.22 (i) the accumulated value of the initial earned premium 370.23 times 58 percent; 370.24 (ii) 85 percent of the accumulated value of prior premium 370.25 rate schedule increases on an earned basis; 370.26 (iii) the present value of future projected initial earned 370.27 premiums times 58 percent; and 370.28 (iv) 85 percent of the present value of future projected 370.29 premiums not in item (iii) on an earned basis; 370.30 (3) if a policy form has both exceptional and other 370.31 increases, the values in clause (2), items (ii) and (iv), must 370.32 also include 70 percent for exceptional rate increase amounts; 370.33 and 370.34 (4) all present and accumulated values used to determine 370.35 rate increases must use the maximum valuation interest rate for 370.36 contract reserves permitted for valuation of whole life 371.1 insurance policies issued in this state on the same date. The 371.2 actuary shall disclose as part of the actuarial memorandum the 371.3 use of any appropriate averages. 371.4 Subd. 4. [PROJECTIONS.] For each rate increase that is 371.5 implemented, the insurer shall file for approval by the 371.6 commissioner updated projections, as described in subdivision 2, 371.7 clause (3), item (i), annually for the next three years and 371.8 include a comparison of actual results to projected values. The 371.9 commissioner may extend the period to greater than three years 371.10 if actual results are not consistent with projected values from 371.11 prior projections. For group insurance policies that meet the 371.12 conditions in subdivision 11, the projections required by this 371.13 subdivision must be provided to the policyholder in lieu of 371.14 filing with the commissioner. 371.15 Subd. 5. [LIFETIME PROJECTIONS.] If any premium rate in 371.16 the revised premium rate schedule is greater than 200 percent of 371.17 the comparable rate in the initial premium schedule, lifetime 371.18 projections, as described in subdivision 2, clause (3), item 371.19 (i), must be filed for approval by the commissioner every five 371.20 years following the end of the required period in subdivision 371.21 4. For group insurance policies that meet the conditions in 371.22 subdivision 11, the projections required by this subdivision 371.23 must be provided to the policyholder in lieu of filing with the 371.24 commissioner. 371.25 Subd. 6. [EFFECT OF ACTUAL EXPERIENCE.] (a) If the 371.26 commissioner has determined that the actual experience following 371.27 a rate increase does not adequately match the projected 371.28 experience and that the current projections under moderately 371.29 adverse conditions demonstrate that incurred claims will not 371.30 exceed proportions of premiums specified in subdivision 3, the 371.31 commissioner may require the insurer to implement any of the 371.32 following: 371.33 (1) premium rate schedule adjustments; or 371.34 (2) other measures to reduce the difference between the 371.35 projected and actual experience. 371.36 (b) In determining whether the actual experience adequately 372.1 matches the projected experience, consideration must be given to 372.2 subdivision 2, clause (3), item (v), if applicable. 372.3 Subd. 7. [CONTINGENT BENEFIT UPON LAPSE.] If the majority 372.4 of the policies or certificates to which the increase is 372.5 applicable are eligible for the contingent benefit upon lapse, 372.6 the insurer shall file: 372.7 (1) a plan, subject to commissioner approval, for improved 372.8 administration or claims processing designed to eliminate the 372.9 potential for further deterioration of the policy form requiring 372.10 further premium rate schedule increases, or both, or a 372.11 demonstration that appropriate administration and claims 372.12 processing have been implemented or are in effect; otherwise, 372.13 the commissioner may impose the condition in subdivision 8, 372.14 paragraph (b); and 372.15 (2) the original anticipated lifetime loss ratio, and the 372.16 premium rate schedule increase that would have been calculated 372.17 according to subdivision 3 had the greater of the original 372.18 anticipated lifetime loss ratio or 58 percent been used in the 372.19 calculations described in subdivision 3, clause (2), items (i) 372.20 and (iii). 372.21 Subd. 8. [PROJECTED LAPSE RATES.] (a) For a rate increase 372.22 filing that meets the following criteria, the commissioner shall 372.23 review, for all policies included in the filing, the projected 372.24 lapse rates and past lapse rates during the 12 months following 372.25 each increase to determine if significant adverse lapsation has 372.26 occurred or is anticipated: 372.27 (1) the rate increase is not the first rate increase 372.28 requested for the specific policy form or forms; 372.29 (2) the rate increase is not an exceptional increase; and 372.30 (3) the majority of the policies or certificates to which 372.31 the increase is applicable are eligible for the contingent 372.32 benefit upon lapse. 372.33 (b) If significant adverse lapsation has occurred, is 372.34 anticipated in the filing, or is evidenced in the actual results 372.35 as presented in the updated projections provided by the insurer 372.36 following the requested rate increase, the commissioner may 373.1 determine that a rate spiral exists. Following the 373.2 determination that a rate spiral exists, the commissioner may 373.3 require the insurer to offer, without underwriting, to all 373.4 in-force insureds subject to the rate increase, the option to 373.5 replace existing coverage with one or more reasonably comparable 373.6 products being offered by the insurer or its affiliates. The 373.7 offer must: 373.8 (1) be subject to the approval of the commissioner; 373.9 (2) be based upon actuarially sound principles, but not be 373.10 based upon attained age; and 373.11 (3) provide that maximum benefits under any new policy 373.12 accepted by an insured are reduced by comparable benefits 373.13 already paid under the existing policy. 373.14 (c) The insurer shall maintain the experience of all the 373.15 replacement insureds separate from the experience of insureds 373.16 originally issued the policy forms. In the event of a request 373.17 for a rate increase on the policy form, the rate increase must 373.18 be limited to the lesser of the maximum rate increase determined 373.19 based on the combined experience and the maximum rate increase 373.20 determined based only upon the experience of the insureds 373.21 originally issued the form plus ten percent. 373.22 Subd. 9. [PERSISTENT PRACTICE OF INADEQUATE INITIAL 373.23 RATES.] If the commissioner determines that the insurer has 373.24 exhibited a persistent practice of filing inadequate initial 373.25 premium rates for long-term care insurance, the commissioner 373.26 may, in addition to the provisions of subdivision 8, prohibit 373.27 the insurer from either of the following: 373.28 (1) filing and marketing comparable coverage for a period 373.29 of up to five years; or 373.30 (2) offering all other similar coverages and limiting 373.31 marketing of new applications to the products subject to recent 373.32 premium rate schedule increases. 373.33 Subd. 10. [INCIDENTAL LONG-TERM CARE 373.34 BENEFITS.] Subdivisions 1 to 9 do not apply to policies for 373.35 which the long-term care benefits provided by the policy are 373.36 incidental, as defined in section 62S.01, subdivision 17a, if 374.1 the policy complies with all of the following provisions: 374.2 (1) the interest credited internally to determine cash 374.3 value accumulations, including long-term care, if any, are 374.4 guaranteed not to be less than the minimum guaranteed interest 374.5 rate for cash value accumulations without long-term care set 374.6 forth in the policy; 374.7 (2) the portion of the policy that provides insurance 374.8 benefits other than long-term care coverage meets the 374.9 nonforfeiture requirements as applicable in any of the following: 374.10 (i) for life insurance, section 61A.25; 374.11 (ii) for individual deferred annuities, section 61A.245; 374.12 and 374.13 (iii) for variable annuities, section 61A.21; 374.14 (3) the policy meets the disclosure requirements of 374.15 sections 62S.10 and 62S.11 if the policy is governed by chapter 374.16 62S and of section 62A.50 if the policy is governed by sections 374.17 62A.46 to 62A.56; 374.18 (4) the portion of the policy that provides insurance 374.19 benefits other than long-term care coverage meets the 374.20 requirements as applicable in the following: 374.21 (i) policy illustrations to the extent required by state 374.22 law applicable to life insurance; 374.23 (ii) disclosure requirements in state law applicable to 374.24 annuities; and 374.25 (iii) disclosure requirements applicable to variable 374.26 annuities; and 374.27 (5) an actuarial memorandum is filed with the commissioner 374.28 that includes: 374.29 (i) a description of the basis on which the long-term care 374.30 rates were determined; 374.31 (ii) a description of the basis for the reserves; 374.32 (iii) a summary of the type of policy, benefits, 374.33 renewability, general marketing method, and limits on ages of 374.34 issuance; 374.35 (iv) a description and a table of each actuarial assumption 374.36 used. For expenses, an insurer must include percent of premium 375.1 dollars per policy and dollars per unit of benefits, if any; 375.2 (v) a description and a table of the anticipated policy 375.3 reserves and additional reserves to be held in each future year 375.4 for active lives; 375.5 (vi) the estimated average annual premium per policy and 375.6 the average issue age; 375.7 (vii) a statement as to whether underwriting is performed 375.8 at the time of application. The statement must indicate whether 375.9 underwriting is used and, if used, the statement shall include a 375.10 description of the type or types of underwriting used, such as 375.11 medical underwriting or functional assessment underwriting. 375.12 Concerning a group policy, the statement must indicate whether 375.13 the enrollee or any dependent will be underwritten and when 375.14 underwriting occurs; and 375.15 (viii) a description of the effect of the long-term care 375.16 policy provision on the required premiums, nonforfeiture values, 375.17 and reserves on the underlying insurance policy, both for active 375.18 lives and those in long-term care claim status. 375.19 Subd. 11. [LARGE GROUP POLICIES.] Subdivisions 6 and 9 do 375.20 not apply to group long-term care insurance policies as defined 375.21 in section 62S.01, subdivision 15, where: 375.22 (1) the policies insure 250 or more persons, and the 375.23 policyholder has 5,000 or more eligible employees of a single 375.24 employer; or 375.25 (2) the policyholder, and not the certificate holders, pays 375.26 a material portion of the premium, which is not less than 20 375.27 percent of the total premium for the group in the calendar year 375.28 prior to the year in which a rate increase is filed. 375.29 [EFFECTIVE DATE.] This section is effective the day 375.30 following final enactment. 375.31 Sec. 12. [62S.266] [NONFORFEITURE BENEFIT REQUIREMENT.] 375.32 Subdivision 1. [APPLICABILITY.] This section does not 375.33 apply to life insurance policies or riders containing 375.34 accelerated long-term care benefits. 375.35 Subd. 2. [REQUIREMENT.] An insurer must offer each 375.36 prospective policyholder a nonforfeiture benefit in compliance 376.1 with the following requirements: 376.2 (1) a policy or certificate offered with nonforfeiture 376.3 benefits must have coverage elements, eligibility, benefit 376.4 triggers, and benefit length that are the same as coverage to be 376.5 issued without nonforfeiture benefits. The nonforfeiture 376.6 benefit included in the offer must be the benefit described in 376.7 subdivision 5; and 376.8 (2) the offer must be in writing if the nonforfeiture 376.9 benefit is not otherwise described in the outline of coverage or 376.10 other materials given to the prospective policyholder. 376.11 Subd. 3. [EFFECT OF REJECTION OF OFFER.] If the offer 376.12 required to be made under subdivision 2 is rejected, the insurer 376.13 shall provide the contingent benefit upon lapse described in 376.14 this section. 376.15 Subd. 4. [CONTINGENT BENEFIT UPON LAPSE.] (a) After 376.16 rejection of the offer required under subdivision 2, for 376.17 individual and group policies without nonforfeiture benefits 376.18 issued after the effective date of this section, the insurer 376.19 shall provide a contingent benefit upon lapse. 376.20 (b) If a group policyholder elects to make the 376.21 nonforfeiture benefit an option to the certificate holder, a 376.22 certificate shall provide either the nonforfeiture benefit or 376.23 the contingent benefit upon lapse. 376.24 (c) The contingent benefit on lapse must be triggered every 376.25 time an insurer increases the premium rates to a level which 376.26 results in a cumulative increase of the annual premium equal to 376.27 or exceeding the percentage of the insured's initial annual 376.28 premium based on the insured's issue age provided in this 376.29 paragraph, and the policy or certificate lapses within 120 days 376.30 of the due date of the premium increase. Unless otherwise 376.31 required, policyholders shall be notified at least 30 days prior 376.32 to the due date of the premium reflecting the rate increase. 376.33 Triggers for a Substantial Premium Increase 376.34 Percent Increase 376.35 Issue Age Over Initial Premium 376.36 29 and Under 200 377.1 30-34 190 377.2 35-39 170 377.3 40-44 150 377.4 45-49 130 377.5 50-54 110 377.6 55-59 90 377.7 60 70 377.8 61 66 377.9 62 62 377.10 63 58 377.11 64 54 377.12 65 50 377.13 66 48 377.14 67 46 377.15 68 44 377.16 69 42 377.17 70 40 377.18 71 38 377.19 72 36 377.20 73 34 377.21 74 32 377.22 75 30 377.23 76 28 377.24 77 26 377.25 78 24 377.26 79 22 377.27 80 20 377.28 81 19 377.29 82 18 377.30 83 17 377.31 84 16 377.32 85 15 377.33 86 14 377.34 87 13 377.35 88 12 377.36 89 11 378.1 90 and over 10 378.2 (d) On or before the effective date of a substantial 378.3 premium increase as defined in paragraph (c), the insurer shall: 378.4 (1) offer to reduce policy benefits provided by the current 378.5 coverage without the requirement of additional underwriting so 378.6 that required premium payments are not increased; 378.7 (2) offer to convert the coverage to a paid-up status with 378.8 a shortened benefit period according to the terms of subdivision 378.9 5. This option may be elected at any time during the 120-day 378.10 period referenced in paragraph (c); and 378.11 (3) notify the policyholder or certificate holder that a 378.12 default or lapse at any time during the 120-day period 378.13 referenced in paragraph (c) is deemed to be the election of the 378.14 offer to convert in clause (2). 378.15 Subd. 5. [NONFORFEITURE BENEFITS; REQUIREMENTS.] (a) 378.16 Benefits continued as nonforfeiture benefits, including 378.17 contingent benefits upon lapse, must be as described in this 378.18 subdivision. 378.19 (b) For purposes of this subdivision, "attained age rating" 378.20 is defined as a schedule of premiums starting from the issue 378.21 date which increases with age at least one percent per year 378.22 prior to age 50, and at least three percent per year beyond age 378.23 50. 378.24 (c) For purposes of this subdivision, the nonforfeiture 378.25 benefit must be of a shortened benefit period providing paid-up, 378.26 long-term care insurance coverage after lapse. The same 378.27 benefits, amounts, and frequency in effect at the time of lapse, 378.28 but not increased thereafter, will be payable for a qualifying 378.29 claim, but the lifetime maximum dollars or days of benefits must 378.30 be determined as specified in paragraph (d). 378.31 (d) The standard nonforfeiture credit will be equal to 100 378.32 percent of the sum of all premiums paid, including the premiums 378.33 paid prior to any changes in benefits. The insurer may offer 378.34 additional shortened benefit period options, so long as the 378.35 benefits for each duration equal or exceed the standard 378.36 nonforfeiture credit for that duration. However, the minimum 379.1 nonforfeiture credit must not be less than 30 times the daily 379.2 nursing home benefit at the time of lapse. In either event, the 379.3 calculation of the nonforfeiture credit is subject to the 379.4 limitation of this subdivision. 379.5 (e) The nonforfeiture benefit must begin not later than the 379.6 end of the third year following the policy or certificate issue 379.7 date. The contingent benefit upon lapse must be effective 379.8 during the first three years as well as thereafter. 379.9 (f) Notwithstanding paragraph (e), for a policy or 379.10 certificate with attained age rating, the nonforfeiture benefit 379.11 must begin on the earlier of: 379.12 (1) the end of the tenth year following the policy or 379.13 certificate issue date; or 379.14 (2) the end of the second year following the date the 379.15 policy or certificate is no longer subject to attained age 379.16 rating. 379.17 (g) Nonforfeiture credits may be used for all care and 379.18 services qualifying for benefits under the terms of the policy 379.19 or certificate, up to the limits specified in the policy or 379.20 certificate. 379.21 Subd. 6. [BENEFIT LIMIT.] All benefits paid by the insurer 379.22 while the policy or certificate is in premium-paying status and 379.23 in the paid-up status will not exceed the maximum benefits which 379.24 would be payable if the policy or certificate had remained in 379.25 premium-paying status. 379.26 Subd. 7. [MINIMUM BENEFITS; INDIVIDUAL AND GROUP 379.27 POLICIES.] There must be no difference in the minimum 379.28 nonforfeiture benefits as required under this section for group 379.29 and individual policies. 379.30 Subd. 8. [APPLICATION; EFFECTIVE DATES.] This section 379.31 becomes effective January 1, 2002, and applies as follows: 379.32 (a) Except as provided in paragraph (b), this section 379.33 applies to any long-term care policy issued in this state on or 379.34 after the effective date of this section. 379.35 (b) For certificates issued on or after the effective date 379.36 of this section, under a group long-term care insurance policy 380.1 that was in force on the effective date of this section, the 380.2 provisions of this section do not apply. 380.3 Subd. 9. [EFFECT ON LOSS RATIO.] Premiums charged for a 380.4 policy or certificate containing nonforfeiture benefits or a 380.5 contingent benefit on lapse are subject to the loss ratio 380.6 requirements of section 62A.48, subdivision 4, or 62S.26, 380.7 treating the policy as a whole, except for policies or 380.8 certificates that are subject to sections 62S.021, 62S.081, and 380.9 62S.265 and that comply with those sections. 380.10 Subd. 10. [PURCHASED BLOCKS OF BUSINESS.] To determine 380.11 whether contingent nonforfeiture upon lapse provisions are 380.12 triggered under subdivision 4, paragraph (c), a replacing 380.13 insurer that purchased or otherwise assumed a block or blocks of 380.14 long-term care insurance policies from another insurer shall 380.15 calculate the percentage increase based on the initial annual 380.16 premium paid by the insured when the policy was first purchased 380.17 from the original insurer. 380.18 Subd. 11. [LEVEL PREMIUM CONTRACTS.] A nonforfeiture 380.19 benefit for qualified long-term care insurance contracts that 380.20 are level premium contracts must be offered that meets the 380.21 following requirements: 380.22 (1) the nonforfeiture provision must be appropriately 380.23 captioned; 380.24 (2) the nonforfeiture provision must provide a benefit 380.25 available in the event of a default in the payment of any 380.26 premiums and must state that the amount of the benefit may be 380.27 adjusted subsequent to being initially granted only as necessary 380.28 to reflect changes in claims, persistency, and interest as 380.29 reflected in changes in rates for premium paying contracts 380.30 approved by the commissioner for the same contract form; and 380.31 (3) the nonforfeiture provision must provide at least one 380.32 of the following: 380.33 (i) reduced paid-up insurance; 380.34 (ii) extended term insurance; 380.35 (iii) shortened benefit period; or 380.36 (iv) other similar offerings approved by the commissioner. 381.1 [EFFECTIVE DATE.] This section is effective the day 381.2 following final enactment. 381.3 Sec. 13. Minnesota Statutes 2000, section 256.975, is 381.4 amended by adding a subdivision to read: 381.5 Subd. 8. [PROMOTION OF LONG-TERM CARE INSURANCE.] The 381.6 Minnesota board on aging, either directly or through contract, 381.7 shall promote the provision of employer-sponsored, long-term 381.8 care insurance. The board shall encourage private and public 381.9 sector employers to make long-term care insurance available to 381.10 employees, provide interested employers with information on the 381.11 long-term care insurance product offered to state employees, and 381.12 provide technical assistance to employers in designing long-term 381.13 care insurance products and contacting companies offering 381.14 long-term care insurance products. 381.15 ARTICLE 9 381.16 MENTAL HEALTH AND CIVIL COMMITMENT 381.17 Section 1. [62Q.471] [EXCLUSION FOR SUICIDE ATTEMPTS 381.18 PROHIBITED.] 381.19 (a) No health plan may exclude or reduce coverage for 381.20 health care for an enrollee that is otherwise covered under the 381.21 health plan, on the basis that the need for the health care 381.22 arose out of a suicide or suicide attempt by the enrollee. 381.23 (b) For purposes of this section, "health plan" has the 381.24 meaning given in section 62Q.01, subdivision 3, but includes the 381.25 coverages described in section 62A.011, clauses (7) and (10). 381.26 [EFFECTIVE DATE.] This section is effective January 1, 381.27 2002, and applies to contracts issued or renewed on or after 381.28 that date. 381.29 Sec. 2. [62Q.527] [COVERAGE OF NONFORMULARY DRUGS FOR 381.30 MENTAL ILLNESS AND EMOTIONAL DISTURBANCE.] 381.31 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 381.32 section, the following terms have the meanings given to them. 381.33 (b) "Emotional disturbance" has the meaning given in 381.34 section 245.4871, subdivision 15. 381.35 (c) "Mental illness" has the meaning given in section 381.36 245.462, subdivision 20, paragraph (a). 382.1 (d) "Health plan" has the meaning given in section 62Q.01, 382.2 subdivision 3, but includes the coverages described in clauses 382.3 (7) and (10). 382.4 Subd. 2. [REQUIRED COVERAGE.] A health plan that provides 382.5 prescription drug coverage must provide coverage for an 382.6 antipsychotic drug prescribed to treat emotional disturbance or 382.7 mental illness regardless of whether the drug is in the health 382.8 plan's drug formulary, if the health care provider prescribing 382.9 the drug: 382.10 (1) indicates to the dispensing pharmacist, orally or in 382.11 writing according to section 151.21, that the prescription must 382.12 be dispensed as communicated; and 382.13 (2) certifies in writing to the health plan company that 382.14 the drug prescribed will best treat the patient's condition. 382.15 The health plan is not required to provide coverage for the drug 382.16 if the drug was removed from the formulary for safety reasons. 382.17 For drugs covered under this section, no health plan company, 382.18 which has received the certification from the health care 382.19 provider, may: 382.20 (i) impose a special deductible, copayment, coinsurance, or 382.21 other special payment requirement that the health plan does not 382.22 apply to drugs that are in the health plan's drug formulary; or 382.23 (ii) require written certification from the prescribing 382.24 provider each time a prescription is refilled or renewed that 382.25 the drug prescribed will best treat the patient's condition. 382.26 Subd. 3. [CONTINUING CARE.] Enrollees receiving a 382.27 prescribed drug to treat a diagnosed mental illness or emotional 382.28 disturbance, may continue to receive the prescribed drug without 382.29 the imposition of a special deductible, copayment, coinsurance, 382.30 or other special payment requirements, when a health plan's drug 382.31 formulary changes or an enrollee changes health plans and the 382.32 medication has been shown to effectively treat the patient's 382.33 condition. In order to be eligible for this continuing care 382.34 benefit: 382.35 (1) the patient must have been treated with the drug for 90 382.36 days prior to a change in a health plan's drug formulary or a 383.1 change in the enrollee's health plan; 383.2 (2) the health care provider prescribing the drug indicates 383.3 to the dispensing pharmacist, orally or in writing according to 383.4 section 151.21, that the prescription must be dispensed as 383.5 communicated; and 383.6 (3) annually certifies in writing to the health plan 383.7 company that the drug prescribed will best treat the patient's 383.8 condition. The health plan is not required to provide coverage 383.9 for the drug if the drug was removed from the formulary for 383.10 safety reasons. 383.11 Subd. 4. [EXCEPTION TO FORMULARY.] A health plan company 383.12 shall promptly grant an exception to the formulary when the 383.13 health care provider prescribing the drug conveys to the health 383.14 plan that: 383.15 (1) the formulary drug causes an adverse reaction; 383.16 (2) the formulary drug is contraindicated; or 383.17 (3) the prescriber demonstrates to the health plan that a 383.18 prescription drug must be dispensed as written to provide 383.19 maximum medical benefit to the patient. 383.20 [EFFECTIVE DATE.] This section is effective July 1, 2001, 383.21 and applies to contracts issued or renewed on or after that date. 383.22 Sec. 3. [62Q.535] [COVERAGE FOR COURT-ORDERED MENTAL 383.23 HEALTH SERVICES.] 383.24 Subdivision 1. [MENTAL HEALTH SERVICES.] For purposes of 383.25 this section, mental health services means all covered services 383.26 that are intended to treat or ameliorate an emotional, 383.27 behavioral, or psychiatric condition and that are covered by the 383.28 policy, contract, or certificate of coverage of the enrollee's 383.29 health plan company or by law. 383.30 Subd. 2. [COVERAGE REQUIRED.] All health plan companies 383.31 that provide coverage for mental health services must cover or 383.32 provide mental health services ordered by a court of competent 383.33 jurisdiction under a court order that is issued on the basis of 383.34 a behavioral care evaluation performed by a licensed 383.35 psychiatrist or a doctoral level licensed psychologist, which 383.36 includes a diagnosis and an individual treatment plan for care 384.1 in the most appropriate, least restrictive environment. The 384.2 health plan company must be given a copy of the court order and 384.3 the behavioral care evaluation. The health plan company shall 384.4 be financially liable for the evaluation if performed by a 384.5 participating provider of the health plan company and shall be 384.6 financially liable for the care included in the court-ordered 384.7 individual treatment plan if the care is covered by the health 384.8 plan and ordered to be provided by a participating provider or 384.9 another provider as required by rule or law. This court-ordered 384.10 coverage must not be subject to a separate medical necessity 384.11 determination by a health plan company under its utilization 384.12 procedures. 384.13 [EFFECTIVE DATE.] This section is effective July 1, 2001, 384.14 and applies to contracts issued or renewed on or after that date. 384.15 Sec. 4. [244.054] [DISCHARGE PLANS; OFFENDERS WITH SERIOUS 384.16 AND PERSISTENT MENTAL ILLNESS.] 384.17 Subdivision 1. [OFFER TO DEVELOP PLAN.] The commissioner 384.18 of human services, in collaboration with the commissioner of 384.19 corrections, shall offer to develop a discharge plan for 384.20 community-based services for every offender with serious and 384.21 persistent mental illness, as defined in section 245.462, 384.22 subdivision 20, paragraph (c), who is being released from a 384.23 correctional facility. If an offender is being released 384.24 pursuant to section 244.05, the offender may choose to have the 384.25 discharge plan made one of the conditions of the offender's 384.26 supervised release and shall follow the conditions to the extent 384.27 that services are available and offered to the offender. 384.28 Subd. 2. [CONTENT OF PLAN.] If an offender chooses to have 384.29 a discharge plan developed, the commissioner of human services 384.30 shall develop and implement a discharge plan, which must include 384.31 at least the following: 384.32 (1) at least 90 days before the offender is due to be 384.33 discharged, the commissioner of human services shall designate 384.34 an agent of the department of human services with mental health 384.35 training to serve as the primary person responsible for carrying 384.36 out discharge planning activities; 385.1 (2) at least 75 days before the offender is due to be 385.2 discharged, the offender's designated agent shall: 385.3 (i) obtain informed consent and releases of information 385.4 from the offender that are needed for transition services; 385.5 (ii) contact the county human services department in the 385.6 community where the offender expects to reside following 385.7 discharge, and inform the department of the offender's impending 385.8 discharge and the planned date of the offender's return to the 385.9 community; determine whether the county or a designated 385.10 contracted provider will provide case management services to the 385.11 offender; refer the offender to the case management services 385.12 provider; and confirm that the case management services provider 385.13 will have opened the offender's case prior to the offender's 385.14 discharge; and 385.15 (iii) refer the offender to appropriate staff in the county 385.16 human services department in the community where the offender 385.17 expects to reside following discharge, for enrollment of the 385.18 offender if eligible in medical assistance or general assistance 385.19 medical care, using special procedures established by process 385.20 and department of human services bulletin; 385.21 (3) at least 2-1/2 months before discharge, the offender's 385.22 designated agent shall secure timely appointments for the 385.23 offender with a psychiatrist no later than 30 days following 385.24 discharge, and with other program staff at a community mental 385.25 health provider that is able to serve former offenders with 385.26 serious and persistent mental illness; 385.27 (4) at least 30 days before discharge, the offender's 385.28 designated agent shall convene a predischarge assessment and 385.29 planning meeting of key staff from the programs in which the 385.30 offender has participated while in the correctional facility, 385.31 the offender, and the supervising agent assigned to the 385.32 offender. At the meeting, attendees shall provide background 385.33 information and continuing care recommendations for the 385.34 offender, including information on the offender's risk for 385.35 relapse; current medications, including dosage and frequency; 385.36 therapy and behavioral goals; diagnostic and assessment 386.1 information, including results of a chemical dependency 386.2 evaluation; confirmation of appointments with a psychiatrist and 386.3 other program staff in the community; a relapse prevention plan; 386.4 continuing care needs; needs for housing, employment, and 386.5 finance support and assistance; and recommendations for 386.6 successful community integration, including chemical dependency 386.7 treatment or support if chemical dependency is a risk factor. 386.8 Immediately following this meeting, the offender's designated 386.9 agent shall summarize this background information and continuing 386.10 care recommendations in a written report; 386.11 (5) immediately following the predischarge assessment and 386.12 planning meeting, the provider of mental health case management 386.13 services who will serve the offender following discharge shall 386.14 offer to make arrangements and referrals for housing, financial 386.15 support, benefits assistance, employment counseling, and other 386.16 services required in sections 245.461 to 245.486; 386.17 (6) at least ten days before the offender's first scheduled 386.18 postdischarge appointment with a mental health provider, the 386.19 offender's designated agent shall transfer the following records 386.20 to the offender's case management services provider and 386.21 psychiatrist: the predischarge assessment and planning report, 386.22 medical records, and pharmacy records. These records may be 386.23 transferred only if the offender provides informed consent for 386.24 their release; 386.25 (7) upon discharge, the offender's designated agent shall 386.26 ensure that the offender leaves the correctional facility with 386.27 at least a ten-day supply of all necessary medications; and 386.28 (8) upon discharge, the prescribing authority at the 386.29 offender's correctional facility shall telephone in 386.30 prescriptions for all necessary medications to a pharmacy in the 386.31 community where the offender plans to reside. The prescriptions 386.32 must provide at least a 30-day supply of all necessary 386.33 medications, and must be able to be refilled once for one 386.34 additional 30-day supply. 386.35 Sec. 5. [244.25] [TRANSITIONAL SERVICES FOR MENTALLY ILL 386.36 OFFENDERS RELEASED FROM PRISON; PILOT PROGRAM.] 387.1 The commissioner of corrections, in collaboration with the 387.2 commissioner of human services, shall establish a pilot project 387.3 grant program with goals and evaluation criteria and make grants 387.4 to provide startup funding for two counties or two groups of 387.5 counties to provide transitional housing and other community 387.6 support services for former state inmates who have been 387.7 diagnosed with a serious mental illness and who have been 387.8 discharged from prison. Grant applicants must submit a proposed 387.9 comprehensive plan for providing the housing and support 387.10 services and evaluating the provision of services, and must 387.11 provide a 25 percent funding match. The commissioner shall make 387.12 grants available to successful applicants by February 1, 2002. 387.13 Grant recipients are eligible for funding under this section for 387.14 the first three years of operation of their programs for housing 387.15 and support services. 387.16 Sec. 6. Minnesota Statutes 2000, section 245.462, is 387.17 amended by adding a subdivision to read: 387.18 Subd. 7a. [CRISIS INTERVENTION SERVICES.] Crisis 387.19 intervention services are short-term, intensive, nonresidential 387.20 mental health services that include assessment, mental health 387.21 rehabilitative services, and a crisis disposition plan. Crisis 387.22 intervention services are intended to help the recipient return 387.23 to a baseline level of functioning or prevent further harmful 387.24 consequences due to the psychiatric symptoms. 387.25 Sec. 7. Minnesota Statutes 2000, section 245.462, is 387.26 amended by adding a subdivision to read: 387.27 Subd. 7b. [CRISIS STABILIZATION SERVICES.] "Crisis 387.28 stabilization services" is defined in section 256B.0624, 387.29 subdivision 2, paragraph (e). 387.30 Sec. 8. Minnesota Statutes 2000, section 245.462, is 387.31 amended by adding a subdivision to read: 387.32 Subd. 14a. [MENTAL HEALTH CRISIS.] "Mental health crisis" 387.33 is defined in section 256B.0624, subdivision 2, paragraph (a). 387.34 Sec. 9. Minnesota Statutes 2000, section 245.462, is 387.35 amended by adding a subdivision to read: 387.36 Subd. 14b. [MENTAL HEALTH EMERGENCY.] "Mental health 388.1 emergency" is defined in section 256B.0624, subdivision 2, 388.2 paragraph (b). 388.3 Sec. 10. Minnesota Statutes 2000, section 245.462, is 388.4 amended by adding a subdivision to read: 388.5 Subd. 14c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 388.6 crisis services" means crisis assessment, crisis intervention, 388.7 and crisis stabilization services. 388.8 Sec. 11. Minnesota Statutes 2000, section 245.462, 388.9 subdivision 18, is amended to read: 388.10 Subd. 18. [MENTAL HEALTH PROFESSIONAL.] "Mental health 388.11 professional" means a person providing clinical services in the 388.12 treatment of mental illness who is qualified in at least one of 388.13 the following ways: 388.14 (1) in psychiatric nursing: a registered nurse who is 388.15 licensed under sections 148.171 to 148.285, and who is certified 388.16 as a clinical specialist in adult psychiatric and mental health 388.17 nursing by a national nurse certification organization or who 388.18 has a master's degree in nursing or one of the behavioral 388.19 sciences or related fields from an accredited college or 388.20 university or its equivalent, with at least 4,000 hours of 388.21 post-master's supervised experience in the delivery of clinical 388.22 services in the treatment of mental illness; 388.23 (2) in clinical social work: a person licensed as an 388.24 independent clinical social worker under section 148B.21, 388.25 subdivision 6, or a person with a master's degree in social work 388.26 from an accredited college or university, with at least 4,000 388.27 hours of post-master's supervised experience in the delivery of 388.28 clinical services in the treatment of mental illness; 388.29 (3) in psychology:a psychologistan individual licensed 388.30 by the board of psychology under sections 148.88 to 148.98 who 388.31 has stated to the board of psychology competencies in the 388.32 diagnosis and treatment of mental illness; 388.33 (4) in psychiatry: a physician licensed under chapter 147 388.34 and certified by the American board of psychiatry and neurology 388.35 or eligible for board certification in psychiatry; 388.36 (5) in marriage and family therapy: the mental health 389.1 professional must be a marriage and family therapist licensed 389.2 under sections 148B.29 to 148B.39 with at least two years of 389.3 post-master's supervised experience in the delivery of clinical 389.4 services in the treatment of mental illness; or 389.5 (6) in allied fields: a person with a master's degree from 389.6 an accredited college or university in one of the behavioral 389.7 sciences or related fields, with at least 4,000 hours of 389.8 post-master's supervised experience in the delivery of clinical 389.9 services in the treatment of mental illness. 389.10 Sec. 12. Minnesota Statutes 2000, section 245.466, 389.11 subdivision 2, is amended to read: 389.12 Subd. 2. [ADULT MENTAL HEALTH SERVICES.] The adult mental 389.13 health service system developed by each county board must 389.14 include the following services: 389.15 (1) education and prevention services in accordance with 389.16 section 245.468; 389.17 (2) emergency services in accordance with section 245.469; 389.18 (3) outpatient services in accordance with section 245.470; 389.19 (4) community support program services in accordance with 389.20 section 245.4711; 389.21 (5) residential treatment services in accordance with 389.22 section 245.472; 389.23 (6) acute care hospital inpatient treatment services in 389.24 accordance with section 245.473; 389.25 (7) regional treatment center inpatient services in 389.26 accordance with section 245.474; 389.27 (8) screening in accordance with section 245.476;and389.28 (9) case management in accordance with sections 245.462, 389.29 subdivision 3; and 245.4711; and 389.30 (10) mental health crisis services in accordance with 389.31 section 245.470, subdivision 3. 389.32 Sec. 13. Minnesota Statutes 2000, section 245.470, is 389.33 amended by adding a subdivision to read: 389.34 Subd. 3. [MENTAL HEALTH CRISIS SERVICES.] County boards 389.35 must provide or contract for enough mental health crisis 389.36 services within the county to meet the needs of adults with 390.1 mental illness residing in the county who are determined, 390.2 through an assessment by a mental health professional, to be 390.3 experiencing a mental health crisis or mental health emergency. 390.4 The mental health crisis services provided must be medically 390.5 necessary, as defined in section 62Q.53, subdivision 2, and 390.6 appropriate or socially necessary for the safety of the adult or 390.7 others regardless of the setting. 390.8 Sec. 14. Minnesota Statutes 2000, section 245.474, 390.9 subdivision 2, is amended to read: 390.10 Subd. 2. [QUALITY OF SERVICE.] The commissioner shall 390.11 biennially determine the needs of all adults with mental illness 390.12 who are served by regional treatment centers or at any state 390.13 facility or program as defined in section 246.50, subdivision 3, 390.14 by administering a client-based evaluation system. The 390.15 client-based evaluation system must include at least the 390.16 following independent measurements: behavioral development 390.17 assessment; habilitation program assessment; medical needs 390.18 assessment; maladaptive behavioral assessment; and vocational 390.19 behavior assessment. The commissioner shallproposeby rule 390.20 establish staff ratiosto the legislaturefor the mental health 390.21 and support units in regional treatment centers as indicated by 390.22 the results of the client-based evaluation system and the types 390.23 of state-operated services needed. Theproposedstaffing ratios 390.24 shall include professional, nursing, direct care, medical, 390.25 clerical, and support staff based on the client-based evaluation 390.26 system. The commissioner shall recompute staffing ratios 390.27 andrecommendationsamend rules on staff ratios as necessary on 390.28 a biennial basis. 390.29 Sec. 15. Minnesota Statutes 2000, section 245.474, is 390.30 amended by adding a subdivision to read: 390.31 Subd. 4. [STAFF SAFETY TRAINING.] The commissioner shall 390.32 by rule require all staff in mental health and support units at 390.33 regional treatment centers who have contact with persons with 390.34 mental illness or severe emotional disturbance to be 390.35 appropriately trained in violence reduction and violence 390.36 prevention, and shall establish criteria for such training. 391.1 Training programs shall be developed with input from consumer 391.2 advocacy organizations, and shall employ violence prevention 391.3 techniques as preferable to physical interaction. 391.4 Sec. 16. Minnesota Statutes 2000, section 245.4871, is 391.5 amended by adding a subdivision to read: 391.6 Subd. 9b. [CRISIS INTERVENTION SERVICES.] Crisis 391.7 intervention services are short-term, intensive, nonresidential 391.8 mental health services that include assessment, mental health 391.9 rehabilitative services, and a crisis disposition plan. Crisis 391.10 intervention services are intended to help the recipient return 391.11 to a baseline level of functioning or prevent further harmful 391.12 consequences due to the psychiatric symptoms. 391.13 Sec. 17. Minnesota Statutes 2000, section 245.4871, is 391.14 amended by adding a subdivision to read: 391.15 Subd. 9c. [CRISIS STABILIZATION SERVICES.] "Crisis 391.16 stabilization services" is defined in section 256B.0624, 391.17 subdivision 2, paragraph (e). 391.18 Sec. 18. Minnesota Statutes 2000, section 245.4871, is 391.19 amended by adding a subdivision to read: 391.20 Subd. 24a. [MENTAL HEALTH CRISIS.] "Mental health crisis" 391.21 is defined in section 256B.0624, subdivision 2, paragraph (a). 391.22 Sec. 19. Minnesota Statutes 2000, section 245.4871, is 391.23 amended by adding a subdivision to read: 391.24 Subd. 24b. [MENTAL HEALTH EMERGENCY.] "Mental health 391.25 emergency" is defined in section 256B.0624, subdivision 2, 391.26 paragraph (b). 391.27 Sec. 20. Minnesota Statutes 2000, section 245.4871, is 391.28 amended by adding a subdivision to read: 391.29 Subd. 24c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 391.30 crisis services" means crisis assessment, crisis intervention, 391.31 and crisis stabilization services. 391.32 Sec. 21. Minnesota Statutes 2000, section 245.4871, 391.33 subdivision 27, is amended to read: 391.34 Subd. 27. [MENTAL HEALTH PROFESSIONAL.] "Mental health 391.35 professional" means a person providing clinical services in the 391.36 diagnosis and treatment of children's emotional disorders. A 392.1 mental health professional must have training and experience in 392.2 working with children consistent with the age group to which the 392.3 mental health professional is assigned. A mental health 392.4 professional must be qualified in at least one of the following 392.5 ways: 392.6 (1) in psychiatric nursing, the mental health professional 392.7 must be a registered nurse who is licensed under sections 392.8 148.171 to 148.285 and who is certified as a clinical specialist 392.9 in child and adolescent psychiatric or mental health nursing by 392.10 a national nurse certification organization or who has a 392.11 master's degree in nursing or one of the behavioral sciences or 392.12 related fields from an accredited college or university or its 392.13 equivalent, with at least 4,000 hours of post-master's 392.14 supervised experience in the delivery of clinical services in 392.15 the treatment of mental illness; 392.16 (2) in clinical social work, the mental health professional 392.17 must be a person licensed as an independent clinical social 392.18 worker under section 148B.21, subdivision 6, or a person with a 392.19 master's degree in social work from an accredited college or 392.20 university, with at least 4,000 hours of post-master's 392.21 supervised experience in the delivery of clinical services in 392.22 the treatment of mental disorders; 392.23 (3) in psychology, the mental health professional must bea392.24psychologistan individual licensed by the board of psychology 392.25 under sections 148.88 to 148.98 who has stated to the board of 392.26 psychology competencies in the diagnosis and treatment of mental 392.27 disorders; 392.28 (4) in psychiatry, the mental health professional must be a 392.29 physician licensed under chapter 147 and certified by the 392.30 American board of psychiatry and neurology or eligible for board 392.31 certification in psychiatry; 392.32 (5) in marriage and family therapy, the mental health 392.33 professional must be a marriage and family therapist licensed 392.34 under sections 148B.29 to 148B.39 with at least two years of 392.35 post-master's supervised experience in the delivery of clinical 392.36 services in the treatment of mental disorders or emotional 393.1 disturbances; or 393.2 (6) in allied fields, the mental health professional must 393.3 be a person with a master's degree from an accredited college or 393.4 university in one of the behavioral sciences or related fields, 393.5 with at least 4,000 hours of post-master's supervised experience 393.6 in the delivery of clinical services in the treatment of 393.7 emotional disturbances. 393.8 Sec. 22. Minnesota Statutes 2000, section 245.4875, 393.9 subdivision 2, is amended to read: 393.10 Subd. 2. [CHILDREN'S MENTAL HEALTH SERVICES.] The 393.11 children's mental health service system developed by each county 393.12 board must include the following services: 393.13 (1) education and prevention services according to section 393.14 245.4877; 393.15 (2) mental health identification and intervention services 393.16 according to section 245.4878; 393.17 (3) emergency services according to section 245.4879; 393.18 (4) outpatient services according to section 245.488; 393.19 (5) family community support services according to section 393.20 245.4881; 393.21 (6) day treatment services according to section 245.4884, 393.22 subdivision 2; 393.23 (7) residential treatment services according to section 393.24 245.4882; 393.25 (8) acute care hospital inpatient treatment services 393.26 according to section 245.4883; 393.27 (9) screening according to section 245.4885; 393.28 (10) case management according to section 245.4881; 393.29 (11) therapeutic support of foster care according to 393.30 section 245.4884, subdivision 4;and393.31 (12) professional home-based family treatment according to 393.32 section 245.4884, subdivision 4; and 393.33 (13) mental health crisis services according to section 393.34 245.488, subdivision 3. 393.35 Sec. 23. Minnesota Statutes 2000, section 245.4876, 393.36 subdivision 1, is amended to read: 394.1 Subdivision 1. [CRITERIA.] Children's mental health 394.2 services required by sections 245.487 to 245.4888 must be: 394.3 (1) based, when feasible, on research findings; 394.4 (2) based on individual clinical, cultural, and ethnic 394.5 needs, and other special needs of the children being served; 394.6 (3) delivered in a manner that improves family functioning 394.7 when clinically appropriate; 394.8 (4) provided in the most appropriate, least restrictive 394.9 setting that meets the requirements in subdivision 1a, and that 394.10 is available to the county board to meet the child's treatment 394.11 needs; 394.12 (5) accessible to all age groups of children; 394.13 (6) appropriate to the developmental age of the child being 394.14 served; 394.15 (7) delivered in a manner that provides accountability to 394.16 the child for the quality of service delivered and continuity of 394.17 services to the child during the years the child needs services 394.18 from the local system of care; 394.19 (8) provided by qualified individuals as required in 394.20 sections 245.487 to 245.4888; 394.21 (9) coordinated with children's mental health services 394.22 offered by other providers; 394.23 (10) provided under conditions that protect the rights and 394.24 dignity of the individuals being served; and 394.25 (11) provided in a manner and setting most likely to 394.26 facilitate progress toward treatment goals. 394.27 Sec. 24. Minnesota Statutes 2000, section 245.4876, is 394.28 amended by adding a subdivision to read: 394.29 Subd. 1a. [APPROPRIATE SETTING TO RECEIVE SERVICES.] A 394.30 child must be provided with mental health services in the least 394.31 restrictive setting that is appropriate to the needs and current 394.32 condition of the individual child. For a child to receive 394.33 mental health services in a residential treatment or acute care 394.34 hospital inpatient setting, the family may not be required to 394.35 demonstrate that services were first provided in a less 394.36 restrictive setting and that the child failed to make progress 395.1 toward or meet treatment goals in the less restrictive setting. 395.2 Sec. 25. Minnesota Statutes 2000, section 245.488, is 395.3 amended by adding a subdivision to read: 395.4 Subd. 3. [MENTAL HEALTH CRISIS SERVICES.] County boards 395.5 must provide or contract for mental health crisis services 395.6 within the county to meet the needs of children with emotional 395.7 disturbance residing in the county who are determined, through 395.8 an assessment by a mental health professional, to be 395.9 experiencing a mental health crisis or mental health emergency. 395.10 The mental health crisis services provided must be medically 395.11 necessary, as defined in section 62Q.53, subdivision 2, and 395.12 necessary for the safety of the child or others regardless of 395.13 the setting. 395.14 Sec. 26. Minnesota Statutes 2000, section 245.4885, 395.15 subdivision 1, is amended to read: 395.16 Subdivision 1. [SCREENING REQUIRED.] The county board 395.17 shall, prior to admission, except in the case of emergency 395.18 admission, screen all children referred for treatment of severe 395.19 emotional disturbance to a residential treatment facility or 395.20 informally admitted to a regional treatment center if public 395.21 funds are used to pay for the services. The county board shall 395.22 also screen all children admitted to an acute care hospital for 395.23 treatment of severe emotional disturbance if public funds other 395.24 than reimbursement under chapters 256B and 256D are used to pay 395.25 for the services. If a child is admitted to a residential 395.26 treatment facility or acute care hospital for emergency 395.27 treatment or held for emergency care by a regional treatment 395.28 center under section 253B.05, subdivision 1, screening must 395.29 occur within three working days of admission. Screening shall 395.30 determine whether the proposed treatment: 395.31 (1) is necessary; 395.32 (2) is appropriate to the child's individual treatment 395.33 needs; 395.34 (3) cannot be effectively provided in the child's home; and 395.35 (4) provides a length of stay as short as possible 395.36 consistent with the individual child's need. 396.1 When a screening is conducted, the county board may not 396.2 determine that referral or admission to a residential treatment 396.3 facility or acute care hospital is not appropriate solely 396.4 because services were not first provided to the child in a less 396.5 restrictive setting and the child failed to make progress toward 396.6 or meet treatment goals in the less restrictive setting. 396.7 Screening shall include both a diagnostic assessment and a 396.8 functional assessment which evaluates family, school, and 396.9 community living situations. If a diagnostic assessment or 396.10 functional assessment has been completed by a mental health 396.11 professional within 180 days, a new diagnostic or functional 396.12 assessment need not be completed unless in the opinion of the 396.13 current treating mental health professional the child's mental 396.14 health status has changed markedly since the assessment was 396.15 completed. The child's parent shall be notified if an 396.16 assessment will not be completed and of the reasons. A copy of 396.17 the notice shall be placed in the child's file. Recommendations 396.18 developed as part of the screening process shall include 396.19 specific community services needed by the child and, if 396.20 appropriate, the child's family, and shall indicate whether or 396.21 not these services are available and accessible to the child and 396.22 family. 396.23 During the screening process, the child, child's family, or 396.24 child's legal representative, as appropriate, must be informed 396.25 of the child's eligibility for case management services and 396.26 family community support services and that an individual family 396.27 community support plan is being developed by the case manager, 396.28 if assigned. 396.29 Screening shall be in compliance with section 256F.07 or 396.30 260C.212, whichever applies. Wherever possible, the parent 396.31 shall be consulted in the screening process, unless clinically 396.32 inappropriate. 396.33 The screening process, and placement decision, and 396.34 recommendations for mental health services must be documented in 396.35 the child's record. 396.36 An alternate review process may be approved by the 397.1 commissioner if the county board demonstrates that an alternate 397.2 review process has been established by the county board and the 397.3 times of review, persons responsible for the review, and review 397.4 criteria are comparable to the standards in clauses (1) to (4). 397.5 Sec. 27. Minnesota Statutes 2000, section 245.4886, 397.6 subdivision 1, is amended to read: 397.7 Subdivision 1. [STATEWIDE PROGRAM; ESTABLISHMENT.] The 397.8 commissioner shall establish a statewide program to assist 397.9 counties in providing services to children with severe emotional 397.10 disturbance as defined in section 245.4871, subdivision 15, and 397.11 their families; and to young adults meeting the criteria for 397.12 transition services in section 245.4875, subdivision 8, and 397.13 their families. Services must be designed to help each child to 397.14 function and remain with the child's family in the community. 397.15 Transition services to eligible young adults must be designed to 397.16 foster independent living in the community. The commissioner 397.17 shall make grants to counties to establish, operate, or contract 397.18 with private providers to provide the following services in the 397.19 following order of priority when these cannot be reimbursed 397.20 under section 256B.0625: 397.21 (1) family community support services including crisis 397.22 placement and crisis respite care as specified in section 397.23 245.4871, subdivision 17; 397.24 (2) case management services as specified in section 397.25 245.4871, subdivision 3; 397.26 (3) day treatment services as specified in section 397.27 245.4871, subdivision 10; 397.28 (4) professional home-based family treatment as specified 397.29 in section 245.4871, subdivision 31; and 397.30 (5) therapeutic support of foster care as specified in 397.31 section 245.4871, subdivision 34. 397.32 Funding appropriated beginning July 1, 1991, must be used 397.33 by county boards to provide family community support services 397.34 and case management services. Additional services shall be 397.35 provided in the order of priority as identified in this 397.36 subdivision. 398.1 Sec. 28. Minnesota Statutes 2000, section 245.99, 398.2 subdivision 4, is amended to read: 398.3 Subd. 4. [ADMINISTRATION OF CRISIS HOUSING ASSISTANCE.] 398.4 The commissioner may contract with organizations or government 398.5 units experienced in housing assistance to operate the program 398.6 under this section. This program is not an entitlement. The 398.7 commissioner may take any of the following steps whenever the 398.8 commissioner projects that funds will be inadequate to meet 398.9 demand in a given fiscal year: 398.10 (1) transfer funds from mental health grants in the same 398.11 appropriation; and 398.12 (2) impose statewide restrictions as to the type and amount 398.13 of assistance available to each recipient under this program, 398.14 including reducing the income eligibility level, limiting 398.15 reimbursement to a percentage of each recipient's costs, 398.16 limiting housing assistance to 60 days per recipient, or closing 398.17 the program for the remainder of the fiscal year. 398.18 Sec. 29. Minnesota Statutes 2000, section 253.28, is 398.19 amended by adding a subdivision to read: 398.20 Subd. 1a. [STATE-OPERATED SERVICES 398.21 AUTHORIZATION.] According to section 246.0136, the commissioner 398.22 of human services is authorized to implement, as an enterprise 398.23 activity, state-operated adult mental health services developed 398.24 for the purposes of preventing inpatient hospitalization or 398.25 facilitating the transition from hospital to community 398.26 placement, that qualify under the standards for adult mental 398.27 health rehabilitative services in section 256B.0623 and adult 398.28 mental health crisis response services in section 256B.0624, 398.29 once those options are incorporated as part of the approved 398.30 state medical assistance plan. 398.31 Sec. 30. Minnesota Statutes 2000, section 253B.02, 398.32 subdivision 10, is amended to read: 398.33 Subd. 10. [INTERESTED PERSON.] "Interested person" means: 398.34 (1) an adult, including but not limited to, a public 398.35 official, including a local welfare agency acting under section 398.36 626.5561, and the legal guardian, spouse, parent, legal counsel, 399.1 adult child, next of kin, or other person designated by a 399.2 proposed patient; or 399.3 (2) a health plan company. 399.4 Sec. 31. Minnesota Statutes 2000, section 253B.03, 399.5 subdivision 5, is amended to read: 399.6 Subd. 5. [PERIODIC ASSESSMENT.] A patient has the right to 399.7 periodic medical assessment, including assessment of the medical 399.8 necessity of continuing care and, if the treatment facility 399.9 declines to provide continuing care, the right to receive 399.10 specific written reasons why continuing care is declined at the 399.11 time of the assessment. The treatment facility shall assess the 399.12 physical and mental condition of every patient as frequently as 399.13 necessary, but not less often than annually. If the patient 399.14 refuses to be examined, the facility shall document in the 399.15 patient's chart its attempts to examine the patient. If a 399.16 person is committed as mentally retarded for an indeterminate 399.17 period of time, the three-year judicial review must include the 399.18 annual reviews for each year as outlined in Minnesota Rules, 399.19 part 9525.0075, subpart 6. 399.20 Sec. 32. Minnesota Statutes 2000, section 253B.03, 399.21 subdivision 10, is amended to read: 399.22 Subd. 10. [NOTIFICATION.] All persons admitted or 399.23 committed to a treatment facility shall be notified in writing 399.24 of their rightsunder this chapterregarding hospitalization and 399.25 other treatment at the time of admission. This notification 399.26 must include: 399.27 (1) patient rights specified in this section and section 399.28 144.651, including nursing home discharge rights; 399.29 (2) the right to obtain treatment and services voluntarily 399.30 under this chapter; 399.31 (3) the right to voluntary admission and release under 399.32 section 253B.04; 399.33 (4) rights in case of an emergency admission under section 399.34 253B.05, including the right to documentation in support of an 399.35 emergency hold and the right to a summary hearing before a judge 399.36 if the patient believes an emergency hold is improper; 400.1 (5) the right to request expedited review under section 400.2 62M.05 if additional days of inpatient stay are denied; 400.3 (6) the right to continuing benefits pending appeal and to 400.4 an expedited administrative hearing under section 256.045 if the 400.5 patient is a recipient of medical assistance, general assistance 400.6 medical care, or MinnesotaCare; and 400.7 (7) the right to an external appeal process under section 400.8 62Q.73, including the right to a second opinion. 400.9 Sec. 33. Minnesota Statutes 2000, section 253B.03, is 400.10 amended by adding a subdivision to read: 400.11 Subd. 11. [PROXY.] A legally authorized health care proxy, 400.12 agent, guardian, or conservator may exercise the patient's 400.13 rights on the patient's behalf. 400.14 Sec. 34. Minnesota Statutes 2000, section 253B.04, 400.15 subdivision 1, is amended to read: 400.16 Subdivision 1. [VOLUNTARY ADMISSION AND TREATMENT.] (a) 400.17 Voluntary admission is preferred over involuntary commitment and 400.18 treatment. Any person 16 years of age or older may request to 400.19 be admitted to a treatment facility as a voluntary patient for 400.20 observation, evaluation, diagnosis, care and treatment without 400.21 making formal written application. Any person under the age of 400.22 16 years may be admitted as a patient with the consent of a 400.23 parent or legal guardian if it is determined by independent 400.24 examination that there is reasonable evidence that (1) the 400.25 proposed patient has a mental illness, or is mentally retarded 400.26 or chemically dependent; and (2) the proposed patient is 400.27 suitable for treatment. The head of the treatment facility 400.28 shall not arbitrarily refuse any person seeking admission as a 400.29 voluntary patient. In making decisions regarding admissions, 400.30 the facility shall use clinical admission criteria consistent 400.31 with the current applicable inpatient admission standards 400.32 established by the American Psychiatric Association or the 400.33 American Academy of Child and Adolescent Psychiatry. These 400.34 criteria must be no more restrictive than, and must be 400.35 consistent with, the requirements of section 62Q.53. The 400.36 facility may not refuse to admit a person voluntarily solely 401.1 because the person does not meet the criteria for involuntary 401.2 holds under section 253B.05 or the definition of mental illness 401.3 under section 253B.02, subdivision 13. 401.4 (b) In addition to the consent provisions of paragraph (a), 401.5 a person who is 16 or 17 years of age who refuses to consent 401.6 personally to admission may be admitted as a patient for mental 401.7 illness or chemical dependency treatment with the consent of a 401.8 parent or legal guardian if it is determined by an independent 401.9 examination that there is reasonable evidence that the proposed 401.10 patient is chemically dependent or has a mental illness and is 401.11 suitable for treatment. The person conducting the examination 401.12 shall notify the proposed patient and the parent or legal 401.13 guardian of this determination. 401.14 Sec. 35. Minnesota Statutes 2000, section 253B.04, 401.15 subdivision 1a, is amended to read: 401.16 Subd. 1a. [VOLUNTARY TREATMENT OR ADMISSION FOR PERSONS 401.17 WITH MENTAL ILLNESS.] (a) A person with a mental illness may 401.18 seek or voluntarily agree to accept treatment or admission to a 401.19 facility. If the mental health provider determines that the 401.20 person lacks the capacity to give informed consent for the 401.21 treatment or admission, and in the absence of a health care 401.22 power of attorney that authorizes consent, the designated agency 401.23 or its designee may give informed consent for mental health 401.24 treatment or admission to a treatment facility on behalf of the 401.25 person. 401.26 (b) The designated agency shall apply the following 401.27 criteria in determining the person's ability to give informed 401.28 consent: 401.29 (1) whether the person demonstrates an awareness of the 401.30 person's illness, and the reasons for treatment, its risks, 401.31 benefits and alternatives, and the possible consequences of 401.32 refusing treatment; and 401.33 (2) whether the person communicates verbally or nonverbally 401.34 a clear choice concerning treatment that is a reasoned one, not 401.35 based on delusion, even though it may not be in the person's 401.36 best interests. 402.1 (c) The basis for the designated agency's decision that the 402.2 person lacks the capacity to give informed consent for treatment 402.3 or admission, and that the patient has voluntarily accepted 402.4 treatment or admission, must be documented in writing. 402.5 (d) A mental health provider that provides treatment in 402.6 reliance on the written consent given by the designated agency 402.7 under this subdivision or by a substitute decision maker 402.8 appointed by the court is not civilly or criminally liable for 402.9 performing treatment without consent. This paragraph does not 402.10 affect any other liability that may result from the manner in 402.11 which the treatment is performed. 402.12 (e) A person who receives treatment or is admitted to a 402.13 facility under this subdivision or subdivision 1b has the right 402.14 to refuse treatment at any time or to be released from a 402.15 facility as provided under subdivision 2. The person or any 402.16 interested person acting on the person's behalf may seek court 402.17 review within five days for a determination of whether the 402.18 person's agreement to accept treatment or admission is 402.19 voluntary. At the time a person agrees to treatment or 402.20 admission to a facility under this subdivision, the designated 402.21 agency or its designee shall inform the person in writing of the 402.22 person's rights under this paragraph. 402.23 (f) This subdivision does not authorize the administration 402.24 of neuroleptic medications. Neuroleptic medications may be 402.25 administered only as provided in section 253B.092. 402.26 Sec. 36. Minnesota Statutes 2000, section 253B.04, is 402.27 amended by adding a subdivision to read: 402.28 Subd. 1b. [COURT APPOINTMENT OF SUBSTITUTE DECISION 402.29 MAKER.] If the designated agency or its designee declines or 402.30 refuses to give informed consent under subdivision 1a, the 402.31 person who is seeking treatment or admission, or an interested 402.32 person acting on behalf of the person, may petition the court 402.33 for appointment of a substitute decision maker who may give 402.34 informed consent for voluntary treatment and services. In 402.35 making this determination, the court shall apply the criteria in 402.36 subdivision 1a, paragraph (b). 403.1 Sec. 37. Minnesota Statutes 2000, section 253B.045, 403.2 subdivision 6, is amended to read: 403.3 Subd. 6. [COVERAGE.]A health plan company must provide403.4coverage, according to the terms of the policy, contract, or403.5certificate of coverage, for all medically necessary covered403.6services as determined by section 62Q.53 provided to an enrollee403.7that are ordered by the court under this chapter.(a) For 403.8 purposes of this section, "mental health services" means all 403.9 covered services that are intended to treat or ameliorate an 403.10 emotional, behavioral, or psychiatric condition and that are 403.11 covered by the policy, contract, or certificate of coverage of 403.12 the enrollee's health plan company or by law. 403.13 (b) All health plan companies that provide coverage for 403.14 mental health services must cover or provide mental health 403.15 services ordered by a court of competent jurisdiction under a 403.16 court order that is issued on the basis of a behavioral care 403.17 evaluation performed by a licensed psychiatrist or a doctoral 403.18 level licensed psychologist, which includes a diagnosis and an 403.19 individual treatment plan for care in the most appropriate, 403.20 least restrictive environment. The health plan company must be 403.21 given a copy of the court order and the behavioral care 403.22 evaluation. The health plan company shall be financially liable 403.23 for the evaluation if performed by a participating provider of 403.24 the health plan company and shall be financially liable for the 403.25 care included in the court-ordered individual treatment plan if 403.26 the care is covered by the health plan company and ordered to be 403.27 provided by a participating provider or another provider as 403.28 required by rule or law. This court-ordered coverage must not 403.29 be subject to a separate medical necessity determination by a 403.30 health plan company under its utilization procedures. 403.31 Sec. 38. Minnesota Statutes 2000, section 253B.05, 403.32 subdivision 1, is amended to read: 403.33 Subdivision 1. [EMERGENCY HOLD.] (a) Any person may be 403.34 admitted or held for emergency care and treatment in a treatment 403.35 facility with the consent of the head of the treatment facility 403.36 upon a written statement by an examiner that: 404.1 (1) the examiner has examined the person not more than 15 404.2 days prior to admission,; 404.3 (2) the examiner is of the opinion, for stated reasons, 404.4 that the person is mentally ill, mentally retarded or chemically 404.5 dependent, and is inimminentdanger of causing injury to self 404.6 or others if not immediatelyrestrained,detained; and 404.7 (3) an order of the court cannot be obtained in time to 404.8 prevent the anticipated injury. 404.9 (b) If the proposed patient has been brought to the 404.10 treatment facility by another person, the examiner shall make a 404.11 good faith effort to obtain a statement of information that is 404.12 available from that person, which must be taken into 404.13 consideration in deciding whether to place the proposed patient 404.14 on an emergency hold. The statement of information must include 404.15 direct observations of the proposed patient's behaviors, 404.16 reliable knowledge of recent and past behavior, and information 404.17 regarding psychiatric history, past treatment, and current 404.18 mental health providers. The examiner shall also inquire into 404.19 the existence of health care directives under chapter 145, and 404.20 advance psychiatric directives under section 253B.03, 404.21 subdivision 6d. 404.22 (c) The examiner's statement shall be: (1) sufficient 404.23 authority for a peace or health officer to transport a patient 404.24 to a treatment facility, (2) stated in behavioral terms and not 404.25 in conclusory language, and (3) of sufficient specificity to 404.26 provide an adequate record for review. Ifimminentdanger to 404.27 specific individuals is a basis for the emergency hold, the 404.28 statement must identify those individuals, to the extent 404.29 practicable. A copy of the examiner's statement shall be 404.30 personally served on the person immediately upon admission and a 404.31 copy shall be maintained by the treatment facility. 404.32 Sec. 39. Minnesota Statutes 2000, section 253B.07, 404.33 subdivision 1, is amended to read: 404.34 Subdivision 1. [PREPETITION SCREENING.] (a) Prior to 404.35 filing a petition for commitment of or early intervention for a 404.36 proposed patient, an interested person shall apply to the 405.1 designated agency in the county of the proposed patient's 405.2 residence or presence for conduct of a preliminary 405.3 investigation, except when the proposed patient has been 405.4 acquitted of a crime under section 611.026 and the county 405.5 attorney is required to file a petition for commitment. The 405.6 designated agency shall appoint a screening team to conduct an 405.7 investigationwhich shall include. The petitioner may not be a 405.8 member of the screening team. The investigation must include: 405.9 (i) a personal interview with the proposed patient and 405.10 other individuals who appear to have knowledge of the condition 405.11 of the proposed patient. If the proposed patient is not 405.12 interviewed, specific reasons must be documented; 405.13 (ii) identification and investigation of specific alleged 405.14 conduct which is the basis for application; 405.15 (iii) identification, exploration, and listing of 405.16 the specific reasons for rejecting or recommending alternatives 405.17 to involuntary placement; 405.18 (iv) in the case of a commitment based on mental illness, 405.19 the following information, if it is known or available:405.20information, that may be relevant to the administration of 405.21 neuroleptic medications,if necessary,including the existence 405.22 of a declaration under section 253B.03, subdivision 6d, or a 405.23 health care directive under chapter 145C or a guardian, 405.24 conservator, proxy, or agent with authority to make health care 405.25 decisions for the proposed patient; information regarding the 405.26 capacity of the proposed patient to make decisions regarding 405.27 administration of neuroleptic medication; and whether the 405.28 proposed patient is likely to consent or refuse consent to 405.29 administration of the medication; and 405.30 (v) seeking input from the proposed patient's health plan 405.31 company to provide the court with information about services the 405.32 enrollee needs and the least restrictive alternatives. 405.33 (vi) in the case of a commitment based on mental illness, 405.34 information listed in clause (iv) for other purposes relevant to 405.35 treatment. 405.36 (b) In conducting the investigation required by this 406.1 subdivision, the screening team shall have access to all 406.2 relevant medical records of proposed patients currently in 406.3 treatment facilities. Data collected pursuant to this clause 406.4 shall be considered private data on individuals. The 406.5 prepetition screening report is not admissible as evidence 406.6 except by agreement of counsel and is not admissible in any 406.7 court proceedings unrelated to the commitment proceedings. 406.8 (c) The prepetition screening team shall provide a notice, 406.9 written in easily understood language, to the proposed patient, 406.10 the petitioner, persons named in a declaration under chapter 406.11 145C or section 253B.03, subdivision 6d, and, with the proposed 406.12 patient's consent, other interested parties. The team shall ask 406.13 the patient if the patient wants the notice read and shall read 406.14 the notice to the patient upon request. The notice must contain 406.15 information regarding the process, purpose, and legal effects of 406.16 civil commitment and early intervention. The notice must inform 406.17 the proposed patient that: 406.18 (1) if a petition is filed, the patient has certain rights, 406.19 including the right to a court-appointed attorney, the right to 406.20 request a second examiner, the right to attend hearings, and the 406.21 right to oppose the proceeding and to present and contest 406.22 evidence; and 406.23 (2) if the proposed patient is committed to a state 406.24 regional treatment center or group home, the patient will be 406.25 billed for the cost of care and the state has the right to make 406.26 a claim against the patient's estate for this cost. 406.27 The ombudsman for mental health and mental retardation 406.28 shall develop a form for the notice, which includes the 406.29 requirements of this paragraph. 406.30 (d) When the prepetition screening team recommends 406.31 commitment, a written report shall be sent to the county 406.32 attorney for the county in which the petition is to be 406.33 filed. The statement of facts contained in the written report 406.34 must meet the requirements of subdivision 2, paragraph (b). 406.35(d)(e) The prepetition screening team shall refuse to 406.36 support a petition if the investigation does not disclose 407.1 evidence sufficient to support commitment. Notice of the 407.2 prepetition screening team's decision shall be provided to the 407.3 prospective petitioner and to the proposed patient. 407.4(e)(f) If the interested person wishes to proceed with a 407.5 petition contrary to the recommendation of the prepetition 407.6 screening team, application may be made directly to the county 407.7 attorney, whomayshall determine whether or not to proceed with 407.8 the petition. Notice of the county attorney's determination 407.9 shall be provided to the interested party. 407.10(f)(g) If the proposed patient has been acquitted of a 407.11 crime under section 611.026, the county attorney shall apply to 407.12 the designated county agency in the county in which the 407.13 acquittal took place for a preliminary investigation unless 407.14 substantially the same information relevant to the proposed 407.15 patient's current mental condition, as could be obtained by a 407.16 preliminary investigation, is part of the court record in the 407.17 criminal proceeding or is contained in the report of a mental 407.18 examination conducted in connection with the criminal 407.19 proceeding. If a court petitions for commitment pursuant to the 407.20 rules of criminal or juvenile procedure or a county attorney 407.21 petitions pursuant to acquittal of a criminal charge under 407.22 section 611.026, the prepetition investigation, if required by 407.23 this section, shall be completed within seven days after the 407.24 filing of the petition. 407.25 Sec. 40. Minnesota Statutes 2000, section 253B.09, 407.26 subdivision 1, is amended to read: 407.27 Subdivision 1. [STANDARD OF PROOF.] (a) If the court finds 407.28 by clear and convincing evidence that the proposed patient is a 407.29 mentally ill, mentally retarded, or chemically dependent person 407.30 and after careful consideration of reasonable alternative 407.31 dispositions, including but not limited to, dismissal of 407.32 petition, voluntary outpatient care, voluntary admission to a 407.33 treatment facility, appointment of a guardian or conservator, or 407.34 release before commitment as provided for in subdivision 4, it 407.35 finds that there is no suitable alternative to judicial 407.36 commitment, the court shall commit the patient to the least 408.1 restrictive treatment program or alternative programs which can 408.2 meet the patient's treatment needs consistent with section 408.3 253B.03, subdivision 7. 408.4 (b) In deciding on the least restrictive program, the court 408.5 shall consider a range of treatment alternatives including, but 408.6 not limited to, community-based nonresidential treatment, 408.7 community residential treatment, partial hospitalization, acute 408.8 care hospital, and regional treatment center services. The 408.9 court shall also consider the proposed patient's treatment 408.10 preferences and willingness to participate voluntarily in the 408.11 treatment ordered. The court may not commit a patient to a 408.12 facility or program that is not capable of meeting the patient's 408.13 needs. 408.14 (c) For purposes of findings under this chapter, none of 408.15 the following constitute a refusal to accept appropriate mental 408.16 health treatment: 408.17 (1) a willingness to take medication but a reasonable 408.18 disagreement about type or dosage; 408.19 (2) a good-faith effort to follow a reasonable alternative 408.20 treatment plan, including treatment as specified in a valid 408.21 advance directive under chapter 145C or section 253B.03, 408.22 subdivision 6d; 408.23 (3) an inability to obtain access to appropriate treatment 408.24 because of inadequate health care coverage or an insurer's 408.25 refusal or delay in providing coverage for the treatment; or 408.26 (4) an inability to obtain access to needed mental health 408.27 services because the provider will only accept patients who are 408.28 under a court order or because the provider gives persons under 408.29 a court order a priority over voluntary patients in obtaining 408.30 treatment and services. 408.31 Sec. 41. Minnesota Statutes 2000, section 253B.10, 408.32 subdivision 4, is amended to read: 408.33 Subd. 4. [PRIVATE TREATMENT.] Patients or other 408.34 responsible persons are required to pay the necessary charges 408.35 for patients committed or transferred to private treatment 408.36 facilities.Private treatment facilities may refuse to accept a409.1committed person.Insurers must provide court-ordered treatment 409.2 and services as ordered by the court under section 253B.045, 409.3 subdivision 6, or as required under chapter 62M. 409.4 Sec. 42. Minnesota Statutes 2000, section 256.969, 409.5 subdivision 3a, is amended to read: 409.6 Subd. 3a. [PAYMENTS.] Acute care hospital billings under 409.7 the medical assistance program must not be submitted until the 409.8 recipient is discharged. However, the commissioner shall 409.9 establish monthly interim payments for inpatient hospitals that 409.10 have individual patient lengths of stay over 30 days regardless 409.11 of diagnostic category. Except as provided in section 256.9693, 409.12 medical assistance reimbursement for treatment of mental illness 409.13 shall be reimbursed based on diagnostic classifications.The409.14commissioner may selectively contract with hospitals for409.15services within the diagnostic categories relating to mental409.16illness and chemical dependency under competitive bidding when409.17reasonable geographic access by recipients can be assured. No409.18physician shall be denied the privilege of treating a recipient409.19required to use a hospital under contract with the commissioner,409.20as long as the physician meets credentialing standards of the409.21individual hospital.Individual hospital payments established 409.22 under this section and sections 256.9685, 256.9686, and 409.23 256.9695, in addition to third party and recipient liability, 409.24 for discharges occurring during the rate year shall not exceed, 409.25 in aggregate, the charges for the medical assistance covered 409.26 inpatient services paid for the same period of time to the 409.27 hospital. This payment limitation shall be calculated 409.28 separately for medical assistance and general assistance medical 409.29 care services. The limitation on general assistance medical 409.30 care shall be effective for admissions occurring on or after 409.31 July 1, 1991. Services that have rates established under 409.32 subdivision 11 or 12, must be limited separately from other 409.33 services. After consulting with the affected hospitals, the 409.34 commissioner may consider related hospitals one entity and may 409.35 merge the payment rates while maintaining separate provider 409.36 numbers. The operating and property base rates per admission or 410.1 per day shall be derived from the best Medicare and claims data 410.2 available when rates are established. The commissioner shall 410.3 determine the best Medicare and claims data, taking into 410.4 consideration variables of recency of the data, audit 410.5 disposition, settlement status, and the ability to set rates in 410.6 a timely manner. The commissioner shall notify hospitals of 410.7 payment rates by December 1 of the year preceding the rate 410.8 year. The rate setting data must reflect the admissions data 410.9 used to establish relative values. Base year changes from 1981 410.10 to the base year established for the rate year beginning January 410.11 1, 1991, and for subsequent rate years, shall not be limited to 410.12 the limits ending June 30, 1987, on the maximum rate of increase 410.13 under subdivision 1. The commissioner may adjust base year 410.14 cost, relative value, and case mix index data to exclude the 410.15 costs of services that have been discontinued by the October 1 410.16 of the year preceding the rate year or that are paid separately 410.17 from inpatient services. Inpatient stays that encompass 410.18 portions of two or more rate years shall have payments 410.19 established based on payment rates in effect at the time of 410.20 admission unless the date of admission preceded the rate year in 410.21 effect by six months or more. In this case, operating payment 410.22 rates for services rendered during the rate year in effect and 410.23 established based on the date of admission shall be adjusted to 410.24 the rate year in effect by the hospital cost index. 410.25 Sec. 43. [256.9693] [CONTINUING CARE PROGRAM FOR PERSONS 410.26 WITH MENTAL ILLNESS.] 410.27 The commissioner shall establish a continuing care benefit 410.28 program for persons with mental illness in which persons with 410.29 mental illness may obtain acute care hospital inpatient 410.30 treatment for mental illness for up to 45 days beyond that 410.31 allowed by section 256.969. Persons with mental illness who are 410.32 eligible for medical assistance may obtain inpatient treatment 410.33 under this program in hospital beds for which the commissioner 410.34 contracts under this section. The commissioner may selectively 410.35 contract with hospitals to provide this benefit through 410.36 competitive bidding when reasonable geographic access by 411.1 recipients can be assured. Payments under this section shall 411.2 not affect payments under section 256.969. The commissioner may 411.3 contract externally with a utilization review organization to 411.4 authorize persons with mental illness to access the continuing 411.5 care benefit program. The commissioner shall, as part of the 411.6 contracting process, establish admission criteria to allow 411.7 persons with mental illness to access the continuing care 411.8 benefit program. If a court orders acute care hospital 411.9 inpatient treatment for mental illness for a person, the person 411.10 may obtain the treatment under the continuing care benefit 411.11 program. The commissioner shall not require, as part of the 411.12 admission criteria, any commitment or petition under chapter 411.13 253B as a condition of accessing the program. This benefit is 411.14 not available for people who are also eligible for Medicare and 411.15 who have not exhausted their annual or lifetime inpatient 411.16 psychiatric benefit under Medicare. If the recipient is 411.17 enrolled in a prepaid health plan, this benefit is included in 411.18 the health plan's coverage. 411.19 Sec. 44. [256B.0623] [ADULT REHABILITATIVE MENTAL HEALTH 411.20 SERVICES.] 411.21 Subdivision 1. [SCOPE.] Medical assistance covers adult 411.22 rehabilitative mental health services as defined in subdivision 411.23 2, subject to federal approval, if provided to recipients as 411.24 defined in subdivision 3 and provided by a qualified provider 411.25 entity meeting the standards in this section and by a qualified 411.26 individual provider working within the provider's scope of 411.27 practice and identified in the recipient's individual treatment 411.28 plan as defined in section 245.462, subdivision 14, and if 411.29 determined to be medically necessary according to section 62Q.53. 411.30 Subd. 2. [DEFINITIONS.] For purposes of this section, the 411.31 following terms have the meanings given them. 411.32 (a) "Adult rehabilitative mental health services" means 411.33 mental health services which are rehabilitative and enable the 411.34 recipient to develop and enhance psychiatric stability, social 411.35 competencies, personal and emotional adjustment, and independent 411.36 living and community skills, when these abilities are impaired 412.1 by the symptoms of mental illness. Adult rehabilitative mental 412.2 health services are also appropriate when provided to enable a 412.3 recipient to retain stability and functioning, if the recipient 412.4 would be at risk of significant functional decompensation or 412.5 more restrictive service settings without these services. 412.6 (1) Adult rehabilitative mental health services instruct, 412.7 assist, and support the recipient in areas such as: 412.8 interpersonal communication skills, community resource 412.9 utilization and integration skills, crisis assistance, relapse 412.10 prevention skills, health care directives, budgeting and 412.11 shopping skills, healthy lifestyle skills and practices, cooking 412.12 and nutrition skills, transportation skills, medication 412.13 education and monitoring, mental illness symptom management 412.14 skills, household management skills, employment-related skills, 412.15 and transition to community living services. 412.16 (2) These services shall be provided to the recipient on a 412.17 one-to-one basis in the recipient's home or another community 412.18 setting or in groups. 412.19 (b) "Medication education services" means services provided 412.20 individually or in groups which focus on educating the recipient 412.21 about mental illness and symptoms; the role and effects of 412.22 medications in treating symptoms of mental illness; and the side 412.23 effects of medications. Medication education is coordinated 412.24 with medication management services, and does not duplicate it. 412.25 Medication education services are provided by physicians, 412.26 pharmacists, or registered nurses. 412.27 (c) "Transition to community living services" means 412.28 services which maintain continuity of contact between the 412.29 rehabilitation services provider and the recipient and which 412.30 facilitate discharge from a hospital, residential treatment 412.31 program under Minnesota Rules, chapter 9505, board and lodging 412.32 facility, or nursing home. Transition to community living 412.33 services are not intended to provide other areas of adult 412.34 rehabilitative mental health services. 412.35 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 412.36 individual who: 413.1 (1) is age 18 or older; 413.2 (2) is diagnosed with a medical condition, such as mental 413.3 illness or traumatic brain injury, for which adult 413.4 rehabilitative mental health services are needed; 413.5 (3) has substantial disability and functional impairment in 413.6 three or more of the areas listed in section 245.462, 413.7 subdivision 11a, so that self-sufficiency is markedly reduced; 413.8 and 413.9 (4) has had a recent diagnostic assessment by a qualified 413.10 professional that documents adult rehabilitative mental health 413.11 services are medically necessary to address identified 413.12 disability and functional impairments and individual recipient 413.13 goals. 413.14 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) The provider 413.15 entity must be: 413.16 (1) a county operated entity certified by the state; or 413.17 (2) a noncounty entity certified by the entity's host 413.18 county. 413.19 (b) The certification process is a determination as to 413.20 whether the entity meets the standards in this subdivision. The 413.21 certification must specify which adult rehabilitative mental 413.22 health services the entity is qualified to provide. 413.23 (c) If an entity seeks to provide services outside its host 413.24 county, it must obtain additional certification from each county 413.25 in which it will provide services. The additional certification 413.26 must be based on the adequacy of the entity's knowledge of that 413.27 county's local health and human service system, and the ability 413.28 of the entity to coordinate its services with the other services 413.29 available in that county. 413.30 (d) Recertification must occur at least every two years. 413.31 (e) The commissioner may intervene at any time and 413.32 decertify providers with cause. The decertification is subject 413.33 to appeal to the state. A county board may recommend that the 413.34 state decertify a provider for cause. 413.35 (f) The adult rehabilitative mental health services 413.36 provider entity must meet the following standards: 414.1 (1) have capacity to recruit, hire, manage, and train 414.2 mental health professionals, mental health practitioners, and 414.3 mental health rehabilitation workers; 414.4 (2) have adequate administrative ability to ensure 414.5 availability of services; 414.6 (3) ensure adequate preservice and inservice training for 414.7 staff; 414.8 (4) ensure that mental health professionals, mental health 414.9 practitioners, and mental health rehabilitation workers are 414.10 skilled in the delivery of the specific adult rehabilitative 414.11 mental health services provided to the individual eligible 414.12 recipient; 414.13 (5) ensure that staff is capable of implementing culturally 414.14 specific services that are culturally competent and appropriate 414.15 as determined by the recipient's culture, beliefs, values, and 414.16 language as identified in the individual treatment plan; 414.17 (6) ensure enough flexibility in service delivery to 414.18 respond to the changing and intermittent care needs of a 414.19 recipient as identified by the recipient and the individual 414.20 treatment plan; 414.21 (7) ensure that the mental health professional or mental 414.22 health practitioner, who is under the clinical supervision of a 414.23 mental health professional, involved in a recipient's services 414.24 participates in the development of the individual treatment 414.25 plan; 414.26 (8) assist the recipient in arranging needed crisis 414.27 assessment, intervention, and stabilization services; 414.28 (9) ensure that services are coordinated with other 414.29 recipient mental health services providers and the county mental 414.30 health authority and the federally recognized American Indian 414.31 authority and necessary others after obtaining the consent of 414.32 the recipient. Services must also be coordinated with the 414.33 recipient's case manager or care coordinator, if the recipient 414.34 is receiving case management or care coordination services; 414.35 (10) develop and maintain recipient files, individual 414.36 treatment plans, and contact charting; 415.1 (11) develop and maintain staff training and personnel 415.2 files; 415.3 (12) submit information as required by the state; 415.4 (13) establish and maintain a quality assurance plan to 415.5 evaluate the outcome of services provided; 415.6 (14) keep all necessary records required by law; 415.7 (15) deliver services as required by section 245.461; 415.8 (16) comply with all applicable laws; 415.9 (17) be an enrolled Medicaid provider; 415.10 (18) maintain a quality assurance plan to determine 415.11 specific service outcomes and the recipient's satisfaction with 415.12 services; and 415.13 (19) develop and maintain written policies and procedures 415.14 regarding service provision and administration of the provider 415.15 entity. 415.16 (g) The commissioner shall develop statewide procedures for 415.17 provider certification, including timelines for counties to 415.18 certify qualified providers. 415.19 Subd. 5. [QUALIFICATIONS OF PROVIDER STAFF.] Adult 415.20 rehabilitative mental health services must be provided by 415.21 qualified individual provider staff of a certified provider 415.22 entity. Individual provider staff must be qualified under one 415.23 of the following criteria: 415.24 (1) a mental health professional as defined in section 415.25 245.462, subdivision 18, clauses (1) to (5); 415.26 (2) a mental health practitioner as defined in section 415.27 245.462, subdivision 17. The mental health practitioner must 415.28 work under the clinical supervision of a mental health 415.29 professional; or 415.30 (3) a mental health rehabilitation worker. A mental health 415.31 rehabilitation worker means a staff person working under the 415.32 direction of a mental health practitioner or mental health 415.33 professional, and under the clinical supervision of a mental 415.34 health professional in the implementation of rehabilitative 415.35 mental health services as identified in the recipient's 415.36 individual treatment plan; and who: 416.1 (i) is at least 21 years of age; 416.2 (ii) has a high school diploma or equivalent; 416.3 (iii) has successfully completed 30 hours of training 416.4 during the past two years in all of the following areas: 416.5 recipient rights, recipient-centered individual treatment 416.6 planning, behavioral terminology, mental illness, co-occurring 416.7 mental illness and substance abuse, psychotropic medications and 416.8 side effects, functional assessment, local community resources, 416.9 adult vulnerability, recipient confidentiality; and 416.10 (iv) meets the qualifications in (A) or (B): 416.11 (A) has an associate of arts degree in one of the 416.12 behavioral sciences or human services, or is a registered nurse 416.13 without a bachelor's degree, or who within the previous ten 416.14 years has: 416.15 (1) three years of personal life experience with serious 416.16 and persistent mental illness; 416.17 (2) three years of life experience as a primary caregiver 416.18 to an adult with a serious mental illness or traumatic brain 416.19 injury; or 416.20 (3) 4,000 hours of supervised paid work experience in the 416.21 delivery of mental health services to adults with a serious 416.22 mental illness or traumatic brain injury; or 416.23 (B)(1) be fluent in the non-English language or competent 416.24 in the culture of the ethnic group to which at least 50 percent 416.25 of the mental health rehabilitation worker's clients belong; 416.26 (2) receives during the first 2,000 hours of work, monthly 416.27 documented individual clinical supervision by a mental health 416.28 professional; 416.29 (3) has 18 hours of documented field supervision by a 416.30 mental health professional or practitioner during the first 160 416.31 hours of contact work with recipients, and at least six hours of 416.32 field supervision quarterly during the following year; 416.33 (4) has review and cosignature of charting of recipient 416.34 contacts during field supervision by a mental health 416.35 professional or practitioner; and 416.36 (5) has 40 hours of additional continuing education on 417.1 mental health topics during the first year of employment. 417.2 Subd. 6. [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 417.3 health rehabilitation workers must receive ongoing continuing 417.4 education training of at least 30 hours every two years in areas 417.5 of mental illness and mental health services and other areas 417.6 specific to the population being served. Mental health 417.7 rehabilitation workers must also be subject to the ongoing 417.8 direction and clinical supervision standards in paragraphs (c) 417.9 and (d). 417.10 (b) Mental health practitioners must receive ongoing 417.11 continuing education training as required by their professional 417.12 license; or if the practitioner is not licensed, the 417.13 practitioner must receive ongoing continuing education training 417.14 of at least 30 hours every two years in areas of mental illness 417.15 and mental health services. Mental health practitioners must 417.16 meet the ongoing clinical supervision standards in paragraph (c). 417.17 (c) A mental health professional providing clinical 417.18 supervision of staff delivering adult rehabilitative mental 417.19 health services must provide the following guidance: 417.20 (1) review the information in the recipient's file; 417.21 (2) review and approve initial and updates of individual 417.22 treatment plans; 417.23 (3) meet with mental health rehabilitation workers and 417.24 practitioners, individually or in small groups, at least monthly 417.25 to discuss treatment topics of interest to the workers and 417.26 practitioners; 417.27 (4) meet with mental health rehabilitation workers and 417.28 practitioners, individually or in small groups, at least monthly 417.29 to discuss treatment plans of recipients, and approve by 417.30 signature and document in the recipient's file any resulting 417.31 plan updates; 417.32 (5) meet at least twice a month with the directing mental 417.33 health practitioner, if there is one, to review needs of the 417.34 adult rehabilitative mental health services program, review 417.35 staff on-site observations and evaluate mental health 417.36 rehabilitation workers, plan staff training, review program 418.1 evaluation and development, and consult with the directing 418.2 practitioner; 418.3 (6) be available for urgent consultation as the individual 418.4 recipient needs or the situation necessitates; and 418.5 (7) provide clinical supervision by full- or part-time 418.6 mental health professionals employed by or under contract with 418.7 the provider entity. 418.8 (d) An adult rehabilitative mental health services provider 418.9 entity must have a treatment director who is a mental health 418.10 practitioner or mental health professional. The treatment 418.11 director must ensure the following: 418.12 (1) while delivering direct services to recipients, a newly 418.13 hired mental health rehabilitation worker must be directly 418.14 observed delivering services to recipients by the mental health 418.15 practitioner or mental health professional for at least six 418.16 hours per 40 hours worked during the first 160 hours that the 418.17 mental health rehabilitation worker works; 418.18 (2) the mental health rehabilitation worker must receive 418.19 ongoing on-site direct service observation by a mental health 418.20 professional or mental health practitioner for at least six 418.21 hours for every six months of employment; 418.22 (3) progress notes are reviewed from on-site service 418.23 observation prepared by the mental health rehabilitation worker 418.24 and mental health practitioner for accuracy and consistency with 418.25 actual recipient contact and the individual treatment plan and 418.26 goals; 418.27 (4) immediate availability by phone or in person for 418.28 consultation by a mental health professional or a mental health 418.29 practitioner to the mental health rehabilitation services worker 418.30 during service provision; 418.31 (5) oversee the identification of changes in individual 418.32 recipient treatment strategies, revise the plan and communicate 418.33 treatment instructions and methodologies as appropriate to 418.34 ensure that treatment is implemented correctly; 418.35 (6) model service practices which: respect the recipient, 418.36 include the recipient in planning and implementation of the 419.1 individual treatment plan, recognize the recipient's strengths, 419.2 collaborate and coordinate with other involved parties and 419.3 providers; 419.4 (7) ensure that mental health practitioners and mental 419.5 health rehabilitation workers are able to effectively 419.6 communicate with the recipients, significant others, and 419.7 providers; and 419.8 (8) oversee the record of the results of on-site 419.9 observation and charting evaluation and corrective actions taken 419.10 to modify the work of the mental health practitioners and mental 419.11 health rehabilitation workers. 419.12 (e) A mental health practitioner who is providing treatment 419.13 direction for a provider entity must receive supervision at 419.14 least monthly from a mental health professional to: 419.15 (1) identify and plan for general needs of the recipient 419.16 population served; 419.17 (2) identify and plan to address provider entity program 419.18 needs and effectiveness; 419.19 (3) identify and plan provider entity staff training and 419.20 personnel needs and issues; and 419.21 (4) plan, implement, and evaluate provider entity quality 419.22 improvement programs. 419.23 Subd. 7. [PERSONNEL FILE.] The adult rehabilitative mental 419.24 health services provider entity must maintain a personnel file 419.25 on each staff. Each file must contain: 419.26 (1) an annual performance review; 419.27 (2) a summary of on-site service observations and charting 419.28 review; 419.29 (3) a criminal background check of all direct service 419.30 staff; 419.31 (4) evidence of academic degree and qualifications; 419.32 (5) a copy of professional license; 419.33 (6) any job performance recognition and disciplinary 419.34 actions; 419.35 (7) any individual staff written input into own personnel 419.36 file; 420.1 (8) all clinical supervision provided; and 420.2 (9) documentation of compliance with continuing education 420.3 requirements. 420.4 Subd. 8. [DIAGNOSTIC ASSESSMENT.] Providers of adult 420.5 rehabilitative mental health services must complete a diagnostic 420.6 assessment as defined in section 245.462, subdivision 9, within 420.7 five days after the recipient's second visit or within 30 days 420.8 after intake, whichever occurs first. In cases where a 420.9 diagnostic assessment is available that reflects the recipient's 420.10 current status, and has been completed within 180 days preceding 420.11 admission, an update must be completed. An update shall include 420.12 a written summary by a mental health professional of the 420.13 recipient's current mental health status and service needs. If 420.14 the recipient's mental health status has changed significantly 420.15 since the adult's most recent diagnostic assessment, a new 420.16 diagnostic assessment is required. 420.17 Subd. 9. [FUNCTIONAL ASSESSMENT.] Providers of adult 420.18 rehabilitative mental health services must complete a written 420.19 functional assessment as defined in section 245.462, subdivision 420.20 11a, for each recipient. The functional assessment must be 420.21 completed within 30 days of intake, and reviewed and updated at 420.22 least every six months after it is developed, unless there is a 420.23 significant change in the functioning of the recipient. If 420.24 there is a significant change in functioning, the assessment 420.25 must be updated. A single functional assessment can meet case 420.26 management and adult rehabilitative mental health services 420.27 requirements, if agreed to by the recipient. Unless the 420.28 recipient refuses, the recipient must have significant 420.29 participation in the development of the functional assessment. 420.30 Subd. 10. [INDIVIDUAL TREATMENT PLAN.] All providers of 420.31 adult rehabilitative mental health services must develop and 420.32 implement an individual treatment plan for each recipient. The 420.33 provisions in clauses (1) and (2) apply: 420.34 (1) Individual treatment plan means a plan of intervention, 420.35 treatment, and services for an individual recipient written by a 420.36 mental health professional or by a mental health practitioner 421.1 under the clinical supervision of a mental health professional. 421.2 The individual treatment plan must be based on diagnostic and 421.3 functional assessments. To the extent possible, the development 421.4 and implementation of a treatment plan must be a collaborative 421.5 process involving the recipient, and with the permission of the 421.6 recipient, the recipient's family and others in the recipient's 421.7 support system. Providers of adult rehabilitative mental health 421.8 services must develop the individual treatment plan within 30 421.9 calendar days of intake. The treatment plan must be updated at 421.10 least every six months thereafter, or more often when there is 421.11 significant change in the recipient's situation or functioning, 421.12 or in services or service methods to be used, or at the request 421.13 of the recipient or the recipient's legal guardian. 421.14 (2) The individual treatment plan must include: 421.15 (i) a list of problems identified in the assessment; 421.16 (ii) the recipient's strengths and resources; 421.17 (iii) concrete, measurable goals to be achieved, including 421.18 time frames for achievement; 421.19 (iv) specific objectives directed toward the achievement of 421.20 each one of the goals; 421.21 (v) documentation of participants in the treatment planning. 421.22 The recipient, if possible, must be a participant. The 421.23 recipient or the recipient's legal guardian must sign the 421.24 treatment plan, or documentation must be provided why this was 421.25 not possible. A copy of the plan must be given to the recipient 421.26 or legal guardian. Referral to formal services must be 421.27 arranged, including specific providers where applicable; 421.28 (vi) cultural considerations, resources, and needs of the 421.29 recipient must be included; 421.30 (vii) planned frequency and type of services must be 421.31 initiated; and 421.32 (viii) clear progress notes on outcome of goals. 421.33 (3) The individual community support plan defined in 421.34 section 245.462, subdivision 12, may serve as the individual 421.35 treatment plan if there is involvement of a mental health case 421.36 manager, and with the approval of the recipient. The individual 422.1 community support plan must include the criteria in clause (2). 422.2 Subd. 11. [RECIPIENT FILE.] Providers of adult 422.3 rehabilitative mental health services must maintain a file for 422.4 each recipient that contains the following information: 422.5 (1) diagnostic assessment or verification of its location, 422.6 that is current and that was reviewed by a mental health 422.7 professional who is employed by or under contract with the 422.8 provider entity; 422.9 (2) functional assessments; 422.10 (3) individual treatment plans signed by the recipient and 422.11 the mental health professional, or if the recipient refused to 422.12 sign the plan, the date and reason stated by the recipient as to 422.13 why the recipient would not sign the plan; 422.14 (4) recipient history; 422.15 (5) signed release forms; 422.16 (6) recipient health information and current medications; 422.17 (7) emergency contacts for the recipient; 422.18 (8) case records which document the date of service, the 422.19 place of service delivery, signature of the person providing the 422.20 service, nature, extent and units of service, and place of 422.21 service delivery; 422.22 (9) contacts, direct or by telephone, with recipient's 422.23 family or others, other providers, or other resources for 422.24 service coordination; 422.25 (10) summary of recipient case reviews by staff; and 422.26 (11) written information by the recipient that the 422.27 recipient requests be included in the file. 422.28 Subd. 12. [ADDITIONAL REQUIREMENTS.] (a) Providers of 422.29 adult rehabilitative mental health services must comply with the 422.30 requirements relating to referrals for case management in 422.31 section 245.467, subdivision 4. 422.32 (b) Adult rehabilitative mental health services are 422.33 provided for most recipients in the recipient's home and 422.34 community. Services may also be provided at the home of a 422.35 relative or significant other, job site, psychosocial clubhouse, 422.36 drop-in center, social setting, classroom, or other places in 423.1 the community. Except for "transition to community services," 423.2 the place of service does not include a regional treatment 423.3 center, nursing home, residential treatment facility licensed 423.4 under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36), 423.5 or an acute care hospital. 423.6 (c) Adult rehabilitative mental health services may be 423.7 provided in group settings if appropriate to each participating 423.8 recipient's needs and treatment plan. A group is defined as two 423.9 to ten clients, at least one of whom is a recipient, who is 423.10 concurrently receiving a service which is identified in this 423.11 section. The service and group must be specified in the 423.12 recipient's treatment plan. No more than two qualified staff 423.13 may bill Medicaid for services provided to the same group of 423.14 recipients. If two adult rehabilitative mental health workers 423.15 bill for recipients in the same group session, they must each 423.16 bill for different recipients. 423.17 Subd. 13. [EXCLUDED SERVICES.] The following services are 423.18 excluded from reimbursement as adult rehabilitative mental 423.19 health services: 423.20 (1) recipient transportation services; 423.21 (2) a service provided and billed by a provider who is not 423.22 enrolled to provide adult rehabilitative mental health service; 423.23 (3) adult rehabilitative mental health services performed 423.24 by volunteers; 423.25 (4) provider performance of household tasks, chores, or 423.26 related activities, such as laundering clothes, moving the 423.27 recipient's household, housekeeping, and grocery shopping for 423.28 the recipient; 423.29 (5) direct billing of time spent "on call" when not 423.30 delivering services to recipients; 423.31 (6) activities which are primarily social or recreational 423.32 in nature, rather than rehabilitative, for the individual 423.33 recipient, as determined by the individual's needs and treatment 423.34 plan; 423.35 (7) job-specific skills services, such as on-the-job 423.36 training; 424.1 (8) provider service time included in case management 424.2 reimbursement; 424.3 (9) outreach services to potential recipients; 424.4 (10) a mental health service that is not medically 424.5 necessary; and 424.6 (11) any services provided by a hospital, board and 424.7 lodging, or residential facility to an individual who is a 424.8 patient in or resident of that facility. 424.9 Subd. 14. [BILLING WHEN SERVICES ARE PROVIDED BY QUALIFIED 424.10 STATE STAFF.] When rehabilitative services are provided by 424.11 qualified state staff who are assigned to pilot projects under 424.12 section 245.4661, the county or other local entity to which the 424.13 qualified state staff are assigned may consider these staff part 424.14 of the local provider entity for which certification is sought 424.15 under this section, and may bill the medical assistance program 424.16 for qualifying services provided by the qualified state staff. 424.17 Notwithstanding section 256.025, subdivision 2, payments for 424.18 services provided by state staff who are assigned to adult 424.19 mental health initiatives shall only be made from federal funds. 424.20 Sec. 45. [256B.0624] [ADULT MENTAL HEALTH CRISIS RESPONSE 424.21 SERVICES.] 424.22 Subdivision 1. [SCOPE.] Medical assistance covers adult 424.23 mental health crisis response services as defined in subdivision 424.24 2, paragraphs (c) to (e), subject to federal approval, if 424.25 provided to a recipient as defined in subdivision 3 and provided 424.26 by a qualified provider entity as defined in this section and by 424.27 a qualified individual provider working within the provider's 424.28 scope of practice and as defined in this subdivision and 424.29 identified in the recipient's individual crisis treatment plan 424.30 as defined in subdivisions 10 and 13 and if determined to be 424.31 medically necessary. 424.32 Subd. 2. [DEFINITIONS.] For purposes of this section, the 424.33 following terms have the meanings given them. 424.34 (a) "Mental health crisis" is a behavioral, emotional, or 424.35 psychiatric situation which, but for the provision of crisis 424.36 response services, would likely result in significantly reduced 425.1 levels of functioning in primary activities of daily living, or 425.2 in an emergency situation, or in the placement of the recipient 425.3 in a more restrictive setting, including, but not limited to, 425.4 inpatient hospitalization. 425.5 (b) "Mental health emergency" is a behavioral, emotional, 425.6 or psychiatric situation which causes an immediate need for 425.7 mental health services and is consistent with section 62Q.55. 425.8 A mental health crisis or emergency is determined for 425.9 medical assistance service reimbursement by a physician, a 425.10 mental health professional, or crisis mental health practitioner 425.11 with input from the recipient whenever possible. 425.12 (c) "Mental health crisis assessment" means an immediate 425.13 face-to-face assessment by a physician, a mental health 425.14 professional, or mental health practitioner under the clinical 425.15 supervision of a mental health professional, following a 425.16 screening that suggests that the adult may be experiencing a 425.17 mental health crisis or mental health emergency situation. 425.18 (d) "Mental health mobile crisis intervention services" 425.19 means face-to-face, short-term intensive mental health services 425.20 initiated during a mental health crisis or mental health 425.21 emergency to help the recipient cope with immediate stressors, 425.22 identify and utilize available resources and strengths, and 425.23 begin to return to the recipient's baseline level of functioning. 425.24 (1) This service is provided on-site by a mobile crisis 425.25 intervention team outside of an inpatient hospital setting. 425.26 Mental health mobile crisis intervention services must be 425.27 available 24 hours a day, seven days a week. 425.28 (2) The initial screening must consider other available 425.29 services to determine which service intervention would best 425.30 address the recipient's needs and circumstances. 425.31 (3) The mobile crisis intervention team must be available 425.32 to meet promptly face-to-face with a person in mental health 425.33 crisis or emergency in a community setting. 425.34 (4) The intervention must consist of a mental health crisis 425.35 assessment and a crisis treatment plan. 425.36 (5) The treatment plan must include recommendations for any 426.1 needed crisis stabilization services for the recipient. 426.2 (e) "Mental health crisis stabilization services" means 426.3 individualized mental health services provided to a recipient 426.4 following crisis intervention services, which are designed to 426.5 restore the recipient to the recipient's prior functional 426.6 level. Mental health crisis stabilization services may be 426.7 provided in the recipient's home, the home of a family member or 426.8 friend of the recipient, another community setting, or a 426.9 short-term supervised, licensed residential program. Mental 426.10 health crisis stabilization does not include partial 426.11 hospitalization or day treatment. 426.12 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 426.13 individual who: 426.14 (1) is age 18 or older; 426.15 (2) is screened as possibly experiencing a mental health 426.16 crisis or emergency where a mental health crisis assessment is 426.17 needed; and 426.18 (3) is assessed as experiencing a mental health crisis or 426.19 emergency, and mental health crisis intervention or crisis 426.20 intervention and stabilization services are determined to be 426.21 medically necessary. 426.22 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A provider 426.23 entity is an entity that meets the standards listed in paragraph 426.24 (b) and: 426.25 (1) is a county board operated entity; or 426.26 (2) is a provider entity that is under contract with the 426.27 county board in the county where the potential crisis or 426.28 emergency is occurring. To provide services under this section, 426.29 the provider entity must directly provide the services; or if 426.30 services are subcontracted, the provider entity must maintain 426.31 responsibility for services and billing. 426.32 (b) The adult mental health crisis response services 426.33 provider entity must meet the following standards: 426.34 (1) has the capacity to recruit, hire, and manage and train 426.35 mental health professionals, practitioners, and rehabilitation 426.36 workers; 427.1 (2) has adequate administrative ability to ensure 427.2 availability of services; 427.3 (3) is able to ensure adequate preservice and in-service 427.4 training; 427.5 (4) is able to ensure that staff providing these services 427.6 are skilled in the delivery of mental health crisis response 427.7 services to recipients; 427.8 (5) is able to ensure that staff are capable of 427.9 implementing culturally specific treatment identified in the 427.10 individual treatment plan that is meaningful and appropriate as 427.11 determined by the recipient's culture, beliefs, values, and 427.12 language; 427.13 (6) is able to ensure enough flexibility to respond to the 427.14 changing intervention and care needs of a recipient as 427.15 identified by the recipient during the service partnership 427.16 between the recipient and providers; 427.17 (7) is able to ensure that mental health professionals and 427.18 mental health practitioners have the communication tools and 427.19 procedures to communicate and consult promptly about crisis 427.20 assessment and interventions as services occur; 427.21 (8) is able to coordinate these services with county 427.22 emergency services and mental health crisis services; 427.23 (9) is able to ensure that mental health crisis assessment 427.24 and mobile crisis intervention services are available 24 hours a 427.25 day, seven days a week; 427.26 (10) is able to ensure that services are coordinated with 427.27 other mental health service providers, county mental health 427.28 authorities, or federally recognized American Indian authorities 427.29 and others as necessary, with the consent of the adult. 427.30 Services must also be coordinated with the recipient's case 427.31 manager if the adult is receiving case management services; 427.32 (11) is able to ensure that crisis intervention services 427.33 are provided in a manner consistent with sections 245.461 to 427.34 245.486; 427.35 (12) is able to submit information as required by the 427.36 state; 428.1 (13) maintains staff training and personnel files; 428.2 (14) is able to establish and maintain a quality assurance 428.3 and evaluation plan to evaluate the outcomes of services and 428.4 recipient satisfaction; 428.5 (15) is able to keep records as required by applicable 428.6 laws; 428.7 (16) is able to comply with all applicable laws and 428.8 statutes; 428.9 (17) is an enrolled medical assistance provider; and 428.10 (18) develops and maintains written policies and procedures 428.11 regarding service provision and administration of the provider 428.12 entity, including safety of staff and recipients in high-risk 428.13 situations. 428.14 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF 428.15 QUALIFICATIONS.] For provision of adult mental health mobile 428.16 crisis intervention services, a mobile crisis intervention team 428.17 is comprised of at least two mental health professionals as 428.18 defined in section 245.462, subdivision 18, clauses (1) to (5), 428.19 or a combination of at least one mental health professional and 428.20 one mental health practitioner as defined in section 245.462, 428.21 subdivision 17, with the required mental health crisis training 428.22 and under the clinical supervision of a mental health 428.23 professional on the team. The team must have at least two 428.24 people with at least one member providing on-site crisis 428.25 intervention services when needed. Team members must be 428.26 experienced in mental health assessment, crisis intervention 428.27 techniques, and clinical decision-making under emergency 428.28 conditions and have knowledge of local services and resources. 428.29 The team must recommend and coordinate the team's services with 428.30 appropriate local resources such as the county social services 428.31 agency, mental health services, and local law enforcement when 428.32 necessary. 428.33 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 428.34 INTERVENTION TREATMENT PLANNING.] (a) Prior to initiating mobile 428.35 crisis intervention services, a screening of the potential 428.36 crisis situation must be conducted. The screening may use the 429.1 resources of crisis assistance and emergency services as defined 429.2 in sections 245.462, subdivision 6, and 245.469, subdivisions 1 429.3 and 2. The screening must gather information, determine whether 429.4 a crisis situation exists, identify parties involved, and 429.5 determine an appropriate response. 429.6 (b) If a crisis exists, a crisis assessment must be 429.7 completed. A crisis assessment evaluates any immediate needs 429.8 for which emergency services are needed and, as time permits, 429.9 the recipient's current life situation, sources of stress, 429.10 mental health problems and symptoms, strengths, cultural 429.11 considerations, support network, vulnerabilities, and current 429.12 functioning. 429.13 (c) If the crisis assessment determines mobile crisis 429.14 intervention services are needed, the intervention services must 429.15 be provided promptly. As opportunity presents during the 429.16 intervention, at least two members of the mobile crisis 429.17 intervention team must confer directly or by telephone about the 429.18 assessment, treatment plan, and actions taken and needed. At 429.19 least one of the team members must be on site providing crisis 429.20 intervention services. If providing on-site crisis intervention 429.21 services, a mental health practitioner must seek clinical 429.22 supervision as required in subdivision 9. 429.23 (d) The mobile crisis intervention team must develop an 429.24 initial, brief crisis treatment plan as soon as appropriate but 429.25 no later than 24 hours after the initial face-to-face 429.26 intervention. The plan must address the needs and problems 429.27 noted in the crisis assessment and include measurable short-term 429.28 goals, cultural considerations, and frequency and type of 429.29 services to be provided to achieve the goals and reduce or 429.30 eliminate the crisis. The treatment plan must be updated as 429.31 needed to reflect current goals and services. 429.32 (e) The team must document which short-term goals have been 429.33 met, and when no further crisis intervention services are 429.34 required. 429.35 (f) If the recipient's crisis is stabilized, but the 429.36 recipient needs a referral to other services, the team must 430.1 provide referrals to these services. If the recipient has a 430.2 case manager, planning for other services must be coordinated 430.3 with the case manager. 430.4 Subd. 7. [CRISIS STABILIZATION SERVICES.] (a) Crisis 430.5 stabilization services must be provided by qualified staff of a 430.6 crisis stabilization services provider entity and must meet the 430.7 following standards: 430.8 (1) a crisis stabilization treatment plan must be developed 430.9 which meets the criteria in subdivision 11; 430.10 (2) staff must be qualified as defined in subdivision 8; 430.11 and 430.12 (3) services must be delivered according to the treatment 430.13 plan and include face-to-face contact with the recipient by 430.14 qualified staff for further assessment, help with referrals, 430.15 updating of the crisis stabilization treatment plan, supportive 430.16 counseling, skills training, and collaboration with other 430.17 service providers in the community. 430.18 (b) If crisis stabilization services are provided in a 430.19 supervised, licensed residential setting, the recipient must be 430.20 contacted face-to-face daily by a qualified mental health 430.21 practitioner or mental health professional. The program must 430.22 have 24-hour-a-day residential staffing which may include staff 430.23 who do not meet the qualifications in subdivision 8. The 430.24 residential staff must have 24-hour-a-day immediate direct or 430.25 telephone access to a qualified mental health professional or 430.26 practitioner. 430.27 (c) If crisis stabilization services are provided in a 430.28 supervised, licensed residential setting that serves no more 430.29 than four adult residents, and no more than two are recipients 430.30 of crisis stabilization services, the residential staff must 430.31 include, for at least eight hours per day, at least one 430.32 individual who meets the qualifications in subdivision 8. 430.33 (d) If crisis stabilization services are provided in a 430.34 supervised, licensed residential setting that serves more than 430.35 four adult residents, and one or more are recipients of crisis 430.36 stabilization services, the residential staff must include, for 431.1 24 hours per day, at least one individual who meets the 431.2 qualifications in subdivision 8. During the first 48 hours that 431.3 a recipient is in the residential program, the residential 431.4 program must have at least two staff working 24 hours a day. 431.5 Staffing levels may be adjusted thereafter according to the 431.6 needs of the recipient as specified in the crisis stabilization 431.7 treatment plan. 431.8 Subd. 8. [ADULT CRISIS STABILIZATION STAFF 431.9 QUALIFICATIONS.] (a) Adult mental health crisis stabilization 431.10 services must be provided by qualified individual staff of a 431.11 qualified provider entity. Individual provider staff must have 431.12 the following qualifications: 431.13 (1) be a mental health professional as defined in section 431.14 245.462, subdivision 18, clauses (1) to (5); 431.15 (2) be a mental health practitioner as defined in section 431.16 245.462, subdivision 17. The mental health practitioner must 431.17 work under the clinical supervision of a mental health 431.18 professional; or 431.19 (3) be a mental health rehabilitation worker who meets the 431.20 criteria in section 256B.0623, subdivision 5, clause (3); works 431.21 under the direction of a mental health practitioner as defined 431.22 in section 245.462, subdivision 17, or under direction of a 431.23 mental health professional; and works under the clinical 431.24 supervision of a mental health professional. 431.25 (b) Mental health practitioners and mental health 431.26 rehabilitation workers must have completed at least 30 hours of 431.27 training in crisis intervention and stabilization during the 431.28 past two years. 431.29 Subd. 9. [SUPERVISION.] Mental health practitioners may 431.30 provide crisis assessment and mobile crisis intervention 431.31 services if the following clinical supervision requirements are 431.32 met: 431.33 (1) the mental health provider entity must accept full 431.34 responsibility for the services provided; 431.35 (2) the mental health professional of the provider entity, 431.36 who is an employee or under contract with the provider entity, 432.1 must be immediately available by phone or in person for clinical 432.2 supervision; 432.3 (3) the mental health professional is consulted, in person 432.4 or by phone, during the first three hours when a mental health 432.5 practitioner provides on-site service; 432.6 (4) the mental health professional must: 432.7 (i) review and approve of the tentative crisis assessment 432.8 and crisis treatment plan; 432.9 (ii) document the consultation; and 432.10 (iii) sign the crisis assessment and treatment plan within 432.11 the next business day; 432.12 (5) if the mobile crisis intervention services continue 432.13 into a second calendar day, a mental health professional must 432.14 contact the recipient face-to-face on the second day to provide 432.15 services and update the crisis treatment plan; and 432.16 (6) the on-site observation must be documented in the 432.17 recipient's record and signed by the mental health professional. 432.18 Subd. 10. [RECIPIENT FILE.] Providers of mobile crisis 432.19 intervention or crisis stabilization services must maintain a 432.20 file for each recipient containing the following information: 432.21 (1) individual crisis treatment plans signed by the 432.22 recipient, mental health professional, and mental health 432.23 practitioner who developed the crisis treatment plan, or if the 432.24 recipient refused to sign the plan, the date and reason stated 432.25 by the recipient as to why the recipient would not sign the 432.26 plan; 432.27 (2) signed release forms; 432.28 (3) recipient health information and current medications; 432.29 (4) emergency contacts for the recipient; 432.30 (5) case records which document the date of service, place 432.31 of service delivery, signature of the person providing the 432.32 service, and the nature, extent, and units of service. Direct 432.33 or telephone contact with the recipient's family or others 432.34 should be documented; 432.35 (6) required clinical supervision by mental health 432.36 professionals; 433.1 (7) summary of the recipient's case reviews by staff; and 433.2 (8) any written information by the recipient that the 433.3 recipient wants in the file. 433.4 Documentation in the file must comply with all requirements of 433.5 the commissioner. 433.6 Subd. 11. [TREATMENT PLAN.] The individual crisis 433.7 stabilization treatment plan must include, at a minimum: 433.8 (1) a list of problems identified in the assessment; 433.9 (2) a list of the recipient's strengths and resources; 433.10 (3) concrete, measurable short-term goals and tasks to be 433.11 achieved, including time frames for achievement; 433.12 (4) specific objectives directed toward the achievement of 433.13 each one of the goals; 433.14 (5) documentation of the participants involved in the 433.15 service planning. The recipient, if possible, must be a 433.16 participant. The recipient or the recipient's legal guardian 433.17 must sign the service plan or documentation must be provided why 433.18 this was not possible. A copy of the plan must be given to the 433.19 recipient and the recipient's legal guardian. The plan should 433.20 include services arranged, including specific providers where 433.21 applicable; 433.22 (6) planned frequency and type of services initiated; 433.23 (7) a crisis response action plan if a crisis should occur; 433.24 (8) clear progress notes on outcome of goals; 433.25 (9) a written plan must be completed within 24 hours of 433.26 beginning services with the recipient; and 433.27 (10) a treatment plan must be developed by a mental health 433.28 professional or mental health practitioner under the clinical 433.29 supervision of a mental health professional. The mental health 433.30 professional must approve and sign all treatment plans. 433.31 Subd. 12. [EXCLUDED SERVICES.] The following services are 433.32 excluded from reimbursement under this section: 433.33 (1) room and board services; 433.34 (2) services delivered to a recipient while admitted to an 433.35 inpatient hospital; 433.36 (3) recipient transportation costs may be covered under 434.1 other medical assistance provisions, but transportation services 434.2 are not an adult mental health crisis response service; 434.3 (4) services provided and billed by a provider who is not 434.4 enrolled under medical assistance to provide adult mental health 434.5 crisis response services; 434.6 (5) services performed by volunteers; 434.7 (6) direct billing of time spent "on call" when not 434.8 delivering services to a recipient; 434.9 (7) provider service time included in case management 434.10 reimbursement. When a provider is eligible to provide more than 434.11 one type of medical assistance service, the recipient must have 434.12 a choice of provider for each service, unless otherwise provided 434.13 for by law; 434.14 (8) outreach services to potential recipients; and 434.15 (9) a mental health service that is not medically necessary. 434.16 Sec. 46. Minnesota Statutes 2000, section 256B.0625, 434.17 subdivision 20, is amended to read: 434.18 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 434.19 extent authorized by rule of the state agency, medical 434.20 assistance covers case management services to persons with 434.21 serious and persistent mental illness and children with severe 434.22 emotional disturbance. Services provided under this section 434.23 must meet the relevant standards in sections 245.461 to 434.24 245.4888, the Comprehensive Adult and Children's Mental Health 434.25 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 434.26 9505.0322, excluding subpart 10. 434.27 (b) Entities meeting program standards set out in rules 434.28 governing family community support services as defined in 434.29 section 245.4871, subdivision 17, are eligible for medical 434.30 assistance reimbursement for case management services for 434.31 children with severe emotional disturbance when these services 434.32 meet the program standards in Minnesota Rules, parts 9520.0900 434.33 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 434.34 (c) Medical assistance and MinnesotaCare payment for mental 434.35 health case management shall be made on a monthly basis. In 434.36 order to receive payment for an eligible child, the provider 435.1 must document at least a face-to-face contact with the child, 435.2 the child's parents, or the child's legal representative. To 435.3 receive payment for an eligible adult, the provider must 435.4 document: 435.5 (1) at least a face-to-face contact with the adult or the 435.6 adult's legal representative; or 435.7 (2) at least a telephone contact with the adult or the 435.8 adult's legal representative and document a face-to-face contact 435.9 with the adult or the adult's legal representative within the 435.10 preceding two months. 435.11 (d) Payment for mental health case management provided by 435.12 county or state staff shall be based on the monthly rate 435.13 methodology under section 256B.094, subdivision 6, paragraph 435.14 (b), with separate rates calculated for child welfare and mental 435.15 health, and within mental health, separate rates for children 435.16 and adults. 435.17 (e) Payment for mental health case management provided by 435.18 Indian health services or by agencies operated by Indian tribes 435.19 may be made according to this section or other relevant 435.20 federally approved rate setting methodology. 435.21 (f) Payment for mental health case management provided by 435.22county-contractedvendors who contract with a county or Indian 435.23 tribe shall be based on a monthly rate negotiated by the host 435.24 county or tribe. The negotiated rate must not exceed the rate 435.25 charged by the vendor for the same service to other payers. If 435.26 the service is provided by a team of contracted vendors, the 435.27 county or tribe may negotiate a team rate with a vendor who is a 435.28 member of the team. The team shall determine how to distribute 435.29 the rate among its members. No reimbursement received by 435.30 contracted vendors shall be returned to the county or tribe, 435.31 except to reimburse the county or tribe for advance funding 435.32 provided by the county or tribe to the vendor. 435.33(f)(g) If the service is provided by a team which includes 435.34 contracted vendors, tribal staff, and county or state staff, the 435.35 costs for county or state staff participation in the team shall 435.36 be included in the rate for county-provided services. In this 436.1 case, the contracted vendor, the tribal agency, and the county 436.2 may each receive separate payment for services provided by each 436.3 entity in the same month. In order to prevent duplication of 436.4 services,the countyeach entity must document, in the 436.5 recipient's file, the need for team case management and a 436.6 description of the roles of the team members. 436.7(g)(h) The commissioner shall calculate the nonfederal 436.8 share of actual medical assistance and general assistance 436.9 medical care payments for each county, based on the higher of 436.10 calendar year 1995 or 1996, by service date, project that amount 436.11 forward to 1999, and transfer one-half of the result from 436.12 medical assistance and general assistance medical care to each 436.13 county's mental health grants under sections 245.4886 and 436.14 256E.12 for calendar year 1999. The annualized minimum amount 436.15 added to each county's mental health grant shall be $3,000 per 436.16 year for children and $5,000 per year for adults. The 436.17 commissioner may reduce the statewide growth factor in order to 436.18 fund these minimums. The annualized total amount transferred 436.19 shall become part of the base for future mental health grants 436.20 for each county. 436.21(h)(i) Any net increase in revenue to the county or tribe 436.22 as a result of the change in this section must be used to 436.23 provide expanded mental health services as defined in sections 436.24 245.461 to 245.4888, the Comprehensive Adult and Children's 436.25 Mental Health Acts, excluding inpatient and residential 436.26 treatment. For adults, increased revenue may also be used for 436.27 services and consumer supports which are part of adult mental 436.28 health projects approved under Laws 1997, chapter 203, article 436.29 7, section 25. For children, increased revenue may also be used 436.30 for respite care and nonresidential individualized 436.31 rehabilitation services as defined in section 245.492, 436.32 subdivisions 17 and 23. "Increased revenue" has the meaning 436.33 given in Minnesota Rules, part 9520.0903, subpart 3. 436.34(i)(j) Notwithstanding section 256B.19, subdivision 1, the 436.35 nonfederal share of costs for mental health case management 436.36 shall be provided by the recipient's county of responsibility, 437.1 as defined in sections 256G.01 to 256G.12, from sources other 437.2 than federal funds or funds used to match other federal 437.3 funds. If the service is provided by a tribal agency, the 437.4 nonfederal share, if any, shall be provided by the recipient's 437.5 tribe. 437.6(j)(k) The commissioner may suspend, reduce, or terminate 437.7 the reimbursement to a provider that does not meet the reporting 437.8 or other requirements of this section. The county of 437.9 responsibility, as defined in sections 256G.01 to 256G.12, or, 437.10 if applicable, the tribal agency, is responsible for any federal 437.11 disallowances. The county or tribe may share this 437.12 responsibility with its contracted vendors. 437.13(k)(l) The commissioner shall set aside a portion of the 437.14 federal funds earned under this section to repay the special 437.15 revenue maximization account under section 256.01, subdivision 437.16 2, clause (15). The repayment is limited to: 437.17 (1) the costs of developing and implementing this section; 437.18 and 437.19 (2) programming the information systems. 437.20(l)(m) Notwithstanding section 256.025, subdivision 2, 437.21 payments to counties and tribal agencies for case management 437.22 expenditures under this section shall only be made from federal 437.23 earnings from services provided under this section. Payments to 437.24contractedcounty-contracted vendors shall include both the 437.25 federal earnings and the county share. 437.26(m)(n) Notwithstanding section 256B.041, county payments 437.27 for the cost of mental health case management services provided 437.28 by county or state staff shall not be made to the state 437.29 treasurer. For the purposes of mental health case management 437.30 services provided by county or state staff under this section, 437.31 the centralized disbursement of payments to counties under 437.32 section 256B.041 consists only of federal earnings from services 437.33 provided under this section. 437.34(n)(o) Case management services under this subdivision do 437.35 not include therapy, treatment, legal, or outreach services. 437.36(o)(p) If the recipient is a resident of a nursing 438.1 facility, intermediate care facility, or hospital, and the 438.2 recipient's institutional care is paid by medical assistance, 438.3 payment for case management services under this subdivision is 438.4 limited to the last 30 days of the recipient's residency in that 438.5 facility and may not exceed more than two months in a calendar 438.6 year. 438.7(p)(q) Payment for case management services under this 438.8 subdivision shall not duplicate payments made under other 438.9 program authorities for the same purpose. 438.10(q)(r) By July 1, 2000, the commissioner shall evaluate 438.11 the effectiveness of the changes required by this section, 438.12 including changes in number of persons receiving mental health 438.13 case management, changes in hours of service per person, and 438.14 changes in caseload size. 438.15(r)(s) For each calendar year beginning with the calendar 438.16 year 2001, the annualized amount of state funds for each county 438.17 determined under paragraph(g)(h) shall be adjusted by the 438.18 county's percentage change in the average number of clients per 438.19 month who received case management under this section during the 438.20 fiscal year that ended six months prior to the calendar year in 438.21 question, in comparison to the prior fiscal year. 438.22(s)(t) For counties receiving the minimum allocation of 438.23 $3,000 or $5,000 described in paragraph(g)(h), the adjustment 438.24 in paragraph(r)(s) shall be determined so that the county 438.25 receives the higher of the following amounts: 438.26 (1) a continuation of the minimum allocation in paragraph 438.27(g)(h); or 438.28 (2) an amount based on that county's average number of 438.29 clients per month who received case management under this 438.30 section during the fiscal year that ended six months prior to 438.31 the calendar year in question,in comparison to the prior fiscal438.32year,times the average statewide grant per person per month for 438.33 counties not receiving the minimum allocation. 438.34(t)(u) The adjustments in paragraphs(r) and(s) and (t) 438.35 shall be calculated separately for children and adults. 438.36 Sec. 47. Minnesota Statutes 2000, section 256B.0625, is 439.1 amended by adding a subdivision to read: 439.2 Subd. 45. [APPEAL PROCESS.] If a county contract or 439.3 certification is required to enroll as an authorized provider of 439.4 mental health services under medical assistance, and if a county 439.5 refuses to grant the necessary contract or certification, the 439.6 provider may appeal the county decision to the commissioner. A 439.7 recipient may initiate an appeal on behalf of a provider who has 439.8 been denied certification. The commissioner shall determine 439.9 whether the provider meets applicable standards under state laws 439.10 and rules based on an independent review of the facts, including 439.11 comments from the county review. If the commissioner finds that 439.12 the provider meets the applicable standards, the commissioner 439.13 shall enroll the provider as an authorized provider. The 439.14 commissioner shall develop procedures for providers and 439.15 recipients to appeal a county decision to refuse to enroll a 439.16 provider. After the commissioner makes a decision regarding an 439.17 appeal, the county, provider, or recipient may request that the 439.18 commissioner reconsider the commissioner's initial decision. 439.19 The commissioner's reconsideration decision is final and not 439.20 subject to further appeal. 439.21 Sec. 48. Minnesota Statutes 2000, section 256B.0625, is 439.22 amended by adding a subdivision to read: 439.23 Subd. 46. [MENTAL HEALTH PROVIDER TRAVEL TIME.] Medical 439.24 assistance covers provider travel time if a recipient's 439.25 individual treatment plan requires the provision of mental 439.26 health services outside of the provider's normal place of 439.27 business. This does not include any travel time which is 439.28 included in other billable services, and is only covered when 439.29 the mental health service being provided to a recipient is 439.30 covered under medical assistance. 439.31 Sec. 49. [256B.761] [REIMBURSEMENT FOR MENTAL HEALTH 439.32 SERVICES.] 439.33 Effective for services rendered on or after July 1, 2001, 439.34 payment for medication management provided to psychiatric 439.35 patients, outpatient mental health services, day treatment 439.36 services, home-based mental health services, and family 440.1 community support services shall be paid at the lower of (1) 440.2 submitted charges, or (2) 75.6 percent of the 50th percentile of 440.3 1999 charges. 440.4 Sec. 50. [256B.82] [PREPAID PLANS AND MENTAL HEALTH 440.5 REHABILITATIVE SERVICES.] 440.6 Medical assistance and MinnesotaCare prepaid health plans 440.7 may include coverage for adult mental health rehabilitative 440.8 services under section 256B.0623 and adult mental health crisis 440.9 response services under section 256B.0624, beginning January 1, 440.10 2004. 440.11 By January 15, 2003, the commissioner shall report to the 440.12 legislature how these services should be included in prepaid 440.13 plans. The commissioner shall consult with mental health 440.14 advocates, health plans, and counties in developing this 440.15 report. The report recommendations must include a plan to 440.16 ensure coordination of these services between health plans and 440.17 counties, assure recipient access to essential community 440.18 providers, and monitor the health plans' delivery of services 440.19 through utilization review and quality standards. 440.20 Sec. 51. [256B.83] [MAINTENANCE OF EFFORT FOR CERTAIN 440.21 MENTAL HEALTH SERVICES.] 440.22 Any net increase in revenue to the county as a result of 440.23 the change in section 256B.0623 or 256B.0624 must be used to 440.24 provide expanded mental health services as defined in sections 440.25 245.461 to 245.486, the Comprehensive Adult Mental Health Act, 440.26 excluding inpatient and residential treatment. Increased 440.27 revenue may also be used for services and consumer supports, 440.28 which are part of adult mental health projects approved under 440.29 section 245.4661. "Increased revenue" has the meaning given in 440.30 Minnesota Rules, part 9520.0903, subpart 3. 440.31 Sec. 52. Minnesota Statutes 2000, section 260C.201, 440.32 subdivision 1, is amended to read: 440.33 Subdivision 1. [DISPOSITIONS.] (a) If the court finds that 440.34 the child is in need of protection or services or neglected and 440.35 in foster care, it shall enter an order making any of the 440.36 following dispositions of the case: 441.1 (1) place the child under the protective supervision of the 441.2 local social services agency or child-placing agency in the home 441.3 of a parent of the child under conditions prescribed by the 441.4 court directed to the correction of the child's need for 441.5 protection or services, or: 441.6 (i) the court may order the child into the home of a parent 441.7 who does not otherwise have legal custody of the child, however, 441.8 an order under this section does not confer legal custody on 441.9 that parent; 441.10 (ii) if the court orders the child into the home of a 441.11 father who is not adjudicated, he must cooperate with paternity 441.12 establishment proceedings regarding the child in the appropriate 441.13 jurisdiction as one of the conditions prescribed by the court 441.14 for the child to continue in his home; 441.15 (iii) the court may order the child into the home of a 441.16 noncustodial parent with conditions and may also order both the 441.17 noncustodial and the custodial parent to comply with the 441.18 requirements of a case plan under subdivision 2; 441.19 (2) transfer legal custody to one of the following: 441.20 (i) a child-placing agency; or 441.21 (ii) the local social services agency. 441.22 In placing a child whose custody has been transferred under 441.23 this paragraph, the agencies shall follow the requirements of 441.24 section 260C.193, subdivision 3; 441.25 (3) if the child has been adjudicated as a child in need of 441.26 protection or services because the child is in need of special 441.27treatment andservices or carefor reasons of physical or mental441.28healthto treat or ameliorate a physical or mental disability, 441.29 the court may order the child's parent, guardian, or custodian 441.30 to provide it. The court may order the child's health plan 441.31 company to provide mental health services to the child. Section 441.32 62Q.535 applies to an order for mental health services directed 441.33 to the child's health plan company. If the health plan, parent, 441.34 guardian, or custodian fails or is unable to provide this 441.35 treatment or care, the court may order it provided. Absent 441.36 specific written findings by the court that the child's 442.1 disability is the result of abuse or neglect by the child's 442.2 parent or guardian, the court shall not transfer legal custody 442.3 of the child for the purpose of obtaining special treatment or 442.4 care solely because the parent is unable to provide the 442.5 treatment or care. If the court's order for mental health 442.6 treatment is based on a diagnosis made by a treatment 442.7 professional, the court may order that the diagnosing 442.8 professional not provide the treatment to the child if it finds 442.9 that such an order is in the child's best interests; or 442.10 (4) if the court believes that the child has sufficient 442.11 maturity and judgment and that it is in the best interests of 442.12 the child, the court may order a child 16 years old or older to 442.13 be allowed to live independently, either alone or with others as 442.14 approved by the court under supervision the court considers 442.15 appropriate, if the county board, after consultation with the 442.16 court, has specifically authorized this dispositional 442.17 alternative for a child. 442.18 (b) If the child was adjudicated in need of protection or 442.19 services because the child is a runaway or habitual truant, the 442.20 court may order any of the following dispositions in addition to 442.21 or as alternatives to the dispositions authorized under 442.22 paragraph (a): 442.23 (1) counsel the child or the child's parents, guardian, or 442.24 custodian; 442.25 (2) place the child under the supervision of a probation 442.26 officer or other suitable person in the child's own home under 442.27 conditions prescribed by the court, including reasonable rules 442.28 for the child's conduct and the conduct of the parents, 442.29 guardian, or custodian, designed for the physical, mental, and 442.30 moral well-being and behavior of the child; or with the consent 442.31 of the commissioner of corrections, place the child in a group 442.32 foster care facility which is under the commissioner's 442.33 management and supervision; 442.34 (3) subject to the court's supervision, transfer legal 442.35 custody of the child to one of the following: 442.36 (i) a reputable person of good moral character. No person 443.1 may receive custody of two or more unrelated children unless 443.2 licensed to operate a residential program under sections 245A.01 443.3 to 245A.16; or 443.4 (ii) a county probation officer for placement in a group 443.5 foster home established under the direction of the juvenile 443.6 court and licensed pursuant to section 241.021; 443.7 (4) require the child to pay a fine of up to $100. The 443.8 court shall order payment of the fine in a manner that will not 443.9 impose undue financial hardship upon the child; 443.10 (5) require the child to participate in a community service 443.11 project; 443.12 (6) order the child to undergo a chemical dependency 443.13 evaluation and, if warranted by the evaluation, order 443.14 participation by the child in a drug awareness program or an 443.15 inpatient or outpatient chemical dependency treatment program; 443.16 (7) if the court believes that it is in the best interests 443.17 of the child and of public safety that the child's driver's 443.18 license or instruction permit be canceled, the court may order 443.19 the commissioner of public safety to cancel the child's license 443.20 or permit for any period up to the child's 18th birthday. If 443.21 the child does not have a driver's license or permit, the court 443.22 may order a denial of driving privileges for any period up to 443.23 the child's 18th birthday. The court shall forward an order 443.24 issued under this clause to the commissioner, who shall cancel 443.25 the license or permit or deny driving privileges without a 443.26 hearing for the period specified by the court. At any time 443.27 before the expiration of the period of cancellation or denial, 443.28 the court may, for good cause, order the commissioner of public 443.29 safety to allow the child to apply for a license or permit, and 443.30 the commissioner shall so authorize; 443.31 (8) order that the child's parent or legal guardian deliver 443.32 the child to school at the beginning of each school day for a 443.33 period of time specified by the court; or 443.34 (9) require the child to perform any other activities or 443.35 participate in any other treatment programs deemed appropriate 443.36 by the court. 444.1 To the extent practicable, the court shall enter a 444.2 disposition order the same day it makes a finding that a child 444.3 is in need of protection or services or neglected and in foster 444.4 care, but in no event more than 15 days after the finding unless 444.5 the court finds that the best interests of the child will be 444.6 served by granting a delay. If the child was under eight years 444.7 of age at the time the petition was filed, the disposition order 444.8 must be entered within ten days of the finding and the court may 444.9 not grant a delay unless good cause is shown and the court finds 444.10 the best interests of the child will be served by the delay. 444.11 (c) If a child who is 14 years of age or older is 444.12 adjudicated in need of protection or services because the child 444.13 is a habitual truant and truancy procedures involving the child 444.14 were previously dealt with by a school attendance review board 444.15 or county attorney mediation program under section 260A.06 or 444.16 260A.07, the court shall order a cancellation or denial of 444.17 driving privileges under paragraph (b), clause (7), for any 444.18 period up to the child's 18th birthday. 444.19 (d) In the case of a child adjudicated in need of 444.20 protection or services because the child has committed domestic 444.21 abuse and been ordered excluded from the child's parent's home, 444.22 the court shall dismiss jurisdiction if the court, at any time, 444.23 finds the parent is able or willing to provide an alternative 444.24 safe living arrangement for the child, as defined in Laws 1997, 444.25 chapter 239, article 10, section 2. 444.26 Sec. 53. [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT 444.27 RESIDENTIAL SERVICES GRANTS.] 444.28 The commissioner of human services shall review funding 444.29 methods for adult residential services grants under Minnesota 444.30 Rules, parts 9535.2000 to 9535.3000, and shall develop a payment 444.31 system that takes into account client difficulty of care as 444.32 manifested by client physical, mental, or behavioral 444.33 conditions. The payment system must provide reimbursement for 444.34 education, consultation, and support services provided to 444.35 families and other individuals as an extension of the treatment 444.36 process. The commissioner shall present recommendations and 445.1 draft legislation for an adult residential services payment 445.2 system to the legislature by January 15, 2002. The 445.3 recommendations must address whether additional funding for 445.4 adult residential services grants is necessary for the provision 445.5 of high quality services under a payment reimbursement system. 445.6 Sec. 54. [NOTICE REGARDING ESTABLISHMENT OF CONTINUING 445.7 CARE BENEFIT PROGRAM.] 445.8 When the continuing care benefit program for persons with 445.9 mental illness under Minnesota Statutes, section 256.9693, is 445.10 established, the commissioner of human services shall notify 445.11 counties, health plan companies with prepaid medical assistance 445.12 contracts, health care providers, and enrollees of the benefit 445.13 program through bulletins, workshops, and other meetings. 445.14 Sec. 55. [STUDY OF CHILDREN'S MENTAL HEALTH SYSTEM.] 445.15 The commissioner of human services shall conduct a 445.16 comprehensive study of the children's mental health system, 445.17 including, but not limited to, governance, funding for services, 445.18 family involvement in the provision of services, the involvement 445.19 of schools and other entities in the provision of services, and 445.20 the use of a public health model for early intervention and 445.21 treatment services. This study shall be conducted in 445.22 consultation with the commissioner of health; the commissioner 445.23 of children, families, and learning; the providers of mental 445.24 health services in schools; other providers of mental health 445.25 services; parents of children receiving mental health services; 445.26 local children's mental health collaboratives; counties; and 445.27 other interested parties. The study shall include an assessment 445.28 and evaluation of the family services collaboratives and mental 445.29 health collaboratives. The commissioner shall report findings 445.30 and recommendations for changes to the children's mental health 445.31 system to the legislature by January 15, 2002. 445.32 Sec. 56. [STUDY; LENGTH OF STAY FOR MEDICARE-ELIGIBLE 445.33 PERSONS.] 445.34 The commissioner of human services shall study and make 445.35 recommendations on how Medicare-eligible persons with mental 445.36 illness may obtain acute care hospital inpatient treatment for 446.1 mental illness for a length of stay beyond that allowed by the 446.2 diagnostic classifications for mental illness according to 446.3 Minnesota Statutes, section 256.969, subdivision 3a. The study 446.4 and recommendations shall be reported to the legislature by 446.5 January 15, 2002. 446.6 Sec. 57. [TRANSITIONAL SERVICES FOR MENTALLY ILL OFFENDERS 446.7 PILOT PROGRAM REPORT.] 446.8 By January 15, 2003, the commissioner of corrections shall 446.9 report to the chairs and ranking minority members of the house 446.10 and senate committees and divisions having jurisdiction over 446.11 criminal justice policy and funding on the effectiveness of the 446.12 grants made and pilot projects funded under section 244.25. 446.13 ARTICLE 10 446.14 ASSISTANCE PROGRAMS 446.15 Section 1. Minnesota Statutes 2000, section 256.98, 446.16 subdivision 8, is amended to read: 446.17 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 446.18 found to be guilty of wrongfully obtaining assistance by a 446.19 federal or state court or by an administrative hearing 446.20 determination, or waiver thereof, through a disqualification 446.21 consent agreement, or as part of any approved diversion plan 446.22 under section 401.065, or any court-ordered stay which carries 446.23 with it any probationary or other conditions, in the Minnesota 446.24 familyassistanceinvestment program, the food stamp program, 446.25 the general assistance program, the group residential housing 446.26 program, or the Minnesota supplemental aid program shall be 446.27 disqualified from that program. In addition, any person 446.28 disqualified from the Minnesota family investment program shall 446.29 also be disqualified from the food stamp program. The needs of 446.30 that individual shall not be taken into consideration in 446.31 determining the grant level for that assistance unit: 446.32 (1) for one year after the first offense; 446.33 (2) for two years after the second offense; and 446.34 (3) permanently after the third or subsequent offense. 446.35 The period of program disqualification shall begin on the 446.36 date stipulated on the advance notice of disqualification 447.1 without possibility of postponement for administrative stay or 447.2 administrative hearing and shall continue through completion 447.3 unless and until the findings upon which the sanctions were 447.4 imposed are reversed by a court of competent jurisdiction. The 447.5 period for which sanctions are imposed is not subject to 447.6 review. The sanctions provided under this subdivision are in 447.7 addition to, and not in substitution for, any other sanctions 447.8 that may be provided for by law for the offense involved. A 447.9 disqualification established through hearing or waiver shall 447.10 result in the disqualification period beginning immediately 447.11 unless the person has become otherwise ineligible for 447.12 assistance. If the person is ineligible for assistance, the 447.13 disqualification period begins when the person again meets the 447.14 eligibility criteria of the program from which they were 447.15 disqualified and makes application for that program. 447.16 (b) A family receiving assistance through child care 447.17 assistance programs under chapter 119B with a family member who 447.18 is found to be guilty of wrongfully obtaining child care 447.19 assistance by a federal court, state court, or an administrative 447.20 hearing determination or waiver, through a disqualification 447.21 consent agreement, as part of an approved diversion plan under 447.22 section 401.065, or a court-ordered stay with probationary or 447.23 other conditions, is disqualified from child care assistance 447.24 programs. The disqualifications must be for periods of three 447.25 months, six months, and two years for the first, second, and 447.26 third offenses respectively. Subsequent violations must result 447.27 in permanent disqualification. During the disqualification 447.28 period, disqualification from any child care program must extend 447.29 to all child care programs and must be immediately applied. 447.30 Sec. 2. Minnesota Statutes 2000, section 256D.053, 447.31 subdivision 1, is amended to read: 447.32 Subdivision 1. [PROGRAM ESTABLISHED.] The Minnesota food 447.33 assistance program is established to provide food assistance to 447.34 legal noncitizens residing in this state who are ineligible to 447.35 participate in the federal Food Stamp Program solely due to the 447.36 provisions of section 402 or 403 of Public Law Number 104-193, 448.1 as authorized by Title VII of the 1997 Emergency Supplemental 448.2 Appropriations Act, Public Law Number 105-18, and as amended by 448.3 Public Law Number 105-185. 448.4Beginning July 1, 2002, the Minnesota food assistance448.5program is limited to those noncitizens described in this448.6subdivision who are 50 years of age or older.448.7 Sec. 3. Minnesota Statutes 2000, section 256D.425, 448.8 subdivision 1, is amended to read: 448.9 Subdivision 1. [PERSONS ENTITLED TO RECEIVE AID.] A person 448.10 who is aged, blind, or 18 years of age or older and disabled and 448.11 who is receiving supplemental security benefits under Title XVI 448.12 on the basis of age, blindness, or disability (or would be 448.13 eligible for such benefits except for excess income) is eligible 448.14 for a payment under the Minnesota supplemental aid program, if 448.15 the person's net income is less than the standards in section 448.16 256D.44. Persons who are not receiving supplemental security 448.17 income benefits under Title XVI of the Social Security Act or 448.18 disability insurance benefits under Title II of the Social 448.19 Security Act due to exhausting time limited benefits are not 448.20 eligible to receive benefits under the MSA program. Persons who 448.21 are not receiving social security or other maintenance benefits 448.22 for failure to meet or comply with the social security or other 448.23 maintenance program requirements are not eligible to receive 448.24 benefits under the MSA program. Persons who are found 448.25 ineligible for supplemental security income because of excess 448.26 income, but whose income is within the limits of the Minnesota 448.27 supplemental aid program, must have blindness or disability 448.28 determined by the state medical review team. 448.29 Sec. 4. [256J.021] [SEPARATE STATE PROGRAM FOR USE OF 448.30 STATE MONEY.] 448.31 (a) Beginning October 1, 2001, and each year thereafter, 448.32 the commissioner of human services must treat financial 448.33 assistance expenditures made to or on behalf of any minor child 448.34 under section 256J.02, subdivision 2, clause (1), who is a 448.35 resident of this state under section 256J.12, and who is part of 448.36 a two-parent eligible household as expenditures under a 449.1 separately funded state program and report those expenditures to 449.2 the federal Department of Health and Human Services as separate 449.3 state program expenditures under Code of Federal Regulations, 449.4 title 45, section 263.5. 449.5 (b) One parent in a two-parent eligible household may meet 449.6 all of the family's hourly work or work activity requirements 449.7 specified under sections 256J.49 to 256J.72, or the hourly 449.8 requirement may be divided between the caregivers as best meets 449.9 the family's needs as documented in the caregiver's workplans. 449.10 Sec. 5. Minnesota Statutes 2000, section 256J.08, 449.11 subdivision 55a, is amended to read: 449.12 Subd. 55a. [MFIP STANDARD OF NEED.] "MFIP standard of 449.13 need" means the appropriate standard used to determine MFIP 449.14 benefit payments for the MFIP unit and applies to: 449.15 (1) the transitional standard, sections 256J.08, 449.16 subdivision 85, and 256J.24, subdivision 5; and 449.17 (2) the shared household standard, section 256J.24, 449.18 subdivision 9; and449.19(3) the interstate transition standard, section 256J.43. 449.20 Sec. 6. Minnesota Statutes 2000, section 256J.08, is 449.21 amended by adding a subdivision to read: 449.22 Subd. 67a. [PERSON TRAINED IN DOMESTIC VIOLENCE.] "Person 449.23 trained in domestic violence" means an individual who works for 449.24 an organization that is designated by the Minnesota center for 449.25 crime victims services as providing services to victims of 449.26 domestic violence, or a county staff person who has received 449.27 similar specialized training, and includes any other person or 449.28 organization designated by a qualifying organization under this 449.29 section. 449.30 [EFFECTIVE DATE.] This section is effective October 1, 2001. 449.31 Sec. 7. Minnesota Statutes 2000, section 256J.21, 449.32 subdivision 2, is amended to read: 449.33 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 449.34 excluded in determining a family's available income: 449.35 (1) payments for basic care, difficulty of care, and 449.36 clothing allowances received for providing family foster care to 450.1 children or adults under Minnesota Rules, parts 9545.0010 to 450.2 9545.0260 and 9555.5050 to 9555.6265, and payments received and 450.3 used for care and maintenance of a third-party beneficiary who 450.4 is not a household member; 450.5 (2) reimbursements for employment training received through 450.6 the Job Training Partnership Act, United States Code, title 29, 450.7 chapter 19, sections 1501 to 1792b; 450.8 (3) reimbursement for out-of-pocket expenses incurred while 450.9 performing volunteer services, jury duty, employment, or 450.10 informal carpooling arrangements directly related to employment; 450.11 (4) all educational assistance, except the county agency 450.12 must count graduate student teaching assistantships, 450.13 fellowships, and other similar paid work as earned income and, 450.14 after allowing deductions for any unmet and necessary 450.15 educational expenses, shall count scholarships or grants awarded 450.16 to graduate students that do not require teaching or research as 450.17 unearned income; 450.18 (5) loans, regardless of purpose, from public or private 450.19 lending institutions, governmental lending institutions, or 450.20 governmental agencies; 450.21 (6) loans from private individuals, regardless of purpose, 450.22 provided an applicant or participant documents that the lender 450.23 expects repayment; 450.24 (7)(i) state income tax refunds; and 450.25 (ii) federal income tax refunds; 450.26 (8)(i) federal earned income credits; 450.27 (ii) Minnesota working family credits; 450.28 (iii) state homeowners and renters credits under chapter 450.29 290A; and 450.30 (iv) federal or state tax rebates; 450.31 (9) funds received for reimbursement, replacement, or 450.32 rebate of personal or real property when these payments are made 450.33 by public agencies, awarded by a court, solicited through public 450.34 appeal, or made as a grant by a federal agency, state or local 450.35 government, or disaster assistance organizations, subsequent to 450.36 a presidential declaration of disaster; 451.1 (10) the portion of an insurance settlement that is used to 451.2 pay medical, funeral, and burial expenses, or to repair or 451.3 replace insured property; 451.4 (11) reimbursements for medical expenses that cannot be 451.5 paid by medical assistance; 451.6 (12) payments by a vocational rehabilitation program 451.7 administered by the state under chapter 268A, except those 451.8 payments that are for current living expenses; 451.9 (13) in-kind income, including any payments directly made 451.10 by a third party to a provider of goods and services; 451.11 (14) assistance payments to correct underpayments, but only 451.12 for the month in which the payment is received; 451.13 (15) emergency assistance payments; 451.14 (16) funeral and cemetery payments as provided by section 451.15 256.935; 451.16 (17) nonrecurring cash gifts of $30 or less, not exceeding 451.17 $30 per participant in a calendar month; 451.18 (18) any form of energy assistance payment made through 451.19 Public Law Number 97-35, Low-Income Home Energy Assistance Act 451.20 of 1981, payments made directly to energy providers by other 451.21 public and private agencies, and any form of credit or rebate 451.22 payment issued by energy providers; 451.23 (19) Supplemental Security Income (SSI), including 451.24 retroactive SSI payments and other income of an SSI recipient; 451.25 (20) Minnesota supplemental aid, including retroactive 451.26 payments; 451.27 (21) proceeds from the sale of real or personal property; 451.28 (22) adoption assistance payments under section 259.67; 451.29 (23) state-funded family subsidy program payments made 451.30 under section 252.32 to help families care for children with 451.31 mental retardation or related conditions, consumer support grant 451.32 funds under section 256.476, and resources and services for a 451.33 disabled household member under one of the home and 451.34 community-based waiver services programs under chapter 256B; 451.35 (24) interest payments and dividends from property that is 451.36 not excluded from and that does not exceed the asset limit; 452.1 (25) rent rebates; 452.2 (26) income earned by a minor caregiver, minor child 452.3 through age 6, or a minor child who is at least a half-time 452.4 student in an approved elementary or secondary education 452.5 program; 452.6 (27) income earned by a caregiver under age 20 who is at 452.7 least a half-time student in an approved elementary or secondary 452.8 education program; 452.9 (28) MFIP child care payments under section 119B.05; 452.10 (29) all other payments made through MFIP to support a 452.11 caregiver's pursuit of greater self-support; 452.12 (30) income a participant receives related to shared living 452.13 expenses; 452.14 (31) reverse mortgages; 452.15 (32) benefits provided by the Child Nutrition Act of 1966, 452.16 United States Code, title 42, chapter 13A, sections 1771 to 452.17 1790; 452.18 (33) benefits provided by the women, infants, and children 452.19 (WIC) nutrition program, United States Code, title 42, chapter 452.20 13A, section 1786; 452.21 (34) benefits from the National School Lunch Act, United 452.22 States Code, title 42, chapter 13, sections 1751 to 1769e; 452.23 (35) relocation assistance for displaced persons under the 452.24 Uniform Relocation Assistance and Real Property Acquisition 452.25 Policies Act of 1970, United States Code, title 42, chapter 61, 452.26 subchapter II, section 4636, or the National Housing Act, United 452.27 States Code, title 12, chapter 13, sections 1701 to 1750jj; 452.28 (36) benefits from the Trade Act of 1974, United States 452.29 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 452.30 (37) war reparations payments to Japanese Americans and 452.31 Aleuts under United States Code, title 50, sections 1989 to 452.32 1989d; 452.33 (38) payments to veterans or their dependents as a result 452.34 of legal settlements regarding Agent Orange or other chemical 452.35 exposure under Public Law Number 101-239, section 10405, 452.36 paragraph (a)(2)(E); 453.1 (39) income that is otherwise specifically excluded from 453.2 MFIP consideration in federal law, state law, or federal 453.3 regulation; 453.4 (40) security and utility deposit refunds; 453.5 (41) American Indian tribal land settlements excluded under 453.6 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 453.7 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 453.8 reservations and payments to members of the White Earth Band, 453.9 under United States Code, title 25, chapter 9, section 331, and 453.10 chapter 16, section 1407; 453.11 (42) all income of the minor parent's parents and 453.12 stepparents when determining the grant for the minor parent in 453.13 households that include a minor parent living with parents or 453.14 stepparents on MFIP with other children; and 453.15 (43) income of the minor parent's parents and stepparents 453.16 equal to 200 percent of the federal poverty guideline for a 453.17 family size not including the minor parent and the minor 453.18 parent's child in households that include a minor parent living 453.19 with parents or stepparents not on MFIP when determining the 453.20 grant for the minor parent. The remainder of income is deemed 453.21 as specified in section 256J.37, subdivision 1b; 453.22 (44) payments made to children eligible for relative 453.23 custody assistance under section 257.85; 453.24 (45) vendor payments for goods and services made on behalf 453.25 of a client unless the client has the option of receiving the 453.26 payment in cash;and453.27 (46) the principal portion of a contract for deed payment; 453.28 and 453.29 (47) participant performance bonuses under section 256J.555. 453.30 Sec. 8. Minnesota Statutes 2000, section 256J.24, 453.31 subdivision 2, is amended to read: 453.32 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 453.33 for minor caregivers and their children who must be in a 453.34 separate assistance unit from the other persons in the 453.35 household, when the following individuals live together, they 453.36 must be included in the assistance unit: 454.1 (1) a minor child, including a pregnant minor; 454.2 (2) the minor child's minor siblings, minor half-siblings, 454.3 and minor step-siblings; 454.4 (3) the minor child's natural parents, adoptive parents, 454.5 and stepparents; and 454.6 (4) the spouse of a pregnant woman. 454.7 A minor child must have a caregiver for the child to be 454.8 included in the assistance unit. 454.9 Sec. 9. Minnesota Statutes 2000, section 256J.24, 454.10 subdivision 9, is amended to read: 454.11 Subd. 9. [SHARED HOUSEHOLD STANDARD; MFIP.] (a) Except as 454.12 prohibited in paragraph (b), the county agency must use the 454.13 shared household standard when the household includes one or 454.14 more unrelated members, as that term is defined in section 454.15 256J.08, subdivision 86a. The county agency must use the shared 454.16 household standard, unless a member of the assistance unit is a 454.17 victim ofdomesticfamily violence and has anapproved safety454.18 alternative employment plan, regardless of the number of 454.19 unrelated members in the household. 454.20 (b) The county agency must not use the shared household 454.21 standard when all unrelated members are one of the following: 454.22 (1) a recipient of public assistance benefits, including 454.23 food stamps, Supplemental Security Income, adoption assistance, 454.24 relative custody assistance, or foster care payments; 454.25 (2) a roomer or boarder, or a person to whom the assistance 454.26 unit is paying room or board; 454.27 (3) a minor child under the age of 18; 454.28 (4) a minor caregiver living with the minor caregiver's 454.29 parents or in an approved supervised living arrangement; 454.30 (5) a caregiver who is not the parent of the minor child in 454.31 the assistance unit; or 454.32 (6) an individual who provides child care to a child in the 454.33 MFIP assistance unit. 454.34 (c) The shared household standard must be discontinued if 454.35 it is not approved by the United States Department of 454.36 Agriculture under the MFIP waiver. 455.1 Sec. 10. Minnesota Statutes 2000, section 256J.24, 455.2 subdivision 10, is amended to read: 455.3 Subd. 10. [MFIP EXIT LEVEL.](a) In state fiscal years455.42000 and 2001,The commissioner shall adjust the MFIP earned 455.5 income disregard to ensure that most participants do not lose 455.6 eligibility for MFIP until their income reaches at least 120 455.7 percent of the federal poverty guidelines in effect in October 455.8 of each fiscal year. The adjustment to the disregard shall be 455.9 based on a household size of three, and the resulting earned 455.10 income disregard percentage must be applied to all household 455.11 sizes. The adjustment under this subdivision must be 455.12 implemented at the same time as the October food stamp 455.13 cost-of-living adjustment is reflected in the food portion of 455.14 MFIP transitional standard as required under subdivision 5a. 455.15(b) In state fiscal year 2002 and thereafter, the earned455.16income disregard percentage must be the same as the percentage455.17implemented in October 2000.455.18 Sec. 11. Minnesota Statutes 2000, section 256J.32, 455.19 subdivision 4, is amended to read: 455.20 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 455.21 verify the following at application: 455.22 (1) identity of adults; 455.23 (2) presence of the minor child in the home, if 455.24 questionable; 455.25 (3) relationship of a minor child to caregivers in the 455.26 assistance unit; 455.27 (4) age, if necessary to determine MFIP eligibility; 455.28 (5) immigration status; 455.29 (6) social security number according to the requirements of 455.30 section 256J.30, subdivision 12; 455.31 (7) income; 455.32 (8) self-employment expenses used as a deduction; 455.33 (9) source and purpose of deposits and withdrawals from 455.34 business accounts; 455.35 (10) spousal support and child support payments made to 455.36 persons outside the household; 456.1 (11) real property; 456.2 (12) vehicles; 456.3 (13) checking and savings accounts; 456.4 (14) savings certificates, savings bonds, stocks, and 456.5 individual retirement accounts; 456.6 (15) pregnancy, if related to eligibility; 456.7 (16) inconsistent information, if related to eligibility; 456.8 (17) medical insurance; 456.9 (18) burial accounts; 456.10 (19) school attendance, if related to eligibility; 456.11 (20) residence; 456.12 (21) a claim ofdomesticfamily violence if used as a basis 456.13 for adeferral or exemptionwaiver from the 60-month time limit 456.14 in section 256J.42orand regular employment and training 456.15 services requirements in section 256J.56; 456.16 (22) disability if used as an exemption from employment and 456.17 training services requirements under section 256J.56; and 456.18 (23) information needed to establish an exception under 456.19 section 256J.24, subdivision 9. 456.20 [EFFECTIVE DATE.] This section is effective October 1, 2001. 456.21 Sec. 12. Minnesota Statutes 2000, section 256J.37, 456.22 subdivision 9, is amended to read: 456.23 Subd. 9. [UNEARNED INCOME.](a)The county agency must 456.24 apply unearned income to the MFIP standard of need. When 456.25 determining the amount of unearned income, the county agency 456.26 must deduct the costs necessary to secure payments of unearned 456.27 income. These costs include legal fees, medical fees, and 456.28 mandatory deductions such as federal and state income taxes. 456.29(b) Effective July 1, 2001, the county agency shall count456.30$100 of the value of public and assisted rental subsidies456.31provided through the Department of Housing and Urban Development456.32(HUD) as unearned income. The full amount of the subsidy must456.33be counted as unearned income when the subsidy is less than $100.456.34(c) The provisions of paragraph (b) shall not apply to MFIP456.35participants who are exempt from the employment and training456.36services component because they are:457.1(i) individuals who are age 60 or older;457.2(ii) individuals who are suffering from a professionally457.3certified permanent or temporary illness, injury, or incapacity457.4which is expected to continue for more than 30 days and which457.5prevents the person from obtaining or retaining employment; or457.6(iii) caregivers whose presence in the home is required457.7because of the professionally certified illness or incapacity of457.8another member in the assistance unit, a relative in the457.9household, or a foster child in the household.457.10(d) The provisions of paragraph (b) shall not apply to an457.11MFIP assistance unit where the parental caregiver receives457.12supplemental security income.457.13 Sec. 13. Minnesota Statutes 2000, section 256J.39, 457.14 subdivision 2, is amended to read: 457.15 Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 457.16 paying assistance directly to a participant may be used when: 457.17 (1) a county agency determines that a vendor payment is the 457.18 most effective way to resolve an emergency situation pertaining 457.19 to basic needs; 457.20 (2) a caregiver makes a written request to the county 457.21 agency asking that part or all of the assistance payment be 457.22 issued by protective or vendor payments for shelter and utility 457.23 service only. The caregiver may withdraw this request in 457.24 writing at any time; 457.25 (3) the vendor payment is part of a sanction under section 457.26 256J.46; 457.27 (4) the vendor payment is required under section 256J.24, 457.28 subdivision 8, or 256J.26, or 256J.43; 457.29 (5) protective payments are required for minor parents 457.30 under section 256J.14; or 457.31 (6) a caregiver has exhibited a continuing pattern of 457.32 mismanaging funds as determined by the county agency. 457.33 The director of a county agency, or the director's 457.34 designee, must approve a proposal for protective or vendor 457.35 payment for money mismanagement when there is a pattern of 457.36 mismanagement under clause (6). During the time a protective or 458.1 vendor payment is being made, the county agency must provide 458.2 services designed to alleviate the causes of the mismanagement. 458.3 The continuing need for and method of payment must be 458.4 documented and reviewed every 12 months. The director of a 458.5 county agency or the director's designee must approve the 458.6 continuation of protective or vendor payments. When it appears 458.7 that the need for protective or vendor payments will continue or 458.8 is likely to continue beyond two years because the county 458.9 agency's efforts have not resulted in sufficiently improved use 458.10 of assistance on behalf of the minor child, judicial appointment 458.11 of a legal guardian or other legal representative must be sought 458.12 by the county agency. 458.13 Sec. 14. Minnesota Statutes 2000, section 256J.42, 458.14 subdivision 1, is amended to read: 458.15 Subdivision 1. [TIME LIMIT.] (a) Exceptfor the exemptions458.16 as otherwise provided for in this section, an assistance unit in 458.17 which any adult caregiver has received 60 months of cash 458.18 assistance funded in whole or in part by the TANF block grant in 458.19 this or any other state or United States territory, or from a 458.20 tribal TANF program, MFIP, the AFDC program formerly codified in 458.21 sections 256.72 to 256.87, or the family general assistance 458.22 program formerly codified in sections 256D.01 to 256D.23, funded 458.23 in whole or in part by state appropriations, is ineligible to 458.24 receive MFIP. Any cash assistance funded with TANF dollars in 458.25 this or any other state or United States territory, or from a 458.26 tribal TANF program, or MFIP assistance funded in whole or in 458.27 part by state appropriations, that was received by the unit on 458.28 or after the date TANF was implemented, including any assistance 458.29 received in states or United States territories of prior 458.30 residence, counts toward the 60-month limitation. The 60-month 458.31 limit applies to a minorwho is the head of a household or who458.32is married to the head of a householdcaregiver except under 458.33 subdivision 5. The 60-month time period does not need to be 458.34 consecutive months for this provision to apply. 458.35 (b) The months before July 1998 in which individuals 458.36 received assistance as part of the field trials as an MFIP, 459.1 MFIP-R, or MFIP or MFIP-R comparison group family are not 459.2 included in the 60-month time limit. 459.3 Sec. 15. Minnesota Statutes 2000, section 256J.42, 459.4 subdivision 3, is amended to read: 459.5 Subd. 3. [ADULTS LIVINGON ANIN INDIAN 459.6RESERVATIONCOUNTRY.] In determining the number of months for 459.7 which an adult has received assistance under MFIP-S, the county 459.8 agency must disregard any month during which the adult livedon459.9anin Indianreservationcountry if during the month at least 50 459.10 percent of the adults livingon the reservationin Indian 459.11 country were not employed. 459.12 Sec. 16. Minnesota Statutes 2000, section 256J.42, 459.13 subdivision 4, is amended to read: 459.14 Subd. 4. [VICTIMS OFDOMESTICFAMILY VIOLENCE.] Any cash 459.15 assistance received by an assistance unit in a month when a 459.16 caregiveris complyingcomplied with a safety plan or after 459.17 October 1, 2001, complied or is complying with an alternative 459.18 employment plan underthe MFIP-S employment and training459.19componentsection 256J.49, subdivision 1a, does not count toward 459.20 the 60-month limitation on assistance. 459.21 Sec. 17. Minnesota Statutes 2000, section 256J.42, 459.22 subdivision 5, is amended to read: 459.23 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 459.24 assistance received by an assistance unit does not count toward 459.25 the 60-month limit on assistance during a month in which the 459.26 caregiver (1) is inthea category in section 256J.56, paragraph459.27(a), clause (1); (2) is earning income and participating in work 459.28 activities, as defined in section 256J.49, subdivision 13, for 459.29 at least 40 hours per week for a two-parent family, 20 hours per 459.30 week for a single-parent family with a child under age six 459.31 years, or 30 hours per week for a single-parent family with a 459.32 child age 6 years or older. If the individualized plan requires 459.33 fewer hours of work activities, then it is the number of hours 459.34 required in the plan; or (3) is in an education or training 459.35 program, including, but not limited to, an English as a second 459.36 language (ESL) program, in which the combination of work 460.1 activities and education are for at least 40 hours per week for 460.2 a two-parent family, or 20 hours per week for a single-parent 460.3 family with a child under age six years, or 30 hours per week 460.4 for a single-parent family with a child age 6 years or older. 460.5 If the individualized plan requires fewer hours of work 460.6 activities, then it is the number of hours required in the plan. 460.7 (b)From July 1, 1997, until the date MFIP is operative in460.8the caregiver's county of financial responsibility, any cash460.9assistance received by a caregiver who is complying with460.10Minnesota Statutes 1996, section 256.73, subdivision 5a, and460.11Minnesota Statutes 1998, section 256.736, if applicable, does460.12not count toward the 60-month limit on assistance. Thereafter,460.13any cash assistance received by a minor caregiver who is460.14complying with the requirements of sections 256J.14 and 256J.54,460.15if applicable, does not count towards the 60-month limit on460.16assistance.460.17(c)Any diversionary assistance or emergency assistance 460.18 received does not count toward the 60-month limit. 460.19(d)(c) Any cash assistance received by an 18- or 460.20 19-year-old caregiver who is complying with the requirements of 460.21 section 256J.54 does not count toward the 60-month limit. 460.22 Sec. 18. [256J.422] [60-MONTH TIME LIMIT REVIEW; 460.23 EXTENSION; APPEAL.] 460.24 Subdivision 1. [EXTENSION OF 60-MONTH TIME LIMIT.] At the 460.25 end of the participant's eligibility period when TANF assistance 460.26 has been exhausted, the participant's time limit will be 460.27 extended provided the participant meets the MFIP eligibility 460.28 criteria. Participants must comply with MFIP requirements or be 460.29 subject to a sanction. The county may choose not to provide an 460.30 extension for participants if after a face-to-face review, the 460.31 participant does not fall under any of the categories in 460.32 subdivision 2. 460.33 Subd. 2. [REVIEW.] (a) A county representative may 460.34 schedule a face-to-face review with a participant who is nearing 460.35 the 60-month time limit on TANF assistance. The face-to-face 460.36 review must be conducted with a county representative, a 461.1 representative from a legal rights organization that primarily 461.2 represents low-income individuals or an advocate, and the 461.3 participant, unless the participant requests that a 461.4 representative or advocate not be present during the review. A 461.5 face-to-face review with the participant must be conducted 461.6 before the participant is denied an extension. The county 461.7 representative makes the final determination regarding the 461.8 extension of assistance. 461.9 (b) In the face-to-face review, the individuals in 461.10 attendance shall determine if: 461.11 (1) the participant's plan is inappropriate or if it should 461.12 be modified in order for the participant to reduce barriers or 461.13 achieve goals that will lead to long-term self-sufficiency; 461.14 (2) the participant falls under any of the exempt 461.15 categories in section 256J.42; 461.16 (3) there are other substantial barriers that need to be 461.17 addressed, which include, but are not limited to, language 461.18 barriers, physical or mental health needs, or learning 461.19 disabilities; 461.20 (4) there are services that were required to be provided or 461.21 necessary in order to fulfill the requirements of the plan that 461.22 were unavailable to the participant; 461.23 (5) there are educational opportunities that will lead to 461.24 self-sufficiency that were not allowed or offered to the 461.25 participant; 461.26 (6) the participant's plan is appropriate and the 461.27 participant is meeting the expectations of the participant's 461.28 individualized plan, or in a two-parent family, at least one 461.29 participant has an appropriate plan and is meeting the 461.30 expectations of that individualized plan; 461.31 (7) the employment held by the participant will not provide 461.32 a wage of at least 120 percent of the federal poverty guidelines 461.33 for the same family size, or in a two-parent family, when at 461.34 least one parent is cooperating with the program requirements, 461.35 the employment held by the cooperating participant will not 461.36 provide a wage of at least 120 percent of the federal poverty 462.1 guidelines for the same family size; or 462.2 (8) there are other issues that need to be addressed before 462.3 the participant is denied an extension. 462.4 Subd. 3. [APPEAL OF COUNTY DECISION.] If the county denies 462.5 an extension under subdivision 2, the participant may appeal the 462.6 decision under section 256J.40. Assistance must continue until 462.7 the appeal is resolved. 462.8 Sec. 19. Minnesota Statutes 2000, section 256J.45, 462.9 subdivision 1, is amended to read: 462.10 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 462.11 county agency must provide orientation to each MFIP caregiver 462.12who is not exempt under section 256J.56, paragraph (a), clause462.13(6) or (8)unless the caregiver: (1) is a single parent, or one 462.14 parent in a two-parent family, employed at least 35 hours per 462.15 week; or (2) a second parent in a two-parent family who is 462.16 employed for 20 or more hours per week provided the first parent 462.17 is employed at least 35 hours per week, with a face-to-face 462.18 orientation. The county agency must inform caregivers who are 462.19 not exempt undersection 256J.56, paragraph (a), clause (6) or462.20(8),clause (1) or (2) that failure to attend the orientation is 462.21 considered an occurrence of noncompliance with program 462.22 requirements, and will result in the imposition of a sanction 462.23 under section 256J.46. If the client complies with the 462.24 orientation requirement prior to the first day of the month in 462.25 which the grant reduction is proposed to occur, the orientation 462.26 sanction shall be lifted. 462.27 Sec. 20. Minnesota Statutes 2000, section 256J.45, 462.28 subdivision 2, is amended to read: 462.29 Subd. 2. [GENERAL INFORMATION.] TheMFIP-SMFIP 462.30 orientation must consist of a presentation that informs 462.31 caregivers of: 462.32 (1) the necessity to obtain immediate employment; 462.33 (2) the work incentives underMFIP-SMFIP, including the 462.34 availability of the federal earned income tax credit and the 462.35 Minnesota working family tax credit; 462.36 (3) the requirement to comply with the employment plan and 463.1 other requirements of the employment and training services 463.2 component ofMFIP-SMFIP, including a description of the range 463.3 of work and training activities that are allowable underMFIP-S463.4 MFIP to meet the individual needs of participants; 463.5 (4) the consequences for failing to comply with the 463.6 employment plan and other program requirements, and that the 463.7 county agency may not impose a sanction when failure to comply 463.8 is due to the unavailability of child care or other 463.9 circumstances where the participant has good cause under 463.10 subdivision 3; 463.11 (5) the rights, responsibilities, and obligations of 463.12 participants; 463.13 (6) the types and locations of child care services 463.14 available through the county agency; 463.15 (7) the availability and the benefits of the early 463.16 childhood health and developmental screening under sections 463.17 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 463.18 (8) the caregiver's eligibility for transition year child 463.19 care assistance under section 119B.05; 463.20 (9) the caregiver's eligibility for extended medical 463.21 assistance when the caregiver loses eligibility forMFIP-SMFIP 463.22 due to increased earnings or increased child or spousal support; 463.23 (10) the caregiver's option to choose an employment and 463.24 training provider and information about each provider, including 463.25 but not limited to, services offered, program components, job 463.26 placement rates, job placement wages, and job retention rates; 463.27 (11) the caregiver's option to request approval of an 463.28 education and training plan according to section 256J.52;and463.29 (12) the work study programs available under the higher 463.30 education system; and 463.31 (13) effective October 1, 2001, information about the 463.32 60-month time limit exemption and waivers of regular employment 463.33 and training requirements for family violence victims and 463.34 referral information about shelters and programs for victims of 463.35 family violence. 463.36 Sec. 21. Minnesota Statutes 2000, section 256J.46, 464.1 subdivision 1, is amended to read: 464.2 Subdivision 1. [SANCTIONS FORPARTICIPANTS NOT COMPLYING 464.3 WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 464.4 good cause to comply with the requirements of this chapter, and 464.5 who is not subject to a sanction under subdivision 2, shall be 464.6 subject to a sanction as provided in this subdivision. A 464.7 participant who fails to comply with an alternative employment 464.8 plan must have the plan reviewed by a person trained in domestic 464.9 violence and the county or a job counselor to determine if 464.10 components of the alternative employment plan are still 464.11 appropriate. If the activities are no longer appropriate, the 464.12 plan must be revised with a person trained in domestic violence 464.13 and approved by the county or a job counselor. A participant 464.14 who fails to comply with a plan that is determined not to need 464.15 revision will lose their exemption and be required to comply 464.16 with regular employment services activities. 464.17 A sanction must not be imposed for the sole purpose of 464.18 failing to participate in work activities for a specified number 464.19 of hours if the participant is a single parent or one parent in 464.20 a two-parent family and is employed at least 35 hours per week. 464.21 A sanction under this subdivision becomes effective the 464.22 month following the month in which a required notice is given. 464.23 A sanction must not be imposed when a participant comes into 464.24 compliance with the requirements for orientation under section 464.25 256J.45 or third-party liability for medical services under 464.26 section 256J.30, subdivision 10, prior to the effective date of 464.27 the sanction. A sanction must not be imposed when a participant 464.28 comes into compliance with the requirements for employment and 464.29 training services under sections 256J.49 to 256J.72 ten days 464.30 prior to the effective date of the sanction. For purposes of 464.31 this subdivision, each month that a participant fails to comply 464.32 with a requirement of this chapter shall be considered a 464.33 separate occurrence of noncompliance. A participant who has had 464.34 one or more sanctions imposed must remain in compliance with the 464.35 provisions of this chapter for six months in order for a 464.36 subsequent occurrence of noncompliance to be considered a first 465.1 occurrence. 465.2 (b) Sanctions for noncompliance shall be imposed as follows: 465.3 (1) For the first occurrence of noncompliance by a 465.4 participant in a single-parent household or by one participant 465.5 in a two-parent household, the job counselor must initiate 465.6 personal contact with the participant by either having a 465.7 personal meeting with the participant or a telephone 465.8 conversation with the participant, and thoroughly review the 465.9 exemption and good cause categories with the participant to 465.10 determine if the participant falls under one or more of the 465.11 categories. If the participant does not fall under an exemption 465.12 or good cause category, the assistance unit's grant shall be 465.13 reduced by ten percent of the MFIP standard of need for an 465.14 assistance unit of the same size with the residual grant paid to 465.15 the participant. The reduction in the grant amount must be in 465.16 effect for a minimum of one month and shall be removed in the 465.17 month following the month that the participant returns to 465.18 compliance. 465.19 (2) For a second or subsequent occurrence of noncompliance, 465.20 or when both participants in a two-parent household are out of 465.21 compliance at the same time, the assistance unit's shelter costs 465.22 shall be vendor paid up to the amount of the cash portion of the 465.23 MFIP grant for which the participant's assistance unit is 465.24 eligible. At county option, the assistance unit's utilities may 465.25 also be vendor paid up to the amount of the cash portion of the 465.26 MFIP grant remaining after vendor payment of the assistance 465.27 unit's shelter costs. The residual amount of the grant after 465.28 vendor payment, if any, must be reduced by an amount equal to 30 465.29 percent of the MFIP standard of need for an assistance unit of 465.30 the same size before the residual grant is paid to the 465.31 assistance unit. The reduction in the grant amount must be in 465.32 effect for a minimum of one month and shall be removed in the 465.33 month following the month that a participant in a one-parent 465.34 household returns to compliance. In a two-parent household, the 465.35 grant reduction must be in effect for a minimum of one month and 465.36 shall be removed in the month following the month both 466.1 participants return to compliance. The vendor payment of 466.2 shelter costs and, if applicable, utilities shall be removed six 466.3 months after the month in which the participant or participants 466.4 return to compliance. 466.5 (3) The food portion of the MFIP grant must not be 466.6 sanctioned. 466.7 (c) No later than during the second month that a sanction 466.8 under paragraph (b), clause (2), is in effect due to 466.9 noncompliance with employment services, the participant's case 466.10 file must be reviewed to determine if: 466.11 (i) the continued noncompliance can be explained and 466.12 mitigated by providing a needed preemployment activity, as 466.13 defined in section 256J.49, subdivision 13, clause (16); 466.14 (ii) the participant qualifies for a good cause exception 466.15 under section 256J.57;or466.16 (iii) the participant qualifies for an exemption under 466.17 section 256J.56; or 466.18 (iv) the participant qualifies for a waiver under section 466.19 256J.52, subdivision 6. 466.20 If the lack of an identified activity can explain the 466.21 noncompliance, the county must work with the participant to 466.22 provide the identified activity, and the county must restore the 466.23 participant's grant amount to the full amount for which the 466.24 assistance unit is eligible. The grant must be restored 466.25 retroactively to the first day of the month in which the 466.26 participant was found to lack preemployment activities or to 466.27 qualify for an exemptionor, a good cause exception, or a family 466.28 violence waiver. 466.29 If the participant is found to qualify for a good cause 466.30 exception oranexemption, or a family violence waiver, the 466.31 county must restore the participant's grant to the full amount 466.32 for which the assistance unit is eligible. 466.33 (d) In the two-parent MFIP program under section 256J.021 466.34 if only one caregiver is out of compliance with the requirements 466.35 for employment and training under sections 256J.49 to 256J.72, 466.36 the MFIP grant shall be reduced by either ten percent or 30 467.1 percent of the noncompliant parent's portion of the transitional 467.2 standard, whichever is applicable to the sanction occurrence. 467.3 [EFFECTIVE DATE.] The language in this section related to 467.4 domestic or family violence is effective October 1, 2001. 467.5 Sec. 22. Minnesota Statutes 2000, section 256J.48, 467.6 subdivision 1, is amended to read: 467.7 Subdivision 1. [EMERGENCY FINANCIAL ASSISTANCE.] County 467.8 human service agencies shall grant emergency financial 467.9 assistance to any needy pregnant woman or needy family with a 467.10 child under the age of 21 who is or was within six months prior 467.11 to application living with an eligible caregiver relative 467.12 specified in section 256J.08. 467.13 Except for ongoing special diets, emergency assistance is 467.14 available to a familyduring one 30-day period infor up to two 467.15 times a year, not to exceed a maximum of 120 days within a 467.16 consecutive 12-month period. A county shall issue assistance 467.17 for needs that accrue beforethat 30-day periodthe eligibility 467.18 period only when it is necessary to resolve emergencies arising 467.19 or continuing during the30-dayperiod of eligibility.When467.20emergency needs continue, a county may issue assistance for up467.21to 30 days beyond the initial 30-day period of eligibility, but467.22only when assistance is authorized during the initial period.467.23 Sec. 23. Minnesota Statutes 2000, section 256J.48, is 467.24 amended by adding a subdivision to read: 467.25 Subd. 1a. [PROCESSING EMERGENCY APPLICATIONS.] Within 467.26 seven days of receiving the application, or sooner if the 467.27 immediacy and severity of the situation warrants it, families 467.28 must be notified in writing whether their application was 467.29 approved, denied, or pended. 467.30 Sec. 24. Minnesota Statutes 2000, section 256J.49, is 467.31 amended by adding a subdivision to read: 467.32 Subd. 1a. [ALTERNATIVE EMPLOYMENT PLAN.] "Alternative 467.33 employment plan" means a plan that is based on an individualized 467.34 assessment of need and is developed with a person trained in 467.35 domestic violence and approved by the county or a job 467.36 counselor. The plan may address safety, legal or emotional 468.1 issues, and other demands on the family as a result of the 468.2 family violence. The information in section 256J.515, clauses 468.3 (1) to (8), must be included as part of the development of the 468.4 alternative employment plan. The primary goal of an alternative 468.5 employment plan is to ensure the safety of the caregiver and 468.6 children. To the extent it is consistent with ensuring safety, 468.7 an alternative employment plan shall also include activities 468.8 that are designed to lead to self-sufficiency. An activity is 468.9 inconsistent with ensuring safety if, in the opinion of a person 468.10 trained in domestic violence, the activity would endanger the 468.11 safety of the participant or children. An alternative 468.12 employment plan may not automatically include a provision that 468.13 requires a participant to obtain an order for protection or to 468.14 attend counseling. 468.15 [EFFECTIVE DATE.] This section is effective October 1, 2001. 468.16 Sec. 25. Minnesota Statutes 2000, section 256J.49, 468.17 subdivision 2, is amended to read: 468.18 Subd. 2. [DOMESTICFAMILY VIOLENCE.] "DomesticFamily 468.19 violence" means: 468.20 (1) physical acts that result, or threaten to result in, 468.21 physical injury to an individual; 468.22 (2) sexual abuse; 468.23 (3) sexual activity involving a minor child; 468.24 (4) being forced as the caregiver of a minor child to 468.25 engage in nonconsensual sexual acts or activities; 468.26 (5) threats of, or attempts at, physical or sexual abuse; 468.27 (6) mental abuse; or 468.28 (7) neglect or deprivation of medical care. 468.29 Claims of family violence must be documented by the applicant or 468.30 participant providing a sworn statement, which is supported by 468.31 collateral documentation. Collateral documentation may consist 468.32 of any one of the following: 468.33 (1) police, government agency, or court records; 468.34 (2) a statement from a battered woman's shelter staff with 468.35 knowledge of circumstances or credible evidence that supports 468.36 the sworn statement; 469.1 (3) a statement from a sexual assault or domestic violence 469.2 advocate with knowledge of the circumstances or credible 469.3 evidence that supports a sworn statement; 469.4 (4) a statement from professionals from whom the applicant 469.5 or recipient has sought assistance for the abuse; or 469.6 (5) a sworn statement from any other individual with 469.7 knowledge of circumstances or credible evidence that supports 469.8 the sworn statement. 469.9 [EFFECTIVE DATE.] This section is effective October 1, 2001. 469.10 Sec. 26. Minnesota Statutes 2000, section 256J.49, 469.11 subdivision 13, is amended to read: 469.12 Subd. 13. [WORK ACTIVITY.] "Work activity" means any 469.13 activity in a participant's approved employment plan that is 469.14 tied to the participant's employment goal. For purposes of the 469.15 MFIP program, any activity that is included in a participant's 469.16 approved employment plan meets the definition of work activity 469.17 as counted under the federal participation standards. Work 469.18 activity includes, but is not limited to: 469.19 (1) unsubsidized employment; 469.20 (2) subsidized private sector or public sector employment, 469.21 including grant diversion as specified in section 256J.69; 469.22 (3) work experience, including CWEP as specified in section 469.23 256J.67, and including work associated with the refurbishing of 469.24 publicly assisted housing if sufficient private sector 469.25 employment is not available; 469.26 (4) on-the-job training as specified in section 256J.66; 469.27 (5) job search, either supervised or unsupervised; 469.28 (6) job readiness assistance; 469.29 (7) job clubs, including job search workshops; 469.30 (8) job placement; 469.31 (9) job development; 469.32 (10) job-related counseling; 469.33 (11) job coaching; 469.34 (12) job retention services; 469.35 (13) job-specific training or education; 469.36 (14) job skills training directly related to employment; 470.1 (15) the self-employment investment demonstration (SEID), 470.2 as specified in section 256J.65; 470.3 (16) preemployment activities, based on availability and 470.4 resources, such as volunteer work, literacy programs and related 470.5 activities, citizenship classes, English as a second language 470.6 (ESL) classes as limited by the provisions of section 256J.52, 470.7 subdivisions 3, paragraph (d), and 5, paragraph (c), or 470.8 participation in dislocated worker services, chemical dependency 470.9 treatment, mental health services, peer group networks, 470.10 displaced homemaker programs, strength-based resiliency 470.11 training, parenting education, or other programs designed to 470.12 help families reach their employment goals and enhance their 470.13 ability to care for their children; 470.14 (17) community service programs; 470.15 (18) vocational educational training or educational 470.16 programs that can reasonably be expected to lead to employment, 470.17 as limited by the provisions of section 256J.53; 470.18 (19) apprenticeships; 470.19 (20) satisfactory attendance in general educational 470.20 development diploma classes or an adult diploma program; 470.21 (21) satisfactory attendance at secondary school, if the 470.22 participant has not received a high school diploma; 470.23 (22) adult basic education classes; 470.24 (23) internships; 470.25 (24) bilingual employment and training services; 470.26 (25) providing child care services to a participant who is 470.27 working in a community service program; and 470.28 (26) activities included ina safetyan alternative 470.29 employment plan that is developed under section 256J.52, 470.30 subdivision 6. 470.31 [EFFECTIVE DATE.] This section is effective October 1, 2001. 470.32 Sec. 27. Minnesota Statutes 2000, section 256J.50, 470.33 subdivision 5, is amended to read: 470.34 Subd. 5. [PARTICIPATION REQUIREMENTS FOR ALL CASES.] (a) 470.35 For two-parent cases, participation is required concurrent with 470.36 the receipt of MFIP cash assistance. 471.1 For single-parent cases, participation is required 471.2 concurrent with the receipt of MFIP cash assistance for all 471.3 counties except Blue Earth and Nicollet, effective July 1, 2000, 471.4 and is required for Blue Earth and Nicollet counties effective 471.5 January 1, 2001. For Blue Earth and Nicollet counties only, 471.6 from July 1, 2000 to December 31, 2000, mandatory participation 471.7 for single-parent cases must be required within six months of 471.8 eligibility for cash assistance. 471.9 (b) Beginning January 1, 1998, with the exception of 471.10 caregivers required to attend high school under the provisions 471.11 of section 256J.54, subdivision 5, MFIP caregivers, upon 471.12 completion of the secondary assessment, must develop an 471.13 employment plan and participate in work activities. 471.14 (c) Upon completion of the secondary assessment: 471.15 (1) In single-parent families with no children under six 471.16 years of age, the job counselor and the caregiver must develop 471.17 an employment plan that includes 20 to 35 hours per week of work 471.18 activities for the period January 1, 1998, to September 30, 471.19 1998; 25 to 35 hours of work activities per week in federal 471.20 fiscal year 1999; and 30 to 35 hours per week of work activities 471.21 in federal fiscal year 2000 and thereafter. 471.22 (2) In single-parent families with a child under six years 471.23 of age, the job counselor and the caregiver must develop an 471.24 employment plan that includes 20 to 35 hours per week of work 471.25 activities. 471.26 (3) In two-parent families, the job counselor and the 471.27 caregivers must develop employment plans which result in a 471.28 combined total of at least 55 hours per week of work activities, 471.29 of which at least 30 hours must be completed by one of the 471.30 parents. 471.31 Sec. 28. Minnesota Statutes 2000, section 256J.50, 471.32 subdivision 10, is amended to read: 471.33 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OFDOMESTIC471.34 FAMILY VIOLENCE.] County agencies and their contractors must 471.35 provide universal notification to all applicants and recipients 471.36 ofMFIP-SMFIP that: 472.1 (1) referrals to counseling and supportive services are 472.2 available for victims ofdomesticfamily violence; 472.3 (2) nonpermanent resident battered individuals married to 472.4 United States citizens or permanent residents may be eligible to 472.5 petition for permanent residency under the federal Violence 472.6 Against Women Act, and that referrals to appropriate legal 472.7 services are available; 472.8 (3) victims ofdomesticfamily violence areexempt from472.9 eligible for an extension of the 60-month limit on assistance 472.10while the individual is complying with an approved safety plan,472.11as defined in section 256J.49, subdivision 11; and 472.12 (4) victims ofdomesticfamily violence may choose tobe472.13exempt or deferred fromhave regular work requirementsfor up to472.1412 monthswaived while the individual is complying with 472.15 anapproved safetyalternative employment plan as defined in 472.16 section 256J.49, subdivision111a. 472.17 If an alternative plan is denied, the county or a job 472.18 counselor must provide reasons why the plan is not approved and 472.19 document how the denial of the plan does not interfere with the 472.20 safety of the participant or children. 472.21 Notification must be in writing and orally at the time of 472.22 application and recertification, when the individual is referred 472.23 to the title IV-D child support agency, and at the beginning of 472.24 any job training or work placement assistance program. 472.25 [EFFECTIVE DATE.] This section is effective October 1, 2001. 472.26 Sec. 29. Minnesota Statutes 2000, section 256J.50, is 472.27 amended by adding a subdivision to read: 472.28 Subd. 12. [ACCESS TO PERSONS TRAINED IN DOMESTIC 472.29 VIOLENCE.] In a county where there is no staff person who is 472.30 trained in domestic violence, as that term is defined in section 472.31 256J.08, subdivision 67a, the county must work with the nearest 472.32 organization that is designated as providing services to victims 472.33 of domestic violence to develop a process, which ensures that 472.34 domestic violence victims have access to a person trained in 472.35 domestic violence. 472.36 [EFFECTIVE DATE.] This section is effective October 1, 2001. 473.1 Sec. 30. Minnesota Statutes 2000, section 256J.515, is 473.2 amended to read: 473.3 256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 473.4 During the first meeting with participants, job counselors 473.5 must ensure that an overview of employment and training services 473.6 is provided that: 473.7 (1) stresses the necessity and opportunity of immediate 473.8 employment; 473.9 (2) outlines the job search resources offered; 473.10 (3) outlines education or training opportunities available; 473.11 (4) describes the range of work activities, including 473.12 activities under section 256J.49, subdivision 13, clause (18), 473.13 that are allowable under MFIP to meet the individual needs of 473.14 participants; 473.15 (5) explains the requirements to comply with an employment 473.16 plan; 473.17 (6) explains the consequences for failing to comply;and473.18 (7) explains the services that are available to support job 473.19 search and work and education; and 473.20 (8) provides referral information about shelters and 473.21 programs for victims of family violence, the time limit 473.22 exemption, and waivers of regular employment and training 473.23 requirements for family violence victims. 473.24 Failure to attend the overview of employment and training 473.25 services without good cause results in the imposition of a 473.26 sanction under section 256J.46. 473.27 Effective October 1, 2001, a participant who has an 473.28 alternative employment plan under section 256J.52, subdivision 473.29 6, as defined in section 256J.49, subdivision 1a, or who is in 473.30 the process of developing such a plan, is exempt from the 473.31 requirement to attend the overview. 473.32 Sec. 31. Minnesota Statutes 2000, section 256J.52, 473.33 subdivision 2, is amended to read: 473.34 Subd. 2. [INITIAL ASSESSMENT.] (a) The job counselor must, 473.35 with the cooperation of the participant, assess the 473.36 participant's ability to obtain and retain employment. This 474.1 initial assessment must include a review of the participant's 474.2 education level, prior employment or work experience, 474.3 transferable work skills, and existing job markets. 474.4 (b) In assessing the participant, the job counselor must 474.5 determine if the participant needs refresher courses for 474.6 professional certification or licensure, in which case, the job 474.7 search plan under subdivision 3 must include the courses 474.8 necessary to obtain the certification or licensure, in addition 474.9 to other work activities, provided the combination of the 474.10 courses and other work activities are at least for 40 hours per 474.11 week. 474.12 (c) If a participant can demonstrate to the satisfaction of 474.13 the county agency that lack of proficiency in English is a 474.14 barrier to obtaining suitable employment, the job counselor must 474.15 include participation in an intensive English as a second 474.16 language program if available or otherwise a regular English as 474.17 a second language program in the individual's employment plan 474.18 under subdivision 5. Lack of proficiency in English is not 474.19 necessarily a barrier to employment. 474.20 (d) The job counselormayshall approve an education or 474.21 training plan, and postpone the job search requirement, if less 474.22 than 30 percent of the statewide MFIP caseload is participating 474.23 in education and training, and if the participant has a proposal 474.24 for an education program which: 474.25 (1) can be completed within1224 months; 474.26 (2) meets the criteria of section 256J.53, subdivisions 2, 474.27 3, and 5; and 474.28 (3) is likely, without additional training, to lead to 474.29 monthly employment earnings which, after subtraction of the 474.30 earnings disregard under section 256J.21, equal or exceed the 474.31 family wage level for the participant's assistance unit. 474.32 (e) A participant who, at the time of the initial 474.33 assessment, presents a plan that includes farming as a 474.34 self-employed work activity must have an employment plan 474.35 developed under subdivision 5 that includes the farming as an 474.36 approved work activity. 475.1 (f) Effective October 1, 2001, an alternative employment 475.2 plan must be offered and explained to a participant who at any 475.3 time declares or reveals current or past family violence. If 475.4 the participant is interested, an alternative employment plan 475.5 must be developed and approved for the participant if the 475.6 current or past violence affects the ability of the person to 475.7 participate with regular employment service activities or denial 475.8 of an alternative employment plan would interfere with the 475.9 safety of the participant or children. 475.10 Sec. 32. Minnesota Statutes 2000, section 256J.52, 475.11 subdivision 3, is amended to read: 475.12 Subd. 3. [JOB SEARCH; JOB SEARCH SUPPORT PLAN.] (a) If, 475.13 after the initial assessment, the job counselor determines that 475.14 the participant possesses sufficient skills that the participant 475.15 is likely to succeed in obtaining suitable employment, the 475.16 participant must conduct job search for a period of up to eight 475.17 weeks, for at least 30 hours per week.The participant must475.18accept any offer of suitable employment. Upon agreement by the475.19job counselor and the participant, a job search support plan may475.20limit a job search to jobs that are consistent with the475.21participant's employment goal.The job counselor and 475.22 participant must develop a job search support plan which 475.23 specifies, at a minimum: a job goal which realistically 475.24 reflects the individual's skills, abilities, and work experience 475.25 and meets the definition of suitable employment, and for which 475.26 there are job openings in the geographic area of the 475.27 participant's job search or an area to which the participant is 475.28 willing to relocate; whether the job search is to be supervised 475.29 or unsupervised; support services that will be provided while 475.30 the participant conducts job search activities; the courses 475.31 necessary to obtain certification or licensure, if applicable, 475.32 and after obtaining the license or certificate, the client must 475.33 comply with subdivision 5; and how frequently the participant 475.34 must report to the job counselor on the status of the 475.35 participant's job search activities. The job goal specified in 475.36 the job search support plan must be intended to enable the 476.1 participant to progress toward employment that provides wages 476.2 sufficient to allow the participant to transition off of MFIP. 476.3 The job search support plan must also specify that the 476.4 participant fulfill no more than half of the required hours of 476.5 job search through attending adult basic education or English as 476.6 a second language classes, if one or both of those activities 476.7 are approved by the job counselor. 476.8 (b) During the eight-week job search period, either the job 476.9 counselor or the participant may request a review of the 476.10 participant's job search plan and progress towards obtaining 476.11suitable employmentparticipant's job goal under paragraph (a). 476.12 If a review is requested by the participant, the job counselor 476.13 must concur that the review is appropriate for the participant 476.14 at that time. If a review is conducted, the job counselor may 476.15 make a determination to conduct a secondary assessment prior to 476.16 the conclusion of the job search. 476.17 (c) Failure to conduct the required job search, to accept 476.18 any offer ofsuitableemployment consistent with the 476.19 participant's job goal under paragraph (a), to develop or comply 476.20 with a job search support plan, or voluntarily quitting suitable 476.21 employment without good cause results in the imposition of a 476.22 sanction under section 256J.46. If at the end of eight weeks 476.23 the participant has not obtained suitable employment, the job 476.24 counselor must conduct a secondary assessment of the participant 476.25 under subdivision34. 476.26 (d) In order for an English as a second language (ESL) 476.27 class to be an approved work activity, a participant must be at 476.28 or below a spoken language proficiency level of SPL5 or its 476.29 equivalent, as measured by a nationally recognized test. A 476.30 participant may not be approved for more than a total of 24 476.31 months of ESL activities while participating in the employment 476.32 and training services component of MFIP. In approving ESL as a 476.33 work activity, the job counselor must give preference to 476.34 enrollment in an intensive ESL program, if one is available, 476.35 over a regular ESL program. If an intensive ESL program is 476.36 approved, the restriction in paragraph (a) that no more than 477.1 half of the required hours of job search is fulfilled through 477.2 attending ESL classes does not apply. 477.3 Sec. 33. Minnesota Statutes 2000, section 256J.52, 477.4 subdivision 6, is amended to read: 477.5 Subd. 6. [SAFETYALTERNATIVE EMPLOYMENT PLAN AND FAMILY 477.6 VIOLENCE WAIVER PROVISIONS.]Notwithstanding subdivisions 1 to477.75, a participant who is a victim of domestic violence and who477.8agrees to develop or has developed a safety plan meeting the477.9definition under section 256J.49, subdivision 11, is deferred477.10from the requirements of this section, sections 256J.54, and477.11256J.55 for a period of three months from the date the safety477.12plan is approved. A participant deferred under this subdivision477.13must submit a safety plan status report to the county agency on477.14a quarterly basis. Based on a review of the status report, the477.15county agency may approve or renew the participant's deferral477.16each quarter, provided the personal safety of the participant is477.17still at risk and the participant is complying with the plan. A477.18participant who is deferred under this subdivision may be477.19deferred for a total of 12 months under a safety plan, provided477.20the individual is complying with the terms of the plan.477.21 Participants who have a safety plan under section 256J.49, 477.22 subdivision 11, prior to October 1, 2001, will have that plan 477.23 converted to an alternative employment plan upon their plan 477.24 renewal date. An alternative employment plan must be reviewed 477.25 at the end of the first six months to determine if the 477.26 activities contained in the alternative employment plan are 477.27 still appropriate. It is the responsibility of the county or a 477.28 job counselor to contact the participant and notify them that 477.29 their plan is up for review, and document whether the 477.30 participant wishes to renew the plan. If the participant does 477.31 not wish to renew the plan, or if the participant fails to 477.32 respond after reasonable efforts to contact the participant are 477.33 made by the county or a job counselor, the participant must 477.34 participate in regular employment services activities. If the 477.35 participant requests renewal of the plan or if there is a 477.36 dispute over whether the plan is still appropriate, the 478.1 participant must receive the assistance of a person trained in 478.2 domestic violence. If the person trained in domestic violence 478.3 recommends that the activities are still appropriate, the county 478.4 or a job counselor must renew the alternative employment plan or 478.5 provide written reasons why the plan is not approved and 478.6 document how denial of the plan renewal does not interfere with 478.7 the safety of the participant or children. If the person 478.8 trained in domestic violence recommends that the activities are 478.9 no longer appropriate, the plan must be revised with the 478.10 assistance of a person trained in domestic violence. The county 478.11 or a job counselor must approve the revised plan or provide 478.12 written reasons why the plan is not approved and document how 478.13 denial of the plan renewal does not interfere with the safety of 478.14 the participant or children. After the first six months reviews 478.15 may take place quarterly. During the time a participant is 478.16 cooperating with the development or revision of an alternative 478.17 employment plan, the participant is not subject to a sanction 478.18 for noncompliance with regular employment services activities. 478.19 Sec. 34. Minnesota Statutes 2000, section 256J.53, 478.20 subdivision 1, is amended to read: 478.21 Subdivision 1. [LENGTH OF PROGRAM.] In order for a 478.22 post-secondary education or training program to be approved work 478.23 activity as defined in section 256J.49, subdivision 13, clause 478.24 (18), it must be a program lasting1224 months or less, and the 478.25 participant must meet the requirements of subdivisions 2 and 3. 478.26A program lasting up to 24 months may be approved on an478.27exception basis if the conditions specified in subdivisions 2 to478.284 are met. A participant may not be approved for more than a478.29total of 24 months of post-secondary education or training.478.30 Sec. 35. Minnesota Statutes 2000, section 256J.53, 478.31 subdivision 2, is amended to read: 478.32 Subd. 2. [DOCUMENTATION SUPPORTING PROGRAM.] (a) In order 478.33 for a post-secondary education or training program to be an 478.34 approved activity in a participant's employment plan, the 478.35 participant or the employment and training service provider must 478.36 provide documentation that: 479.1 (1) the participant's employment plan identifies specific 479.2 goals that can only be met with the additional education or 479.3 training; 479.4 (2) there are suitable employment opportunities that 479.5 require the specific education or training in the area in which 479.6 the participant resides or is willing to reside; 479.7 (3) the education or training will result in significantly 479.8 higher wages for the participant than the participant could earn 479.9 without the education or training; 479.10 (4) the participant can meet the requirements for admission 479.11 into the program; and 479.12 (5) there is a reasonable expectation that the participant 479.13 will complete the training program based on such factors as the 479.14 participant's MFIP-S assessment, previous education, training, 479.15 and work history; current motivation; and changes in previous 479.16 circumstances. 479.17 (b) The job counselor shall approve an education or 479.18 training program that meets the requirements under paragraph (a). 479.19 Sec. 36. Minnesota Statutes 2000, section 256J.53, 479.20 subdivision 3, is amended to read: 479.21 Subd. 3. [SATISFACTORY PROGRESS REQUIRED.] In order for a 479.22post-secondary education or training program to be an approved479.23activity in a participant's employment planparticipant to 479.24 continue with post-secondary education or training, the 479.25 participant must maintain satisfactory progress in the program. 479.26 "Satisfactory progress" in an education or training program 479.27 means (1) the participant remains in good standing while the 479.28 participant is enrolled in the program, as defined by the 479.29 education or training institution, or (2) the participant makes 479.30 satisfactory progress as the term is defined in the 479.31 participant's employment plan. 479.32 Sec. 37. [256J.555] [PARTICIPANT PERFORMANCE BONUSES.] 479.33 If a county elects to provide participant performance 479.34 bonuses under section 256J.625, subdivision 4, paragraph (d), a 479.35 participant enrolled in employment and training services is 479.36 eligible to receive the cash bonuses if the participant has been 480.1 in compliance with all the requirements of the participant's job 480.2 search support plan or employment plan for the previous six 480.3 months. A participant may receive each bonus only once. Income 480.4 received from the cash bonuses is excluded in determining MFIP 480.5 eligibility and benefits. Bonuses are available for the 480.6 completion of the following goals: 480.7 (1) for continuous employment of at least 20 hours per week 480.8 for six months, the bonus is $200. The caregiver is eligible to 480.9 receive this bonus if the participant remains on MFIP while 480.10 employed or if the participant has exited MFIP as the result of 480.11 employment; 480.12 (2) for continuous employment of at least 20 hours per week 480.13 for 12 months, the bonus is $300. The caregiver is eligible to 480.14 receive this bonus if the participant remains on MFIP while 480.15 employed or if the participant has exited MFIP as the result of 480.16 employment; 480.17 (3) for employment that leads to earnings sufficient for a 480.18 caregiver to transition off of MFIP and stay off for six months, 480.19 the bonus is $300; 480.20 (4) for completion of an English as a second language 480.21 program, the bonus is $300; 480.22 (5) for completion of a high school diploma or GED, the 480.23 bonus is $300; and 480.24 (6) for completion of a job skills training program from a 480.25 certified provider, the bonus is $300. 480.26 Sec. 38. Minnesota Statutes 2000, section 256J.56, is 480.27 amended to read: 480.28 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 480.29 EXEMPTIONS.] 480.30 (a) An MFIP caregiver is exempt from the requirements of 480.31 sections 256J.52 to 256J.55 if the caregiver belongs to any of 480.32 the following groups: 480.33 (1) individuals who are age 60 or older; 480.34 (2) individuals who are suffering from a professionally 480.35 certified permanent or temporary illness, injury, or incapacity 480.36 which is expected to continue for more than 30 days and which 481.1 prevents the person from obtaining or retaining employment. 481.2 Persons in this category with a temporary illness, injury, or 481.3 incapacity must be reevaluated at least quarterly; 481.4 (3) caregivers whose presence in the home is required as a 481.5 caregiver because ofthea professionally certified illness or 481.6 incapacity of another member in the assistance unit, a relative 481.7 in the household, or a foster child in the household; 481.8 (4) women who are pregnant, if the pregnancy has resulted 481.9 in a professionally certified incapacity that prevents the woman 481.10 from obtaining or retaining employment; 481.11 (5) caregivers of a child under the age of one year who 481.12 personally provide full-time care for the child. This exemption 481.13 may be used for only 12 months in a lifetime. In two-parent 481.14 households, only one parent or other relative may qualify for 481.15 this exemption; 481.16 (6)individuals who are single parents, or one parent in a481.17two-parent family, employed at least 35 hours per week;481.18(7)individuals experiencing a personal or family crisis 481.19 that makes them incapable of participating in the program, as 481.20 determined by the county agency. If the participant does not 481.21 agree with the county agency's determination, the participant 481.22 may seek professional certification, as defined in section 481.23 256J.08, that the participant is incapable of participating in 481.24 the program. Persons in this exemption category must be 481.25 reevaluated every 60 days. A personal or family crisis related 481.26 to family violence, as determined by the county or a job 481.27 counselor with the assistance of a person trained in domestic 481.28 violence, should not result in an exemption, but should be 481.29 addressed through the development or revision of an alternative 481.30 employment plan under section 256J.52, subdivision 6; 481.31(8)(7) second parents in two-parent families employed for 481.32 20 or more hours per week, provided the first parent is employed 481.33 at least 35 hours per week; or 481.34(9)(8) caregivers with a child or an adult in the 481.35 household who meets the disability or medical criteria for home 481.36 care services under section 256B.0627, subdivision 1, paragraph 482.1 (c), or a home and community-based waiver services program under 482.2 chapter 256B, or meets the criteria for severe emotional 482.3 disturbance under section 245.4871, subdivision 6, or for 482.4 serious and persistent mental illness under section 245.462, 482.5 subdivision 20, paragraph (c).Caregivers in this exemption482.6category are presumed to be prevented from obtaining or482.7retaining employment.482.8 (b) A caregiver who is exempt under clause (5) must enroll 482.9 in and attend an early childhood and family education class, a 482.10 parenting class, or some similar activity, if available, during 482.11 the period of time the caregiver is exempt under this section. 482.12 Notwithstanding section 256J.46, failure to attend the required 482.13 activity shall not result in the imposition of a sanction. 482.14(b)(c) The county agency must provide employment and 482.15 training services to MFIP caregivers who are exempt under this 482.16 section, but who volunteer to participate. Exempt volunteers 482.17 may request approval for any work activity under section 482.18 256J.49, subdivision 13. The hourly participation requirements 482.19 for nonexempt caregivers under section 256J.50, subdivision 5, 482.20 do not apply to exempt caregivers who volunteer to participate. 482.21 Sec. 39. Minnesota Statutes 2000, section 256J.62, 482.22 subdivision 2a, is amended to read: 482.23 Subd. 2a. [CASELOAD-BASED FUNDS ALLOCATION.] Effective for 482.24 state fiscal year 2000, and for all subsequent years, money 482.25 shall be allocated to counties and eligible tribal providers 482.26 based on their average number of MFIP cases as a proportion of 482.27 the statewide total number of MFIP cases: 482.28 (1) the average number of cases must be based upon counts 482.29 of MFIP or tribal TANF cases as of March 31, June 30, September 482.30 30, and December 31 of the previous calendar year, less the 482.31 number of child only cases and cases where all the caregivers 482.32 are age 60 or over. Two-parent cases, with the exception of 482.33 those with a caregiver age 60 or over, will be multiplied by a 482.34 factor of two; 482.35 (2) the MFIP or tribal TANF case count for each eligible 482.36 tribal provider shall be based upon the number of MFIP or tribal 483.1 TANF cases who are enrolled in, or are eligible for enrollment 483.2 in the tribe; and the case must be an active MFIP case; and the 483.3 case members must reside within the tribal program's service 483.4 delivery area; and 483.5 (3) MFIP or tribal TANF cases counted for determining 483.6 allocations to tribal providers shall be removed from the case 483.7 counts of the respective counties where they reside to prevent 483.8 duplicate counts;. 483.9(4) prior to allocating funds to counties and tribal483.10providers, $1,000,000 shall be set aside to allow the483.11commissioner to use these set-aside funds to provide funding to483.12county or tribal providers who experience an unforeseen influx483.13of participants or other emergent situations beyond their483.14control; and483.15(5) the commissioner shall use a portion of the funds in483.16clause (4) to offset a reduction in funds allocated to any483.17county between state fiscal year 1999 and state fiscal year 2000483.18that results from the adjustment in clause (3). The funding483.19provided under this clause must reduce by half the reduction for483.20state fiscal year 2000 that any county would otherwise483.21experience in the absence of this clause.483.22Any funds specified in this clause that remain unspent by March483.2331 of each year shall be reallocated out to county and tribal483.24providers using the funding formula detailed in clauses (1) to483.25(5).483.26 Sec. 40. Minnesota Statutes 2000, section 256J.62, 483.27 subdivision 9, is amended to read: 483.28 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] At the 483.29 request of the caregiver, the county may continue to provide 483.30 case management, counseling or other support services to a 483.31 participant following the participant's achievement of the 483.32 employment goal, for up to 12 months following termination of 483.33 the participant's eligibility for MFIP, as long as the 483.34 participant's household income is below 200 percent of the 483.35 federal poverty guidelines. 483.36A county may expend funds for a specific employment and484.1training service for the duration of that service to a484.2participant if the funds are obligated or expended prior to the484.3participant losing MFIP eligibility.484.4 Sec. 41. Minnesota Statutes 2000, section 256J.625, is 484.5 amended to read: 484.6 256J.625 [LOCAL INTERVENTION GRANTS FOR SELF-SUFFICIENCY.] 484.7 Subdivision 1. [ESTABLISHMENT; GUARANTEED MINIMUM 484.8 ALLOCATION.](a)The commissioner shall make grants under this 484.9 subdivision to assist county and tribal TANF programs to more 484.10 effectively serve hard-to-employ MFIP participants. Funds 484.11 appropriated for local intervention grants for self-sufficiency 484.12 must be allocated first in amounts equal to the guaranteed 484.13 minimum inparagraph (b)subdivision 1b, and second according to 484.14 the provisions of subdivision 2. Any remaining funds must be 484.15 allocated according to the formula in subdivision 3. 484.16 Subd. 1a. [LOCAL SERVICE UNIT PLAN REQUIRED.] Counties or 484.17 tribes must have an approved local service unit plan under 484.18 section 256J.50, subdivision 7, paragraph (b), in order to 484.19 receive and expend funds under subdivisions 2 and 3. If a 484.20 county or tribe does not submit a local service unit plan under 484.21 section 256J.50, subdivision 7, paragraph (b), or if the plan is 484.22 not approved at the full amount allocated to the county or tribe 484.23 under subdivision 3, the remaining funds under subdivision 3 may 484.24 be used by the commissioner to contract with other public, 484.25 private, or nonprofit entities in the county or region to 484.26 deliver services that meet the purposes of subdivision 4. 484.27(b)Subd. 1b. [GUARANTEED MINIMUM.] Each county or tribal 484.28 program shall receive a guaranteed minimum annual allocationof484.29$25,000. The minimum annual allocation for each county or tribe 484.30 that has fewer than 25 long-term dependent adults on MFIP based 484.31 on the formula in subdivision 3 is $5,000, and the minimum 484.32 annual allocation for each county or tribe that has 25 or more 484.33 long-term dependent adults on MFIP based on the formula in 484.34 subdivision 3 is $10,000. 484.35 Subd. 2. [SET-ASIDE FUNDS.] (a) Of the funds appropriated 484.36 for grants under this section, after the allocation in 485.1 subdivision1, paragraph (b)1b, is made,20 percent of the485.2remaining funds$3,576,000 each year shall be retained by the 485.3 commissioner and awarded to counties or tribes whose approved 485.4 plans demonstrate additional need based on their identification 485.5 of hard-to-employ families and working participants in need of 485.6 job retention and wage advancement services, strong anticipated 485.7 outcomes for families and an effective plan for monitoring 485.8 performance, or, use of a multicounty, multi-entity or regional 485.9 approach to serve hard-to-employ families and working 485.10 participants in need of job retention and wage advancement 485.11 services who are identified as a target population to be served 485.12 in the plan submitted under section 256J.50, subdivision 7, 485.13 paragraph (b). In distributing funds under this paragraph, the 485.14 commissioner must achieve a geographic balance. The 485.15 commissioner may award funds under this paragraph to other 485.16 public, private, or nonprofit entities to deliver services in a 485.17 county or region where the entity or entities submit a plan that 485.18 demonstrates a strong capability to fulfill the terms of the 485.19 plan and where the plan shows an innovative or multi-entity 485.20 approach. 485.21 (b) For fiscal year 2001 only, of the funds available under 485.22 this subdivision the commissioner must allocate funding in the 485.23 amounts specified in article 1, section 2, subdivision 7, for an 485.24 intensive intervention transitional employment training project 485.25 and for nontraditional career assistance and training programs. 485.26 These allocations must occur before any set-aside funds are 485.27 allocated under paragraph (a). 485.28Subd. 2a. [ALTERNATIVE DISTRIBUTION FORMULA.] (a) By485.29January 31, 2001, the commissioner of human services must485.30develop and present to the appropriate legislative committees a485.31distribution formula that is an alternative to the formula485.32allocation specified in subdivision 3. The proposed485.33distribution formula must target hard-to-employ MFIP485.34participants, and it must include an incentive-based component485.35that is designed to encourage county and tribal programs to485.36effectively serve hard-to-employ participants. The486.1commissioner's proposal must also be designed to be implemented486.2for fiscal years 2002 and 2003 in place of the formula486.3allocation specified in subdivision 3.486.4(b) Notwithstanding the provisions of subdivision 2,486.5paragraph (a), if the commissioner does not develop a proposed486.6formula as required in paragraph (a), the set-aside funds for486.7fiscal years 2002 and 2003 that the commissioner would otherwise486.8distribute under subdivision 2, paragraph (a), must not be486.9distributed under that provision. Funds available under486.10subdivision 2, paragraph (a), must instead be allocated in equal486.11amounts to each county and tribal program in fiscal years 2002486.12and 2003.486.13 Subd. 3. [FORMULA ALLOCATION.] Funds remaining after the 486.14 allocations in subdivisions11b and 2 must be allocatedas486.15follows:to counties and tribes based on the average proportion 486.16 of the MFIP caseload that has received MFIP assistance for 24 of 486.17 the last 36 months, as sampled on March 31, June 30, September 486.18 30, and December 31 of the previous calendar year, less the 486.19 number of child-only cases and cases where all the caregivers 486.20 are age 60 or over. Two-parent cases, with the exception of 486.21 those with a caregiver age 60 or over, will be multiplied by a 486.22 factor of two. 486.23(1) 85 percent shall be allocated in proportion to each486.24county's and tribal TANF program's one-parent MFIP cases that486.25have received MFIP assistance for at least 25 months, as sampled486.26on December 31 of the previous calendar year, excluding cases486.27where all caregivers are age 60 or over.486.28(2) 15 percent shall be allocated to each county's and486.29tribal TANF program's two-parent MFIP cases that have received486.30MFIP assistance for at least 25 months, as sampled on December486.3131 of the previous calendar year, excluding cases where all486.32caregivers are age 60 or over.486.33 Subd. 4. [USE OF FUNDS.] (a) A county or tribal program, 486.34 or other public, private, or nonprofit entity in the county or 486.35 region may use funds allocated under thissubdivisionsection to 486.36 provide services to MFIP participants who are hard-to-employ and 487.1 their families. Services provided must be intended to reduce 487.2 the number of MFIP participants who are expected to reach the 487.3 60-month time limit under section 256J.42. Counties, tribes, 487.4 and other entities receiving funds under subdivision 2 or 3 must 487.5 submit semiannual progress reports to the commissioner which 487.6 detail program outcomes. 487.7 (b) Funds allocated under this section may not be used to 487.8 provide benefits that are defined as "assistance" in Code of 487.9 Federal Regulations, title 45, section 260.31, to an assistance 487.10 unit that is only receiving the food portion of MFIP benefits. 487.11 (c) A county may use funds allocated under this section for 487.12 that part of the match for federal access to jobs transportation 487.13 funds that is TANF-eligible. A county may also use funds 487.14 allocated under this section to enhance transportation choices 487.15 for eligible recipients up to 150 percent of the federal poverty 487.16 guidelines. 487.17 (d) A county may use funds allocated under this section to 487.18 provide any or all of the participant performance bonuses to 487.19 MFIP participants as defined in section 256J.555. The dollar 487.20 amount of the bonus or bonuses provided must not exceed the 487.21 amounts in section 256J.555. 487.22 Subd. 5. [SUNSET.] The grant program under this section 487.23 sunsets on June 30, 2003. 487.24 Sec. 42. Minnesota Statutes 2000, section 256J.645, is 487.25 amended to read: 487.26 256J.645 [INDIAN TRIBEMFIP-SMFIP EMPLOYMENTAND TRAINING487.27 SERVICES.] 487.28 Subdivision 1. [AUTHORIZATION TO ENTER INTO AGREEMENTS.] 487.29 Effective July 1, 1997, the commissioner may enter into 487.30 agreements with federally recognized Indian tribes with a 487.31 reservation in the state to provideMFIP-SMFIP employmentand487.32trainingservices to members of the Indian tribe and to other 487.33 caregivers who are a part of the tribal member'sMFIP-SMFIP 487.34 assistance unit. For purposes of this section, "Indian tribe" 487.35 means a tribe, band, nation, or other federally recognized group 487.36 or community of Indians. The commissioner may also enter into 488.1 an agreement with a consortium of Indian tribes providing the 488.2 governing body of each Indian tribe in the consortium complies 488.3 with the provisions of this section. 488.4 Subd. 2. [TRIBAL REQUIREMENTS.] The Indian tribe must: 488.5 (1) agree to fulfill the responsibilities provided under 488.6 the employmentand trainingservices component ofMFIP-SMFIP 488.7 regarding operation ofMFIP-SMFIP employmentand training488.8 services, as designated by the commissioner; 488.9 (2) operate its employmentand trainingservices program 488.10 within a geographic service area not to exceed the counties 488.11 within which a border of the reservation falls; 488.12 (3) operate its program in conformity with section 13.46 488.13 and any applicable federal regulations in the use of data about 488.14MFIP-SMFIP recipients; 488.15 (4) coordinate operation of its program with the county 488.16 agency,Job Training PartnershipWorkforce Investment Act 488.17 programs, and other support services or employment-related 488.18 programs in the counties in which the tribal unit's program 488.19 operates; 488.20 (5) provide financial and program participant activity 488.21 recordkeeping and reporting in the manner and using the forms 488.22 and procedures specified by the commissioner and permit 488.23 inspection of its program and records by representatives of the 488.24 state; and 488.25 (6) have the Indian tribe's employmentand trainingservice 488.26 provider certified by the commissioner of economic security, or 488.27 approved by the county. 488.28 Subd. 3. [FUNDING.] If the commissioner and an Indian 488.29 tribe are parties to an agreement under this subdivision, the 488.30 agreementmayshall annually provide to the Indian tribe the 488.31 fundingamount in clause (1) or (2):allocated in section 488.32 256J.62, subdivisions 1 and 2a. 488.33(1) if the Indian tribe operated a tribal STRIDE program488.34during state fiscal year 1997, the amount to be provided is the488.35amount the Indian tribe received from the state for operation of488.36its tribal STRIDE program in state fiscal year 1997, except that489.1the amount provided for a fiscal year may increase or decrease489.2in the same proportion that the total amount of state and489.3federal funds available for MFIP-S employment and training489.4services increased or decreased that fiscal year; or489.5(2) if the Indian tribe did not operate a tribal STRIDE489.6program during state fiscal year 1997, the commissioner may489.7provide to the Indian tribe for the first year of operations the489.8amount determined by multiplying the state allocation for MFIP-S489.9employment and training services to each county agency in the489.10Indian tribe's service delivery area by the percentage of MFIP-S489.11recipients in that county who were members of the Indian tribe489.12during the previous state fiscal year. The resulting amount489.13shall also be the amount that the commissioner may provide to489.14the Indian tribe annually thereafter through an agreement under489.15this subdivision, except that the amount provided for a fiscal489.16year may increase or decrease in the same proportion that the489.17total amount of state and federal funds available for MFIP-S489.18employment and training services increased or decreased that489.19fiscal year.489.20 Subd. 4. [COUNTY AGENCY REQUIREMENT.] Indian tribal 489.21 members receivingMFIP-SMFIP benefits and residing in the 489.22 service area of an Indian tribe operating employmentand489.23trainingservices under an agreement with the commissioner must 489.24 be referred by county agencies in the service area to the Indian 489.25 tribe for employmentand trainingservices. 489.26 Sec. 43. Minnesota Statutes 2000, section 256K.03, 489.27 subdivision 5, is amended to read: 489.28 Subd. 5. [EXEMPTION CATEGORIES.] (a) The applicant will be 489.29 exempt from the job search requirements and development of a job 489.30 search plan and an employability development plan under 489.31 subdivisions 3, 4, and 8 if the applicant belongs to any of the 489.32 following groups: 489.33 (1) individuals who are age 60 or older; 489.34 (2) individuals who are suffering from a professionally 489.35 certified permanent or temporary illness, injury, or incapacity 489.36 which is expected to continue for more than 30 days and which 490.1 prevents the person from obtaining or retaining employment. 490.2 Persons in this category with a temporary illness, injury, or 490.3 incapacity must be reevaluated at least quarterly; 490.4 (3) caregivers whose presence in the home is needed as a 490.5 caregiver because ofthea professionally certified illness or 490.6 incapacity of another member in the assistance unit, a relative 490.7 in the household, or a foster child in the household; 490.8 (4) women who are pregnant, if the pregnancy has resulted 490.9 in a professionally certified incapacity that prevents the woman 490.10 from obtaining and retaining employment; 490.11 (5) caregivers of a child under the age of one year who 490.12 personally provide full-time care for the child. This exemption 490.13 may be used for only 12 months in a lifetime. In two-parent 490.14 households, only one parent or other relative may qualify for 490.15 this exemption; 490.16 (6)individuals who are single parents or one parent in a490.17two-parent family employed at least 35 hours per week;490.18(7)individuals experiencing a personal or family crisis 490.19 that makes them incapable of participating in the program, as 490.20 determined by the county agency. If the participant does not 490.21 agree with the county agency's determination, the participant 490.22 may seek professional certification, as defined in section 490.23 256J.08, that the participant is incapable of participating in 490.24 the program. Persons in this exemption category must be 490.25 reevaluated every 60 days; or 490.26(8)(7) second parents in two-parent families employed for 490.27 20 or more hours per week provided the first parent is employed 490.28 at least 35 hours per week. 490.29 (b) A caregiver who is exempt under clause (5) must enroll 490.30 in and attend an early childhood and family education class, a 490.31 parenting class, or some similar activity, if available, during 490.32 the period of time the caregiver is exempt under this section. 490.33 Notwithstanding section 256J.46, failure to attend the required 490.34 activity shall not result in the imposition of a sanction. 490.35 Sec. 44. [DOMESTIC VIOLENCE TRAINING FOR COUNTY AGENCIES.] 490.36 During fiscal year 2002, the commissioner of human services 491.1 will provide training for county agency staff to receive 491.2 specialized domestic violence training in order to carry out the 491.3 responsibilities in Minnesota Statutes, sections 256J.46, 491.4 subdivision 1a; 256J.49, subdivision 1a; 256J.52, subdivision 6; 491.5 and 256J.56, subdivision 6. This training must be similar to 491.6 the training provided to individuals who work for an 491.7 organization designated by the Minnesota center for crime 491.8 victims services as providing services to victims of domestic 491.9 violence. 491.10 Sec. 45. [SANCTION REPORT.] 491.11 The request for the report under this section must be 491.12 referred to the legislative audit commission for consideration. 491.13 If approved, the legislative auditor, with input from previous 491.14 and current MFIP participants, shall investigate inconsistent or 491.15 illegal sanctions that were imposed on MFIP participants from 491.16 January of 1998 to the present. The legislative auditor shall 491.17 report the nature of erroneous sanction activity, the scope or 491.18 extent of the errors or problems among sanctioned cases, and 491.19 provide recommendations or corrective actions to reconcile past 491.20 illegal or inconsistent sanctions, and recommend solutions that 491.21 will ensure that MFIP sanctions are imposed fairly and 491.22 consistently in the future. The report to the members of the 491.23 senate and house committees having jurisdiction over MFIP issues 491.24 is due by January 15, 2002. 491.25 Sec. 46. [REVISOR INSTRUCTION.] 491.26 In the next edition of Minnesota Statutes and Minnesota 491.27 Rules, the revisor shall change all references to Minnesota 491.28 Family Investment Program-Statewide (MFIP-S) to Minnesota Family 491.29 Investment Program (MFIP). 491.30 Sec. 47. [REPEALER.] 491.31 (a) Minnesota Statutes 2000, sections 256J.08, subdivision 491.32 50a; 256J.12, subdivision 3; 256J.43; and 256J.53, subdivision 491.33 4, are repealed. 491.34 (b) Minnesota Statutes 2000, section 256J.49, subdivision 491.35 11, is repealed October 1, 2001. 491.36 (c) Minnesota Statutes 2000, section 256D.066, is repealed. 492.1 (d) Minnesota Statutes 2000, sections 256.01, subdivision 492.2 18; 256J.32, subdivision 7a; and Laws 2000, chapter 488, article 492.3 10, section 30, are repealed effective July 1, 2001. 492.4 (e) Laws 1997, chapter 203, article 9, section 21; Laws 492.5 1998, chapter 407, article 6, section 111; and Laws 2000, 492.6 chapter 488, article 10, section 28, are repealed. 492.7 ARTICLE 11 492.8 CHILD WELFARE AND FOSTER CARE 492.9 Section 1. Minnesota Statutes 2000, section 13.461, 492.10 subdivision 17, is amended to read: 492.11 Subd. 17. [VULNERABLE ADULTMALTREATMENT REVIEWPANEL492.12 PANELS.] Data of the vulnerable adult maltreatment review 492.13 panel or the child maltreatment review panel are classified 492.14 under section 256.021 or section 3. 492.15 Sec. 2. Minnesota Statutes 2000, section 245.814, 492.16 subdivision 1, is amended to read: 492.17 Subdivision 1. [INSURANCE FOR FOSTER HOME PROVIDERS.] The 492.18 commissioner of human services shall within the appropriation 492.19 provided purchase and provide insurance to individuals licensed 492.20 as foster home providers to cover their liability for: 492.21 (1) injuries or property damage caused or sustained by 492.22 persons in foster care in their home; and 492.23 (2) actions arising out of alienation of affections 492.24 sustained by the birth parents of a foster child or birth 492.25 parents or children of a foster adult. 492.26 For purposes of this subdivision, insurance for homes 492.27 licensed to provide adult foster care shall be limited to family 492.28 adult foster care homes as defined in section 144D.01, 492.29 subdivision 7. 492.30 Sec. 3. [256.022] [CHILD MALTREATMENT REVIEW PANEL.] 492.31 Subdivision 1. [CREATION.] The commissioner of human 492.32 services shall establish a review panel for purposes of 492.33 reviewing investigating agency determinations regarding 492.34 maltreatment of a child in a facility in response to requests 492.35 received under section 626.556, subdivision 10i, paragraph (b). 492.36 The review panel consists of the commissioners of health; human 493.1 services; children, families, and learning; corrections; the 493.2 ombudsman for crime victims; and the ombudsman for mental health 493.3 and mental retardation; or their designees. 493.4 Subd. 2. [REVIEW PROCEDURE.] (a) The panel shall hold 493.5 quarterly meetings for purposes of conducting reviews under this 493.6 section. If an interested person acting on behalf of a child 493.7 requests a review under this section, the panel shall review the 493.8 request at its next quarterly meeting. If the next quarterly 493.9 meeting is within ten days of the panel's receipt of the request 493.10 for review, the review may be delayed until the next subsequent 493.11 meeting. The panel shall review the request and the final 493.12 determination regarding maltreatment made by the investigating 493.13 agency and may review any other data on the investigation 493.14 maintained by the agency that are pertinent and necessary to its 493.15 review of the determination. If more than one person requests a 493.16 review under this section with respect to the same 493.17 determination, the review panel shall combine the requests into 493.18 one review. Upon receipt of a request for a review, the panel 493.19 shall notify the alleged perpetrator of maltreatment that a 493.20 review has been requested and provide an approximate timeline 493.21 for conducting the review. 493.22 (b) Within 30 days of the review under this section, the 493.23 panel shall notify the investigating agency and the interested 493.24 person who requested the review as to whether the panel agrees 493.25 with the determination or whether the investigating agency must 493.26 reconsider the determination. If the panel determines that the 493.27 agency must reconsider the determination, the panel must make 493.28 specific investigative recommendations to the agency. Within 30 493.29 days the investigating agency shall conduct a review and report 493.30 back to the panel with its reconsidered determination and the 493.31 specific rationale for its determination. 493.32 Subd. 3. [REPORT.] By January 15 of each year, the panel 493.33 shall submit a report to the committees of the legislature with 493.34 jurisdiction over section 626.556 regarding the number of 493.35 requests for review it receives under this section, the number 493.36 of cases where the panel requires the investigating agency to 494.1 reconsider its final determination, the number of cases where 494.2 the final determination is changed, and any recommendations to 494.3 improve the review or investigative process. 494.4 Subd. 4. [DATA.] Data of the review panel created as part 494.5 of a review under this section are private data on individuals 494.6 as defined in section 13.02. 494.7 Sec. 4. Minnesota Statutes 2000, section 257.0725, is 494.8 amended to read: 494.9 257.0725 [ANNUAL REPORT.] 494.10 The commissioner of human services shall publish an annual 494.11 report on child maltreatment and on children in out-of-home 494.12 placement. The commissioner shall confer with counties, child 494.13 welfare organizations, child advocacy organizations, the courts, 494.14 and other groups on how to improve the content and utility of 494.15 the department's annual report. In regard to child 494.16 maltreatment, the report shall include the number and kinds of 494.17 maltreatment reports received and any other data that the 494.18 commissioner determines is appropriate to include in a report on 494.19 child maltreatment. In regard to children in out-of-home 494.20 placement, the report shall include, by county and statewide, 494.21 information on legal status, living arrangement, age, sex, race, 494.22 accumulated length of time in placement, reason for most recent 494.23 placement, race of family with whom placed, and other 494.24 information deemed appropriate on all children in out-of-home 494.25 placement. Out-of-home placement includes placement in any 494.26 facility by an authorized child-placing agency. 494.27 Sec. 5. Minnesota Statutes 2000, section 626.556, 494.28 subdivision 2, is amended to read: 494.29 Subd. 2. [DEFINITIONS.] As used in this section, the 494.30 following terms have the meanings given them unless the specific 494.31 content indicates otherwise: 494.32 (a) "Sexual abuse" means the subjection of a child by a 494.33 person responsible for the child's care, by a person who has a 494.34 significant relationship to the child, as defined in section 494.35 609.341, or by a person in a position of authority, as defined 494.36 in section 609.341, subdivision 10, to any act which constitutes 495.1 a violation of section 609.342 (criminal sexual conduct in the 495.2 first degree), 609.343 (criminal sexual conduct in the second 495.3 degree), 609.344 (criminal sexual conduct in the third degree), 495.4 609.345 (criminal sexual conduct in the fourth degree), or 495.5 609.3451 (criminal sexual conduct in the fifth degree). Sexual 495.6 abuse also includes any act which involves a minor which 495.7 constitutes a violation of prostitution offenses under sections 495.8 609.321 to 609.324 or 617.246. Sexual abuse includes threatened 495.9 sexual abuse. 495.10 (b) "Person responsible for the child's care" means (1) an 495.11 individual functioning within the family unit and having 495.12 responsibilities for the care of the child such as a parent, 495.13 guardian, or other person having similar care responsibilities, 495.14 or (2) an individual functioning outside the family unit and 495.15 having responsibilities for the care of the child such as a 495.16 teacher, school administrator, or other lawful custodian of a 495.17 child having either full-time or short-term care 495.18 responsibilities including, but not limited to, day care, 495.19 babysitting whether paid or unpaid, counseling, teaching, and 495.20 coaching. 495.21 (c) "Neglect" means: 495.22 (1) failure by a person responsible for a child's care to 495.23 supply a child with necessary food, clothing, shelter, health, 495.24 medical, or other care required for the child's physical or 495.25 mental health when reasonably able to do so; 495.26 (2) failure to protect a child from conditions or actions 495.27 which imminently and seriously endanger the child's physical or 495.28 mental health when reasonably able to do so; 495.29 (3) failure to provide for necessary supervision or child 495.30 care arrangements appropriate for a child after considering 495.31 factors as the child's age, mental ability, physical condition, 495.32 length of absence, or environment, when the child is unable to 495.33 care for the child's own basic needs or safety, or the basic 495.34 needs or safety of another child in their care; 495.35 (4) failure to ensure that the child is educated as defined 495.36 in sections 120A.22 and 260C.163, subdivision 11; 496.1 (5) nothing in this section shall be construed to mean that 496.2 a child is neglected solely because the child's parent, 496.3 guardian, or other person responsible for the child's care in 496.4 good faith selects and depends upon spiritual means or prayer 496.5 for treatment or care of disease or remedial care of the child 496.6 in lieu of medical care; except that a parent, guardian, or 496.7 caretaker, or a person mandated to report pursuant to 496.8 subdivision 3, has a duty to report if a lack of medical care 496.9 may cause serious danger to the child's health. This section 496.10 does not impose upon persons, not otherwise legally responsible 496.11 for providing a child with necessary food, clothing, shelter, 496.12 education, or medical care, a duty to provide that care; 496.13 (6) prenatal exposure to a controlled substance, as defined 496.14 in section 253B.02, subdivision 2, used by the mother for a 496.15 nonmedical purpose, as evidenced by withdrawal symptoms in the 496.16 child at birth, results of a toxicology test performed on the 496.17 mother at delivery or the child at birth, or medical effects or 496.18 developmental delays during the child's first year of life that 496.19 medically indicate prenatal exposure to a controlled substance; 496.20 (7) "medical neglect" as defined in section 260C.007, 496.21 subdivision 4, clause (5); 496.22 (8) chronic and severe use of alcohol or a controlled 496.23 substance by a parent or person responsible for the care of the 496.24 child that adversely affects the child's basic needs and safety; 496.25 or 496.26 (9) emotional harm from a pattern of behavior which 496.27 contributes to impaired emotional functioning of the child which 496.28 may be demonstrated by a substantial and observable effect in 496.29 the child's behavior, emotional response, or cognition that is 496.30 not within the normal range for the child's age and stage of 496.31 development, with due regard to the child's culture. 496.32 (d) "Physical abuse" means any physical injury, mental 496.33 injury, or threatened injury, inflicted by a person responsible 496.34 for the child's care on a child other than by accidental means, 496.35 or any physical or mental injury that cannot reasonably be 496.36 explained by the child's history of injuries, or any aversive 497.1 and deprivation procedures that have not been authorized under 497.2 section 245.825. Abuse does not include reasonable and moderate 497.3 physical discipline of a child administered by a parent or legal 497.4 guardian which does not result in an injury. Actions which are 497.5 not reasonable and moderate include, but are not limited to, any 497.6 of the following that are done in anger or without regard to the 497.7 safety of the child: 497.8 (1) throwing, kicking, burning, biting, or cutting a child; 497.9 (2) striking a child with a closed fist; 497.10 (3) shaking a child under age three; 497.11 (4) striking or other actions which result in any 497.12 nonaccidental injury to a child under 18 months of age; 497.13 (5) unreasonable interference with a child's breathing; 497.14 (6) threatening a child with a weapon, as defined in 497.15 section 609.02, subdivision 6; 497.16 (7) striking a child under age one on the face or head; 497.17 (8) purposely giving a child poison, alcohol, or dangerous, 497.18 harmful, or controlled substances which were not prescribed for 497.19 the child by a practitioner, in order to control or punish the 497.20 child; or other substances that substantially affect the child's 497.21 behavior, motor coordination, or judgment or that results in 497.22 sickness or internal injury, or subjects the child to medical 497.23 procedures that would be unnecessary if the child were not 497.24 exposed to the substances; or 497.25 (9) unreasonable physical confinement or restraint not 497.26 permitted under section 609.379, including but not limited to 497.27 tying, caging, or chaining. 497.28 (e) "Report" means any report received by the local welfare 497.29 agency, police department, or county sheriff pursuant to this 497.30 section. 497.31 (f) "Facility" means a licensed or unlicensed day care 497.32 facility, residential facility, agency, hospital, sanitarium, or 497.33 other facility or institution required to be licensed under 497.34 sections 144.50 to 144.58, 241.021, or 245A.01 to 245A.16, or 497.35 chapter 245B; or a school as defined in sections 120A.05, 497.36 subdivisions 9, 11, and 13; and 124D.10; or a nonlicensed 498.1 personal care provider organization as defined in sections 498.2 256B.04, subdivision 16, and 256B.0625, subdivision 19a. 498.3 (g) "Operator" means an operator or agency as defined in 498.4 section 245A.02. 498.5 (h) "Commissioner" means the commissioner of human services. 498.6 (i) "Assessment" includes authority to interview the child, 498.7 the person or persons responsible for the child's care, the 498.8 alleged perpetrator, and any other person with knowledge of the 498.9 abuse or neglect for the purpose of gathering the facts, 498.10 assessing the risk to the child, and formulating a plan. 498.11 (j) "Practice of social services," for the purposes of 498.12 subdivision 3, includes but is not limited to employee 498.13 assistance counseling and the provision of guardian ad litem and 498.14 parenting time expeditor services. 498.15 (k) "Mental injury" means an injury to the psychological 498.16 capacity or emotional stability of a child as evidenced by an 498.17 observable or substantial impairment in the child's ability to 498.18 function within a normal range of performance and behavior with 498.19 due regard to the child's culture. 498.20 (l) "Threatened injury" means a statement, overt act, 498.21 condition, or status that represents a substantial risk of 498.22 physical or sexual abuse or mental injury. 498.23 (m) Persons who conduct assessments or investigations under 498.24 this section shall take into account accepted child-rearing 498.25 practices of the culture in which a child participates, which 498.26 are not injurious to the child's health, welfare, and safety. 498.27 (n) "Maltreatment of a child in a facility" means physical 498.28 abuse, sexual abuse, or neglect that occurs while a child is 498.29 under the care of a facility, or the following acts committed by 498.30 a person other than a child receiving services, with a child or 498.31 in the presence of a child who is or should be under the 498.32 supervision of the facility: 498.33 (1) an act against a child that constitutes a violation of, 498.34 an attempt to violate, or aiding and abetting a violation of: 498.35 (i) sections 609.221 to 609.224 (assault in the first 498.36 through fifth degrees); or 499.1 (ii) section 609.52 (theft); 499.2 (2) conduct that is not an accident or authorized conduct 499.3 that produces or could reasonably be expected to produce 499.4 physical pain or injury or mental injury, including, but not 499.5 limited to, the following: 499.6 (i) hitting, slapping, kicking, pinching, biting, or 499.7 shaking; 499.8 (ii) use of an aversive or deprivation procedure, 499.9 unreasonable confinement, or involuntary seclusion, including an 499.10 unreasonable, forced separation of the child from other persons, 499.11 except aversive or deprivation procedures for developmentally 499.12 disabled children authorized under section 245.825; or 499.13 (iii) use of an unreasonable restraint, including tying, 499.14 caging, chaining, or any other unreasonable physical or manual 499.15 method of restricting or prohibiting movement; 499.16 (3) in the absence of legal authority, willfully using, 499.17 withholding, or disposing of funds or property of a child 499.18 receiving services in a facility that is not considered to be 499.19 contraband by the facility or school; 499.20 (4) sexual conduct with a child or in the presence of a 499.21 child that a reasonable person would consider to be sexual 499.22 behavior or exposing the child to sexual behavior or material 499.23 that is inappropriate for the age and developmental level of the 499.24 child; or 499.25 (5) sexual contact as defined in section 609.341 between a 499.26 facility staff, or an associate of the facility staff, and a 499.27 child receiving services. 499.28 For purposes of this paragraph, a child is not abused for 499.29 the sole reason that a person is engaged in authorized conduct. 499.30 (o) "Authorized conduct" means the provision of program 499.31 services, education for schools, health care, or other personal 499.32 care services; or provision of services or education under a 499.33 written program plan, individual education plan, or school 499.34 discipline plan, done in the best interests of the child by an 499.35 individual, facility, or employee or person providing services 499.36 or education in a facility under the rights, privileges, and 500.1 responsibilities conferred by state license, certification, or 500.2 registration. 500.3 (p) "Accident" means a sudden, unforeseen, and unexpected 500.4 occurrence or event that: 500.5 (1) was not likely to occur and could not have been 500.6 prevented by the exercise of due care; and 500.7 (2) if occurring while a child is receiving services from a 500.8 facility, occurs when the facility and the staff person 500.9 providing the services in the facility are in compliance with 500.10 applicable law relevant to the occurrence or event. 500.11 Sec. 6. Minnesota Statutes 2000, section 626.556, is 500.12 amended by adding a subdivision to read: 500.13 Subd. 3d. [FACILITY PROCEDURES; INTERNAL REPORTING.] (a) 500.14 Except for child foster care and family child care, a facility 500.15 licensed under sections 245A.01 to 245A.16 and chapter 245B 500.16 shall establish and enforce an ongoing written procedure in 500.17 compliance with applicable licensing rules to ensure that all 500.18 cases of suspected maltreatment are reported. The procedure 500.19 must include the definitions of maltreatment and the phone 500.20 numbers for the local welfare agency, police department, county 500.21 sheriff, and agency responsible for assessing or investigating 500.22 maltreatment under this section. Procedures must include a 500.23 method for providing children or family members with written 500.24 information on where to report suspected maltreatment. Mandated 500.25 reporters in a facility must receive orientation on this 500.26 procedure before having direct contact with children and annual 500.27 training on reporting of maltreatment. 500.28 (b) If a facility has an internal reporting procedure, a 500.29 mandated reporter may meet the reporting requirements of this 500.30 section by reporting internally. The facility remains 500.31 responsible for complying with the immediate reporting 500.32 requirements of this section. A facility with an internal 500.33 reporting procedure that receives an internal report from a 500.34 mandated reporter shall give the mandated reporter a written 500.35 notice if the facility has not reported the incident to the 500.36 agency responsible for assessing or investigating maltreatment. 501.1 The written notice must be provided within two working days of 501.2 receipt of the internal report in a manner that protects the 501.3 confidentiality of the reporter. The written notice to the 501.4 mandated reporter must inform the reporter that if the reporter 501.5 is not satisfied with the action taken by the facility, the 501.6 reporter may report externally. 501.7 (c) A facility may not prohibit a mandated reporter from 501.8 reporting externally and may not retaliate against a mandated 501.9 reporter who, in good faith, reports an incident to the agency 501.10 responsible for assessing or investigating maltreatment. 501.11 Sec. 7. Minnesota Statutes 2000, section 626.556, 501.12 subdivision 10, is amended to read: 501.13 Subd. 10. [DUTIES OF LOCAL WELFARE AGENCY AND LOCAL LAW 501.14 ENFORCEMENT AGENCY UPON RECEIPT OF A REPORT.] (a) If the report 501.15 alleges neglect, physical abuse, or sexual abuse by a parent, 501.16 guardian, or individual functioning within the family unit as a 501.17 person responsible for the child's care, the local welfare 501.18 agency shall immediately conduct an assessment including 501.19 gathering information on the existence of substance abuse and 501.20 offer protective social services for purposes of preventing 501.21 further abuses, safeguarding and enhancing the welfare of the 501.22 abused or neglected minor, and preserving family life whenever 501.23 possible. If the report alleges a violation of a criminal 501.24 statute involving sexual abuse, physical abuse, or neglect or 501.25 endangerment, under section 609.378, the local law enforcement 501.26 agency and local welfare agency shall coordinate the planning 501.27 and execution of their respective investigation and assessment 501.28 efforts to avoid a duplication of fact-finding efforts and 501.29 multiple interviews. Each agency shall prepare a separate 501.30 report of the results of its investigation. In cases of alleged 501.31 child maltreatment resulting in death, the local agency may rely 501.32 on the fact-finding efforts of a law enforcement investigation 501.33 to make a determination of whether or not maltreatment 501.34 occurred. When necessary the local welfare agency shall seek 501.35 authority to remove the child from the custody of a parent, 501.36 guardian, or adult with whom the child is living. In performing 502.1 any of these duties, the local welfare agency shall maintain 502.2 appropriate records. 502.3 If the assessment indicates there is a potential for abuse 502.4 of alcohol or other drugs by the parent, guardian, or person 502.5 responsible for the child's care, the local welfare agency shall 502.6 conduct a chemical use assessment pursuant to Minnesota Rules, 502.7 part 9530.6615. The local welfare agency shall report the 502.8 determination of the chemical use assessment, and the 502.9 recommendations and referrals for alcohol and other drug 502.10 treatment services to the state authority on alcohol and drug 502.11 abuse. 502.12 (b) When a local agency receives a report or otherwise has 502.13 information indicating that a child who is a client, as defined 502.14 in section 245.91, has been the subject of physical abuse, 502.15 sexual abuse, or neglect at an agency, facility, or program as 502.16 defined in section 245.91, it shall, in addition to its other 502.17 duties under this section, immediately inform the ombudsman 502.18 established under sections 245.91 to 245.97. 502.19 (c) Authority of the local welfare agency responsible for 502.20 assessing the child abuse or neglect report and of the local law 502.21 enforcement agency for investigating the alleged abuse or 502.22 neglect includes, but is not limited to, authority to interview, 502.23 without parental consent, the alleged victim and any other 502.24 minors who currently reside with or who have resided with the 502.25 alleged offender. The interview may take place at school or at 502.26 any facility or other place where the alleged victim or other 502.27 minors might be found or the child may be transported to, and 502.28 the interview conducted at, a place appropriate for the 502.29 interview of a child designated by the local welfare agency or 502.30 law enforcement agency. The interview may take place outside 502.31 the presence of the alleged offender or parent, legal custodian, 502.32 guardian, or school official. Except as provided in this 502.33 paragraph, the parent, legal custodian, or guardian shall be 502.34 notified by the responsible local welfare or law enforcement 502.35 agency no later than the conclusion of the investigation or 502.36 assessment that this interview has occurred. Notwithstanding 503.1 rule 49.02 of the Minnesota rules of procedure for juvenile 503.2 courts, the juvenile court may, after hearing on an ex parte 503.3 motion by the local welfare agency, order that, where reasonable 503.4 cause exists, the agency withhold notification of this interview 503.5 from the parent, legal custodian, or guardian. If the interview 503.6 took place or is to take place on school property, the order 503.7 shall specify that school officials may not disclose to the 503.8 parent, legal custodian, or guardian the contents of the 503.9 notification of intent to interview the child on school 503.10 property, as provided under this paragraph, and any other 503.11 related information regarding the interview that may be a part 503.12 of the child's school record. A copy of the order shall be sent 503.13 by the local welfare or law enforcement agency to the 503.14 appropriate school official. 503.15 (d) When the local welfare or local law enforcement agency 503.16 determines that an interview should take place on school 503.17 property, written notification of intent to interview the child 503.18 on school property must be received by school officials prior to 503.19 the interview. The notification shall include the name of the 503.20 child to be interviewed, the purpose of the interview, and a 503.21 reference to the statutory authority to conduct an interview on 503.22 school property. For interviews conducted by the local welfare 503.23 agency, the notification shall be signed by the chair of the 503.24 local social services agency or the chair's designee. The 503.25 notification shall be private data on individuals subject to the 503.26 provisions of this paragraph. School officials may not disclose 503.27 to the parent, legal custodian, or guardian the contents of the 503.28 notification or any other related information regarding the 503.29 interview until notified in writing by the local welfare or law 503.30 enforcement agency that the investigation or assessment has been 503.31 concluded. Until that time, the local welfare or law 503.32 enforcement agency shall be solely responsible for any 503.33 disclosures regarding the nature of the assessment or 503.34 investigation. 503.35 Except where the alleged offender is believed to be a 503.36 school official or employee, the time and place, and manner of 504.1 the interview on school premises shall be within the discretion 504.2 of school officials, but the local welfare or law enforcement 504.3 agency shall have the exclusive authority to determine who may 504.4 attend the interview. The conditions as to time, place, and 504.5 manner of the interview set by the school officials shall be 504.6 reasonable and the interview shall be conducted not more than 24 504.7 hours after the receipt of the notification unless another time 504.8 is considered necessary by agreement between the school 504.9 officials and the local welfare or law enforcement agency. 504.10 Where the school fails to comply with the provisions of this 504.11 paragraph, the juvenile court may order the school to comply. 504.12 Every effort must be made to reduce the disruption of the 504.13 educational program of the child, other students, or school 504.14 staff when an interview is conducted on school premises. 504.15 (e) Where the alleged offender or a person responsible for 504.16 the care of the alleged victim or other minor prevents access to 504.17 the victim or other minor by the local welfare agency, the 504.18 juvenile court may order the parents, legal custodian, or 504.19 guardian to produce the alleged victim or other minor for 504.20 questioning by the local welfare agency or the local law 504.21 enforcement agency outside the presence of the alleged offender 504.22 or any person responsible for the child's care at reasonable 504.23 places and times as specified by court order. 504.24 (f) Before making an order under paragraph (e), the court 504.25 shall issue an order to show cause, either upon its own motion 504.26 or upon a verified petition, specifying the basis for the 504.27 requested interviews and fixing the time and place of the 504.28 hearing. The order to show cause shall be served personally and 504.29 shall be heard in the same manner as provided in other cases in 504.30 the juvenile court. The court shall consider the need for 504.31 appointment of a guardian ad litem to protect the best interests 504.32 of the child. If appointed, the guardian ad litem shall be 504.33 present at the hearing on the order to show cause. 504.34 (g) The commissioner, the ombudsman for mental health and 504.35 mental retardation, the local welfare agencies responsible for 504.36 investigating reports, and the local law enforcement agencies 505.1 have the right to enter facilities as defined in subdivision 2 505.2 and to inspect and copy the facility's records, including 505.3 medical records, as part of the investigation. Notwithstanding 505.4 the provisions of chapter 13, they also have the right to inform 505.5 the facility under investigation that they are conducting an 505.6 investigation, to disclose to the facility the names of the 505.7 individuals under investigation for abusing or neglecting a 505.8 child, and to provide the facility with a copy of the report and 505.9 the investigative findings. 505.10 (h) The local welfare agency shall collect available and 505.11 relevant information to ascertain whether maltreatment occurred 505.12 and whether protective services are needed. Information 505.13 collected includes, when relevant, information with regard to 505.14 the person reporting the alleged maltreatment, including the 505.15 nature of the reporter's relationship to the child and to the 505.16 alleged offender, and the basis of the reporter's knowledge for 505.17 the report; the child allegedly being maltreated; the alleged 505.18 offender; the child's caretaker; and other collateral sources 505.19 having relevant information related to the alleged 505.20 maltreatment. The local welfare agency may make a determination 505.21 of no maltreatment early in an assessment, and close the case 505.22 and retain immunity, if the collected information shows no basis 505.23 for a full assessment or investigation. 505.24 Information relevant to the assessment or investigation 505.25 must be asked for, and may include: 505.26 (1) the child's sex and age, prior reports of maltreatment, 505.27 information relating to developmental functioning, credibility 505.28 of the child's statement, and whether the information provided 505.29 under this clause is consistent with other information collected 505.30 during the course of the assessment or investigation; 505.31 (2) the alleged offender's age, a record check for prior 505.32 reports of maltreatment, and criminal charges and convictions. 505.33 The local welfare agency must provide the alleged offender with 505.34 an opportunity to make a statement. The alleged offender may 505.35 submit supporting documentation relevant to the assessment or 505.36 investigation; 506.1 (3) collateral source information regarding the alleged 506.2 maltreatment and care of the child. Collateral information 506.3 includes, when relevant: (i) a medical examination of the 506.4 child; (ii) prior medical records relating to the alleged 506.5 maltreatment or the care of the child maintained by any 506.6 facility, clinic, or health care professional and an interview 506.7 with the treating professionals; and (iii) interviews with the 506.8 child's caretakers, including the child's parent, guardian, 506.9 foster parent, child care provider, teachers, counselors, family 506.10 members, relatives, and other persons who may have knowledge 506.11 regarding the alleged maltreatment and the care of the child; 506.12 and 506.13 (4) information on the existence of domestic abuse and 506.14 violence in the home of the child, and substance abuse. 506.15 Nothing in this paragraph precludes the local welfare 506.16 agency from collecting other relevant information necessary to 506.17 conduct the assessment or investigation. Notwithstanding 506.18 section 13.384 or 144.335, the local welfare agency has access 506.19 to medical data and records for purposes of clause (3). 506.20 Notwithstanding the data's classification in the possession of 506.21 any other agency, data acquired by the local welfare agency 506.22 during the course of the assessment or investigation are private 506.23 data on individuals and must be maintained in accordance with 506.24 subdivision 11. 506.25 (i) In the initial stages of an assessment or 506.26 investigation, the local welfare agency shall conduct a 506.27 face-to-face observation of the child reported to be maltreated 506.28 and a face-to-face interview of the alleged offender. The 506.29 interview with the alleged offender may be postponed if it would 506.30 jeopardize an active law enforcement investigation. 506.31 (j) The local welfare agency shall use a question and 506.32 answer interviewing format with questioning as nondirective as 506.33 possible to elicit spontaneous responses. The following 506.34 interviewing methods and procedures must be used whenever 506.35 possible when collecting information: 506.36 (1) audio recordings of all interviews with witnesses and 507.1 collateral sources; and 507.2 (2) in cases of alleged sexual abuse, audio-video 507.3 recordings of each interview with the alleged victim and child 507.4 witnesses. 507.5 Sec. 8. Minnesota Statutes 2000, section 626.556, 507.6 subdivision 10b, is amended to read: 507.7 Subd. 10b. [DUTIES OF COMMISSIONER; NEGLECT OR ABUSE IN 507.8 FACILITY.] (a) This section applies to the commissioners of 507.9 human services, health, and children, families, and learning. 507.10 The commissioner of the agency responsible for assessing or 507.11 investigating the report shall immediately investigate if the 507.12 report alleges that: 507.13 (1) a child who is in the care of a facility as defined in 507.14 subdivision 2 is neglected, physically abused,orsexually 507.15 abused, or is the victim of maltreatment in a facility by an 507.16 individual in that facility, or has been so neglected or 507.17 abused or been the victim of maltreatment in a facility by an 507.18 individual in that facility within the three years preceding the 507.19 report; or 507.20 (2) a child was neglected, physically abused,orsexually 507.21 abused, or is the victim of maltreatment in a facility by an 507.22 individual in a facility defined in subdivision 2, while in the 507.23 care of that facility within the three years preceding the 507.24 report. 507.25 The commissioner of the agency responsible for assessing or 507.26 investigating the report shall arrange for the transmittal to 507.27 the commissioner of reports received by local agencies and may 507.28 delegate to a local welfare agency the duty to investigate 507.29 reports. In conducting an investigation under this section, the 507.30 commissioner has the powers and duties specified for local 507.31 welfare agencies under this section. The commissioner of the 507.32 agency responsible for assessing or investigating the report or 507.33 local welfare agency may interview any children who are or have 507.34 been in the care of a facility under investigation and their 507.35 parents, guardians, or legal custodians. 507.36 (b) Prior to any interview, the commissioner of the agency 508.1 responsible for assessing or investigating the report or local 508.2 welfare agency shall notify the parent, guardian, or legal 508.3 custodian of a child who will be interviewed in the manner 508.4 provided for in subdivision 10d, paragraph (a). If reasonable 508.5 efforts to reach the parent, guardian, or legal custodian of a 508.6 child in an out-of-home placement have failed, the child may be 508.7 interviewed if there is reason to believe the interview is 508.8 necessary to protect the child or other children in the 508.9 facility. The commissioner of the agency responsible for 508.10 assessing or investigating the report or local agency must 508.11 provide the information required in this subdivision to the 508.12 parent, guardian, or legal custodian of a child interviewed 508.13 without parental notification as soon as possible after the 508.14 interview. When the investigation is completed, any parent, 508.15 guardian, or legal custodian notified under this subdivision 508.16 shall receive the written memorandum provided for in subdivision 508.17 10d, paragraph (c). 508.18 (c) In conducting investigations under this subdivision the 508.19 commissioner or local welfare agency shall obtain access to 508.20 information consistent with subdivision 10, paragraphs (h), (i), 508.21 and (j). 508.22 (d) Except for foster care and family child care, the 508.23 commissioner has the primary responsibility for the 508.24 investigations and notifications required under subdivisions 10d 508.25 and 10f for reports that allege maltreatment related to the care 508.26 provided by or in facilities licensed by the commissioner. The 508.27 commissioner may request assistance from the local social 508.28 services agency. 508.29 Sec. 9. Minnesota Statutes 2000, section 626.556, 508.30 subdivision 10d, is amended to read: 508.31 Subd. 10d. [NOTIFICATION OF NEGLECT OR ABUSE IN FACILITY.] 508.32 (a) When a report is received that alleges neglect, physical 508.33 abuse,orsexual abuse, or maltreatment of a child while in the 508.34 care of a licensed or unlicensed day care facility, residential 508.35 facility, agency, hospital, sanitarium, or other facility or 508.36 institution required to be licensed according to sections 144.50 509.1 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B, or a 509.2 school as defined in sections 120A.05, subdivisions 9, 11, and 509.3 13; and 124D.10; or a nonlicensed personal care provider 509.4 organization as defined in section 256B.04, subdivision 16, and 509.5 256B.0625, subdivision 19a, the commissioner of the agency 509.6 responsible for assessing or investigating the report or local 509.7 welfare agency investigating the report shall provide the 509.8 following information to the parent, guardian, or legal 509.9 custodian of a child alleged to have been neglected, physically 509.10 abused,orsexually abused, or the victim of maltreatment of a 509.11 child in the facility: the name of the facility; the fact that 509.12 a report alleging neglect, physical abuse,orsexual abuse, or 509.13 maltreatment of a child in the facility has been received; the 509.14 nature of the alleged neglect, physical abuse,orsexual abuse, 509.15 or maltreatment of a child in the facility; that the agency is 509.16 conducting an investigation; any protective or corrective 509.17 measures being taken pending the outcome of the investigation; 509.18 and that a written memorandum will be provided when the 509.19 investigation is completed. 509.20 (b) The commissioner of the agency responsible for 509.21 assessing or investigating the report or local welfare agency 509.22 may also provide the information in paragraph (a) to the parent, 509.23 guardian, or legal custodian of any other child in the facility 509.24 if the investigative agency knows or has reason to believe the 509.25 alleged neglect, physical abuse,orsexual abuse, or 509.26 maltreatment of a child in the facility has occurred. In 509.27 determining whether to exercise this authority, the commissioner 509.28 of the agency responsible for assessing or investigating the 509.29 report or local welfare agency shall consider the seriousness of 509.30 the alleged neglect, physical abuse,orsexual abuse, or 509.31 maltreatment of a child in the facility; the number of children 509.32 allegedly neglected, physically abused,orsexually abused, or 509.33 victims of maltreatment of a child in the facility; the number 509.34 of alleged perpetrators; and the length of the investigation. 509.35 The facility shall be notified whenever this discretion is 509.36 exercised. 510.1 (c) When the commissioner of the agency responsible for 510.2 assessing or investigating the report or local welfare agency 510.3 has completed its investigation, every parent, guardian, or 510.4 legal custodian notified of the investigation by the 510.5 commissioner or local welfare agency shall be provided with the 510.6 following information in a written memorandum: the name of the 510.7 facility investigated; the nature of the alleged neglect, 510.8 physical abuse,orsexual abuse, or maltreatment of a child in 510.9 the facility; the investigator's name; a summary of the 510.10 investigation findings; a statement whether maltreatment was 510.11 found; and the protective or corrective measures that are being 510.12 or will be taken. The memorandum shall be written in a manner 510.13 that protects the identity of the reporter and the child and 510.14 shall not contain the name, or to the extent possible, reveal 510.15 the identity of the alleged perpetrator or of those interviewed 510.16 during the investigation. If maltreatment is determined to 510.17 exist, the commissioner or local welfare agency shall also 510.18 provide the written memorandum to the parent, guardian, or legal 510.19 custodian of each child in the facilityif maltreatment is510.20determined to existwho had contact with the individual 510.21 responsible for the maltreatment. When the facility is the 510.22 responsible party for maltreatment, the commissioner or local 510.23 welfare agency shall also provide the written memorandum to the 510.24 parent, guardian, or legal custodian of each child who received 510.25 services in the population of the facility where the 510.26 maltreatment occurred. This notification must be provided to 510.27 the parent, guardian, or legal custodian of each child receiving 510.28 services from the time the maltreatment occurred until either 510.29 the individual responsible for maltreatment is no longer in 510.30 contact with a child or children in the facility or the 510.31 conclusion of the investigation. 510.32 Sec. 10. Minnesota Statutes 2000, section 626.556, 510.33 subdivision 10e, is amended to read: 510.34 Subd. 10e. [DETERMINATIONS.] Upon the conclusion of every 510.35 assessment or investigation it conducts, the local welfare 510.36 agency shall make two determinations: first, whether 511.1 maltreatment has occurred; and second, whether child protective 511.2 services are needed. When maltreatment is determined in an 511.3 investigation involving a facility, the investigating agency 511.4 shall also determine whether the facility or individual was 511.5 responsible for the maltreatment using the mitigating factors in 511.6 paragraph (d). Determinations under this subdivision must be 511.7 made based on a preponderance of the evidence. 511.8 (a) For the purposes of this subdivision, "maltreatment" 511.9 means any of the following acts or omissionscommitted by a511.10person responsible for the child's care: 511.11 (1) physical abuse as defined in subdivision 2, paragraph 511.12 (d); 511.13 (2) neglect as defined in subdivision 2, paragraph (c); 511.14 (3) sexual abuse as defined in subdivision 2, paragraph 511.15 (a);or511.16 (4) mental injury as defined in subdivision 2, paragraph 511.17 (k); or 511.18 (5) maltreatment of a child in a facility as defined in 511.19 subdivision 2, paragraph (n). 511.20 (b) For the purposes of this subdivision, a determination 511.21 that child protective services are needed means that the local 511.22 welfare agency has documented conditions during the assessment 511.23 or investigation sufficient to cause a child protection worker, 511.24 as defined in section 626.559, subdivision 1, to conclude that a 511.25 child is at significant risk of maltreatment if protective 511.26 intervention is not provided and that the individuals 511.27 responsible for the child's care have not taken or are not 511.28 likely to take actions to protect the child from maltreatment or 511.29 risk of maltreatment. 511.30 (c) This subdivision does not mean that maltreatment has 511.31 occurred solely because the child's parent, guardian, or other 511.32 person responsible for the child's care in good faith selects 511.33 and depends upon spiritual means or prayer for treatment or care 511.34 of disease or remedial care of the child, in lieu of medical 511.35 care. However, if lack of medical care may result in serious 511.36 danger to the child's health, the local welfare agency may 512.1 ensure that necessary medical services are provided to the child. 512.2 (d) When determining whether the facility or individual is 512.3 the responsible party for determined maltreatment in a facility, 512.4 the investigating agency shall consider at least the following 512.5 mitigating factors: 512.6 (1) whether the actions of the facility or the individual 512.7 caregivers were according to, and followed the terms of, an 512.8 erroneous physician order, prescription, individual care plan, 512.9 or directive; however, this is not a mitigating factor when the 512.10 facility or caregiver was responsible for the issuance of the 512.11 erroneous order, prescription, individual care plan, or 512.12 directive or knew or should have known of the errors and took no 512.13 reasonable measures to correct the defect before administering 512.14 care; 512.15 (2) comparative responsibility between the facility, other 512.16 caregivers, and requirements placed upon an employee, including 512.17 the facility's compliance with related regulatory standards and 512.18 the adequacy of facility policies and procedures, facility 512.19 training, an individual's participation in the training, the 512.20 caregiver's supervision, and facility staffing levels and the 512.21 scope of the individual employee's authority and discretion; and 512.22 (3) whether the facility or individual followed 512.23 professional standards in exercising professional judgment. 512.24 Individual counties may implement more detailed definitions 512.25 or criteria that indicate which allegations to investigate, as 512.26 long as a county's policies are consistent with the definitions 512.27 in the statutes and rules and are approved by the county board. 512.28 Each local welfare agency shall periodically inform mandated 512.29 reporters under subdivision 3 who work in the county of the 512.30 definitions of maltreatment in the statutes and rules and any 512.31 additional definitions or criteria that have been approved by 512.32 the county board. 512.33 Sec. 11. Minnesota Statutes 2000, section 626.556, 512.34 subdivision 10f, is amended to read: 512.35 Subd. 10f. [NOTICE OF DETERMINATIONS.] Within ten working 512.36 days of the conclusion of an assessment, the local welfare 513.1 agency or agency responsible for assessing or investigating the 513.2 report shall notify the parent or guardian of the child, the 513.3 person determined to be maltreating the child, and if 513.4 applicable, the director of the facility, of the determination 513.5 and a summary of the specific reasons for the determination. 513.6 The notice must also include a certification that the 513.7 information collection procedures under subdivision 10, 513.8 paragraphs (h), (i), and (j), were followed and a notice of the 513.9 right of a data subject to obtain access to other private data 513.10 on the subject collected, created, or maintained under this 513.11 section. In addition, the notice shall include the length of 513.12 time that the records will be kept under subdivision 11c. The 513.13 investigating agency shall notify the parent or guardian of the 513.14 child who is the subject of the report, and any person or 513.15 facility determined to have maltreated a child, of their 513.16 appeal or review rights under this section or section 3. 513.17 Sec. 12. Minnesota Statutes 2000, section 626.556, 513.18 subdivision 10i, is amended to read: 513.19 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL 513.20 DETERMINATION OF MALTREATMENT; REVIEW PANEL.] (a) An individual 513.21 or facility that the commissioner or a local social service 513.22 agency determines has maltreated a child, orthe child's513.23designeean interested person acting on behalf of the child, 513.24 regardless of the determination, who contests the investigating 513.25 agency's final determination regarding maltreatment, may request 513.26 the investigating agency to reconsider its final determination 513.27 regarding maltreatment. The request for reconsideration must be 513.28 submitted in writing to the investigating agency within 15 513.29 calendar days after receipt of notice of the final determination 513.30 regarding maltreatment or, if the request is made by an 513.31 interested person who is not entitled to notice, within 15 days 513.32 after receipt of the notice by the parent or guardian of the 513.33 child. 513.34 (b) If the investigating agency denies the request or fails 513.35 to act upon the request within 15 calendar days after receiving 513.36 the request for reconsideration, the person or facility entitled 514.1 to a fair hearing under section 256.045 may submit to the 514.2 commissioner of human services a written request for a hearing 514.3 under that section. For reports involving maltreatment of a 514.4 child in a facility, an interested person acting on behalf of 514.5 the child may request a review by the child maltreatment review 514.6 panel under section 3 if the investigating agency denies the 514.7 request or fails to act upon the request or if the interested 514.8 person contests a reconsidered determination. The investigating 514.9 agency shall notify persons who request reconsideration of their 514.10 rights under this paragraph. The request must be submitted in 514.11 writing to the review panel and a copy sent to the investigating 514.12 agency within 30 calendar days of receipt of notice of a denial 514.13 of a request for reconsideration or of a reconsidered 514.14 determination. The request must specifically identify the 514.15 aspects of the agency determination with which the person is 514.16 dissatisfied. 514.17 (c) If, as a result ofthea reconsideration or review, the 514.18 investigating agency changes the final determination of 514.19 maltreatment, that agency shall notify the parties specified in 514.20 subdivisions 10b, 10d, and 10f. 514.21 (d) If an individual or facility contests the investigating 514.22 agency's final determination regarding maltreatment by 514.23 requesting a fair hearing under section 256.045, the 514.24 commissioner of human services shall assure that the hearing is 514.25 conducted and a decision is reached within 90 days of receipt of 514.26 the request for a hearing. The time for action on the decision 514.27 may be extended for as many days as the hearing is postponed or 514.28 the record is held open for the benefit of either party. 514.29 (e) For purposes of this subdivision, "interested person 514.30 acting on behalf of the child" means a parent or legal guardian; 514.31 stepparent; grandparent; guardian ad litem; adult stepbrother, 514.32 stepsister, or sibling; or adult aunt or uncle; unless the 514.33 person has been determined to be the perpetrator of the 514.34 maltreatment. 514.35 Sec. 13. Minnesota Statutes 2000, section 626.556, 514.36 subdivision 11, is amended to read: 515.1 Subd. 11. [RECORDS.] (a) Except as provided in paragraph 515.2 (b) or (c) and subdivisions 10b, 10d, 10g, and 11b, all records 515.3 concerning individuals maintained by a local welfare agency or 515.4 agency responsible for assessing or investigating the report 515.5 under this section, including any written reports filed under 515.6 subdivision 7, shall be private data on individuals, except 515.7 insofar as copies of reports are required by subdivision 7 to be 515.8 sent to the local police department or the county sheriff. 515.9 Reports maintained by any police department or the county 515.10 sheriff shall be private data on individuals except the reports 515.11 shall be made available to the investigating, petitioning, or 515.12 prosecuting authority, including county medical examiners or 515.13 county coroners. Section 13.82, subdivisions 7, 5a, and 5b, 515.14 apply to law enforcement data other than the reports. The local 515.15 social services agency or agency responsible for assessing or 515.16 investigating the report shall make available to the 515.17 investigating, petitioning, or prosecuting authority, including 515.18 county medical examiners or county coroners or their 515.19 professional delegates, any records which contain information 515.20 relating to a specific incident of neglect or abuse which is 515.21 under investigation, petition, or prosecution and information 515.22 relating to any prior incidents of neglect or abuse involving 515.23 any of the same persons. The records shall be collected and 515.24 maintained in accordance with the provisions of chapter 13. In 515.25 conducting investigations and assessments pursuant to this 515.26 section, the notice required by section 13.04, subdivision 2, 515.27 need not be provided to a minor under the age of ten who is the 515.28 alleged victim of abuse or neglect. An individual subject of a 515.29 record shall have access to the record in accordance with those 515.30 sections, except that the name of the reporter shall be 515.31 confidential while the report is under assessment or 515.32 investigation except as otherwise permitted by this 515.33 subdivision. Any person conducting an investigation or 515.34 assessment under this section who intentionally discloses the 515.35 identity of a reporter prior to the completion of the 515.36 investigation or assessment is guilty of a misdemeanor. After 516.1 the assessment or investigation is completed, the name of the 516.2 reporter shall be confidential. The subject of the report may 516.3 compel disclosure of the name of the reporter only with the 516.4 consent of the reporter or upon a written finding by the court 516.5 that the report was false and that there is evidence that the 516.6 report was made in bad faith. This subdivision does not alter 516.7 disclosure responsibilities or obligations under the rules of 516.8 criminal procedure. 516.9 (b) Upon request of the legislative auditor, data on 516.10 individuals maintained under this section must be released to 516.11 the legislative auditor in order for the auditor to fulfill the 516.12 auditor's duties under section 3.971. The auditor shall 516.13 maintain the data in accordance with chapter 13. 516.14 (c) The investigating agency shall exchange not public data 516.15 with the child maltreatment review panel under section 3 if the 516.16 data are pertinent and necessary for a review requested under 516.17 section 3. Upon completion of the review, the not public data 516.18 received by the review panel must be returned to the 516.19 investigating agency. 516.20 Sec. 14. Minnesota Statutes 2000, section 626.556, 516.21 subdivision 12, is amended to read: 516.22 Subd. 12. [DUTIES OF FACILITY OPERATORS.] Any operator, 516.23 employee, or volunteer worker at any facility who intentionally 516.24 neglects, physically abuses, or sexually abuses any child in the 516.25 care of that facility may be charged with a violation of section 516.26 609.255, 609.377, or 609.378. Any operator of a facility who 516.27 knowingly permits conditions to exist which result in neglect, 516.28 physical abuse,orsexual abuse, or maltreatment of a child in a 516.29 facility while in the care of that facility may be charged with 516.30 a violation of section 609.378. The facility operator shall 516.31 inform all mandated reporters employed by or otherwise 516.32 associated with the facility of the duties required of mandated 516.33 reporters and shall inform all mandatory reporters of the 516.34 prohibition against retaliation for reports made in good faith 516.35 under this section. 516.36 Sec. 15. Minnesota Statutes 2000, section 626.559, 517.1 subdivision 2, is amended to read: 517.2 Subd. 2. [JOINT TRAINING.] The commissioners of human 517.3 services and public safety shall cooperate in the development of 517.4 a joint program for training child abuse services professionals 517.5 in the appropriate techniques for child abuse assessment and 517.6 investigation. The program shall include but need not be 517.7 limited to the following areas: 517.8 (1) the public policy goals of the state as set forth in 517.9 section 260C.001 and the role of the assessment or investigation 517.10 in meeting these goals; 517.11 (2) the special duties of child protection workers and law 517.12 enforcement officers under section 626.556; 517.13 (3) the appropriate methods for directing and managing 517.14 affiliated professionals who may be utilized in providing 517.15 protective services and strengthening family ties; 517.16 (4) the appropriate methods for interviewing alleged 517.17 victims of child abuse and other minors in the course of 517.18 performing an assessment or an investigation; 517.19 (5) the dynamics of child abuse and neglect within family 517.20 systems and the appropriate methods for interviewing parents in 517.21 the course of the assessment or investigation, including 517.22 training in recognizing cases in which one of the parents is a 517.23 victim of domestic abuse and in need of special legal or medical 517.24 services; 517.25 (6) the legal, evidentiary considerations that may be 517.26 relevant to the conduct of an assessment or an investigation; 517.27 (7) the circumstances under which it is appropriate to 517.28 remove the alleged abuser or the alleged victim from the home; 517.29 (8) the protective social services that are available to 517.30 protect alleged victims from further abuse, to prevent child 517.31 abuse and domestic abuse, and to preserve the family unit, and 517.32 training in the preparation of case plans to coordinate services 517.33 for the alleged child abuse victim with services for any parents 517.34 who are victims of domestic abuse;and517.35 (9) the methods by which child protection workers and law 517.36 enforcement workers cooperate in conducting assessments and 518.1 investigations in order to avoid duplication of efforts; and 518.2 (10) appropriate methods for interviewing alleged victims 518.3 of child abuse and conducting investigations in cases where the 518.4 alleged victim is developmentally, physically, or mentally 518.5 disabled. 518.6 Sec. 16. [CHILD WELFARE COST CONSOLIDATION REPORT.] 518.7 By January 15, 2002, the commissioner of human services 518.8 shall report to the chairs and ranking minority members of 518.9 appropriate legislative committees the feasibility and cost of 518.10 creating a single benefit package for all children removed from 518.11 the care of a parent or guardian pursuant to a court order under 518.12 Minnesota Statutes, chapter 260C, regardless of a particular 518.13 child's legal status. Legal status includes any placement away 518.14 from the parent or guardian, including foster or other 518.15 residential care, guardianship with the commissioner, adoption, 518.16 or legal custody with a relative except a birth or adoptive 518.17 parent. The report shall be prepared after consultation with 518.18 public and private child-placing agencies, foster and adoptive 518.19 parents, relatives who are legal custodians, judges, county 518.20 attorneys, attorneys for children and parents, guardians ad 518.21 litem, representatives of the councils on Asian-Pacific, African 518.22 American, American Indian, and Spanish-speaking Minnesotans, and 518.23 other appropriate child protection system stakeholders. The 518.24 benefit package addressed in the report shall include the cost 518.25 of room and board, additional monthly payments associated with 518.26 special efforts a caretaker must make or special skills or 518.27 training a caretaker must have in order to adequately address 518.28 the daily needs of the child, the availability of respite care, 518.29 and any other costs associated with safely maintaining a 518.30 particular child in a legally secure home and adequately 518.31 addressing any special needs the child may have. 518.32 Sec. 17. [STUDY OF OUTCOMES FOR CHILDREN IN THE CHILD 518.33 WELFARE SYSTEM.] 518.34 (a) The commissioner of human services, in consultation 518.35 with local social services agencies, councils of color, 518.36 representatives of communities of color, child advocates, 519.1 representatives of courts, and other interested parties, shall 519.2 study why African American children in Minnesota are 519.3 disproportionately represented in child welfare out-of-home 519.4 placements. The commissioner also shall study each stage of the 519.5 proceedings concerning children in need of protection or 519.6 services, including the point at which children enter the child 519.7 welfare system, each decision-making point in the child welfare 519.8 system, and the outcomes for children in the child welfare 519.9 system, to determine why outcomes for children differ by race. 519.10 The commissioner shall use child welfare performance and outcome 519.11 indicators and data and other available data as part of this 519.12 study. The commissioner also shall study and determine if there 519.13 are decision-making points in the child protection system that 519.14 lead to different outcomes for children and how those 519.15 decision-making points affect outcomes for children. The 519.16 commissioner shall report and make legislative recommendations 519.17 on the following: 519.18 (1) amend the child protection statutes to reduce any 519.19 identified disparities in the child protection system relating 519.20 to outcomes for children of color, as compared to white 519.21 children; 519.22 (2) reduce any identified bias in the child protection 519.23 system; 519.24 (3) reduce the number and duration of out-of-home 519.25 placements for African American children; and 519.26 (4) improve the long-term outcomes for African American 519.27 children in out-of-home placements. 519.28 (b) The commissioner of human services shall submit the 519.29 report and recommended legislation to the chairs and ranking 519.30 minority members of the committees in the house of 519.31 representatives and senate with jurisdiction over child 519.32 protection and out-of-home placement issues by January 15, 2002. 519.33 ARTICLE 12 519.34 CHILD SUPPORT 519.35 Section 1. Minnesota Statutes 2000, section 13B.06, 519.36 subdivision 4, is amended to read: 520.1 Subd. 4. [METHOD TO PROVIDE DATA.] To comply with the 520.2 requirements of this section, a financial institutionmay either:520.3(1) provide to the public authority a list containing only520.4the names and other necessary personal identifying information520.5of all account holders for the public authority to compare520.6against its list of child support obligors for the purpose of520.7identifying which obligors maintain an account at the financial520.8institution; the names of the obligors who maintain an account520.9at the institution shall then be transmitted to the financial520.10institution which shall provide the public authority with520.11account information on those obligors; or520.12(2)must obtain a list of child support obligors from the 520.13 public authority and compare that data to the data maintained at 520.14 the financial institution to identify which of the identified 520.15 obligors maintains an account at the financial institution. 520.16A financial institution shall elect either method in520.17writing upon written request of the public authority, and the520.18election remains in effect unless the public authority agrees in520.19writing to a change.520.20The commissioner shall keep track of the number of520.21financial institutions that elect to report under clauses (1)520.22and (2) respectively and shall report this information to the520.23legislature by December 1, 1999.520.24 Sec. 2. Minnesota Statutes 2000, section 13B.06, 520.25 subdivision 7, is amended to read: 520.26 Subd. 7. [FEES.] A financial institution may charge and 520.27 collect a fee from the public authority for providing account 520.28 information to the public authority. The commissioner may pay a 520.29 financial institution up to $150 each quarter if the 520.30 commissioner and the financial institution have entered into a 520.31 signed agreement that complies with federal law. The 520.32 commissioner shall develop procedures for the financial 520.33 institutions to charge and collect the fee. Payment of the fee 520.34 is limited by the amount of the appropriation for this purpose. 520.35 If the appropriation is insufficient, or if fund availability in 520.36 the fourth quarter would allow payments for actual costs in 521.1 excess of $150, the commissioner shall prorate the available 521.2 funds among the financial institutions that have submitted a 521.3 claim for the fee. No financial institution shall charge or 521.4 collect a fee that exceeds its actual costs of complying with 521.5 this section. The commissioner, together with an advisory group 521.6 consisting of representatives of the financial institutions in 521.7 the state, shalldetermine a fee structure that minimizes the521.8cost to the state and reasonably meets the needs of the521.9financial institutions, and shall report to the chairs of the521.10judiciary committees in the house of representatives and the521.11senate by February 1, 1998, a recommended fee structure for521.12inclusion in this sectionevaluate whether the fee paid to 521.13 financial institutions compensates them for their actual costs, 521.14 including start-up costs, of complying with this section and 521.15 shall submit a report to the legislature by July 1, 2002, with a 521.16 recommendation for retaining or modifying the fee. 521.17 Sec. 3. Minnesota Statutes 2000, section 256.01, 521.18 subdivision 2, is amended to read: 521.19 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 521.20 section 241.021, subdivision 2, the commissioner of human 521.21 services shall: 521.22 (1) Administer and supervise all forms of public assistance 521.23 provided for by state law and other welfare activities or 521.24 services as are vested in the commissioner. Administration and 521.25 supervision of human services activities or services includes, 521.26 but is not limited to, assuring timely and accurate distribution 521.27 of benefits, completeness of service, and quality program 521.28 management. In addition to administering and supervising human 521.29 services activities vested by law in the department, the 521.30 commissioner shall have the authority to: 521.31 (a) require county agency participation in training and 521.32 technical assistance programs to promote compliance with 521.33 statutes, rules, federal laws, regulations, and policies 521.34 governing human services; 521.35 (b) monitor, on an ongoing basis, the performance of county 521.36 agencies in the operation and administration of human services, 522.1 enforce compliance with statutes, rules, federal laws, 522.2 regulations, and policies governing welfare services and promote 522.3 excellence of administration and program operation; 522.4 (c) develop a quality control program or other monitoring 522.5 program to review county performance and accuracy of benefit 522.6 determinations; 522.7 (d) require county agencies to make an adjustment to the 522.8 public assistance benefits issued to any individual consistent 522.9 with federal law and regulation and state law and rule and to 522.10 issue or recover benefits as appropriate; 522.11 (e) delay or deny payment of all or part of the state and 522.12 federal share of benefits and administrative reimbursement 522.13 according to the procedures set forth in section 256.017; 522.14 (f) make contracts with and grants to public and private 522.15 agencies and organizations, both profit and nonprofit, and 522.16 individuals, using appropriated funds; and 522.17 (g) enter into contractual agreements with federally 522.18 recognized Indian tribes with a reservation in Minnesota to the 522.19 extent necessary for the tribe to operate a federally approved 522.20 family assistance program or any other program under the 522.21 supervision of the commissioner. The commissioner shall consult 522.22 with the affected county or counties in the contractual 522.23 agreement negotiations, if the county or counties wish to be 522.24 included, in order to avoid the duplication of county and tribal 522.25 assistance program services. The commissioner may establish 522.26 necessary accounts for the purposes of receiving and disbursing 522.27 funds as necessary for the operation of the programs. 522.28 (2) Inform county agencies, on a timely basis, of changes 522.29 in statute, rule, federal law, regulation, and policy necessary 522.30 to county agency administration of the programs. 522.31 (3) Administer and supervise all child welfare activities; 522.32 promote the enforcement of laws protecting handicapped, 522.33 dependent, neglected and delinquent children, and children born 522.34 to mothers who were not married to the children's fathers at the 522.35 times of the conception nor at the births of the children; 522.36 license and supervise child-caring and child-placing agencies 523.1 and institutions; supervise the care of children in boarding and 523.2 foster homes or in private institutions; and generally perform 523.3 all functions relating to the field of child welfare now vested 523.4 in the state board of control. 523.5 (4) Administer and supervise all noninstitutional service 523.6 to handicapped persons, including those who are visually 523.7 impaired, hearing impaired, or physically impaired or otherwise 523.8 handicapped. The commissioner may provide and contract for the 523.9 care and treatment of qualified indigent children in facilities 523.10 other than those located and available at state hospitals when 523.11 it is not feasible to provide the service in state hospitals. 523.12 (5) Assist and actively cooperate with other departments, 523.13 agencies and institutions, local, state, and federal, by 523.14 performing services in conformity with the purposes of Laws 523.15 1939, chapter 431. 523.16 (6) Act as the agent of and cooperate with the federal 523.17 government in matters of mutual concern relative to and in 523.18 conformity with the provisions of Laws 1939, chapter 431, 523.19 including the administration of any federal funds granted to the 523.20 state to aid in the performance of any functions of the 523.21 commissioner as specified in Laws 1939, chapter 431, and 523.22 including the promulgation of rules making uniformly available 523.23 medical care benefits to all recipients of public assistance, at 523.24 such times as the federal government increases its participation 523.25 in assistance expenditures for medical care to recipients of 523.26 public assistance, the cost thereof to be borne in the same 523.27 proportion as are grants of aid to said recipients. 523.28 (7) Establish and maintain any administrative units 523.29 reasonably necessary for the performance of administrative 523.30 functions common to all divisions of the department. 523.31 (8) Act as designated guardian of both the estate and the 523.32 person of all the wards of the state of Minnesota, whether by 523.33 operation of law or by an order of court, without any further 523.34 act or proceeding whatever, except as to persons committed as 523.35 mentally retarded. For children under the guardianship of the 523.36 commissioner whose interests would be best served by adoptive 524.1 placement, the commissioner may contract with a licensed 524.2 child-placing agency to provide adoption services. A contract 524.3 with a licensed child-placing agency must be designed to 524.4 supplement existing county efforts and may not replace existing 524.5 county programs, unless the replacement is agreed to by the 524.6 county board and the appropriate exclusive bargaining 524.7 representative or the commissioner has evidence that child 524.8 placements of the county continue to be substantially below that 524.9 of other counties. Funds encumbered and obligated under an 524.10 agreement for a specific child shall remain available until the 524.11 terms of the agreement are fulfilled or the agreement is 524.12 terminated. 524.13 (9) Act as coordinating referral and informational center 524.14 on requests for service for newly arrived immigrants coming to 524.15 Minnesota. 524.16 (10) The specific enumeration of powers and duties as 524.17 hereinabove set forth shall in no way be construed to be a 524.18 limitation upon the general transfer of powers herein contained. 524.19 (11) Establish county, regional, or statewide schedules of 524.20 maximum fees and charges which may be paid by county agencies 524.21 for medical, dental, surgical, hospital, nursing and nursing 524.22 home care and medicine and medical supplies under all programs 524.23 of medical care provided by the state and for congregate living 524.24 care under the income maintenance programs. 524.25 (12) Have the authority to conduct and administer 524.26 experimental projects to test methods and procedures of 524.27 administering assistance and services to recipients or potential 524.28 recipients of public welfare. To carry out such experimental 524.29 projects, it is further provided that the commissioner of human 524.30 services is authorized to waive the enforcement of existing 524.31 specific statutory program requirements, rules, and standards in 524.32 one or more counties. The order establishing the waiver shall 524.33 provide alternative methods and procedures of administration, 524.34 shall not be in conflict with the basic purposes, coverage, or 524.35 benefits provided by law, and in no event shall the duration of 524.36 a project exceed four years. It is further provided that no 525.1 order establishing an experimental project as authorized by the 525.2 provisions of this section shall become effective until the 525.3 following conditions have been met: 525.4 (a) The secretary of health and human services of the 525.5 United States has agreed, for the same project, to waive state 525.6 plan requirements relative to statewide uniformity. 525.7 (b) A comprehensive plan, including estimated project 525.8 costs, shall be approved by the legislative advisory commission 525.9 and filed with the commissioner of administration. 525.10 (13) According to federal requirements, establish 525.11 procedures to be followed by local welfare boards in creating 525.12 citizen advisory committees, including procedures for selection 525.13 of committee members. 525.14 (14) Allocate federal fiscal disallowances or sanctions 525.15 which are based on quality control error rates for the aid to 525.16 families with dependent children program formerly codified in 525.17 sections 256.72 to 256.87, medical assistance, or food stamp 525.18 program in the following manner: 525.19 (a) One-half of the total amount of the disallowance shall 525.20 be borne by the county boards responsible for administering the 525.21 programs. For the medical assistance and the AFDC program 525.22 formerly codified in sections 256.72 to 256.87, disallowances 525.23 shall be shared by each county board in the same proportion as 525.24 that county's expenditures for the sanctioned program are to the 525.25 total of all counties' expenditures for the AFDC program 525.26 formerly codified in sections 256.72 to 256.87, and medical 525.27 assistance programs. For the food stamp program, sanctions 525.28 shall be shared by each county board, with 50 percent of the 525.29 sanction being distributed to each county in the same proportion 525.30 as that county's administrative costs for food stamps are to the 525.31 total of all food stamp administrative costs for all counties, 525.32 and 50 percent of the sanctions being distributed to each county 525.33 in the same proportion as that county's value of food stamp 525.34 benefits issued are to the total of all benefits issued for all 525.35 counties. Each county shall pay its share of the disallowance 525.36 to the state of Minnesota. When a county fails to pay the 526.1 amount due hereunder, the commissioner may deduct the amount 526.2 from reimbursement otherwise due the county, or the attorney 526.3 general, upon the request of the commissioner, may institute 526.4 civil action to recover the amount due. 526.5 (b) Notwithstanding the provisions of paragraph (a), if the 526.6 disallowance results from knowing noncompliance by one or more 526.7 counties with a specific program instruction, and that knowing 526.8 noncompliance is a matter of official county board record, the 526.9 commissioner may require payment or recover from the county or 526.10 counties, in the manner prescribed in paragraph (a), an amount 526.11 equal to the portion of the total disallowance which resulted 526.12 from the noncompliance, and may distribute the balance of the 526.13 disallowance according to paragraph (a). 526.14 (15) Develop and implement special projects that maximize 526.15 reimbursements and result in the recovery of money to the 526.16 state. For the purpose of recovering state money, the 526.17 commissioner may enter into contracts with third parties. Any 526.18 recoveries that result from projects or contracts entered into 526.19 under this paragraph shall be deposited in the state treasury 526.20 and credited to a special account until the balance in the 526.21 account reaches $1,000,000. When the balance in the account 526.22 exceeds $1,000,000, the excess shall be transferred and credited 526.23 to the general fund. All money in the account is appropriated 526.24 to the commissioner for the purposes of this paragraph. 526.25 (16) Have the authority to make direct payments to 526.26 facilities providing shelter to women and their children 526.27 according to section 256D.05, subdivision 3. Upon the written 526.28 request of a shelter facility that has been denied payments 526.29 under section 256D.05, subdivision 3, the commissioner shall 526.30 review all relevant evidence and make a determination within 30 526.31 days of the request for review regarding issuance of direct 526.32 payments to the shelter facility. Failure to act within 30 days 526.33 shall be considered a determination not to issue direct payments. 526.34 (17) Have the authority to establish and enforce the 526.35 following county reporting requirements: 526.36 (a) The commissioner shall establish fiscal and statistical 527.1 reporting requirements necessary to account for the expenditure 527.2 of funds allocated to counties for human services programs. 527.3 When establishing financial and statistical reporting 527.4 requirements, the commissioner shall evaluate all reports, in 527.5 consultation with the counties, to determine if the reports can 527.6 be simplified or the number of reports can be reduced. 527.7 (b) The county board shall submit monthly or quarterly 527.8 reports to the department as required by the commissioner. 527.9 Monthly reports are due no later than 15 working days after the 527.10 end of the month. Quarterly reports are due no later than 30 527.11 calendar days after the end of the quarter, unless the 527.12 commissioner determines that the deadline must be shortened to 527.13 20 calendar days to avoid jeopardizing compliance with federal 527.14 deadlines or risking a loss of federal funding. Only reports 527.15 that are complete, legible, and in the required format shall be 527.16 accepted by the commissioner. 527.17 (c) If the required reports are not received by the 527.18 deadlines established in clause (b), the commissioner may delay 527.19 payments and withhold funds from the county board until the next 527.20 reporting period. When the report is needed to account for the 527.21 use of federal funds and the late report results in a reduction 527.22 in federal funding, the commissioner shall withhold from the 527.23 county boards with late reports an amount equal to the reduction 527.24 in federal funding until full federal funding is received. 527.25 (d) A county board that submits reports that are late, 527.26 illegible, incomplete, or not in the required format for two out 527.27 of three consecutive reporting periods is considered 527.28 noncompliant. When a county board is found to be noncompliant, 527.29 the commissioner shall notify the county board of the reason the 527.30 county board is considered noncompliant and request that the 527.31 county board develop a corrective action plan stating how the 527.32 county board plans to correct the problem. The corrective 527.33 action plan must be submitted to the commissioner within 45 days 527.34 after the date the county board received notice of noncompliance. 527.35 (e) The final deadline for fiscal reports or amendments to 527.36 fiscal reports is one year after the date the report was 528.1 originally due. If the commissioner does not receive a report 528.2 by the final deadline, the county board forfeits the funding 528.3 associated with the report for that reporting period and the 528.4 county board must repay any funds associated with the report 528.5 received for that reporting period. 528.6 (f) The commissioner may not delay payments, withhold 528.7 funds, or require repayment under paragraph (c) or (e) if the 528.8 county demonstrates that the commissioner failed to provide 528.9 appropriate forms, guidelines, and technical assistance to 528.10 enable the county to comply with the requirements. If the 528.11 county board disagrees with an action taken by the commissioner 528.12 under paragraph (c) or (e), the county board may appeal the 528.13 action according to sections 14.57 to 14.69. 528.14 (g) Counties subject to withholding of funds under 528.15 paragraph (c) or forfeiture or repayment of funds under 528.16 paragraph (e) shall not reduce or withhold benefits or services 528.17 to clients to cover costs incurred due to actions taken by the 528.18 commissioner under paragraph (c) or (e). 528.19 (18) Allocate federal fiscal disallowances or sanctions for 528.20 audit exceptions when federal fiscal disallowances or sanctions 528.21 are based on a statewide random sample for the foster care 528.22 program under title IV-E of the Social Security Act, United 528.23 States Code, title 42, in direct proportion to each county's 528.24 title IV-E foster care maintenance claim for that period. 528.25 (19) Be responsible for ensuring the detection, prevention, 528.26 investigation, and resolution of fraudulent activities or 528.27 behavior by applicants, recipients, and other participants in 528.28 the human services programs administered by the department. 528.29 (20) Require county agencies to identify overpayments, 528.30 establish claims, and utilize all available and cost-beneficial 528.31 methodologies to collect and recover these overpayments in the 528.32 human services programs administered by the department. 528.33 (21) Have the authority to administer a drug rebate program 528.34 for drugs purchased pursuant to the prescription drug program 528.35 established under section 256.955 after the beneficiary's 528.36 satisfaction of any deductible established in the program. The 529.1 commissioner shall require a rebate agreement from all 529.2 manufacturers of covered drugs as defined in section 256B.0625, 529.3 subdivision 13. Rebate agreements for prescription drugs 529.4 delivered on or after July 1, 2002, must include rebates for 529.5 individuals covered under the prescription drug program who are 529.6 under 65 years of age. For each drug, the amount of the rebate 529.7 shall be equal to the basic rebate as defined for purposes of 529.8 the federal rebate program in United States Code, title 42, 529.9 section 1396r-8(c)(1). This basic rebate shall be applied to 529.10 single-source and multiple-source drugs. The manufacturers must 529.11 provide full payment within 30 days of receipt of the state 529.12 invoice for the rebate within the terms and conditions used for 529.13 the federal rebate program established pursuant to section 1927 529.14 of title XIX of the Social Security Act. The manufacturers must 529.15 provide the commissioner with any information necessary to 529.16 verify the rebate determined per drug. The rebate program shall 529.17 utilize the terms and conditions used for the federal rebate 529.18 program established pursuant to section 1927 of title XIX of the 529.19 Social Security Act. 529.20 (22) Operate the department's communication systems account 529.21 established in Laws 1993, First Special Session chapter 1, 529.22 article 1, section 2, subdivision 2, to manage shared 529.23 communication costs necessary for the operation of the programs 529.24 the commissioner supervises. A communications account may also 529.25 be established for each regional treatment center which operates 529.26 communications systems. Each account must be used to manage 529.27 shared communication costs necessary for the operations of the 529.28 programs the commissioner supervises. The commissioner may 529.29 distribute the costs of operating and maintaining communication 529.30 systems to participants in a manner that reflects actual usage. 529.31 Costs may include acquisition, licensing, insurance, 529.32 maintenance, repair, staff time and other costs as determined by 529.33 the commissioner. Nonprofit organizations and state, county, 529.34 and local government agencies involved in the operation of 529.35 programs the commissioner supervises may participate in the use 529.36 of the department's communications technology and share in the 530.1 cost of operation. The commissioner may accept on behalf of the 530.2 state any gift, bequest, devise or personal property of any 530.3 kind, or money tendered to the state for any lawful purpose 530.4 pertaining to the communication activities of the department. 530.5 Any money received for this purpose must be deposited in the 530.6 department's communication systems accounts. Money collected by 530.7 the commissioner for the use of communication systems must be 530.8 deposited in the state communication systems account and is 530.9 appropriated to the commissioner for purposes of this section. 530.10 (23) Receive any federal matching money that is made 530.11 available through the medical assistance program for the 530.12 consumer satisfaction survey. Any federal money received for 530.13 the survey is appropriated to the commissioner for this 530.14 purpose. The commissioner may expend the federal money received 530.15 for the consumer satisfaction survey in either year of the 530.16 biennium. 530.17 (24) Incorporate cost reimbursement claims from First Call 530.18 Minnesota into the federal cost reimbursement claiming processes 530.19 of the department according to federal law, rule, and 530.20 regulations. Any reimbursement received is appropriated to the 530.21 commissioner and shall be disbursed to First Call Minnesota 530.22 according to normal department payment schedules. 530.23 (25) Develop recommended standards for foster care homes 530.24 that address the components of specialized therapeutic services 530.25 to be provided by foster care homes with those services. 530.26 (26) In consultation with county child support 530.27 representatives and county attorneys, adopt rules, in accordance 530.28 with chapter 14, that are necessary for the operation of a 530.29 statewide child support county performance management program. 530.30 Sec. 4. Minnesota Statutes 2000, section 256.741, 530.31 subdivision 1, is amended to read: 530.32 Subdivision 1. [PUBLIC ASSISTANCE.] (a) The term "direct 530.33 support" as used in this chapter and chapters 257, 518, and 518C 530.34 refers to an assigned support payment from an obligor which is 530.35 paid directly to a recipient of TANF or MFIP. 530.36 (b) The term "public assistance" as used in this chapter 531.1 and chapters 257, 518, and 518C, includes any form of assistance 531.2 provided under the AFDC program formerly codified in sections 531.3 256.72 to 256.87, MFIP and MFIP-R formerly codified under 531.4 chapter 256, MFIP under chapter 256J, work first program under 531.5 chapter 256K; child care assistance provided through the child 531.6 care fund under chapter 119B; any form of medical assistance 531.7 under chapter 256B; MinnesotaCare under chapter 256L; and foster 531.8 care as provided under title IV-E of the Social Security Act. 531.9(b)(c) The term "child support agency" as used in this 531.10 section refers to the public authority responsible for child 531.11 support enforcement. 531.12(c)(d) The term "public assistance agency" as used in this 531.13 section refers to a public authority providing public assistance 531.14 to an individual. 531.15 Sec. 5. Minnesota Statutes 2000, section 256.741, 531.16 subdivision 5, is amended to read: 531.17 Subd. 5. [COOPERATION WITH CHILD SUPPORT ENFORCEMENT.] 531.18 After notification from a public assistance agency that an 531.19 individual has applied for or is receiving any form of public 531.20 assistance, the child support agency shall determine whether the 531.21 party is cooperating with the agency in establishing paternity, 531.22 child support, modification of an existing child support order, 531.23 or enforcement of an existing child support order. The public 531.24 assistance agency shall notify each applicant or recipient in 531.25 writing of the right to claim a good cause exemption from 531.26 cooperating with the requirements in this section. A copy of 531.27 the notice must be furnished to the applicant or recipient, and 531.28 the applicant or recipient and a representative from the public 531.29 authority shall acknowledge receipt of the notice by signing and 531.30 dating a copy of the notice. The individual shall cooperate 531.31 with the child support agency by: 531.32 (1) providing all known information regarding the alleged 531.33 father or obligor, including name, address, social security 531.34 number, telephone number, place of employment or school, and the 531.35 names and addresses of any relatives; 531.36 (2) appearing at interviews, hearings and legal 532.1 proceedings; 532.2 (3) submitting to genetic tests including genetic testing 532.3 of the child, under a judicial or administrative order; and 532.4 (4) providing additional information known by the 532.5 individual as necessary for cooperating in good faith with the 532.6 child support agency. 532.7 The caregiver of a minor child must cooperate with the 532.8 efforts of the public authority to collect support according to 532.9 this subdivision. A caregiver mustforward tonotify the public 532.10 authority of all support the caregiver receives during the 532.11 period the assignment of support required under subdivision 2 is 532.12 in effect.Support received by a caregiver and not forwarded to532.13the public authority must be repaid to the child support532.14enforcement unit for any month following the date on which532.15initial eligibility is determinedDirect support retained by a 532.16 caregiver must be counted as unearned income when determining 532.17 the amount of the assistance payment,except as provided under532.18subdivision 8, paragraph (b), clause (4)and repaid to the child 532.19 support agency for any month when the direct support retained is 532.20 greater than the court-ordered child support and the assistance 532.21 payment and the obligor owes support arrears. 532.22 Sec. 6. Minnesota Statutes 2000, section 256.741, 532.23 subdivision 8, is amended to read: 532.24 Subd. 8. [REFUSAL TO COOPERATE WITH SUPPORT REQUIREMENTS.] 532.25 (a) Failure by a caregiver to satisfy any of the requirements of 532.26 subdivision 5 constitutes refusal to cooperate, and the 532.27 sanctions under paragraph (b) apply. The IV-D agency must 532.28 determine whether a caregiver has refused to cooperate according 532.29 to subdivision 5. 532.30 (b) Determination by the IV-D agency that a caregiver has 532.31 refused to cooperate has the following effects: 532.32 (1) a caregiver is subject to the applicable sanctions 532.33 under section 256J.46; 532.34 (2) a caregiver who is not a parent of a minor child in an 532.35 assistance unit may choose to remove the child from the 532.36 assistance unit unless the child is required to be in the 533.1 assistance unit; and 533.2 (3) a parental caregiver who refuses to cooperate is 533.3 ineligible for medical assistance; and533.4(4) direct support retained by a caregiver must be counted533.5as unearned income when determining the amount of the assistance533.6payment. 533.7 Sec. 7. Minnesota Statutes 2000, section 256.979, 533.8 subdivision 5, is amended to read: 533.9 Subd. 5. [PATERNITY ESTABLISHMENT AND CHILD SUPPORT ORDER 533.10 ESTABLISHMENT AND MODIFICATION BONUS INCENTIVES.] (a) A bonus 533.11 incentive program is created to increase the number of paternity 533.12 establishments and establishment and modifications of child 533.13 support orders done by county child support enforcement agencies. 533.14 (b) A bonus must be awarded to a county child support 533.15 agency for eachcasechild for which the agency completes a 533.16 paternity or child support order establishment or modification 533.17 through judicial or administrative processes. 533.18 (c) The rate of bonus incentive is $100 per child for each 533.19 paternity or child support order establishment and modification 533.20 set in a specific dollar amount. 533.21 (d) No bonus shall be paid for a modification that is a 533.22 result of a termination of child care costs according to section 533.23 518.551, subdivision 5, paragraph (b), or due solely to a 533.24 reduction of child care expenses. 533.25 Sec. 8. Minnesota Statutes 2000, section 256.979, 533.26 subdivision 6, is amended to read: 533.27 Subd. 6. [CLAIMS FOR BONUS INCENTIVE.] (a) The 533.28 commissioner of human services and the county agency shall 533.29 develop procedures for the claims process and criteria using 533.30 automated systems where possible. 533.31 (b) Only one county agency may receive a bonus per 533.32 paternity establishment or child support order establishment or 533.33 modification for eachcasechild. The county agency completing 533.34 the action or procedure needed to establish paternity or a child 533.35 support order or modify an order is the county agency entitled 533.36 to claim the bonus incentive. 534.1 (c) Disputed claims must be submitted to the commissioner 534.2 of human services and the commissioner's decision is final. 534.3(d) For purposes of this section, "case" means a family534.4unit for whom the county agency is providing child support534.5enforcement services.534.6 Sec. 9. Minnesota Statutes 2000, section 393.07, is 534.7 amended by adding a subdivision to read: 534.8 Subd. 9a. [ADMINISTRATIVE PENALTIES.] (a) The public 534.9 authority, as defined in section 518.54, may sanction an 534.10 employer or payor of funds up to $700 for failing to comply with 534.11 section 518.5513, subdivision 5, paragraph (a), clauses (5) and 534.12 (8), if: 534.13 (1) the public authority mails the employer or payor of 534.14 funds a notice of an administrative sanction, at the employer's 534.15 or payor's of funds last known address, which includes the date 534.16 the sanction will take effect, the amount of the sanction, the 534.17 reason for imposing the sanction, and the corrective action that 534.18 must be taken to avoid the sanction; and 534.19 (2) the employer or payor of funds fails to correct the 534.20 violation before the effective date of the sanction. 534.21 (b) The public authority shall include with the sanction 534.22 notice an additional notice of the right to appeal the sanction 534.23 and the process for making the appeal. 534.24 (c) Unless an appeal is made, the administrative 534.25 determination of the sanction is final and binding. 534.26 Sec. 10. Minnesota Statutes 2000, section 518.551, 534.27 subdivision 13, is amended to read: 534.28 Subd. 13. [DRIVER'S LICENSE SUSPENSION.] (a) Upon motion 534.29 of an obligee, which has been properly served on the obligor and 534.30 upon which there has been an opportunity for hearing, if a court 534.31 finds that the obligor has been or may be issued a driver's 534.32 license by the commissioner of public safety and the obligor is 534.33 in arrears in court-ordered child support or maintenance 534.34 payments, or both, in an amount equal to or greater than three 534.35 times the obligor's total monthly support and maintenance 534.36 payments and is not in compliance with a written payment 535.1 agreement regarding both current support and arrearages approved 535.2 by the court, a child support magistrate, or the public 535.3 authority, the court shall order the commissioner of public 535.4 safety to suspend the obligor's driver's license. The court's 535.5 order must be stayed for 90 days in order to allow the obligor 535.6 to execute a written payment agreement regarding both current 535.7 support and arrearages, which payment agreement must be approved 535.8 by either the court or the public authority responsible for 535.9 child support enforcement. If the obligor has not executed or 535.10 is not in compliance with a written payment agreement regarding 535.11 both current support and arrearages after the 90 days expires, 535.12 the court's order becomes effective and the commissioner of 535.13 public safety shall suspend the obligor's driver's license. The 535.14 remedy under this subdivision is in addition to any other 535.15 enforcement remedy available to the court. An obligee may not 535.16 bring a motion under this paragraph within 12 months of a denial 535.17 of a previous motion under this paragraph. 535.18 (b) If a public authority responsible for child support 535.19 enforcement determines that the obligor has been or may be 535.20 issued a driver's license by the commissioner of public safety 535.21 and the obligor is in arrears in court-ordered child support or 535.22 maintenance payments or both in an amount equal to or greater 535.23 than three times the obligor's total monthly support and 535.24 maintenance payments and not in compliance with a written 535.25 payment agreement regarding both current support and arrearages 535.26 approved by the court, a child support magistrate, or the public 535.27 authority, the public authority shall direct the commissioner of 535.28 public safety to suspend the obligor's driver's license. The 535.29 remedy under this subdivision is in addition to any other 535.30 enforcement remedy available to the public authority. 535.31 (c) At least 90 days prior to notifying the commissioner of 535.32 public safety according to paragraph (b), the public authority 535.33 must mail a written notice to the obligor at the obligor's last 535.34 known address, that it intends to seek suspension of the 535.35 obligor's driver's license and that the obligor must request a 535.36 hearing within 30 days in order to contest the suspension. If 536.1 the obligor makes a written request for a hearing within 30 days 536.2 of the date of the notice, a court hearing must be held. 536.3 Notwithstanding any law to the contrary, the obligor must be 536.4 served with 14 days' notice in writing specifying the time and 536.5 place of the hearing and the allegations against the obligor. 536.6 The notice may be served personally or by mail. If the public 536.7 authority does not receive a request for a hearing within 30 536.8 days of the date of the notice, and the obligor does not execute 536.9 a written payment agreement regarding both current support and 536.10 arrearages approved by the public authority within 90 days of 536.11 the date of the notice, the public authority shall direct the 536.12 commissioner of public safety to suspend the obligor's driver's 536.13 license under paragraph (b). 536.14 (d) At a hearing requested by the obligor under paragraph 536.15 (c), and on finding that the obligor is in arrears in 536.16 court-ordered child support or maintenance payments or both in 536.17 an amount equal to or greater than three times the obligor's 536.18 total monthly support and maintenance payments, the district 536.19 court or child support magistrate shall order the commissioner 536.20 of public safety to suspend the obligor's driver's license or 536.21 operating privileges unless the court or child support 536.22 magistrate determines that the obligor has executed and is in 536.23 compliance with a written payment agreement regarding both 536.24 current support and arrearages approved by the court, a child 536.25 support magistrate, or the public authority. 536.26 (e) An obligor whose driver's license or operating 536.27 privileges are suspended may provide proof to the public 536.28 authority responsible for child support enforcement that the 536.29 obligor is in compliance with all written payment agreements 536.30 regarding both current support and arrearages. Within 15 days 536.31 of the receipt of that proof, the public authority shall inform 536.32 the commissioner of public safety that the obligor's driver's 536.33 license or operating privileges should no longer be suspended. 536.34 (f) On January 15, 1997, and every two years after that, 536.35 the commissioner of human services shall submit a report to the 536.36 legislature that identifies the following information relevant 537.1 to the implementation of this section: 537.2 (1) the number of child support obligors notified of an 537.3 intent to suspend a driver's license; 537.4 (2) the amount collected in payments from the child support 537.5 obligors notified of an intent to suspend a driver's license; 537.6 (3) the number of cases paid in full and payment agreements 537.7 executed in response to notification of an intent to suspend a 537.8 driver's license; 537.9 (4) the number of cases in which there has been 537.10 notification and no payments or payment agreements; 537.11 (5) the number of driver's licenses suspended; and 537.12 (6) the cost of implementation and operation of the 537.13 requirements of this section. 537.14 (g) In addition to the criteria established under this 537.15 section for the suspension of an obligor's driver's license, a 537.16 court, a child support magistrate, or the public authority may 537.17 direct the commissioner of public safety to suspend the license 537.18 of a party who has failed, after receiving notice, to comply 537.19 with a subpoena relating to a paternity or child support 537.20 proceeding. Notice to an obligor of intent to suspend must be 537.21 served by first class mail at the obligor's last known address. 537.22 The notice must inform the obligor of the right to request a 537.23 hearing. If the obligor makes a written request within ten days 537.24 of the date of the hearing, a hearing must be held. At the 537.25 hearing, the only issues to be considered are mistake of fact 537.26 and whether the obligor received the subpoena. 537.27 (h) The license of an obligor who fails to remain in 537.28 compliance with an approved payment agreement may be 537.29 suspended if the obligor misses one month's payment. Notice to 537.30 the obligor ofanintent to suspend under this paragraph must be 537.31served by first class mailmailed to the obligor at the 537.32 obligor's last known addressand must include a notice of537.33hearing. This notice must inform the obligor that unless the 537.34 delinquency on the payment agreement is paid in full within 30 537.35 days of the date of notice or the obligor requests a hearing, 537.36 the public authority will direct the department of public safety 538.1 to suspend the obligor's license. If the obligor does not pay 538.2 the delinquency in full or request a hearing within 30 days of 538.3 the date of notice, the public authority may direct the 538.4 department of public safety to suspend the obligor's license. 538.5 If the obligor requests a hearing to determine failure to comply 538.6 with the payment agreement, the notice of hearing must beserved538.7uponmailed to the obligor at the obligor's last known address 538.8 not less than ten days before the date of the hearing. If the 538.9 obligor appears at the hearing and thejudgedistrict court or 538.10 child support magistrate determines that the obligor has failed 538.11 to comply with an approved payment agreement, thejudgedistrict 538.12 court or child support magistrate shallnotifyorder the 538.13 department of public safety to suspend the obligor's 538.14 licenseunder paragraph (c). If the obligor fails to appear at 538.15 the hearing, the public authority maynotifydirect the 538.16 department of public safety to suspend the obligor's 538.17 licenseunder paragraph (c). 538.18 Sec. 11. Minnesota Statutes 2000, section 518.5513, 538.19 subdivision 5, is amended to read: 538.20 Subd. 5. [ADMINISTRATIVE AUTHORITY.] (a) The public 538.21 authority may take the following actions relating to 538.22 establishment of paternity or to establishment, modification, or 538.23 enforcement of support orders, without the necessity of 538.24 obtaining an order from any judicial or administrative tribunal: 538.25 (1) recognize and enforce orders of child support agencies 538.26 of other states; 538.27 (2) upon request for genetic testing by a child, parent, or 538.28 any alleged parent, and using the procedure in paragraph (b), 538.29 order the child, parent, or alleged parent to submit to blood or 538.30 genetic testing for the purpose of establishing paternity; 538.31 (3) subpoena financial or other information needed to 538.32 establish, modify, or enforce a child support order andrequest538.33sanctionssanction a party for failure to respond to a subpoena; 538.34 (4) upon notice to the obligor, obligee, and the 538.35 appropriate court, direct the obligor or other payor to change 538.36 the payee to the central collections unit under sections 539.1 518.5851 to 518.5853; 539.2 (5) order income withholding of child support under section 539.3 518.6111 and sanction an employer or payor of funds pursuant to 539.4 section 393.07, subdivision 9a, for failing to comply with an 539.5 income withholding notice; 539.6 (6) secure assets to satisfy the debt or arrearage in cases 539.7 in which there is a support debt or arrearage by: 539.8 (i) intercepting or seizing periodic or lump sum payments 539.9 from state or local agencies, including unemployment benefits, 539.10 workers' compensation payments, judgments, settlements, 539.11 lotteries, and other lump sum payments; 539.12 (ii) attaching and seizing assets of the obligor held in 539.13 financial institutions or public or private retirement funds; 539.14 and 539.15 (iii) imposing liens in accordance with section 548.091 539.16 and, in appropriate cases, forcing the sale of property and the 539.17 distribution of proceeds; 539.18 (7) for the purpose of securing overdue support, increase 539.19 the amount of the monthly support payments by an additional 539.20 amount equal to 20 percent of the monthly support payment to 539.21 include amounts for debts or arrearages; and 539.22 (8) subpoena an employer or payor of funds to provide 539.23 promptly information on the employment, compensation, and 539.24 benefits of an individual employed by that employer as an 539.25 employee or contractor, andto request sanctionssanction an 539.26 employer or payor of funds pursuant to section 393.07, 539.27 subdivision 9a, for failure to respond to the subpoenaas539.28provided by law. 539.29 (b) A request for genetic testing by a child, parent, or 539.30 alleged parent must be supported by a sworn statement by the 539.31 person requesting genetic testing alleging paternity, which sets 539.32 forth facts establishing a reasonable possibility of the 539.33 requisite sexual contact between the parties, or denying 539.34 paternity, and setting forth facts establishing a reasonable 539.35 possibility of the nonexistence of sexual contact between the 539.36 alleged parties. The order for genetic tests may be served 540.1 anywhere within the state and served outside the state in the 540.2 same manner as prescribed by law for service of subpoenas issued 540.3 by the district court of this state. If the child, parent, or 540.4 alleged parent fails to comply with the genetic testing order, 540.5 the public authority may seek to enforce that order in district 540.6 court through a motion to compel testing. No results obtained 540.7 through genetic testing done in response to an order issued 540.8 under this section may be used in any criminal proceeding. 540.9 (c) Subpoenas may be served anywhere within the state and 540.10 served outside the state in the same manner as prescribed by law 540.11 for service of process of subpoenas issued by the district court 540.12 of this state. When a subpoena under this subdivision is served 540.13 on a third-party recordkeeper, written notice of the subpoena 540.14 shall be mailed to the person who is the subject of the 540.15 subpoenaed material at the person's last known address within 540.16 three days of the day the subpoena is served. This notice 540.17 provision does not apply if there is reasonable cause to believe 540.18 the giving of the notice may lead to interference with the 540.19 production of the subpoenaed documents. 540.20 (d) A person served with a subpoena may make a written 540.21 objection to the public authority or court before the time 540.22 specified in the subpoena for compliance. The public authority 540.23 or the court shall cancel or modify the subpoena, if 540.24 appropriate. The public authority shall pay the reasonable 540.25 costs of producing the documents, if requested. 540.26 (e) Subpoenas are enforceable in the same manner as 540.27 subpoenas of the district court. Upon motion of the county 540.28 attorney, the court may issue an order directing the production 540.29 of the records. Failure to comply with the court order may 540.30 subject the person who fails to comply to civil or criminal 540.31 contempt of court. 540.32 (f) The administrative actions under this subdivision are 540.33 subject to due process safeguards, including requirements for 540.34 notice, opportunity to contest the action, and opportunity to 540.35 appeal the order to the judge, judicial officer, or child 540.36 support magistrate. 541.1 Sec. 12. Minnesota Statutes 2000, section 518.575, 541.2 subdivision 1, is amended to read: 541.3 Subdivision 1. [MAKING NAMES PUBLIC.] At least once each 541.4 year, the commissioner of human services, in consultation with 541.5 the attorney general,shallmay publish a list of the names and 541.6 other identifying information of no more than 25 persons who (1) 541.7 are child support obligors, (2) are at least $10,000 in arrears, 541.8 (3) are not in compliance with a written payment agreement 541.9 regarding both current support and arrearages approved by the 541.10 court, a child support magistrate, or the public authority, (4) 541.11 cannot currently be located by the public authority for the 541.12 purposes of enforcing a support order, and (5) have not made a 541.13 support payment except tax intercept payments, in the preceding 541.14 12 months. 541.15 Identifying information may include the obligor's name, 541.16 last known address, amount owed, date of birth, photograph, the 541.17 number of children for whom support is owed, and any additional 541.18 information about the obligor that would assist in identifying 541.19 or locating the obligor. The commissioner and attorney general 541.20 may use posters, media presentations, electronic technology, and 541.21 other means that the commissioner and attorney general determine 541.22 are appropriate for dissemination of the information, including 541.23 publication on the Internet. The commissioner and attorney 541.24 general may make any or all of the identifying information 541.25 regarding these persons public. Information regarding an 541.26 obligor who meets the criteria in this subdivision will only be 541.27 made public subsequent to that person's selection by the 541.28 commissioner and attorney general. 541.29 Before making public the name of the obligor, the 541.30 department of human services shall send a notice to the 541.31 obligor's last known address which states the department's 541.32 intention to make public information on the obligor. The notice 541.33 must also provide an opportunity to have the obligor's name 541.34 removed from the list by paying the arrearage or by entering 541.35 into an agreement to pay the arrearage, or by providing 541.36 information to the public authority that there is good cause not 542.1 to make the information public. The notice must include the 542.2 final date when the payment or agreement can be accepted. 542.3 The department of human services shall obtain the written 542.4 consent of the obligee to make the name of the obligor public. 542.5 Sec. 13. Minnesota Statutes 2000, section 518.5851, is 542.6 amended by adding a subdivision to read: 542.7 Subd. 7. [UNCLAIMED SUPPORT FUNDS.] "Unclaimed support 542.8 funds" means any support payments collected by the public 542.9 authority from the obligor, which have not been disbursed to the 542.10 obligee or public authority. 542.11 Sec. 14. Minnesota Statutes 2000, section 518.5853, is 542.12 amended by adding a subdivision to read: 542.13 Subd. 12. [UNCLAIMED SUPPORT FUNDS.] (a) If support 542.14 payments have not been disbursed to an obligee because the 542.15 obligee is not located, the public authority shall continue 542.16 locate efforts for one year from the date the public authority 542.17 determines that the obligee is not located. 542.18 (b) If the public authority is unable to locate the obligee 542.19 after one year, the public authority shall mail a written notice 542.20 to the obligee at the obligee's last known address. The notice 542.21 shall give the obligee 60 days to contact the public authority. 542.22 If the obligee does not contact the public authority within 60 542.23 days from the date of notice, the public authority shall: 542.24 (1) close the nonpublic assistance portion of the case; 542.25 (2) disburse unclaimed support funds to pay public 542.26 assistance arrears. If public assistance arrears remain after 542.27 disbursing the unclaimed support funds, the public authority may 542.28 continue enforcement and collection of child support until all 542.29 public assistance arrears have been paid. If there are no 542.30 public assistance arrears, or unclaimed support funds remain 542.31 after paying public assistance arrears, remaining unclaimed 542.32 support funds shall be returned to the obligor; and 542.33 (3) mail, when all public assistance arrears have been paid 542.34 the public authority, to the obligor at the obligor's last known 542.35 address a written notice of termination of income withholding 542.36 and case closure due to the public authority's inability to 543.1 locate the obligee. The notice must indicate that the obligor's 543.2 support or maintenance obligation will remain in effect until 543.3 further order of the court and must inform the obligor that the 543.4 obligor can contact the public authority for assistance to 543.5 modify the order. A copy of the form prepared by the state 543.6 court administrator's office under section 518.64, subdivision 543.7 5, must be included with the notice. 543.8 (c) If the obligor is not located when attempting to return 543.9 unclaimed support funds, the public authority shall continue 543.10 locate efforts for one year from the date the public authority 543.11 determines that the obligor is not located. If the public 543.12 authority is unable to locate the obligor after one year, the 543.13 funds shall be treated as unclaimed property according to 543.14 federal law and chapter 345. 543.15 Sec. 15. Minnesota Statutes 2000, section 518.6111, 543.16 subdivision 5, is amended to read: 543.17 Subd. 5. [PAYOR OF FUNDS RESPONSIBILITIES.] (a) An order 543.18 for or notice of withholding is binding on a payor of funds upon 543.19 receipt. Withholding must begin no later than the first pay 543.20 period that occurs after 14 days following the date of receipt 543.21 of the order for or notice of withholding. In the case of a 543.22 financial institution, preauthorized transfers must occur in 543.23 accordance with a court-ordered payment schedule. 543.24 (b) A payor of funds shall withhold from the income payable 543.25 to the obligor the amount specified in the order or notice of 543.26 withholding and amounts specified under subdivisions 6 and 9 and 543.27 shall remit the amounts withheld to the public authority within 543.28 seven business days of the date the obligor is paid the 543.29 remainder of the income. The payor of funds shall include with 543.30 the remittance the social security number of the obligor, the 543.31 case type indicator as provided by the public authority and the 543.32 date the obligor is paid the remainder of the income. The 543.33 obligor is considered to have paid the amount withheld as of the 543.34 date the obligor received the remainder of the income. A payor 543.35 of funds may combine all amounts withheld from one pay period 543.36 into one payment to each public authority, but shall separately 544.1 identify each obligor making payment. 544.2 (c) A payor of funds shall not discharge, or refuse to 544.3 hire, or otherwise discipline an employee as a result of wage or 544.4 salary withholding authorized by this section. A payor of funds 544.5 shall be liable to the obligee for any amounts required to be 544.6 withheld. A payor of funds that fails to withhold or transfer 544.7 funds in accordance with this section is also liable to the 544.8 obligee for interest on the funds at the rate applicable to 544.9 judgments under section 549.09, computed from the date the funds 544.10 were required to be withheld or transferred. A payor of funds 544.11 is liable for reasonable attorney fees of the obligee or public 544.12 authority incurred in enforcing the liability under this 544.13 paragraph. A payor of funds that has failed to comply with the 544.14 requirements of this section is subject to contempt sanctions 544.15 under section 518.615. If the payor of funds is an employer or 544.16 independent contractor and violates this subdivision, a court 544.17 may award the obligor twice the wages lost as a result of this 544.18 violation. If a court finds a payor of funds violated this 544.19 subdivision, the court shall impose a civil fine of not less 544.20 than $500. The liabilities in this paragraph apply to 544.21 intentional noncompliance with this section. 544.22 (d) If a single employee is subject to multiple withholding 544.23 orders or multiple notices of withholding for the support of 544.24 more than one child, the payor of funds shall comply with all of 544.25 the orders or notices to the extent that the total amount 544.26 withheld from the obligor's income does not exceed the limits 544.27 imposed under the Consumer Credit Protection Act, United States 544.28 Code, title 15, section 1673(b), giving priority to amounts 544.29 designated in each order or notice as current support as follows: 544.30 (1) if the total of the amounts designated in the orders 544.31 for or notices of withholding as current support exceeds the 544.32 amount available for income withholding, the payor of funds 544.33 shall allocate to each order or notice an amount for current 544.34 support equal to the amount designated in that order or notice 544.35 as current support, divided by the total of the amounts 544.36 designated in the orders or notices as current support, 545.1 multiplied by the amount of the income available for income 545.2 withholding; and 545.3 (2) if the total of the amounts designated in the orders 545.4 for or notices of withholding as current support does not exceed 545.5 the amount available for income withholding, the payor of funds 545.6 shall pay the amounts designated as current support, and shall 545.7 allocate to each order or notice an amount for past due support, 545.8 equal to the amount designated in that order or notice as past 545.9 due support, divided by the total of the amounts designated in 545.10 the orders or notices as past due support, multiplied by the 545.11 amount of income remaining available for income withholding 545.12 after the payment of current support. 545.13 (e) When an order for or notice of withholding is in effect 545.14 and the obligor's employment is terminated, the obligor and the 545.15 payor of funds shall notify the public authority of the 545.16 termination within ten days of the termination date. The 545.17 termination notice shall include the obligor's home address and 545.18 the name and address of the obligor's new payor of funds, if 545.19 known. 545.20 (f) A payor of funds may deduct one dollar from the 545.21 obligor's remaining salary for each payment made pursuant to an 545.22 order for or notice of withholding under this section to cover 545.23 the expenses of withholding. 545.24 Sec. 16. Minnesota Statutes 2000, section 518.6195, is 545.25 amended to read: 545.26 518.6195 [COLLECTION; ARREARS ONLY.] 545.27 (a) Remedies available for the collection and enforcement 545.28 of support in this chapter and chapters 256, 257, and 518C also 545.29 apply to cases in which the child or children for whom support 545.30 is owed are emancipated and the obligor owes past support or has 545.31 an accumulated arrearage as of the date of the youngest child's 545.32 emancipation. Child support arrearages under this section 545.33 include arrearages for child support, medical support, child 545.34 care, pregnancy and birth expenses, and unreimbursed medical 545.35 expenses as defined in section 518.171. 545.36 (b) This section applies retroactively to any support 546.1 arrearage that accrued on or before the date of enactment and to 546.2 all arrearages accruing after the date of enactment. 546.3 (c) Past support or pregnancy and confinement expenses 546.4 ordered for which the obligor has specific court ordered terms 546.5 for repayment may not be enforced using drivers' and 546.6 occupational or professional license suspension, credit bureau 546.7 reporting, and additional income withholding under section 546.8 518.6111, subdivision 10, paragraph (a), unless the obligor 546.9 fails to comply with the terms of the court order for repayment. 546.10 (d) If an arrearage exists at the time a support order 546.11 would otherwise terminate and section 518.6111, subdivision 10, 546.12 paragraph (c), does not apply to this section, the arrearage 546.13 shall be repaid in an amount equal to the current support order 546.14 plus an additional 20 percent of the monthly child support 546.15 obligation until all arrears have been paid in full, absent a 546.16 court order to the contrary. 546.17 (e) If an arrearage exists according to a support order 546.18 which fails to establish a monthly support obligation in a 546.19 specific dollar amount, the public authority, if it provides 546.20 child support services, or the obligee, may establish a payment 546.21 agreement which shall equal what the obligor would pay for 546.22 current support after application of section 518.551, plus an 546.23 additional 20 percent of the current support obligation, until 546.24 all arrears have been paid in full. If the obligor fails to 546.25 enter into or comply with a payment agreement, the public 546.26 authority, if it provides child support services, or the 546.27 obligee, may move the district court or child support 546.28 magistrate, if section 484.702 applies, for an order 546.29 establishing repayment terms. It shall be presumed that the 546.30 obligor is able to repay arrears at a rate which at a minimum 546.31 equals a current monthly obligation after application of section 546.32 518.551, plus an additional 20 percent of the current monthly 546.33 obligation. 546.34 Sec. 17. Minnesota Statutes 2000, section 518.64, 546.35 subdivision 2, is amended to read: 546.36 Subd. 2. [MODIFICATION.] (a) The terms of an order 547.1 respecting maintenance or support may be modified upon a showing 547.2 of one or more of the following: (1) substantially increased or 547.3 decreased earnings of a party; (2) substantially increased or 547.4 decreased need of a party or the child or children that are the 547.5 subject of these proceedings; (3) receipt of assistance under 547.6 the AFDC program formerly codified under sections 256.72 to 547.7 256.87 or 256B.01 to 256B.40, or chapter 256J or 256K; (4) a 547.8 change in the cost of living for either party as measured by the 547.9 federal bureau of statistics, any of which makes the terms 547.10 unreasonable and unfair; (5) extraordinary medical expenses of 547.11 the child not provided for under section 518.171; or (6) the 547.12 addition of work-related or education-related child care 547.13 expenses of the obligee or a substantial increase or decrease in 547.14 existing work-related or education-related child care expenses. 547.15 On a motion to modify support, the needs of any child the 547.16 obligor has after the entry of the support order that is the 547.17 subject of a modification motion shall be considered as provided 547.18 by section 518.551, subdivision 5f. 547.19 (b) It is presumed that there has been a substantial change 547.20 in circumstances under paragraph (a) and the terms of a current 547.21 support order shall be rebuttably presumed to be unreasonable 547.22 and unfair if: 547.23 (1) the application of the child support guidelines in 547.24 section 518.551, subdivision 5, to the current circumstances of 547.25 the parties results in a calculated court order that is at least 547.26 20 percent and at least $50 per month higher or lower than the 547.27 current support order; 547.28 (2) the medical support provisions of the order established 547.29 under section 518.171 are not enforceable by the public 547.30 authority or the custodial parent; 547.31 (3) health coverage ordered under section 518.171 is not 547.32 available to the child for whom the order is established by the 547.33 parent ordered to provide; or 547.34 (4) the existing support obligation is in the form of a 547.35 statement of percentage and not a specific dollar amount. 547.36 (c) On a motion for modification of maintenance, including 548.1 a motion for the extension of the duration of a maintenance 548.2 award, the court shall apply, in addition to all other relevant 548.3 factors, the factors for an award of maintenance under section 548.4 518.552 that exist at the time of the motion. On a motion for 548.5 modification of support, the court: 548.6 (1) shall apply section 518.551, subdivision 5, and shall 548.7 not consider the financial circumstances of each party's spouse, 548.8 if any; and 548.9 (2) shall not consider compensation received by a party for 548.10 employment in excess of a 40-hour work week, provided that the 548.11 party demonstrates, and the court finds, that: 548.12 (i) the excess employment began after entry of the existing 548.13 support order; 548.14 (ii) the excess employment is voluntary and not a condition 548.15 of employment; 548.16 (iii) the excess employment is in the nature of additional, 548.17 part-time employment, or overtime employment compensable by the 548.18 hour or fractions of an hour; 548.19 (iv) the party's compensation structure has not been 548.20 changed for the purpose of affecting a support or maintenance 548.21 obligation; 548.22 (v) in the case of an obligor, current child support 548.23 payments are at least equal to the guidelines amount based on 548.24 income not excluded under this clause; and 548.25 (vi) in the case of an obligor who is in arrears in child 548.26 support payments to the obligee, any net income from excess 548.27 employment must be used to pay the arrearages until the 548.28 arrearages are paid in full. 548.29 (d) A modification of support or maintenance, including 548.30 interest that accrued pursuant to section 548.091, may be made 548.31 retroactive only with respect to any period during which the 548.32 petitioning party has pending a motion for modification but only 548.33 from the date of service of notice of the motion on the 548.34 responding party and on the public authority if public 548.35 assistance is being furnished or the county attorney is the 548.36 attorney of record. However, modification may be applied to an 549.1 earlier period if the court makes express findings that: 549.2 (1) the party seeking modification was precluded from 549.3 serving a motion by reason of a significant physical or mental 549.4 disability, a material misrepresentation of another party, or 549.5 fraud upon the court and that the party seeking modification, 549.6 when no longer precluded, promptly served a motion; 549.7 (2) the party seeking modification was a recipient of 549.8 federal Supplemental Security Income (SSI), Title II Older 549.9 Americans, Survivor's Disability Insurance (OASDI), other 549.10 disability benefits, or public assistance based upon need during 549.11 the period for which retroactive modification is sought;or549.12 (3) the order for which the party seeks amendment was 549.13 entered by default, the party shows good cause for not 549.14 appearing, and the record contains no factual evidence, or 549.15 clearly erroneous evidence regarding the individual obligor's 549.16 ability to pay.; or 549.17 (4) the party seeking modification was institutionalized or 549.18 incarcerated for an offense other than nonsupport of a child 549.19 during the period for which retroactive modification is sought 549.20 and lacked the financial ability to pay the support ordered 549.21 during that time period. In determining whether to allow the 549.22 retroactive modification, the court shall consider whether and 549.23 when a request was made to the public authority for support 549.24 modification. 549.25 The court may provide that a reduction in the amount allocated 549.26 for child care expenses based on a substantial decrease in the 549.27 expenses is effective as of the date the expenses decreased. 549.28 (e) Except for an award of the right of occupancy of the 549.29 homestead, provided in section 518.63, all divisions of real and 549.30 personal property provided by section 518.58 shall be final, and 549.31 may be revoked or modified only where the court finds the 549.32 existence of conditions that justify reopening a judgment under 549.33 the laws of this state, including motions under section 518.145, 549.34 subdivision 2. The court may impose a lien or charge on the 549.35 divided property at any time while the property, or subsequently 549.36 acquired property, is owned by the parties or either of them, 550.1 for the payment of maintenance or support money, or may 550.2 sequester the property as is provided by section 518.24. 550.3 (f) The court need not hold an evidentiary hearing on a 550.4 motion for modification of maintenance or support. 550.5 (g) Section 518.14 shall govern the award of attorney fees 550.6 for motions brought under this subdivision. 550.7 Sec. 18. Minnesota Statutes 2000, section 518.641, 550.8 subdivision 1, is amended to read: 550.9 Subdivision 1. [REQUIREMENT.] (a) An orderfor550.10 establishing, modifying, or enforcing maintenance or child 550.11 support shall provide for a biennial adjustment in the amount to 550.12 be paid based on a change in the cost of living. An order that 550.13 provides for a cost-of-living adjustment shall specify the 550.14 cost-of-living index to be applied and the date on which the 550.15 cost-of-living adjustment shall become effective. The court may 550.16 use the consumer price index for all urban consumers, 550.17 Minneapolis-St. Paul (CPI-U), the consumer price index for wage 550.18 earners and clerical, Minneapolis-St. Paul (CPI-W), or another 550.19 cost-of-living index published by the department of labor which 550.20 it specifically finds is more appropriate. Cost-of-living 550.21 increases under this section shall be compounded. The court may 550.22 also increase the amount by more than the cost-of-living 550.23 adjustment by agreement of the parties or by making further 550.24 findings. 550.25 (b) The adjustment becomes effective on the first of May of 550.26 the year in which it is made, for cases in which payment is made 550.27 to the public authority. For cases in which payment is not made 550.28 to the public authority, application for an adjustment may be 550.29 made in any month but no application for an adjustment may be 550.30 made sooner than two years after the date of the dissolution 550.31 decree. A court may waive the requirement of the cost-of-living 550.32 clause if it expressly finds that the obligor's occupation or 550.33 income, or both, does not provide for cost-of-living adjustment 550.34 or that the order for maintenance or child support has a 550.35 provision such as a step increase that has the effect of a 550.36 cost-of-living clause. The court may waive a cost-of-living 551.1 adjustment in a maintenance order if the parties so agree in 551.2 writing. The commissioner of human services may promulgate 551.3 rules for child support adjustments under this section in 551.4 accordance with the rulemaking provisions of chapter 14. Notice 551.5 of this statute must comply with section 518.68, subdivision 2. 551.6 Sec. 19. Minnesota Statutes 2000, section 518.641, 551.7 subdivision 2, is amended to read: 551.8 Subd. 2. [CONDITIONSNOTICE.] No adjustment under this 551.9 section may be made unless the order provides for it anduntil551.10the following conditions are met:551.11(a) the obligee serves notice of the application for551.12adjustment by mail on the obligor at the obligor's last known551.13address at least 20 days before the effective date of the551.14adjustment;551.15(b) the notice to the obligor informs the obligor of the551.16date on which the adjustment in payments will become effective;551.17(c) after receipt of notice and before the effective day of551.18the adjustment, the obligor fails to request a hearing on the551.19issue of whether the adjustment should take effect, and ex551.20parte, to stay imposition of the adjustment pending outcome of551.21the hearing; or551.22(d) the public authoritythe public authority or the 551.23 obligee, if the obligee is requesting the cost-of-living 551.24 adjustment, sends notice ofits application forthe intended 551.25 adjustment to the obligor at the obligor's last known address at 551.26 least 20 days before the effective date of the adjustment, and. 551.27 The noticeinformsshall inform the obligor of the date on which 551.28 the adjustment will become effective and the procedures for 551.29 contesting the adjustmentaccording to section 484.702. 551.30 Sec. 20. Minnesota Statutes 2000, section 518.641, is 551.31 amended by adding a subdivision to read: 551.32 Subd. 2a. [PROCEDURES FOR CONTESTING ADJUSTMENT.] (a) To 551.33 contest cost-of-living adjustments initiated by the public 551.34 authority or an obligee who has applied for or is receiving 551.35 child support and maintenance collection services from the 551.36 public authority, other than income withholding only services, 552.1 the obligor, before the effective date of the adjustment, must: 552.2 (1) file a motion contesting the cost-of-living adjustment 552.3 with the court administrator; and 552.4 (2) serve the motion by first-class mail on the public 552.5 authority and the obligee. 552.6 The hearing shall take place in the expedited child support 552.7 process as governed by section 484.702. 552.8 (b) To contest cost-of-living adjustments initiated by an 552.9 obligee who is not receiving child support and maintenance 552.10 collection services from the public authority, or for an obligee 552.11 who receives income withholding only services from the public 552.12 authority, the obligor must, before the effective date of the 552.13 adjustment: 552.14 (1) file a motion contesting the cost-of-living adjustment 552.15 with the court administrator; and 552.16 (2) serve the motion by first-class mail on the obligee. 552.17 The hearing shall take place in district court. 552.18 (c) Upon receipt of a motion contesting the cost-of-living 552.19 adjustment, the cost-of-living adjustment shall be stayed 552.20 pending further order of the court. 552.21 (d) The court administrator shall make available pro se 552.22 motion forms for contesting a cost-of-living adjustment under 552.23 this subdivision. 552.24 Sec. 21. Minnesota Statutes 2000, section 518.641, 552.25 subdivision 3, is amended to read: 552.26 Subd. 3. [RESULT OF HEARING.] If, at a hearing pursuant to 552.27 this section, the obligor establishes an insufficient cost of 552.28 living or other increase in income that prevents fulfillment of 552.29 the adjusted maintenance or child support obligation, the 552.30 court or child support magistrate may direct that all or part of 552.31 the adjustment not take effect. If, at the hearing, the obligor 552.32 does not establish this insufficient increase in income, the 552.33 adjustment shall take effect as of the date it would have become 552.34 effective had no hearing been requested. 552.35 Sec. 22. Minnesota Statutes 2000, section 548.091, 552.36 subdivision 1a, is amended to read: 553.1 Subd. 1a. [CHILD SUPPORT JUDGMENT BY OPERATION OF LAW.] 553.2 (a) Any payment or installment of support required by a judgment 553.3 or decree of dissolution or legal separation, determination of 553.4 parentage, an order under chapter 518C, an order under section 553.5 256.87, or an order under section 260B.331 or 260C.331, that is 553.6 not paid or withheld from the obligor's income as required under 553.7 section 518.6111, or which is ordered as child support by 553.8 judgment, decree, or order by a court in any other state, is a 553.9 judgment by operation of law on and after the date it is due, is 553.10 entitled to full faith and credit in this state and any other 553.11 state, and shall be entered and docketed by the court 553.12 administrator on the filing of affidavits as provided in 553.13 subdivision 2a. Except as otherwise provided by paragraph (b), 553.14 interest accrues from the date the unpaid amount due is greater 553.15 than the current support due at the annual rate provided in 553.16 section 549.09, subdivision 1, plus two percent, not to exceed 553.17 an annual rate of 18 percent. A payment or installment of 553.18 support that becomes a judgment by operation of law between the 553.19 date on which a party served notice of a motion for modification 553.20 under section 518.64, subdivision 2, and the date of the court's 553.21 order on modification may be modified under that subdivision. 553.22 (b) Notwithstanding the provisions of section 549.09, upon 553.23 motion to the court and upon proof by the obligor of 36 553.24 consecutive months of complete and timely payments of both 553.25 current support and court-ordered paybacks of a child support 553.26 debt or arrearage, the court may order interest on the remaining 553.27 debt or arrearage to stop accruing. Timely payments are those 553.28 made in the month in which they are due. If, after that time, 553.29 the obligor fails to make complete and timely payments of both 553.30 current support and court-ordered paybacks of child support debt 553.31 or arrearage, the public authority or the obligee may move the 553.32 court for the reinstatement of interest as of the month in which 553.33 the obligor ceased making complete and timely payments. 553.34 The court shall provide copies of all orders issued under 553.35 this section to the public authority. The commissioner of human 553.36 services shall prepare and make available to the court and the 554.1 parties forms to be submitted by the parties in support of a 554.2 motion under this paragraph. 554.3 (c) Notwithstanding the provisions of section 549.09, upon 554.4 motion to the court, the court may order interest on a child 554.5 support debt to stop accruing where the court finds that the 554.6 obligor is: 554.7 (1) unable to pay support because of a significant physical 554.8 or mental disability;or554.9 (2) a recipient of Supplemental Security Income (SSI), 554.10 Title II Older Americans Survivor's Disability Insurance 554.11 (OASDI), other disability benefits, or public assistance based 554.12 upon need; or 554.13 (3) institutionalized or incarcerated for at least 30 days 554.14 for an offense other than nonsupport of the child or children 554.15 involved, and is otherwise financially unable to pay support. 554.16 Sec. 23. [REPEALER.] 554.17 Minnesota Statutes 2000, section 518.641, subdivisions 4 554.18 and 5, are repealed. 554.19 ARTICLE 13 554.20 DEPARTMENT OF HUMAN SERVICES LICENSING 554.21 Section 1. Minnesota Statutes 2000, section 13.46, 554.22 subdivision 4, is amended to read: 554.23 Subd. 4. [LICENSING DATA.] (a) As used in this subdivision: 554.24 (1) "licensing data" means all data collected, maintained, 554.25 used, or disseminated by the welfare system pertaining to 554.26 persons licensed or registered or who apply for licensure or 554.27 registration or who formerly were licensed or registered under 554.28 the authority of the commissioner of human services; 554.29 (2) "client" means a person who is receiving services from 554.30 a licensee or from an applicant for licensure; and 554.31 (3) "personal and personal financial data" means social 554.32 security numbers, identity of and letters of reference, 554.33 insurance information, reports from the bureau of criminal 554.34 apprehension, health examination reports, and social/home 554.35 studies. 554.36 (b)(1) Except as provided in paragraph (c), the following 555.1 data on current and former licensees are public: name, address, 555.2 telephone number of licensees, licensed capacity, type of client 555.3 preferred, variances granted, type of dwelling, name and 555.4 relationship of other family members, previous license history, 555.5 class of license, and the existence and status of complaints. 555.6 When disciplinary action has been taken against a licensee or 555.7 the complaint is resolved, the following data are public: the 555.8 substance of the complaint, the findings of the investigation of 555.9 the complaint, the record of informal resolution of a licensing 555.10 violation, orders of hearing, findings of fact, conclusions of 555.11 law, and specifications of the final disciplinary action 555.12 contained in the record of disciplinary action. 555.13 (2) The following data on persons subject to 555.14 disqualification under section 245A.04 in connection with a 555.15 license to provide family day care for children, child care 555.16 center services, foster care for children in the provider's 555.17 home, or foster care or day care services for adults in the 555.18 provider's home, are public: the nature of any disqualification 555.19 set aside under section 245A.04, subdivision 3b, and the reasons 555.20 for setting aside the disqualification; and the reasons for 555.21 granting any variance under section 245A.04, subdivision 9. 555.22 (3) When maltreatment is substantiated under section 555.23 626.556 or 626.557 and the victim and the substantiated 555.24 perpetrator are affiliated with a program licensed under chapter 555.25 245A, the commissioner of human services, local social services 555.26 agency, or county welfare agency may inform the license holder 555.27 where the maltreatment occurred of the identity of the 555.28 substantiated perpetrator and the victim. 555.29 (c) The following are private data on individuals under 555.30 section 13.02, subdivision 12, or nonpublic data under section 555.31 13.02, subdivision 9: personal and personal financial data on 555.32 family day care program and family foster care program 555.33 applicants and licensees and their family members who provide 555.34 services under the license. 555.35 (d) The following are private data on individuals: the 555.36 identity of persons who have made reports concerning licensees 556.1 or applicants that appear in inactive investigative data, and 556.2 the records of clients or employees of the licensee or applicant 556.3 for licensure whose records are received by the licensing agency 556.4 for purposes of review or in anticipation of a contested 556.5 matter. The names of reporters under sections 626.556 and 556.6 626.557 may be disclosed only as provided in section 626.556, 556.7 subdivision 11, or 626.557, subdivision 12b. 556.8 (e) Data classified as private, confidential, nonpublic, or 556.9 protected nonpublic under this subdivision become public data if 556.10 submitted to a court or administrative law judge as part of a 556.11 disciplinary proceeding in which there is a public hearing 556.12 concerning the disciplinary action. 556.13 (f) Data generated in the course of licensing 556.14 investigations that relate to an alleged violation of law are 556.15 investigative data under subdivision 3. 556.16 (g) Data that are not public data collected, maintained, 556.17 used, or disseminated under this subdivision that relate to or 556.18 are derived from a report as defined in section 626.556, 556.19 subdivision 2, are subject to the destruction provisions of 556.20 section 626.556, subdivision 11. 556.21 (h) Upon request, not public data collected, maintained, 556.22 used, or disseminated under this subdivision that relate to or 556.23 are derived from a report of substantiated maltreatment as 556.24 defined in section 626.556 or 626.557 may be exchanged with the 556.25 department of health for purposes of completing background 556.26 studies pursuant to section 144.057. 556.27 (i) Data on individuals collected according to licensing 556.28 activities under chapter 245A, and data on individuals collected 556.29 by the commissioner of human services according to maltreatment 556.30 investigations under sections 626.556 and 626.557, may be shared 556.31 with the department of human rights, the department of health, 556.32 the department of corrections, the ombudsman for mental health 556.33 and retardation, and the individual's professional regulatory 556.34 board when there is reason to believe that laws or standards 556.35 under the jurisdiction of those agencies may have been violated. 556.36 (j) In addition to the notice of determinations required 557.1 under section 626.556, subdivision 10f, if the commissioner or 557.2 the local social services agency has determined that an 557.3 individual is a substantiated perpetrator of maltreatment of a 557.4 child based on sexual abuse, as defined in section 626.556, 557.5 subdivision 2, and the commissioner or local social services 557.6 agency knows that the individual is a person responsible for a 557.7 child's care in another facility, the commissioner or local 557.8 social services agency shall notify the head of that facility of 557.9 this determination. The notification must include an 557.10 explanation of the individual's available appeal rights and the 557.11 status of any appeal. If a notice is given under this 557.12 paragraph, the government entity making the notification shall 557.13 provide a copy of the notice to the individual who is the 557.14 subject of the notice. 557.15 Sec. 2. Minnesota Statutes 2000, section 144.057, 557.16 subdivision 3, is amended to read: 557.17 Subd. 3. [RECONSIDERATIONS.] The commissioner of health 557.18 shall review and decide reconsideration requests, including the 557.19 granting of variances, in accordance with the procedures and 557.20 criteria contained in chapter 245A and Minnesota Rules, parts 557.21 9543.3000 to 9543.3090. The commissioner's decision shall be 557.22 provided to the individual and to the department of human 557.23 services. Except as provided under section 245A.04, 557.24 subdivisions 3b, paragraphs (e) and (f); and 3c, paragraph (a), 557.25 the commissioner's decision to grant or deny a reconsideration 557.26 of disqualification is the final administrative agency action. 557.27 Sec. 3. Minnesota Statutes 2000, section 214.104, is 557.28 amended to read: 557.29 214.104 [HEALTH-RELATED LICENSING BOARDS; DETERMINATIONS 557.30 REGARDINGDISQUALIFICATIONS FORMALTREATMENT.] 557.31 (a) A health-related licensing board shall make 557.32 determinations as to whetherlicenseesregulated persons who are 557.33 under the board's jurisdiction should bedisqualified under557.34section 245A.04, subdivision 3d, from positions allowing direct557.35contact with persons receiving servicesthe subject of 557.36 disciplinary or corrective action because of substantiated 558.1 maltreatment under section 626.556 or 626.557.A determination558.2under this section may be done as part of an investigation under558.3section 214.103.The board shall make a determinationwithin 90558.4days ofupon receipt, and after the review, of an investigation 558.5 memorandum or other notice of substantiated maltreatment under 558.6 section 626.556 or 626.557, or of a notice from the commissioner 558.7 of human services that a background study of alicensee558.8 regulated person shows substantiated maltreatment.The board558.9shall also make a determination under this section upon558.10consideration of the licensure of an individual who was subject558.11to disqualification before licensure because of substantiated558.12maltreatment.558.13(b) In making a determination under this section, the board558.14shall consider the nature and extent of any injury or harm558.15resulting from the conduct that would constitute grounds for558.16disqualification, the seriousness of the misconduct, the extent558.17that disqualification is necessary to protect persons receiving558.18services or the public, and other factors specified in section558.19245A.04, subdivision 3b, paragraph (b).558.20(c) The board shall determine the duration and extent of558.21the disqualification or may establish conditions under which the558.22licensee may hold a position allowing direct contact with558.23persons receiving services or in a licensed facility.558.24 (b) Upon completion of its review of a report of 558.25 substantiated maltreatment, the board shall notify the 558.26 commissioner of human servicesand the lead agency that558.27conducted an investigation under section 626.556 or 626.557, as558.28applicable,of its determination. The board shall notify the 558.29 commissioner of human services if, following a review of the 558.30 report of substantiated maltreatment, the board determines that 558.31 it does not have jurisdiction in the matter and the commissioner 558.32 shall make the appropriate disqualification decision regarding 558.33 the regulated person as otherwise provided in chapter 245A. The 558.34 board shall also notify the commissioner of health or the 558.35 commissioner of human services immediately upon receipt of 558.36 knowledge of a facility or program allowing a regulated person 559.1 to provide direct contact services at the facility or program 559.2 while not complying with requirements placed on the regulated 559.3 person. 559.4 (c) In addition to any other remedy provided by law, the 559.5 board may, through its designated board member, temporarily 559.6 suspend the license of a licensee; deny a credential to an 559.7 applicant; or require the regulated person to be continuously 559.8 supervised, if the board finds there is probable cause to 559.9 believe the regulated person referred to the board according to 559.10 paragraph (a) poses an immediate risk of harm to vulnerable 559.11 persons. The board shall consider all relevant information 559.12 available, which may include but is not limited to: 559.13 (1) the extent the action is needed to protect persons 559.14 receiving services or the public; 559.15 (2) the recency of the maltreatment; 559.16 (3) the number of incidents of maltreatment; 559.17 (4) the intrusiveness or violence of the maltreatment; and 559.18 (5) the vulnerability of the victim of maltreatment. 559.19 The action shall take effect upon written notice to the 559.20 regulated person, served by certified mail, specifying the 559.21 statute violated. The board shall notify the commissioner of 559.22 health or the commissioner of human services of the suspension 559.23 or denial of a credential. The action shall remain in effect 559.24 until the board issues a temporary stay or a final order in the 559.25 matter after a hearing or upon agreement between the board and 559.26 the regulated person. At the time the board issues the notice, 559.27 the regulated person shall inform the board of all settings in 559.28 which the regulated person is employed or practices. The board 559.29 shall inform all known employment and practice settings of the 559.30 board action and schedule a disciplinary hearing to be held 559.31 under chapter 14. The board shall provide the regulated person 559.32 with at least 30 days' notice of the hearing, unless the parties 559.33 agree to a hearing date that provides less than 30 days' notice, 559.34 and shall schedule the hearing to begin no later than 90 days 559.35 after issuance of the notice of hearing. 559.36 Sec. 4. Minnesota Statutes 2000, section 245A.03, 560.1 subdivision 2b, is amended to read: 560.2 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 560.3 clause (2), does not apply to: 560.4 (1) a child care provider who as an applicant for licensure 560.5 or as a license holder has received a license denial under 560.6 section 245A.05, afineconditional license under section 560.7 245A.06, or a sanction under section 245A.07 from the 560.8 commissioner that has not been reversed on appeal; or 560.9 (2) a child care provider, or a child care provider who has 560.10 a household member who, as a result of a licensing process, has 560.11 a disqualification under this chapter that has not been set 560.12 aside by the commissioner. 560.13 Sec. 5. Minnesota Statutes 2000, section 245A.04, 560.14 subdivision 3, is amended to read: 560.15 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 560.16 (a) Before the commissioner issues a license, the commissioner 560.17 shall conduct a study of the individuals specified in paragraph 560.18(c)(d), clauses (1) to (5), according to rules of the 560.19 commissioner. 560.20 Beginning January 1, 1997, the commissioner shall also 560.21 conduct a study of employees providing direct contact services 560.22 for nonlicensed personal care provider organizations described 560.23 in paragraph(c)(d), clause (5). 560.24 The commissioner shall recover the cost of these background 560.25 studies through a fee of no more than $12 per study charged to 560.26 the personal care provider organization. 560.27 Beginning August 1, 1997, the commissioner shall conduct 560.28 all background studies required under this chapter for adult 560.29 foster care providers who are licensed by the commissioner of 560.30 human services and registered under chapter 144D. The 560.31 commissioner shall conduct these background studies in 560.32 accordance with this chapter. The commissioner shall initiate a 560.33 pilot project to conduct up to 5,000 background studies under 560.34 this chapter in programs with joint licensure as home and 560.35 community-based services and adult foster care for people with 560.36 developmental disabilities when the license holder does not 561.1 reside in the foster care residence. 561.2 (b) Beginning July 1, 1998, the commissioner shall conduct 561.3 a background study on individuals specified in 561.4 paragraph(c)(d), clauses (1) to (5), who perform direct 561.5 contact services in a nursing home or a home care agency 561.6 licensed under chapter 144A or a boarding care home licensed 561.7 under sections 144.50 to 144.58, when the subject of the study 561.8 resides outside Minnesota; the study must be at least as 561.9 comprehensive as that of a Minnesota resident and include a 561.10 search of information from the criminal justice data 561.11 communications network in the state where the subject of the 561.12 study resides. 561.13 (c) Beginning August 1, 2001, the commissioner shall 561.14 conduct all background studies required under this chapter and 561.15 initiated by supplemental nursing services agencies registered 561.16 under section 144A.71, subdivision 1. Studies for the agencies 561.17 must be initiated annually by each agency. The commissioner 561.18 shall conduct the background studies according to this chapter. 561.19 The commissioner shall recover the cost of the background 561.20 studies through a fee of no more than $8 per study, charged to 561.21 the supplemental nursing services agency. Money collected under 561.22 this paragraph is appropriated to the commissioner to pay the 561.23 costs of background studies. 561.24 (d) The applicant, license holder,theregistrant under 561.25 section 144A.71, subdivision 1, bureau of criminal apprehension, 561.26thecommissioner of health, and county agencies, after written 561.27 notice to the individual who is the subject of the study, shall 561.28 help with the study by giving the commissioner criminal 561.29 conviction data and reports about the maltreatment of adults 561.30 substantiated under section 626.557 and the maltreatment of 561.31 minors in licensed programs substantiated under section 561.32 626.556. The individuals to be studied shall include: 561.33 (1) the applicant; 561.34 (2) persons over the age of 13 living in the household 561.35 where the licensed program will be provided; 561.36 (3) current employees or contractors of the applicant who 562.1 will have direct contact with persons served by the facility, 562.2 agency, or program; 562.3 (4) volunteers or student volunteers who have direct 562.4 contact with persons served by the program to provide program 562.5 services, if the contact is not directly supervised by the 562.6 individuals listed in clause (1) or (3); and 562.7 (5) any person who, as an individual or as a member of an 562.8 organization, exclusively offers, provides, or arranges for 562.9 personal care assistant services under the medical assistance 562.10 program as authorized under sections 256B.04, subdivision 16, 562.11 and 256B.0625, subdivision 19a. 562.12 The juvenile courts shall also help with the study by 562.13 giving the commissioner existing juvenile court records on 562.14 individuals described in clause (2) relating to delinquency 562.15 proceedings held within either the five years immediately 562.16 preceding the application or the five years immediately 562.17 preceding the individual's 18th birthday, whichever time period 562.18 is longer. The commissioner shall destroy juvenile records 562.19 obtained pursuant to this subdivision when the subject of the 562.20 records reaches age 23. 562.21 For purposes of this section and Minnesota Rules, part 562.22 9543.3070, a finding that a delinquency petition is proven in 562.23 juvenile court shall be considered a conviction in state 562.24 district court. 562.25 For purposes of this subdivision, "direct contact" means 562.26 providing face-to-face care, training, supervision, counseling, 562.27 consultation, or medication assistance to persons served by a 562.28 program. For purposes of this subdivision, "directly supervised" 562.29 means an individual listed in clause (1), (3), or (5) is within 562.30 sight or hearing of a volunteer to the extent that the 562.31 individual listed in clause (1), (3), or (5) is capable at all 562.32 times of intervening to protect the health and safety of the 562.33 persons served by the program who have direct contact with the 562.34 volunteer. 562.35 A study of an individual in clauses (1) to (5) shall be 562.36 conducted at least upon application for initial license or 563.1 registration under section 144A.71, subdivision 1, and 563.2 reapplication for a license or registration. The commissioner 563.3 is not required to conduct a study of an individual at the time 563.4 of reapplication for a license or if the individual has been 563.5 continuously affiliated with a foster care provider licensed by 563.6 the commissioner of human services and registered under chapter 563.7 144D, other than a family day care or foster care license, if: 563.8 (i) a study of the individual was conducted either at the time 563.9 of initial licensure or when the individual became affiliated 563.10 with the license holder; (ii) the individual has been 563.11 continuously affiliated with the license holder since the last 563.12 study was conducted; and (iii) the procedure described in 563.13 paragraph(d)(e) has been implemented and was in effect 563.14 continuously since the last study was conducted. For the 563.15 purposes of this section, a physician licensed under chapter 147 563.16 is considered to be continuously affiliated upon the license 563.17 holder's receipt from the commissioner of health or human 563.18 services of the physician's background study results. For 563.19 individuals who are required to have background studies under 563.20 clauses (1) to (5) and who have been continuously affiliated 563.21 with a foster care provider that is licensed in more than one 563.22 county, criminal conviction data may be shared among those 563.23 counties in which the foster care programs are licensed. A 563.24 county agency's receipt of criminal conviction data from another 563.25 county agency shall meet the criminal data background study 563.26 requirements of this section. 563.27 The commissioner may also conduct studies on individuals 563.28 specified in clauses (3) and (4) when the studies are initiated 563.29 by: 563.30 (i) personnel pool agencies; 563.31 (ii) temporary personnel agencies; 563.32 (iii) educational programs that train persons by providing 563.33 direct contact services in licensed programs; and 563.34 (iv) professional services agencies that are not licensed 563.35 and which contract with licensed programs to provide direct 563.36 contact services or individuals who provide direct contact 564.1 services. 564.2 Studies on individuals in items (i) to (iv) must be 564.3 initiated annually by these agencies, programs, and 564.4 individuals. Except for personal care provider 564.5 organizations and supplemental nursing services agencies, no 564.6 applicant, license holder, or individual who is the subject of 564.7 the study shall pay any fees required to conduct the study. 564.8 (1) At the option of the licensed facility, rather than 564.9 initiating another background study on an individual required to 564.10 be studied who has indicated to the licensed facility that a 564.11 background study by the commissioner was previously completed, 564.12 the facility may make a request to the commissioner for 564.13 documentation of the individual's background study status, 564.14 provided that: 564.15 (i) the facility makes this request using a form provided 564.16 by the commissioner; 564.17 (ii) in making the request the facility informs the 564.18 commissioner that either: 564.19 (A) the individual has been continuously affiliated with a 564.20 licensed facility since the individual's previous background 564.21 study was completed, or since October 1, 1995, whichever is 564.22 shorter; or 564.23 (B) the individual is affiliated only with a personnel pool 564.24 agency, a temporary personnel agency, an educational program 564.25 that trains persons by providing direct contact services in 564.26 licensed programs, or a professional services agency that is not 564.27 licensed and which contracts with licensed programs to provide 564.28 direct contact services or individuals who provide direct 564.29 contact services; and 564.30 (iii) the facility provides notices to the individual as 564.31 required in paragraphs (a) to(d)(e), and that the facility is 564.32 requesting written notification of the individual's background 564.33 study status from the commissioner. 564.34 (2) The commissioner shall respond to each request under 564.35 paragraph (1) with a written or electronic notice to the 564.36 facility and the study subject. If the commissioner determines 565.1 that a background study is necessary, the study shall be 565.2 completed without further request from a licensed agency or 565.3 notifications to the study subject. 565.4 (3) When a background study is being initiated by a 565.5 licensed facility or a foster care provider that is also 565.6 registered under chapter 144D, a study subject affiliated with 565.7 multiple licensed facilities may attach to the background study 565.8 form a cover letter indicating the additional facilities' names, 565.9 addresses, and background study identification numbers. When 565.10 the commissioner receives such notices, each facility identified 565.11 by the background study subject shall be notified of the study 565.12 results. The background study notice sent to the subsequent 565.13 agencies shall satisfy those facilities' responsibilities for 565.14 initiating a background study on that individual. 565.15(d)(e) If an individual who is affiliated with a program 565.16 or facility regulated by the department of human services or 565.17 department of health or who is affiliated with a nonlicensed 565.18 personal care provider organization, is convicted of a crime 565.19 constituting a disqualification under subdivision 3d, the 565.20 probation officer or corrections agent shall notify the 565.21 commissioner of the conviction. The commissioner, in 565.22 consultation with the commissioner of corrections, shall develop 565.23 forms and information necessary to implement this paragraph and 565.24 shall provide the forms and information to the commissioner of 565.25 corrections for distribution to local probation officers and 565.26 corrections agents. The commissioner shall inform individuals 565.27 subject to a background study that criminal convictions for 565.28 disqualifying crimes will be reported to the commissioner by the 565.29 corrections system. A probation officer, corrections agent, or 565.30 corrections agency is not civilly or criminally liable for 565.31 disclosing or failing to disclose the information required by 565.32 this paragraph. Upon receipt of disqualifying information, the 565.33 commissioner shall provide the notifications required in 565.34 subdivision 3a, as appropriate to agencies on record as having 565.35 initiated a background study or making a request for 565.36 documentation of the background study status of the individual. 566.1 This paragraph does not apply to family day care and child 566.2 foster care programs. 566.3(e)(f) The individual who is the subject of the study must 566.4 provide the applicant or license holder with sufficient 566.5 information to ensure an accurate study including the 566.6 individual's first, middle, and last name; home address, city, 566.7 county, and state of residence for the past five years; zip 566.8 code; sex; date of birth; and driver's license number. The 566.9 applicant or license holder shall provide this information about 566.10 an individual in paragraph(c)(d), clauses (1) to (5), on forms 566.11 prescribed by the commissioner. By January 1, 2000, for 566.12 background studies conducted by the department of human 566.13 services, the commissioner shall implement a system for the 566.14 electronic transmission of: (1) background study information to 566.15 the commissioner; and (2) background study results to the 566.16 license holder. The commissioner may request additional 566.17 information of the individual, which shall be optional for the 566.18 individual to provide, such as the individual's social security 566.19 number or race. 566.20(f)(g) Except for child foster care, adult foster care, 566.21 and family day care homes, a study must include information 566.22 related to names of substantiated perpetrators of maltreatment 566.23 of vulnerable adults that has been received by the commissioner 566.24 as required under section 626.557, subdivision 9c, paragraph 566.25 (i), and the commissioner's records relating to the maltreatment 566.26 of minors in licensed programs, information from juvenile courts 566.27 as required in paragraph(c)(d) for persons listed in paragraph 566.28(c)(d), clause (2), and information from the bureau of criminal 566.29 apprehension. For child foster care, adult foster care, and 566.30 family day care homes, the study must include information from 566.31 the county agency's record of substantiated maltreatment of 566.32 adults, and the maltreatment of minors, information from 566.33 juvenile courts as required in paragraph(c)(d) for persons 566.34 listed in paragraph(c)(d), clause (2), and information from 566.35 the bureau of criminal apprehension. The commissioner may also 566.36 review arrest and investigative information from the bureau of 567.1 criminal apprehension, the commissioner of health, a county 567.2 attorney, county sheriff, county agency, local chief of police, 567.3 other states, the courts, or the Federal Bureau of Investigation 567.4 if the commissioner has reasonable cause to believe the 567.5 information is pertinent to the disqualification of an 567.6 individual listed in paragraph(c)(d), clauses (1) to (5). The 567.7 commissioner is not required to conduct more than one review of 567.8 a subject's records from the Federal Bureau of Investigation if 567.9 a review of the subject's criminal history with the Federal 567.10 Bureau of Investigation has already been completed by the 567.11 commissioner and there has been no break in the subject's 567.12 affiliation with the license holder who initiated the background 567.13 studies. 567.14 When the commissioner has reasonable cause to believe that 567.15 further pertinent information may exist on the subject, the 567.16 subject shall provide a set of classifiable fingerprints 567.17 obtained from an authorized law enforcement agency. For 567.18 purposes of requiring fingerprints, the commissioner shall be 567.19 considered to have reasonable cause under, but not limited to, 567.20 the following circumstances: 567.21 (1) information from the bureau of criminal apprehension 567.22 indicates that the subject is a multistate offender; 567.23 (2) information from the bureau of criminal apprehension 567.24 indicates that multistate offender status is undetermined; or 567.25 (3) the commissioner has received a report from the subject 567.26 or a third party indicating that the subject has a criminal 567.27 history in a jurisdiction other than Minnesota. 567.28(g)(h) The failure or refusal of anapplicant's or license567.29holder's failure or refusalapplicant, license holder, or 567.30 registrant under section 144A.71, subdivision 1, to cooperate 567.31 with the commissioner is reasonable cause to disqualify a 567.32 subject, deny a license application or immediately suspend, 567.33 suspend, or revoke a license or registration. Failure or 567.34 refusal of an individual to cooperate with the study is just 567.35 cause for denying or terminating employment of the individual if 567.36 the individual's failure or refusal to cooperate could cause the 568.1 applicant's application to be denied or the license holder's 568.2 license to be immediately suspended, suspended, or revoked. 568.3(h)(i) The commissioner shall not consider an application 568.4 to be complete until all of the information required to be 568.5 provided under this subdivision has been received. 568.6(i)(j) No person in paragraph(c)(d), clause (1), (2), 568.7 (3), (4), or (5), who is disqualified as a result of this 568.8 section may be retained by the agency in a position involving 568.9 direct contact with persons served by the program. 568.10(j)(k) Termination of persons in paragraph(c)(d), clause 568.11 (1), (2), (3), (4), or (5), made in good faith reliance on a 568.12 notice of disqualification provided by the commissioner shall 568.13 not subject the applicant or license holder to civil liability. 568.14(k)(l) The commissioner may establish records to fulfill 568.15 the requirements of this section. 568.16(l)(m) The commissioner may not disqualify an individual 568.17 subject to a study under this section because that person has, 568.18 or has had, a mental illness as defined in section 245.462, 568.19 subdivision 20. 568.20(m)(n) An individual subject to disqualification under 568.21 this subdivision has the applicable rights in subdivision 3a, 568.22 3b, or 3c. 568.23(n)(o) For the purposes of background studies completed by 568.24 tribal organizations performing licensing activities otherwise 568.25 required of the commissioner under this chapter, after obtaining 568.26 consent from the background study subject, tribal licensing 568.27 agencies shall have access to criminal history data in the same 568.28 manner as county licensing agencies and private licensing 568.29 agencies under this chapter. 568.30 Sec. 6. Minnesota Statutes 2000, section 245A.04, 568.31 subdivision 3a, is amended to read: 568.32 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 568.33 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 568.34 commissioner shall notify the applicantor, license holder, or 568.35 registrant under section 144A.71, subdivision 1 and the 568.36 individual who is the subject of the study, in writing or by 569.1 electronic transmission, of the results of the study. When the 569.2 study is completed, a notice that the study was undertaken and 569.3 completed shall be maintained in the personnel files of the 569.4 program. For studies on individuals pertaining to a license to 569.5 provide family day care or group family day care, foster care 569.6 for children in the provider's own home, or foster care or day 569.7 care services for adults in the provider's own home, the 569.8 commissioner is not required to provide a separate notice of the 569.9 background study results to the individual who is the subject of 569.10 the study unless the study results in a disqualification of the 569.11 individual. 569.12 The commissioner shall notify the individual studied if the 569.13 information in the study indicates the individual is 569.14 disqualified from direct contact with persons served by the 569.15 program. The commissioner shall disclose the information 569.16 causing disqualification and instructions on how to request a 569.17 reconsideration of the disqualification to the individual 569.18 studied. An applicant or license holder who is not the subject 569.19 of the study shall be informed that the commissioner has found 569.20 information that disqualifies the subject from direct contact 569.21 with persons served by the program. However, only the 569.22 individual studied must be informed of the information contained 569.23 in the subject's background study unless theonlybasis for the 569.24 disqualification is failure to cooperate, substantiated 569.25 maltreatment under section 626.556 or 626.557, the Data 569.26 Practices Act provides for release of the information, or the 569.27 individual studied authorizes the release of the 569.28 information. When a disqualification is based on the subject's 569.29 failure to cooperate with the background study or substantiated 569.30 maltreatment under section 626.556 or 626.557, the agency that 569.31 initiated the study shall be informed by the commissioner of the 569.32 reason for the disqualification. 569.33 (b) Except as provided in subdivision 3d, paragraph (b), if 569.34 the commissioner determines that the individual studied has a 569.35 disqualifying characteristic, the commissioner shall review the 569.36 information immediately available and make a determination as to 570.1 the subject's immediate risk of harm to persons served by the 570.2 program where the individual studied will have direct contact. 570.3 The commissioner shall consider all relevant information 570.4 available, including the following factors in determining the 570.5 immediate risk of harm: the recency of the disqualifying 570.6 characteristic; the recency of discharge from probation for the 570.7 crimes; the number of disqualifying characteristics; the 570.8 intrusiveness or violence of the disqualifying characteristic; 570.9 the vulnerability of the victim involved in the disqualifying 570.10 characteristic; and the similarity of the victim to the persons 570.11 served by the program where the individual studied will have 570.12 direct contact. The commissioner may determine that the 570.13 evaluation of the information immediately available gives the 570.14 commissioner reason to believe one of the following: 570.15 (1) The individual poses an imminent risk of harm to 570.16 persons served by the program where the individual studied will 570.17 have direct contact. If the commissioner determines that an 570.18 individual studied poses an imminent risk of harm to persons 570.19 served by the program where the individual studied will have 570.20 direct contact, the individual and the license holder must be 570.21 sent a notice of disqualification. The commissioner shall order 570.22 the license holder to immediately remove the individual studied 570.23 from direct contact. The notice to the individual studied must 570.24 include an explanation of the basis of this determination. 570.25 (2) The individual poses a risk of harm requiring 570.26 continuous supervision while providing direct contact services 570.27 during the period in which the subject may request a 570.28 reconsideration. If the commissioner determines that an 570.29 individual studied poses a risk of harm that requires continuous 570.30 supervision, the individual and the license holder must be sent 570.31 a notice of disqualification. The commissioner shall order the 570.32 license holder to immediately remove the individual studied from 570.33 direct contact services or assure that the individual studied is 570.34 within sight or hearing of another staff person when providing 570.35 direct contact services during the period in which the 570.36 individual may request a reconsideration of the 571.1 disqualification. If the individual studied does not submit a 571.2 timely request for reconsideration, or the individual submits a 571.3 timely request for reconsideration, but the disqualification is 571.4 not set aside for that license holder, the license holder will 571.5 be notified of the disqualification and ordered to immediately 571.6 remove the individual from any position allowing direct contact 571.7 with persons receiving services from the license holder. 571.8 (3) The individual does not pose an imminent risk of harm 571.9 or a risk of harm requiring continuous supervision while 571.10 providing direct contact services during the period in which the 571.11 subject may request a reconsideration. If the commissioner 571.12 determines that an individual studied does not pose a risk of 571.13 harm that requires continuous supervision, only the individual 571.14 must be sent a notice of disqualification. The license holder 571.15 must be sent a notice that more time is needed to complete the 571.16 individual's background study. If the individual studied 571.17 submits a timely request for reconsideration, and if the 571.18 disqualification is set aside for that license holder, the 571.19 license holder will receive the same notification received by 571.20 license holders in cases where the individual studied has no 571.21 disqualifying characteristic. If the individual studied does 571.22 not submit a timely request for reconsideration, or the 571.23 individual submits a timely request for reconsideration, but the 571.24 disqualification is not set aside for that license holder, the 571.25 license holder will be notified of the disqualification and 571.26 ordered to immediately remove the individual from any position 571.27 allowing direct contact with persons receiving services from the 571.28 license holder. 571.29 (c) County licensing agencies performing duties under this 571.30 subdivision may develop an alternative system for determining 571.31 the subject's immediate risk of harm to persons served by the 571.32 program, providing the notices under paragraph (b), and 571.33 documenting the action taken by the county licensing agency. 571.34 Each county licensing agency's implementation of the alternative 571.35 system is subject to approval by the commissioner. 571.36 Notwithstanding this alternative system, county licensing 572.1 agencies shall complete the requirements of paragraph (a). 572.2 Sec. 7. Minnesota Statutes 2000, section 245A.04, 572.3 subdivision 3b, is amended to read: 572.4 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 572.5 individual who is the subject of the disqualification may 572.6 request a reconsideration of the disqualification. 572.7 The individual must submit the request for reconsideration 572.8 to the commissioner in writing. A request for reconsideration 572.9 for an individual who has been sent a notice of disqualification 572.10 under subdivision 3a, paragraph (b), clause (1) or (2), must be 572.11 submitted within 30 calendar days of the disqualified 572.12 individual's receipt of the notice of disqualification. A 572.13 request for reconsideration for an individual who has been sent 572.14 a notice of disqualification under subdivision 3a, paragraph 572.15 (b), clause (3), must be submitted within 15 calendar days of 572.16 the disqualified individual's receipt of the notice of 572.17 disqualification. An individual who was determined to have 572.18 maltreated a child under section 626.556 or a vulnerable adult 572.19 under section 626.557, and who was disqualified under this 572.20 section on the basis of serious or recurring maltreatment, may 572.21 request reconsideration of both the maltreatment and the 572.22 disqualification determinations. The request for 572.23 reconsideration of the maltreatment determination and the 572.24 disqualification must be submitted within 30 calendar days of 572.25 the individual's receipt of the notice of disqualification. 572.26 Removal of a disqualified individual from direct contact shall 572.27 be ordered if the individual does not request reconsideration 572.28 within the prescribed time, and for an individual who submits a 572.29 timely request for reconsideration, if the disqualification is 572.30 not set aside. The individual must present information showing 572.31 that: 572.32 (1) the information the commissioner relied upon is 572.33 incorrect or inaccurate. If the basis of a reconsideration 572.34 request is that a maltreatment determination or disposition 572.35 under section 626.556 or 626.557 is incorrect, and the 572.36 commissioner has issued a final order in an appeal of that 573.1 determination or disposition under section 256.045 or 245A.08, 573.2 subdivision 5, the commissioner's order is conclusive on the 573.3 issue of maltreatment. If the individual did not request 573.4 reconsideration of the maltreatment determination, the 573.5 maltreatment determination is deemed conclusive; or 573.6 (2) the subject of the study does not pose a risk of harm 573.7 to any person served by the applicantor, license holder, or 573.8 registrant under section 144A.71, subdivision 1. 573.9 (b) The commissioner shall rescind the disqualification if 573.10 the commissioner finds that the information relied on to 573.11 disqualify the subject is incorrect. The commissioner may set 573.12 aside the disqualification under this section if the 573.13 commissioner finds that theinformation the commissioner relied573.14upon is incorrect or theindividual does not pose a risk of harm 573.15 to any person served by the applicantor, license holder, or 573.16 registrant under section 144A.71, subdivision 1. In determining 573.17 that an individual does not pose a risk of harm, the 573.18 commissioner shall consider the consequences of the event or 573.19 events that lead to disqualification, whether there is more than 573.20 one disqualifying event, the vulnerability of the victim at the 573.21 time of the event, the time elapsed without a repeat of the same 573.22 or similar event, documentation of successful completion by the 573.23 individual studied of training or rehabilitation pertinent to 573.24 the event, and any other information relevant to 573.25 reconsideration. In reviewing a disqualification under this 573.26 section, the commissioner shall give preeminent weight to the 573.27 safety of each person to be served by the license holderor, 573.28 applicant, or registrant under section 144A.71, subdivision 1, 573.29 over the interests of the license holderor, applicant, or 573.30 registrant under section 144A.71, subdivision 1. 573.31 (c) Unless the information the commissioner relied on in 573.32 disqualifying an individual is incorrect, the commissioner may 573.33 not set aside the disqualification of an individual in 573.34 connection with a license to provide family day care for 573.35 children, foster care for children in the provider's own home, 573.36 or foster care or day care services for adults in the provider's 574.1 own home if: 574.2 (1) less than ten years have passed since the discharge of 574.3 the sentence imposed for the offense; and the individual has 574.4 been convicted of a violation of any offense listed in sections 574.5 609.20 (manslaughter in the first degree), 609.205 (manslaughter 574.6 in the second degree), criminal vehicular homicide under 609.21 574.7 (criminal vehicular homicide and injury), 609.215 (aiding 574.8 suicide or aiding attempted suicide), felony violations under 574.9 609.221 to 609.2231 (assault in the first, second, third, or 574.10 fourth degree), 609.713 (terroristic threats), 609.235 (use of 574.11 drugs to injure or to facilitate crime), 609.24 (simple 574.12 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 574.13 609.255 (false imprisonment), 609.561 or 609.562 (arson in the 574.14 first or second degree), 609.71 (riot), burglary in the first or 574.15 second degree under 609.582 (burglary), 609.66 (dangerous 574.16 weapon), 609.665 (spring guns), 609.67 (machine guns and 574.17 short-barreled shotguns), 609.749 (harassment; stalking), 574.18 152.021 or 152.022 (controlled substance crime in the first or 574.19 second degree), 152.023, subdivision 1, clause (3) or (4), or 574.20 subdivision 2, clause (4) (controlled substance crime in the 574.21 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 574.22 (controlled substance crime in the fourth degree), 609.224, 574.23 subdivision 2, paragraph (c) (fifth-degree assault by a 574.24 caregiver against a vulnerable adult), 609.228 (great bodily 574.25 harm caused by distribution of drugs), 609.23 (mistreatment of 574.26 persons confined), 609.231 (mistreatment of residents or 574.27 patients), 609.2325 (criminal abuse of a vulnerable adult), 574.28 609.233 (criminal neglect of a vulnerable adult), 609.2335 574.29 (financial exploitation of a vulnerable adult), 609.234 (failure 574.30 to report), 609.265 (abduction), 609.2664 to 609.2665 574.31 (manslaughter of an unborn child in the first or second degree), 574.32 609.267 to 609.2672 (assault of an unborn child in the first, 574.33 second, or third degree), 609.268 (injury or death of an unborn 574.34 child in the commission of a crime), 617.293 (disseminating or 574.35 displaying harmful material to minors), a gross misdemeanor 574.36 offense under 609.324, subdivision 1 (other prohibited acts), a 575.1 gross misdemeanor offense under 609.378 (neglect or endangerment 575.2 of a child), a gross misdemeanor offense under 609.377 575.3 (malicious punishment of a child), 609.72, subdivision 3 575.4 (disorderly conduct against a vulnerable adult); or an attempt 575.5 or conspiracy to commit any of these offenses, as each of these 575.6 offenses is defined in Minnesota Statutes; or an offense in any 575.7 other state, the elements of which are substantially similar to 575.8 the elements of any of the foregoing offenses; 575.9 (2) regardless of how much time has passed since the 575.10 discharge of the sentence imposed for the offense, the 575.11 individual was convicted of a violation of any offense listed in 575.12 sections 609.185 to 609.195 (murder in the first, second, or 575.13 third degree), 609.2661 to 609.2663 (murder of an unborn child 575.14 in the first, second, or third degree), a felony offense under 575.15 609.377 (malicious punishment of a child), a felony offense 575.16 under 609.324, subdivision 1 (other prohibited acts), a felony 575.17 offense under 609.378 (neglect or endangerment of a child), 575.18 609.322 (solicitation, inducement, and promotion of 575.19 prostitution), 609.342 to 609.345 (criminal sexual conduct in 575.20 the first, second, third, or fourth degree), 609.352 575.21 (solicitation of children to engage in sexual conduct), 617.246 575.22 (use of minors in a sexual performance), 617.247 (possession of 575.23 pictorial representations of a minor), 609.365 (incest), a 575.24 felony offense under sections 609.2242 and 609.2243 (domestic 575.25 assault), a felony offense of spousal abuse, a felony offense of 575.26 child abuse or neglect, a felony offense of a crime against 575.27 children, or an attempt or conspiracy to commit any of these 575.28 offenses as defined in Minnesota Statutes, or an offense in any 575.29 other state, the elements of which are substantially similar to 575.30 any of the foregoing offenses; 575.31 (3) within the seven years preceding the study, the 575.32 individual committed an act that constitutes maltreatment of a 575.33 child under section 626.556, subdivision 10e, and that resulted 575.34 in substantial bodily harm as defined in section 609.02, 575.35 subdivision 7a, or substantial mental or emotional harm as 575.36 supported by competent psychological or psychiatric evidence; or 576.1 (4) within the seven years preceding the study, the 576.2 individual was determined under section 626.557 to be the 576.3 perpetrator of a substantiated incident of maltreatment of a 576.4 vulnerable adult that resulted in substantial bodily harm as 576.5 defined in section 609.02, subdivision 7a, or substantial mental 576.6 or emotional harm as supported by competent psychological or 576.7 psychiatric evidence. 576.8 In the case of any ground for disqualification under 576.9 clauses (1) to (4), if the act was committed by an individual 576.10 other than the applicantor, license holder, or registrant under 576.11 section 144A.71, subdivision 1, residing in the applicant's or 576.12 license holder's home, or the home of a registrant under section 576.13 144A.71, subdivision 1, the applicantor, license holder, or 576.14 registrant under section 144A.71, subdivision 1, may seek 576.15 reconsideration when the individual who committed the act no 576.16 longer resides in the home. 576.17 The disqualification periods provided under clauses (1), 576.18 (3), and (4) are the minimum applicable disqualification 576.19 periods. The commissioner may determine that an individual 576.20 should continue to be disqualified from licensure or 576.21 registration under section 144A.71, subdivision 1, because the 576.22 license holderor, applicant, or registrant under section 576.23 144A.71, subdivision 1, poses a risk of harm to a person served 576.24 by that individual after the minimum disqualification period has 576.25 passed. 576.26 (d) The commissioner shall respond in writing or by 576.27 electronic transmission to all reconsideration requests for 576.28 which the basis for the request is that the information relied 576.29 upon by the commissioner to disqualify is incorrect or 576.30 inaccurate within 30 working days of receipt of a request and 576.31 all relevant information. If the basis for the request is that 576.32 the individual does not pose a risk of harm, the commissioner 576.33 shall respond to the request within 15 working days after 576.34 receiving the request for reconsideration and all relevant 576.35 information. If the request is based on both the correctness or 576.36 accuracy of the information relied on to disqualify the 577.1 individual and the risk of harm, the commissioner shall respond 577.2 to the request within 45 working days after receiving the 577.3 request for reconsideration and all relevant information. If 577.4 the disqualification is set aside, the commissioner shall notify 577.5 the applicant or license holder in writing or by electronic 577.6 transmission of the decision. 577.7 (e) Except as provided in subdivision 3c,the577.8commissioner's decision to disqualify an individual, including577.9the decision to grant or deny a rescission or set aside a577.10disqualification under this section, is the final administrative577.11agency action and shall not be subject to further review in a577.12contested case under chapter 14 involving a negative licensing577.13appeal taken in response to the disqualification or involving an577.14accuracy and completeness appeal under section 13.04if a 577.15 disqualification is not set aside or is not rescinded, an 577.16 individual who was disqualified on the basis of a preponderance 577.17 of evidence that the individual committed an act or acts that 577.18 meet the definition of any of the crimes lists in subdivision 577.19 3d, paragraph (a), clauses (1) to (4); or for failure to make 577.20 required reports under section 626.556, subdivision 3, or 577.21 626.557, subdivision 3, pursuant to subdivision 3d, paragraph 577.22 (a), clause (4), may request a fair hearing under section 577.23 256.045. Except as provided under subdivision 3c, the 577.24 commissioner's final order for an individual under this 577.25 paragraph is conclusive on the issue of maltreatment and 577.26 disqualification, including for purposes of subsequent studies 577.27 conducted under subdivision 3, and is the only administrative 577.28 appeal of the final agency determination, specifically, 577.29 including a challenge to the accuracy and completeness of data 577.30 under section 13.04. 577.31 (f) Except as provided under subdivision 3c, if an 577.32 individual was disqualified on the basis of a determination of 577.33 maltreatment under section 626.556 or 626.557, which was serious 577.34 or recurring, and the individual has requested reconsideration 577.35 of the maltreatment determination under section 626.556, 577.36 subdivision 10i, or 626.557, subdivision 9d, and also requested 578.1 reconsideration of the disqualification under this subdivision, 578.2 reconsideration of the maltreatment determination and 578.3 reconsideration of the disqualification shall be consolidated 578.4 into a single reconsideration. For maltreatment and 578.5 disqualification determinations made by county agencies, the 578.6 consolidated reconsideration shall be conducted by the county 578.7 agency. Except as provided under subdivision 3c, if an 578.8 individual who was disqualified on the basis of serious or 578.9 recurring maltreatment requests a fair hearing on the 578.10 maltreatment determination under section 626.556, subdivision 578.11 10i, or 626.557, subdivision 9d, the scope of the fair hearing 578.12 under section 256.045 shall include the maltreatment 578.13 determination and the disqualification. Except as provided 578.14 under subdivision 3c, the commissioner's final order for an 578.15 individual under this paragraph is conclusive on the issue of 578.16 maltreatment and disqualification, including for purposes of 578.17 subsequent studies conducted under subdivision 3, and is the 578.18 only administrative appeal of the final agency determination, 578.19 specifically, including a challenge to the accuracy and 578.20 completeness of data under section 13.04. 578.21 Sec. 8. Minnesota Statutes 2000, section 245A.04, 578.22 subdivision 3c, is amended to read: 578.23 Subd. 3c. [CONTESTED CASE.] (a) Notwithstanding 578.24 subdivision 3b, paragraphs (e) and (f), if a disqualification is 578.25 not set aside, a person who is an employee of an employer, as 578.26 defined in section 179A.03, subdivision 15, may request a 578.27 contested case hearing under chapter 14. If the 578.28 disqualification which was not set aside or was not rescinded 578.29 was based on a maltreatment determination, the scope of the 578.30 contested case hearing includes the maltreatment determination 578.31 and the disqualification. In such cases, a fair hearing shall 578.32 not be conducted under section 256.045. Rules adopted under 578.33 this chapter may not preclude an employee in a contested case 578.34 hearing for disqualification from submitting evidence concerning 578.35 information gathered under subdivision 3, paragraph (e). 578.36 (b) If a disqualification for which reconsideration was 579.1 requested and which was not set aside or was not rescinded under 579.2 subdivision 3b is the basis for a denial of a license under 579.3 section 245A.05 or a licensing sanction under section 245A.07, 579.4 the license holder has the right to a contested case hearing 579.5 under chapter 14 and Minnesota Rules, parts 1400.8550 to 579.6 1400.8612. The appeal must be submitted in accordance with 579.7 section 245A.05 or 245A.07, subdivision 3. As provided for 579.8 under section 245A.08, subdivision 2a, the scope of the 579.9 consolidated contested case hearing shall include the 579.10 disqualification and the licensing sanction or denial of a 579.11 license. If the disqualification was based on a determination 579.12 of substantiated serious or recurring maltreatment under section 579.13 626.556 or 626.557, the appeal must be submitted in accordance 579.14 with sections 245A.07, subdivision 3, and 626.556, subdivision 579.15 10i, or 626.557, subdivision 9d. As provided for under section 579.16 245A.08, subdivision 2a, the scope of the contested case hearing 579.17 shall include the maltreatment determination, the 579.18 disqualification, and the licensing sanction or denial of a 579.19 license. In such cases, a fair hearing shall not be conducted 579.20 under section 256.045. 579.21 (c) If a maltreatment determination or disqualification, 579.22 which was not set aside or was not rescinded under subdivision 579.23 3b, is the basis for a denial of a license under section 245A.05 579.24 or a licensing sanction under section 245A.07, and the 579.25 disqualified subject is an individual other than the license 579.26 holder and upon whom a background study must be conducted under 579.27 subdivision 3, the hearing of all parties may be consolidated 579.28 into a single contested case hearing upon consent of all parties 579.29 and the administrative law judge. 579.30 (d) The commissioner's final order under section 245A.08, 579.31 subdivision 5, is conclusive on the issue of maltreatment and 579.32 disqualification, including for purposes of subsequent 579.33 background studies. The contested case hearing under this 579.34 subdivision is the only administrative appeal of the final 579.35 agency determination, specifically, including a challenge to the 579.36 accuracy and completeness of data under section 13.04. 580.1 Sec. 9. Minnesota Statutes 2000, section 245A.04, 580.2 subdivision 3d, is amended to read: 580.3 Subd. 3d. [DISQUALIFICATION.] (a) Except as provided in 580.4 paragraph (b), when a background study completed under 580.5 subdivision 3 shows any of the following: a conviction of one 580.6 or more crimes listed in clauses (1) to (4); the individual has 580.7 admitted to or a preponderance of the evidence indicates the 580.8 individual has committed an act or acts that meet the definition 580.9 of any of the crimes listed in clauses (1) to (4); or an 580.10 investigation results in an administrative determination listed 580.11 under clause (4), the individual shall be disqualified from any 580.12 position allowing direct contact with persons receiving services 580.13 from the license holder, or registrant under section 144A.71, 580.14 subdivision 1, and for individuals studied under section 580.15 245A.04, subdivision 3, paragraph (c), clauses (2), (6), and 580.16 (7), the individual shall also be disqualified from access to a 580.17 person receiving services from the license holder: 580.18 (1) regardless of how much time has passed since the 580.19 discharge of the sentence imposed for the offense, and unless 580.20 otherwise specified, regardless of the level of the conviction, 580.21 the individual was convicted of any of the following offenses: 580.22 sections 609.185 (murder in the first degree); 609.19 (murder in 580.23 the second degree); 609.195 (murder in the third degree); 580.24 609.2661 (murder of an unborn child in the first degree); 580.25 609.2662 (murder of an unborn child in the second degree); 580.26 609.2663 (murder of an unborn child in the third degree); 580.27 609.322 (solicitation, inducement, and promotion of 580.28 prostitution); 609.342 (criminal sexual conduct in the first 580.29 degree); 609.343 (criminal sexual conduct in the second degree); 580.30 609.344 (criminal sexual conduct in the third degree); 609.345 580.31 (criminal sexual conduct in the fourth degree); 609.352 580.32 (solicitation of children to engage in sexual conduct); 609.365 580.33 (incest); felony offense under 609.377 (malicious punishment of 580.34 a child); a felony offense under 609.378 (neglect or 580.35 endangerment of a child); a felony offense under 609.324, 580.36 subdivision 1 (other prohibited acts); 617.246 (use of minors in 581.1 sexual performance prohibited); 617.247 (possession of pictorial 581.2 representations of minors); a felony offense under sections 581.3 609.2242 and 609.2243 (domestic assault), a felony offense of 581.4 spousal abuse, a felony offense of child abuse or neglect, a 581.5 felony offense of a crime against children; or attempt or 581.6 conspiracy to commit any of these offenses as defined in 581.7 Minnesota Statutes, or an offense in any other state or country, 581.8 where the elements are substantially similar to any of the 581.9 offenses listed in this clause; 581.10 (2) if less than 15 years have passed since the discharge 581.11 of the sentence imposed for the offense; and the individual has 581.12 received a felony conviction for a violation of any of these 581.13 offenses: sections 609.20 (manslaughter in the first degree); 581.14 609.205 (manslaughter in the second degree); 609.21 (criminal 581.15 vehicular homicide and injury); 609.215 (suicide); 609.221 to 581.16 609.2231 (assault in the first, second, third, or fourth 581.17 degree); repeat offenses under 609.224 (assault in the fifth 581.18 degree); repeat offenses under 609.3451 (criminal sexual conduct 581.19 in the fifth degree); 609.713 (terroristic threats); 609.235 581.20 (use of drugs to injure or facilitate crime); 609.24 (simple 581.21 robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 581.22 609.255 (false imprisonment); 609.561 (arson in the first 581.23 degree); 609.562 (arson in the second degree); 609.563 (arson in 581.24 the third degree); repeat offenses under 617.23 (indecent 581.25 exposure; penalties); repeat offenses under 617.241 (obscene 581.26 materials and performances; distribution and exhibition 581.27 prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 581.28 609.67 (machine guns and short-barreled shotguns); 609.749 581.29 (harassment; stalking; penalties); 609.228 (great bodily harm 581.30 caused by distribution of drugs); 609.2325 (criminal abuse of a 581.31 vulnerable adult); 609.2664 (manslaughter of an unborn child in 581.32 the first degree); 609.2665 (manslaughter of an unborn child in 581.33 the second degree); 609.267 (assault of an unborn child in the 581.34 first degree); 609.2671 (assault of an unborn child in the 581.35 second degree); 609.268 (injury or death of an unborn child in 581.36 the commission of a crime); 609.52 (theft); 609.2335 (financial 582.1 exploitation of a vulnerable adult); 609.521 (possession of 582.2 shoplifting gear); 609.582 (burglary); 609.625 (aggravated 582.3 forgery); 609.63 (forgery); 609.631 (check forgery; offering a 582.4 forged check); 609.635 (obtaining signature by false pretense); 582.5 609.27 (coercion); 609.275 (attempt to coerce); 609.687 582.6 (adulteration); 260C.301 (grounds for termination of parental 582.7 rights); and chapter 152 (drugs; controlled substance). An 582.8 attempt or conspiracy to commit any of these offenses, as each 582.9 of these offenses is defined in Minnesota Statutes; or an 582.10 offense in any other state or country, the elements of which are 582.11 substantially similar to the elements of the offenses in this 582.12 clause. If the individual studied is convicted of one of the 582.13 felonies listed in this clause, but the sentence is a gross 582.14 misdemeanor or misdemeanor disposition, the lookback period for 582.15 the conviction is the period applicable to the disposition, that 582.16 is the period for gross misdemeanors or misdemeanors; 582.17 (3) if less than ten years have passed since the discharge 582.18 of the sentence imposed for the offense; and the individual has 582.19 received a gross misdemeanor conviction for a violation of any 582.20 of the following offenses: sections 609.224 (assault in the 582.21 fifth degree); 609.2242 and 609.2243 (domestic assault); 582.22 violation of an order for protection under 518B.01, subdivision 582.23 14; 609.3451 (criminal sexual conduct in the fifth degree); 582.24 repeat offenses under 609.746 (interference with privacy); 582.25 repeat offenses under 617.23 (indecent exposure); 617.241 582.26 (obscene materials and performances); 617.243 (indecent 582.27 literature, distribution); 617.293 (harmful materials; 582.28 dissemination and display to minors prohibited); 609.71 (riot); 582.29 609.66 (dangerous weapons); 609.749 (harassment; stalking; 582.30 penalties); 609.224, subdivision 2, paragraph (c) (assault in 582.31 the fifth degree by a caregiver against a vulnerable adult); 582.32 609.23 (mistreatment of persons confined); 609.231 (mistreatment 582.33 of residents or patients); 609.2325 (criminal abuse of a 582.34 vulnerable adult); 609.233 (criminal neglect of a vulnerable 582.35 adult); 609.2335 (financial exploitation of a vulnerable adult); 582.36 609.234 (failure to report maltreatment of a vulnerable adult); 583.1 609.72, subdivision 3 (disorderly conduct against a vulnerable 583.2 adult); 609.265 (abduction); 609.378 (neglect or endangerment of 583.3 a child); 609.377 (malicious punishment of a child); 609.324, 583.4 subdivision 1a (other prohibited acts; minor engaged in 583.5 prostitution); 609.33 (disorderly house); 609.52 (theft); 583.6 609.582 (burglary); 609.631 (check forgery; offering a forged 583.7 check); 609.275 (attempt to coerce); or an attempt or conspiracy 583.8 to commit any of these offenses, as each of these offenses is 583.9 defined in Minnesota Statutes; or an offense in any other state 583.10 or country, the elements of which are substantially similar to 583.11 the elements of any of the offenses listed in this clause. If 583.12 the defendant is convicted of one of the gross misdemeanors 583.13 listed in this clause, but the sentence is a misdemeanor 583.14 disposition, the lookback period for the conviction is the 583.15 period applicable to misdemeanors; or 583.16 (4) if less than seven years have passed since the 583.17 discharge of the sentence imposed for the offense; and the 583.18 individual has received a misdemeanor conviction for a violation 583.19 of any of the following offenses: sections 609.224 (assault in 583.20 the fifth degree); 609.2242 (domestic assault); violation of an 583.21 order for protection under 518B.01 (Domestic Abuse Act); 583.22 violation of an order for protection under 609.3232 (protective 583.23 order authorized; procedures; penalties); 609.746 (interference 583.24 with privacy); 609.79 (obscene or harassing phone calls); 583.25 609.795 (letter, telegram, or package; opening; harassment); 583.26 617.23 (indecent exposure; penalties); 609.2672 (assault of an 583.27 unborn child in the third degree); 617.293 (harmful materials; 583.28 dissemination and display to minors prohibited); 609.66 583.29 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 583.30 exploitation of a vulnerable adult); 609.234 (failure to report 583.31 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 583.32 (coercion); or an attempt or conspiracy to commit any of these 583.33 offenses, as each of these offenses is defined in Minnesota 583.34 Statutes; or an offense in any other state or country, the 583.35 elements of which are substantially similar to the elements of 583.36 any of the offenses listed in this clause; failure to make 584.1 required reports under section 626.556, subdivision 3, or 584.2 626.557, subdivision 3, for incidents in which: (i) the final 584.3 disposition under section 626.556 or 626.557 was substantiated 584.4 maltreatment, and (ii) the maltreatment was recurring or 584.5 serious; or substantiated serious or recurring maltreatment of a 584.6 minor under section 626.556 or of a vulnerable adult under 584.7 section 626.557 for which there is a preponderance of evidence 584.8 that the maltreatment occurred, and that the subject was 584.9 responsible for the maltreatment. 584.10 For the purposes of this section, "serious maltreatment" 584.11 means sexual abuse; maltreatment resulting in death; or 584.12 maltreatment resulting in serious injury which reasonably 584.13 requires the care of a physician whether or not the care of a 584.14 physician was sought; or abuse resulting in serious injury. For 584.15 purposes of this section, "abuse resulting in serious injury" 584.16 means: bruises, bites, skin laceration or tissue damage; 584.17 fractures; dislocations; evidence of internal injuries; head 584.18 injuries with loss of consciousness; extensive second-degree or 584.19 third-degree burns and other burns for which complications are 584.20 present; extensive second-degree or third-degree frostbite, and 584.21 others for which complications are present; irreversible 584.22 mobility or avulsion of teeth; injuries to the eyeball; 584.23 ingestion of foreign substances and objects that are harmful; 584.24 near drowning; and heat exhaustion or sunstroke. For purposes 584.25 of this section, "care of a physician" is treatment received or 584.26 ordered by a physician, but does not include diagnostic testing, 584.27 assessment, or observation. For the purposes of this section, 584.28 "recurring maltreatment" means more than one incident of 584.29 maltreatment for which there is a preponderance of evidence that 584.30 the maltreatment occurred, and that the subject was responsible 584.31 for the maltreatment. For purposes of this section, "access" 584.32 means physical access to an individual receiving services or the 584.33 individual's personal property without continuous, direct 584.34 supervision as defined in section 245A.04, subdivision 3. 584.35 (b)IfExcept for background studies related to child 584.36 foster care, adult foster care, or family child care licensure, 585.1 when the subject of a background study islicensedregulated by 585.2 a health-related licensing board as defined in chapter 214, and 585.3 the regulated person has been determined to have been 585.4 responsible for substantiated maltreatment under section 626.556 585.5 or 626.557, instead of the commissioner making a decision 585.6 regarding disqualification, the board shall makethea 585.7 determinationregarding a disqualification under this585.8subdivision based on a finding of substantiated maltreatment585.9under section 626.556 or 626.557. The commissioner shall notify585.10the health-related licensing board if a background study shows585.11that a licensee would be disqualified because of substantiated585.12maltreatment and the board shall make a determination under585.13section 214.104.whether to impose disciplinary or corrective 585.14 action under chapter 214. 585.15 (1) The commissioner shall notify the health-related 585.16 licensing board: 585.17 (i) upon completion of a background study that produces a 585.18 record showing that the individual was determined to have been 585.19 responsible for substantiated maltreatment; 585.20 (ii) upon the commissioner's completion of an investigation 585.21 that determined the individual was responsible for substantiated 585.22 maltreatment; or 585.23 (iii) upon receipt from another agency of a finding of 585.24 substantiated maltreatment for which the individual was 585.25 responsible. 585.26 (2) The commissioner's notice shall indicate whether the 585.27 individual would have been disqualified by the commissioner for 585.28 the substantiated maltreatment if the individual were not 585.29 regulated by the board. The commissioner shall concurrently 585.30 send this notice to the individual. 585.31 (3) Notwithstanding the exclusion from this subdivision for 585.32 individuals who provide child foster care, adult foster care, or 585.33 family child care, when the commissioner or a local agency has 585.34 reason to believe that the direct contact services provided by 585.35 the individual may fall within the jurisdiction of a 585.36 health-related licensing board, a referral shall be made to the 586.1 board as provided in this section. 586.2 (4) If, upon review of the information provided by the 586.3 commissioner, a health-related licensing board informs the 586.4 commissioner that the board does not have jurisdiction to take 586.5 disciplinary or corrective action, the commissioner shall make 586.6 the appropriate disqualification decision regarding the 586.7 individual as otherwise provided in this chapter. 586.8 (5) The commissioner has the authority to monitor the 586.9 facility's compliance with any requirements that the 586.10 health-related licensing board places on regulated persons 586.11 practicing in a facility either during the period pending a 586.12 final decision on a disciplinary or corrective action or as a 586.13 result of a disciplinary or corrective action. The commissioner 586.14 has the authority to order the immediate removal of a regulated 586.15 person from direct contact or access when a board issues an 586.16 order of temporary suspension based on a determination that the 586.17 regulated person poses an immediate risk of harm to persons 586.18 receiving services in a licensed facility. 586.19 (6) A facility that allows a regulated person to provide 586.20 direct contact services while not complying with the 586.21 requirements imposed by the health-related licensing board is 586.22 subject to action by the commissioner as specified under 586.23 sections 245A.06 and 245A.07. 586.24 (7) The commissioner shall notify a health-related 586.25 licensing board immediately upon receipt of knowledge of 586.26 noncompliance with requirements placed on a facility or upon a 586.27 person regulated by the board. 586.28 Sec. 10. Minnesota Statutes 2000, section 245A.05, is 586.29 amended to read: 586.30 245A.05 [DENIAL OF APPLICATION.] 586.31 The commissioner may deny a license if an applicant fails 586.32 to comply with applicable laws or rules, or knowingly withholds 586.33 relevant information from or gives false or misleading 586.34 information to the commissioner in connection with an 586.35 application for a license or during an investigation. An 586.36 applicant whose application has been denied by the commissioner 587.1 must be given notice of the denial. Notice must be given by 587.2 certified mail. The notice must state the reasons the 587.3 application was denied and must inform the applicant of the 587.4 right to a contested case hearing under chapter 14 and Minnesota 587.5 Rules, parts 1400.8550 to 1400.8612. The applicant may appeal 587.6 the denial by notifying the commissioner in writing by certified 587.7 mail within 20 calendar days after receiving notice that the 587.8 application was denied. Section 245A.08 applies to hearings 587.9 held to appeal the commissioner's denial of an application. 587.10 Sec. 11. Minnesota Statutes 2000, section 245A.06, is 587.11 amended to read: 587.12 245A.06 [CORRECTION ORDER ANDFINESCONDITIONAL LICENSE.] 587.13 Subdivision 1. [CONTENTS OF CORRECTION ORDERSOR FINESAND 587.14 CONDITIONAL LICENSES.] (a) If the commissioner finds that the 587.15 applicant or license holder has failed to comply with an 587.16 applicable law or rule and this failure does not imminently 587.17 endanger the health, safety, or rights of the persons served by 587.18 the program, the commissioner may issue a correction order and 587.19 an order of conditional license toor impose a fine onthe 587.20 applicant or license holder. When issuing a conditional 587.21 license, the commissioner shall consider the nature, chronicity, 587.22 or severity of the violation of law or rule and the effect of 587.23 the violation on the health, safety, or rights of persons served 587.24 by the program. The correction order orfineconditional 587.25 license must state: 587.26 (1) the conditions that constitute a violation of the law 587.27 or rule; 587.28 (2) the specific law or rule violated; 587.29 (3) the time allowed to correct each violation; and 587.30 (4) if afine is imposed, the amount of the finelicense is 587.31 made conditional, the length and terms of the conditional 587.32 license. 587.33 (b) Nothing in this section prohibits the commissioner from 587.34 proposing a sanction as specified in section 245A.07, prior to 587.35 issuing a correction order orfineconditional license. 587.36 Subd. 2. [RECONSIDERATION OF CORRECTION ORDERS.] If the 588.1 applicant or license holder believes that the contents of the 588.2 commissioner's correction order are in error, the applicant or 588.3 license holder may ask the department of human services to 588.4 reconsider the parts of the correction order that are alleged to 588.5 be in error. The request for reconsideration must be in writing 588.6 and received by the commissioner within 20 calendar days after 588.7 receipt of the correction order by the applicant or license 588.8 holder, and: 588.9 (1) specify the parts of the correction order that are 588.10 alleged to be in error; 588.11 (2) explain why they are in error; and 588.12 (3) include documentation to support the allegation of 588.13 error. 588.14 A request for reconsideration does not stay any provisions 588.15 or requirements of the correction order. The commissioner's 588.16 disposition of a request for reconsideration is final and not 588.17 subject to appeal under chapter 14. 588.18 Subd. 3. [FAILURE TO COMPLY.] If the commissioner finds 588.19 that the applicant or license holder has not corrected the 588.20 violations specified in the correction order or conditional 588.21 license, the commissioner may impose a fine and order other 588.22 licensing sanctions pursuant to section 245A.07.If a fine was588.23imposed and the violation was not corrected, the commissioner588.24may impose an additional fine. This section does not prohibit588.25the commissioner from seeking a court order, denying an588.26application, or suspending, revoking, or making conditional the588.27license in addition to imposing a fine.588.28 Subd. 4. [NOTICE OFFINECONDITIONAL LICENSE; 588.29 RECONSIDERATION OFFINECONDITIONAL LICENSE.]A license holder588.30who is ordered to pay a fineIf a license is made conditional, 588.31 the license holder must be notified of the order by certified 588.32 mail. The notice must be mailed to the address shown on the 588.33 application or the last known address of the license holder. 588.34 The notice must state the reasons thefineconditional license 588.35 was ordered and must inform the license holder of the 588.36responsibility for payment of fines in subdivision 7 and the589.1 right to request reconsideration of thefineconditional license 589.2 by the commissioner. The license holder may request 589.3 reconsideration of the orderto forfeit a fineof conditional 589.4 license by notifying the commissioner by certified mailwithin589.520 calendar days after receiving the order. The request must be 589.6 in writing and must be received by the commissioner within ten 589.7 calendar days after the license holder received the order. The 589.8 license holder may submit with the request for reconsideration 589.9 written argument or evidence in support of the request for 589.10 reconsideration. A timely request for reconsideration shall 589.11 stayforfeiture of the fineimposition of the terms of the 589.12 conditional license until the commissioner issues a decision on 589.13 the request for reconsideration.The request for589.14reconsideration must be in writing and:589.15(1) specify the parts of the violation that are alleged to589.16be in error;589.17(2) explain why they are in error;589.18(3) include documentation to support the allegation of589.19error; and589.20(4) any other information relevant to the fine or the589.21amount of the fine.589.22 The commissioner's disposition of a request for 589.23 reconsideration is final and not subject to appeal under chapter 589.24 14. 589.25Subd. 5. [FORFEITURE OF FINES.] The license holder shall589.26pay the fines assessed on or before the payment date specified589.27in the commissioner's order. If the license holder fails to589.28fully comply with the order, the commissioner shall issue a589.29second fine or suspend the license until the license holder589.30complies. If the license holder receives state funds, the589.31state, county, or municipal agencies or departments responsible589.32for administering the funds shall withhold payments and recover589.33any payments made while the license is suspended for failure to589.34pay a fine.589.35Subd. 5a. [ACCRUAL OF FINES.] A license holder shall589.36promptly notify the commissioner of human services, in writing,590.1when a violation specified in an order to forfeit is corrected.590.2If upon reinspection the commissioner determines that a590.3violation has not been corrected as indicated by the order to590.4forfeit, the commissioner may issue a second fine. The590.5commissioner shall notify the license holder by certified mail590.6that a second fine has been assessed. The license holder may590.7request reconsideration of the second fine under the provisions590.8of subdivision 4.590.9Subd. 6. [AMOUNT OF FINES.] Fines shall be assessed as590.10follows:590.11(1) the license holder shall forfeit $1,000 for each590.12occurrence of violation of law or rule prohibiting the590.13maltreatment of children or the maltreatment of vulnerable590.14adults, including but not limited to corporal punishment,590.15illegal or unauthorized use of physical, mechanical, or chemical590.16restraints, and illegal or unauthorized use of aversive or590.17deprivation procedures;590.18(2) the license holder shall forfeit $200 for each590.19occurrence of a violation of law or rule governing matters of590.20health, safety, or supervision, including but not limited to the590.21provision of adequate staff to child or adult ratios; and590.22(3) the license holder shall forfeit $100 for each590.23occurrence of a violation of law or rule other than those590.24included in clauses (1) and (2).590.25For the purposes of this section, "occurrence" means each590.26violation identified in the commissioner's forfeiture order.590.27Subd. 7. [RESPONSIBILITY FOR PAYMENT OF FINES.] When a590.28fine has been assessed, the license holder may not avoid payment590.29by closing, selling, or otherwise transferring the licensed590.30program to a third party. In such an event, the license holder590.31will be personally liable for payment. In the case of a590.32corporation, each controlling individual is personally and590.33jointly liable for payment.590.34Fines for child care centers must be assessed according to590.35this section.590.36 Sec. 12. Minnesota Statutes 2000, section 245A.07, is 591.1 amended to read: 591.2 245A.07 [SANCTIONS.] 591.3 Subdivision 1. [SANCTIONS AVAILABLE.] In addition to 591.4ordering forfeiture of finesmaking a license conditional under 591.5 section 245A.06, the commissioner may propose to suspend,or 591.6 revoke, or make conditionalthe license, impose a fine, or 591.7 secure an injunction against the continuing operation of the 591.8 program of a license holder who does not comply with applicable 591.9 law or rule. When applying sanctions authorized under this 591.10 section, the commissioner shall consider the nature, chronicity, 591.11 or severity of the violation of law or rule and the effect of 591.12 the violation on the health, safety, or rights of persons served 591.13 by the program. 591.14 Subd. 2. [IMMEDIATE SUSPENSION IN CASES OF IMMINENT DANGER591.15TO HEALTH, SAFETY, OR RIGHTSTEMPORARY IMMEDIATE SUSPENSION.] If 591.16 the license holder's actions or failure to comply with 591.17 applicable law or rulehas placedposes an imminent risk of harm 591.18 to the health, safety, or rights of persons served by the 591.19 programin imminent danger, the commissioner shall act 591.20 immediately to temporarily suspend the license. No state funds 591.21 shall be made available or be expended by any agency or 591.22 department of state, county, or municipal government for use by 591.23 a license holder regulated under this chapter while a license is 591.24 under immediate suspension. A notice stating the reasons for 591.25 the immediate suspension and informing the license holder of the 591.26 right toa contested casean expedited hearing under chapter 591.27 14 and Minnesota Rules, parts 1400.8550 to 1400.8612, must be 591.28 delivered by personal service to the address shown on the 591.29 application or the last known address of the license holder. 591.30 The license holder may appeal an order immediately suspending a 591.31 license. The appeal of an order immediately suspending a 591.32 license must be made in writing by certified mail and must be 591.33 received by the commissioner within five calendar days after the 591.34 license holder receives notice that the license has been 591.35 immediately suspended. A license holder and any controlling 591.36 individual shall discontinue operation of the program upon 592.1 receipt of the commissioner's order to immediately suspend the 592.2 license. 592.3 Subd. 2a. [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 592.4 Within five working days of receipt of the license holder's 592.5 timely appeal, the commissioner shall request assignment of an 592.6 administrative law judge. The request must include a proposed 592.7 date, time, and place of a hearing. A hearing must be conducted 592.8 by an administrative law judge within 30 calendar days of the 592.9 request for assignment, unless an extension is requested by 592.10 either party and granted by the administrative law judge for 592.11 good cause. The commissioner shall issue a notice of hearing by 592.12 certified mail at least ten working days before the hearing. 592.13 The scope of the hearing shall be limited solely to the issue of 592.14 whether the temporary immediate suspension should remain in 592.15 effect pending the commissioner's final order under section 592.16 245A.08, regarding a licensing sanction issued under subdivision 592.17 3 following the immediate suspension. The burden of proof in 592.18 expedited hearings under this subdivision shall be limited to 592.19 the commissioner's demonstration that reasonable cause exists to 592.20 believe that the license holder's actions or failure to comply 592.21 with applicable law or rule poses an imminent risk of harm to 592.22 the health, safety, or rights of persons served by the program. 592.23 (b) The administrative law judge shall issue findings of 592.24 fact, conclusions, and a recommendation within ten working days 592.25 from the date of hearing. The commissioner's final order shall 592.26 be issued within ten working days from receipt of the 592.27 recommendation of the administrative law judge. Within 90 592.28 calendar days after a final order affirming an immediate 592.29 suspension, the commissioner shall make a determination 592.30 regarding whether a final licensing sanction shall be issued 592.31 under subdivision 3. The license holder shall continue to be 592.32 prohibited from operation of the program during this 90-day 592.33 period. 592.34 Subd. 3. [LICENSE SUSPENSION, REVOCATION,DENIALOR 592.35CONDITIONAL LICENSEFINE.] The commissioner may suspend,or 592.36 revoke, make conditional, or denya license, or impose a fine if 593.1an applicant ora license holder fails to comply fully with 593.2 applicable laws or rules, or knowingly withholds relevant 593.3 information from or gives false or misleading information to the 593.4 commissioner in connection with an application for a license or 593.5 during an investigation. A license holder who has had a license 593.6 suspended, revoked,or made conditionalor has been ordered to 593.7 pay a fine must be given notice of the action by certified 593.8 mail. The notice must be mailed to the address shown on the 593.9 application or the last known address of the license holder. 593.10 The notice must state the reasons the license was suspended, 593.11 revoked, ormade conditionala fine was ordered. 593.12 (a) If the license was suspended or revoked, the notice 593.13 must inform the license holder of the right to a contested case 593.14 hearing under chapter 14 and Minnesota Rules, parts 1400.8550 to 593.15 1400.8612. The license holder may appeal an order suspending or 593.16 revoking a license. The appeal of an order suspending or 593.17 revoking a license must be made in writing by certified mail and 593.18 must be received by the commissioner within ten calendar days 593.19 after the license holder receives notice that the license has 593.20 been suspended or revoked. 593.21 (b)If the license was made conditional, the notice must593.22inform the license holder of the right to request a593.23reconsideration by the commissioner. The request for593.24reconsideration must be made in writing by certified mail and593.25must be received by the commissioner within ten calendar days593.26after the license holder receives notice that the license has593.27been made conditional. The license holder may submit with the593.28request for reconsideration written argument or evidence in593.29support of the request for reconsideration. The commissioner's593.30disposition of a request for reconsideration is final and is not593.31subject to appeal under chapter 14(1) If the license holder was 593.32 ordered to pay a fine, the notice must inform the license holder 593.33 of the responsibility for payment of fines and the right to a 593.34 contested case hearing under chapter 14 and Minnesota Rules, 593.35 parts 1400.8550 to 1400.8612. The appeal of an order to pay a 593.36 fine must be made in writing by certified mail and must be 594.1 received by the commissioner within ten calendar days after the 594.2 license holder receives notice that the fine has been ordered. 594.3 (2) The license holder shall pay the fines assessed on or 594.4 before the payment date specified. If the license holder fails 594.5 to fully comply with the order, the commissioner may issue a 594.6 second fine or suspend the license until the license holder 594.7 complies. If the license holder receives state funds, the 594.8 state, county, or municipal agencies or departments responsible 594.9 for administering the funds shall withhold payments and recover 594.10 any payments made while the license is suspended for failure to 594.11 pay a fine. A timely appeal shall stay payment of the fine 594.12 until the commissioner issues a final order. 594.13 (3) A license holder shall promptly notify the commissioner 594.14 of human services, in writing, when a violation specified in the 594.15 order to forfeit a fine is corrected. If upon reinspection the 594.16 commissioner determines that a violation has not been corrected 594.17 as indicated by the order to forfeit a fine, the commissioner 594.18 may issue a second fine. The commissioner shall notify the 594.19 license holder by certified mail that a second fine has been 594.20 assessed. The license holder may appeal the second fine as 594.21 provided under this subdivision. 594.22 (4) Fines shall be assessed as follows: the license holder 594.23 shall forfeit $1,000 for each determination of maltreatment of a 594.24 child under section 626.556 or the maltreatment of a vulnerable 594.25 adult under section 626.557; the license holder shall forfeit 594.26 $200 for each occurrence of a violation of law or rule governing 594.27 matters of health, safety, or supervision, including, but not 594.28 limited to, the provision of adequate staff-to-child or adult 594.29 ratios and the failure to submit a background study; and the 594.30 license holder shall forfeit $100 for each occurrence of a 594.31 violation of law or rule other than those subject to a $1,000 or 594.32 $200 fine above. For purposes of this section, "occurrence" 594.33 means each violation identified in the commissioner's fine order. 594.34 (5) When a fine has been assessed, the license holder may 594.35 not avoid payment by closing, selling, or otherwise transferring 594.36 the licensed program to a third party. In such an event, the 595.1 license holder will be personally liable for payment. In the 595.2 case of a corporation, each controlling individual is personally 595.3 and jointly liable for payment. 595.4 Subd. 4. [ADOPTION AGENCY VIOLATIONS.] If a license holder 595.5 licensed to place children for adoption fails to provide 595.6 services as described in the disclosure form required by section 595.7 259.37, subdivision 2, the sanctions under this section may be 595.8 imposed. 595.9 Sec. 13. Minnesota Statutes 2000, section 245A.08, is 595.10 amended to read: 595.11 245A.08 [HEARINGS.] 595.12 Subdivision 1. [RECEIPT OF APPEAL; CONDUCT OF HEARING.] 595.13 Upon receiving a timely appeal or petition pursuant to 595.14 section 245A.04, subdivision 3c, 245A.05, or 245A.07, 595.15 subdivision 3, the commissioner shall issue a notice of and 595.16 order for hearing to the appellant under chapter 14 and 595.17 Minnesota Rules, parts 1400.8550 to 1400.8612. 595.18 Subd. 2. [CONDUCT OF HEARINGS.] At any hearing provided 595.19 for by section 245A.04, subdivision 3c, 245A.05, or 245A.07, 595.20 subdivision 3, the appellant may be represented by counsel and 595.21 has the right to call, examine, and cross-examine witnesses. 595.22 The administrative law judge may require the presence of 595.23 witnesses and evidence by subpoena on behalf of any party. 595.24 Subd. 2a. [CONSOLIDATED CONTESTED CASE HEARINGS FOR 595.25 SANCTIONS BASED ON MALTREATMENT DETERMINATIONS AND 595.26 DISQUALIFICATIONS.] (a) When a denial of a license under section 595.27 245A.05 or a licensing sanction under section 245A.07, 595.28 subdivision 3, is based on a disqualification for which 595.29 reconsideration was requested and which was not set aside or was 595.30 not rescinded under section 245A.04, subdivision 3b, the scope 595.31 of the contested case hearing shall include the disqualification 595.32 and the licensing sanction or denial of a license. When the 595.33 licensing sanction or denial of a license is based on a 595.34 determination of maltreatment under section 626.556 or 626.557, 595.35 or a disqualification for serious or recurring maltreatment 595.36 which was not set aside or was not rescinded, the scope of the 596.1 contested case hearing shall include the maltreatment 596.2 determination, disqualification, and the licensing sanction or 596.3 denial of a license. In such cases, a fair hearing under 596.4 section 256.045 shall not be conducted as provided for in 596.5 sections 626.556, subdivision 10i, and 626.557, subdivision 9d. 596.6 (b) In consolidated contested case hearings regarding 596.7 sanctions issued in family child care, child foster care, and 596.8 adult foster care, the county attorney shall defend the 596.9 commissioner's orders in accordance with section 245A.16, 596.10 subdivision 4. 596.11 (c) The commissioner's final order under subdivision 5 is 596.12 the final agency action on the issue of maltreatment and 596.13 disqualification, including for purposes of subsequent 596.14 background studies under section 245A.04, subdivision 3, and is 596.15 the only administrative appeal of the final agency 596.16 determination, specifically, including a challenge to the 596.17 accuracy and completeness of data under section 13.04. 596.18 (d) When consolidated hearings under this subdivision 596.19 involve a licensing sanction based on a previous maltreatment 596.20 determination for which the commissioner has issued a final 596.21 order in an appeal of that determination under section 256.045, 596.22 or the individual failed to exercise the right to appeal the 596.23 previous maltreatment determination under section 626.556, 596.24 subdivision 10i, or 626.557, subdivision 9d, the commissioner's 596.25 order is conclusive on the issue of maltreatment. In such 596.26 cases, the scope of the administrative law judge's review shall 596.27 be limited to the disqualification and the licensing sanction or 596.28 denial of a license. In the case of a denial of a license or a 596.29 licensing sanction issued to a facility based on a maltreatment 596.30 determination regarding an individual who is not the license 596.31 holder or a household member, the scope of the administrative 596.32 law judge's review includes the maltreatment determination. 596.33 (e) If a maltreatment determination or disqualification, 596.34 which was not set aside or was not rescinded under section 596.35 245A.04, subdivision 3b, is the basis for a denial of a license 596.36 under section 245A.05 or a licensing sanction under section 597.1 245A.07, and the disqualified subject is an individual other 597.2 than the license holder and upon whom a background study must be 597.3 conducted under section 245A.04, subdivision 3, the hearings of 597.4 all parties may be consolidated into a single contested case 597.5 hearing upon consent of all parties and the administrative law 597.6 judge. 597.7 Subd. 3. [BURDEN OF PROOF.] (a) At a hearing regarding 597.8suspension, immediate suspension, or revocation of a license for597.9family day care or foster carea licensing sanction under 597.10 section 245.07, including consolidated hearings under 597.11 subdivision 2a, the commissioner may demonstrate reasonable 597.12 cause for action taken by submitting statements, reports, or 597.13 affidavits to substantiate the allegations that the license 597.14 holder failed to comply fully with applicable law or rule. If 597.15 the commissioner demonstrates that reasonable cause existed, the 597.16 burden of proofin hearings involving suspension, immediate597.17suspension, or revocation of a family day care or foster care597.18licenseshifts to the license holder to demonstrate by a 597.19 preponderance of the evidence that the license holder was in 597.20 full compliance with those laws or rules that the commissioner 597.21 alleges the license holder violated, at the time that the 597.22 commissioner alleges the violations of law or rules occurred. 597.23 (b) At a hearing on denial of an application, the applicant 597.24 bears the burden of proof to demonstrate by a preponderance of 597.25 the evidence that the appellant has complied fully withsections597.26245A.01 to 245A.15this chapter and other applicable law or rule 597.27 and that the application should be approved and a license 597.28 granted. 597.29(c) At all other hearings under this section, the597.30commissioner bears the burden of proof to demonstrate, by a597.31preponderance of the evidence, that the violations of law or597.32rule alleged by the commissioner occurred.597.33 Subd. 4. [RECOMMENDATION OF ADMINISTRATIVE LAW JUDGE.] The 597.34 administrative law judge shall recommend whether or not the 597.35 commissioner's order should be affirmed. The recommendations 597.36 must be consistent with this chapter and the rules of the 598.1 commissioner. The recommendations must be in writing and 598.2 accompanied by findings of fact and conclusions and must be 598.3 mailed to the parties by certified mail to their last known 598.4 addresses as shown on the license or application. 598.5 Subd. 5. [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 598.6 considering the findings of fact, conclusions, and 598.7 recommendations of the administrative law judge, the 598.8 commissioner shall issue a final order. The commissioner shall 598.9 consider, but shall not be bound by, the recommendations of the 598.10 administrative law judge. The appellant must be notified of the 598.11 commissioner's final order as required by chapter 14 and 598.12 Minnesota Rules, parts 1400.8550 to 1400.8612. The notice must 598.13 also contain information about the appellant's rights under 598.14 chapter 14 and Minnesota Rules, parts 1400.8550 to 1400.8612. 598.15 The institution of proceedings for judicial review of the 598.16 commissioner's final order shall not stay the enforcement of the 598.17 final order except as provided in section 14.65. A license 598.18 holder and each controlling individual of a license holder whose 598.19 license has been revoked because of noncompliance with 598.20 applicable law or rule must not be granted a license for five 598.21 years following the revocation. An applicant whose application 598.22 was denied must not be granted a license for two years following 598.23 a denial, unless the applicant's subsequent application contains 598.24 new information which constitutes a substantial change in the 598.25 conditions that caused the previous denial. 598.26 Sec. 14. Minnesota Statutes 2000, section 245A.16, 598.27 subdivision 1, is amended to read: 598.28 Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 598.29 County agencies and private agencies that have been designated 598.30 or licensed by the commissioner to perform licensing functions 598.31 and activities under section 245A.04, to recommend denial of 598.32 applicants under section 245A.05, to issue correction orders, to 598.33 issue variances, and recommendfinesa conditional license under 598.34 section 245A.06, or to recommend suspending,or revoking, and598.35making licenses probationarya license or issuing a fine under 598.36 section 245A.07, shall comply with rules and directives of the 599.1 commissioner governing those functions and with this section. 599.2 (b) For family day care programs, the commissioner may 599.3 authorize licensing reviews every two years after a licensee has 599.4 had at least one annual review. 599.5 Sec. 15. Minnesota Statutes 2000, section 245B.08, 599.6 subdivision 3, is amended to read: 599.7 Subd. 3. [SANCTIONS AVAILABLE.] Nothing in this 599.8 subdivision shall be construed to limit the commissioner's 599.9 authority to suspend,or revoke, or make conditionala license 599.10 or issue a fine at any timea licenseunder section 245A.07; 599.11 make correction orders andrequire finesmake a license 599.12 conditional for failure to comply with applicable laws or rules 599.13 under section 245A.06; or deny an application for license under 599.14 section 245A.05. 599.15 Sec. 16. Minnesota Statutes 2000, section 256.045, 599.16 subdivision 3, is amended to read: 599.17 Subd. 3. [STATE AGENCY HEARINGS.] (a) State agency 599.18 hearings are available for the following: (1) any person 599.19 applying for, receiving or having received public assistance, 599.20 medical care, or a program of social services granted by the 599.21 state agency or a county agency or the federal Food Stamp Act 599.22 whose application for assistance is denied, not acted upon with 599.23 reasonable promptness, or whose assistance is suspended, 599.24 reduced, terminated, or claimed to have been incorrectly paid; 599.25 (2) any patient or relative aggrieved by an order of the 599.26 commissioner under section 252.27; (3) a party aggrieved by a 599.27 ruling of a prepaid health plan; (4) except as provided under 599.28 chapter 245A, any individual or facility determined by a lead 599.29 agency to have maltreated a vulnerable adult under section 599.30 626.557 after they have exercised their right to administrative 599.31 reconsideration under section 626.557; (5) any person whose 599.32 claim for foster care payment according to a placement of the 599.33 child resulting from a child protection assessment under section 599.34 626.556 is denied or not acted upon with reasonable promptness, 599.35 regardless of funding source; (6) any person to whom a right of 599.36 appeal according to this section is given by other provision of 600.1 law; (7) an applicant aggrieved by an adverse decision to an 600.2 application for a hardship waiver under section 600.3 256B.15;or(8) except as provided under chapter 245A, an 600.4 individual or facility determined to have maltreated a minor 600.5 under section 626.556, after the individual or facility has 600.6 exercised the right to administrative reconsideration under 600.7 section 626.556; or (9) except as provided under chapter 245A, 600.8 an individual disqualified under section 245A.04, subdivision 600.9 3d, on the basis of serious or recurring maltreatment; a 600.10 preponderance of the evidence that the individual has committed 600.11 an act or acts that meet the definition of any of the crimes 600.12 listed in section 245A.04, subdivision 3d, paragraph (a), 600.13 clauses (1) to (4); or for failing to make reports required 600.14 under section 626.556, subdivision 3, or 626.557, subdivision 600.15 3. Hearings regarding a maltreatment determination under clause 600.16 (4) or (8) and a disqualification under this clause in which the 600.17 basis for a disqualification is serious or recurring 600.18 maltreatment, which has not been set aside or rescinded under 600.19 section 245A.04, subdivision 3b, shall be consolidated into a 600.20 single fair hearing. In such cases, the scope of review by the 600.21 human services referee shall include both the maltreatment 600.22 determination and the disqualification. The failure to exercise 600.23 the right to an administrative reconsideration shall not be a 600.24 bar to a hearing under this section if federal law provides an 600.25 individual the right to a hearing to dispute a finding of 600.26 maltreatment. Individuals and organizations specified in this 600.27 section may contest the specified action, decision, or final 600.28 disposition before the state agency by submitting a written 600.29 request for a hearing to the state agency within 30 days after 600.30 receiving written notice of the action, decision, or final 600.31 disposition, or within 90 days of such written notice if the 600.32 applicant, recipient, patient, or relative shows good cause why 600.33 the request was not submitted within the 30-day time limit. 600.34 The hearing for an individual or facility under clause 600.35 (4)or, (8), or (9) is the only administrative appeal to the 600.36 final agency determination specifically, including a challenge 601.1 to the accuracy and completeness of data under section 13.04. 601.2 Hearings requested under clause (4) apply only to incidents of 601.3 maltreatment that occur on or after October 1, 1995. Hearings 601.4 requested by nursing assistants in nursing homes alleged to have 601.5 maltreated a resident prior to October 1, 1995, shall be held as 601.6 a contested case proceeding under the provisions of chapter 14. 601.7 Hearings requested under clause (8) apply only to incidents of 601.8 maltreatment that occur on or after July 1, 1997. A hearing for 601.9 an individual or facility under clause (8) is only available 601.10 when there is no juvenile court or adult criminal action 601.11 pending. If such action is filed in either court while an 601.12 administrative review is pending, the administrative review must 601.13 be suspended until the judicial actions are completed. If the 601.14 juvenile court action or criminal charge is dismissed or the 601.15 criminal action overturned, the matter may be considered in an 601.16 administrative hearing. 601.17 For purposes of this section, bargaining unit grievance 601.18 procedures are not an administrative appeal. 601.19 The scope of hearings involving claims to foster care 601.20 payments under clause (5) shall be limited to the issue of 601.21 whether the county is legally responsible for a child's 601.22 placement under court order or voluntary placement agreement 601.23 and, if so, the correct amount of foster care payment to be made 601.24 on the child's behalf and shall not include review of the 601.25 propriety of the county's child protection determination or 601.26 child placement decision. 601.27 (b) A vendor of medical care as defined in section 256B.02, 601.28 subdivision 7, or a vendor under contract with a county agency 601.29 to provide social services under section 256E.08, subdivision 4, 601.30 is not a party and may not request a hearing under this section, 601.31 except if assisting a recipient as provided in subdivision 4. 601.32 (c) An applicant or recipient is not entitled to receive 601.33 social services beyond the services included in the amended 601.34 community social services plan developed under section 256E.081, 601.35 subdivision 3, if the county agency has met the requirements in 601.36 section 256E.081. 602.1 (d) The commissioner may summarily affirm the county or 602.2 state agency's proposed action without a hearing when the sole 602.3 issue is an automatic change due to a change in state or federal 602.4 law. 602.5 Sec. 17. Minnesota Statutes 2000, section 256.045, 602.6 subdivision 3b, is amended to read: 602.7 Subd. 3b. [STANDARD OF EVIDENCE FOR MALTREATMENT AND 602.8 DISQUALIFICATION HEARINGS.] The state human services referee 602.9 shall determine that maltreatment has occurred if a 602.10 preponderance of evidence exists to support the final 602.11 disposition under sections 626.556 and 626.557. For purposes of 602.12 hearings regarding disqualification, the state human services 602.13 referee shall affirm the proposed disqualification in an appeal 602.14 under subdivision 3, paragraph (a), clause (9), if a 602.15 preponderance of the evidence shows the individual has: 602.16 (1) committed maltreatment under section 626.556 or 602.17 626.557, which is serious or recurring; 602.18 (2) committed an act or acts meeting the definition of any 602.19 of the crimes listed in section 245A.04, subdivision 3d, 602.20 paragraph (a), clauses (1) to (4); or 602.21 (3) failed to make required reports under section 626.556 602.22 or 626.557, for incidents in which: 602.23 (i) the final disposition under section 626.556 or 626.557 602.24 was substantiated maltreatment; and 602.25 (ii) the maltreatment was recurring or serious; or 602.26 substantiated serious or recurring maltreatment of a minor under 602.27 section 626.556 or of a vulnerable adult under section 626.557 602.28 for which there is a preponderance of evidence that the 602.29 maltreatment occurred, and that the subject was responsible for 602.30 the maltreatment. If the disqualification is affirmed, the 602.31 state human services referee shall determine whether the 602.32 individual poses a risk of harm in accordance with the 602.33 requirements of section 245A.04, subdivision 3b. 602.34 The state human services referee shall recommend an order 602.35 to the commissioner of health or human services, as applicable, 602.36 who shall issue a final order. The commissioner shall affirm, 603.1 reverse, or modify the final disposition. Any order of the 603.2 commissioner issued in accordance with this subdivision is 603.3 conclusive upon the parties unless appeal is taken in the manner 603.4 provided in subdivision 7. Except as provided under section 603.5 245A.04, subdivisions 3b, paragraphs (e) and (f), and 3c, in any 603.6 licensing appeal under chapter 245A and sections 144.50 to 603.7 144.58 and 144A.02 to 144A.46, the commissioner's determination 603.8 as to maltreatment is conclusive. 603.9 Sec. 18. Minnesota Statutes 2000, section 256.045, 603.10 subdivision 4, is amended to read: 603.11 Subd. 4. [CONDUCT OF HEARINGS.] (a) All hearings held 603.12 pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 603.13 according to the provisions of the federal Social Security Act 603.14 and the regulations implemented in accordance with that act to 603.15 enable this state to qualify for federal grants-in-aid, and 603.16 according to the rules and written policies of the commissioner 603.17 of human services. County agencies shall install equipment 603.18 necessary to conduct telephone hearings. A state human services 603.19 referee may schedule a telephone conference hearing when the 603.20 distance or time required to travel to the county agency offices 603.21 will cause a delay in the issuance of an order, or to promote 603.22 efficiency, or at the mutual request of the parties. Hearings 603.23 may be conducted by telephone conferences unless the applicant, 603.24 recipient, former recipient, person, or facility contesting 603.25 maltreatment objects. The hearing shall not be held earlier 603.26 than five days after filing of the required notice with the 603.27 county or state agency. The state human services referee shall 603.28 notify all interested persons of the time, date, and location of 603.29 the hearing at least five days before the date of the hearing. 603.30 Interested persons may be represented by legal counsel or other 603.31 representative of their choice, including a provider of therapy 603.32 services, at the hearing and may appear personally, testify and 603.33 offer evidence, and examine and cross-examine witnesses. The 603.34 applicant, recipient, former recipient, person, or facility 603.35 contesting maltreatment shall have the opportunity to examine 603.36 the contents of the case file and all documents and records to 604.1 be used by the county or state agency at the hearing at a 604.2 reasonable time before the date of the hearing and during the 604.3 hearing. In hearings under subdivision 3, paragraph (a), 604.4 clauses (4)and, (8), and (9), either party may subpoena the 604.5 private data relating to the investigation prepared by the 604.6 agency under section 626.556 or 626.557 that is not otherwise 604.7 accessible under section 13.04, provided the identity of the 604.8 reporter may not be disclosed. 604.9 (b) The private data obtained by subpoena in a hearing 604.10 under subdivision 3, paragraph (a), clause (4)or, (8), or (9), 604.11 must be subject to a protective order which prohibits its 604.12 disclosure for any other purpose outside the hearing provided 604.13 for in this section without prior order of the district court. 604.14 Disclosure without court order is punishable by a sentence of 604.15 not more than 90 days imprisonment or a fine of not more than 604.16 $700, or both. These restrictions on the use of private data do 604.17 not prohibit access to the data under section 13.03, subdivision 604.18 6. Except for appeals under subdivision 3, paragraph (a), 604.19 clauses (4), (5),and(8), and (9), upon request, the county 604.20 agency shall provide reimbursement for transportation, child 604.21 care, photocopying, medical assessment, witness fee, and other 604.22 necessary and reasonable costs incurred by the applicant, 604.23 recipient, or former recipient in connection with the appeal. 604.24 All evidence, except that privileged by law, commonly accepted 604.25 by reasonable people in the conduct of their affairs as having 604.26 probative value with respect to the issues shall be submitted at 604.27 the hearing and such hearing shall not be "a contested case" 604.28 within the meaning of section 14.02, subdivision 3. The agency 604.29 must present its evidence prior to or at the hearing, and may 604.30 not submit evidence after the hearing except by agreement of the 604.31 parties at the hearing, provided the petitioner has the 604.32 opportunity to respond. 604.33 Sec. 19. Minnesota Statutes 2000, section 626.556, 604.34 subdivision 10i, is amended to read: 604.35 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL 604.36 DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 605.1 SERIOUS OR RECURRING MALTREATMENT.] (a) Except as provided under 605.2 paragraph (e), an individual or facility that the commissioner 605.3 or a local social service agency determines has maltreated a 605.4 child, or the child's designee, regardless of the determination, 605.5 who contests the investigating agency's final determination 605.6 regarding maltreatment, may request the investigating agency to 605.7 reconsider its final determination regarding maltreatment. The 605.8 request for reconsideration must be submitted in writing to the 605.9 investigating agency within 15 calendar days after receipt of 605.10 notice of the final determination regarding maltreatment. An 605.11 individual who was determined to have maltreated a child under 605.12 this section and who was disqualified on the basis of serious or 605.13 recurring maltreatment under section 245A.04, subdivision 3d, 605.14 may request reconsideration of the maltreatment determination 605.15 and the disqualification. The request for reconsideration of 605.16 the maltreatment determination and the disqualification must be 605.17 submitted within 30 calendar days of the individual's receipt of 605.18 the notice of disqualification under section 245A.04, 605.19 subdivision 3a. 605.20 (b) Except as provided under paragraphs (e) and (f), if the 605.21 investigating agency denies the request or fails to act upon the 605.22 request within 15 calendar days after receiving the request for 605.23 reconsideration, the person or facility entitled to a fair 605.24 hearing under section 256.045 may submit to the commissioner of 605.25 human services a written request for a hearing under that 605.26 section. 605.27 (c) If, as a result of the reconsideration, the 605.28 investigating agency changes the final determination of 605.29 maltreatment, that agency shall notify the parties specified in 605.30 subdivisions 10b, 10d, and 10f. 605.31 (d) Except as provided under paragraph (f), if an 605.32 individual or facility contests the investigating agency's final 605.33 determination regarding maltreatment by requesting a fair 605.34 hearing under section 256.045, the commissioner of human 605.35 services shall assure that the hearing is conducted and a 605.36 decision is reached within 90 days of receipt of the request for 606.1 a hearing. The time for action on the decision may be extended 606.2 for as many days as the hearing is postponed or the record is 606.3 held open for the benefit of either party. 606.4 (e) If an individual was disqualified under section 606.5 245A.04, subdivision 3d, on the basis of a determination of 606.6 maltreatment, which was serious or recurring, and the individual 606.7 has requested reconsideration of the maltreatment determination 606.8 under paragraph (a) and requested reconsideration of the 606.9 disqualification under section 245A.04, subdivision 3b, 606.10 reconsideration of the maltreatment determination and 606.11 reconsideration of the disqualification shall be consolidated 606.12 into a single reconsideration. If an individual disqualified on 606.13 the basis of a determination of maltreatment, which was serious 606.14 or recurring requests a fair hearing under paragraph (b), the 606.15 scope of the fair hearing shall include the maltreatment 606.16 determination and the disqualification. 606.17 (f) If a maltreatment determination or a disqualification 606.18 based on serious or recurring maltreatment is the basis for a 606.19 denial of a license under section 245A.05 or a licensing 606.20 sanction under section 245A.07, the license holder has the right 606.21 to a contested case hearing under chapter 14 and Minnesota 606.22 Rules, parts 1400.8550 to 1400.8612. As provided for under 606.23 section 245A.08, subdivision 2a, the scope of the contested case 606.24 hearing shall include the maltreatment determination, 606.25 disqualification, and licensing sanction or denial of a 606.26 license. In such cases, a fair hearing regarding the 606.27 maltreatment determination shall not be conducted under 606.28 paragraph (b). If the disqualified subject is an individual 606.29 other than the license holder and upon whom a background study 606.30 must be conducted under section 245A.04, subdivision 3, the 606.31 hearings of all parties may be consolidated into a single 606.32 contested case hearing upon consent of all parties and the 606.33 administrative law judge. 606.34 Sec. 20. Minnesota Statutes 2000, section 626.557, 606.35 subdivision 3, is amended to read: 606.36 Subd. 3. [TIMING OF REPORT.] (a) A mandated reporter who 607.1 has reason to believe that a vulnerable adult is being or has 607.2 been maltreated, or who has knowledge that a vulnerable adult 607.3 has sustained a physical injury which is not reasonably 607.4 explained shall immediately report the information to the common 607.5 entry point. If an individual is a vulnerable adult solely 607.6 because the individual is admitted to a facility, a mandated 607.7 reporter is not required to report suspected maltreatment of the 607.8 individual that occurred prior to admission, unless: 607.9 (1) the individual was admitted to the facility from 607.10 another facility and the reporter has reason to believe the 607.11 vulnerable adult was maltreated in the previous facility; or 607.12 (2) the reporter knows or has reason to believe that the 607.13 individual is a vulnerable adult as defined in section 626.5572, 607.14 subdivision 21, clause (4). 607.15 (b) A person not required to report under the provisions of 607.16 this section may voluntarily report as described above. 607.17 (c) Nothing in this section requires a report of known or 607.18 suspected maltreatment, if the reporter knows or has reason to 607.19 know that a report has been made to the common entry point. 607.20 (d) Nothing in this section shall preclude a reporter from 607.21 also reporting to a law enforcement agency. 607.22 (e) A mandated reporter who knows or has reason to believe 607.23 that an error under section 626.5572, subdivision 17, paragraph 607.24 (c), clause (5), occurred must make a report under this 607.25 subdivision. If the reporter or facility at any time believes 607.26 that an investigation by a lead agency will determine or should 607.27 determine that the reported error was not neglect according to 607.28 the criteria under section 626.5572, subdivision 17, paragraph 607.29 (c), clause (5), the reporter or facility may provide to the 607.30 common entry point or directly to the lead agency information 607.31 explaining how the event meets the criteria under section 607.32 626.5572, subdivision 17, paragraph (c), clause (5). The lead 607.33 agency shall consider this information when making an initial 607.34 disposition of the report under subdivision 9c. 607.35 Sec. 21. Minnesota Statutes 2000, section 626.557, 607.36 subdivision 9d, is amended to read: 608.1 Subd. 9d. [ADMINISTRATIVE RECONSIDERATION OF FINAL 608.2 DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 608.3 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 608.4 provided under paragraph (e), any individual or facility which a 608.5 lead agency determines has maltreated a vulnerable adult, or the 608.6 vulnerable adult or an interested person acting on behalf of the 608.7 vulnerable adult, regardless of the lead agency's determination, 608.8 who contests the lead agency's final disposition of an 608.9 allegation of maltreatment, may request the lead agency to 608.10 reconsider its final disposition. The request for 608.11 reconsideration must be submitted in writing to the lead agency 608.12 within 15 calendar days after receipt of notice of final 608.13 disposition or, if the request is made by an interested person 608.14 who is not entitled to notice, within 15 days after receipt of 608.15 the notice by the vulnerable adult or the vulnerable adult's 608.16 legal guardian. An individual who was determined to have 608.17 maltreated a vulnerable adult under this section and who was 608.18 disqualified on the basis of serious or recurring maltreatment 608.19 under section 245A.04, subdivision 3d, may request 608.20 reconsideration of the maltreatment determination and the 608.21 disqualification. The request for reconsideration of the 608.22 maltreatment determination and the disqualification must be 608.23 submitted within 30 calendar days of the individual's receipt of 608.24 the notice of disqualification under section 245A.04, 608.25 subdivision 3a. 608.26 (b) Except as provided under paragraphs (e) and (f), if the 608.27 lead agency denies the request or fails to act upon the request 608.28 within 15 calendar days after receiving the request for 608.29 reconsideration, the person or facility entitled to a fair 608.30 hearing under section 256.045, may submit to the commissioner of 608.31 human services a written request for a hearing under that 608.32 statute. The vulnerable adult, or an interested person acting 608.33 on behalf of the vulnerable adult, may request a review by the 608.34 vulnerable adult maltreatment review panel under section 256.021 608.35 if the lead agency denies the request or fails to act upon the 608.36 request, or if the vulnerable adult or interested person 609.1 contests a reconsidered disposition. The lead agency shall 609.2 notify persons who request reconsideration of their rights under 609.3 this paragraph. The request must be submitted in writing to the 609.4 review panel and a copy sent to the lead agency within 30 609.5 calendar days of receipt of notice of a denial of a request for 609.6 reconsideration or of a reconsidered disposition. The request 609.7 must specifically identify the aspects of the agency 609.8 determination with which the person is dissatisfied. 609.9 (c) If, as a result of a reconsideration or review, the 609.10 lead agency changes the final disposition, it shall notify the 609.11 parties specified in subdivision 9c, paragraph (d). 609.12 (d) For purposes of this subdivision, "interested person 609.13 acting on behalf of the vulnerable adult" means a person 609.14 designated in writing by the vulnerable adult to act on behalf 609.15 of the vulnerable adult, or a legal guardian or conservator or 609.16 other legal representative, a proxy or health care agent 609.17 appointed under chapter 145B or 145C, or an individual who is 609.18 related to the vulnerable adult, as defined in section 245A.02, 609.19 subdivision 13. 609.20 (e) If an individual was disqualified under section 609.21 245A.04, subdivision 3d, on the basis of a determination of 609.22 maltreatment, which was serious or recurring, and the individual 609.23 has requested reconsideration of the maltreatment determination 609.24 under paragraph (a) and reconsideration of the disqualification 609.25 under section 245A.04, subdivision 3b, reconsideration of the 609.26 maltreatment determination and requested reconsideration of the 609.27 disqualification shall be consolidated into a single 609.28 reconsideration. If an individual who was disqualified on the 609.29 basis of serious or recurring maltreatment requests a fair 609.30 hearing under paragraph (b), the scope of the fair hearing shall 609.31 include the maltreatment determination and the disqualification. 609.32 (f) If a maltreatment determination or a disqualification 609.33 based on serious or recurring maltreatment is the basis for a 609.34 denial of a license under section 245A.05 or a licensing 609.35 sanction under section 245A.07, the license holder has the right 609.36 to a contested case hearing under chapter 14 and Minnesota 610.1 Rules, parts 1400.8550 to 1400.8612. As provided for under 610.2 section 245A.08, the scope of the contested case hearing shall 610.3 include the maltreatment determination, disqualification, and 610.4 licensing sanction or denial of a license. In such cases, a 610.5 fair hearing shall not be conducted under paragraph (b). If the 610.6 disqualified subject is an individual other than the license 610.7 holder and upon whom a background study must be conducted under 610.8 section 245A.04, subdivision 3, the hearings of all parties may 610.9 be consolidated into a single contested case hearing upon 610.10 consent of all parties and the administrative law judge. 610.11 (g) Until August 1, 2002, an individual or facility that 610.12 was determined by the commissioner of human services or the 610.13 commissioner of health to be responsible for neglect under 610.14 section 626.5572, subdivision 17, after October 1, 1995, and 610.15 before August 1, 2001, that believes that the finding of neglect 610.16 does not meet an amended definition of neglect may request a 610.17 reconsideration of the determination of neglect. The 610.18 commissioner of human services or the commissioner of health 610.19 shall mail a notice to the last known address of individuals who 610.20 are eligible to seek this reconsideration. The request for 610.21 reconsideration must state how the established findings no 610.22 longer meet the elements of the definition of neglect. The 610.23 commissioner shall review the request for reconsideration and 610.24 make a determination within 15 calendar days. The 610.25 commissioner's decision on this reconsideration is the final 610.26 agency action. 610.27 (1) For purposes of compliance with the data destruction 610.28 schedule under section 626.557, subdivision 12b, paragraph (d), 610.29 when a finding of substantiated maltreatment has been changed as 610.30 a result of a reconsideration under this paragraph, the date of 610.31 the original finding of a substantiated maltreatment must be 610.32 used to calculate the destruction date. 610.33 (2) For purposes of any background studies under section 610.34 245A.04, when a determination of substantiated maltreatment has 610.35 been changed as a result of a reconsideration under this 610.36 paragraph, any prior disqualification of the individual under 611.1 section 245A.04 that was based on this determination of 611.2 maltreatment shall be rescinded, and for future background 611.3 studies under section 245A.04 the commissioner must not use the 611.4 previous determination of substantiated maltreatment as a basis 611.5 for disqualification or as a basis for referring the 611.6 individual's maltreatment history to a health-related licensing 611.7 board under section 245A.04, subdivision 3d, paragraph (b). 611.8 Sec. 22. Minnesota Statutes 2000, section 626.5572, 611.9 subdivision 17, is amended to read: 611.10 Subd. 17. [NEGLECT.] "Neglect" means: 611.11 (a) The failure or omission by a caregiver to supply a 611.12 vulnerable adult with care or services, including but not 611.13 limited to, food, clothing, shelter, health care, or supervision 611.14 which is: 611.15 (1) reasonable and necessary to obtain or maintain the 611.16 vulnerable adult's physical or mental health or safety, 611.17 considering the physical and mental capacity or dysfunction of 611.18 the vulnerable adult; and 611.19 (2) which is not the result of an accident or therapeutic 611.20 conduct. 611.21 (b) The absence or likelihood of absence of care or 611.22 services, including but not limited to, food, clothing, shelter, 611.23 health care, or supervision necessary to maintain the physical 611.24 and mental health of the vulnerable adult which a reasonable 611.25 person would deem essential to obtain or maintain the vulnerable 611.26 adult's health, safety, or comfort considering the physical or 611.27 mental capacity or dysfunction of the vulnerable adult. 611.28 (c) For purposes of this section, a vulnerable adult is not 611.29 neglected for the sole reason that: 611.30 (1) the vulnerable adult or a person with authority to make 611.31 health care decisions for the vulnerable adult under sections 611.32 144.651, 144A.44, chapter 145B, 145C, or 252A, or section 611.33 253B.03, or 525.539 to 525.6199, refuses consent or withdraws 611.34 consent, consistent with that authority and within the boundary 611.35 of reasonable medical practice, to any therapeutic conduct, 611.36 including any care, service, or procedure to diagnose, maintain, 612.1 or treat the physical or mental condition of the vulnerable 612.2 adult, or, where permitted under law, to provide nutrition and 612.3 hydration parenterally or through intubation; this paragraph 612.4 does not enlarge or diminish rights otherwise held under law by: 612.5 (i) a vulnerable adult or a person acting on behalf of a 612.6 vulnerable adult, including an involved family member, to 612.7 consent to or refuse consent for therapeutic conduct; or 612.8 (ii) a caregiver to offer or provide or refuse to offer or 612.9 provide therapeutic conduct; or 612.10 (2) the vulnerable adult, a person with authority to make 612.11 health care decisions for the vulnerable adult, or a caregiver 612.12 in good faith selects and depends upon spiritual means or prayer 612.13 for treatment or care of disease or remedial care of the 612.14 vulnerable adult in lieu of medical care, provided that this is 612.15 consistent with the prior practice or belief of the vulnerable 612.16 adult or with the expressed intentions of the vulnerable adult; 612.17 (3) the vulnerable adult, who is not impaired in judgment 612.18 or capacity by mental or emotional dysfunction or undue 612.19 influence, engages in sexual contact with: 612.20 (i) a person including a facility staff person when a 612.21 consensual sexual personal relationship existed prior to the 612.22 caregiving relationship; or 612.23 (ii) a personal care attendant, regardless of whether the 612.24 consensual sexual personal relationship existed prior to the 612.25 caregiving relationship; or 612.26 (4) an individual makes an error in the provision of 612.27 therapeutic conduct to a vulnerable adult which: (i)does not 612.28 result in injury or harm which reasonably requires medical or 612.29 mental health care; or, if it reasonably requires care,612.30 (5) an individual makes an error in the provision of 612.31 therapeutic conduct to a vulnerable adult that results in injury 612.32 or harm, which reasonably requires the care of a physician; and: 612.33 (i) the necessary care issought andprovided in a timely 612.34 fashion as dictated by the condition of the vulnerable adult; 612.35and the injury or harm that required care does not result in612.36substantial acute, or chronic injury or illness, or permanent613.1disability above and beyond the vulnerable adult's preexisting613.2condition; 613.3 (ii) is after receiving care, the health status of the 613.4 vulnerable adult can be reasonably expected to be restored to 613.5 the vulnerable adult's preexisting condition; 613.6 (iii) the error is not part of a pattern of errors by the 613.7 individual; 613.8 (iv) if in a facility, the error is immediately reported as 613.9 required under section 626.557, and recorded internallyby the613.10employee or person providing servicesin the facilityin order613.11to evaluate and identify corrective action; 613.12 (v) if in a facility, the facility identifies and takes 613.13 corrective action and implements measures designed to reduce the 613.14 risk of further occurrence of this error and similar errors; and 613.15(iii) is(vi) if in a facility, the actions required under 613.16 items (iv) and (v) are sufficiently documented for review and 613.17 evaluation by the facility and any applicable licensing, 613.18 certification, and ombudsman agency; and613.19(iv) is not part of a pattern of errors by the individual. 613.20 (d) Nothing in this definition requires a caregiver, if 613.21 regulated, to provide services in excess of those required by 613.22 the caregiver's license, certification, registration, or other 613.23 regulation. 613.24 (e) If the findings of an investigation by a lead agency 613.25 result in a determination of substantiated maltreatment for the 613.26 sole reason that the actions required of a facility under 613.27 paragraph (c), clause (5), item (iv), (v), or (vi), were not 613.28 taken, then the facility is subject to a correction order. This 613.29 must not alter the lead agency's determination of mitigating 613.30 factors under section 626.557, subdivision 9c, paragraph (c). 613.31 Sec. 23. [FEDERAL LAW CHANGE REQUEST OR WAIVER.] 613.32 The commissioner of health or human services, whichever is 613.33 appropriate, shall pursue changes to federal law necessary to 613.34 allow greater discretion on disciplinary activities of 613.35 unlicensed health care workers, and apply for necessary federal 613.36 waivers or approval that would allow for a set-aside process 614.1 related to disqualifications for nurse aides in nursing homes by 614.2 July 1, 2002. 614.3 Sec. 24. [WAIVER FROM FEDERAL RULES AND REGULATIONS.] 614.4 By January 2002, the commissioner of health shall work with 614.5 providers to examine federal rules and regulations prohibiting 614.6 neglect, abuse, and financial exploitation of residents in 614.7 licensed nursing facilities and shall apply for federal waivers 614.8 to: 614.9 (1) allow the use of Minnesota Statutes, section 626.5572, 614.10 to control the identification and prevention of maltreatment of 614.11 residents in licensed nursing facilities, rather than the 614.12 definitions under federal rules and regulations; and 614.13 (2) allow the use of Minnesota Statutes, sections 214.104, 614.14 245A.04, and 626.557, to control the disqualification or 614.15 discipline of any persons providing services to residents in 614.16 licensed nursing facilities, rather than the nurse aide registry 614.17 or other exclusionary provisions of federal rules and 614.18 regulations. 614.19 Sec. 25. [EFFECTIVE DATES.] 614.20 (a) Sections 20; 21, paragraph (g); and 22 are effective 614.21 the day following final enactment. 614.22 (b) Sections 1; 3; 5; 9; 23; and 24 are effective July 1, 614.23 2001. 614.24 (c) Sections 2; 4; 7; 8; 10 to 19; and 21, paragraphs (a), 614.25 (b), (e), and (f), are effective January 1, 2002. 614.26 ARTICLE 14 614.27 MISCELLANEOUS 614.28 Section 1. [144.582] [PROHIBITING CERTAIN ACTIONS AGAINST 614.29 NURSES.] 614.30 Subdivision 1. [PROHIBITED ACTIONS.] Except as provided in 614.31 subdivision 2, a hospital or other entity licensed under 614.32 sections 144.50 to 144.58, and its agent; a hospice licensed 614.33 under section 144A.48, and its agent; or another health care 614.34 facility licensed by the commissioner of health, and the 614.35 facility's agent, is prohibited from taking action against a 614.36 nurse solely on the grounds that the nurse fails to accept an 615.1 assignment of additional consecutive hours at the facility in 615.2 excess of an agreed upon, predetermined work shift, if the nurse 615.3 declines to work additional hours because doing so may, in the 615.4 nurse's judgment, jeopardize patient safety. A nurse who fails 615.5 to accept additional hours under this subdivision must document 615.6 in writing why, in the nurse's judgment, the additional work 615.7 hours may jeopardize patient safety. This subdivision does not 615.8 apply to a nursing facility, an intermediate care facility for 615.9 persons with mental retardation, or a licensed boarding care 615.10 facility. 615.11 Subd. 2. [EMERGENCY.] Notwithstanding subdivision 1, a 615.12 nurse may be scheduled for duty or required to continue on duty 615.13 for more than one normal work period in an emergency. 615.14 Subd. 3. [DEFINITIONS.] For purposes of this section, the 615.15 following terms have the meanings given them: 615.16 (1) "emergency" means a period when replacement staff are 615.17 not able to report for duty for the next shift because of 615.18 unusual circumstances such as a disease outbreak, adverse 615.19 weather conditions, natural disasters, or, in the case of nurse 615.20 supervisors, a strike; 615.21 (2) "normal work period" means 12 or fewer consecutive 615.22 hours consistent with a predetermined work shift; 615.23 (3) "nurse" has the meaning given in section 148.171, 615.24 subdivision 9; and 615.25 (4) "taking action against" means discharging; 615.26 disciplining; threatening; reporting to the board of nursing; 615.27 discriminating against; or penalizing regarding compensation, 615.28 terms, conditions, location, or privileges of employment. 615.29 Subd. 4. [NOTIFICATION.] Each health care facility subject 615.30 to subdivision 1 shall post on each nursing unit in an area to 615.31 which all employees have access the following statement: "This 615.32 facility is prohibited by law from taking any action against a 615.33 nurse who fails to accept a request or order to work additional 615.34 hours at the facility in excess of the predetermined work shift 615.35 if, in the nurse's judgment, working the additional hours may 615.36 jeopardize patient safety." The facility shall also post 616.1 adjacent to the statement the telephone number of the Minnesota 616.2 department of health facility and provider compliance division. 616.3 Sec. 2. Minnesota Statutes 2000, section 148.212, is 616.4 amended to read: 616.5 148.212 [TEMPORARY PERMIT.] 616.6 Upon receipt of the applicable licensure or reregistration 616.7 fee and permit fee, and in accordance with rules of the board, 616.8 the board may issue a nonrenewable temporary permit to practice 616.9 professional or practical nursing to an applicant for licensure 616.10 or reregistration who is not the subject of a pending 616.11 investigation or disciplinary action, nor disqualified for any 616.12 other reason, under the following circumstances: 616.13 (a) The applicant for licensure by examination under 616.14 section 148.211, subdivision 1, has graduated from an approved 616.15 nursing program within the 60 days preceding board receipt of an 616.16 affidavit of graduation or transcript and has been authorized by 616.17 the board to write the licensure examination for the first time 616.18 in the United States. The permit holder must practice 616.19 professional or practical nursing under the direct supervision 616.20 of a registered nurse. The permit is valid from the date of 616.21 issue until the date the board takes action on the application 616.22 or for 60 days whichever occurs first. 616.23 (b) The applicant for licensure by endorsement under 616.24 section 148.211, subdivision 2, is currently licensed to 616.25 practice professional or practical nursing in another state, 616.26 territory, or Canadian province. The permit is valid from 616.27 submission of a proper request until the date of board action on 616.28 the application. 616.29 (c) The applicant for licensure by endorsement under 616.30 section 148.211, subdivision 2, or for reregistration under 616.31 section 148.231, subdivision 5, is currently registered in a 616.32 formal, structured refresher course or its equivalent for nurses 616.33 that includes clinical practice. 616.34 (d) The applicant for licensure by examination under 616.35 section 148.211, subdivision 1, has been issued a Commission on 616.36 Graduates of Foreign Nursing Schools certificate, has completed 617.1 all requirements for licensure except the examination, and has 617.2 been authorized by the board to write the licensure examination 617.3 for the first time in the United States. The permit holder must 617.4 practice professional nursing under the direct supervision of a 617.5 registered nurse. The permit is valid from the date of issue 617.6 until the date the board takes action on the application or for 617.7 60 days, whichever occurs first. 617.8 Sec. 3. Minnesota Statutes 2000, section 148.263, 617.9 subdivision 2, is amended to read: 617.10 Subd. 2. [INSTITUTIONS.] (a) The chief nursing executive 617.11 or chief administrative officer of any hospital, clinic, prepaid 617.12 medical plan, or other health care institution or organization 617.13 located in this state shall report to the board any action taken 617.14 by the institution or organization or any of its administrators 617.15 or committees to revoke, suspend, limit, or condition a nurse's 617.16 privilege to practice in the institution, or as part of the 617.17 organization, any denial of privileges, any dismissal from 617.18 employment, or any other disciplinary action. The institution 617.19 or organization shall also report the resignation of any nurse 617.20 before the conclusion of any disciplinary proceeding, or before 617.21 commencement of formal charges, but after the nurse had 617.22 knowledge that formal charges were contemplated or in 617.23 preparation. The reporting described by this subdivision is 617.24 required only if the action pertains to grounds for disciplinary 617.25 action under section 148.261. 617.26 (b) This subdivision does not require any entity to report 617.27 the refusal of a nurse to accept an assignment of additional 617.28 hours in excess of an agreed upon, predetermined work schedule. 617.29 Sec. 4. Minnesota Statutes 2000, section 148.284, is 617.30 amended to read: 617.31 148.284 [CERTIFICATION OF ADVANCED PRACTICE REGISTERED 617.32 NURSES.] 617.33 (a) No person shall practice advanced practice registered 617.34 nursing or use any title, abbreviation, or other designation 617.35 tending to imply that the person is an advanced practice 617.36 registered nurse, clinical nurse specialist, nurse anesthetist, 618.1 nurse-midwife, or nurse practitioner unless the person is 618.2 certified for such advanced practice registered nursing by a 618.3 national nurse certification organization. 618.4 (b) Paragraph (a) does not apply to an advanced practice 618.5 registered nurse who is within six months after completion of an 618.6 advanced practice registered nurse course of study and is 618.7 awaiting certification, provided that the person has not 618.8 previously failed the certification examination. 618.9 (c) An advanced practice registered nurse who has completed 618.10 a formal course of study as an advanced practice registered 618.11 nurse and has been certified by a national nurse certification 618.12 organization prior to January 1, 1999, may continue to practice 618.13 in the field of nursing in which the advanced practice 618.14 registered nurse is practicing as of July 1, 1999, regardless of 618.15 the type of certification held if the advanced practice 618.16 registered nurse is not eligible for the proper certification. 618.17 Sec. 5. Minnesota Statutes 2000, section 214.001, is 618.18 amended by adding a subdivision to read: 618.19 Subd. 4. [INFORMATION FROM COUNCIL OF HEALTH BOARDS.] The 618.20 chair of a standing committee in either house of the legislature 618.21 may request information from the council of health boards on 618.22 proposals relating to the regulation of health occupations. 618.23 Sec. 6. Minnesota Statutes 2000, section 214.002, 618.24 subdivision 1, is amended to read: 618.25 Subdivision 1. [WRITTEN REPORT.] Within 15 days of the 618.26 introduction of a bill proposing new or expanded regulation of 618.27 an occupation, the proponents of the new or expanded regulation 618.28 shall submit a written report to the chair of the standing 618.29 committee in each house of the legislature to which the bill was 618.30 referred and to the council of health boards setting out the 618.31 information required by this section. If a committee chair 618.32 requests that the report be submitted earlier, but no fewer than 618.33 five days from introduction of the bill, the proponents shall 618.34 comply with the request. 618.35 Sec. 7. Minnesota Statutes 2000, section 214.01, is 618.36 amended by adding a subdivision to read: 619.1 Subd. 1a. [COUNCIL OF HEALTH BOARDS.] "Council of health 619.2 boards" means a collaborative body established by the 619.3 health-related licensing boards. 619.4 Sec. 8. [214.025] [COUNCIL OF HEALTH BOARDS.] 619.5 The health-related licensing boards may establish a council 619.6 of health boards consisting of representatives of the 619.7 health-related licensing boards and the emergency medical 619.8 services regulatory board. When reviewing legislation or 619.9 legislative proposals relating to the regulation of health 619.10 occupations, the council shall include the commissioner of 619.11 health or a designee. 619.12 Sec. 9. [214.105] [HEALTH-RELATED LICENSING BOARDS AND 619.13 COMMISSIONER OF HEALTH; DEFAULT ON FEDERAL LOANS OR SERVICE 619.14 OBLIGATIONS.] 619.15 Subdivision 1. [SUSPENSION OF LICENSE.] If the 619.16 commissioner of health or a health-related licensing board 619.17 receives a report from a federal agency certifying that a person 619.18 licensed by the commissioner or board is in nonpayment, default, 619.19 or breach of a repayment or service obligation under any federal 619.20 educational loan, loan repayment, or service conditional 619.21 scholarship program, the commissioner or board may suspend the 619.22 person's license within 30 days of receipt of the report. The 619.23 commissioner or board shall consider the reasons for nonpayment, 619.24 default, or breach of a repayment or service obligation and may 619.25 not suspend the person's license in cases of total and permanent 619.26 disability or long-term temporary disability lasting more than a 619.27 year. Prior to the suspension, the person must be given notice 619.28 of the board's or commissioner's intended action and must be 619.29 given the opportunity for a hearing before the board or 619.30 commissioner before the suspension takes effect. 619.31 Subd. 2. [ISSUANCE, REINSTATEMENT, RENEWAL OF 619.32 LICENSE.] The commissioner or a health-related licensing board 619.33 shall not issue, reinstate, or renew a license that has been 619.34 suspended under this section until the person whose license was 619.35 suspended provides the commissioner or board with a written 619.36 release issued by the federal agency that reported the person to 620.1 the commissioner or board. The written release must state that 620.2 the person is making payments on the loan or satisfying the 620.3 service requirements in accordance with an agreement approved by 620.4 the federal agency. If the person has continued to meet all 620.5 other requirements for licensure during the period of license 620.6 suspension, the commissioner or board must reinstate the 620.7 person's license upon receipt of the written release. 620.8 Sec. 10. Minnesota Statutes 2000, section 245.98, is 620.9 amended by adding a subdivision to read: 620.10 Subd. 6. [TREATMENT.] (a) The commissioner of human 620.11 services shall develop and maintain a comprehensive program for 620.12 the treatment of problem and pathological gambling. This 620.13 program should include primary treatment, crisis intervention, 620.14 assessment and pretreatment services, transitional and 620.15 after-care services, and intervention and support services, 620.16 including financial, budget, and debt restitution counseling. 620.17 The program should also provide services for family members and 620.18 other victims whether or not the pathological or problem gambler 620.19 is in treatment. The program should encourage multidisciplinary 620.20 providers and different programming models, including inpatient, 620.21 residential, halfway houses, and treatment in chemical 620.22 dependency programs and other institutions. 620.23 (b) The commissioner of human services shall develop 620.24 programs for gambling prevention, intervention, and treatment 620.25 for underserved populations, including youth and seniors, and 620.26 high-risk or vulnerable populations. The commissioner shall 620.27 consult with appropriate councils, representatives, and agency 620.28 groups to gather information about specific populations and 620.29 tailor appropriate gambling-related services for those 620.30 populations. 620.31 Sec. 11. Minnesota Statutes 2000, section 245.982, is 620.32 amended to read: 620.33 245.982 [COMPULSIVE GAMBLING PROGRAM SUPPORT.] 620.34 In order to addresstheproblemofand compulsive gambling 620.35in this, the state, the compulsive gambling fund should attempt620.36to assess the beneficiaries of gambling, on a percentage basis621.1according to the revenue they receive from gambling, for the621.2costs of programs to help problem gamblers and their families.621.3In that light, the governor is requested to contact the chairs621.4of the 11 tribal governments in this state and request a621.5contribution of funds for the compulsive gambling program. The621.6governor should seek a total supplemental contribution of621.7$643,000. Funds received from the tribal governments in this621.8state shall be deposited in the Indian gaming revolving621.9accountof Minnesota should make sure that its prevention and 621.10 treatment efforts are sufficient to meet the needs of problem 621.11 gamblers and their families. Furthermore, the costs of 621.12 compulsive gambling programs should be funded out of the lottery 621.13 prize fund, and if available, with support from other gambling 621.14 enterprises instead of with state general fund appropriations. 621.15 Sec. 12. Minnesota Statutes 2000, section 256I.05, 621.16 subdivision 1d, is amended to read: 621.17 Subd. 1d. [SUPPLEMENTARY SERVICE RATES FOR CERTAIN 621.18 FACILITIES SERVING PERSONS WITH MENTAL ILLNESS OR CHEMICAL 621.19 DEPENDENCY.] Notwithstanding the provisions of subdivisions 1a 621.20 and 1cfor the fiscal year ending June 30, 1998, a county agency 621.21 may negotiate a supplementary service rate in addition to the 621.22 board and lodging rate for facilities licensed and registered by 621.23 the Minnesota department of health under section 157.17 prior to 621.24 December 31, 1996, if the facility meets the following criteria: 621.25 (1) at least 75 percent of the residents have a primary 621.26 diagnosis of mental illness, chemical dependency, or both, and 621.27 have related special needs; 621.28 (2) the facility provides 24-hour, on-site, year-round 621.29 supportive services by qualified staff capable of intervention 621.30 in a crisis of persons with late-state inebriety or mental 621.31 illness who are vulnerable to abuse or neglect; 621.32 (3) the services at the facility include, but are not 621.33 limited to: 621.34 (i) secure central storage of medication; 621.35 (ii) reminders and monitoring of medication for 621.36 self-administration; 622.1 (iii) support for developing an individual medical and 622.2 social service plan, updating the plan, and monitoring 622.3 compliance with the plan; and 622.4 (iv) assistance with setting up meetings, appointments, and 622.5 transportation to access medical, chemical health, and mental 622.6 health service providers; 622.7 (4) each resident has a documented need for at least one of 622.8 the services provided; 622.9 (5) each resident has been offered an opportunity to apply 622.10 for admission to a licensed residential treatment program for 622.11 mental illness, chemical dependency, or both, have refused that 622.12 offer, and the offer and their refusal has been documented to 622.13 writing; and 622.14 (6) the residents are not eligible for home and 622.15 community-based services waivers because of their unique need 622.16 for community support. 622.17 The total supplementary service rate must not exceed 622.18$57543.2 percent of the nonfederal share of the adult case mix 622.19 class A rate established for purposes of the community 622.20 alternatives for disabled individuals program. 622.21 Sec. 13. Minnesota Statutes 2000, section 256I.05, 622.22 subdivision 1e, is amended to read: 622.23 Subd. 1e. [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.] 622.24 Notwithstanding the provisions of subdivisions 1a and 1c, 622.25 beginning July 1,19992001, a county agency shall negotiate a 622.26 supplementary rate in addition to the rate specified in 622.27 subdivision 1, equal to2541 percent of the amount specified in 622.28 subdivision 1a, including any legislatively authorized 622.29 inflationary adjustments, for a group residential housing 622.30 provider that: 622.31 (1) is located in Hennepin county and has had a group 622.32 residential housing contract with the county since June 1996; 622.33 (2) operates in three separate locations a 56-bed facility, 622.34 a 40-bed facility, and a 30-bed facility; and 622.35 (3) serves a chemically dependent clientele, providing 24 622.36 hours per day supervision and limiting a resident's maximum 623.1 length of stay to 13 months out of a consecutive 24-month period. 623.2 Sec. 14. Minnesota Statutes 2000, section 256I.05, is 623.3 amended by adding a subdivision to read: 623.4 Subd. 1f. [SUPPLEMENTARY SERVICE RATE INCREASES ON OR 623.5 AFTER JULY 1, 2001.] For rate years beginning on or after July 623.6 1, 2001, a county agency may increase the supplementary service 623.7 rate for recipients of assistance under section 256I.04 who 623.8 reside in a residence that is licensed by the commissioner of 623.9 health as a boarding care home but is not certified for purposes 623.10 of the medical assistance program. The supplementary service 623.11 rate shall not exceed the nonfederal share of the statewide 623.12 weighted average monthly medical assistance nursing facility 623.13 payment rate for case mix class A. 623.14 Sec. 15. [299A.76] [SUICIDE STATISTICS.] 623.15 (a) The commissioner of public safety shall not: 623.16 (1) include any statistics on committing suicide or 623.17 attempting suicide in any compilation of crime statistics 623.18 published by the commissioner; or 623.19 (2) label as a crime statistic, any data on committing 623.20 suicide or attempting suicide. 623.21 (b) This section does not apply to the crimes of aiding 623.22 suicide under section 609.215, subdivision 1, or aiding 623.23 attempted suicide under section 609.215, subdivision 2, or to 623.24 statistics on a suicide directly related to the commission of a 623.25 crime. 623.26 Sec. 16. Minnesota Statutes 2000, section 609.115, 623.27 subdivision 9, is amended to read: 623.28 Subd. 9. [COMPULSIVE GAMBLING ASSESSMENT REQUIRED.] (a) If 623.29 a person is convicted of theft under section 609.52, 623.30 embezzlement of public funds under section 609.54, or forgery 623.31 under section 609.625, 609.63, or 609.631, the probation officer 623.32 shall determine in the report prepared under subdivision 1 623.33 whether or not compulsive gambling contributed to the commission 623.34 of the offense. If so, the report shall contain the results of 623.35 a compulsive gambling assessment conducted in accordance with 623.36 this subdivision. The probation officer shall make an 624.1 appointment for the offender to undergo the assessment if so 624.2 indicated. 624.3 (b) The compulsive gambling assessment report must include 624.4 a recommended level of treatment for the offender if the 624.5 assessor concludes that the offender is in need of compulsive 624.6 gambling treatment. The assessment must be conducted by an 624.7 assessor qualified under section 245.98, subdivision 2a, to 624.8 perform these assessments or to provide compulsive gambling 624.9 treatment. An assessor providing a compulsive gambling 624.10 assessment may not have any direct or shared financial interest 624.11 or referral relationship resulting in shared financial gain with 624.12 a treatment provider. If an independent assessor is not 624.13 available, the probation officer may use the services of an 624.14 assessor with a financial interest or referral relationship as 624.15 authorized under rules adopted by the commissioner of human 624.16 services under section 245.98, subdivision 2a. 624.17 (c) The commissioner of human services shall reimburse the 624.18 assessor for the costs associated with a compulsive gambling 624.19 assessment at a rate established by the commissioner up to a 624.20 maximum of$100$200 for each assessment. The commissioner 624.21 shall reimburse these costs after receiving written verification 624.22 from the probation officer that the assessment was performed and 624.23 found acceptable. 624.24 Sec. 17. Laws 1998, chapter 407, article 8, section 9, is 624.25 amended to read: 624.26 Sec. 9. [PREVALENCE STUDY.] 624.27If funding is available,(a) The compulsive gambling 624.28 program shall providebaseline prevalencestudies to identify 624.29those at highest risk of developing a compulsive gambling624.30problem, including a replication in 1999 of the 1994 adult624.31prevalence surveythe prevalence of pathological and problem 624.32 gambling and, to the extent possible, the demographic and 624.33 socioeconomic characteristics of these gamblers. The study must 624.34 be completed by January 15, 2003. 624.35 (b) The compulsive gambling program shall also study the 624.36 impact of problem gambling on Minnesota. The studies may 625.1 include the effect of gambling on children of parental gamblers, 625.2 the prevalence of gambling in underserved populations and 625.3 developmentally disabled populations, the impact of gambling on 625.4 crime, and the prevalence of school-based gambling. 625.5 Sec. 18. Laws 1999, chapter 152, section 4, is amended to 625.6 read: 625.7 Sec. 4. [REPORT.] 625.8 The task force shall present a report recommending a new 625.9 payment rate structure to the legislature by January 15, 2000, 625.10 and shall make recommendations to the commissioner of human 625.11 services regarding the implementation of the pilot project for 625.12 the individualized payment rate structure, so the pilot project 625.13 can be implemented by January 1, 2002, as required in section 625.14 3. The task force expires onMarch 15, 2000December 30, 2003. 625.15 Sec. 19. Laws 1999, chapter 245, article 10, section 10, 625.16 as amended by Laws 2000, chapter 488, article 9, section 30, is 625.17 amended to read: 625.18 Sec. 10. [REPEALER.] 625.19(a) Minnesota Statutes 1998, section 256.973, is repealed625.20effective June 30, 2002.625.21(b)Laws 1997, chapter 225, article 6, section 8, is 625.22 repealed. 625.23 Sec. 20. [DAY TRAINING AND HABILITATION PAYMENT STRUCTURE 625.24 PILOT PROJECT.] 625.25 Subdivision 1. [INDIVIDUALIZED PAYMENT RATE 625.26 STRUCTURE.] Notwithstanding Minnesota Statutes, sections 625.27 252.451, subdivision 5; and 252.46; and Minnesota Rules, part 625.28 9525.1290, subpart 1, items A and B, after federal waivers have 625.29 been approved and the legislature has authorized the pilot 625.30 project, the commissioner of human services shall initiate a 625.31 pilot project for the individualized payment rate structure 625.32 described in this section and section 3. The pilot project 625.33 shall include actual transfers of funds, not simulated 625.34 transfers. The pilot project may include all or some of the 625.35 vendors in up to eight counties, with no more than two counties 625.36 from the seven-county Minneapolis-St. Paul metropolitan area. 626.1 Subd. 2. [SUNSET.] The pilot project shall sunset upon 626.2 implementation of a new statewide rate structure to be 626.3 recommended by the task force described in subdivision 3, in its 626.4 report to the legislature on December 1, 2003. The rates of 626.5 vendors participating in the pilot project must be modified to 626.6 be consistent with the new statewide rate structure, if 626.7 implemented. 626.8 Subd. 3. [TASK FORCE RESPONSIBILITIES.] The day training 626.9 and habilitation task force established under Laws 1999, chapter 626.10 152, section 4, shall evaluate at least six months of the pilot 626.11 project authorized under subdivision 1, and by December 1, 2003, 626.12 shall report to the legislature with recommendations regarding 626.13 whether the pilot project individualized payment rate structure 626.14 should be implemented statewide and with recommendations for any 626.15 amendments that should be made before statewide implementation. 626.16 These recommendations shall be made in a report to the chairs of 626.17 the house health and human services policy and finance 626.18 committees and the senate health and family security committee 626.19 and finance division. 626.20 Subd. 4. [RATE SETTING.] (a) The rate structure under this 626.21 section is intended to allow a county to authorize an individual 626.22 rate for each client in the vendor's program based on the needs 626.23 and expected outcomes of the individual client. Rates shall be 626.24 based on an authorized package of services for each individual 626.25 over a typical time frame. Rates may be established across 626.26 multiple sites run by a single vendor. 626.27 (b) With county concurrence, a vendor shall establish up to 626.28 four levels of service, A through D, based on the intensity of 626.29 services provided to an individual client of day training and 626.30 habilitation services. Service level A shall be the highest 626.31 intensity of services, marked primarily, but not exclusively, by 626.32 a one-to-one client-to-staff ratio. Service level D shall be 626.33 the lowest intensity of services. The county shall document the 626.34 vendor's description of the type and amount of services 626.35 associated with each service level. 626.36 (c) For each vendor, a county board shall establish a 627.1 dollar value for one hour of service at each of the service 627.2 levels defined in paragraph (b). In establishing these values 627.3 for existing vendors transitioning from the payment rate 627.4 structure under Minnesota Statutes, section 252.46, subdivision 627.5 1, the county board shall follow the formula and guidelines 627.6 developed by the day training and habilitation task force under 627.7 paragraph (e). 627.8 (d) A vendor may elect to maintain a single transportation 627.9 rate or may elect to establish up to five types of 627.10 transportation services: public transportation, public special 627.11 transportation, nonambulatory transportation, out-of-service 627.12 area transportation, and ambulatory transportation. For vendors 627.13 that elect to establish multiple transportation services, the 627.14 county board shall establish a dollar value for a round trip on 627.15 each type of transportation service offered through the vendor. 627.16 With vendor concurrence, the county may also establish a uniform 627.17 one-way trip value for some or all of the transportation service 627.18 types. 627.19 (e) In conducting the pilot project, the county board shall 627.20 ensure that the vendor translates the vendor's existing program 627.21 and transportation rates to the rates and values in the pilot 627.22 project by using the conversion calculations for services and 627.23 transportation approved by the day training and habilitation 627.24 task force established under Laws 1999, chapter 152, and 627.25 included in the task force's recommendations to the 627.26 legislature. The conversion calculation may be amended by the 627.27 task force with the approval of the commissioner and any 627.28 amendments shall become effective upon notification to the pilot 627.29 project counties from the commissioner. The calculation shall 627.30 take the total reimbursement dollars available to the vendor and 627.31 divide by the units of service expected at each service level 627.32 and of each transportation type. In determining the total 627.33 reimbursement dollars available to a vendor, the vendor shall 627.34 multiply the vendor's current per diem rate for both services 627.35 and transportation, including any new rate increases, by the 627.36 vendor's actual utilization for the year prior to implementation 628.1 of the pilot project. Vendors shall be allowed to allocate 628.2 available reimbursement dollars between service and 628.3 transportation before the vendor's service level and 628.4 transportation values are calculated. After translating its 628.5 existing service and transportation rates to the service level 628.6 and transportation values under the pilot, the vendor shall 628.7 project its expected reimbursement income using the expected 628.8 service and transportation packages for its existing clients, 628.9 based on current service authorizations. If the projected 628.10 reimbursement income is less than the vendor would have received 628.11 under the payment structure of Minnesota Statutes, section 628.12 252.46, the vendor and the county, with the approval of the 628.13 commissioner, shall adjust the vendor's service level and 628.14 transportation values to eliminate the shortfall. The 628.15 commissioner shall report all adjustments to the day training 628.16 and habilitation task force for consideration of possible 628.17 modifications to the pilot project individualized payment rate 628.18 structure. 628.19 Subd. 5. [INDIVIDUAL RATE AUTHORIZATION.] (a) As part of 628.20 its annual authorization of services for each client under 628.21 Minnesota Statutes, section 252.44, paragraph (a), clause (1), 628.22 and Minnesota Rules, part 9525.0016, subpart 12, the county 628.23 shall authorize and document a service package and a 628.24 transportation package as follows: 628.25 (1) the service package shall include the amount and type 628.26 of services at each applicable service level to be provided to 628.27 the client over a package period. An individual client may 628.28 receive services at multiple service levels over the course of 628.29 the package period. The service package rate shall be the sum 628.30 of the amount of services at each level over the package period, 628.31 multiplied by the dollar value for each service level; 628.32 (2) the transportation package shall include the amount and 628.33 type of transportation services to be provided to the client 628.34 over the package period. The transportation package rate shall 628.35 be the sum of the amount of transportation services, multiplied 628.36 by the dollar value associated with the type of transportation 629.1 service authorized for the client; 629.2 (3) the package period shall be established by the county, 629.3 and may be one week, two weeks, or one month; and 629.4 (4) the individual rate authorization may be reviewed and 629.5 modified by the county at any time and must be reviewed and 629.6 reauthorized by the county at least annually. 629.7 (b) For purposes of the pilot project, a service day under 629.8 Minnesota Statutes, sections 245B.06 and 252.44, includes any 629.9 day in which a client receives any reimbursable service from a 629.10 vendor or attends employment arranged by the vendor. 629.11 Subd. 6. [BILLING FOR SERVICES.] The vendor shall bill 629.12 for, and shall be reimbursed for, the service package rate and 629.13 transportation package rate for the package period as authorized 629.14 by the county for each client in the vendor's program. The 629.15 length of the package period shall not affect the timing or 629.16 frequency of vendors' submissions of claims for payment under 629.17 the Medicaid Management Information System II (MMIS) or its 629.18 successors. 629.19 Subd. 7. [NOTIFICATION OF CHANGE IN CLIENT NEEDS.] The 629.20 vendor shall notify an individual client's case manager if the 629.21 vendor has knowledge of a material change in the client's needs 629.22 that may indicate a need for a change in service authorization. 629.23 Factors that would require such notice include, but are not 629.24 limited to, significant changes in medical status, residential 629.25 placement, attendance patterns, behavioral needs, or skill 629.26 functioning. The vendor shall notify the case manager as soon 629.27 as possible but no later than 30 calendar days after becoming 629.28 aware of the change in needs. The service authorization for the 629.29 client shall not change until the county authorizes a new 629.30 service and transportation package for the client in accordance 629.31 with the provisions in Minnesota Statutes, section 256B.092. 629.32 Subd. 8. [COUNTY BOARD RESPONSIBILITIES.] For each vendor 629.33 with rates established under this section, the county board 629.34 shall document the vendor's description of the type and amount 629.35 of services associated with each service level, the vendor's 629.36 service level values, the vendor's transportation values, and 630.1 the package period that will be used to determine the rate for 630.2 each individual client. The county shall establish a package 630.3 period of one week, two weeks, or one month. 630.4 Sec. 21. [DEAF/BLIND SERVICES STUDY.] 630.5 The department of human services shall convene and lead an 630.6 interagency workgroup for the purpose of studying and developing 630.7 recommendations regarding: 630.8 (1) how the state can most effectively and efficiently use 630.9 state appropriations and other resources to provide needed 630.10 services to deaf/blind children, adults, and their families; 630.11 (2) how state agencies can work together to enhance and 630.12 ensure that a seamless service delivery system exists across 630.13 agency lines for persons who are deaf/blind; and 630.14 (3) how other existing barriers to the effective and 630.15 efficient delivery of service for deaf/blind Minnesotans can be 630.16 removed. 630.17 The workgroup shall include representatives from the 630.18 departments of human services, economic security, children, 630.19 families, and learning; the state academy for the deaf; the 630.20 state academy for the blind; the Minnesota commission serving 630.21 deaf and hard-of-hearing; a consumer who is deaf/blind; a parent 630.22 of a deaf/blind child from the metro area and a parent of a 630.23 deaf/blind child from greater Minnesota; and anyone else that 630.24 the workgroup finds necessary to complete its work. 630.25 The departments of human services, economic security, and 630.26 children, families, and learning shall share equally in the 630.27 costs of the workgroup. 630.28 The workgroup shall report its findings and recommendations 630.29 to the legislature by February 1, 2002. 630.30 Sec. 22. [ESTABLISHMENT OF NEW FEE FOR COMPULSIVE GAMBLING 630.31 TREATMENT PROVIDERS.] 630.32 The commissioner of human services, in consultation with 630.33 compulsive gambling treatment providers, shall establish a fee 630.34 structure, which increases the rates provided for purposes of 630.35 gambling treatment. The fee structure must reflect the real 630.36 costs associated with providing treatment services and should be 631.1 sufficient to attract new and retain existing compulsive 631.2 gambling treatment providers. The new rate structure must be 631.3 implemented no later than October 1, 2001. 631.4 Sec. 23. [PROGRAM OPTIONS FOR CERTAIN PERSONS WITH 631.5 DEVELOPMENTAL DISABILITIES.] 631.6 (a) The commissioner of human services shall ensure that 631.7 services continue to be available to persons with developmental 631.8 disabilities who were covered by social services supplemental 631.9 grants prior to July 1, 2001. Services shall be provided in 631.10 priority order as follows: 631.11 (1) to the extent possible, the commissioner shall 631.12 establish for these persons targeted slots under the home and 631.13 community-based waivered services program for persons with 631.14 mental retardation or related conditions; 631.15 (2) those persons who cannot be accommodated under clause 631.16 (1) shall, to the extent possible, be provided services through 631.17 other home and community-based waivered services programs; 631.18 (3) notwithstanding Minnesota Statutes, section 256I.04, 631.19 subdivision 2a, those persons who cannot be served by a waiver 631.20 program under clause (1) or (2) shall be eligible for services 631.21 under Minnesota Statutes, chapter 256I; and 631.22 (4) any remaining persons shall continue to receive 631.23 services through community social services supplemental grants 631.24 to the affected counties. 631.25 (b) This section applies only to individuals receiving 631.26 services under social services supplemental grants as of June 631.27 30, 2001. 631.28 Sec. 24. [STUDY OF DAY TRAINING AND HABILITATION VENDOR 631.29 RATES.] 631.30 The commissioner shall identify the vendors with the lowest 631.31 rates or underfunded programs in the state and make 631.32 recommendations to reconcile the discrepancies prior to the 631.33 implementation of the individualized payment rate structure. 631.34 Sec. 25. [FEDERAL APPROVAL.] 631.35 The commissioner shall seek any amendments to the state 631.36 Medicaid plan and any waivers necessary to permit implementation 632.1 of the day training and habilitation individualized payment 632.2 structure pilot project within the timelines specified. When 632.3 the necessary waivers are approved by the federal government, 632.4 the commissioner shall obtain authorization from the legislature 632.5 before implementing the pilot project. 632.6 Sec. 26. [REPEALER.] 632.7 Minnesota Statutes 2000, section 256E.06, subdivision 2b, 632.8 is repealed. 632.9 Sec. 27. [EFFECTIVE DATE.] 632.10 The repealer in section 26 is effective July 1, 2003. 632.11 ARTICLE 15 632.12 APPROPRIATIONS 632.13 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 632.14 The sums shown in the columns marked "APPROPRIATIONS" are 632.15 appropriated from the general fund, or any other fund named, to 632.16 the agencies and for the purposes specified in the following 632.17 sections of this article, to be available for the fiscal years 632.18 indicated for each purpose. The figures "2002" and "2003" where 632.19 used in this article, mean that the appropriation or 632.20 appropriations listed under them are available for the fiscal 632.21 year ending June 30, 2002, or June 30, 2003, respectively. 632.22 Where a dollar amount appears in parentheses, it means a 632.23 reduction of an appropriation. 632.24 SUMMARY BY FUND 632.25 APPROPRIATIONS BIENNIAL 632.26 2002 2003 TOTAL 632.27 General $3,194,073,000 $3,538,650,000 $6,732,723,000 632.28 State Government 632.29 Special Revenue 38,548,000 40,671,000 79,219,000 632.30 Health Care 632.31 Access 233,995,000 308,027,000 542,022,000 632.32 Federal TANF 295,060,000 302,841,000 597,901,000 632.33 Lottery Cash Flow 4,090,000 3,540,000 7,630,000 632.34 TOTAL $3,765,766,000 $4,193,729,000 $7,959,495,000 632.35 APPROPRIATIONS 632.36 Available for the Year 632.37 Ending June 30 632.38 2002 2003 632.39 Sec. 2. COMMISSIONER OF 633.1 HUMAN SERVICES 633.2 Subdivision 1. Total 633.3 Appropriation $3,587,027,000 $4,014,723,000 633.4 Summary by Fund 633.5 General 3,073,837,000 3,413,688,000 633.6 State Government 633.7 Special Revenue 520,000 534,000 633.8 Health Care 633.9 Access 222,060,000 300,660,000 633.10 Federal TANF 288,520,000 296,301,000 633.11 Lottery Cash Flow 4,090,000 3,540,000 633.12 TOTAL 3,587,027,000 4,014,723,000 633.13 [RECEIPTS FOR SYSTEMS PROJECTS.] 633.14 Appropriations and federal receipts for 633.15 information system projects for MAXIS, 633.16 PRISM, MMIS, and SSIS must be deposited 633.17 in the state system account authorized 633.18 in Minnesota Statutes, section 633.19 256.014. Money appropriated for 633.20 computer projects approved by the 633.21 Minnesota office of technology, funded 633.22 by the legislature, and approved by the 633.23 commissioner of finance may be 633.24 transferred from one project to another 633.25 and from development to operations as 633.26 the commissioner of human services 633.27 considers necessary. Any unexpended 633.28 balance in the appropriation for these 633.29 projects does not cancel but is 633.30 available for ongoing development and 633.31 operations. 633.32 [GIFTS.] Notwithstanding Minnesota 633.33 Statutes, chapter 7, the commissioner 633.34 may accept on behalf of the state 633.35 additional funding from sources other 633.36 than state funds for the purpose of 633.37 financing the cost of assistance 633.38 program grants or nongrant 633.39 administration. All additional funding 633.40 is appropriated to the commissioner for 633.41 use as designated by the grantor of 633.42 funding. 633.43 [SYSTEMS CONTINUITY.] In the event of 633.44 disruption of technical systems or 633.45 computer operations, the commissioner 633.46 may use available grant appropriations 633.47 to ensure continuity of payments for 633.48 maintaining the health, safety, and 633.49 well-being of clients served by 633.50 programs administered by the department 633.51 of human services. Grant funds must be 633.52 used in a manner consistent with the 633.53 original intent of the appropriation. 633.54 [SPECIAL REVENUE FUND INFORMATION.] On 633.55 December 1, 2001, and December 1, 2002, 633.56 the commissioner shall provide the 633.57 chairs of the house health and human 633.58 services finance committee and the 633.59 senate health, human services, and 634.1 corrections budget division with 634.2 detailed fund balance information for 634.3 each special revenue fund account. 634.4 [FEDERAL ADMINISTRATIVE REIMBURSEMENT.] 634.5 Federal administrative reimbursement 634.6 resulting from MinnesotaCare outreach 634.7 grants and the Minnesota senior health 634.8 options project are appropriated to the 634.9 commissioner for these activities. 634.10 [NONFEDERAL SHARE TRANSFERS.] The 634.11 nonfederal share of activities for 634.12 which federal administrative 634.13 reimbursement is appropriated to the 634.14 commissioner may be transferred to the 634.15 special revenue fund. 634.16 [MAJOR SYSTEMS ONE-TIME TRANSFER.] 634.17 $29,000,000 of funds available in the 634.18 state systems account authorized in 634.19 Minnesota Statutes, section 256.014, is 634.20 transferred in fiscal year 2002 to the 634.21 general fund. 634.22 [TANF FUNDS APPROPRIATED TO OTHER 634.23 ENTITIES.] Any expenditures from the 634.24 TANF block grant shall be expended in 634.25 accordance with the requirements and 634.26 limitations of part A of title IV of 634.27 the Social Security Act, as amended, 634.28 and any other applicable federal 634.29 requirement or limitation. Prior to 634.30 any expenditure of these funds, the 634.31 commissioner shall assure that funds 634.32 are expended in compliance with the 634.33 requirements and limitations of federal 634.34 law and that any reporting requirements 634.35 of federal law are met. It shall be 634.36 the responsibility of any entity to 634.37 which these funds are appropriated to 634.38 implement a memorandum of understanding 634.39 with the commissioner that provides the 634.40 necessary assurance of compliance prior 634.41 to any expenditure of funds. The 634.42 commissioner shall receipt TANF funds 634.43 appropriated to other state agencies 634.44 and coordinate all related interagency 634.45 accounting transactions necessary to 634.46 implement these appropriations. 634.47 Unexpended TANF funds appropriated to 634.48 any state, local, or nonprofit entity 634.49 cancel at the end of the state fiscal 634.50 year unless appropriating language 634.51 permits otherwise. 634.52 [TANF FUNDS TRANSFERRED TO OTHER 634.53 FEDERAL GRANTS.] The commissioner must 634.54 authorize transfers from TANF to other 634.55 federal block grants so that funds are 634.56 available to meet the annual 634.57 expenditure needs as appropriated. 634.58 Transfers may be authorized prior to 634.59 the expenditure year with the agreement 634.60 of the receiving entity. Transferred 634.61 funds must be expended in the year for 634.62 which the funds were appropriated 634.63 unless appropriation language permits 634.64 otherwise. In accelerating transfer 634.65 authorizations, the commissioner must 634.66 aim to preserve the future potential 635.1 transfer capacity from TANF to other 635.2 block grants. 635.3 [TANF MAINTENANCE OF EFFORT.] (a) In 635.4 order to meet the basic maintenance of 635.5 effort (MOE) requirements of the TANF 635.6 block grant specified under Code of 635.7 Federal Regulations, title 45, section 635.8 263.1, the commissioner may only report 635.9 nonfederal money expended for allowable 635.10 activities listed in the following 635.11 clauses as TANF MOE expenditures: 635.12 (1) MFIP cash and food assistance 635.13 benefits under Minnesota Statutes, 635.14 chapter 256J; 635.15 (2) the child care assistance programs 635.16 under Minnesota Statutes, sections 635.17 119B.03 and 119B.05, and county child 635.18 care administrative costs under 635.19 Minnesota Statutes, section 119B.15; 635.20 (3) state and county MFIP 635.21 administrative costs under Minnesota 635.22 Statutes, chapters 256J and 256K; 635.23 (4) state, county, and tribal MFIP 635.24 employment services under Minnesota 635.25 Statutes, chapters 256J and 256K; and 635.26 (5) expenditures made on behalf of 635.27 noncitizen MFIP recipients who qualify 635.28 for the medical assistance without 635.29 federal financial participation program 635.30 under Minnesota Statutes, section 635.31 256B.06, subdivision 4, paragraphs (d), 635.32 (e), and (j). 635.33 (b) The commissioner shall ensure that 635.34 sufficient qualified nonfederal 635.35 expenditures are made each year to meet 635.36 the state's TANF MOE requirements. For 635.37 the activities listed in paragraph (a), 635.38 clauses (2) to (5), the commissioner 635.39 may only report expenditures that are 635.40 excluded from the definition of 635.41 assistance under Code of Federal 635.42 Regulations, title 45, section 260.31. 635.43 (c) By August 31 of each year, the 635.44 commissioner shall make a preliminary 635.45 calculation to determine the likelihood 635.46 that the state will meet its annual 635.47 federal work participation requirement 635.48 under Code of Federal Regulations, 635.49 title 45, sections 261.21 and 261.23, 635.50 after adjustment for any caseload 635.51 reduction credit under Code of Federal 635.52 Regulations, title 45, section 261.41. 635.53 If the commissioner determines that the 635.54 state will meet its federal work 635.55 participation rate for the federal 635.56 fiscal year ending that September, the 635.57 commissioner may reduce the expenditure 635.58 under paragraph (a), clause (1), to the 635.59 extent allowed under Code of Federal 635.60 Regulations, title 45, section 635.61 263.1(a)(2). 635.62 (d) For fiscal years beginning with 636.1 state fiscal year 2003, the 636.2 commissioner shall assure that the 636.3 maintenance of effort used by the 636.4 commissioner of finance for the 636.5 February and November forecasts 636.6 required under Minnesota Statutes, 636.7 section 16A.103, contains expenditures 636.8 under paragraph (a), clause (1), equal 636.9 to at least 25 percent of the total 636.10 required under Code of Federal 636.11 Regulations, title 45, section 263.1. 636.12 (e) If nonfederal expenditures for the 636.13 programs and purposes listed in 636.14 paragraph (a) are insufficient to meet 636.15 the state's TANF MOE requirements, the 636.16 commissioner shall recommend additional 636.17 allowable sources of nonfederal 636.18 expenditures to the legislature, if the 636.19 legislature is or will be in session to 636.20 take action to specify additional 636.21 sources of nonfederal expenditures for 636.22 TANF MOE before a federal penalty is 636.23 imposed. The commissioner shall 636.24 otherwise provide notice to the 636.25 legislative commission on planning and 636.26 fiscal policy under paragraph (g). 636.27 (f) If the commissioner uses authority 636.28 granted under Laws 1999, chapter 245, 636.29 article 1, section 10, or similar 636.30 authority granted by a subsequent 636.31 legislature, to meet the state's TANF 636.32 MOE requirements in a reporting period, 636.33 the commissioner shall inform the 636.34 chairs of the appropriate legislative 636.35 committees about all transfers made 636.36 under that authority for this purpose. 636.37 (g) If the commissioner determines that 636.38 nonfederal expenditures for the 636.39 programs under paragraph (a), are 636.40 insufficient to meet TANF MOE 636.41 expenditure requirements, and if the 636.42 legislature is not or will not be in 636.43 session to take timely action to avoid 636.44 a federal penalty, the commissioner may 636.45 report nonfederal expenditures from 636.46 other allowable sources as TANF MOE 636.47 expenditures after the requirements of 636.48 this paragraph are met. The 636.49 commissioner may report nonfederal 636.50 expenditures in addition to those 636.51 specified under paragraph (a) as 636.52 nonfederal TANF MOE expenditures, but 636.53 only ten days after the commissioner of 636.54 finance has first submitted the 636.55 commissioner's recommendations for 636.56 additional allowable sources of 636.57 nonfederal TANF MOE expenditures to the 636.58 members of the legislative commission 636.59 on planning and fiscal policy for their 636.60 review. 636.61 (h) The commissioner of finance shall 636.62 not incorporate any changes in federal 636.63 TANF expenditures or nonfederal 636.64 expenditures for TANF MOE that may 636.65 result from reporting additional 636.66 allowable sources of nonfederal TANF 636.67 MOE expenditures under the interim 637.1 procedures in paragraph (g) into the 637.2 February or November forecasts required 637.3 under Minnesota Statutes, section 637.4 16A.103, unless the commissioner of 637.5 finance has approved the additional 637.6 sources of expenditures under paragraph 637.7 (g). 637.8 (i) The provisions of Minnesota 637.9 Statutes, section 256.011, subdivision 637.10 3, which require that federal grants or 637.11 aids secured or obtained under that 637.12 subdivision be used to reduce any 637.13 direct appropriations provided by law, 637.14 do not apply if the grants or aids are 637.15 federal TANF funds. 637.16 (j) Notwithstanding section 14 of this 637.17 article, paragraphs (a) to (j) expire 637.18 June 30, 2005. 637.19 Subd. 2. Agency Management 637.20 General 38,212,000 37,694,000 637.21 State Government 637.22 Special Revenue 403,000 415,000 637.23 Health Care 637.24 Access 3,631,000 3,673,000 637.25 Federal TANF 165,000 165,000 637.26 The amounts that may be spent from the 637.27 appropriation for each purpose are as 637.28 follows: 637.29 (a) Financial Operations 637.30 General 6,872,000 7,041,000 637.31 Health Care 637.32 Access 815,000 828,000 637.33 Federal TANF 165,000 165,000 637.34 (b) Legal & Regulation Operations 637.35 General 8,405,000 8,239,000 637.36 State Government 637.37 Special Revenue 403,000 415,000 637.38 Health Care 637.39 Access 239,000 244,000 637.40 (c) Management Operations 637.41 General 22,935,000 22,414,000 637.42 [ELECTRONIC GOVERNMENT SERVICES.] The 637.43 general fund appropriation for 637.44 electronic government services shall be 637.45 reduced by $307,000 in fiscal year 2002 637.46 and $184,000 in fiscal year 2003. 637.47 Health Care 637.48 Access 2,577,000 2,601,000 637.49 Subd. 3. Administrative Reimbursement/ 637.50 Passthrough 638.1 Federal TANF 58,605 56,992 638.2 Subd. 4. Children's Services Grants 638.3 General 66,147,000 71,129,000 638.4 Federal TANF 6,290,000 6,290,000 638.5 [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 638.6 Federal funds available during the 638.7 biennium ending June 30, 2003, for 638.8 adoption incentive grants are 638.9 appropriated to the commissioner for 638.10 these purposes. 638.11 [EMPLOYMENT AND TRAINING.] (a) 638.12 $1,810,000 is appropriated from the 638.13 state's federal TANF block grant to the 638.14 commissioner in fiscal year 2002 and in 638.15 fiscal year 2003 for employment and 638.16 training grants. 638.17 (b) $5,000,000 is appropriated from the 638.18 state's federal TANF block grant to the 638.19 commissioner in fiscal year 2002 and in 638.20 fiscal year 2003 for welfare-to-work 638.21 programs administered by the 638.22 commissioner of economic security that 638.23 have utilized all of the federal 638.24 welfare-to-work funding received. The 638.25 commissioner of economic security shall 638.26 establish guidelines for distributing 638.27 the available funds to local workforce 638.28 service areas based on current 638.29 expenditures and the documented need. 638.30 (c) The appropriations in paragraphs 638.31 (a) and (b) shall not become part of 638.32 the base level funding for the 638.33 2004-2005 biennium. 638.34 [TANF TRANSFER TO SOCIAL SERVICES.] 638.35 $4,650,000 is appropriated to the 638.36 commissioner in fiscal year 2002 and in 638.37 fiscal year 2003 for purposes of 638.38 increasing services for families with 638.39 children whose incomes are at or below 638.40 200 percent of the federal poverty 638.41 guidelines. The commissioner shall 638.42 authorize a sufficient transfer of 638.43 funds from the state's federal TANF 638.44 block grant to the state's federal 638.45 social services block grant to meet 638.46 this appropriation. 638.47 [SOCIAL SERVICES BLOCK GRANT FUNDS FOR 638.48 CONCURRENT PERMANENCY PLANNING.] 638.49 Notwithstanding Minnesota Statutes, 638.50 section 256E.07, $4,650,000 in fiscal 638.51 year 2002 and $4,650,000 in fiscal year 638.52 2003 in social services block grant 638.53 funds allocated to the commissioner 638.54 under title XX of the Social Security 638.55 Act are available for distribution to 638.56 counties under the formula in Minnesota 638.57 Statutes, section 260C.213, for the 638.58 purposes of concurrent permanency 638.59 planning. 638.60 [CHILDREN'S MENTAL HEALTH GRANTS.] Of 638.61 the general fund appropriation, 639.1 $1,000,000 in fiscal year 2002 and 639.2 $1,000,000 in fiscal year 2003 is for 639.3 children's mental health grants under 639.4 Minnesota Statutes, section 245.4886. 639.5 Subd. 5. Children's Services Management 639.6 General 5,645,000 5,724,000 639.7 [FEDERAL FINANCIAL PARTICIPATION 639.8 MAXIMIZATION FOR OUT-OF-HOME CARE.] The 639.9 commissioner of human services and the 639.10 commissioner of corrections shall 639.11 cooperate in efforts to maximize 639.12 federal financial participation in the 639.13 costs of providing out-of-home 639.14 placements for juveniles. 639.15 Subd. 6. Basic Health Care Grants 639.16 Summary by Fund 639.17 General 1,164,615,000 1,386,582,000 639.18 Health Care 639.19 Access 198,568,000 277,503,000 639.20 The amounts that may be spent from this 639.21 appropriation for each purpose are as 639.22 follows: 639.23 (a) MinnesotaCare Grants 639.24 Health Care 639.25 Access 197,818,000 276,753,000 639.26 [MINNESOTACARE FEDERAL RECEIPTS.] 639.27 Receipts received as a result of 639.28 federal participation pertaining to 639.29 administrative costs of the Minnesota 639.30 health care reform waiver shall be 639.31 deposited as nondedicated revenue in 639.32 the health care access fund. Receipts 639.33 received as a result of federal 639.34 participation pertaining to grants 639.35 shall be deposited in the federal fund 639.36 and shall offset health care access 639.37 funds for payments to providers. 639.38 [MINNESOTACARE FUNDING.] The 639.39 commissioner may expend money 639.40 appropriated from the health care 639.41 access fund for MinnesotaCare in either 639.42 fiscal year of the biennium. 639.43 [DENTAL ACCESS GRANTS.] Of this 639.44 appropriation, $1,000,000 in fiscal 639.45 year 2002 is to be distributed as 639.46 dental access grants in accordance with 639.47 Minnesota Statutes, section 256B.53. 639.48 If the amount appropriated is not used 639.49 within the fiscal year, the 639.50 commissioner of finance shall transfer 639.51 any remaining amount to the 639.52 commissioner of health to be 639.53 distributed as rural hospital capital 639.54 improvement grants for fiscal year 2003. 639.55 [HEALTH CARE SAFETY NET ENDOWMENT 639.56 FUND.] The commissioner of finance 639.57 shall transfer $150,000,000 from the 639.58 health care access fund to the health 640.1 care safety net endowment fund. 640.2 (b) MA Basic Health Care Grants - 640.3 Families and Children 640.4 General 475,611,000 575,996,000 640.5 [INDIAN HEALTH SERVICES FEDERAL MATCH.] 640.6 In the event the federal medical 640.7 assistance percentage rate increases to 640.8 100 percent for services provided as a 640.9 result of a referral by the federal 640.10 Indian health service or a tribal 640.11 provider, the commissioner is 640.12 authorized to increase the payment rate 640.13 for referrals by ten percent as an 640.14 incentive for the completion of 640.15 documentation required for increased 640.16 federal participation. Unspent state 640.17 medical assistance appropriations 640.18 resulting from the increase in the 640.19 federal medical assistance percentage 640.20 rate shall be transferred to the 640.21 appropriate account and are available 640.22 to the commissioner for covering the 640.23 costs of out-stationed health care 640.24 program eligibility services on 640.25 reservations. The base appropriation 640.26 for the 2004-2005 biennium for these 640.27 services must not exceed the state 640.28 medical assistance savings. These 640.29 actions are intended to improve access 640.30 to health care and assist in 640.31 eliminating disparities in health 640.32 status for American Indian people. 640.33 [PROVIDER SURCHARGE OFFSET.] The 640.34 commissioner shall reduce future 640.35 billings under Minnesota Statutes, 640.36 section 256.9657, to offset $1,600,000 640.37 in excess provider surcharges 640.38 erroneously collected from a health 640.39 care system established in 1994. The 640.40 future billings must be reduced by 640.41 $400,000 in each of the fiscal years 640.42 beginning with fiscal year 2002 through 640.43 fiscal year 2005, for a total reduction 640.44 of $1,600,000. Notwithstanding section 640.45 14, this provision expires on June 30, 640.46 2005. 640.47 [PMAP RATES.] Prepaid medical 640.48 assistance, general assistance medical 640.49 care, and MinnesotaCare program rates 640.50 set by the commissioner under Minnesota 640.51 Statutes, section 256B.69, effective on 640.52 or after January 1, 2002, shall not 640.53 reflect any increase in cost due to 640.54 changes made to Minnesota Statutes, 640.55 sections 62Q.56 and 62Q.58, by the 2001 640.56 legislature. Notwithstanding section 640.57 14, this paragraph shall not expire. 640.58 [COLLECTION OF HOSPITAL OVERPAYMENTS.] 640.59 (a) The commissioner shall not commence 640.60 collection of hospital overpayments 640.61 resulting from a determination that 640.62 medical assistance and general 640.63 assistance payments exceeded the charge 640.64 limit during the period from 1994 to 640.65 1997 until after any available appeals 641.1 have been exhausted. 641.2 (b) For small rural hospitals, as 641.3 defined in Minnesota Statutes, section 641.4 144.148, any amounts then due to the 641.5 state may be funded through the grant 641.6 program provided in section 3 for those 641.7 hospitals. 641.8 (c) MA Basic Health Care Grants - 641.9 Elderly and Disabled 641.10 General 520,190,000 609,372,000 641.11 (d) General Assistance Medical Care 641.12 General 157,384,000 179,229,000 641.13 (e) Health Care Grants - Other Assistance 641.14 General 11,430,000 21,985,000 641.15 Health Care Access 750,000 750,000 641.16 [STOP-LOSS FUND ACCOUNT.] Of the 641.17 general fund appropriation, $200,000 in 641.18 fiscal year 2002 and $385,000 in fiscal 641.19 year 2003 is to the commissioner to be 641.20 deposited in the stop-loss fund account 641.21 to be distributed in accordance with 641.22 Minnesota Statutes, section 256.956. 641.23 Subd. 7. Basic Health Care Management 641.24 General 22,467,000 24,091,000 641.25 Health Care 641.26 Access 16,528,000 18,135,000 641.27 The amounts that may be spent from this 641.28 appropriation for each purpose are as 641.29 follows: 641.30 (a) Health Care Policy Administration 641.31 General 3,595,000 4,938,000 641.32 Health Care 641.33 Access 578,000 595,000 641.34 [OUTREACH EFFORTS.] (a) Of the general 641.35 fund appropriation, $120,000 each year 641.36 is to the commissioner to: 641.37 (1) coordinate a public/private 641.38 partnership to provide a statewide 641.39 outreach campaign on the importance of 641.40 health coverage and the availability of 641.41 coverage through both public assistance 641.42 health care programs and the private 641.43 health insurance market. The campaign 641.44 shall include messages directed to the 641.45 general population as well as 641.46 culturally specific and community-based 641.47 messages; and 641.48 (2) award grants to public or private 641.49 organizations to provide local 641.50 community-based outreach to assist 641.51 families with children in obtaining 641.52 health coverage. In awarding these 642.1 grants, the commissioner shall consider 642.2 the following: 642.3 (i) the ability to contact or serve 642.4 non-English-speaking families; 642.5 (ii) the ability to provide trained 642.6 workers at accessible outreach centers 642.7 to assist families with children by 642.8 offering services ranging from 642.9 providing information up to on-site 642.10 enrollment in a health care program; 642.11 and 642.12 (iii) the ability to serve geographic 642.13 areas and populations with the greatest 642.14 disparity in health coverage and health 642.15 status. 642.16 (b) The commissioner shall include 642.17 specific performance expectations that 642.18 will require grantees to track the 642.19 number of enrollees in state programs, 642.20 monitor these grants, and may terminate 642.21 a grant if the outreach effort does not 642.22 increase enrollment in the state health 642.23 care programs. 642.24 (c) The commissioner shall provide 642.25 applications and other health care 642.26 program information to provider 642.27 offices, hospitals, local human 642.28 services agencies, community health 642.29 sites, and elementary schools to 642.30 encourage and assist these sites in 642.31 conducting outreach efforts. These 642.32 sites may assist families with children 642.33 by offering services ranging from 642.34 providing information up to on-site 642.35 enrollment in public assistance 642.36 programs. 642.37 [LONG-TERM CARE EMPLOYEE INSURANCE 642.38 PROGRAM ADMINISTRATION.] Of the general 642.39 fund appropriation, $500,000 in fiscal 642.40 year 2002 and $1,750,000 in fiscal year 642.41 2003 is for the administrative costs 642.42 associated with the long-term care 642.43 employee insurance program under 642.44 Minnesota Statutes, section 256.956. 642.45 (b) Health Care Operations 642.46 General 18,872,000 19,153,000 642.47 Health Care 642.48 Access 15,950,000 17,540,000 642.49 [PREPAID MEDICAL PROGRAMS.] The 642.50 nonfederal share of the prepaid medical 642.51 assistance program fund, which has been 642.52 appropriated to fund county managed 642.53 care advocacy and enrollment operating 642.54 costs, shall be disbursed as grants 642.55 using either a reimbursement or block 642.56 grant mechanism and may also be 642.57 transferred between grants and nongrant 642.58 administration costs with approval of 642.59 the commissioner of finance. 642.60 Subd. 8. State-Operated Services 643.1 General 211,440,000 206,465,000 643.2 [MITIGATION RELATED TO STATE-OPERATED 643.3 SERVICES RESTRUCTURING.] Money 643.4 appropriated to finance mitigation 643.5 expenses related to restructuring 643.6 state-operated services programs and 643.7 administrative services may be 643.8 transferred between fiscal years within 643.9 the biennium. 643.10 [STATE-OPERATED SERVICES CHEMICAL 643.11 DEPENDENCY PROGRAMS.] When the 643.12 operations of the state-operated 643.13 services chemical dependency fund 643.14 created in Minnesota Statutes, section 643.15 246.18, subdivision 2, are impeded by 643.16 projected cash deficiencies resulting 643.17 from delays in the receipt of grants, 643.18 dedicated income, or other similar 643.19 receivables, and when the deficiencies 643.20 would be corrected within the budget 643.21 period involved, the commissioner of 643.22 finance may transfer general fund cash 643.23 reserves into this account as necessary 643.24 to meet cash demands. The cash flow 643.25 transfers must be returned to the 643.26 general fund in the fiscal year that 643.27 the transfer was made. Any interest 643.28 earned on general fund cash flow 643.29 transfers accrues to the general fund 643.30 and not the state-operated services 643.31 chemical dependency fund. 643.32 [STATE-OPERATED SERVICES 643.33 RESTRUCTURING.] For purposes of 643.34 restructuring state-operated services, 643.35 any state-operated services employee 643.36 whose position is to be eliminated 643.37 shall be afforded the options provided 643.38 in applicable collective bargaining 643.39 agreements. All salary and mitigation 643.40 allocations from fiscal year 2002 shall 643.41 be carried forward into fiscal year 643.42 2003. Provided there is no conflict 643.43 with any collective bargaining 643.44 agreement, any state-operated services 643.45 position reduction must only be 643.46 accomplished through mitigation, 643.47 attrition, transfer, and other measures 643.48 as provided in state or applicable 643.49 collective bargaining agreements and in 643.50 Minnesota Statutes, section 252.50, 643.51 subdivision 11, and not through layoff. 643.52 [REPAIRS AND BETTERMENTS.] The 643.53 commissioner may transfer unencumbered 643.54 appropriation balances between fiscal 643.55 years for the state residential 643.56 facilities repairs and betterments 643.57 account and special equipment. 643.58 [NAMES REQUIRED ON GRAVES.] (a) Of this 643.59 appropriation, $300,000 in fiscal year 643.60 2002 is to replace numbers with the 643.61 names of individuals at all graves 643.62 located at regional treatment centers 643.63 operated or formerly operated by the 643.64 commissioner. 643.65 (b) Twenty percent of this 644.1 appropriation must be transferred to a 644.2 consumer run disability rights 644.3 organization located in St. Paul for 644.4 community organizing, coordination, 644.5 fundraising, and administrative costs. 644.6 (c) Any unexpended portion of this 644.7 appropriation shall not cancel but 644.8 shall be available in fiscal year 2003 644.9 for these purposes. This is a one-time 644.10 appropriation and shall not become part 644.11 of the base level funding for the 644.12 2004-2005 biennium. 644.13 [BUILDING REMODELING.] The commissioner 644.14 shall use $400,000 from the 644.15 appropriation for repairs and 644.16 betterments to remodel building 6 at 644.17 the Brainerd regional human services 644.18 center to make the structure suitable 644.19 for school programs. The Brainerd 644.20 school district shall reimburse the 644.21 commissioner $200,000 in fiscal year 644.22 2002 and $200,000 in fiscal year 2003 644.23 through a lease agreement for these 644.24 remodeling costs. 644.25 Subd. 9. Continuing Care Grants 644.26 General 1,363,147,000 1,474,989,000 644.27 Lottery Cash Flow 3,850,000 3,300,000 644.28 The amounts that may be spent from this 644.29 appropriation for each purpose are as 644.30 follows: 644.31 (a) Community Social Services 644.32 Block Grants 644.33 48,910,000 49,836,000 644.34 [CSSA TRADITIONAL APPROPRIATION.] 644.35 Notwithstanding Minnesota Statutes, 644.36 section 256E.06, subdivisions 1 and 2, 644.37 the appropriations available under that 644.38 section in fiscal years 2002 and 2003 644.39 must be distributed to each county 644.40 proportionately to the aid received by 644.41 the county in calendar year 2000. 644.42 (b) Aging Adult Service Grants 644.43 14,117,000 13,788,000 644.44 [AGING AND ADULT SERVICE GRANT 644.45 CARRYFORWARD AUTHORITY.] (a) Money 644.46 appropriated for Senior LinkAge line, 644.47 community services grants, and access 644.48 demonstration project grants shall be 644.49 used by the commissioner to maximize 644.50 federal reimbursement according to 644.51 federal law, rule, and regulation. 644.52 (b) Unexpended funds appropriated for 644.53 Senior LinkAge line, community services 644.54 grants, and access demonstration 644.55 project grants for fiscal year 2002 do 644.56 not cancel but are available to the 644.57 commissioner for these purposes for 644.58 fiscal year 2003. 645.1 [HOME-SHARING GRANTS.] Of this 645.2 appropriation, $225,000 in fiscal year 645.3 2002 and $400,000 in fiscal year 2003 645.4 is for the home-sharing grant program 645.5 under Minnesota Statutes, section 645.6 256.973. This appropriation shall 645.7 become part of the base level funding 645.8 for the 2004-2005 biennium. 645.9 [THE CENTER FOR VICTIMS OF TORTURE.] Of 645.10 the appropriation for fiscal year 2002, 645.11 $450,000 is for a grant to the center 645.12 for victims of torture. The grant is 645.13 to be used to conduct continuing 645.14 education and training of health care 645.15 and human service workers on how to 645.16 identify torture survivors, provide 645.17 appropriate care and make referrals, 645.18 and to establish a network of care 645.19 providers who will offer pro bono 645.20 services for survivors of politically 645.21 motivated torture. This is a one-time 645.22 appropriation requiring a one-to-one, 645.23 nonstate, in-kind match, and is 645.24 available until expended. 645.25 (c) Deaf and Hard-of-Hearing 645.26 Services Grants 645.27 2,169,000 1,943,000 645.28 [SERVICES TO DEAF PERSONS WITH MENTAL 645.29 ILLNESS.] (a) Of this appropriation, 645.30 $125,000 in fiscal year 2002 and 645.31 $60,000 in fiscal year 2003 is for a 645.32 grant to a nonprofit agency that 645.33 currently serves deaf and 645.34 hard-of-hearing adults with mental 645.35 illness through residential programs 645.36 and supportive housing outreach 645.37 activities. The grant must be used to 645.38 continue and maintain community support 645.39 services for deaf and hard-of-hearing 645.40 adults with mental illness who use or 645.41 wish to use sign language as their 645.42 primary means of communication. 645.43 (b) The grant for fiscal year 2003 645.44 shall be increased by $65,000 minus 645.45 earnings achieved by the grantee 645.46 through participation in the medical 645.47 assistance rehabilitation option for 645.48 persons with mental illness under 645.49 Minnesota Statutes, section 256B.0623. 645.50 The grant shall not be less than 645.51 $60,000. 645.52 (c) The base level funding for the 645.53 2004-2005 biennium shall be $125,000 645.54 minus earnings achieved by the grantee 645.55 through participation in the medical 645.56 assistance rehabilitation option for 645.57 persons with mental illness under 645.58 Minnesota Statutes, section 256B.0623. 645.59 [COMMISSION SERVING DEAF AND 645.60 HARD-OF-HEARING PEOPLE.] Of this 645.61 appropriation, $5,000 in fiscal year 645.62 2002 is to the commissioner for the 645.63 Minnesota commission serving deaf and 645.64 hard-of-hearing people to carry out the 646.1 duties under Minnesota Statutes, 646.2 section 256C.28. 646.3 [DEAF-BLIND SERVICES.] Of this 646.4 appropriation, $212,000 in fiscal year 646.5 2002 and $150,000 in fiscal year 2003 646.6 are for grants to providers to provide 646.7 deaf-blind persons with residential 646.8 training and self-sufficiency supports. 646.9 (d) Mental Health Grants 646.10 General 52,694,000 54,386,000 646.11 Lottery Cash Flow 3,850,000 3,300,000 646.12 [MENTAL HEALTH COUNSELING FOR FARM 646.13 FAMILIES.] Of the general fund 646.14 appropriation, $150,000 in fiscal year 646.15 2002 and $150,000 in fiscal year 2003 646.16 is to be transferred to the board of 646.17 trustees of the Minnesota state 646.18 colleges and universities for mental 646.19 health counseling support to farm 646.20 families and business operators through 646.21 the farm business management program at 646.22 Central Lakes College and Ridgewater 646.23 College. This appropriation is 646.24 available until June 30, 2003. 646.25 [COSTS ASSOCIATED WITH STATE INMATES 646.26 WITH MENTAL ILLNESS.] (a) Of the 646.27 general fund appropriation, $125,000 in 646.28 fiscal year 2002 and $185,000 in fiscal 646.29 year 2003 is for evaluation and support 646.30 staff to do discharge planning under 646.31 Minnesota Statutes, section 244.054, 646.32 for persons with serious and persistent 646.33 mental illness being discharged from 646.34 prison. These staff shall be employed 646.35 by the commissioner but assigned at the 646.36 direction of the commissioner of 646.37 corrections. 646.38 (b) Of the general fund appropriation, 646.39 the following amounts shall be 646.40 transferred to the commissioner of 646.41 corrections for the purposes indicated: 646.42 (1) $258,000 in fiscal year 2002 and 646.43 $258,000 in fiscal year 2003 for the 646.44 staff and travel costs associated with 646.45 discharge planning under Minnesota 646.46 Statutes, section 244.054, for persons 646.47 with serious and persistent mental 646.48 illness; 646.49 (2) $769,000 in fiscal year 2002 and 646.50 $638,000 in fiscal year 2003 for grants 646.51 to counties under the transitional 646.52 housing and community support program 646.53 for former state inmates with serious 646.54 and persistent mental illness; and 646.55 (3) $24,000 in fiscal year 2002 and 646.56 $24,000 in fiscal year 2003 for the 646.57 cost of medications for state inmates 646.58 with serious and persistent mental 646.59 illness. 646.60 [ADULT MENTAL HEALTH EMERGENCY 647.1 SERVICES.] Of the general fund 647.2 appropriation, $1,000,000 in fiscal 647.3 year 2002 and $1,000,000 in fiscal year 647.4 2003 is for adult mental health 647.5 emergency services under Minnesota 647.6 Statutes, section 245.469. 647.7 [COMPULSIVE GAMBLING.] Of the 647.8 appropriation from the lottery prize 647.9 fund to the commissioner for the 647.10 compulsive gambling treatment program: 647.11 (1) $1,500,000 in fiscal year 2002 and 647.12 $1,500,000 in fiscal year 2003 is for 647.13 treatment of pathological and problem 647.14 gambling as specified under Minnesota 647.15 Statutes, section 245.98, subdivision 647.16 6; 647.17 (2) $100,000 in fiscal year 2002 and 647.18 $200,000 in fiscal year 2003 is for 647.19 compulsive gambling treatment for 647.20 minority groups or persons with 647.21 disabilities on a grant basis to at 647.22 least two different providers serving 647.23 different populations; 647.24 (3) $500,000 in fiscal year 2003 is for 647.25 grants to be used as start-up funding 647.26 for new treatment programs in 647.27 underserved areas of the state. This 647.28 is a one-time appropriation and shall 647.29 not become part of the base level 647.30 funding for the 2004-2005 biennium; 647.31 (4) $300,000 in fiscal year 2002 is for 647.32 a prevalence study required by Laws 647.33 1998, chapter 407, article 8, section 647.34 9, paragraph (a). This is a one-time 647.35 appropriation and shall not become part 647.36 of the base appropriation for the 647.37 2004-2005 biennium; 647.38 (5) $100,000 for fiscal year 2002 is 647.39 for study on the impact of problem 647.40 gambling as required by Laws 1998, 647.41 chapter 407, article 8, section 9, 647.42 paragraph (b). This is a one-time 647.43 appropriation and shall not become part 647.44 of the base level funding for the 647.45 2004-2005 biennium; 647.46 (6) $50,000 in fiscal year 2002 and 647.47 $50,000 in fiscal year 2003 is for the 647.48 purposes of assessing the results of 647.49 treatment provided through the 647.50 compulsive gambling program. This is a 647.51 one-time appropriation and shall not 647.52 become part of the base level funding 647.53 for the 2004-2005 biennium; 647.54 (7) $100,000 in fiscal year 2002 and 647.55 $100,000 in fiscal year 2003 is for a 647.56 grant to the University of Minnesota 647.57 medical school for research on the 647.58 effectiveness of pharmaceutical 647.59 treatment of pathological gambling. 647.60 This is a one-time appropriation and 647.61 shall not become part of the base 647.62 appropriation for the 2004-2005 647.63 biennium; 648.1 (8) $600,000 in fiscal year 2002 and 648.2 $600,000 in fiscal year 2003 is for the 648.3 state problem gambling help line and 648.4 for initiatives to increase public 648.5 awareness of problem and pathological 648.6 gambling and to assist in its 648.7 prevention; 648.8 (9) $150,000 in fiscal year 2002 and 648.9 $150,000 in fiscal year 2003 is for 648.10 grants for educating and training in 648.11 the the identification of individuals 648.12 who may need treatment for problem or 648.13 pathological gambling and counseling 648.14 individuals or families on treatment 648.15 options. This is a one-time 648.16 appropriation and shall not become part 648.17 of the base level funding for the 648.18 2004-2005 biennium; 648.19 (10) $50,000 in fiscal year 2002 and 648.20 $50,000 in fiscal year 2003 is for 648.21 training of individuals who will 648.22 provide treatment and prevention for 648.23 minority or underserved populations. 648.24 This is a one-time appropriation and 648.25 shall not become part of the base level 648.26 funding for the 2004-2005 biennium; 648.27 (11) $750,000 in fiscal year 2002 is 648.28 for a grant to reconstruct project 648.29 turnabout in Granite Falls that was 648.30 destroyed by the Granite Falls 648.31 tornado. This is a one-time 648.32 appropriation and shall not become part 648.33 of the base appropriation for the 648.34 2004-2005 biennium; and 648.35 (12) $150,000 in fiscal year 2002 and 648.36 $150,000 in fiscal year 2003 is for a 648.37 grant to a compulsive gambling council 648.38 located in St. Louis county. The 648.39 gambling council shall provide a 648.40 statewide compulsive gambling 648.41 prevention and education project for 648.42 adolescents. This is a one-time 648.43 appropriation and shall not become part 648.44 of the base appropriation for the 648.45 2004-2005 biennium. 648.46 The unencumbered balance of the 648.47 appropriation from the lottery prize 648.48 fund in the first year of the biennium 648.49 does not cancel but is available for 648.50 the second year. 648.51 (e) Community Support Grants 648.52 12,555,000 12,815,000 648.53 (f) Medical Assistance Long-Term 648.54 Care Waivers and Home Care 648.55 452,925,000 536,099,000 648.56 [NURSING FACILITY OPERATED BY THE RED 648.57 LAKE BAND OF CHIPPEWA INDIANS.] (1) The 648.58 medical assistance payment rates for 648.59 the 47-bed nursing facility operated by 648.60 the Red Lake Band of Chippewa Indians 648.61 must be calculated according to 649.1 allowable reimbursement costs under the 649.2 medical assistance program, as 649.3 specified in Minnesota Statutes, 649.4 section 246.50, and are subject to the 649.5 facility-specific Medicare upper limits. 649.6 (2) In addition, the commissioner shall 649.7 make available rate adjustments for the 649.8 biennium beginning July 1, 2001, on the 649.9 same basis as the adjustments provided 649.10 to nursing facilities under Minnesota 649.11 Statutes, section 256B.431. The 649.12 commissioner must use the facility's 649.13 final 2000 and 2001 Medicare cost 649.14 reports to calculate the adjustments. 649.15 This rate increase shall become part of 649.16 the facility's base rate for future 649.17 rate years. 649.18 (g) Medical Assistance Long-Term 649.19 Care Facilities 649.20 574,687,000 575,318,000 649.21 [LONG-TERM CARE CONSULTATION SERVICES.] 649.22 Long-term care consultation services 649.23 payments to all counties shall continue 649.24 at the payment amount in effect for 649.25 preadmission screening in fiscal year 649.26 2001, as adjusted for county 649.27 participation in the access 649.28 demonstration project. 649.29 [MORATORIUM EXCEPTION ADMINISTRATIVE 649.30 PROCESS.] Of this appropriation, 649.31 $350,000 in fiscal year 2002 and 649.32 $650,000 in fiscal year 2003 is for the 649.33 moratorium exception administrative 649.34 process under Minnesota Statutes, 649.35 section 144A.073. The annualized state 649.36 share of medical assistance costs for 649.37 projects approved during each year of 649.38 the biennium must not exceed $1,400,000. 649.39 [RATE INCREASE APPLICABILITY.] The 649.40 nursing facility rate increase provided 649.41 under Minnesota Statutes, section 649.42 256B.431, subdivision 32, for the first 649.43 90 paid days of an admission shall 649.44 apply only to admissions occurring on 649.45 or after July 1, 2001. 649.46 (h) Alternative Care Grants 649.47 General 76,204,000 90,680,000 649.48 [ALTERNATIVE CARE TRANSFER.] Any money 649.49 allocated to the alternative care 649.50 program that is not spent for the 649.51 purposes indicated does not cancel but 649.52 shall be transferred to the medical 649.53 assistance account. 649.54 [ALTERNATIVE CARE APPROPRIATION.] The 649.55 commissioner may expend the money 649.56 appropriated for the alternative care 649.57 program for that purpose in either year 649.58 of the biennium. 649.59 (i) Group Residential Housing 650.1 General 80,228,000 88,583,000 650.2 (j) Chemical Dependency 650.3 Entitlement Grants 650.4 General 42,330,000 45,213,000 650.5 (k) Chemical Dependency 650.6 Nonentitlement Grants 650.7 General 6,328,000 6,328,000 650.8 Subd. 10. Continuing Care Management 650.9 General 22,215,000 22,421,000 650.10 State Government 650.11 Special Revenue 117,000 119,000 650.12 Lottery Cash Flow 240,000 240,000 650.13 [COUNTY INVOLVEMENT COSTS.] Of the 650.14 general fund appropriation, up to 650.15 $384,000 in fiscal year 2002 and up to 650.16 $514,000 in fiscal year 2003 is for the 650.17 commissioner to allocate to counties 650.18 for resident relocation costs resulting 650.19 from planned closures under Minnesota 650.20 Statutes, section 256B.437, and 650.21 resident relocations under Minnesota 650.22 Statutes, section 144A.161. Unexpended 650.23 funds for fiscal year 2002 do not 650.24 cancel but are available to the 650.25 commissioner for this purpose in fiscal 650.26 year 2003. 650.27 [COMPULSIVE GAMBLING ADMINISTRATION.] 650.28 Of the lottery cash flow appropriation, 650.29 $240,000 in fiscal year 2002 and 650.30 $240,000 in fiscal year 2003 is for 650.31 administration of the compulsive 650.32 gambling treatment program. 650.33 Subd. 11. Economic Support Grants 650.34 General 134,006,000 137,928,000 650.35 Federal TANF 223,257,000 232,111,000 650.36 The amounts that may be spent from this 650.37 appropriation for each purpose are as 650.38 follows: 650.39 (a) Assistance to Families Grants 650.40 General 69,932,000 72,531,000 650.41 Federal TANF 115,732,000 107,116,000 650.42 (b) Work Grants 650.43 General 9,844,000 9,844,000 650.44 Federal TANF 68,513,000 68,513,000 650.45 [LOCAL INTERVENTION GRANTS FOR 650.46 SELF-SUFFICIENCY CARRYFORWARD.] 650.47 Unexpended funds appropriated for local 650.48 intervention grants under Minnesota 650.49 Statutes, section 256J.625, for fiscal 650.50 year 2002 do not cancel but are 651.1 available to the commissioner for these 651.2 purposes in fiscal year 2003. 651.3 [SOUTHEAST ASIAN TRANSITIONAL 651.4 EMPLOYMENT TRAINING PROJECT.] (a) 651.5 Federal TANF funds, as specified in 651.6 this paragraph, are appropriated to the 651.7 commissioner for a grant to a nonprofit 651.8 collaborative in Hennepin county 651.9 specializing in services to Southeast 651.10 Asians for an "intensive intervention" 651.11 transitional employment training 651.12 project to move refugee and immigrant 651.13 welfare recipients into unsubsidized 651.14 employment leading to 651.15 self-sufficiency. $800,000 in fiscal 651.16 year 2002 and $800,000 in fiscal year 651.17 2003 is appropriated to the 651.18 commissioner for a grant to a nonprofit 651.19 collaborative in Hennepin county 651.20 specializing in services to Southeast 651.21 Asians. This is a one-time 651.22 appropriation and shall not become part 651.23 of the base level funding for the 651.24 2004-2005 biennium. 651.25 (b) One of the five partners in the 651.26 collaborative shall be chosen as the 651.27 fiscal agent by the commissioner. The 651.28 primary effort must be on intensive 651.29 employment skills training, including 651.30 workplace English and overcoming 651.31 cultural barriers, and on specialized 651.32 training in fields of work which 651.33 involve a credit-based curriculum. For 651.34 recipients without a high school 651.35 diploma or a GED, extra effort shall be 651.36 made to help the recipient meet the 651.37 "ability to benefit test" so the 651.38 recipient can receive financial aid for 651.39 further training. During the 651.40 specialized training, efforts shall be 651.41 made to involve the recipients with an 651.42 internship program and retention 651.43 specialist. Up to ten percent of the 651.44 grant shall be used for other efforts 651.45 to make the recipient families more 651.46 self-sufficient as provided within TANF 651.47 rules. 651.48 (c) Economic Support Grants - 651.49 Other Assistance 651.50 General 2,907,000 3,065,000 651.51 Federal TANF 38,752,000 56,222,000 651.52 [TANF TRANSFER TO CHILD CARE BLOCK 651.53 GRANT.] $2,009,000 for fiscal year 2002 651.54 and $16,097,000 for fiscal year 2003 is 651.55 appropriated to the commissioner of 651.56 children, families, and learning for 651.57 the purposes of Minnesota Statutes, 651.58 section 119B.05. The commissioner of 651.59 human services shall authorize a 651.60 sufficient transfer of funds from the 651.61 state's federal TANF block grant to the 651.62 state's child care development fund 651.63 block grant to meet this appropriation. 651.64 [WORKING FAMILY CREDIT.] (a) On a 652.1 regular basis, the commissioner of 652.2 revenue, with the assistance of the 652.3 commissioner of human services, shall 652.4 calculate the value of the refundable 652.5 portion of the Minnesota working family 652.6 credits provided under Minnesota 652.7 Statutes, section 290.0671, that 652.8 qualifies for federal reimbursement 652.9 from the TANF block grant. The 652.10 commissioner of revenue shall provide 652.11 the commissioner of human services with 652.12 such expenditure records and 652.13 information as are necessary to support 652.14 draw-down of federal funds. 652.15 (b) Federal TANF funds, as specified in 652.16 this paragraph, are appropriated to the 652.17 commissioner of human services on 652.18 calculations under paragraph (a) of 652.19 working family tax credit expenditures 652.20 that qualify for reimbursement from the 652.21 TANF block grant for income tax refunds 652.22 payable in federal fiscal years 652.23 beginning October 1, 2001. The 652.24 draw-down of federal TANF funds shall 652.25 be made on a regular basis based on 652.26 calculations of credit expenditures by 652.27 the commissioner of revenue. 652.28 $35,743,000 in fiscal year 2002, 652.29 $39,125,000 in fiscal year 2003, 652.30 $37,720,000 in fiscal year 2004, and 652.31 $40,149,000 in fiscal year 2005 are 652.32 appropriated to the commissioner of 652.33 human services. These funds shall be 652.34 transferred to the commissioner of 652.35 revenue to deposit into the general 652.36 fund. 652.37 [PRIOR YEAR APPROPRIATION REPEALED.] 652.38 Notwithstanding Laws 2000, chapter 488, 652.39 article 8, section 2, subdivision 6, as 652.40 amended by Laws 2000, chapter 499, 652.41 sections 22 and 39, the commissioner 652.42 shall not transfer $7,500,000 from the 652.43 state's federal TANF block grant to the 652.44 state's federal Title XX block grant in 652.45 fiscal year 2002 for purposes of 652.46 increasing services for families with 652.47 children whose incomes are at or below 652.48 200 percent of the federal poverty 652.49 guidelines. 652.50 [MINNESOTA FOOD ASSISTANCE PROGRAM.] Of 652.51 the general fund appropriation, 652.52 $225,000 in fiscal year 2002 and 652.53 $1,134,000 in fiscal year 2003 is for 652.54 the Minnesota food assistance program. 652.55 (d) Child Support Enforcement 652.56 General 4,239,000 4,239,000 652.57 Federal TANF 260,000 260,000 652.58 [CHILD SUPPORT PAYMENT CENTER.] 652.59 Payments to the commissioner from other 652.60 governmental units, private 652.61 enterprises, and individuals for 652.62 services performed by the child support 652.63 payment center must be deposited in the 652.64 state systems account authorized under 653.1 Minnesota Statutes, section 256.014. 653.2 These payments are appropriated to the 653.3 commissioner for the operation of the 653.4 child support payment center or system, 653.5 according to Minnesota Statutes, 653.6 section 256.014. 653.7 (e) General Assistance 653.8 General 17,156,000 16,648,000 653.9 [GENERAL ASSISTANCE STANDARD.] The 653.10 commissioner shall set the monthly 653.11 standard of assistance for general 653.12 assistance units consisting of an adult 653.13 recipient who is childless and 653.14 unmarried or living apart from his or 653.15 her parents or a legal guardian at 653.16 $203. The commissioner may reduce this 653.17 amount in accordance with Laws 1997, 653.18 chapter 85, article 3, section 54. 653.19 (f) Minnesota Supplemental Aid 653.20 General 29,678,000 31,351,000 653.21 (g) Refugee Services 653.22 General 250,000 250,000 653.23 Subd. 12. Economic Support 653.24 Management 653.25 General 45,943,000 46,665,000 653.26 Health Care 653.27 Access 1,333,000 1,349,000 653.28 Federal TANF 743,000 743,000 653.29 The amounts that may be spent from this 653.30 appropriation for each purpose are as 653.31 follows: 653.32 (a) Economic Support Policy 653.33 Administration 653.34 General 8,655,000 8,789,000 653.35 Federal TANF 743,000 743,000 653.36 [FOOD STAMP ADMINISTRATIVE 653.37 REIMBURSEMENT.] The commissioner shall 653.38 reduce quarterly food stamp 653.39 administrative reimbursement to 653.40 counties in fiscal years 2002 and 2003 653.41 by the amount that the United States 653.42 Department of Health and Human Services 653.43 determines to be the county random 653.44 moment study share of the food stamp 653.45 adjustment under Public Law Number 653.46 105-185. The reductions shall be 653.47 allocated to each county in proportion 653.48 to each county's contribution, if any, 653.49 to the amount of the adjustment. Any 653.50 adjustment to medical assistance 653.51 administrative reimbursement that is 653.52 based on the United States Department 653.53 of Health and Human Services' 653.54 determinations under Public Law Number 653.55 105-185 shall be distributed to 654.1 counties in the same manner. 654.2 (b) Economic Support Operations 654.3 General 37,288,000 37,876,000 654.4 Health Care 654.5 Access 1,333,000 1,349,000 654.6 [SPENDING AUTHORITY FOR FOOD STAMP 654.7 ENHANCED FUNDING.] In the event that 654.8 Minnesota qualifies for United States 654.9 Department of Agriculture Food and 654.10 Nutrition Services Food Stamp Program 654.11 enhanced funding beginning in federal 654.12 fiscal year 1998, the money is 654.13 appropriated to the commissioner for 654.14 the purposes of the program. The 654.15 commissioner may retain 25 percent of 654.16 the enhanced funding, with the 654.17 remaining 75 percent divided among the 654.18 counties according to a formula that 654.19 takes into account each county's impact 654.20 on the statewide food stamp error rate. 654.21 [FINANCIAL INSTITUTION DATA MATCH AND 654.22 PAYMENT OF FEES.] The commissioner is 654.23 authorized to allocate up to $310,000 654.24 in each year of the biennium from the 654.25 PRISM special revenue account to make 654.26 payments to financial institutions in 654.27 exchange for performing data matches 654.28 between account information held by 654.29 financial institutions and the public 654.30 authority's database of child support 654.31 obligors as authorized by Minnesota 654.32 Statutes, section 13B.06, subdivision 7. 654.33 Sec. 3. COMMISSIONER OF HEALTH 654.34 Subdivision 1. Total 654.35 Appropriation 131,234,000 130,339,000 654.36 Summary by Fund 654.37 General 83,930,000 87,719,000 654.38 State Government 654.39 Special Revenue 26,829,000 28,713,000 654.40 Health Care 654.41 Access 13,935,000 7,367,000 654.42 Federal TANF 6,540,000 6,540,000 654.43 Subd. 2. Family and 654.44 Community Health 68,501,000 72,669,000 654.45 Summary by Fund 654.46 General 57,318,000 60,430,000 654.47 State Government 654.48 Special Revenue 961,000 1,987,000 654.49 Health Care 654.50 Access 3,682,000 3,712,000 654.51 Federal TANF 6,540,000 6,540,000 654.52 [HEALTH DISPARITIES.] Of the general 655.1 fund appropriation, $6,450,000 in 655.2 fiscal year 2002 and $7,450,000 in 655.3 fiscal year 2003 is for reducing health 655.4 disparities to be spent as follows: 655.5 (1) $3,400,000 the first year and 655.6 $4,150,000 the second year for grants 655.7 to community organizations for 655.8 prevention services targeted to 655.9 populations affected by health 655.10 disparities; 655.11 (2) $2,150,000 the first year and 655.12 $2,350,000 the second year for grants 655.13 to community health boards. 655.14 (3) $500,000 each year for grants to 655.15 tribal governments to support efforts 655.16 to identify and implement culturally 655.17 based community interventions that 655.18 reduce health disparities for American 655.19 Indians; 655.20 (4) $200,000 the first year and 655.21 $250,000 the second year for 655.22 distribution to the community health 655.23 boards in accordance with Minnesota 655.24 Statutes, section 145.9269, subdivision 655.25 9, for health screening and follow-up 655.26 services for foreign-born persons; and 655.27 (5) $200,000 each year for state 655.28 administrative costs. 655.29 [IMMUNIZATION INFORMATION SERVICE.] Of 655.30 the general fund appropriation, 655.31 $1,000,000 the first year and 655.32 $2,000,000 the second year is available 655.33 to the commissioner for grants to 655.34 community health boards as defined in 655.35 Minnesota Statutes, section 145A.02, to 655.36 support the development of a statewide 655.37 immunization information service and to 655.38 support maintenance of current registry 655.39 activities related to tracking medical 655.40 assistance-eligible children. 655.41 [PROMOTING HEALTHY LIFESTYLES.] 655.42 $6,540,000 from the TANF fund in fiscal 655.43 years 2002 and 2003 is appropriated to 655.44 the commissioner to award grants to 655.45 promote healthy behaviors among youth 655.46 in accordance with Minnesota Statutes, 655.47 section 145.9263. 655.48 Of this amount, $3,000,000 is for local 655.49 grants under Minnesota Statutes, 655.50 section 145.9263, subdivision 2; 655.51 $3,000,000 is for community youth 655.52 grants under Minnesota Statutes, 655.53 section 145.9263, subdivision 3; 655.54 $480,000 is for a statewide outreach 655.55 campaign under Minnesota Statutes, 655.56 section 145.9263, subdivision 4; and 655.57 $60,000 is for training and technical 655.58 assistance. 655.59 [PROMOTING HEALTHY LIFESTYLES 655.60 CARRYFORWARD.] Any unexpended balance 655.61 of the TANF funds appropriated for the 655.62 promoting healthy lifestyles grant 656.1 program established under Minnesota 656.2 Statutes, section 145.9263, in the 656.3 first fiscal year of the biennium does 656.4 not cancel but is available for the 656.5 second year. 656.6 [HEALTH WORKFORCE DEVELOPMENT.] Of the 656.7 general fund appropriation, $1,003,000 656.8 in the first year and $1,967,000 in the 656.9 second year is to expand the health 656.10 professionals loan program, of which 656.11 $963,000 in the first year and 656.12 $1,927,000 in the second year is for 656.13 direct grants to increase the placement 656.14 of physicians, dentists, pharmacists, 656.15 mental health providers, health care 656.16 technicians in rural communities, and 656.17 nurses in nursing homes, ICFs/MR, and 656.18 home health care agencies statewide. 656.19 [POISON INFORMATION SYSTEM.] Of the 656.20 general fund appropriation, $1,360,000 656.21 each fiscal year is for poison control 656.22 system grants under Minnesota Statutes, 656.23 section 145.93. 656.24 [WIC TRANSFERS.] The general fund 656.25 appropriation for the women, infants, 656.26 and children (WIC) food supplement 656.27 program is available for either year of 656.28 the biennium. Transfers of these funds 656.29 between fiscal years must be either to 656.30 maximize federal funds or to minimize 656.31 fluctuations in the number of program 656.32 participants. 656.33 [MINNESOTA CHILDREN WITH SPECIAL HEALTH 656.34 NEEDS CARRYFORWARD.] General fund 656.35 appropriations for treatment services 656.36 in the services for Minnesota children 656.37 with special health needs program are 656.38 available for either year of the 656.39 biennium. 656.40 [HOME VISITING PROGRAM.] Of the general 656.41 fund appropriation, $7,000,000 each 656.42 year is for distribution to county 656.43 boards according to the formula in 656.44 Minnesota Statutes, section 256J.625, 656.45 subdivision 3, to be used by county 656.46 public health boards to serve families 656.47 with incomes at or below 200 percent of 656.48 the federal poverty guidelines, in the 656.49 manner specified by Minnesota Statutes, 656.50 section 145A.16, subdivision 3, clauses 656.51 (2), (3), (4), (5), and (6). Training, 656.52 evaluation, and technical assistance 656.53 shall be provided in accordance with 656.54 Minnesota Statutes, section 145A.16, 656.55 subdivisions 5, 6, and 7. This 656.56 appropriation shall not become a part 656.57 of the agency's base funding for the 656.58 2004-2005 biennium. 656.59 [HOME VISITING TANF BASE REDUCTION.] 656.60 Notwithstanding Laws 2000, chapter 488, 656.61 article 8, section 2, subdivision 6, as 656.62 amended by Laws 2000, chapter 499, 656.63 sections 22 and 39, base level funding 656.64 from the state's federal TANF block 656.65 grant for the home visiting program 657.1 under Minnesota Statutes, section 657.2 145A.16, for fiscal year 2002 and 657.3 fiscal year 2003 is zero. 657.4 [SUICIDE PREVENTION.] Of the general 657.5 fund appropriation, $1,025,000 each 657.6 year is to fund community-based suicide 657.7 prevention programs under Minnesota 657.8 Statutes, section 145.56, subdivision 657.9 2, and $75,000 each year is for the 657.10 commissioner for suicide prevention 657.11 activities under Minnesota Statutes, 657.12 section 145.56, subdivisions 1, 3, 4, 657.13 and 5. 657.14 [INFORMED CONSENT.] $172,000 in fiscal 657.15 year 2002 and $359,000 in fiscal year 657.16 2003 are for the commissioner to 657.17 implement Minnesota Statutes, sections 657.18 145.4241 to 145.4247. 657.19 Subd. 3. Access and Quality 657.20 Improvement 27,028,000 20,480,000 657.21 Summary by Fund 657.22 General 8,263,000 8,231,000 657.23 State Government 657.24 Special Revenue 8,512,000 8,594,000 657.25 Health Care 657.26 Access 10,253,000 3,655,000 657.27 [STOP-LOSS FUND.] Of the health care 657.28 access fund appropriation, $200,000 the 657.29 first year and $50,000 the second year 657.30 is for grants to organizations 657.31 developing health care purchasing 657.32 alliances established under Minnesota 657.33 Statutes, chapter 62T. Of this 657.34 appropriation, $50,000 the first year 657.35 is for a grant to the University of 657.36 Minnesota-Crookston to support the 657.37 northwest purchasing alliance; $50,000 657.38 the first year is for a grant to the 657.39 southwest regional development 657.40 commission to support the southwest 657.41 purchasing alliance; $50,000 the first 657.42 year is for a grant to the arrowhead 657.43 regional development commission to 657.44 support the development of a northeast 657.45 Minnesota purchasing alliance; and 657.46 $50,000 each year is for a grant to the 657.47 Brainerd lakes area chamber of commerce 657.48 education association to support the 657.49 north central purchasing alliance. The 657.50 state grants must be matched on a 657.51 one-to-one basis by nonstate funds. 657.52 This is a one-time appropriation and 657.53 shall not become part of the base level 657.54 funding for the 2004-2005 biennium. 657.55 [HEALTH CARE SAFETY NET.] Of the health 657.56 care access fund appropriation, 657.57 $6,500,000 the first year is to provide 657.58 financial support to Minnesota health 657.59 care safety net providers. This 657.60 appropriation shall not become part of 657.61 base funding for the agency for the 657.62 2004-2005 biennium. Of the amounts 658.1 available: 658.2 (1) $2,000,000 is for a grant program 658.3 to aid safety net community clinics; 658.4 (2) $2,000,000 is to be transferred to 658.5 the Minnesota comprehensive health 658.6 association (MCHA); and 658.7 (3) $2,500,000 is for a grant program 658.8 to provide rural hospital capital 658.9 improvement grants described in 658.10 Minnesota Statutes, section 144.148. 658.11 [GRANTS TO COMMUNITY CLINICS.] Of the 658.12 general fund appropriation, $2,000,000 658.13 each year is for grants to eligible 658.14 community clinics under Minnesota 658.15 Statutes, section 145.9268, to improve 658.16 the ongoing viability of Minnesota's 658.17 clinic-based safety net providers. 658.18 This appropriation is contingent on 658.19 federal approval of the 658.20 intergovernmental transfers and 658.21 payments to safety net hospitals 658.22 authorized under Minnesota Statutes, 658.23 section 256B.195. This appropriation 658.24 shall become part of base level funding 658.25 for the 2004-2005 biennium. 658.26 [HOME CARE PROVIDERS FEE WAIVER.] 658.27 Notwithstanding the provisions of 658.28 Minnesota Rules, chapter 4669, and 658.29 Minnesota Statutes, section 144A.4605, 658.30 subdivision 5, the commissioner of 658.31 health may, during the biennium 658.32 beginning July 1, 2001, waive license 658.33 fees for all home care providers who 658.34 hold a current license as of June 30, 658.35 2001, for the purpose of reducing 658.36 surplus home care fees in the state 658.37 government special revenue fund. 658.38 [RURAL AMBULANCE STUDY.] (a) The 658.39 commissioner shall direct the rural 658.40 health advisory committee to conduct a 658.41 study and make recommendations 658.42 regarding the challenges faced by rural 658.43 ambulance services related to: 658.44 personnel shortages for volunteer 658.45 ambulance services; personnel shortages 658.46 for full-time, paid ambulance services; 658.47 funding for ambulance operations; and 658.48 the impact on rural ambulance services 658.49 from changes in ambulance reimbursement 658.50 as a result of the federal Balanced 658.51 Budget Act of 1997, Public Law Number 658.52 105-33. 658.53 (b) The advisory committee may also 658.54 examine and make recommendations on: 658.55 (1) whether state law allows adequate 658.56 flexibility to address operational and 658.57 staffing problems encountered by rural 658.58 ambulance services; and 658.59 (2) whether current incentive programs, 658.60 such as the volunteer ambulance 658.61 recruitment program and state 658.62 reimbursement for volunteer training, 659.1 are adequate to ensure ambulance 659.2 service volunteers will be available in 659.3 rural areas. 659.4 (c) The advisory committee shall 659.5 identify existing state, regional, and 659.6 local resources supporting the 659.7 provision of local ambulance services 659.8 in rural areas. 659.9 (d) The advisory committee shall, if 659.10 appropriate, make recommendations for 659.11 addressing alternative delivery models 659.12 for rural volunteer ambulance 659.13 services. Such alternatives may 659.14 include, but are not limited to, 659.15 multiprovider service coalitions, 659.16 purchasing cooperatives, regional 659.17 response strategies, and different 659.18 utilization of first responder and 659.19 rescue squads. 659.20 (e) In conducting its study, the 659.21 advisory committee shall consult with 659.22 groups broadly representative of rural 659.23 health and emergency medical services. 659.24 Such groups may include: local elected 659.25 officials; ambulance and emergency 659.26 medical services associations; 659.27 hospitals and nursing homes; 659.28 physicians, nurses, and mid-level 659.29 practitioners; rural health groups; the 659.30 emergency medical services regulatory 659.31 board and regional emergency medical 659.32 services boards; and fire and sheriff's 659.33 departments. 659.34 (f) The advisory committee shall report 659.35 its findings and recommendations to the 659.36 commissioner by September 1, 2002. 659.37 Subd. 4. Health Protection 30,250,000 31,323,000 659.38 Summary by Fund 659.39 General 13,045,000 13,346,000 659.40 State Government 659.41 Special Revenue 17,205,000 17,977,000 659.42 [EMERGING HEALTH THREATS.] (a) Of the 659.43 general fund appropriation, $750,000 in 659.44 the first year and $850,000 in the 659.45 second year is to maintain the state 659.46 capacity to identify and respond to 659.47 emerging health threats. 659.48 (b) Of these amounts, $450,000 in the 659.49 first year and $550,000 in the second 659.50 year is to expand state laboratory 659.51 capacity to identify infectious disease 659.52 organisms, evaluate environmental 659.53 contaminants, and develop new 659.54 analytical techniques to deal with 659.55 biological and chemical health threats. 659.56 (c) $300,000 each year is to train, 659.57 consult, and otherwise assist local 659.58 officials responding to clandestine 659.59 drug laboratories and minimizing health 659.60 risks to responders and the public. 660.1 The commissioner is authorized to bill 660.2 local governments to reimburse the 660.3 general fund for the costs incurred. 660.4 [SEXUALLY TRANSMITTED INFECTIONS.] Of 660.5 the general fund appropriation, 660.6 $150,000 each year is to increase 660.7 access to free screening for sexually 660.8 transmitted infections, including 660.9 efforts to provide screening to members 660.10 of high-risk communities, and $250,000 660.11 each year is for grants to 660.12 community-based organizations and local 660.13 public health entities to increase the 660.14 screening of members of high-risk 660.15 communities. These appropriations 660.16 shall become part of the base level 660.17 funding for the 2004-2005 biennium. 660.18 [BASE FUNDING TRANSFER.] $250,000 each 660.19 fiscal year is transferred from the 660.20 base appropriation for sexually 660.21 transmitted disease program operations 660.22 to the HIV grants program and shall 660.23 become part of base level funding for 660.24 the HIV grants program for the 660.25 2004-2005 biennium. 660.26 [COMMUNITY HEALTH EDUCATION AND 660.27 PROMOTION PROGRAM ON FOOD SAFETY.] (a) 660.28 Of the general fund appropriation, 660.29 $200,000 each year is for a grant to 660.30 the city of Minneapolis to establish a 660.31 community-based health education and 660.32 promotion program on food safety in the 660.33 Latino, Somali, and Southeast Asian 660.34 communities. 660.35 (b) The program shall consist of direct 660.36 training of food industry operators and 660.37 workers on safe handling of food and 660.38 proper operation of food establishments 660.39 and a community consumer awareness 660.40 campaign to increase community 660.41 awareness of food safety and access to 660.42 food regulatory services. 660.43 (c) This is a one-time appropriation 660.44 and shall not become part of the base 660.45 level funding for the 2004-2005 660.46 biennium. 660.47 Subd. 5. Management and 660.48 Support Services 5,455,000 5,867,000 660.49 Summary by Fund 660.50 General 5,304,000 5,712,000 660.51 State Government 660.52 Special Revenue 151,000 155,000 660.53 Sec. 4. VETERANS NURSING 660.54 HOMES BOARD 30,948,000 32,030,000 660.55 [VETERANS HOMES SPECIAL REVENUE 660.56 ACCOUNT.] The general fund 660.57 appropriations made to the board may be 660.58 transferred to a veterans homes special 660.59 revenue account in the special revenue 660.60 fund in the same manner as other 661.1 receipts are deposited according to 661.2 Minnesota Statutes, section 198.34, and 661.3 are appropriated to the board for the 661.4 operation of board facilities and 661.5 programs. 661.6 [SETTING COST OF CARE.] The cost of 661.7 care for the domiciliary residents at 661.8 the Minneapolis veterans home for 661.9 fiscal year 2002 and fiscal year 2003 661.10 shall be calculated based on 100 661.11 percent occupancy. 661.12 [DEFICIENCY FUNDING.] Of the general 661.13 fund appropriation in fiscal year 2002, 661.14 $2,000,000 is available with the 661.15 approval of the commissioner of 661.16 finance. Approval of the commissioner 661.17 of finance is contingent upon review of 661.18 the board's submittal of a report 661.19 outlining the following: 661.20 (1) a long-term revenue outlook for the 661.21 homes; 661.22 (2) a review and recommendation of 661.23 alternative funding sources for the 661.24 homes' operations; and 661.25 (3) administrative and service options 661.26 to bring cost growth in line with 661.27 revenues. 661.28 Sec. 5. HEALTH-RELATED BOARDS 661.29 Subdivision 1. Total 661.30 Appropriation 11,199,000 11,424,000 661.31 [STATE GOVERNMENT SPECIAL REVENUE 661.32 FUND.] The appropriations in this 661.33 section are from the state government 661.34 special revenue fund. 661.35 [NO SPENDING IN EXCESS OF REVENUES.] 661.36 The commissioner of finance shall not 661.37 permit the allotment, encumbrance, or 661.38 expenditure of money appropriated in 661.39 this section in excess of the 661.40 anticipated biennial revenues or 661.41 accumulated surplus revenues from fees 661.42 collected by the boards. Neither this 661.43 provision nor Minnesota Statutes, 661.44 section 214.06, applies to transfers 661.45 from the general contingent account. 661.46 Subd. 2. Board of Chiropractic 661.47 Examiners 372,000 384,000 661.48 Subd. 3. Board of Dentistry 946,000 855,000 661.49 [EXPANDED DUTIES.] Of this 661.50 appropriation, $115,000 in fiscal year 661.51 2002 is to the board for the costs 661.52 associated with the expanded duties 661.53 relative to the regulation of dental 661.54 hygienists and foreign-trained 661.55 dentists. This is a one-time 661.56 appropriation and shall not become part 661.57 of the base level funding for the 661.58 2004-2005 biennium. 662.1 Subd. 4. Board of Dietetic 662.2 and Nutrition Practice 98,000 101,000 662.3 Subd. 5. Board of Marriage and 662.4 Family Therapy 114,000 118,000 662.5 [FEE INCREASE.] The board may increase 662.6 fees to meet the requirements of 662.7 Minnesota Statutes, section 214.06. 662.8 Subd. 6. Board of Medical 662.9 Practice 3,334,000 3,400,000 662.10 Subd. 7. Board of Nursing 2,789,000 2,902,000 662.11 [DEVELOPMENT OF POSTERS.] Of this 662.12 appropriation, $20,000 in fiscal year 662.13 2002 is for the board to develop and 662.14 distribute posters that may be used by 662.15 facilities to satisfy the requirements 662.16 of Minnesota Statutes, section 144.582, 662.17 subdivision 4. 662.18 [HEALTH PROFESSIONAL SERVICES 662.19 ACTIVITY.] Of these appropriations, 662.20 $515,,000 the first year and $546,000 662.21 the second year are for the health 662.22 professional services activity. 662.23 [FEE INCREASE.] The board may increase 662.24 fees to meet the requirements of 662.25 Minnesota Statutes, section 214.06. 662.26 Subd. 8. Board of Nursing 662.27 Home Administrators 200,000 198,000 662.28 Subd. 9. Board of Optometry 93,000 96,000 662.29 Subd. 10. Board of Pharmacy 1,336,000 1,386,000 662.30 [ADMINISTRATIVE SERVICES UNIT.] Of this 662.31 appropriation, $354,000 the first year 662.32 and $359,000 the second year are for 662.33 the health boards administrative 662.34 services unit. The administrative 662.35 services unit may receive and expend 662.36 reimbursements for services performed 662.37 for other agencies. 662.38 Subd. 11. Board of Physical Therapy 191,000 197,000 662.39 Subd. 12. Board of Podiatry 53,000 45,000 662.40 Subd. 13. Board of Psychology 669,000 680,000 662.41 Subd. 14. Board of Social Work 846,000 873,000 662.42 Subd. 15. Board of Veterinary 662.43 Medicine 158,000 189,000 662.44 Sec. 6. EMERGENCY MEDICAL 662.45 SERVICES BOARD 2,663,000 2,675,000 662.46 [COMPREHENSIVE ADVANCED LIFE SUPPORT 662.47 EDUCATIONAL PROGRAM.] Of this 662.48 appropriation, $200,000 in fiscal year 662.49 2002 and $200,000 in fiscal year 2003 662.50 is to increase funding for the 662.51 comprehensive advanced life support 662.52 educational program under Minnesota 662.53 Statutes, section 144E.37. This 663.1 appropriation shall become part of base 663.2 level funding for the 2004-2005 663.3 biennium. 663.4 [AUTOMATIC DEFIBRILLATOR STUDY.] Of 663.5 this appropriation, $25,000 in fiscal 663.6 year 2002 is to the board to study, in 663.7 consultation with the commissioner of 663.8 public safety, and report to the 663.9 legislature by December 15, 2002, 663.10 regarding the availability of automatic 663.11 defibrillators outside the seven-county 663.12 metropolitan area. The report shall 663.13 include recommendations to make these 663.14 devices accessible within a reasonable 663.15 distance through the nonmetropolitan 663.16 area, including recommendations for 663.17 funding their acquisition and 663.18 distribution. 663.19 Sec. 7. COUNCIL ON DISABILITY 692,000 714,000 663.20 Sec. 8. OMBUDSMAN FOR MENTAL 663.21 HEALTH AND MENTAL RETARDATION 1,752,000 1,568,000 663.22 [CENTER FOR OMBUDSMAN SERVICES.] (a) Of 663.23 this appropriation, $250,000 in fiscal 663.24 year 2002 is for the one-time costs of 663.25 establishing a center for Minnesota 663.26 ombudsman services. Unexpended funds 663.27 for fiscal year 2002 do not cancel but 663.28 are available for this purpose in 663.29 fiscal year 2003. 663.30 (b) The following agencies shall 663.31 colocate to establish the center: the 663.32 ombudsman for corrections, the crime 663.33 victims ombudsman, the ombudsman for 663.34 mental health and mental retardation, 663.35 the ombudsman for older Minnesotans, 663.36 the ombudsman for state-managed health 663.37 care programs, and the ombudsman for 663.38 families. 663.39 (c) Each agency described in paragraph 663.40 (b) shall retain its statutory 663.41 authority and funding for the special 663.42 populations served. 663.43 (d) Each agency described in paragraph 663.44 (b) shall contribute to the shared 663.45 operational expenses and shall pool 663.46 administrative capabilities and 663.47 resources as appropriate in at least 663.48 the following areas: purchasing, 663.49 payroll, human resources, information 663.50 technology, inventory, leasing, 663.51 contracts, and telecommunications. 663.52 (e) The functions described in 663.53 paragraph (d) shall be administered by 663.54 a board composed of the six 663.55 ombudspersons referenced in paragraph 663.56 (b). 663.57 (f) The center shall make a preliminary 663.58 report to the legislature by January 663.59 15, 2003, and a final report by January 663.60 15, 2004, on implementation of the 663.61 colocation requirement. 664.1 Sec. 9. OMBUDSMAN 664.2 FOR FAMILIES 251,000 256,000 664.3 Sec. 10. TRANSFERS 664.4 Subdivision 1. Grants 664.5 The commissioner of human services, 664.6 with the approval of the commissioner 664.7 of finance, and after notification of 664.8 the chair of the senate health and 664.9 family security budget division and the 664.10 chair of the house health and human 664.11 services finance committee, may 664.12 transfer unencumbered appropriation 664.13 balances for the biennium ending June 664.14 30, 2003, within fiscal years among the 664.15 MFIP, general assistance, general 664.16 assistance medical care, medical 664.17 assistance, Minnesota supplemental aid, 664.18 and group residential housing programs, 664.19 and the entitlement portion of the 664.20 chemical dependency consolidated 664.21 treatment fund, and between fiscal 664.22 years of the biennium. 664.23 Subd. 2. Administration 664.24 Positions, salary money, and nonsalary 664.25 administrative money may be transferred 664.26 within the departments of human 664.27 services and health and within the 664.28 programs operated by the veterans 664.29 nursing homes board as the 664.30 commissioners and the board consider 664.31 necessary, with the advance approval of 664.32 the commissioner of finance. The 664.33 commissioner or the board shall inform 664.34 the chairs of the house health and 664.35 human services finance committee and 664.36 the senate health and family security 664.37 budget division quarterly about 664.38 transfers made under this provision. 664.39 Subd. 3. Prohibited Transfers 664.40 Grant money shall not be transferred to 664.41 operations within the departments of 664.42 human services and health and within 664.43 the programs operated by the veterans 664.44 nursing homes board without the 664.45 approval of the legislature. 664.46 Sec. 11. MINNESOTACARE AVAILABILITY 664.47 Of the appropriation for MinnesotaCare 664.48 for fiscal year 2002, an amount 664.49 sufficient to fund a fiscal year 2001 664.50 deficiency is available in fiscal year 664.51 2001. This amount shall be determined 664.52 by the commissioner of human services 664.53 with the approval of the commissioner 664.54 of finance. 664.55 Sec. 12. INDIRECT COSTS NOT TO 664.56 FUND PROGRAMS. 664.57 The commissioners of health and of 664.58 human services shall not use indirect 664.59 cost allocations to pay for the 664.60 operational costs of any program for 665.1 which they are responsible. 665.2 Sec. 13. CARRYOVER LIMITATION 665.3 None of the appropriations in this act 665.4 which are allowed to be carried forward 665.5 from fiscal year 2002 to fiscal year 665.6 2003 shall become part of the base 665.7 level funding for the 2004-2005 665.8 biennial budget, unless specifically 665.9 directed by the legislature. 665.10 Sec. 14. SUNSET OF UNCODIFIED LANGUAGE 665.11 All uncodified language contained in 665.12 this article expires on June 30, 2003, 665.13 unless a different expiration date is 665.14 explicit. 665.15 Sec. 15. Minnesota Statutes 2000, section 16A.06, is 665.16 amended by adding a subdivision to read: 665.17 Subd. 10. [TRANSFERS TO HEALTH CARE ACCESS FUND.] For 665.18 fiscal years beginning on or after July 1, 2002, the 665.19 commissioner shall transfer from the general fund to the health 665.20 care access fund an amount equal to the state share of the cost 665.21 of covering children in families with income under 185 percent 665.22 of the federal poverty guidelines. In determining the amount of 665.23 this transfer, the commissioner shall disregard MinnesotaCare 665.24 program changes enacted after July 1, 2001. 665.25 Sec. 16. [246.141] [PROJECT LABOR.] 665.26 Wages for project labor may be paid by the commissioner out 665.27 of repairs and betterments money if the individual is to be 665.28 engaged in a construction project or a repair project of 665.29 short-term and nonrecurring nature. Compensation for project 665.30 labor shall be based on the prevailing wage rates, as defined in 665.31 section 177.42, subdivision 6. Project laborers are excluded 665.32 from the provisions of sections 43A.22 to 43A.30, and shall not 665.33 be eligible for state-paid insurance and benefits. 665.34 Sec. 17. Laws 1998, chapter 404, section 18, subdivision 665.35 4, is amended to read: 665.36 Subd. 4. People, Inc. North Side Community 665.37 Support Program 375,000 665.38 For a grant toHennepin countyPeople, 665.39 Inc. to purchase, remodel, and complete 665.40 accessibility upgrades to an existing 665.41 building or to acquire land or 665.42 construct a building to be used by the 665.43 People, Inc. North Side Community 665.44 Support Program which may provide 666.1 office space for state employees. 666.2 This appropriation is from the general 666.3 fund. 666.4 Sec. 18. [EFFECTIVE DATE.] 666.5 Section 11 is effective the day following final enactment. 666.6 ARTICLE 16 666.7 CRIMINAL JUSTICE 666.8 Section 1. [CRIMINAL JUSTICE APPROPRIATIONS.] 666.9 The sums shown in the columns marked "APPROPRIATIONS" are 666.10 appropriated from the general fund, or another fund named, to 666.11 the agencies and for the purposes specified in this act, to be 666.12 available for the fiscal years indicated for each purpose. The 666.13 figures "2002" and "2003" where used in this article, mean that 666.14 the appropriation or appropriations listed under them are 666.15 available for the year ending June 30, 2002, or June 30, 2003, 666.16 respectively. 666.17 SUMMARY BY FUND 666.18 2002 2003 TOTAL 666.19 General $ 413,130,000 $ 428,035,000 $ 841,165,000 666.20 Special Revenue $ 1,389,000 $ 1,242,000 $ 2,631,000 666.21 TOTAL $ 414,519,000 $ 429,277,000 $ 843,796,000 666.22 APPROPRIATIONS 666.23 Available for the Year 666.24 Ending June 30 666.25 2002 2003 666.26 Sec. 2. BOARD OF PUBLIC DEFENSE 666.27 Subdivision 1. Total 666.28 Appropriation 51,030,000 54,716,000 666.29 None of this appropriation shall be 666.30 used to pay for lawsuits against public 666.31 agencies or public officials to change 666.32 social or public policy. 666.33 During the biennium ending June 30, 666.34 2003, the state public defender may, 666.35 with the approval of the commissioner 666.36 of finance, transfer funds for 666.37 transcript costs from the office of 666.38 administrative services to the state 666.39 public defender. 666.40 The amounts that may be spent from this 666.41 appropriation for each program are 666.42 specified in the following subdivisions. 666.43 Subd. 2. State Public 666.44 Defender 667.1 3,450,000 3,734,000 667.2 $109,000 the first year and $227,000 667.3 the second year are for salary and 667.4 benefit increases. 667.5 Subd. 3. Administrative Services 667.6 Office 667.7 2,467,000 2,553,000 667.8 $300,000 the first year and $310,000 667.9 the second year are for the statewide 667.10 corrections information system project. 667.11 $32,000 the first year and $68,000 the 667.12 second year are for salary and benefit 667.13 increases. 667.14 Subd. 4. District Public 667.15 Defense 667.16 45,113,000 48,429,000 667.17 $1,326,000 the first year and 667.18 $1,366,000 the second year are for 667.19 grants to the five existing public 667.20 defense corporations under Minnesota 667.21 Statutes, section 611.216. 667.22 $1,315,000 the first year and 667.23 $3,276,000 the second year are for the 667.24 part-time public defender viability 667.25 initiative. 667.26 Sec. 3. CORRECTIONS 667.27 Subdivision 1. Total 667.28 Appropriation 362,641,000 373,675,000 667.29 Summary by Fund 667.30 General 361,252,000 372,433,000 667.31 Special Revenue 1,389,000 1,242,000 667.32 The amounts that may be spent from this 667.33 appropriation for each program are 667.34 specified in the following subdivisions. 667.35 Any unencumbered balances remaining in 667.36 the first year do not cancel but are 667.37 available for the second year of the 667.38 biennium. 667.39 Positions and administrative money may 667.40 be transferred within the department of 667.41 corrections as the commissioner 667.42 considers necessary, upon the advance 667.43 approval of the commissioner of finance. 667.44 For the biennium ending June 30, 2003, 667.45 the commissioner of corrections may, 667.46 with the approval of the commissioner 667.47 of finance, transfer funds to or from 667.48 salaries. 667.49 During the biennium ending June 30, 667.50 2003, the commissioner may enter into 667.51 contracts with private corporations or 667.52 governmental units of the state of 668.1 Minnesota to house adult offenders 668.2 committed to the commissioner of 668.3 corrections. Every effort shall be 668.4 made to house individuals committed to 668.5 the commissioner of corrections in 668.6 Minnesota correctional facilities. 668.7 During the biennium ending June 30, 668.8 2003, if it is necessary to reduce 668.9 services or staffing within a 668.10 correctional facility, the commissioner 668.11 or the commissioner's designee shall 668.12 meet with affected exclusive 668.13 representatives. The commissioner 668.14 shall make every reasonable effort to 668.15 retain correctional officer and prison 668.16 industry employees should reductions be 668.17 necessary. 668.18 Subd. 2. Correctional 668.19 Institutions 668.20 Summary by Fund 668.21 General Fund 225,765,000 230,147,000 668.22 Special Revenue Fund 932,000 785,000 668.23 If the commissioner contracts with 668.24 other states, local units of 668.25 government, or the federal government 668.26 to rent beds in the Rush City 668.27 correctional facility under Minnesota 668.28 Statutes, section 243.51, subdivision 668.29 1, to the extent possible, the 668.30 commissioner shall charge a per diem 668.31 under the contract that is equal to or 668.32 greater than the per diem cost of 668.33 housing Minnesota inmates in the 668.34 facility. This per diem cost shall be 668.35 based on the assumption that the 668.36 facility is at or near capacity. 668.37 Notwithstanding any laws to the 668.38 contrary, the commissioner may use the 668.39 per diem monies to operate the state 668.40 correctional institutions. 668.41 The commissioner may use any cost 668.42 savings generated through the 668.43 implementation of a per diem reduction 668.44 plan for capital improvements, which 668.45 will contribute to further per diem 668.46 reductions at adult correctional 668.47 facilities. 668.48 Subd. 3. Juvenile Services 668.49 13,984,000 14,283,000 668.50 In order to maximize federal IV-E 668.51 funding for state committed juvenile 668.52 girls, the department of corrections 668.53 shall make necessary changes to the 668.54 Mesabi Academy facility and program in 668.55 order to be in compliance with IV-E 668.56 guidelines and requirements. IV-E 668.57 reimbursement revenue shall be 668.58 deposited in the state general fund. 668.59 Subd. 4. Community Services 669.1 Summary by Fund 669.2 General 107,923,000 114,168,000 669.3 Special Revenue 150,000 150,000 669.4 All money received by the commissioner 669.5 pursuant to the domestic abuse 669.6 investigation fee under Minnesota 669.7 Statutes, section 609.2244, is 669.8 available for use by the commissioner 669.9 and is appropriated annually to the 669.10 commissioner for costs related to 669.11 conducting the investigations. 669.12 $6,125,000 the first year and 669.13 $7,464,000 the second year are for an 669.14 increase in community correction act 669.15 grants under Minnesota Statutes, 669.16 section 401.10. Counties receiving 669.17 grants under this appropriation shall 669.18 continue to spend the local matching 669.19 funds required in Minnesota Statutes, 669.20 section 401.12. Counties receiving 669.21 grants under this appropriation shall 669.22 consider using a portion of the grant 669.23 to increase supervision of high risk 669.24 domestic abuse offenders who are on 669.25 probation, conditional release, or 669.26 supervised release by means of caseload 669.27 reduction so that the number of 669.28 offenders supervised by officers with 669.29 specialized caseloads is reduced. 669.30 $932,000 the first year and $1,277,000 669.31 the second year are for probation and 669.32 supervised release services. 669.33 $621,000 the first year and $851,000 669.34 the second year are for county 669.35 probation officer reimbursements. 669.36 $1,265,000 the first year and 669.37 $1,335,000 the second year are for 669.38 grants related to restorative justice 669.39 programs as defined in Minnesota 669.40 Statutes, section 611A.775. Grant 669.41 awards must be allocated in a balanced 669.42 manner among rural, suburban, and urban 669.43 organizations operating restorative 669.44 justice programs. Preference must be 669.45 given to organizations or programs that: 669.46 (1) are currently operating and have 669.47 had successful results; 669.48 (2) are community-based; and 669.49 (3) are supported by both private and 669.50 public funding. 669.51 $4,283,000 the first year and 669.52 $8,000,000 the second year are for 669.53 juvenile residential treatment grants. 669.54 Subd. 5. Management Services 669.55 Summary by Fund 669.56 General Fund 13,580,000 13,835,000 670.1 Special Revenue Fund 307,000 307,000 670.2 $750,000 the first year and $750,000 670.3 the second year are for: 670.4 (1) detention grants for the Statewide 670.5 Supervision System; 670.6 (2) out-of-home placement system 670.7 development; 670.8 (3) electronic probation file 670.9 transfers; and 670.10 (4) maintaining and conforming the 670.11 department's systems to the CriMNet 670.12 standards and backbone, including the 670.13 Corrections Operational Management 670.14 System (COMS), Statewide Supervision 670.15 System (SSS), Detention Information 670.16 System (DIS), Court Services Tracking 670.17 System (CSTS), and the sentencing 670.18 guidelines worksheet system. 670.19 This money may not be used by the 670.20 commissioner for any other purpose. 670.21 $10,000 the first year and $10,000 the 670.22 second year are for clergy 670.23 reimbursements under Minnesota 670.24 Statutes, section 241.052. 670.25 Sec. 4. CORRECTIONS OMBUDSMAN 323,000 336,000 670.26 Sec. 5. SENTENCING GUIDELINES 670.27 COMMISSION 525,000 550,000 670.28 Sec. 6. Minnesota Statutes 2000, section 15A.083, 670.29 subdivision 4, is amended to read: 670.30 Subd. 4. [RANGES FOR OTHER JUDICIAL POSITIONS.] Salaries 670.31 or salary ranges are provided for the following positions in the 670.32 judicial branch of government. The appointing authority of any 670.33 position for which a salary range has been provided shall fix 670.34 the individual salary within the prescribed range, considering 670.35 the qualifications and overall performance of the employee. The 670.36 supreme court shall set the salary of the state court 670.37 administrator and the salaries of district court 670.38 administrators. The salary of the state court administrator or 670.39 a district court administrator may not exceed the salary of a 670.40 district court judge. If district court administrators die, the 670.41 amounts of their unpaid salaries for the months in which their 670.42 deaths occur must be paid to their estates. The salary of the 670.43 state public defendermust be 95 percent of the salary of the670.44attorney generalshall be fixed by the state board of public 671.1 defense but must not exceed the salary of a district court judge. 671.2 Salary or Range 671.3 Effective 671.4 July 1, 1994 671.5 Board on judicial standards 671.6 executive director $44,000-60,000 671.7 Sec. 7. [241.052] [CLERGY COMPENSATION.] 671.8 Subject to the availability of money specifically 671.9 appropriated for this purpose, the commissioner of corrections 671.10 shall reimburse, upon request, the instate travel and lodging 671.11 expenses of members of the clergy of good standing in any church 671.12 or denomination for imparting religious rites or instruction at 671.13 correctional facilities under the commissioner's control. 671.14 Sec. 8. Minnesota Statutes 2000, section 241.272, 671.15 subdivision 6, is amended to read: 671.16 Subd. 6. [USE OF FEES.] Excluding correctional fees 671.17 collected from offenders supervised by department agents under 671.18 the authority of section 244.19, subdivision 1, paragraph (a), 671.19 clause (3), all correctional fees collected under this section 671.20 go to the general fund. One-half of the fees collected by 671.21 agents under the authority of section 244.19, subdivision 1, 671.22 paragraph (a), clause (3), shall go to the county treasurer in 671.23 the county where supervision is provided. The remaining 671.24 one-half of the fees go to the general fund. Fees retained by 671.25 counties may only be used in accordance with section 244.18, 671.26 subdivision 6. 671.27 Sec. 9. Minnesota Statutes 2000, section 242.192, is 671.28 amended to read: 671.29 242.192 [CHARGES TO COUNTIES.] 671.30 (a) Until June 30,20012002, the commissioner shall charge 671.31 counties or other appropriate jurisdictions 65 percent of the 671.32 per diem cost of confinement, excluding educational costs and 671.33 nonbillable service, of juveniles at the Minnesota correctional 671.34 facility-Red Wing and of juvenile females committed to the 671.35 commissioner of corrections. This charge applies to juveniles 671.36 committed to the commissioner of corrections and juveniles 672.1 admitted to the Minnesota correctional facility-Red Wing under 672.2 established admissions criteria. This charge applies to both 672.3 counties that participate in the Community Corrections Act and 672.4 those that do not. The commissioner shall determine the per 672.5 diem cost of confinement based on projected population, pricing 672.6 incentives, market conditions, and the requirement that expense 672.7 and revenue balance out over a period of two years. All money 672.8 received under this section must be deposited in the state 672.9 treasury and credited to the general fund. 672.10 (b) Until June 30,20012002, the department of corrections 672.11 shall be responsible for 35 percent of the per diem cost of 672.12 confinement described in this section. 672.13 Sec. 10. Minnesota Statutes 2000, section 611.23, is 672.14 amended to read: 672.15 611.23 [OFFICE OF STATE PUBLIC DEFENDER; APPOINTMENT; 672.16 SALARY.] 672.17 The state public defender is responsible to the state board 672.18 of public defense. The state public defender shall be appointed 672.19 by the state board of public defense for a term of four years, 672.20 except as otherwise provided in this section, and until a 672.21 successor is appointed and qualified. The state public defender 672.22 shall be a full-time qualified attorney, licensed to practice 672.23 law in this state, serve in the unclassified service of the 672.24 state, and be removed only for cause by the appointing 672.25 authority. Vacancies in the office shall be filled by the 672.26 appointing authority for the unexpired term. The salary of the 672.27 state public defender shall be fixed by the state board of 672.28 public defense but must not exceed the salary ofthe chief672.29deputy attorney generala district court judge. Terms of the 672.30 state public defender shall commence on July 1. The state 672.31 public defender shall devote full time to the performance of 672.32 duties and shall not engage in the general practice of law. 672.33 Sec. 11. Laws 1999, chapter 216, article 1, section 13, 672.34 subdivision 4, is amended to read: 672.35 Subd. 4. Community Services 672.36 Summary by Fund 673.1 General 95,327,000 97,416,000 673.2 Special Revenue 90,000 90,000 673.3 All money received by the commissioner 673.4 of corrections pursuant to the domestic 673.5 abuse investigation fee under Minnesota 673.6 Statutes, section 609.2244, is 673.7 available for use by the commissioner 673.8 and is appropriated annually to the 673.9 commissioner of corrections for costs 673.10 related to conducting the 673.11 investigations. 673.12 $500,000 the first year and $500,000 673.13 the second year are for increased 673.14 funding for intensive community 673.15 supervision. 673.16 $1,500,000 the first year and 673.17 $3,500,000 the second year are for a 673.18 statewide probation and supervised 673.19 release caseload and workload reduction 673.20 grant program. Counties that deliver 673.21 correctional services through Minnesota 673.22 Statutes, chapter 244, and that qualify 673.23 for new probation officers under this 673.24 program shall receive full 673.25 reimbursement for the officers' 673.26 salaries and reimbursement for the 673.27 officers' benefits and support as set 673.28 forth in the probations standards task 673.29 force report, not to exceed $70,000 per 673.30 officer annually. Positions funded by 673.31 this appropriation may not supplant 673.32 existing services. Position control 673.33 numbers for these positions must be 673.34 annually reported to the commissioner 673.35 of corrections. 673.36 The commissioner shall distribute money 673.37 appropriated for state and county 673.38 probation officer caseload and workload 673.39 reduction, increased supervised release 673.40 and probation services, and county 673.41 probation officer reimbursement 673.42 according to the formula contained in 673.43 Minnesota Statutes, section 401.10. 673.44 These appropriations may not be used to 673.45 supplant existing state or county 673.46 probation officer positions or existing 673.47 correctional services or programs. The 673.48 money appropriated under this provision 673.49 is intended to reduce state and county 673.50 probation officer caseload and workload 673.51 overcrowding and to increase 673.52 supervision of individuals sentenced to 673.53 probation at the county level. This 673.54 increased supervision may be 673.55 accomplished through a variety of 673.56 methods, including, but not limited to: 673.57 (1) innovative technology services, 673.58 such as automated probation reporting 673.59 systems and electronic monitoring; 673.60 (2) prevention and diversion programs; 673.61 (3) intergovernmental cooperation 673.62 agreements between local governments 673.63 and appropriate community resources; 674.1 and 674.2 (4) traditional probation program 674.3 services. 674.4 By January 15, 2001, the commissioner 674.5 of corrections shall report to the 674.6 chairs and ranking minority members of 674.7 the senate and house committees and 674.8 divisions having jurisdiction over 674.9 criminal justice funding on the 674.10 outcomes achieved through the use of 674.11 state probation caseload reduction 674.12 appropriations made since 1995. The 674.13 commissioner shall, to the extent 674.14 possible, include an analysis of the 674.15 ongoing results relating to the 674.16 measures described in the uniform 674.17 statewide probation outcome measures 674.18 workgroup's 1998 report to the 674.19 legislature. 674.20 $150,000 each year is for a grant to 674.21 the Dodge-Filmore-Olmsted community 674.22 corrections agency for a pilot project 674.23 to increase supervision of sex 674.24 offenders who are on probation, 674.25 intensive community supervision, 674.26 supervised release, or intensive 674.27 supervised release by means of caseload 674.28 reduction. The grant shall be used to 674.29 reduce the number of offenders 674.30 supervised by officers with specialized 674.31 caseloads to an average of 35 674.32 offenders. This is a one-time 674.33 appropriation. The grant recipient 674.34 shall report by January 15, 2002, to 674.35 the House and Senate committees and 674.36 divisions with jurisdiction over 674.37 criminal justice policy and funding on 674.38 the outcomes of the pilot project. 674.39 $175,000 the first year and $175,000 674.40 the second year are for county 674.41 probation officer reimbursements. 674.42 $50,000 the first year and $50,000 the 674.43 second year are for the emergency 674.44 housing initiative. The commissioner 674.45 of corrections may enter into rental 674.46 agreements per industry standards for 674.47 emergency housing. 674.48 $150,000 the first year and $150,000 674.49 the second year are for probation and 674.50 supervised release services. 674.51 $250,000 the first year and $250,000 674.52 the second year are for increased 674.53 funding of the sentencing to service 674.54 program and for a housing coordinator 674.55 for the institution work crews in the 674.56 sentencing to serve program. 674.57 $25,000 the first year and $25,000 the 674.58 second year are for sex offender 674.59 transition programming. 674.60 $250,000 each year is for increased bed 674.61 capacity for work release offenders. 675.1 $50,000 each year is for programming 675.2 for adult female offenders. 675.3 The following amounts are one-time 675.4 appropriations for the statewide 675.5 productive day initiative program 675.6 defined in Minnesota Statutes, section 675.7 241.275: 675.8 $472,000 to the Hennepin county 675.9 community corrections agency; 675.10 $472,000 to the Ramsey county community 675.11 corrections agency; 675.12 $590,000 to the Arrowhead regional 675.13 community corrections agency; 675.14 $425,000 to the Dodge-Fillmore-Olmsted 675.15 community corrections agency; 675.16 $283,000 to the Anoka county community 675.17 corrections agency; and 675.18 $118,000 to the Tri-county (Polk, 675.19 Norman, and Red Lake) community 675.20 corrections agency. 675.21 $250,000 the first year and $250,000 675.22 the second year are for grants to 675.23 Dakota county for the community justice 675.24 zone pilot project described in article 675.25 2, section 24. This is a one-time 675.26 appropriation. 675.27 $230,000 the first year is for grants 675.28 related to restorative justice 675.29 programs. The commissioner may make 675.30 grants to fund new as well as existing 675.31 programs. This is a one-time 675.32 appropriation. 675.33 The money appropriated for restorative 675.34 justice program grants under this 675.35 subdivision may be used to fund the use 675.36 of restorative justice in domestic 675.37 abuse cases, except in cases where the 675.38 restorative justice process that is 675.39 used includes a meeting at which the 675.40 offender and victim are both present at 675.41 the same time. "Domestic abuse" has 675.42 the meaning given in Minnesota 675.43 Statutes, section 518B.01, subdivision 675.44 2. 675.45 $25,000 each year is for the juvenile 675.46 mentoring project. This is a one-time 675.47 appropriation.