1st Unofficial Engrossment - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to human services; modifying provisions 1.3 relating to health department; health care; continuing 1.4 care and home care; consumer information and 1.5 assistance and community-based care; long-term care 1.6 reform and reimbursement; work force; regulation of 1.7 supplemental nursing services agencies; long-term 1.8 insurance; mental health and civil commitment; 1.9 assistance programs; licensing; adding an informed 1.10 consent provision for abortion procedures; creating a 1.11 child maltreatment review panel; requiring studies; 1.12 adding provisions relating to termination of parental 1.13 rights; appropriating money; amending Minnesota 1.14 Statutes 2000, sections 13.46, subdivision 4; 13.461, 1.15 subdivision 17; 13B.06, subdivision 4; 62A.48, 1.16 subdivision 4, by adding subdivisions; 62S.01, by 1.17 adding subdivisions; 62S.26; 103I.101, subdivision 6; 1.18 103I.112; 103I.208, subdivisions 1, 2; 103I.235, 1.19 subdivision 1; 103I.525, subdivisions 2, 6, 8, 9; 1.20 103I.531, subdivisions 2, 6, 8, 9; 103I.535, 1.21 subdivisions 2, 6, 8, 9; 103I.541, subdivisions 2b, 4, 1.22 5; 103I.545; 121A.15, subdivision 6; 135A.14, by 1.23 adding a subdivision; 144.057; 144.1202, subdivision 1.24 4; 144.122; 144.1222, by adding a subdivision; 1.25 144.1464; 144.148, subdivision 2; 144.226, subdivision 1.26 4; 144.551, subdivision 1; 144.98, subdivision 3; 1.27 144A.071, subdivisions 1, 1a, 2, 4a; 144A.073, 1.28 subdivisions 2, 4; 144A.44, subdivision 1; 144A.4605, 1.29 subdivision 4; 144A.62, subdivisions 1, 2, 3, 4; 1.30 144D.03, subdivision 2; 144D.04, subdivisions 2, 3; 1.31 144D.06; 145.881, subdivision 2; 145.882, subdivision 1.32 7, by adding a subdivision; 145.885, subdivision 2; 1.33 145.924; 145.925, subdivisions 1, 1a; 145A.15, 1.34 subdivision 1, by adding a subdivision; 145A.16, 1.35 subdivision 1, by adding a subdivision; 148.212; 1.36 148B.21, subdivision 6a; 148B.22, subdivision 3; 1.37 157.16, subdivision 3; 157.22; 214.104; 245.462, 1.38 subdivisions 8, 18, by adding a subdivision; 245.4871, 1.39 subdivisions 10, 27; 245.4876, subdivision 1, by 1.40 adding a subdivision; 245.4885, subdivision 1; 1.41 245.4886, subdivision 1; 245.99, subdivision 4; 1.42 245A.03, subdivision 2b; 245A.04, subdivisions 3, 3a, 1.43 3b, 3c, 3d; 245A.05; 245A.06; 245A.07; 245A.08; 1.44 245A.13, subdivisions 7, 8; 245A.14, by adding a 1.45 subdivision; 245A.16, subdivision 1; 245B.08, 1.46 subdivision 3; 246.57, by adding a subdivision; 2.1 252.275, subdivision 4b; 252A.02, subdivisions 12, 13, 2.2 by adding a subdivision; 252A.111, subdivision 6; 2.3 252A.16, subdivision 1; 252A.19, subdivision 2; 2.4 252A.20, subdivision 1; 254B.02, subdivision 3; 2.5 254B.03, subdivision 1; 254B.04, subdivision 1; 2.6 254B.09, by adding a subdivision; 256.01, subdivisions 2.7 2, 18, by adding a subdivision; 256.045, subdivisions 2.8 3, 3b, 4; 256.476, subdivisions 1, 2, 3, 4, 5, 8; 2.9 256.482, subdivision 8; 256.955, subdivision 2b; 2.10 256.9657, subdivision 2; 256.969, subdivisions 2b, 3a, 2.11 by adding a subdivision; 256.973, by adding a 2.12 subdivision; 256.975, by adding subdivisions; 256B.04, 2.13 by adding a subdivision; 256B.055, subdivision 3a; 2.14 256B.056, subdivisions 1a, 3, 4, 5; 256B.057, 2.15 subdivision 9, by adding a subdivision; 256B.0625, 2.16 subdivisions 3b, 7, 13, 13a, 17, 17a, 18a, 19a, 19c, 2.17 20, 30, 34, by adding subdivisions; 256B.0627, 2.18 subdivisions 1, 2, 4, 5, 7, 8, 10, 11, by adding 2.19 subdivisions; 256B.0635, subdivisions 1, 2; 256B.0911, 2.20 subdivisions 1, 3, 5, 6, 7, by adding subdivisions; 2.21 256B.0913, subdivisions 1, 2, 4, 5, 6, 7, 8, 9, 10, 2.22 11, 12, 13, 14; 256B.0915, subdivisions 1d, 3, 5; 2.23 256B.0916, subdivisions 1, 7, 9, by adding a 2.24 subdivision; 256B.0917, subdivision 7; 256B.092, 2.25 subdivisions 2a, 5; 256B.093, subdivision 3; 256B.095; 2.26 256B.0951, subdivisions 1, 3, 4, 5, 7, by adding 2.27 subdivisions; 256B.0952, subdivisions 1, 4; 256B.431, 2.28 subdivision 17, by adding subdivisions; 256B.434, 2.29 subdivision 4, by adding subdivisions; 256B.49, by 2.30 adding subdivisions; 256B.501, by adding a 2.31 subdivision; 256B.69, subdivisions 4, 5, 5b, 23, by 2.32 adding a subdivision; 256B.75; 256B.76; 256D.03, 2.33 subdivisions 3, 4; 256D.35, by adding subdivisions; 2.34 256D.44, subdivision 5; 256I.05, subdivision 1e; 2.35 256J.09, subdivisions 1, 2, 3, by adding subdivisions; 2.36 256J.15, by adding a subdivision; 256J.24, subdivision 2.37 10; 256J.26, subdivision 1; 256J.31, subdivisions 4, 2.38 12; 256J.32, subdivision 7a; 256J.42, by adding a 2.39 subdivision; 256J.45, subdivision 1; 256J.46, 2.40 subdivisions 1, 2a, by adding a subdivision; 256J.50, 2.41 subdivisions 1, 7; 256J.56; 256J.57, subdivision 2; 2.42 256J.62, subdivision 9; 256J.625, subdivisions 1, 2, 2.43 4; 256J.751; 256K.03, subdivision 1; 256K.07; 256K.25, 2.44 subdivisions 1, 3, 4, 5, 6; 256L.06, subdivision 3; 2.45 256L.12, subdivision 9, by adding a subdivision; 2.46 256L.16; 260C.301, by adding subdivisions; 260C.307, 2.47 subdivision 3; 260C.317, by adding a subdivision; 2.48 261.062; 268.0122, subdivision 2; 626.556, 2.49 subdivisions 3, 3c, 10, 10b, 10d, 10e, 10f, 10i, 11, 2.50 12, by adding subdivisions; 626.557, subdivisions 3, 2.51 9d; 626.5572, subdivision 17; 626.559, subdivision 2; 2.52 Laws 1995, chapter 178, article 2, section 36; Laws 2.53 1995, chapter 207, article 3, section 21, as amended; 2.54 Laws 1997, chapter 203, article 9, section 21, as 2.55 amended; Laws 1999, chapter 152, sections 1, 4; Laws 2.56 1999, chapter 245, article 3, section 45, as amended; 2.57 Laws 1999, chapter 245, article 4, section 110; 2.58 proposing coding for new law in Minnesota Statutes, 2.59 chapters 62S; 144; 144A; 145; 145A; 246; 256; 256B; 2.60 256I; 256J; 260; 299A; 325F; repealing Minnesota 2.61 Statutes 2000, sections 144.0721, subdivision 1; 2.62 144.148, subdivision 8; 145.882, subdivisions 3, 4; 2.63 145.9245; 145.927; 252A.111, subdivision 3; 256.476, 2.64 subdivision 7; 256B.037, subdivision 5; 256B.0635, 2.65 subdivision 3; 256B.0911, subdivisions 2, 2a, 4, 8, 9; 2.66 256B.0912; 256B.0913, subdivisions 3, 15a, 15b, 15c, 2.67 16; 256B.0915, subdivisions 3a, 3b, 3c; 256B.0951, 2.68 subdivision 6; 256B.434, subdivision 5; 256B.49, 2.69 subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10; 256E.06, 2.70 subdivision 2b; 256J.42, subdivision 4; 256J.44; 2.71 256J.46, subdivision 1a; Laws 1995, chapter 178, 3.1 article 2, section 48, subdivision 6; Minnesota Rules, 3.2 parts 9505.2390; 9505.2395; 9505.2396; 9505.2400; 3.3 9505.2405; 9505.2410; 9505.2413; 9505.2415; 9505.2420; 3.4 9505.2425; 9505.2426; 9505.2430; 9505.2435; 9505.2440; 3.5 9505.2445; 9505.2450; 9505.2455; 9505.2458; 9505.2460; 3.6 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 3.7 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 3.8 9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 3.9 9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 3.10 9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 3.11 9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 3.12 9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 3.13 9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 3.14 9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 3.15 9505.3660; 9505.3670. 3.16 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.17 ARTICLE 1 3.18 HEALTH DEPARTMENT 3.19 Section 1. Minnesota Statutes 2000, section 103I.101, 3.20 subdivision 6, is amended to read: 3.21 Subd. 6. [FEES FOR VARIANCES.] The commissioner shall 3.22 charge a nonrefundable application fee of$120$150 to cover the 3.23 administrative cost of processing a request for a variance or 3.24 modification of rules adopted by the commissioner under this 3.25 chapter. 3.26 Sec. 2. Minnesota Statutes 2000, section 103I.112, is 3.27 amended to read: 3.28 103I.112 [FEE EXEMPTIONS FOR STATE AND LOCAL GOVERNMENT.] 3.29 (a) The commissioner of health may not charge fees required 3.30 under this chapter to a federal agency, state agency, or a local 3.31 unit of government or to a subcontractor performing work for the 3.32 state agency or local unit of government. 3.33 (b) "Local unit of government" means a statutory or home 3.34 rule charter city, town, county, or soil and water conservation 3.35 district, watershed district, an organization formed for the 3.36 joint exercise of powers under section 471.59, a board of health 3.37 or community health board, or other special purpose district or 3.38 authority with local jurisdiction in water and related land 3.39 resources management. 3.40 Sec. 3. Minnesota Statutes 2000, section 103I.208, 3.41 subdivision 1, is amended to read: 3.42 Subdivision 1. [WELL NOTIFICATION FEE.] The well 3.43 notification fee to be paid by a property owner is: 4.1 (1) for a new well,$120$150, which includes the state 4.2 core function fee; 4.3 (2) for a well sealing,$20$30 for each well, which 4.4 includes the state core function fee, except that for monitoring 4.5 wells constructed on a single property, having depths within a 4.6 25 foot range, and sealed within 48 hours of start of 4.7 construction, a single fee of$20$30; and 4.8 (3) for construction of a dewatering well,$120$150, which 4.9 includes the state core function fee, for each well except a 4.10 dewatering project comprising five or more wells shall be 4.11 assessed a single fee of$600$750 for the wells recorded on the 4.12 notification. 4.13 Sec. 4. Minnesota Statutes 2000, section 103I.208, 4.14 subdivision 2, is amended to read: 4.15 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 4.16 property owner is: 4.17 (1) for a well that is not in use under a maintenance 4.18 permit,$100$125 annually; 4.19 (2) for construction of a monitoring well,$120$150, which 4.20 includes the state core function fee; 4.21 (3) for a monitoring well that is unsealed under a 4.22 maintenance permit,$100$125 annually; 4.23 (4) for monitoring wells used as a leak detection device at 4.24 a single motor fuel retail outlet, a single petroleum bulk 4.25 storage site excluding tank farms, or a single agricultural 4.26 chemical facility site, the construction permit fee 4.27 is$120$150, which includes the state core function fee, per 4.28 site regardless of the number of wells constructed on the site, 4.29 and the annual fee for a maintenance permit for unsealed 4.30 monitoring wells is$100$125 per site regardless of the number 4.31 of monitoring wells located on site; 4.32 (5) for a groundwater thermal exchange device, in addition 4.33 to the notification fee for wells,$120$150, which includes the 4.34 state core function fee; 4.35 (6) for a vertical heat exchanger,$120$150; 4.36 (7) for a dewatering well that is unsealed under a 5.1 maintenance permit,$100$125 annually for each well, except a 5.2 dewatering project comprising more than five wells shall be 5.3 issued a single permit for$500$625 annually for wells recorded 5.4 on the permit; and 5.5 (8) for excavating holes for the purpose of installing 5.6 elevator shafts,$120$150 for each hole. 5.7 Sec. 5. Minnesota Statutes 2000, section 103I.235, 5.8 subdivision 1, is amended to read: 5.9 Subdivision 1. [DISCLOSURE OF WELLS TO BUYER.] (a) Before 5.10 signing an agreement to sell or transfer real property, the 5.11 seller must disclose in writing to the buyer information about 5.12 the status and location of all known wells on the property, by 5.13 delivering to the buyer either a statement by the seller that 5.14 the seller does not know of any wells on the property, or a 5.15 disclosure statement indicating the legal description and 5.16 county, and a map drawn from available information showing the 5.17 location of each well to the extent practicable. In the 5.18 disclosure statement, the seller must indicate, for each well, 5.19 whether the well is in use, not in use, or sealed. 5.20 (b) At the time of closing of the sale, the disclosure 5.21 statement information, name and mailing address of the buyer, 5.22 and the quartile, section, township, and range in which each 5.23 well is located must be provided on a well disclosure 5.24 certificate signed by the seller or a person authorized to act 5.25 on behalf of the seller. 5.26 (c) A well disclosure certificate need not be provided if 5.27 the seller does not know of any wells on the property and the 5.28 deed or other instrument of conveyance contains the statement: 5.29 "The Seller certifies that the Seller does not know of any wells 5.30 on the described real property." 5.31 (d) If a deed is given pursuant to a contract for deed, the 5.32 well disclosure certificate required by this subdivision shall 5.33 be signed by the buyer or a person authorized to act on behalf 5.34 of the buyer. If the buyer knows of no wells on the property, a 5.35 well disclosure certificate is not required if the following 5.36 statement appears on the deed followed by the signature of the 6.1 grantee or, if there is more than one grantee, the signature of 6.2 at least one of the grantees: "The Grantee certifies that the 6.3 Grantee does not know of any wells on the described real 6.4 property." The statement and signature of the grantee may be on 6.5 the front or back of the deed or on an attached sheet and an 6.6 acknowledgment of the statement by the grantee is not required 6.7 for the deed to be recordable. 6.8 (e) This subdivision does not apply to the sale, exchange, 6.9 or transfer of real property: 6.10 (1) that consists solely of a sale or transfer of severed 6.11 mineral interests; or 6.12 (2) that consists of an individual condominium unit as 6.13 described in chapters 515 and 515B. 6.14 (f) For an area owned in common under chapter 515 or 515B 6.15 the association or other responsible person must report to the 6.16 commissioner by July 1, 1992, the location and status of all 6.17 wells in the common area. The association or other responsible 6.18 person must notify the commissioner within 30 days of any change 6.19 in the reported status of wells. 6.20 (g) For real property sold by the state under section 6.21 92.67, the lessee at the time of the sale is responsible for 6.22 compliance with this subdivision. 6.23 (h) If the seller fails to provide a required well 6.24 disclosure certificate, the buyer, or a person authorized to act 6.25 on behalf of the buyer, may sign a well disclosure certificate 6.26 based on the information provided on the disclosure statement 6.27 required by this section or based on other available information. 6.28 (i) A county recorder or registrar of titles may not record 6.29 a deed or other instrument of conveyance dated after October 31, 6.30 1990, for which a certificate of value is required under section 6.31 272.115, or any deed or other instrument of conveyance dated 6.32 after October 31, 1990, from a governmental body exempt from the 6.33 payment of state deed tax, unless the deed or other instrument 6.34 of conveyance contains the statement made in accordance with 6.35 paragraph (c) or (d) or is accompanied by the well disclosure 6.36 certificate containing all the information required by paragraph 7.1 (b) or (d). The county recorder or registrar of titles must not 7.2 accept a certificate unless it contains all the required 7.3 information. The county recorder or registrar of titles shall 7.4 note on each deed or other instrument of conveyance accompanied 7.5 by a well disclosure certificate that the well disclosure 7.6 certificate was received. The notation must include the 7.7 statement "No wells on property" if the disclosure certificate 7.8 states there are no wells on the property. The well disclosure 7.9 certificate shall not be filed or recorded in the records 7.10 maintained by the county recorder or registrar of titles. After 7.11 noting "No wells on property" on the deed or other instrument of 7.12 conveyance, the county recorder or registrar of titles shall 7.13 destroy or return to the buyer the well disclosure certificate. 7.14 The county recorder or registrar of titles shall collect from 7.15 the buyer or the person seeking to record a deed or other 7.16 instrument of conveyance, a fee of$20$30 for receipt of a 7.17 completed well disclosure certificate. By the tenth day of each 7.18 month, the county recorder or registrar of titles shall transmit 7.19 the well disclosure certificates to the commissioner of health. 7.20 By the tenth day after the end of each calendar quarter, the 7.21 county recorder or registrar of titles shall transmit to the 7.22 commissioner of health$17.50$27.50 of the fee for each well 7.23 disclosure certificate received during the quarter. The 7.24 commissioner shall maintain the well disclosure certificate for 7.25 at least six years. The commissioner may store the certificate 7.26 as an electronic image. A copy of that image shall be as valid 7.27 as the original. 7.28 (j) No new well disclosure certificate is required under 7.29 this subdivision if the buyer or seller, or a person authorized 7.30 to act on behalf of the buyer or seller, certifies on the deed 7.31 or other instrument of conveyance that the status and number of 7.32 wells on the property have not changed since the last previously 7.33 filed well disclosure certificate. The following statement, if 7.34 followed by the signature of the person making the statement, is 7.35 sufficient to comply with the certification requirement of this 7.36 paragraph: "I am familiar with the property described in this 8.1 instrument and I certify that the status and number of wells on 8.2 the described real property have not changed since the last 8.3 previously filed well disclosure certificate." The 8.4 certification and signature may be on the front or back of the 8.5 deed or on an attached sheet and an acknowledgment of the 8.6 statement is not required for the deed or other instrument of 8.7 conveyance to be recordable. 8.8 (k) The commissioner in consultation with county recorders 8.9 shall prescribe the form for a well disclosure certificate and 8.10 provide well disclosure certificate forms to county recorders 8.11 and registrars of titles and other interested persons. 8.12 (l) Failure to comply with a requirement of this 8.13 subdivision does not impair: 8.14 (1) the validity of a deed or other instrument of 8.15 conveyance as between the parties to the deed or instrument or 8.16 as to any other person who otherwise would be bound by the deed 8.17 or instrument; or 8.18 (2) the record, as notice, of any deed or other instrument 8.19 of conveyance accepted for filing or recording contrary to the 8.20 provisions of this subdivision. 8.21 Sec. 6. Minnesota Statutes 2000, section 103I.525, 8.22 subdivision 2, is amended to read: 8.23 Subd. 2. [APPLICATION FEE.] The application fee for a well 8.24 contractor's license is$50$75. The commissioner may not act 8.25 on an application until the application fee is paid. 8.26 Sec. 7. Minnesota Statutes 2000, section 103I.525, 8.27 subdivision 6, is amended to read: 8.28 Subd. 6. [LICENSE FEE.] The fee for a well contractor's 8.29 license is $250, except the fee for an individual well 8.30 contractor's license is$50$75. 8.31 Sec. 8. Minnesota Statutes 2000, section 103I.525, 8.32 subdivision 8, is amended to read: 8.33 Subd. 8. [RENEWAL.] (a) A licensee must file an 8.34 application and a renewal application fee to renew the license 8.35 by the date stated in the license. 8.36 (b) The renewal application feeshall be set by the9.1commissioner under section 16A.1285for a well contractor's 9.2 license is $250. 9.3 (c) The renewal application must include information that 9.4 the applicant has met continuing education requirements 9.5 established by the commissioner by rule. 9.6 (d) At the time of the renewal, the commissioner must have 9.7 on file all properly completed well reports, well sealing 9.8 reports, reports of excavations to construct elevator shafts, 9.9 well permits, and well notifications for work conducted by the 9.10 licensee since the last license renewal. 9.11 Sec. 9. Minnesota Statutes 2000, section 103I.525, 9.12 subdivision 9, is amended to read: 9.13 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 9.14 to submit all information required for renewal in subdivision 8 9.15 or submits the application and information after the required 9.16 renewal date: 9.17 (1) the licensee must includean additionala late feeset9.18by the commissionerof $75; and 9.19 (2) the licensee may not conduct activities authorized by 9.20 the well contractor's license until the renewal application, 9.21 renewal application fee, late fee, and all other information 9.22 required in subdivision 8 are submitted. 9.23 Sec. 10. Minnesota Statutes 2000, section 103I.531, 9.24 subdivision 2, is amended to read: 9.25 Subd. 2. [APPLICATION FEE.] The application fee for a 9.26 limited well/boring contractor's license is$50$75. The 9.27 commissioner may not act on an application until the application 9.28 fee is paid. 9.29 Sec. 11. Minnesota Statutes 2000, section 103I.531, 9.30 subdivision 6, is amended to read: 9.31 Subd. 6. [LICENSE FEE.] The fee for a limited well/boring 9.32 contractor's license is$50$75. 9.33 Sec. 12. Minnesota Statutes 2000, section 103I.531, 9.34 subdivision 8, is amended to read: 9.35 Subd. 8. [RENEWAL.] (a) A person must file an application 9.36 and a renewal application fee to renew the limited well/boring 10.1 contractor's license by the date stated in the license. 10.2 (b) The renewal application feeshall be set by the10.3commissioner under section 16A.1285for a limited well/boring 10.4 contractor's license is $75. 10.5 (c) The renewal application must include information that 10.6 the applicant has met continuing education requirements 10.7 established by the commissioner by rule. 10.8 (d) At the time of the renewal, the commissioner must have 10.9 on file all properly completed well sealing reports, well 10.10 permits, vertical heat exchanger permits, and well notifications 10.11 for work conducted by the licensee since the last license 10.12 renewal. 10.13 Sec. 13. Minnesota Statutes 2000, section 103I.531, 10.14 subdivision 9, is amended to read: 10.15 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 10.16 to submit all information required for renewal in subdivision 8 10.17 or submits the application and information after the required 10.18 renewal date: 10.19 (1) the licensee must includean additionala late feeset10.20by the commissionerof $75; and 10.21 (2) the licensee may not conduct activities authorized by 10.22 the limited well/boring contractor's license until the renewal 10.23 application, renewal application fee, and late fee, and all 10.24 other information required in subdivision 8 are submitted. 10.25 Sec. 14. Minnesota Statutes 2000, section 103I.535, 10.26 subdivision 2, is amended to read: 10.27 Subd. 2. [APPLICATION FEE.] The application fee for an 10.28 elevator shaft contractor's license is$50$75. The 10.29 commissioner may not act on an application until the application 10.30 fee is paid. 10.31 Sec. 15. Minnesota Statutes 2000, section 103I.535, 10.32 subdivision 6, is amended to read: 10.33 Subd. 6. [LICENSE FEE.] The fee for an elevator shaft 10.34 contractor's license is$50$75. 10.35 Sec. 16. Minnesota Statutes 2000, section 103I.535, 10.36 subdivision 8, is amended to read: 11.1 Subd. 8. [RENEWAL.] (a) A person must file an application 11.2 and a renewal application fee to renew the license by the date 11.3 stated in the license. 11.4 (b) The renewal application feeshall be set by the11.5commissioner under section 16A.1285for an elevator shaft 11.6 contractor's license is $75. 11.7 (c) The renewal application must include information that 11.8 the applicant has met continuing education requirements 11.9 established by the commissioner by rule. 11.10 (d) At the time of renewal, the commissioner must have on 11.11 file all reports and permits for elevator shaft work conducted 11.12 by the licensee since the last license renewal. 11.13 Sec. 17. Minnesota Statutes 2000, section 103I.535, 11.14 subdivision 9, is amended to read: 11.15 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 11.16 to submit all information required for renewal in subdivision 8 11.17 or submits the application and information after the required 11.18 renewal date: 11.19 (1) the licensee must includean additionala late feeset11.20by the commissionerof $75; and 11.21 (2) the licensee may not conduct activities authorized by 11.22 the elevator shaft contractor's license until the renewal 11.23 application, renewal application fee, and late fee, and all 11.24 other information required in subdivision 8 are submitted. 11.25 Sec. 18. Minnesota Statutes 2000, section 103I.541, 11.26 subdivision 2b, is amended to read: 11.27 Subd. 2b. [APPLICATION FEE.] The application fee for a 11.28 monitoring well contractor registration is$50$75. The 11.29 commissioner may not act on an application until the application 11.30 fee is paid. 11.31 Sec. 19. Minnesota Statutes 2000, section 103I.541, 11.32 subdivision 4, is amended to read: 11.33 Subd. 4. [RENEWAL.] (a) A person must file an application 11.34 and a renewal application fee to renew the registration by the 11.35 date stated in the registration. 11.36 (b) The renewal application feeshall be set by the12.1commissioner under section 16A.1285for a monitoring well 12.2 contractor's registration is $75. 12.3 (c) The renewal application must include information that 12.4 the applicant has met continuing education requirements 12.5 established by the commissioner by rule. 12.6 (d) At the time of the renewal, the commissioner must have 12.7 on file all well reports, well sealing reports, well permits, 12.8 and notifications for work conducted by the registered person 12.9 since the last registration renewal. 12.10 Sec. 20. Minnesota Statutes 2000, section 103I.541, 12.11 subdivision 5, is amended to read: 12.12 Subd. 5. [INCOMPLETE OR LATE RENEWAL.] If a registered 12.13 person submits a renewal application after the required renewal 12.14 date: 12.15 (1) the registered person must includean additionala late 12.16 feeset by the commissionerof $75; and 12.17 (2) the registered person may not conduct activities 12.18 authorized by the monitoring well contractor's registration 12.19 until the renewal application, renewal application fee, late 12.20 fee, and all other information required in subdivision 4 are 12.21 submitted. 12.22 Sec. 21. Minnesota Statutes 2000, section 103I.545, is 12.23 amended to read: 12.24 103I.545 [REGISTRATION OF DRILLING MACHINES REQUIRED.] 12.25 Subdivision 1. [DRILLING MACHINE.] (a) A person may not 12.26 use a drilling machine such as a cable tool, rotary tool, hollow 12.27 rod tool, or auger for a drilling activity requiring a license 12.28 or registration under this chapter unless the drilling machine 12.29 is registered with the commissioner. 12.30 (b) A person must apply for the registration on forms 12.31 prescribed by the commissioner and submit a$50$75 registration 12.32 fee. 12.33 (c) A registration is valid for one year. 12.34 Subd. 2. [PUMP HOIST.] (a) A person may not use a machine 12.35 such as a pump hoist for an activity requiring a license or 12.36 registration under this chapter to repair wells or borings, seal 13.1 wells or borings, or install pumps unless the machine is 13.2 registered with the commissioner. 13.3 (b) A person must apply for the registration on forms 13.4 prescribed by the commissioner and submit a$50$75 registration 13.5 fee. 13.6 (c) A registration is valid for one year. 13.7[EFFECTIVE DATE.] This section is effective July 1, 2002. 13.8 Sec. 22. Minnesota Statutes 2000, section 121A.15, 13.9 subdivision 6, is amended to read: 13.10 Subd. 6. [SUSPENSION OF IMMUNIZATION REQUIREMENT; 13.11 MODIFICATION TO SCHEDULE.] (a) The commissioner of health, on 13.12 finding that an immunization required pursuant to this section 13.13 is not necessary to protect the public's health, may suspend for 13.14 one year the requirement that children receive that immunization. 13.15 (b) During portions of the year in which the legislature is 13.16 not meeting in regular or special session, the commissioner of 13.17 health may modify the immunization requirements of this section. 13.18 A modification made under this paragraph must be part of the 13.19 current immunization recommendations of each of the following 13.20 organizations: the United States Public Health Service's 13.21 Advisory Committee on Immunization Practices, the American 13.22 Academy of Family Physicians, and the American Academy of 13.23 Pediatrics. The commissioner shall modify the immunization 13.24 requirements through rulemaking using the expedited process in 13.25 section 14.389. A rule adopted under this paragraph shall be in 13.26 effect until the adjournment of the next regular legislative 13.27 session held after the rule is adopted. The commissioner shall 13.28 report to the legislature on any rules adopted under this 13.29 paragraph during the previous calendar year. Such reports are 13.30 due by January 15 of the year following the calendar year in 13.31 which the rule is adopted, except that if a rule is adopted in 13.32 January, a report on that rule is due by February 15 of that 13.33 year. 13.34 Sec. 23. Minnesota Statutes 2000, section 135A.14, is 13.35 amended by adding a subdivision to read: 13.36 Subd. 7. [MODIFICATIONS TO SCHEDULE.] During portions of 14.1 the year in which the legislature is not meeting in regular or 14.2 special session, the commissioner of health may modify the 14.3 immunization requirements of this section. A modification made 14.4 under this subdivision must be part of the current immunization 14.5 recommendations of each of the following organizations: the 14.6 United States Public Health Service's Advisory Committee on 14.7 Immunization Practices, the American Academy of Family 14.8 Physicians, and the American Academy of Pediatrics. The 14.9 commissioner shall modify the immunization requirements through 14.10 rulemaking using the expedited process in section 14.389. A 14.11 rule adopted under this subdivision shall be in effect until the 14.12 adjournment of the next regular legislative session held after 14.13 the rule is adopted. The commissioner shall report to the 14.14 legislature on any rules adopted under this subdivision during 14.15 the previous calendar year. Such reports are due by January 15 14.16 of the year following the calendar year in which the rule is 14.17 adopted, except that if a rule is adopted in January, a report 14.18 on that rule is due by February 15 of that year. 14.19 Sec. 24. [144.0751] [HEALTH STANDARDS.] 14.20 When establishing or revising safe drinking water or air 14.21 quality standards, the commissioner shall take into account only 14.22 peer-reviewed, scientifically acceptable information which 14.23 includes a reasonable margin of safety in setting the standards 14.24 to adequately protect the health of infants, children, and 14.25 adults by taking into consideration each of the following 14.26 specific risks: 14.27 (1) reproductive development and function; 14.28 (2) respiratory function; 14.29 (3) immunologic suppression or hypersensitization; 14.30 (4) development of the brain and nervous system; 14.31 (5) endocrine (hormonal) function; 14.32 (6) cancer; 14.33 (7) general infant and child development; and 14.34 (8) any other important health outcomes identified by the 14.35 commissioner. 14.36 Sec. 25. Minnesota Statutes 2000, section 144.1202, 15.1 subdivision 4, is amended to read: 15.2 Subd. 4. [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 15.3 agreement entered into before August 2,20022003, must remain 15.4 in effect until terminated under the Atomic Energy Act of 1954, 15.5 United States Code, title 42, section 2021, paragraph (j). The 15.6 governor may not enter into an initial agreement with the 15.7 Nuclear Regulatory Commission after August 1,20022003. If an 15.8 agreement is not entered into by August 1,20022003, any rules 15.9 adopted under this section are repealed effective August 1,200215.10 2003. 15.11 (b) An agreement authorized under subdivision 1 must be 15.12 approved by law before it may be implemented. 15.13 Sec. 26. [144.1205] [RADIOACTIVE MATERIAL; SOURCE AND 15.14 SPECIAL NUCLEAR MATERIAL; FEES; INSPECTION.] 15.15 Subdivision 1. [APPLICATION AND LICENSE RENEWAL FEE.] When 15.16 a license is required for radioactive material or source or 15.17 special nuclear material by a rule adopted under section 15.18 144.1202, subdivision 2, an application fee according to 15.19 subdivision 4 must be paid upon initial application for a 15.20 license. The licensee must renew the license 60 days before the 15.21 expiration date of the license by paying a license renewal fee 15.22 equal to the application fee under subdivision 4. The 15.23 expiration date of a license is the date set by the United 15.24 States Nuclear Regulatory Commission before transfer of the 15.25 licensing program under section 144.1202 and thereafter as 15.26 specified by rule of the commissioner of health. 15.27 Subd. 2. [ANNUAL FEE.] A licensee must pay an annual fee 15.28 at least 60 days before the anniversary date of the issuance of 15.29 the license. The annual fee is an amount equal to 80 percent of 15.30 the application fee under subdivision 4, rounded to the nearest 15.31 whole dollar. 15.32 Subd. 3. [FEE CATEGORIES; INCORPORATION OF FEDERAL 15.33 LICENSING CATEGORIES.] (a) Fee categories under this section are 15.34 equivalent to the licensing categories used by the United States 15.35 Nuclear Regulatory Commission under Code of Federal Regulations, 15.36 title 10, parts 30 to 36, 39, 40, 70, 71, and 150, except as 16.1 provided in paragraph (b). 16.2 (b) The category of "Academic, small" is the type of 16.3 license required for the use of radioactive materials in a 16.4 teaching institution. Radioactive materials are limited to ten 16.5 radionuclides not to exceed a total activity amount of one curie. 16.6 Subd. 4. [APPLICATION FEE.] A licensee must pay an 16.7 application fee as follows: 16.8 Radioactive material, Application U.S. Nuclear Regulatory 16.9 source and fee Commission licensing 16.10 special material category as reference 16.12 Type A broadscope $20,000 Medical institution type A 16.13 Type B broadscope $15,000 Research and development 16.14 type B 16.15 Type C broadscope $10,000 Academic type C 16.16 Medical use $4,000 Medical 16.17 Medical institution 16.18 Medical private practice 16.19 Mobile nuclear 16.20 medical laboratory $4,000 Mobile medical laboratory 16.21 Medical special use 16.22 sealed sources $6,000 Teletherapy 16.23 High dose rate remote 16.24 afterloaders 16.25 Stereotactic 16.26 radiosurgery devices 16.27 In vitro testing $2,300 In vitro testing 16.28 laboratories 16.29 Measuring gauge, 16.30 sealed sources $2,000 Fixed gauges 16.31 Portable gauges 16.32 Analytical instruments 16.33 Measuring systems - other 16.34 Gas chromatographs $1,200 Gas chromatographs 16.35 Manufacturing and 16.36 distribution $14,700 Manufacturing and 17.1 distribution - other 17.2 Distribution only $8,800 Distribution of 17.3 radioactive material 17.4 for commercial use only 17.5 Other services $1,500 Other services 17.6 Nuclear medicine 17.7 pharmacy $4,100 Nuclear pharmacy 17.8 Waste disposal $9,400 Waste disposal service 17.9 prepackage 17.10 Waste disposal service 17.11 processing/repackage 17.12 Waste storage only $7,000 To receive and store 17.13 radioactive material waste 17.14 Industrial 17.15 radiography $8,400 Industrial radiography 17.16 fixed location 17.17 Industrial radiography 17.18 portable/temporary sites 17.19 Irradiator - 17.20 self-shielded $4,100 Irradiators self-shielded 17.21 less than 10,000 curies 17.22 Irradiator - 17.23 less than 10,000 Ci $7,500 Irradiators less than 17.24 10,000 curies 17.25 Irradiator - 17.26 more than 10,000 Ci $11,500 Irradiators greater than 17.27 10,000 curies 17.28 Research and 17.29 development, 17.30 no distribution $4,100 Research and development 17.31 Radioactive material 17.32 possession only $1,000 By-product possession only 17.33 Source material $1,000 Source material shielding 17.34 Special nuclear 17.35 material, less than 17.36 200 grams $1,000 Special nuclear material 18.1 plutonium-neutron sources 18.2 less than 200 grams 18.3 Pacemaker 18.4 manufacturing $1,000 Pacemaker by-product 18.5 and/or special nuclear 18.6 material - medical 18.7 institution 18.8 General license 18.9 distribution $2,100 General license 18.10 distribution 18.11 General license 18.12 distribution, exempt $1,500 General license 18.13 distribution - 18.14 certain exempt items 18.15 Academic, small $1,000 Possession limit of ten 18.16 radionuclides, not to 18.17 exceed a total of one curie 18.18 of activity 18.19 Veterinary $2,000 Veterinary use 18.20 Well logging $5,000 Well logging 18.21 Subd. 5. [PENALTY FOR LATE PAYMENT.] An annual fee or a 18.22 license renewal fee submitted to the commissioner after the due 18.23 date specified by rule must be accompanied by an additional 18.24 amount equal to 25 percent of the fee due. 18.25 Subd. 6. [INSPECTIONS.] The commissioner of health shall 18.26 make periodic safety inspections of the radioactive material and 18.27 source and special nuclear material of a licensee. The 18.28 commissioner shall prescribe the frequency of safety inspections 18.29 by rule. 18.30 Subd. 7. [RECOVERY OF REINSPECTION COST.] If the 18.31 commissioner finds serious violations of public health standards 18.32 during an inspection under subdivision 6, the licensee must pay 18.33 all costs associated with subsequent reinspection of the 18.34 source. The costs shall be the actual costs incurred by the 18.35 commissioner and include, but are not limited to, labor, 18.36 transportation, per diem, materials, legal fees, testing, and 19.1 monitoring costs. 19.2 Subd. 8. [RECIPROCITY FEE.] A licensee submitting an 19.3 application for reciprocal recognition of a materials license 19.4 issued by another agreement state or the United States Nuclear 19.5 Regulatory Commission for a period of 180 days or less during a 19.6 calendar year must pay one-half of the application fee specified 19.7 under subdivision 4. For a period of 181 days or more, the 19.8 licensee must pay the entire application fee under subdivision 4. 19.9 Subd. 9. [FEES FOR LICENSE AMENDMENTS.] A licensee must 19.10 pay a fee to amend a license as follows: 19.11 (1) to amend a license requiring no license review 19.12 including, but not limited to, facility name change or removal 19.13 of a previously authorized user, no fee; 19.14 (2) to amend a license requiring review including, but not 19.15 limited to, addition of isotopes, procedure changes, new 19.16 authorized users, or a new radiation safety officer, $200; and 19.17 (3) to amend a license requiring review and a site visit 19.18 including, but not limited to, facility move or addition of 19.19 processes, $400. 19.20[EFFECTIVE DATE.] This section is effective July 1, 2002. 19.21 Sec. 27. Minnesota Statutes 2000, section 144.122, is 19.22 amended to read: 19.23 144.122 [LICENSE, PERMIT, AND SURVEY FEES.] 19.24 (a) The state commissioner of health, by rule, may 19.25 prescribe reasonable procedures and fees for filing with the 19.26 commissioner as prescribed by statute and for the issuance of 19.27 original and renewal permits, licenses, registrations, and 19.28 certifications issued under authority of the commissioner. The 19.29 expiration dates of the various licenses, permits, 19.30 registrations, and certifications as prescribed by the rules 19.31 shall be plainly marked thereon. Fees may include application 19.32 and examination fees and a penalty fee for renewal applications 19.33 submitted after the expiration date of the previously issued 19.34 permit, license, registration, and certification. The 19.35 commissioner may also prescribe, by rule, reduced fees for 19.36 permits, licenses, registrations, and certifications when the 20.1 application therefor is submitted during the last three months 20.2 of the permit, license, registration, or certification period. 20.3 Fees proposed to be prescribed in the rules shall be first 20.4 approved by the department of finance. All fees proposed to be 20.5 prescribed in rules shall be reasonable. The fees shall be in 20.6 an amount so that the total fees collected by the commissioner 20.7 will, where practical, approximate the cost to the commissioner 20.8 in administering the program. All fees collected shall be 20.9 deposited in the state treasury and credited to the state 20.10 government special revenue fund unless otherwise specifically 20.11 appropriated by law for specific purposes. 20.12 (b) The commissioner may charge a fee for voluntary 20.13 certification of medical laboratories and environmental 20.14 laboratories, and for environmental and medical laboratory 20.15 services provided by the department, without complying with 20.16 paragraph (a) or chapter 14. Fees charged for environment and 20.17 medical laboratory services provided by the department must be 20.18 approximately equal to the costs of providing the services. 20.19 (c) The commissioner may develop a schedule of fees for 20.20 diagnostic evaluations conducted at clinics held by the services 20.21 for children with handicaps program. All receipts generated by 20.22 the program are annually appropriated to the commissioner for 20.23 use in the maternal and child health program. 20.24 (d) The commissioner, for fiscal years 1996 and beyond,20.25 shall set license fees for hospitals and nursing homes that are 20.26 not boarding care homes at the following levels: 20.27 Joint Commission on Accreditation of Healthcare 20.28 Organizations (JCAHO hospitals)$1,01720.29 $7,055 20.30 Non-JCAHO hospitals$762 plus $34 per bed20.31 $4,680 plus $234 per bed 20.32 Nursing home$78 plus $19 per bed20.33 $183 plus $91 per bed 20.34For fiscal years 1996 and beyond,The commissioner shall 20.35 set license fees for outpatient surgical centers, boarding care 20.36 homes, and supervised living facilities at the following levels: 21.1 Outpatient surgical centers$51721.2 $1,512 21.3 Boarding care homes$78 plus $19 per bed21.4 $183 plus $91 per bed 21.5 Supervised living facilities$78 plus $19 per bed21.6 $183 plus $91 per bed. 21.7 (e) Unless prohibited by federal law, the commissioner of 21.8 health shall charge applicants the following fees to cover the 21.9 cost of any initial certification surveys required to determine 21.10 a provider's eligibility to participate in the Medicare or 21.11 Medicaid program: 21.12 Prospective payment surveys for $ 900 21.13 hospitals 21.15 Swing bed surveys for nursing homes $1,200 21.17 Psychiatric hospitals $1,400 21.19 Rural health facilities $1,100 21.21 Portable X-ray providers $ 500 21.23 Home health agencies $1,800 21.25 Outpatient therapy agencies $ 800 21.27 End stage renal dialysis providers $2,100 21.29 Independent therapists $ 800 21.31 Comprehensive rehabilitation $1,200 21.32 outpatient facilities 21.34 Hospice providers $1,700 21.36 Ambulatory surgical providers $1,800 21.38 Hospitals $4,200 21.40 Other provider categories or Actual surveyor costs: 21.41 additional resurveys required average surveyor cost x 21.42 to complete initial certification number of hours for the 21.43 survey process. 21.44 These fees shall be submitted at the time of the 21.45 application for federal certification and shall not be 21.46 refunded. All fees collected after the date that the imposition 21.47 of fees is not prohibited by federal law shall be deposited in 21.48 the state treasury and credited to the state government special 21.49 revenue fund. 21.50 Sec. 28. Minnesota Statutes 2000, section 144.148, 21.51 subdivision 2, is amended to read: 22.1 Subd. 2. [PROGRAM.] (a) The commissioner of health shall 22.2 award rural hospital capital improvement grants to eligible 22.3 rural hospitals. Except as provided in paragraph (b), A grant 22.4 shall not exceed $300,000 per hospital. Prior to the receipt of 22.5 any grant, the hospital must certify to the commissioner that at 22.6 least one-quarter of the grant amount, which may include in-kind 22.7 services, is available for the same purposes from nonstate 22.8 resources. 22.9 (b) A grant shall not exceed $1,500,000 per eligible rural 22.10 hospital that also satisfies the following criteria: 22.11 (1) is the only hospital in a county; 22.12 (2) has 25 or fewer licensed hospital beds with a net 22.13 hospital operating margin not greater than an average of two 22.14 percent over the three fiscal years prior to application; 22.15 (3) is located in a medically underserved community (MUC) 22.16 or a health professional shortage area (HPSA); 22.17 (4) is located near a migrant worker employment site and 22.18 regularly treats significant numbers of migrant workers and 22.19 their families; and 22.20 (5) has not previously received a grant under this section 22.21 prior to July 1, 1999. 22.22 Sec. 29. Minnesota Statutes 2000, section 144.226, 22.23 subdivision 4, is amended to read: 22.24 Subd. 4. [VITAL RECORDS SURCHARGE.] In addition to any fee 22.25 prescribed under subdivision 1, there is a nonrefundable 22.26 surcharge of$3$2 for each certified and noncertified birth or 22.27 death record, and for a certification that the record cannot be 22.28 found. The local or state registrar shall forward this amount 22.29 to the state treasurer to be deposited into the state government 22.30 special revenue fund. This surcharge shall not be charged under 22.31 those circumstances in which no fee for a birth or death record 22.32 is permitted under subdivision 1, paragraph (a).This surcharge22.33requirement expires June 30, 2002.22.34 Sec. 30. Minnesota Statutes 2000, section 144.551, 22.35 subdivision 1, is amended to read: 22.36 Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.] 23.1 (a) The following construction or modification may not be 23.2 commenced: 23.3 (1) any erection, building, alteration, reconstruction, 23.4 modernization, improvement, extension, lease, or other 23.5 acquisition by or on behalf of a hospital that increases the bed 23.6 capacity of a hospital, relocates hospital beds from one 23.7 physical facility, complex, or site to another, or otherwise 23.8 results in an increase or redistribution of hospital beds within 23.9 the state; and 23.10 (2) the establishment of a new hospital. 23.11 (b) This section does not apply to: 23.12 (1) construction or relocation within a county by a 23.13 hospital, clinic, or other health care facility that is a 23.14 national referral center engaged in substantial programs of 23.15 patient care, medical research, and medical education meeting 23.16 state and national needs that receives more than 40 percent of 23.17 its patients from outside the state of Minnesota; 23.18 (2) a project for construction or modification for which a 23.19 health care facility held an approved certificate of need on May 23.20 1, 1984, regardless of the date of expiration of the 23.21 certificate; 23.22 (3) a project for which a certificate of need was denied 23.23 before July 1, 1990, if a timely appeal results in an order 23.24 reversing the denial; 23.25 (4) a project exempted from certificate of need 23.26 requirements by Laws 1981, chapter 200, section 2; 23.27 (5) a project involving consolidation of pediatric 23.28 specialty hospital services within the Minneapolis-St. Paul 23.29 metropolitan area that would not result in a net increase in the 23.30 number of pediatric specialty hospital beds among the hospitals 23.31 being consolidated; 23.32 (6) a project involving the temporary relocation of 23.33 pediatric-orthopedic hospital beds to an existing licensed 23.34 hospital that will allow for the reconstruction of a new 23.35 philanthropic, pediatric-orthopedic hospital on an existing site 23.36 and that will not result in a net increase in the number of 24.1 hospital beds. Upon completion of the reconstruction, the 24.2 licenses of both hospitals must be reinstated at the capacity 24.3 that existed on each site before the relocation; 24.4 (7) the relocation or redistribution of hospital beds 24.5 within a hospital building or identifiable complex of buildings 24.6 provided the relocation or redistribution does not result in: 24.7 (i) an increase in the overall bed capacity at that site; (ii) 24.8 relocation of hospital beds from one physical site or complex to 24.9 another; or (iii) redistribution of hospital beds within the 24.10 state or a region of the state; 24.11 (8) relocation or redistribution of hospital beds within a 24.12 hospital corporate system that involves the transfer of beds 24.13 from a closed facility site or complex to an existing site or 24.14 complex provided that: (i) no more than 50 percent of the 24.15 capacity of the closed facility is transferred; (ii) the 24.16 capacity of the site or complex to which the beds are 24.17 transferred does not increase by more than 50 percent; (iii) the 24.18 beds are not transferred outside of a federal health systems 24.19 agency boundary in place on July 1, 1983; and (iv) the 24.20 relocation or redistribution does not involve the construction 24.21 of a new hospital building; 24.22 (9) a construction project involving up to 35 new beds in a 24.23 psychiatric hospital in Rice county that primarily serves 24.24 adolescents and that receives more than 70 percent of its 24.25 patients from outside the state of Minnesota; 24.26 (10) a project to replace a hospital or hospitals with a 24.27 combined licensed capacity of 130 beds or less if: (i) the new 24.28 hospital site is located within five miles of the current site; 24.29 and (ii) the total licensed capacity of the replacement 24.30 hospital, either at the time of construction of the initial 24.31 building or as the result of future expansion, will not exceed 24.32 70 licensed hospital beds, or the combined licensed capacity of 24.33 the hospitals, whichever is less; 24.34 (11) the relocation of licensed hospital beds from an 24.35 existing state facility operated by the commissioner of human 24.36 services to a new or existing facility, building, or complex 25.1 operated by the commissioner of human services; from one 25.2 regional treatment center site to another; or from one building 25.3 or site to a new or existing building or site on the same 25.4 campus; 25.5 (12) the construction or relocation of hospital beds 25.6 operated by a hospital having a statutory obligation to provide 25.7 hospital and medical services for the indigent that does not 25.8 result in a net increase in the number of hospital beds;or25.9 (13) a construction project involving the addition of up to 25.10 31 new beds in an existing nonfederal hospital in Beltrami 25.11 county; or 25.12 (14) a construction project involving the addition of up to 25.13 eight new beds in an existing nonfederal hospital in Otter Tail 25.14 county with 100 licensed acute care beds. 25.15 Sec. 31. [144.585] [HOSPITAL CHARITY CARE AID.] 25.16 Subdivision 1. [PURPOSE.] The purpose of charity care aid 25.17 is to help offset excess charity care burdens at Minnesota acute 25.18 care, short-term hospitals. 25.19 Subd. 2. [DEFINITIONS.] (a) For purposes of this section, 25.20 the terms in this subdivision have the meanings given to them. 25.21 (b) "Charity care" is the dollar amount of charity care 25.22 adjustments as determined under subdivision 3. 25.23 (c) "Cost-to-charge ratio" means a hospital's total 25.24 operating expenses over the sum of gross patient revenue and 25.25 other operating revenue, as reported to the commissioner of 25.26 health under rules adopted under sections 144.695 to 144.703. 25.27 The commissioner shall use the most recently available data to 25.28 calculate the cost-to-charge ratio. 25.29 Subd. 3. [CHARITY CARE REPORTING.] (a) For a hospital to 25.30 report amounts as charity care adjustments, the hospital: 25.31 (1) must generate and record a charge; 25.32 (2) have a policy on the provision of charity care and must 25.33 communicate the policy to the public; 25.34 (3) have made a reasonable effort to identify a third party 25.35 payer, encourage the patient to enroll in public programs, and 25.36 should, to the extent possible, aid the patient in the 26.1 enrollment process; and 26.2 (4) ensure that the patient meets the charity care criteria 26.3 of this subdivision, which must be consistent with statewide 26.4 income standards set out in paragraph (c). 26.5 (b) In determining whether to classify care as charity 26.6 care, the hospital must consider the following: 26.7 (1) charity care may include services which the provider is 26.8 obligated to render independently of the ability to collect; 26.9 (2) charity care may include care provided to low-income 26.10 patients who meet the charity care income standards under 26.11 paragraph (c) and have partial coverage, but are unable to pay 26.12 the remainder of their medical bills. This does not apply to 26.13 that portion of the bill which has been determined to be the 26.14 patient's responsibility after a partial charity care 26.15 classification; 26.16 (3) charity care may include care provided to low-income 26.17 patients who may qualify for a public health insurance program 26.18 and meet the statewide eligibility criteria for charity care, 26.19 but who do not complete the application process for public 26.20 insurance despite the facility's best efforts; 26.21 (4) charity care may include care to individuals whose 26.22 eligibility for charity care was determined through third party 26.23 services employed by the hospital for information gathering 26.24 purposes only; 26.25 (5) charity care may not include contractual allowances, 26.26 which is the difference between gross charges and payments 26.27 received under contractual arrangements with insurance companies 26.28 and payers; 26.29 (6) charity care may not include bad debt; 26.30 (7) charity care may not include what may be perceived as 26.31 underpayments for operating public programs; 26.32 (8) charity care may not include cases which are paid 26.33 through a charitable contribution through a third party or 26.34 facility-related foundation; 26.35 (9) charity care may not include unreimbursed costs of 26.36 basic or clinical research and of professional education and 27.1 training; 27.2 (10) charity care may not include professional courtesy 27.3 discounts; 27.4 (11) charity care may not include community service or 27.5 outreach activities; and 27.6 (12) charity care may not include services for patients 27.7 against whom collection actions where taken which result in a 27.8 credit report. 27.9 (c) The hospital must use the income standards in this 27.10 paragraph for determining charity care eligibility for reporting 27.11 purposes. The hospital does not need to make a patient asset 27.12 determination in order to apply charity care income standards. 27.13 (1) Care to a patient with a family income at or below 150 27.14 percent of the Federal Poverty Guideline (FPG) may be reported 27.15 as full charity care or free care. 27.16 (2) The hospital's share of discounted charges for care to 27.17 a patient with family income below 275 percent of the FPG 27.18 qualifies for classification as charity care. The following 27.19 sliding fee schedules apply: 27.20 income as charges paid corresponding 27.21 % of FPG by patient charity care 27.22 151-200% 20% 80% 27.23 201-225% 40% 60% 27.24 226-250% 60% 40% 27.25 251-275% 80% 20% 27.26 (3) Care to a patient is considered medical hardship when 27.27 qualified medical expenses, as defined for the purposes of 27.28 federal income tax deductibility, exceeds 30 percent of family 27.29 income. Qualified medical expenses may be counted as charity 27.30 care in the amount that exceeds 30 percent of family income. 27.31 This clause applies even if the patient's family income exceeds 27.32 the charity care income standards in clauses (1) and (2). 27.33 Subd. 4. [APPLICATION.] To be eligible for funds under 27.34 this section, hospitals must submit an application to the 27.35 commissioner of health by the deadline established by the 27.36 commissioner. Applications must meet the criteria as 28.1 established by the commissioner, but must contain: 28.2 (1) the dollar amount of charity care in the previous year, 28.3 as defined in subdivision 3, paragraphs (b) and (c); 28.4 (2) a list with the most common diagnoses for which charity 28.5 care is provided; and 28.6 (3) descriptive aggregate statistics of the characteristics 28.7 of patients who receive charity care. 28.8 Subd. 5. [ALLOCATION OF FUNDS.] A hospital's share of the 28.9 available charity care aid is equal to that hospital's share of 28.10 charity care relative to the total charity care provided by 28.11 applicants. 28.12 Sec. 32. Minnesota Statutes 2000, section 144.98, 28.13 subdivision 3, is amended to read: 28.14 Subd. 3. [FEES.] (a) An application for certification 28.15 under subdivision 1 must be accompanied by the biennial fee 28.16 specified in this subdivision. The fees are for: 28.17 (1) nonrefundable base certification fee,$500$1,200; and 28.18 (2) test category certification fees: 28.19 Test Category Certification Fee 28.20 Clean water program bacteriology$200$600 28.21 Safe drinking water program bacteriology $600 28.22 Clean water program inorganic chemistry,28.23fewer than four constituents$100$600 28.24 Safe drinking water program inorganic chemistry,28.25four or more constituents$300$600 28.26 Clean water program chemistry metals,28.27fewer than four constituents$200$800 28.28 Safe drinking water program chemistry metals,28.29four or more constituents$500$800 28.30 Resource conservation and recovery program 28.31 chemistry metals $800 28.32 Clean water program volatile organic compounds$600$1,200 28.33 Safe drinking water program 28.34 volatile organic compounds $1,200 28.35 Resource conservation and recovery program 28.36 volatile organic compounds $1,200 29.1 Underground storage tank program 29.2 volatile organic compounds $1,200 29.3 Clean water program other organic compounds$600$1,200 29.4 Safe drinking water program other organic compounds $1,200 29.5 Resource conservation and recovery program 29.6 other organic compounds $1,200 29.7 (b) The total biennial certification fee is the base fee 29.8 plus the applicable test category fees.The biennial29.9certification fee for a contract laboratory is 1.5 times the29.10total certification fee.29.11 (c) Laboratories located outside of this state that require 29.12 an on-site survey will be assessed an additional$1,200$2,500 29.13 fee. 29.14 (d) Fees must be set so that the total fees support the 29.15 laboratory certification program. Direct costs of the 29.16 certification service include program administration, 29.17 inspections, the agency's general support costs, and attorney 29.18 general costs attributable to the fee function. 29.19 (e) A change fee shall be assessed if a laboratory requests 29.20 additional analytes or methods at any time other than when 29.21 applying for or renewing its certification. The change fee is 29.22 equal to the test category certification fee for the analyte. 29.23 (f) A variance fee shall be assessed if a laboratory 29.24 requests and is granted a variance from a rule adopted under 29.25 this section. The variance fee is $500 per variance. 29.26 (g) Refunds or credits shall not be made for analytes or 29.27 methods requested but not approved. 29.28 (h) Certification of a laboratory shall not be awarded 29.29 until all fees are paid. 29.30 Sec. 33. Minnesota Statutes 2000, section 144A.44, 29.31 subdivision 1, is amended to read: 29.32 Subdivision 1. [STATEMENT OF RIGHTS.] A person who 29.33 receives home care services has these rights: 29.34 (1) the right to receive written information about rights 29.35 in advance of receiving care or during the initial evaluation 29.36 visit before the initiation of treatment, including what to do 30.1 if rights are violated; 30.2 (2) the right to receive care and services according to a 30.3 suitable and up-to-date plan, and subject to accepted medical or 30.4 nursing standards, to take an active part in creating and 30.5 changing the plan and evaluating care and services; 30.6 (3) the right to be told in advance of receiving care about 30.7 the services that will be provided, the disciplines that will 30.8 furnish care, the frequency of visits proposed to be furnished, 30.9 other choices that are available, and the consequences of these 30.10 choices including the consequences of refusing these services; 30.11 (4) the right to be told in advance of any change in the 30.12 plan of care and to take an active part in any change; 30.13 (5) the right to refuse services or treatment; 30.14 (6) the right to know, in advance, any limits to the 30.15 services available from a provider, and the provider's grounds 30.16 for a termination of services; 30.17 (7) the right to know in advance of receiving care whether 30.18 the services are covered by health insurance, medical 30.19 assistance, or other health programs, the charges for services 30.20 that will not be covered by Medicare, and the charges that the 30.21 individual may have to pay; 30.22 (8) the right to know what the charges are for services, no 30.23 matter who will be paying the bill; 30.24 (9) the right to know that there may be other services 30.25 available in the community, including other home care services 30.26 and providers, and to know where to go for information about 30.27 these services; 30.28 (10) the right to choose freely among available providers 30.29 and to change providers after services have begun, within the 30.30 limits of health insurance, medical assistance, or other health 30.31 programs; 30.32 (11) the right to have personal, financial, and medical 30.33 information kept private, and to be advised of the provider's 30.34 policies and procedures regarding disclosure of such 30.35 information; 30.36 (12) the right to be allowed access to records and written 31.1 information from records in accordance with section 144.335; 31.2 (13) the right to be served by people who are properly 31.3 trained and competent to perform their duties; 31.4 (14) the right to be treated with courtesy and respect, and 31.5 to have the patient's property treated with respect; 31.6 (15) the right to be free from physical and verbal abuse; 31.7 (16) the right to reasonable, advance notice of changes in 31.8 services or charges, including at least ten days' advance notice 31.9 of the termination of a service by a provider, except in cases 31.10 where: 31.11 (i) the recipient of services engages in conduct that 31.12 alters the conditions of employment as specified in the 31.13 employment contract between the home care provider and the 31.14 individual providing home care services, or creates an abusive 31.15 or unsafe work environment for the individual providing home 31.16 care services; or 31.17 (ii) an emergency for the informal caregiver or a 31.18 significant change in the recipient's condition has resulted in 31.19 service needs that exceed the current service provider agreement 31.20 and that cannot be safely met by the home care provider; 31.21 (17) the right to a coordinated transfer when there will be 31.22 a change in the provider of services; 31.23 (18) the right to voice grievances regarding treatment or 31.24 care that is, or fails to be, furnished, or regarding the lack 31.25 of courtesy or respect to the patient or the patient's property; 31.26 (19) the right to know how to contact an individual 31.27 associated with the provider who is responsible for handling 31.28 problems and to have the provider investigate and attempt to 31.29 resolve the grievance or complaint; 31.30 (20) the right to know the name and address of the state or 31.31 county agency to contact for additional information or 31.32 assistance; and 31.33 (21) the right to assert these rights personally, or have 31.34 them asserted by the patient's family or guardian when the 31.35 patient has been judged incompetent, without retaliation. 31.36 Sec. 34. Minnesota Statutes 2000, section 144A.4605, 32.1 subdivision 4, is amended to read: 32.2 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 32.3 establishment registered under chapter 144D that is required to 32.4 obtain a home care license must obtain an assisted living home 32.5 care license according to this section or a class A or class E 32.6 license according to rule. A housing with services 32.7 establishment that obtains a class E license under this 32.8 subdivision remains subject to the payment limitations in 32.9 sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915, 32.10 subdivision 3, paragraph (g). 32.11 (b) A board and lodging establishment registered for 32.12 special services as of December 31, 1996, and also registered as 32.13 a housing with services establishment under chapter 144D, must 32.14 deliver home care services according to sections 144A.43 to 32.15 144A.48, and may apply for a waiver from requirements under 32.16 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 32.17 licensed agency under the standards of section 157.17. Such 32.18 waivers as may be granted by the department will expire upon 32.19 promulgation of home care rules implementing section 144A.4605. 32.20 (c) An adult foster care provider licensed by the 32.21 department of human services and registered under chapter 144D 32.22 may continue to provide health-related services under its foster 32.23 care license until the promulgation of home care rules 32.24 implementing this section. 32.25 (d) An assisted living home care provider licensed under 32.26 this section must comply with the disclosure provisions of 32.27 section 325F.691 to the extent they are applicable. 32.28 Sec. 35. Minnesota Statutes 2000, section 144D.03, 32.29 subdivision 2, is amended to read: 32.30 Subd. 2. [REGISTRATION INFORMATION.] The establishment 32.31 shall provide the following information to the commissioner in 32.32 order to be registered: 32.33 (1) the business name, street address, and mailing address 32.34 of the establishment; 32.35 (2) the name and mailing address of the owner or owners of 32.36 the establishment and, if the owner or owners are not natural 33.1 persons, identification of the type of business entity of the 33.2 owner or owners, and the names and addresses of the officers and 33.3 members of the governing body, or comparable persons for 33.4 partnerships, limited liability corporations, or other types of 33.5 business organizations of the owner or owners; 33.6 (3) the name and mailing address of the managing agent, 33.7 whether through management agreement or lease agreement, of the 33.8 establishment, if different from the owner or owners, and the 33.9 name of the on-site manager, if any; 33.10 (4) verification that the establishment has entered into an 33.11 elderly housing with services contract, as required in section 33.12 144D.04, with each resident or resident's representative; 33.13 (5) verification that the establishment is complying with 33.14 the requirements of section 325F.691, if applicable; 33.15(5)(6) the name and address of at least one natural person 33.16 who shall be responsible for dealing with the commissioner on 33.17 all matters provided for in sections 144D.01 to 144D.06, and on 33.18 whom personal service of all notices and orders shall be made, 33.19 and who shall be authorized to accept service on behalf of the 33.20 owner or owners and the managing agent, if any; and 33.21(6)(7) the signature of the authorized representative of 33.22 the owner or owners or, if the owner or owners are not natural 33.23 persons, signatures of at least two authorized representatives 33.24 of each owner, one of which shall be an officer of the owner. 33.25 Personal service on the person identified under clause(5)33.26 (6) by the owner or owners in the registration shall be 33.27 considered service on the owner or owners, and it shall not be a 33.28 defense to any action that personal service was not made on each 33.29 individual or entity. The designation of one or more 33.30 individuals under this subdivision shall not affect the legal 33.31 responsibility of the owner or owners under sections 144D.01 to 33.32 144D.06. 33.33 Sec. 36. Minnesota Statutes 2000, section 144D.04, 33.34 subdivision 2, is amended to read: 33.35 Subd. 2. [CONTENTS OF CONTRACT.] An elderly housing with 33.36 services contract, which need not be entitled as such to comply 34.1 with this section, shall include at least the following elements 34.2 in itself or through supporting documents or attachments: 34.3 (1) name, street address, and mailing address of the 34.4 establishment; 34.5 (2) the name and mailing address of the owner or owners of 34.6 the establishment and, if the owner or owners is not a natural 34.7 person, identification of the type of business entity of the 34.8 owner or owners; 34.9 (3) the name and mailing address of the managing agent, 34.10 through management agreement or lease agreement, of the 34.11 establishment, if different from the owner or owners; 34.12 (4) the name and address of at least one natural person who 34.13 is authorized to accept service on behalf of the owner or owners 34.14 and managing agent; 34.15 (5) statement describing the registration and licensure 34.16 status of the establishment and any provider providing 34.17 health-related or supportive services under an arrangement with 34.18 the establishment; 34.19 (6) term of the contract; 34.20 (7) description of the services to be provided to the 34.21 resident in the base rate to be paid by resident; 34.22 (8) description of any additional services available for an 34.23 additional fee from the establishment directly or through 34.24 arrangements with the establishment; 34.25 (9) fee schedules outlining the cost of any additional 34.26 services; 34.27 (10) description of the process through which the contract 34.28 may be modified, amended, or terminated; 34.29 (11) description of the establishment's complaint 34.30 resolution process available to residents including the 34.31 toll-free complaint line for the office of ombudsman for older 34.32 Minnesotans; 34.33 (12) the resident's designated representative, if any; 34.34 (13) the establishment's referral procedures if the 34.35 contract is terminated; 34.36 (14) criteria used by the establishment to determine who 35.1 may continue to reside in the elderly housing with services 35.2 establishment; 35.3 (15) billing and payment procedures and requirements; 35.4 (16) statement regarding the ability of residents to 35.5 receive services from service providers with whom the 35.6 establishment does not have an arrangement; and 35.7 (17) statement regarding the availability of public funds 35.8 for payment for residence or services in the establishment. 35.9 Sec. 37. Minnesota Statutes 2000, section 144D.04, 35.10 subdivision 3, is amended to read: 35.11 Subd. 3. [CONTRACTS IN PERMANENT FILES.] Elderly housing 35.12 with services contracts and related documents executed by each 35.13 resident or resident's representative shall be maintained by the 35.14 establishment in files from the date of execution until three 35.15 years after the contract is terminated. The contracts and the 35.16 written disclosures required under section 325F.691, if 35.17 applicable, shall be made available for on-site inspection by 35.18 the commissioner upon request at any time. 35.19 Sec. 38. Minnesota Statutes 2000, section 144D.06, is 35.20 amended to read: 35.21 144D.06 [OTHER LAWS.] 35.22 A housing with services establishment shall obtain and 35.23 maintain all other licenses, permits, registrations, or other 35.24 governmental approvals required of it in addition to 35.25 registration under this chapter. A housing with services 35.26 establishment is subject to the provisions of section 325F.691 35.27 and chapter 504B. 35.28 Sec. 39. [145.4241] [DEFINITIONS.] 35.29 Subdivision 1. [APPLICABILITY.] As used in sections 35.30 145.4241 to 145.4246, the following terms have the meaning given 35.31 them. 35.32 Subd. 2. [ABORTION.] "Abortion" includes an act, 35.33 procedure, or use of any instrument, medicine, or drug which is 35.34 supplied or prescribed for or administered to a woman known to 35.35 be pregnant with the intention to terminate the pregnancy with 35.36 an intention other than to increase the probability of live 36.1 birth, to preserve the life or health of the child after live 36.2 birth, or to remove a dead fetus. 36.3 Subd. 3. [ATTEMPT TO PERFORM AN ABORTION.] "Attempt to 36.4 perform an abortion" means an act, or an omission of a 36.5 statutorily required act, that, under the circumstances as the 36.6 actor believes them to be, constitutes a substantial step in a 36.7 course of conduct planned to culminate in the performance of an 36.8 abortion in Minnesota in violation of sections 145.4241 to 36.9 145.4246. 36.10 Subd. 4. [MEDICAL EMERGENCY.] "Medical emergency" means 36.11 any condition that, on the basis of the physician's good faith 36.12 clinical judgment, complicates the medical condition of a 36.13 pregnant female to the extent that: 36.14 (1) an immediate abortion of her pregnancy is necessary to 36.15 avert her death; or 36.16 (2) a 24-hour delay in performing an abortion creates a 36.17 serious risk of substantial injury or impairment of a major 36.18 bodily function. 36.19 Subd. 5. [PHYSICIAN.] "Physician" means a person licensed 36.20 under chapter 147. 36.21 Subd. 6. [PROBABLE GESTATIONAL AGE OF THE FETUS.] 36.22 "Probable gestational age of the fetus" means what will, in the 36.23 judgment of the physician, with reasonable probability, be the 36.24 gestational age of the fetus at the time the abortion is planned 36.25 to be performed. 36.26 Sec. 40. [145.4242] [INFORMED CONSENT.] 36.27 (a) No abortion shall be performed in this state except 36.28 with the voluntary and informed consent of the female upon whom 36.29 the abortion is to be performed. Except in the case of a 36.30 medical emergency, consent to an abortion is voluntary and 36.31 informed only if the female is told the following, by telephone 36.32 or in person, by the physician who is to perform the abortion, 36.33 the referring physician, a registered nurse, or a licensed 36.34 practical nurse, at least 24 hours prior to the abortion: 36.35 (1) the particular medical risks associated with the 36.36 particular abortion procedure to be employed including, when 37.1 medically accurate, the risks of infection, hemorrhage, breast 37.2 cancer, danger to subsequent pregnancies, and infertility; 37.3 (2) the probable gestational age of the fetus at the time 37.4 the abortion is to be performed; 37.5 (3) the medical risks associated with carrying to term; 37.6 (4) that medical assistance benefits may be available for 37.7 prenatal care, childbirth, and neonatal care; 37.8 (5) that the father is liable to assist in the support of 37.9 her child except under certain circumstances, even in instances 37.10 when the father has offered to pay for the abortion; 37.11 (6) the availability of a toll-free number and Web site 37.12 that can provide information on support services during 37.13 pregnancy and while the child is dependent and offer 37.14 alternatives to abortion; and 37.15 (7) that she has the right to review the printed materials 37.16 described in section 145.4243, and the printed materials are 37.17 available on the state Web site. 37.18 (b) The physician or the physician's agent shall orally 37.19 inform the female that the materials have been provided by the 37.20 state of Minnesota and that they describe the unborn child and 37.21 list agencies that offer alternatives to abortion. 37.22 (c) The physician or the physician's agent shall orally 37.23 inform the female of the Web site address and toll-free number. 37.24 (d) If the female chooses to view the materials, they shall 37.25 either be given to her at least 24 hours before the abortion or 37.26 mailed to her at least 72 hours before the abortion by first 37.27 class mail, or at the woman's request, by certified mail, 37.28 restricted delivery to addressee, which means the postal 37.29 employee may only deliver the mail to the addressee. The 37.30 envelope used by the physician shall not identify the name of 37.31 the physician or the physician's clinic or business. 37.32 (e) If a physical examination, tests, or the availability 37.33 of other information to the physician subsequently indicates, in 37.34 the medical judgment of the physician, a revision of the 37.35 information previously supplied to the patient, that revised 37.36 information may be communicated to the patient at any time prior 38.1 to the performance of the abortion. 38.2 Sec. 41. [145.4243] [PRINTED INFORMATION.] 38.3 Subdivision 1. [MATERIALS.] (a) Within 90 days after the 38.4 effective date of sections 145.4241 to 145.4246, the department 38.5 of health shall cause to be published, in English and in each 38.6 language that is the primary language of two percent or more of 38.7 the state's population, the printed materials described in 38.8 paragraphs (b) and (c) in such a way as to ensure that the 38.9 information is easily comprehensible. 38.10 (b) The materials must be designed to inform the female of 38.11 the probable anatomical and physiological characteristics of the 38.12 fetus at two-week gestational increments from the time when a 38.13 female can be known to be pregnant to full term, including any 38.14 relevant information on the possibility of the fetus' survival 38.15 and pictures or drawings representing the development of the 38.16 fetus at two-week gestational increments, provided that any such 38.17 pictures or drawings must contain the dimensions of the fetus 38.18 and must be realistic and appropriate for the stage of pregnancy 38.19 depicted. The materials must be objective, nonjudgmental, and 38.20 designed to convey only accurate scientific information about 38.21 the fetus at the various gestational ages. 38.22 (c) The materials must contain objective information 38.23 describing the methods of abortion procedures commonly employed, 38.24 the medical risks commonly associated with each procedure, the 38.25 possible detrimental psychological effects of abortion, and the 38.26 medical risks commonly associated with carrying a child to term. 38.27 Subd. 2. [TYPEFACE; AVAILABILITY.] The materials referred 38.28 to in this section must be printed in a typeface large enough to 38.29 be clearly legible. The materials required under this section 38.30 must be available from the department of health upon request and 38.31 in appropriate number to any person, facility, or hospital at no 38.32 cost. 38.33 Sec. 42. [145.4244] [PROCEDURE IN CASE OF MEDICAL 38.34 EMERGENCY.] 38.35 When a medical emergency compels the performance of an 38.36 abortion, the physician shall inform the female, prior to the 39.1 abortion if possible, of the medical indications supporting the 39.2 physician's judgment that an abortion is necessary to avert her 39.3 death or that a 24-hour delay in conformance with section 39.4 145.4242 creates a serious risk of substantial injury or 39.5 impairment of a major bodily function. 39.6 Sec. 43. [145.4245] [TOLL-FREE TELEPHONE NUMBER AND WEB 39.7 SITE.] 39.8 Subdivision 1. [RIGHT TO KNOW.] All pregnant women have 39.9 the right to know information about resources available to 39.10 assist them and their families. The commissioner of health 39.11 shall establish and maintain a statewide toll-free telephone 39.12 number available seven days a week to provide information and 39.13 referrals to local community resources to assist women and 39.14 families through pregnancy and childbirth and while the child is 39.15 dependent. 39.16 Subd. 2. [INFORMATION.] The toll-free telephone number 39.17 must provide information regarding community resources on the 39.18 following topics: 39.19 (1) information regarding avoiding unplanned pregnancies; 39.20 (2) prenatal care, including the need for an initial risk 39.21 screening and assessment; 39.22 (3) adoption; 39.23 (4) health education, including the importance of good 39.24 nutrition during pregnancy and the risks associated with alcohol 39.25 and tobacco use during pregnancy; 39.26 (5) available social services, including medical assistance 39.27 benefits for prenatal care, childbirth, and neonatal care; 39.28 (6) legal assistance in obtaining child support; and 39.29 (7) community support services and other resources to 39.30 enhance family strengths and reduce the possibility of family 39.31 violence. 39.32 Subd. 3. [WEB SITE.] The commissioner shall design and 39.33 maintain a secure Web site to provide the information described 39.34 under subdivision 2 and section 145.4243 with a minimum 39.35 resolution of 72 PPI. The Web site shall provide the toll-free 39.36 information and referral telephone number described under 40.1 subdivision 2. 40.2 Sec. 44. [145.4246] [ENFORCEMENT PENALTIES.] 40.3 Subdivision 1. [STANDING.] A person with standing may 40.4 maintain an action against the performance or attempted 40.5 performance of abortions in violation of section 145.4242. 40.6 Those with standing are: 40.7 (1) a woman upon whom an abortion in violation of section 40.8 145.4242 has been performed or attempted to be performed; and 40.9 (2) the parent of an unemancipated minor upon whom an 40.10 abortion in violation of section 145.4242 has been, is about to 40.11 be, or was attempted to be performed; and 40.12 (3) attorney general of the state of Minnesota. 40.13 Subd. 2. [INJUNCTIONS.] Parties bringing actions against 40.14 the performance or attempted performance of abortions in 40.15 violation of section 145.4242 may seek temporary restraining 40.16 orders, preliminary injunctions, and injunctions related only to 40.17 the physician or facility where the violation occurred in 40.18 accordance with the Rules of Civil Procedure. Persons with 40.19 standing must bring any actions within six months of the date of 40.20 the performed or attempted performance of abortions in violation 40.21 of section 145.4242. 40.22 Subd. 3. [CONTEMPT.] Any person knowingly violating the 40.23 terms of an injunction against the performance or attempted 40.24 performance of abortions in violation of section 145.4242 is 40.25 subject to civil contempt, and shall be fined no more than 40.26 $1,000 for the first violation, no more than $5,000 for the 40.27 second violation, no more than $10,000 for the third violation, 40.28 and for each successive violation an amount sufficient to deter 40.29 future violations. The fine shall be the exclusive penalty for 40.30 a violation. Each performance or attempted performance of 40.31 abortion in violation of section 145.4242 is a separate 40.32 violation. No fine shall be assessed against the woman on whom 40.33 an abortion is performed or attempted. 40.34 Subd. 4. [REALLOCATION OF THE FINE.] Any fines collected 40.35 under this section must be sent to a special account at the 40.36 Minnesota department of health to be used for materials cited in 41.1 section 145.4243. 41.2 Sec. 45. [145.4247] [CUMULATIVE RIGHTS.] 41.3 The provisions of sections 145.4241 to 145.4246 are 41.4 cumulative with existing law regarding an individual's right to 41.5 consent to medical treatment and shall not impair any existing 41.6 right any patient may have under the common law or statutes of 41.7 this state. 41.8 Sec. 46. Minnesota Statutes 2000, section 145.881, 41.9 subdivision 2, is amended to read: 41.10 Subd. 2. [DUTIES.] The advisory task force shall meet on a 41.11 regular basis to perform the following duties: 41.12 (a) review and report on the health care needs of mothers 41.13 and children throughout the state of Minnesota; 41.14 (b) review and report on the type, frequency and impact of 41.15 maternal and child health care services provided to mothers and 41.16 children under existing maternal and child health care programs, 41.17 including programs administered by the commissioner of health; 41.18 (c) establish, review, and report to the commissioner a 41.19 list of program guidelines and criteria which the advisory task 41.20 force considers essential to providing an effective maternal and 41.21 child health care program to low income populations and high 41.22 risk persons and fulfilling the purposes defined in section 41.23 145.88; 41.24 (d) review staff recommendations of the department of 41.25 health regarding maternal and child health grant awards before 41.26 the awards are made; 41.27 (e) make recommendations to the commissioner for the use of 41.28 other federal and state funds available to meet maternal and 41.29 child health needs; 41.30 (f) make recommendations to the commissioner of health on 41.31 priorities for funding the following maternal and child health 41.32 services: (1) prenatal, delivery and postpartum care, (2) 41.33 comprehensive health care for children, especially from birth 41.34 through five years of age, (3) adolescent health services, (4) 41.35 family planning services, (5) preventive dental care, (6) 41.36 special services for chronically ill and handicapped children 42.1 and (7) any other services which promote the health of mothers 42.2 and children;and42.3 (g) make recommendations to the commissioner of health on 42.4 the process to distribute, award and administer the maternal and 42.5 child health block grant funds; and 42.6 (h) review the measures that are used to define the 42.7 variables of the funding distribution formula in section 42.8 145.882, subdivision 4a, every two years and make 42.9 recommendations to the commissioner of health for changes based 42.10 upon principles established by the advisory task force for this 42.11 purpose. 42.12 Sec. 47. Minnesota Statutes 2000, section 145.882, is 42.13 amended by adding a subdivision to read: 42.14 Subd. 4a. [ALLOCATION TO COMMUNITY HEALTH BOARDS.] (a) 42.15 Federal maternal and child health block grant money remaining 42.16 after distributions made under subdivision 2 and money 42.17 appropriated for allocation to community health boards must be 42.18 allocated according to paragraphs (b) to (d) to community health 42.19 boards as defined in section 145A.02, subdivision 5. 42.20 (b) All community health boards must receive 95 percent of 42.21 the funding awarded to them for the 1998-1999 funding cycle. If 42.22 the amount of state and federal funding available is less than 42.23 95 percent of the amount awarded to community health boards for 42.24 the 1998-1999 funding cycle, the available funding must be 42.25 apportioned to reflect a proportional decrease for each 42.26 recipient. 42.27 (c) The federal and state funding remaining after 42.28 distributions made under paragraph (b) must be allocated to each 42.29 community health board based on the following three variables: 42.30 (1) 25 percent based on the maternal and child population 42.31 in the area served by the community health board; 42.32 (2) 50 percent based on the following factors, as 42.33 determined by averaging the data available for the three most 42.34 recent years: 42.35 (i) the proportion of infants in the area served by the 42.36 community health board whose weight at birth was less than 2,500 43.1 grams; 43.2 (ii) the proportion of mothers in the area served by the 43.3 community health board who received inadequate or no prenatal 43.4 care; 43.5 (iii) the proportion of births in the area served by the 43.6 community health board to women under age 19; and 43.7 (iv) the proportion of births in the area served by the 43.8 community health board to American Indian women and women of 43.9 color; and 43.10 (3) 25 percent based on the income of the maternal and 43.11 child population in the area served by the community health 43.12 board. 43.13 (d) Each variable must be expressed as a city or county 43.14 score consisting of the city or county frequency of each 43.15 variable in relation to the statewide frequency of the 43.16 variable. A total score for each city or county jurisdiction 43.17 must be computed by totaling the scores of the three variables. 43.18 Each community health board must be allocated an amount equal to 43.19 the total score obtained for the city, county, or counties in 43.20 its area multiplied by the amount of money available. 43.21 Sec. 48. Minnesota Statutes 2000, section 145.882, 43.22 subdivision 7, is amended to read: 43.23 Subd. 7. [USE OF BLOCK GRANT MONEY.](a)Maternal and 43.24 child health block grant money allocated to a community health 43.25 board or community health services area under this section must 43.26 be used for qualified programs for high risk and low-income 43.27 individuals. Block grant money must be used for programs that: 43.28 (1) specifically address the highest risk populations, 43.29 particularly low-income and minority groups with a high rate of 43.30 infant mortality and children with low birth weight, by 43.31 providing services,includingexcluding prepregnancy family 43.32 planning services, calculated to produce measurable decreases in 43.33 infant mortality rates, instances of children with low birth 43.34 weight, and medical complications associated with pregnancy and 43.35 childbirth, including infant mortality, low birth rates, and 43.36 medical complications arising from chemical abuse by a mother 44.1 during pregnancy; 44.2 (2) specifically target pregnant women whose age, medical 44.3 condition, maternal history, or chemical abuse substantially 44.4 increases the likelihood of complications associated with 44.5 pregnancy and childbirth or the birth of a child with an 44.6 illness, disability, or special medical needs; 44.7 (3) specifically address the health needs of young children 44.8 who have or are likely to have a chronic disease or disability 44.9 or special medical needs, including physical, neurological, 44.10 emotional, and developmental problems that arise from chemical 44.11 abuse by a mother during pregnancy; 44.12 (4) providefamily planning andpreventive medical care, 44.13 excluding prepregnancy family planning services, for 44.14 specifically identified target populations, such as minority and 44.15 low-income teenagers, in a manner calculated todecrease the44.16occurrence of inappropriate pregnancy andminimize the risk of 44.17 complications associated with pregnancy and childbirth; or 44.18 (5) specifically address the frequency and severity of 44.19 childhood injuries and other child and adolescent health 44.20 problems in high-risk target populations by providing services, 44.21 excluding prepregnancy family planning services, calculated to 44.22 produce measurable decreases in mortality and 44.23 morbidity.However, money may be used for this purpose only if44.24the community health board's application includes program44.25components for the purposes in clauses (1) to (4) in the44.26proposed geographic service area and the total expenditure for44.27injury-related programs under this clause does not exceed ten44.28percent of the total allocation under subdivision 3.44.29(b) Maternal and child health block grant money may be used44.30for purposes other than the purposes listed in this subdivision44.31only under the following conditions:44.32(1) the community health board or community health services44.33area can demonstrate that existing programs fully address the44.34needs of the highest risk target populations described in this44.35subdivision; or44.36(2) the money is used to continue projects that received45.1funding before creation of the maternal and child health block45.2grant in 1981.45.3(c) Projects that received funding before creation of the45.4maternal and child health block grant in 1981, must be allocated45.5at least the amount of maternal and child health special project45.6grant funds received in 1989, unless (1) the local board of45.7health provides equivalent alternative funding for the project45.8from another source; or (2) the local board of health45.9demonstrates that the need for the specific services provided by45.10the project has significantly decreased as a result of changes45.11in the demographic characteristics of the population, or other45.12factors that have a major impact on the demand for services. If45.13the amount of federal funding to the state for the maternal and45.14child health block grant is decreased, these projects must45.15receive a proportional decrease as required in subdivision 1.45.16Increases in allocation amounts to local boards of health under45.17subdivision 4 may be used to increase funding levels for these45.18projects.45.19 Sec. 49. Minnesota Statutes 2000, section 145.885, 45.20 subdivision 2, is amended to read: 45.21 Subd. 2. [ADDITIONAL REQUIREMENTS FOR COMMUNITY BOARDS OF 45.22 HEALTH.] Applications by community health boards as defined in 45.23 section 145A.02, subdivision 5, under section 145.882, 45.24 subdivision34a, must also contain a summary of the process 45.25 used to develop the local program, including evidence that the 45.26 community health board notified local public and private 45.27 providers of the availability of funding through the community 45.28 health board for maternal and child health services; a list of 45.29 all public and private agency requests for grants submitted to 45.30 the community health board indicating which requests were 45.31 included in the grant application; and an explanation of how 45.32 priorities were established for selecting the requests to be 45.33 included in the grant application. The community health board 45.34 shall include, with the grant application, a written statement 45.35 of the criteria to be applied to public and private agency 45.36 requests for funding. 46.1 Sec. 50. Minnesota Statutes 2000, section 145.924, is 46.2 amended to read: 46.3 145.924 [AIDS PREVENTION GRANTS.] 46.4 Subdivision 1. [GRANT AWARDS.] (a) The commissioner may 46.5 award grants to boards of health as defined in section 145A.02, 46.6 subdivision 2, state agencies, state councils, or nonprofit 46.7 corporations to provide evaluation and counseling services to 46.8 populations at risk for acquiring human immunodeficiency virus 46.9 infection, including, but not limited to, minorities, 46.10 adolescents, intravenous drug users, and homosexual men. 46.11 (b) The commissioner may award grants to agencies 46.12 experienced in providing services to communities of color, for 46.13 the design of innovative outreach and education programs for 46.14 targeted groups within the community who may be at risk of 46.15 acquiring the human immunodeficiency virus infection, including 46.16 intravenous drug users and their partners, adolescents, gay and 46.17 bisexual individuals and women. Grants shall be awarded on a 46.18 request for proposal basis and shall include funds for 46.19 administrative costs. Priority for grants shall be given to 46.20 agencies or organizations that have experience in providing 46.21 service to the particular community which the grantee proposes 46.22 to serve; that have policymakers representative of the targeted 46.23 population; that have experience in dealing with issues relating 46.24 to HIV/AIDS; and that have the capacity to deal effectively with 46.25 persons of differing sexual orientations. For purposes of this 46.26 paragraph, the "communities of color" are: the American-Indian 46.27 community; the Hispanic community; the African-American 46.28 community; and the Asian-Pacific community. 46.29 (c) All state grants awarded under thissectionsubdivision 46.30 for programs targeted to adolescents shall include the promotion 46.31 of abstinence from sexual activity and drug use. 46.32 Subd. 2. [OUTCOMES.] The commissioner, in consultation 46.33 with boards of health, agencies, councils, and nonprofit 46.34 organizations involved in human immunodeficiency virus infection 46.35 prevention efforts shall establish measurable outcomes to 46.36 determine the effectiveness of the grants provided under this 47.1 section in reducing the number of people who acquire human 47.2 immunodeficiency virus, the rates of infection, and average 47.3 numbers of sexual partners for populations served by grants 47.4 funded under this section. 47.5 Subd. 3. [EVALUATION.] (a) Using the outcomes established 47.6 according to subdivision 2, the commissioner shall conduct a 47.7 biennial evaluation of activities funded under this section. 47.8 The evaluation must include: 47.9 (1) the effect of these activities on the number of people 47.10 who acquire human immunodeficiency virus and the rates of 47.11 infection; 47.12 (2) the effect of these activities on average numbers of 47.13 sexual partners for populations served by grants funded under 47.14 this section; and 47.15 (3) a longitudinal tracking of outcomes for targeted 47.16 populations who are served under subdivision 1, paragraphs (a) 47.17 and (b). 47.18 (b) Grant recipients shall cooperate with the commissioner 47.19 in the evaluation and shall provide the commissioner with the 47.20 information needed to conduct the evaluation. Beginning January 47.21 15, 2003, the results of each evaluation must be submitted to 47.22 the chairs of the policy and finance committees in the house and 47.23 senate with jurisdiction over health and human services. 47.24 Sec. 51. Minnesota Statutes 2000, section 145.925, 47.25 subdivision 1, is amended to read: 47.26 Subdivision 1. [ELIGIBLE ORGANIZATIONS; PURPOSE.] The 47.27 commissioner of health may make special grants to cities, 47.28 counties, tribal governments, or groups of citiesor, counties, 47.29or nonprofit corporationsor tribal governments to provide 47.30 prepregnancy family planning services.targeted to low-income 47.31 and minority populations. A city, county, tribal government, or 47.32 group of cities, counties, or tribal governments that receives a 47.33 grant is responsible for ensuring that the grant funds are used 47.34 for services targeted to low-income and minority populations, 47.35 and must establish a goal for reducing specific pregnancy rates 47.36 in the service area. In determining populations to serve and 48.1 services to provide, a city, county, tribal government, or group 48.2 of cities, counties, or tribal governments must consider the 48.3 spacing of pregnancies in low-income and minority populations in 48.4 the service area, teen birth rates in the service area, and the 48.5 needs of populations of color in the service area. A city, 48.6 county, tribal government, or group of cities, counties, or 48.7 tribal governments may contract for the provision of 48.8 prepregnancy family planning services using grant funds provided 48.9 under this section only if the contract is specifically 48.10 authorized by the governing body of the city, county, or tribal 48.11 government that is contracting for the services. 48.12 Any organization or an affiliate of an organization which 48.13 provides abortions, promotes abortions, or directly refers for 48.14 abortions, shall be ineligible to receive funds under this 48.15 subdivision. 48.16 Sec. 52. Minnesota Statutes 2000, section 145.925, 48.17 subdivision 1a, is amended to read: 48.18 Subd. 1a. [FAMILY PLANNING SERVICES; DEFINED.] "Family 48.19 planning services" means counseling by trained personnel 48.20 regarding family planning; distribution of information relating 48.21 to family planning, referral to licensed physicians or local 48.22 health agencies for consultation, examination, medical 48.23 treatment, genetic counseling, and prescriptions for the purpose 48.24 of family planning; and the distribution of family planning 48.25 products, such as charts, thermometers, drugs, medical 48.26 preparations, and contraceptive devices. Family planning 48.27 services do not include services that, directly or indirectly, 48.28 encourage, counsel, refer, or provide abortions or abortion 48.29 referrals. For purposes of sections 145A.01 to 145A.14, family 48.30 planning shall mean voluntary action by individuals to prevent 48.31 or aid conception but does not includethe performance, or make48.32referrals for encouragement of voluntary termination of48.33pregnancyservices that, directly or indirectly, encourage, 48.34 counsel, refer, or provide abortions or abortion referrals. 48.35 Sec. 53. [145.9257] [TEEN PREGNANCY PREVENTION.] 48.36 Subdivision 1. [GOAL.] It is the goal of the state to 49.1 reduce teen pregnancy rates by 24 percent by 2006. To do so, 49.2 the commissioner of health shall establish a grant program to 49.3 reduce the rates of unintended teen pregnancies in the state. 49.4 If this goal of reducing teen pregnancy rates by 24 percent is 49.5 not met by December 31, 2006, this section expires June 30, 49.6 2007. No funds awarded under this section may be used for 49.7 medical services or family planning services or for services 49.8 that, directly or indirectly, encourage, counsel, refer, or 49.9 provide abortions or abortion referrals. 49.10 Any organization or an affiliate of an organization which 49.11 provides abortions, promotes abortions, or directly refers for 49.12 abortions, shall be ineligible to receive funds under this 49.13 section. 49.14 Subd. 2. [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The 49.15 commissioner, in consultation with the commissioner of children, 49.16 families, and learning; the commissioner of human services; the 49.17 maternal and child health advisory task force under section 49.18 145.881; the Indian affairs council under section 3.922; the 49.19 council on affairs of Chicano/Latino people under section 49.20 3.9223; the council on Black Minnesotans under section 3.9225; 49.21 the council on Asian-Pacific Minnesotans under section 3.9226; 49.22 community health boards as defined in section 145A.02; tribal 49.23 governments; nonprofit community organizations; and others 49.24 interested in teen pregnancy prevention, shall develop and 49.25 implement a comprehensive, coordinated plan to reduce the number 49.26 of teen pregnancies. 49.27 Subd. 3. [MEASURABLE OUTCOMES.] The commissioner, in 49.28 consultation with the commissioners and community partners 49.29 listed in subdivision 2, shall establish measurable outcomes to 49.30 achieve the goal specified in subdivision 1 and to determine the 49.31 effectiveness of the grants provided under this section in 49.32 reducing teen pregnancies. The development of measurable 49.33 outcomes must be completed before any funds are distributed 49.34 under this section. 49.35 Subd. 4. [STATEWIDE ASSESSMENT.] The commissioner shall 49.36 use and enhance current statewide assessments of teen pregnancy 50.1 risk behaviors and attitudes among youth to establish a baseline 50.2 to measure the statewide effect of teen pregnancy prevention 50.3 activities. To the extent feasible, the commissioner shall 50.4 conduct the assessment so that the results may be compared to 50.5 national data. 50.6 Subd. 5. [PROCESS.] The commissioner, in consultation with 50.7 the commissioners and community partners listed in subdivision 50.8 2, shall develop the criteria and procedures used to allocate 50.9 grants under this section. In developing the criteria, the 50.10 commissioner shall establish an administrative cost limit for 50.11 grant recipients. At the time a grant is awarded, the 50.12 commissioner shall provide a grant recipient with information on 50.13 the outcomes established according to subdivision 3. 50.14 Subd. 6. [TEEN PREGNANCY PREVENTION DISPARITY GRANTS.] (a) 50.15 The commissioner shall award competitive grants to eligible 50.16 applicants for projects to reduce disparities in unintended teen 50.17 pregnancy rates for American Indians and populations of color, 50.18 as compared with unintended teen pregnancy rates for whites. 50.19 (b) No funds awarded under this subdivision may be used for 50.20 medical services or family planning services or for services 50.21 that, directly or indirectly, encourage, counsel, refer, or 50.22 provide abortions or abortion referrals. 50.23 Any organization or an affiliate of an organization which 50.24 provides abortions, promotes abortions, or directly refers for 50.25 abortions, shall be ineligible to receive funds under this 50.26 subdivision. 50.27 (c) Eligible applicants may include, but are not limited 50.28 to, nonprofit organizations, school districts, faith-based 50.29 organizations, community health boards, and tribal governments. 50.30 Applicants must submit proposals to the commissioner. A 50.31 proposal must specify the strategies to be implemented and must 50.32 take into account the need for a coordinated, statewide teen 50.33 pregnancy prevention effort. Strategies may include youth 50.34 development programs, after-school enrichment programs, youth 50.35 mentoring programs, academic support programs, and abstinence 50.36 until marriage education programs. 51.1 (d) The commissioner shall give priority to applicants who 51.2 demonstrate that their proposed project: 51.3 (1) emphasizes abstinence until marriage; 51.4 (2) is research-based or based on proven, effective 51.5 strategies; 51.6 (3) is designed to coordinate with related youth risk 51.7 behavior reduction activities; 51.8 (4) involves youth and parents in the project's development 51.9 and implementation; 51.10 (5) reflects racially and ethnically appropriate 51.11 approaches; and 51.12 (6) will be implemented through or with persons or 51.13 community-based organizations that reflect the race or ethnicity 51.14 of the population to be reached. 51.15 Subd. 7. [HIGH-RISK COMMUNITY TEEN PREGNANCY PREVENTION 51.16 GRANTS.] (a) The commissioner shall award grants to communities 51.17 that have significant risk factors for teen pregnancies, that 51.18 currently have in place youth development programs, and that are 51.19 interested in expanding existing efforts to prevent teen 51.20 pregnancies. 51.21 (b) No funds awarded under this subdivision may be used for 51.22 medical services or family planning services or for services 51.23 that, directly or indirectly, encourage, counsel, refer, or 51.24 provide abortions or abortion referrals. 51.25 Any organization or an affiliate of an organization which 51.26 provides abortions, promotes abortions, or directly refers for 51.27 abortions, shall be ineligible to receive funds under this 51.28 subdivision. 51.29 (c) To be eligible for a grant under this subdivision, an 51.30 applicant must be a tribal government or a community health 51.31 board as defined in section 145A.02. Applicants must submit 51.32 proposals to the commissioner. A proposal must specify the 51.33 strategies to be implemented. Strategies may include, but are 51.34 not limited to, youth development programs, youth mentoring 51.35 programs, academic support programs, and abstinence until 51.36 marriage education programs. Applicants must demonstrate that a 52.1 proposed project: 52.2 (1) emphasizes abstinence until marriage; 52.3 (2) is research-based or based on proven, effective 52.4 strategies; 52.5 (3) is designed to coordinate with related youth risk 52.6 behavior reduction activities; 52.7 (4) involves youth and parents in the project's development 52.8 and implementation; 52.9 (5) reflects racially and ethnically appropriate 52.10 approaches; and 52.11 (6) will be implemented through or with persons or 52.12 community-based organizations that reflect the race or ethnicity 52.13 of the population to be reached. 52.14 (d) Grants may be awarded to up to 15 community health 52.15 boards and three tribal governments based on areas having the 52.16 highest risk factors for teen pregnancies. The commissioner 52.17 shall award grants based on the following risk factors: 52.18 (1) the proportion of teens in the applicant's service area 52.19 who are sexually active; 52.20 (2) the proportion of births to teens in the applicant's 52.21 service area; and 52.22 (3) the proportion of births to teens who are American 52.23 Indian or of a population of color in the applicant's service 52.24 area. 52.25 Subd. 8. [ADOLESCENT PARENT GRANTS.] The commissioner 52.26 shall transfer funds to the commissioner of children, families, 52.27 and learning to increase the number of adolescent parent grants 52.28 currently provided by the commissioner of children, families, 52.29 and learning under section 124D.33. 52.30 Subd. 9. [COORDINATION.] The commissioner shall coordinate 52.31 the projects and initiatives funded under this section with 52.32 other efforts at the local, state, and national levels to avoid 52.33 duplication and promote complementary efforts. 52.34 Subd. 10. [EVALUATION.] Using the outcomes established 52.35 according to subdivision 3, the commissioner shall conduct a 52.36 biennial evaluation of the impact of each teen pregnancy 53.1 prevention initiative in this section. Grant recipients and the 53.2 commissioner of children, families, and learning shall cooperate 53.3 with the commissioner in the evaluation and shall provide the 53.4 commissioner with the information needed to conduct the 53.5 evaluation. 53.6 Subd. 11. [REPORT.] By January 15, 2002, and January 15 of 53.7 each even-numbered year thereafter, the commissioner shall 53.8 submit a report to the legislature on the projects funded under 53.9 this section and the results of the biennial evaluation. 53.10 Sec. 54. [145.9268] [COMMUNITY CLINIC GRANTS.] 53.11 Subdivision 1. [DEFINITION.] For purposes of this section, 53.12 "eligible community clinic" means: 53.13 (1) a clinic that provides services under conditions as 53.14 defined in Minnesota Rules, part 9505.0255 or 9505.0380, and 53.15 utilizes a sliding fee scale to determine eligibility for 53.16 charity care; 53.17 (2) an Indian tribal government or Indian health service 53.18 unit; or 53.19 (3) a consortium of clinics comprised of entities under 53.20 clause (1) or (2). 53.21 Subd. 2. [GRANTS AUTHORIZED.] The commissioner of health 53.22 shall award grants to eligible community clinics to improve the 53.23 ongoing viability of Minnesota's clinic-based safety net 53.24 providers. Grants shall be awarded to support the capacity of 53.25 eligible community clinics to serve low-income populations, 53.26 reduce current or future uncompensated care burdens, or provide 53.27 for improved care delivery infrastructure. 53.28 Subd. 3. [ALLOCATION OF GRANTS.] (a) To receive a grant 53.29 under this section, an eligible community clinic must submit an 53.30 application to the commissioner of health by the deadline 53.31 established by the commissioner. A grant may be awarded upon 53.32 the signing of a grant contract. 53.33 (b) An application must be on a form and contain 53.34 information as specified by the commissioner but at a minimum 53.35 must contain: 53.36 (1) a description of the project for which grant funds will 54.1 be used; 54.2 (2) a description of the problem the proposed project will 54.3 address; and 54.4 (3) a description of achievable objectives, a workplan, and 54.5 a timeline for project completion. 54.6 (c) The commissioner shall review each application to 54.7 determine whether the application is complete and whether the 54.8 applicant and the project are eligible for a grant. In 54.9 evaluating applications according to paragraph (e), the 54.10 commissioner shall establish criteria including, but not limited 54.11 to: the priority level of the project; the applicant's 54.12 thoroughness and clarity in describing the problem; a 54.13 description of the applicant's proposed project; the manner in 54.14 which the applicant will demonstrate the effectiveness of the 54.15 project; and evidence of efficiencies and effectiveness gained 54.16 through collaborative efforts. The commissioner may also take 54.17 into account other relevant factors, including, but not limited 54.18 to, the percentage for which uninsured patients represent the 54.19 applicant's patient base. During application review, the 54.20 commissioner may request additional information about a proposed 54.21 project, including information on project cost. Failure to 54.22 provide the information requested disqualifies an applicant. 54.23 (d) A grant awarded to an eligible community clinic may not 54.24 exceed $300,000 per eligible community clinic. For an applicant 54.25 applying as a consortium of clinics, a grant may not exceed 54.26 $300,000 per clinic included in the consortium. The 54.27 commissioner has discretion over the number of grants awarded. 54.28 (e) In determining which eligible community clinics will 54.29 receive grants under this section, the commissioner shall give 54.30 preference to those grant applications that show evidence of 54.31 collaboration with other eligible community clinics, hospitals, 54.32 health care providers, or community organizations. In addition, 54.33 the commissioner shall give priority, in declining order, to 54.34 grant applications for projects that: 54.35 (1) establish, update, or improve information, data 54.36 collection, or billing systems; 55.1 (2) procure, modernize, remodel, or replace equipment used 55.2 an the delivery of direct patient care at a clinic; 55.3 (3) provide improvements for care delivery, such as 55.4 increased translation and interpretation services; 55.5 (4) provide a direct offset to expenses incurred for 55.6 charity care services; or 55.7 (5) other projects determined by the commissioner to 55.8 improve the ability of applicants to provide care to the 55.9 vulnerable populations they serve. 55.10 Subd. 4. [EVALUATION.] The commissioner of health shall 55.11 evaluate the overall effectiveness of the grant program. The 55.12 commissioner shall collect progress reports to evaluate the 55.13 grant program from the eligible community clinics receiving 55.14 grants. 55.15 Sec. 55. [145.928] [ELIMINATING HEALTH DISPARITIES.] 55.16 Subdivision 1. [GOAL; ESTABLISHMENT.] It is the goal of 55.17 the state, by 2010, to decrease by 50 percent the disparities in 55.18 infant mortality rates and adult and child immunization rates 55.19 for American Indians and populations of color, as compared with 55.20 rates for whites. To do so and to achieve other measurable 55.21 outcomes, the commissioner of health shall establish a program 55.22 to close the gap in the health status of American Indians and 55.23 populations of color as compared with whites in the following 55.24 priority areas: infant mortality, breast and cervical cancer 55.25 screening, HIV/AIDS and sexually transmitted infections, adult 55.26 and child immunizations, cardiovascular disease, diabetes, and 55.27 accidental injuries and violence. If this goal of reducing 55.28 disparities in infant mortality rates and adult and child 55.29 immunization rates is not met by December 31, 2010, this section 55.30 expires June 30, 2011. 55.31 Subd. 2. [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The 55.32 commissioner, in partnership with culturally-based community 55.33 organizations; the Indian affairs council under section 3.922; 55.34 the council on affairs of Chicano/Latino people under section 55.35 3.9223; the council on Black Minnesotans under section 3.9225; 55.36 the council on Asian-Pacific Minnesotans under section 3.9226; 56.1 community health boards as defined in section 145A.02; and 56.2 tribal governments, shall develop and implement a comprehensive, 56.3 coordinated plan to reduce health disparities in the health 56.4 disparity priority areas identified in subdivision 1. 56.5 Subd. 3. [MEASURABLE OUTCOMES.] The commissioner, in 56.6 consultation with the community partners listed in subdivision 56.7 2, shall establish measurable outcomes to achieve the goal 56.8 specified in subdivision 1 and to determine the effectiveness of 56.9 the grants and other activities funded under this section in 56.10 reducing health disparities in the priority areas identified in 56.11 subdivision 1. The development of measurable outcomes must be 56.12 completed before any funds are distributed under this section. 56.13 Subd. 4. [STATEWIDE ASSESSMENT.] The commissioner shall 56.14 enhance current data tools to ensure a statewide assessment of 56.15 the risk behaviors associated with the health disparity priority 56.16 areas identified in subdivision 1. The statewide assessment 56.17 must be used to establish a baseline to measure the effect of 56.18 activities funded under this section. To the extent feasible, 56.19 the commissioner shall conduct the assessment so that the 56.20 results may be compared to national data. 56.21 Subd. 5. [TECHNICAL ASSISTANCE.] The commissioner shall 56.22 provide the necessary expertise to grant applicants to ensure 56.23 that submitted proposals are likely to be successful in reducing 56.24 the health disparities identified in subdivision 1. The 56.25 commissioner shall provide grant recipients with guidance and 56.26 training on best or most promising strategies to use to reduce 56.27 the health disparities identified in subdivision 1. The 56.28 commissioner shall also assist grant recipients in the 56.29 development of materials and procedures to evaluate local 56.30 community activities. 56.31 Subd. 6. [PROCESS.] (a) The commissioner, in consultation 56.32 with the community partners listed in subdivision 2, shall 56.33 develop the criteria and procedures used to allocate grants 56.34 under this section. In developing the criteria, the 56.35 commissioner shall establish an administrative cost limit for 56.36 grant recipients. At the time a grant is awarded, the 57.1 commissioner must provide a grant recipient with information on 57.2 the outcomes established according to subdivision 3. 57.3 (b) A grant recipient must coordinate its activities to 57.4 reduce health disparities with other entities receiving funds 57.5 under this section that are in the grant recipient's service 57.6 area. 57.7 Subd. 7. [COMMUNITY GRANT PROGRAM; IMMUNIZATION RATES AND 57.8 INFANT MORTALITY RATES.] (a) The commissioner shall award grants 57.9 to eligible applicants for local or regional projects and 57.10 initiatives directed at reducing health disparities in one or 57.11 both of the following priority areas: 57.12 (1) decreasing racial and ethnic disparities in infant 57.13 mortality rates; or 57.14 (2) increasing adult and child immunization rates in 57.15 nonwhite racial and ethnic populations. 57.16 (b) The commissioner may award up to 20 percent of the 57.17 funds available as planning grants. Planning grants must be 57.18 used to address such areas as community assessment, coordination 57.19 activities, and development of community supported strategies. 57.20 (c) Eligible applicants may include, but are not limited 57.21 to, faith-based organizations, social service organizations, 57.22 community nonprofit organizations, community health boards, 57.23 tribal governments, and community clinics. Applicants must 57.24 submit proposals to the commissioner. A proposal must specify 57.25 the strategies to be implemented to address one or both of the 57.26 priority areas listed in paragraph (a) and must be targeted to 57.27 achieve the outcomes established according to subdivision 3. 57.28 (d) The commissioner shall give priority to applicants who 57.29 demonstrate that their proposed project or initiative: 57.30 (1) is supported by the community the applicant will serve; 57.31 (2) is research-based or based on promising strategies; 57.32 (3) is designed to complement other related community 57.33 activities; 57.34 (4) utilizes strategies that positively impact both 57.35 priority areas; 57.36 (5) reflects racially and ethnically appropriate 58.1 approaches; and 58.2 (6) will be implemented through or with community-based 58.3 organizations that reflect the race or ethnicity of the 58.4 population to be reached. 58.5 Subd. 8. [COMMUNITY GRANT PROGRAM; OTHER HEALTH 58.6 DISPARITIES.] (a) The commissioner shall award grants to 58.7 eligible applicants for local or regional projects and 58.8 initiatives directed at reducing health disparities in one or 58.9 more of the following priority areas: 58.10 (1) decreasing racial and ethnic disparities in morbidity 58.11 and mortality rates from breast and cervical cancer; 58.12 (2) decreasing racial and ethnic disparities in morbidity 58.13 and mortality rates from HIV/AIDS and sexually transmitted 58.14 infections; 58.15 (3) decreasing racial and ethnic disparities in morbidity 58.16 and mortality rates from cardiovascular disease; 58.17 (4) decreasing racial and ethnic disparities in morbidity 58.18 and mortality rates from diabetes; or 58.19 (5) decreasing racial and ethnic disparities in morbidity 58.20 and mortality rates from accidental injuries or violence. 58.21 (b) The commissioner may award up to 20 percent of the 58.22 funds available as planning grants. Planning grants must be 58.23 used to address such areas as community assessment, determining 58.24 community priority areas, coordination activities, and 58.25 development of community supported strategies. 58.26 (c) Eligible applicants may include, but are not limited 58.27 to, faith-based organizations, social service organizations, 58.28 community nonprofit organizations, community health boards, 58.29 tribal governments, and community clinics. Applicants shall 58.30 submit proposals to the commissioner. A proposal must specify 58.31 the strategies to be implemented to address one or more of the 58.32 priority areas listed in paragraph (a) and must be targeted to 58.33 achieve the outcomes established according to subdivision 3. 58.34 (d) The commissioner shall give priority to applicants who 58.35 demonstrate that their proposed project or initiative: 58.36 (1) is supported by the community the applicant will serve; 59.1 (2) is research-based or based on promising strategies; 59.2 (3) is designed to complement other related community 59.3 activities; 59.4 (4) utilizes strategies that positively impact more than 59.5 one priority area; 59.6 (5) reflects racially and ethnically appropriate 59.7 approaches; and 59.8 (6) will be implemented through or with community-based 59.9 organizations that reflect the race or ethnicity of the 59.10 population to be reached. 59.11 Subd. 9. [REFUGEE AND IMMIGRANT HEALTH.] (a) The 59.12 commissioner shall distribute funds to community health boards 59.13 for health screening and follow-up services for tuberculosis for 59.14 refugees. Funds shall be distributed based on the following 59.15 formula: 59.16 (1) $1,500 per refugee with pulmonary tuberculosis in the 59.17 community health board's service area; 59.18 (2) $500 per refugee with extrapulmonary tuberculosis in 59.19 the community health board's service area; 59.20 (3) $500 per month of directly observed therapy provided by 59.21 the community health board for each uninsured refugee with 59.22 pulmonary or extrapulmonary tuberculosis; and 59.23 (4) $50 per refugee in the community health board's service 59.24 area. 59.25 (b) Payments must be made at the end of each state fiscal 59.26 year. The amount paid per tuberculosis case, per month of 59.27 directly observed therapy, and per refugee must be 59.28 proportionately increased or decreased to fit the actual amount 59.29 appropriated for that fiscal year. 59.30 Subd. 10. [COORDINATION.] The commissioner shall 59.31 coordinate the projects and initiatives funded under this 59.32 section with other efforts at the local, state, or national 59.33 level to avoid duplication and promote complementary efforts. 59.34 Subd. 11. [EVALUATION.] Using the outcomes established 59.35 according to subdivision 3, the commissioner shall conduct a 59.36 biennial evaluation of the community grant programs under 60.1 subdivisions 7 and 8. Grant recipients shall cooperate with the 60.2 commissioner in the evaluation and shall provide the 60.3 commissioner with the information needed to conduct the 60.4 evaluation. 60.5 Subd. 12. [REPORT.] By January 15, 2002, and January 15 of 60.6 each even-numbered year thereafter, the commissioner shall 60.7 submit a report to the legislature on the local community 60.8 projects and community health board activities funded under this 60.9 section. The report must include information on grant 60.10 recipients, activities conducted using grant funds, and 60.11 evaluation data and outcome measures if available. 60.12 Sec. 56. Minnesota Statutes 2000, section 145A.15, 60.13 subdivision 1, is amended to read: 60.14 Subdivision 1. [ESTABLISHMENT.] (a) The commissioner of 60.15 health shall expand the current grant program to fund additional 60.16 projects designed to prevent child abuse and neglect and reduce 60.17 juvenile delinquency by promoting positive parenting, resiliency 60.18 in children, and a healthy beginning for children by providing 60.19 early intervention services for families in need. Grant dollars 60.20 shall be available to train paraprofessionals to provide in-home 60.21 intervention services and to allow public health nurses to do 60.22 case management of services. The grant program shall provide 60.23 early intervention services for families in need and will 60.24 include: 60.25 (1) expansion of current public health nurse and family 60.26 aide home visiting programs and public health home visiting 60.27 projects which prevent child abuse and neglect, prevent juvenile 60.28 delinquency, and build resiliency in children; 60.29 (2) early intervention to promote a healthy and nurturing 60.30 beginning; 60.31 (3) distribution of educational and public information 60.32 programs and materials in hospital maternity divisions, 60.33 well-baby clinics, obstetrical clinics, and community clinics; 60.34 and 60.35 (4) training of home visitors in skills necessary for 60.36 comprehensive home visiting which promotes a healthy and 61.1 nurturing beginning for the child. 61.2 (b) No new grants shall be awarded under this section after 61.3 June 30, 2001. Grant contracts awarded and in effect under this 61.4 section as of July 1, 2001, shall continue until their 61.5 expiration date. 61.6 Sec. 57. Minnesota Statutes 2000, section 145A.15, is 61.7 amended by adding a subdivision to read: 61.8 Subd. 5. [EXPIRATION.] This section expires June 30, 2003. 61.9 Sec. 58. Minnesota Statutes 2000, section 145A.16, 61.10 subdivision 1, is amended to read: 61.11 Subdivision 1. [ESTABLISHMENT.] The commissioner shall 61.12 establish a grant program to fund universally offered home 61.13 visiting programs designed to serve all live births in 61.14 designated geographic areas. The commissioner shall designate 61.15 the geographic area to be served by each program. At least one 61.16 program must provide home visiting services to families within 61.17 the seven-county metropolitan area, and at least one program 61.18 must provide home visiting services to families outside the 61.19 metropolitan area. The purpose of the program is to strengthen 61.20 families and to promote positive parenting and healthy child 61.21 development. No new grants shall be awarded under this section 61.22 after June 30, 2001. Competitive grant contracts awarded and in 61.23 effect under this section as of July 1, 2001, shall expire 61.24 December 31, 2003. 61.25 Sec. 59. Minnesota Statutes 2000, section 145A.16, is 61.26 amended by adding a subdivision to read: 61.27 Subd. 10. [EXPIRATION.] This section expires December 31, 61.28 2003. 61.29 Sec. 60. [145A.17] [FAMILY HOME VISITING PROGRAMS.] 61.30 Subdivision 1. [ESTABLISHMENT; GOALS.] The commissioner 61.31 shall establish a program to fund family home visiting programs 61.32 designed to foster a healthy beginning for children in families 61.33 at or below 200 percent of the federal poverty guidelines, 61.34 prevent child abuse and neglect, reduce juvenile delinquency, 61.35 promote positive parenting and resiliency in children, and 61.36 promote family health and economic self-sufficiency. A program 62.1 funded under this section must serve families at or below 200 62.2 percent of the federal poverty guidelines, and other families 62.3 determined to be at risk for child abuse, neglect, or juvenile 62.4 delinquency. Programs must give priority for services to 62.5 families considered to be in need of services, including but not 62.6 limited to families with: 62.7 (1) adolescent parents; 62.8 (2) a history of alcohol or other drug abuse; 62.9 (3) a history of child abuse, domestic abuse, or other 62.10 types of violence; 62.11 (4) a history of domestic abuse, rape, or other forms of 62.12 victimization; 62.13 (5) reduced cognitive functioning; 62.14 (6) a lack of knowledge of child growth and development 62.15 stages; 62.16 (7) low resiliency to adversities and environmental 62.17 stresses; or 62.18 (8) insufficient financial resources to meet family needs. 62.19 Subd. 2. [ALLOCATION OF FUNDS.] The commissioner shall 62.20 distribute funds available under this section to community 62.21 health boards, as defined in section 145A.02, and to tribal 62.22 governments. Funds shall be distributed to community health 62.23 boards as follows: (1) each community health board shall 62.24 receive an allocation of $25,000 per year; and (2) remaining 62.25 funds available to community health boards shall be distributed 62.26 according to the formula in section 256J.625, subdivision 3. 62.27 The commissioner, in consultation with tribal governments, shall 62.28 establish a formula for distributing funds to tribal governments. 62.29 Subd. 3. [REQUIREMENTS FOR PROGRAMS; PROCESS.] (a) Before 62.30 a community health board or tribal government may receive an 62.31 allocation under subdivision 2, a community health board or 62.32 tribal government must submit a proposal to the commissioner 62.33 that includes identification, based on a community assessment, 62.34 of the populations at or below 200 percent of the federal 62.35 poverty guidelines that will be served and the other populations 62.36 that will be served. Each program that receives funds must: 63.1 (1) use either a broad community-based or selective 63.2 community-based strategy to provide preventive and early 63.3 intervention home visiting services; 63.4 (2) offer a home visit by a trained home visitor. If a 63.5 home visit is accepted, the first home visit must occur 63.6 prenatally or as soon after birth as possible and must include a 63.7 public health nursing assessment by a public health nurse; 63.8 (3) offer, at a minimum, information on infant care, child 63.9 growth and development, positive parenting, preventing diseases, 63.10 preventing exposure to environmental hazards, and support 63.11 services available in the community; 63.12 (4) provide information on and referrals to health care 63.13 services, if needed, including information on health care 63.14 coverage for which the child or family may be eligible; and 63.15 provide information on preventive services, developmental 63.16 assessments, and the availability of public assistance programs 63.17 as appropriate; 63.18 (5) recruit home visitors who will represent, to the extent 63.19 possible, the races, cultures, and languages spoken by families 63.20 that may be served; 63.21 (6) train and supervise home visitors in accordance with 63.22 the requirements established under subdivision 4; 63.23 (7) maximize resources and minimize duplication by 63.24 coordinating activities with local social and human services 63.25 organizations, education organizations, and other appropriate 63.26 governmental entities and community-based organizations and 63.27 agencies; and 63.28 (8) utilize appropriate racial and ethnic approaches to 63.29 providing home visiting services. 63.30 (b) Funds available under this section shall not be used 63.31 for medical services. The commissioner shall establish an 63.32 administrative cost limit for recipients of funds. The outcome 63.33 measures established under subdivision 6 must be specified to 63.34 recipients of funds at the time the funds are distributed. 63.35 (c) Data collected on individuals served by the home 63.36 visiting programs must remain confidential and must not be 64.1 disclosed by providers of home visiting services without a 64.2 specific informed written consent that identifies disclosures to 64.3 be made. Upon request, agencies providing home visiting 64.4 services must provide recipients with information on 64.5 disclosures, including the names of entities and individuals 64.6 receiving the information and the general purpose of the 64.7 disclosure. Prospective and current recipients of home visiting 64.8 services must be told and informed in writing that written 64.9 consent for disclosure of data is not required for access to 64.10 home visiting services. 64.11 Subd. 4. [TRAINING.] The commissioner shall establish 64.12 training requirements for home visitors and minimum requirements 64.13 for supervision by a public health nurse. The requirements for 64.14 nurses must be consistent with chapter 148. Training must 64.15 include child development, positive parenting techniques, and 64.16 diverse cultural practices in child rearing and family systems. 64.17 Subd. 5. [TECHNICAL ASSISTANCE.] The commissioner shall 64.18 provide administrative and technical assistance to each program, 64.19 including assistance in data collection and other activities 64.20 related to conducting short- and long-term evaluations of the 64.21 programs as required under subdivision 7. The commissioner may 64.22 request research and evaluation support from the University of 64.23 Minnesota. 64.24 Subd. 6. [OUTCOME MEASURES.] The commissioner shall 64.25 establish outcomes to determine the impact of family home 64.26 visiting programs funded under this section on the following 64.27 areas: 64.28 (1) appropriate utilization of preventive health care; 64.29 (2) rates of substantiated child abuse and neglect; 64.30 (3) rates of unintentional child injuries; and 64.31 (4) any additional qualitative goals and quantitative 64.32 measures established by the commissioner. 64.33 Subd. 7. [EVALUATION.] Using the qualitative goals and 64.34 quantitative outcome measures established under subdivisions 1 64.35 and 6, the commissioner shall conduct ongoing evaluations of the 64.36 programs funded under this section. Community health boards and 65.1 tribal governments shall cooperate with the commissioner in the 65.2 evaluations and shall provide the commissioner with the 65.3 information necessary to conduct the evaluations. As part of 65.4 the ongoing evaluations, the commissioner shall rate the impact 65.5 of the programs on the outcome measures listed in subdivision 6, 65.6 and shall periodically determine whether home visiting programs 65.7 are the best way to achieve the qualitative goals established in 65.8 subdivision 1 and by the commissioner. If the commissioner 65.9 determines that home visiting programs are not the best way to 65.10 achieve these goals, the commissioner shall provide the 65.11 legislature with alternative methods for achieving them. 65.12 Subd. 8. [REPORT.] By January 15, 2002, and January 15 of 65.13 each even-numbered year thereafter, the commissioner shall 65.14 submit a report to the legislature on the family home visiting 65.15 programs funded under this section and on the results of the 65.16 evaluations conducted under subdivision 7. 65.17 Subd. 9. [NO SUPPLANTING OF EXISTING FUNDS.] Funding 65.18 available under this section may be used only to supplement, not 65.19 to replace, nonstate funds being used for home visiting services 65.20 as of July 1, 2001. 65.21 Sec. 61. Minnesota Statutes 2000, section 157.16, 65.22 subdivision 3, is amended to read: 65.23 Subd. 3. [ESTABLISHMENT FEES; DEFINITIONS.] (a) The 65.24 following fees are required for food and beverage service 65.25 establishments, hotels, motels, lodging establishments, and 65.26 resorts licensed under this chapter. Food and beverage service 65.27 establishments must pay the highest applicable fee under 65.28 paragraph (e), clause (1), (2), (3), or (4), and establishments 65.29 serving alcohol must pay the highest applicable fee under 65.30 paragraph (e), clause (6) or (7). The license fee for new 65.31 operators previously licensed under this chapter for the same 65.32 calendar year is one-half of the appropriate annual license fee, 65.33 plus any penalty that may be required. The license fee for 65.34 operators opening on or after October 1 is one-half of the 65.35 appropriate annual license fee, plus any penalty that may be 65.36 required. The fees in paragraphs (b), (c), and (d) effective 66.1 until June 30, 2001, shall be phased up as specified in section 66.2 64 to the fee amounts effective beginning July 1, 2004. 66.3 Notwithstanding section 16A.1285, in fiscal years 2002, 2003, 66.4 and 2004, the commissioner shall regulate food and beverage 66.5 service establishments, hotels, motels, lodging establishments, 66.6 and resorts with the fees collected for that purpose. 66.7 (b) All food and beverage service establishments, except 66.8 special event food stands, and all hotels, motels, lodging 66.9 establishments, and resorts shall pay an annual base fee of $100 66.10 until June 30, 2001. Effective July 1, 2004, the annual base 66.11 fee shall be $145. 66.12 (c) A special event food stand shall pay a flat fee of $30 66.13 annually until June 30, 2001. Effective July 1, 2004, the 66.14 annual flat fee shall be $35. "Special event food stand" means 66.15 a fee category where food is prepared or served in conjunction 66.16 with celebrations, county fairs, or special events from a 66.17 special event food stand as defined in section 157.15. 66.18 (d) In addition to the base fee in paragraph (b), each food 66.19 and beverage service establishment, other than a special event 66.20 food stand, and each hotel, motel, lodging establishment, and 66.21 resort shall pay an additional annual fee for each fee category 66.22 as specified in this paragraph: 66.23 (1) Limited food menu selection, $30 until June 30, 2001. 66.24 Effective July 1, 2004, the annual fee shall be $40. "Limited 66.25 food menu selection" means a fee category that provides one or 66.26 more of the following: 66.27 (i) prepackaged food that receives heat treatment and is 66.28 served in the package; 66.29 (ii) frozen pizza that is heated and served; 66.30 (iii) a continental breakfast such as rolls, coffee, juice, 66.31 milk, and cold cereal; 66.32 (iv) soft drinks, coffee, or nonalcoholic beverages; or 66.33 (v) cleaning for eating, drinking, or cooking utensils, 66.34 when the only food served is prepared off site. 66.35 (2) Small establishment, including boarding establishments, 66.36 $55 until June 30, 2001. Effective July 1, 2004, the annual fee 67.1 shall be $75. "Small establishment" means a fee category that 67.2 has no salad bar and meets one or more of the following: 67.3 (i) possesses food service equipment that consists of no 67.4 more than a deep fat fryer, a grill, two hot holding containers, 67.5 and one or more microwave ovens; 67.6 (ii) serves dipped ice cream or soft serve frozen desserts; 67.7 (iii) serves breakfast in an owner-occupied bed and 67.8 breakfast establishment; 67.9 (iv) is a boarding establishment; or 67.10 (v) meets the equipment criteria in clause (3), item (i) or 67.11 (ii), and has a maximum patron seating capacity of not more than 67.12 50. 67.13 (3) Medium establishment, $150 until June 30, 2001. 67.14 Effective July 1, 2004, the annual fee shall be $210. "Medium 67.15 establishment" means a fee category that meets one or more of 67.16 the following: 67.17 (i) possesses food service equipment that includes a range, 67.18 oven, steam table, salad bar, or salad preparation area; 67.19 (ii) possesses food service equipment that includes more 67.20 than one deep fat fryer, one grill, or two hot holding 67.21 containers; or 67.22 (iii) is an establishment where food is prepared at one 67.23 location and served at one or more separate locations. 67.24 Establishments meeting criteria in clause (2), item (v), 67.25 are not included in this fee category. 67.26 (4) Large establishment, $250 until June 30, 2001. 67.27 Effective July 1, 2004, the annual fee shall be $350. "Large 67.28 establishment" means either: 67.29 (i) a fee category that (A) meets the criteria in clause 67.30 (3), items (i) or (ii), for a medium establishment, (B) seats 67.31 more than 175 people, and (C) offers the full menu selection an 67.32 average of five or more days a week during the weeks of 67.33 operation; or 67.34 (ii) a fee category that (A) meets the criteria in clause 67.35 (3), item (iii), for a medium establishment, and (B) prepares 67.36 and serves 500 or more meals per day. 68.1 (5) Other food and beverage service, including food carts, 68.2 mobile food units, seasonal temporary food stands, and seasonal 68.3 permanent food stands, $30 until June 30, 2001. Effective July 68.4 1, 2004, the annual fee shall be $40. 68.5 (6) Beer or wine table service, $30 until June 30, 2001. 68.6 Effective July 1, 2004, the annual fee shall be $40. "Beer or 68.7 wine table service" means a fee category where the only 68.8 alcoholic beverage service is beer or wine, served to customers 68.9 seated at tables. 68.10 (7) Alcoholic beverage service, other than beer or wine 68.11 table service, $75 until June 30, 2001. Effective July 1, 2004, 68.12 the annual fee shall be $105. 68.13 "Alcohol beverage service, other than beer or wine table 68.14 service" means a fee category where alcoholic mixed drinks are 68.15 served or where beer or wine are served from a bar. 68.16 (8) Until June 30, 2001, lodging per sleeping accommodation 68.17 unit, $4, including hotels, motels, lodging establishments, and 68.18 resorts, up to a maximum of $400. Effective July 1, 2004, 68.19 lodging per sleeping accommodation unit, $6, including hotels, 68.20 motels, lodging establishments, and resorts, up to a maximum of 68.21 $600. "Lodging per sleeping accommodation unit" means a fee 68.22 category including the number of guest rooms, cottages, or other 68.23 rental units of a hotel, motel, lodging establishment, or 68.24 resort; or the number of beds in a dormitory. 68.25 (9) First public swimming pool, $100 until June 30, 2001; 68.26 each additional public swimming pool, $50 until June 30, 2001. 68.27 Effective July 1, 2004, first public swimming pool, $140; each 68.28 additional public swimming pool, $80. "Public swimming pool" 68.29 means a fee category that has the meaning given in Minnesota 68.30 Rules, part 4717.0250, subpart 8. 68.31 (10) First spa, $50 until June 30, 2001; each additional 68.32 spa, $25 until June 30, 2001. Effective July 1, 2004, first 68.33 spa, $80; each additional spa, $40. "Spa pool" means a fee 68.34 category that has the meaning given in Minnesota Rules, part 68.35 4717.0250, subpart 9. 68.36 (11) Private sewer or water, $30 until June 30, 2001. 69.1 Effective July 1, 2004, private sewer or water, $40. 69.2 "Individual private water" means a fee category with a water 69.3 supply other than a community public water supply as defined in 69.4 Minnesota Rules, chapter 4720. "Individual private sewer" means 69.5 a fee category with an individual sewage treatment system which 69.6 uses subsurface treatment and disposal. 69.7 (e)A fee is not required for a food and beverage service69.8establishment operated by a school as defined in sections69.9120A.05, subdivisions 9, 11, 13, and 17 and 120A.22.69.10(f)A fee of $150 for review of the construction plans must 69.11 accompany the initial license application for food and beverage 69.12 service establishments, hotels, motels, lodging establishments, 69.13 or resorts. 69.14(g)(f) When existing food and beverage service 69.15 establishments, hotels, motels, lodging establishments, or 69.16 resorts are extensively remodeled, a fee of $150 must be 69.17 submitted with the remodeling plans. 69.18(h)(g) Seasonal temporary food stands and special event 69.19 food stands are not required to submit construction or 69.20 remodeling plans for review. 69.21 Sec. 62. Minnesota Statutes 2000, section 157.22, is 69.22 amended to read: 69.23 157.22 [EXEMPTIONS.] 69.24 This chapter shall not be construed to apply to: 69.25 (1) interstate carriers under the supervision of the United 69.26 States Department of Health and Human Services; 69.27 (2) any building constructed and primarily used for 69.28 religious worship; 69.29 (3) any building owned, operated, and used by a college or 69.30 university in accordance with health regulations promulgated by 69.31 the college or university under chapter 14; 69.32 (4) any person, firm, or corporation whose principal mode 69.33 of business is licensed under sections 28A.04 and 28A.05, is 69.34 exempt at that premises from licensure as a food or beverage 69.35 establishment; provided that the holding of any license pursuant 69.36 to sections 28A.04 and 28A.05 shall not exempt any person, firm, 70.1 or corporation from the applicable provisions of this chapter or 70.2 the rules of the state commissioner of health relating to food 70.3 and beverage service establishments; 70.4 (5) family day care homes and group family day care homes 70.5 governed by sections 245A.01 to 245A.16; 70.6 (6) nonprofit senior citizen centers for the sale of 70.7 home-baked goods;and70.8 (7) food not prepared at an establishment and brought in by 70.9 individuals attending a potluck event for consumption at the 70.10 potluck event. An organization sponsoring a potluck event under 70.11 this clause may advertise the potluck event to the public 70.12 through any means. Individuals who are not members of an 70.13 organization sponsoring a potluck event under this clause may 70.14 attend the potluck event and consume the food at the event. 70.15 Licensed food establishments cannot be sponsors of potluck 70.16 events. Potluck event food shall not be brought into a licensed 70.17 food establishment kitchen; and 70.18 (8) a home school in which a child is provided instruction 70.19 at home. 70.20 Sec. 63. [325F.691] [DISCLOSURE OF SPECIAL CARE STATUS 70.21 REQUIRED.] 70.22 Subdivision 1. [PERSONS TO WHOM DISCLOSURE IS 70.23 REQUIRED.] Housing with services establishments, as defined in 70.24 sections 144D.01 to 144D.07, that secure, segregate, or provide 70.25 a special program or special unit for residents with a diagnosis 70.26 of probable Alzheimer's disease or a related disorder or that 70.27 advertise, market, or otherwise promote the establishment as 70.28 providing specialized care for Alzheimer's disease or a related 70.29 disorder are considered a "special care unit." All special care 70.30 units shall provide a written disclosure to the following: 70.31 (1) the commissioner of health, if requested; 70.32 (2) the office of ombudsman for older Minnesotans; and 70.33 (3) each person seeking placement within a residence, or 70.34 the person's authorized representative, before an agreement to 70.35 provide the care is entered into. 70.36 Subd. 2. [CONTENT.] Written disclosure shall include, but 71.1 is not limited to, the following: 71.2 (1) a statement of the overall philosophy and how it 71.3 reflects the special needs of residents with Alzheimer's disease 71.4 or other dementias; 71.5 (2) the criteria for determining who may reside in the 71.6 special care unit; 71.7 (3) the process used for assessment and establishment of 71.8 the service plan or agreement, including how the plan is 71.9 responsive to changes in the resident's condition; 71.10 (4) staffing credentials, job descriptions, and staff 71.11 duties and availability, including any training specific to 71.12 dementia; 71.13 (5) physical environment as well as design and security 71.14 features that specifically address the needs of residents with 71.15 Alzheimer's disease or other dementias; 71.16 (6) frequency and type of programs and activities for 71.17 residents of the special care unit; 71.18 (7) involvement of families in resident care and 71.19 availability of family support programs; 71.20 (8) fee schedules for additional services to the residents 71.21 of the special care unit; and 71.22 (9) a statement that residents will be given a written 71.23 notice 30 days prior to changes in the fee schedule. 71.24 Subd. 3. [DUTY TO UPDATE.] Substantial changes to 71.25 disclosures must be reported to the parties listed in 71.26 subdivision 1 at the time the change is made. 71.27 Subd. 4. [REMEDY.] The attorney general may seek the 71.28 remedies set forth in section 8.31 for repeated and intentional 71.29 violations of this section. However, no private right of action 71.30 may be maintained as provided under section 8.31, subdivision 3a. 71.31 Sec. 64. [ESTABLISHMENT FEES DURING TRANSITION PERIOD.] 71.32 For fiscal years 2002, 2003, and 2004, the following fees 71.33 shall apply to food and beverage service establishments, hotels, 71.34 motels, lodging establishments, and resorts for which fees are 71.35 established under Minnesota Statutes, section 157.16, 71.36 subdivision 3, paragraphs (b), (c), and (d): 72.1 Fiscal Year Fiscal Year Fiscal Year 72.2 Fee Category 2002 2003 2004 72.3 Annual base fee, all $111.25 $122.50 $133.75 72.4 food and beverage 72.5 service establishments 72.6 except special event 72.7 food stands and all 72.8 hotels, motels, lodging 72.9 establishments, and 72.10 resorts 72.11 Special event food $ 31.25 $ 32.50 $ 33.75 72.12 stand 72.13 Establishment with $ 32.50 $ 35.00 $ 37.50 72.14 limited food menu 72.15 selection 72.16 Small establishment $ 60.00 $ 65.00 $ 70.00 72.17 Medium establishment $165.00 $180.00 $195.00 72.18 Large establishment $275.00 $300.00 $325.00 72.19 Other food and $ 32.50 $ 35.00 $ 37.50 72.20 beverage service 72.21 Beer or wine table $ 32.50 $ 35.00 $ 37.50 72.22 service 72.23 Alcoholic beverage $ 82.50 $ 90.00 $ 97.50 72.24 service other than 72.25 beer or wine table 72.26 service 72.27 Lodging per sleeping $4.50 per $5.00 per $5.50 per 72.28 accommodation unit, unit, $450 unit, $500 unit, $550 72.29 up to a specified maximum maximum maximum 72.30 maximum 72.31 First public $110.00 $120.00 $130.00 72.32 swimming pool 72.33 Each additional $ 57.50 $ 65.00 $ 72.50 72.34 public swimming pool 72.35 First spa $ 57.50 $ 65.00 $ 72.50 72.36 Each additional spa $ 28.75 $ 32.50 $ 36.25 73.1 Private sewer or $ 32.50 $ 35.00 $ 37.50 73.2 water 73.3 Sec. 65. [RECOMMENDATIONS; INCENTIVES FOR MAGNET 73.4 HOSPITALS.] 73.5 The commissioner of health shall develop recommendations 73.6 for incentives that may be implemented to increase the number of 73.7 magnet hospitals in Minnesota. These recommendations must be 73.8 reported by December 1, 2001 to the chairs of the house and 73.9 senate committees with jurisdiction over health and human 73.10 services policy and finance issues. 73.11 Sec. 66. [STUDY; REIMBURSEMENT FOR CERTAIN ANTI-TOBACCO 73.12 USE EDUCATION ACTIVITIES.] 73.13 The commissioner of health, in consultation with persons 73.14 who have had laryngectomies to treat larynx cancer, who use 73.15 artificial larynxes for communication, and who engage in 73.16 anti-tobacco use education activities, shall study and develop 73.17 recommendations establishing a program to reimburse these 73.18 persons for mileage and other costs associated with traveling to 73.19 schools in the state to educate students about the health risks 73.20 of tobacco use. The recommendations must include proposals for 73.21 reimbursement levels, a funding source, expenses for which 73.22 persons may be reimbursed, and persons eligible for 73.23 reimbursement. The recommendations must be reported to the 73.24 chairs of the policy and finance committees in the House and 73.25 Senate with jurisdiction over health and human services issues 73.26 by January 15, 2002. 73.27 Sec. 67. [STUDY; EFFECTS OF NURSE STAFFING SHORTAGES.] 73.28 The commissioner of health, in consultation with consumers, 73.29 representatives of the Minnesota nurses association, and 73.30 representatives of the Minnesota hospital and healthcare 73.31 partnership, shall study and identify the effects of nurse 73.32 staffing shortages in health care facilities on patient care and 73.33 patient safety. The results of this study shall be reported by 73.34 December 1, 2001 to the chairs of the house and senate 73.35 committees with jurisdiction over health and human services 73.36 policy issues. 74.1 Sec. 68. [REPEALER.] 74.2 (a) Minnesota Statutes 2000, sections 145.882, subdivisions 74.3 3 and 4; and 145.927, are repealed. 74.4 (b) Minnesota Statutes 2000, section 144.148, subdivision 74.5 8, is repealed. 74.6[EFFECTIVE DATE.] Paragraph (b) of this section is 74.7 effective the day following final enactment. 74.8 ARTICLE 2 74.9 HEALTH CARE 74.10 Section 1. Minnesota Statutes 2000, section 256.01, 74.11 subdivision 2, is amended to read: 74.12 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 74.13 section 241.021, subdivision 2, the commissioner of human 74.14 services shall: 74.15 (1) Administer and supervise all forms of public assistance 74.16 provided for by state law and other welfare activities or 74.17 services as are vested in the commissioner. Administration and 74.18 supervision of human services activities or services includes, 74.19 but is not limited to, assuring timely and accurate distribution 74.20 of benefits, completeness of service, and quality program 74.21 management. In addition to administering and supervising human 74.22 services activities vested by law in the department, the 74.23 commissioner shall have the authority to: 74.24 (a) require county agency participation in training and 74.25 technical assistance programs to promote compliance with 74.26 statutes, rules, federal laws, regulations, and policies 74.27 governing human services; 74.28 (b) monitor, on an ongoing basis, the performance of county 74.29 agencies in the operation and administration of human services, 74.30 enforce compliance with statutes, rules, federal laws, 74.31 regulations, and policies governing welfare services and promote 74.32 excellence of administration and program operation; 74.33 (c) develop a quality control program or other monitoring 74.34 program to review county performance and accuracy of benefit 74.35 determinations; 74.36 (d) require county agencies to make an adjustment to the 75.1 public assistance benefits issued to any individual consistent 75.2 with federal law and regulation and state law and rule and to 75.3 issue or recover benefits as appropriate; 75.4 (e) delay or deny payment of all or part of the state and 75.5 federal share of benefits and administrative reimbursement 75.6 according to the procedures set forth in section 256.017; 75.7 (f) make contracts with and grants to public and private 75.8 agencies and organizations, both profit and nonprofit, and 75.9 individuals, using appropriated funds; and 75.10 (g) enter into contractual agreements with federally 75.11 recognized Indian tribes with a reservation in Minnesota to the 75.12 extent necessary for the tribe to operate a federally approved 75.13 family assistance program or any other program under the 75.14 supervision of the commissioner. The commissioner shall consult 75.15 with the affected county or counties in the contractual 75.16 agreement negotiations, if the county or counties wish to be 75.17 included, in order to avoid the duplication of county and tribal 75.18 assistance program services. The commissioner may establish 75.19 necessary accounts for the purposes of receiving and disbursing 75.20 funds as necessary for the operation of the programs. 75.21 (2) Inform county agencies, on a timely basis, of changes 75.22 in statute, rule, federal law, regulation, and policy necessary 75.23 to county agency administration of the programs. 75.24 (3) Administer and supervise all child welfare activities; 75.25 promote the enforcement of laws protecting handicapped, 75.26 dependent, neglected and delinquent children, and children born 75.27 to mothers who were not married to the children's fathers at the 75.28 times of the conception nor at the births of the children; 75.29 license and supervise child-caring and child-placing agencies 75.30 and institutions; supervise the care of children in boarding and 75.31 foster homes or in private institutions; and generally perform 75.32 all functions relating to the field of child welfare now vested 75.33 in the state board of control. 75.34 (4) Administer and supervise all noninstitutional service 75.35 to handicapped persons, including those who are visually 75.36 impaired, hearing impaired, or physically impaired or otherwise 76.1 handicapped. The commissioner may provide and contract for the 76.2 care and treatment of qualified indigent children in facilities 76.3 other than those located and available at state hospitals when 76.4 it is not feasible to provide the service in state hospitals. 76.5 (5) Assist and actively cooperate with other departments, 76.6 agencies and institutions, local, state, and federal, by 76.7 performing services in conformity with the purposes of Laws 76.8 1939, chapter 431. 76.9 (6) Act as the agent of and cooperate with the federal 76.10 government in matters of mutual concern relative to and in 76.11 conformity with the provisions of Laws 1939, chapter 431, 76.12 including the administration of any federal funds granted to the 76.13 state to aid in the performance of any functions of the 76.14 commissioner as specified in Laws 1939, chapter 431, and 76.15 including the promulgation of rules making uniformly available 76.16 medical care benefits to all recipients of public assistance, at 76.17 such times as the federal government increases its participation 76.18 in assistance expenditures for medical care to recipients of 76.19 public assistance, the cost thereof to be borne in the same 76.20 proportion as are grants of aid to said recipients. 76.21 (7) Establish and maintain any administrative units 76.22 reasonably necessary for the performance of administrative 76.23 functions common to all divisions of the department. 76.24 (8) Act as designated guardian of both the estate and the 76.25 person of all the wards of the state of Minnesota, whether by 76.26 operation of law or by an order of court, without any further 76.27 act or proceeding whatever, except as to persons committed as 76.28 mentally retarded. For children under the guardianship of the 76.29 commissioner whose interests would be best served by adoptive 76.30 placement, the commissioner may contract with a licensed 76.31 child-placing agency to provide adoption services. A contract 76.32 with a licensed child-placing agency must be designed to 76.33 supplement existing county efforts and may not replace existing 76.34 county programs, unless the replacement is agreed to by the 76.35 county board and the appropriate exclusive bargaining 76.36 representative or the commissioner has evidence that child 77.1 placements of the county continue to be substantially below that 77.2 of other counties. Funds encumbered and obligated under an 77.3 agreement for a specific child shall remain available until the 77.4 terms of the agreement are fulfilled or the agreement is 77.5 terminated. 77.6 (9) Act as coordinating referral and informational center 77.7 on requests for service for newly arrived immigrants coming to 77.8 Minnesota. 77.9 (10) The specific enumeration of powers and duties as 77.10 hereinabove set forth shall in no way be construed to be a 77.11 limitation upon the general transfer of powers herein contained. 77.12 (11) Establish county, regional, or statewide schedules of 77.13 maximum fees and charges which may be paid by county agencies 77.14 for medical, dental, surgical, hospital, nursing and nursing 77.15 home care and medicine and medical supplies under all programs 77.16 of medical care provided by the state and for congregate living 77.17 care under the income maintenance programs. 77.18 (12) Have the authority to conduct and administer 77.19 experimental projects to test methods and procedures of 77.20 administering assistance and services to recipients or potential 77.21 recipients of public welfare. To carry out such experimental 77.22 projects, it is further provided that the commissioner of human 77.23 services is authorized to waive the enforcement of existing 77.24 specific statutory program requirements, rules, and standards in 77.25 one or more counties. The order establishing the waiver shall 77.26 provide alternative methods and procedures of administration, 77.27 shall not be in conflict with the basic purposes, coverage, or 77.28 benefits provided by law, and in no event shall the duration of 77.29 a project exceed four years. It is further provided that no 77.30 order establishing an experimental project as authorized by the 77.31 provisions of this section shall become effective until the 77.32 following conditions have been met: 77.33 (a) The secretary of health and human services of the 77.34 United States has agreed, for the same project, to waive state 77.35 plan requirements relative to statewide uniformity. 77.36 (b) A comprehensive plan, including estimated project 78.1 costs, shall be approved by the legislative advisory commission 78.2 and filed with the commissioner of administration. 78.3 (13) According to federal requirements, establish 78.4 procedures to be followed by local welfare boards in creating 78.5 citizen advisory committees, including procedures for selection 78.6 of committee members. 78.7 (14) Allocate federal fiscal disallowances or sanctions 78.8 which are based on quality control error rates for the aid to 78.9 families with dependent children program formerly codified in 78.10 sections 256.72 to 256.87, medical assistance, or food stamp 78.11 program in the following manner: 78.12 (a) One-half of the total amount of the disallowance shall 78.13 be borne by the county boards responsible for administering the 78.14 programs. For the medical assistance and the AFDC program 78.15 formerly codified in sections 256.72 to 256.87, disallowances 78.16 shall be shared by each county board in the same proportion as 78.17 that county's expenditures for the sanctioned program are to the 78.18 total of all counties' expenditures for the AFDC program 78.19 formerly codified in sections 256.72 to 256.87, and medical 78.20 assistance programs. For the food stamp program, sanctions 78.21 shall be shared by each county board, with 50 percent of the 78.22 sanction being distributed to each county in the same proportion 78.23 as that county's administrative costs for food stamps are to the 78.24 total of all food stamp administrative costs for all counties, 78.25 and 50 percent of the sanctions being distributed to each county 78.26 in the same proportion as that county's value of food stamp 78.27 benefits issued are to the total of all benefits issued for all 78.28 counties. Each county shall pay its share of the disallowance 78.29 to the state of Minnesota. When a county fails to pay the 78.30 amount due hereunder, the commissioner may deduct the amount 78.31 from reimbursement otherwise due the county, or the attorney 78.32 general, upon the request of the commissioner, may institute 78.33 civil action to recover the amount due. 78.34 (b) Notwithstanding the provisions of paragraph (a), if the 78.35 disallowance results from knowing noncompliance by one or more 78.36 counties with a specific program instruction, and that knowing 79.1 noncompliance is a matter of official county board record, the 79.2 commissioner may require payment or recover from the county or 79.3 counties, in the manner prescribed in paragraph (a), an amount 79.4 equal to the portion of the total disallowance which resulted 79.5 from the noncompliance, and may distribute the balance of the 79.6 disallowance according to paragraph (a). 79.7 (15) Develop and implement special projects that maximize 79.8 reimbursements and result in the recovery of money to the 79.9 state. For the purpose of recovering state money, the 79.10 commissioner may enter into contracts with third parties. Any 79.11 recoveries that result from projects or contracts entered into 79.12 under this paragraph shall be deposited in the state treasury 79.13 and credited to a special account until the balance in the 79.14 account reaches $1,000,000. When the balance in the account 79.15 exceeds $1,000,000, the excess shall be transferred and credited 79.16 to the general fund. All money in the account is appropriated 79.17 to the commissioner for the purposes of this paragraph. 79.18 (16) Have the authority to make direct payments to 79.19 facilities providing shelter to women and their children 79.20 according to section 256D.05, subdivision 3. Upon the written 79.21 request of a shelter facility that has been denied payments 79.22 under section 256D.05, subdivision 3, the commissioner shall 79.23 review all relevant evidence and make a determination within 30 79.24 days of the request for review regarding issuance of direct 79.25 payments to the shelter facility. Failure to act within 30 days 79.26 shall be considered a determination not to issue direct payments. 79.27 (17) Have the authority to establish and enforce the 79.28 following county reporting requirements: 79.29 (a) The commissioner shall establish fiscal and statistical 79.30 reporting requirements necessary to account for the expenditure 79.31 of funds allocated to counties for human services programs. 79.32 When establishing financial and statistical reporting 79.33 requirements, the commissioner shall evaluate all reports, in 79.34 consultation with the counties, to determine if the reports can 79.35 be simplified or the number of reports can be reduced. 79.36 (b) The county board shall submit monthly or quarterly 80.1 reports to the department as required by the commissioner. 80.2 Monthly reports are due no later than 15 working days after the 80.3 end of the month. Quarterly reports are due no later than 30 80.4 calendar days after the end of the quarter, unless the 80.5 commissioner determines that the deadline must be shortened to 80.6 20 calendar days to avoid jeopardizing compliance with federal 80.7 deadlines or risking a loss of federal funding. Only reports 80.8 that are complete, legible, and in the required format shall be 80.9 accepted by the commissioner. 80.10 (c) If the required reports are not received by the 80.11 deadlines established in clause (b), the commissioner may delay 80.12 payments and withhold funds from the county board until the next 80.13 reporting period. When the report is needed to account for the 80.14 use of federal funds and the late report results in a reduction 80.15 in federal funding, the commissioner shall withhold from the 80.16 county boards with late reports an amount equal to the reduction 80.17 in federal funding until full federal funding is received. 80.18 (d) A county board that submits reports that are late, 80.19 illegible, incomplete, or not in the required format for two out 80.20 of three consecutive reporting periods is considered 80.21 noncompliant. When a county board is found to be noncompliant, 80.22 the commissioner shall notify the county board of the reason the 80.23 county board is considered noncompliant and request that the 80.24 county board develop a corrective action plan stating how the 80.25 county board plans to correct the problem. The corrective 80.26 action plan must be submitted to the commissioner within 45 days 80.27 after the date the county board received notice of noncompliance. 80.28 (e) The final deadline for fiscal reports or amendments to 80.29 fiscal reports is one year after the date the report was 80.30 originally due. If the commissioner does not receive a report 80.31 by the final deadline, the county board forfeits the funding 80.32 associated with the report for that reporting period and the 80.33 county board must repay any funds associated with the report 80.34 received for that reporting period. 80.35 (f) The commissioner may not delay payments, withhold 80.36 funds, or require repayment under paragraph (c) or (e) if the 81.1 county demonstrates that the commissioner failed to provide 81.2 appropriate forms, guidelines, and technical assistance to 81.3 enable the county to comply with the requirements. If the 81.4 county board disagrees with an action taken by the commissioner 81.5 under paragraph (c) or (e), the county board may appeal the 81.6 action according to sections 14.57 to 14.69. 81.7 (g) Counties subject to withholding of funds under 81.8 paragraph (c) or forfeiture or repayment of funds under 81.9 paragraph (e) shall not reduce or withhold benefits or services 81.10 to clients to cover costs incurred due to actions taken by the 81.11 commissioner under paragraph (c) or (e). 81.12 (18) Allocate federal fiscal disallowances or sanctions for 81.13 audit exceptions when federal fiscal disallowances or sanctions 81.14 are based on a statewide random sample for the foster care 81.15 program under title IV-E of the Social Security Act, United 81.16 States Code, title 42, in direct proportion to each county's 81.17 title IV-E foster care maintenance claim for that period. 81.18 (19) Be responsible for ensuring the detection, prevention, 81.19 investigation, and resolution of fraudulent activities or 81.20 behavior by applicants, recipients, and other participants in 81.21 the human services programs administered by the department. 81.22 (20) Require county agencies to identify overpayments, 81.23 establish claims, and utilize all available and cost-beneficial 81.24 methodologies to collect and recover these overpayments in the 81.25 human services programs administered by the department. 81.26 (21) Have the authority to administer a drug rebate program 81.27 for drugs purchased pursuant to the prescription drug program 81.28 established under section 256.955 after the beneficiary's 81.29 satisfaction of any deductible established in the program. The 81.30 commissioner shall require a rebate agreement from all 81.31 manufacturers of covered drugs as defined in section 256B.0625, 81.32 subdivision 13. Rebate agreements for prescription drugs 81.33 delivered on or after July 1, 2002, must include rebates for 81.34 individuals covered under the prescription drug program who are 81.35 under 65 years of age. For each drug, the amount of the rebate 81.36 shall be equal to the basic rebate as defined for purposes of 82.1 the federal rebate program in United States Code, title 42, 82.2 section 1396r-8(c)(1). This basic rebate shall be applied to 82.3 single-source and multiple-source drugs. The manufacturers must 82.4 provide full payment within 30 days of receipt of the state 82.5 invoice for the rebate within the terms and conditions used for 82.6 the federal rebate program established pursuant to section 1927 82.7 of title XIX of the Social Security Act. The manufacturers must 82.8 provide the commissioner with any information necessary to 82.9 verify the rebate determined per drug. The rebate program shall 82.10 utilize the terms and conditions used for the federal rebate 82.11 program established pursuant to section 1927 of title XIX of the 82.12 Social Security Act. 82.13 (22) Have the authority to administer the federal drug 82.14 rebate program for drugs purchased under the medical assistance 82.15 program as allowed by section 1927 of title XIX of the Social 82.16 Security Act and according to the terms and conditions of 82.17 section 1927. Rebates shall be collected for all drugs that 82.18 have been dispensed or administered in an outpatient setting and 82.19 that are from manufacturers who have signed a rebate agreement 82.20 with the United States Department of Health and Human Services. 82.21(22)(23) Operate the department's communication systems 82.22 account established in Laws 1993, First Special Session chapter 82.23 1, article 1, section 2, subdivision 2, to manage shared 82.24 communication costs necessary for the operation of the programs 82.25 the commissioner supervises. A communications account may also 82.26 be established for each regional treatment center which operates 82.27 communications systems. Each account must be used to manage 82.28 shared communication costs necessary for the operations of the 82.29 programs the commissioner supervises. The commissioner may 82.30 distribute the costs of operating and maintaining communication 82.31 systems to participants in a manner that reflects actual usage. 82.32 Costs may include acquisition, licensing, insurance, 82.33 maintenance, repair, staff time and other costs as determined by 82.34 the commissioner. Nonprofit organizations and state, county, 82.35 and local government agencies involved in the operation of 82.36 programs the commissioner supervises may participate in the use 83.1 of the department's communications technology and share in the 83.2 cost of operation. The commissioner may accept on behalf of the 83.3 state any gift, bequest, devise or personal property of any 83.4 kind, or money tendered to the state for any lawful purpose 83.5 pertaining to the communication activities of the department. 83.6 Any money received for this purpose must be deposited in the 83.7 department's communication systems accounts. Money collected by 83.8 the commissioner for the use of communication systems must be 83.9 deposited in the state communication systems account and is 83.10 appropriated to the commissioner for purposes of this section. 83.11(23)(24) Receive any federal matching money that is made 83.12 available through the medical assistance program for the 83.13 consumer satisfaction survey. Any federal money received for 83.14 the survey is appropriated to the commissioner for this 83.15 purpose. The commissioner may expend the federal money received 83.16 for the consumer satisfaction survey in either year of the 83.17 biennium. 83.18(24)(25) Incorporate cost reimbursement claims from First 83.19 Call Minnesota into the federal cost reimbursement claiming 83.20 processes of the department according to federal law, rule, and 83.21 regulations. Any reimbursement received is appropriated to the 83.22 commissioner and shall be disbursed to First Call Minnesota 83.23 according to normal department payment schedules. 83.24(25)(26) Develop recommended standards for foster care 83.25 homes that address the components of specialized therapeutic 83.26 services to be provided by foster care homes with those services. 83.27 Sec. 2. Minnesota Statutes 2000, section 256.955, 83.28 subdivision 2b, is amended to read: 83.29 Subd. 2b. [ELIGIBILITY.] Effective July 1, 2002, an 83.30 individual satisfying the following requirements and the 83.31 requirements described in subdivision 2, paragraph (d), is 83.32 eligible for the prescription drug program: 83.33 (1) is under 65 years of age; and 83.34 (2) is eligible as a qualified Medicare beneficiary 83.35 according to section 256B.057, subdivision 3 or 3a, or is 83.36 eligible under section 256B.057, subdivision 3 or 3a, and is 84.1 also eligible for medical assistance or general assistance 84.2 medical care with a spenddown as defined in section 256B.056, 84.3 subdivision 5. 84.4 Sec. 3. [256.956] [PURCHASING ALLIANCE STOP-LOSS FUND.] 84.5 Subdivision 1. [DEFINITIONS.] For purposes of this 84.6 section, the following definitions apply: 84.7 (a) "Commissioner" means the commissioner of human services. 84.8 (b) "Health plan" means a policy, contract, or certificate 84.9 issued by a health plan company to a qualifying purchasing 84.10 alliance. Any health plan issued to the members of a qualifying 84.11 purchasing alliance must meet the requirements of chapter 62L. 84.12 (c) "Health plan company" means: 84.13 (1) a health carrier as defined under section 62A.011, 84.14 subdivision 2; 84.15 (2) a community integrated service network operating under 84.16 chapter 62N; or 84.17 (3) an accountable provider network operating under chapter 84.18 62T. 84.19 (d) "Qualifying employer" means an employer who: 84.20 (1) is a member of a qualifying purchasing alliance; 84.21 (2) has at least one employee but no more than ten 84.22 employees or is a sole proprietor or farmer; 84.23 (3) did not offer employer-subsidized health care coverage 84.24 to its employees for at least 12 months prior to joining the 84.25 purchasing alliance; and 84.26 (4) is offering health coverage through the purchasing 84.27 alliance to all employees who work at least 20 hours per week 84.28 unless the employee is eligible for Medicare. 84.29 For purposes of this subdivision, "employer-subsidized health 84.30 coverage" means health coverage for which the employer pays at 84.31 least 50 percent of the cost of coverage for the employee. 84.32 (e) "Qualifying enrollee" means an employee of a qualifying 84.33 employer or the employee's dependent covered by a health plan. 84.34 (f) "Qualifying purchasing alliance" means a purchasing 84.35 alliance as defined in section 62T.01, subdivision 2, that: 84.36 (1) meets the requirements of chapter 62T; 85.1 (2) services a geographic area located in outstate 85.2 Minnesota, excluding the city of Duluth; and 85.3 (3) is organized and operating before May 1, 2001. 85.4 The criteria used by the qualifying purchasing alliance for 85.5 membership must be approved by the commissioner of health. A 85.6 qualifying purchasing alliance may begin enrolling qualifying 85.7 employers after July 1, 2001, with enrollment ending by December 85.8 31, 2003. 85.9 Subd. 2. [CREATION OF ACCOUNT.] A purchasing alliance 85.10 stop-loss fund account is established in the general fund. The 85.11 commissioner shall use the money to establish a stop-loss fund 85.12 from which a health plan company may receive reimbursement for 85.13 claims paid for qualifying enrollees. The account consists of 85.14 money appropriated by the legislature. Money from the account 85.15 must be used for the stop-loss fund. 85.16 Subd. 3. [REIMBURSEMENT.] (a) A health plan company may 85.17 receive reimbursement from the fund for 90 percent of the 85.18 portion of the claim that exceeds $30,000 but not of the portion 85.19 that exceeds $100,000 in a calendar year for a qualifying 85.20 enrollee. 85.21 (b) Claims shall be reported and funds shall be distributed 85.22 on a calendar-year basis. Claims shall be eligible for 85.23 reimbursement only for the calendar year in which the claims 85.24 were paid. 85.25 (c) Once claims paid on behalf of a qualifying enrollee 85.26 reach $100,000 in a given calendar year, no further claims may 85.27 be submitted for reimbursement on behalf of that enrollee in 85.28 that calendar year. 85.29 Subd. 4. [REQUEST PROCESS.] (a) Each health plan company 85.30 must submit a request for reimbursement from the fund on a form 85.31 prescribed by the commissioner. Requests for payment must be 85.32 submitted no later than April 1 following the end of the 85.33 calendar year for which the reimbursement request is being made, 85.34 beginning April 1, 2002. 85.35 (b) The commissioner may require a health plan company to 85.36 submit claims data as needed in connection with the 86.1 reimbursement request. 86.2 Subd. 5. [DISTRIBUTION.] (a) The commissioner shall 86.3 calculate the total claims reimbursement amount for all 86.4 qualifying health plan companies for the calendar year for which 86.5 claims are being reported and shall distribute the stop-loss 86.6 funds on an annual basis. 86.7 (b) In the event that the total amount requested for 86.8 reimbursement by the health plan companies for a calendar year 86.9 exceeds the funds available for distribution for claims paid by 86.10 all health plan companies during the same calendar year, the 86.11 commissioner shall provide for the pro rata distribution of the 86.12 available funds. Each health plan company shall be eligible to 86.13 receive only a proportionate amount of the available funds as 86.14 the health plan company's total eligible claims paid compares to 86.15 the total eligible claims paid by all health plan companies. 86.16 (c) In the event that funds available for distribution for 86.17 claims paid by all health plan companies during a calendar year 86.18 exceed the total amount requested for reimbursement by all 86.19 health plan companies during the same calendar year, any excess 86.20 funds shall be reallocated for distribution in the next calendar 86.21 year. 86.22 Subd. 6. [DATA.] Upon the request of the commissioner, 86.23 each health plan company shall furnish such data as the 86.24 commissioner deems necessary to administer the fund. The 86.25 commissioner may require that such data be submitted on a per 86.26 enrollee, aggregate, or categorical basis. Any data submitted 86.27 under this section shall be classified as private data or 86.28 nonpublic data as defined in section 13.02. 86.29 Subd. 7. [DELEGATION.] The commissioner may delegate any 86.30 or all of the commissioner's administrative duties to another 86.31 state agency or to a private contractor. 86.32 Subd. 8. [REPORT.] The commissioner of commerce, in 86.33 consultation with the office of rural health and the qualifying 86.34 purchasing alliances, shall evaluate the extent to which the 86.35 purchasing alliance stop-loss fund increases the availability of 86.36 employer-subsidized health care coverage for residents residing 87.1 in the geographic areas served by the qualifying purchasing 87.2 alliances. A preliminary report must be submitted to the 87.3 legislature by February 15, 2003, and a final report must be 87.4 submitted by February 15, 2004. 87.5 Subd. 9. [SUNSET.] This section shall expire January 1, 87.6 2005. 87.7 Sec. 4. [256.958] [RETIRED DENTIST PROGRAM.] 87.8 Subdivision 1. [PROGRAM.] The commissioner of human 87.9 services shall establish a program to reimburse a retired 87.10 dentist for the dentist's license fee and for the cost of 87.11 malpractice insurance in exchange for the dentist providing 100 87.12 hours of dental services on a volunteer basis within a 12-month 87.13 period at a community dental clinic or a dental training clinic 87.14 located at a Minnesota state college or university. 87.15 Subd. 2. [DOCUMENTATION.] Upon completion of the required 87.16 hours, the retired dentist shall submit to the commissioner the 87.17 following: 87.18 (1) documentation of service provided; 87.19 (2) the cost of malpractice insurance for the 12-month 87.20 period; and 87.21 (3) the cost of the license. 87.22 Subd. 3. [REIMBURSEMENT.] Upon receipt of the information 87.23 described in subdivision 2, the commissioner shall provide 87.24 reimbursement to the retired dentist for the cost of malpractice 87.25 insurance for the previous 12-month period and the cost of the 87.26 license. 87.27 Sec. 5. Minnesota Statutes 2000, section 256.9657, 87.28 subdivision 2, is amended to read: 87.29 Subd. 2. [HOSPITAL SURCHARGE.] (a) Effective October 1, 87.30 1992, each Minnesota hospital except facilities of the federal 87.31 Indian Health Service and regional treatment centers shall pay 87.32 to the medical assistance account a surcharge equal to 1.4 87.33 percent of net patient revenues excluding net Medicare revenues 87.34 reported by that provider to the health care cost information 87.35 system according to the schedule in subdivision 4. 87.36 (b) Effective July 1, 1994, the surcharge under paragraph 88.1 (a) is increased to 1.56 percent. 88.2 (c) Notwithstanding the Medicare cost finding and allowable 88.3 cost principles, the hospital surcharge is not an allowable cost 88.4 for purposes of rate setting under sections 256.9685 to 256.9695. 88.5 Sec. 6. Minnesota Statutes 2000, section 256.969, 88.6 subdivision 2b, is amended to read: 88.7 Subd. 2b. [OPERATING PAYMENT RATES.] In determining 88.8 operating payment rates for admissions occurring on or after the 88.9 rate year beginning January 1, 1991, and every two years after, 88.10 or more frequently as determined by the commissioner, the 88.11 commissioner shall obtain operating data from an updated base 88.12 year and, within the limits of available appropriations, 88.13 establish operating payment rates per admission for each 88.14 hospital based on the cost-finding methods and allowable costs 88.15 of the Medicare program in effect during the base year. Rates 88.16 under the general assistance medical care, medical assistance, 88.17 and MinnesotaCare programs shall not be rebased to more current 88.18 data on January 1, 1997. The base year operating payment rate 88.19 per admission is standardized by the case mix index and adjusted 88.20 by the hospital cost index, relative values, and 88.21 disproportionate population adjustment. The cost and charge 88.22 data used to establish operating rates shall only reflect 88.23 inpatient services covered by medical assistance and shall not 88.24 include property cost information and costs recognized in 88.25 outlier payments. 88.26 Sec. 7. Minnesota Statutes 2000, section 256.969, is 88.27 amended by adding a subdivision to read: 88.28 Subd. 26. [GREATER MINNESOTA PAYMENT ADJUSTMENT AFTER JUNE 88.29 30, 2001.] (a) For admissions occurring after June 30, 2001, the 88.30 commissioner shall pay all medical assistance inpatient 88.31 fee-for-service admissions for the diagnosis-related groups 88.32 specified in paragraph (b) at hospitals located outside of the 88.33 seven-county metropolitan area at the higher of: 88.34 (1) the hospital's current payment rate for the diagnostic 88.35 category to which the diagnosis-related group belongs, exclusive 88.36 of disproportionate population adjustments received under 89.1 subdivision 9 and hospital payment adjustments received under 89.2 subdivision 23; or 89.3 (2) the rate in clause (1) plus a proportion of the 89.4 difference between the current average payment rate for that 89.5 diagnostic category for hospitals located within the 89.6 seven-county metropolitan area, exclusive of disproportionate 89.7 population adjustments received under subdivision 9 and hospital 89.8 payment adjustments received under subdivision 23, and the 89.9 current rate in clause (1). This proportion shall be 12.5 89.10 percent for the fiscal year beginning July 1, 2001, and shall 89.11 increase by 12.5 percentage points for each of the next seven 89.12 fiscal years, such that the proportion is 100 percent for the 89.13 fiscal year beginning July 1, 2008. 89.14 (b) The reimbursement increases provided in paragraph (a) 89.15 apply to the following diagnosis-related groups as they fall 89.16 within the diagnostic categories: 89.17 (1) 370 C-section with complicating diagnosis; 89.18 (2) 371 C-section without complicating diagnosis; 89.19 (3) 372 vaginal delivery with complicating diagnosis; 89.20 (4) 373 vaginal delivery without complicating diagnosis; 89.21 (5) 386 extreme immaturity, weight greater than 1,500 89.22 grams; 89.23 (6) 388 full-term neonates with other problems; 89.24 (7) 390 prematurity without major problems; 89.25 (8) 391 normal newborn case; 89.26 (9) 385 neonate, died or transferred to another health care 89.27 facility; 89.28 (10) 425 acute adjustment reaction and psychosocial 89.29 dysfunctioning; 89.30 (11) 430 psychosis; 89.31 (12) 431 childhood mental disorders; and 89.32 (13) 164-167 appendectomy. 89.33 Sec. 8. Minnesota Statutes 2000, section 256B.04, is 89.34 amended by adding a subdivision to read: 89.35 Subd. 1b. [CONTRACT FOR SERVICES FOR AMERICAN INDIAN 89.36 CHILDREN.] Notwithstanding subdivision 1, the commissioner may 90.1 contract with federally recognized Indian tribes with a 90.2 reservation in Minnesota for the provision of early and periodic 90.3 screening, diagnosis, and treatment administrative services for 90.4 American Indian children, according to Code of Federal 90.5 Regulations, title 42, section 441, subpart B, and Minnesota 90.6 Rules, part 9505.1693 et seq., when the tribe chooses to provide 90.7 such services. For purposes of this subdivision, "American 90.8 Indian" has the meaning given to persons to whom services will 90.9 be provided for in Code of Federal Regulations, title 42, 90.10 section 36.12. Notwithstanding Minnesota Rules, part 9505.1748, 90.11 subpart 1, the commissioner, the local agency, and the tribe may 90.12 contract with any entity for the provision of early and periodic 90.13 screening, diagnosis, and treatment administrative services. 90.14[EFFECTIVE DATE.] This section is effective the day 90.15 following final enactment. 90.16 Sec. 9. Minnesota Statutes 2000, section 256B.055, 90.17 subdivision 3a, is amended to read: 90.18 Subd. 3a. [MFIP-S FAMILIES;FAMILIES ELIGIBLE UNDER PRIOR 90.19 AFDC RULES.] (a)Beginning January 1, 1998, or on the date that90.20MFIP-S is implemented in counties, medical assistance may be90.21paid for a person receiving public assistance under the MFIP-S90.22program.Beginning July 1, 2002, medical assistance may be paid 90.23 for a person who would have been eligible, but for excess income 90.24 or assets, under the state's AFDC plan in effect as of July 16, 90.25 1996, with the base AFDC standard increased by three percent 90.26 effective July 1, 2000. 90.27 (b) BeginningJanuary 1, 1998,July 1, 2002, medical 90.28 assistance may be paid for a person who would have been eligible 90.29 for public assistance under the income andresourceassets 90.30 standards, or who would have been eligible but for excess income90.31or assets,under the state's AFDC plan in effect as of July 16, 90.32 1996,as required by the Personal Responsibility and Work90.33Opportunity Reconciliation Act of 1996 (PRWORA), Public Law90.34Number 104-193with the base AFDC rate increased by three 90.35 percent effective July 1, 2000. 90.36[EFFECTIVE DATE.] This section is effective July 1, 2002. 91.1 Sec. 10. Minnesota Statutes 2000, section 256B.056, 91.2 subdivision 1a, is amended to read: 91.3 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 91.4 specifically required by state law or rule or federal law or 91.5 regulation, the methodologies used in counting income and assets 91.6 to determine eligibility for medical assistance for persons 91.7 whose eligibility category is based on blindness, disability, or 91.8 age of 65 or more years, the methodologies for the supplemental 91.9 security income program shall be used. Effective upon federal 91.10 approval, for children eligible under section 256B.055, 91.11 subdivision 12, or for home and community-based waiver services 91.12 whose eligibility for medical assistance is determined without 91.13 regard to parental income, child support payments, including any 91.14 payments made by an obligor in satisfaction of or in addition to 91.15 a temporary or permanent order for child support, social 91.16 security payments, and other benefits for basic needs are not 91.17 counted as income. For families and children, which includes 91.18 all other eligibility categories, the methodologies under the 91.19 state's AFDC plan in effect as of July 16, 1996, as required by 91.20 the Personal Responsibility and Work Opportunity Reconciliation 91.21 Act of 1996 (PRWORA), Public Law Number 104-193, shall be used. 91.22 Effective upon federal approval, in-kind contributions to, and 91.23 payments made on behalf of, a recipient, by an obligor, in 91.24 satisfaction of or in addition to a temporary or permanent order 91.25 for child support or maintenance, shall be considered income to 91.26 the recipient. For these purposes, a "methodology" does not 91.27 include an asset or income standard, or accounting method, or 91.28 method of determining effective dates. 91.29 Sec. 11. Minnesota Statutes 2000, section 256B.056, 91.30 subdivision 3, is amended to read: 91.31 Subd. 3. [ASSET LIMITATIONS.] To be eligible for medical 91.32 assistance, a person must not individually own more than $3,000 91.33 in assets, or if a member of a household with two family 91.34 members, husband and wife, or parent and child, the household 91.35 must not own more than $6,000 in assets, plus $200 for each 91.36 additional legal dependent. In addition to these maximum 92.1 amounts, an eligible individual or family may accrue interest on 92.2 these amounts, but they must be reduced to the maximum at the 92.3 time of an eligibility redetermination. The accumulation of the 92.4 clothing and personal needs allowance according to section 92.5 256B.35 must also be reduced to the maximum at the time of the 92.6 eligibility redetermination. The value of assets that are not 92.7 considered in determining eligibility for medical assistance is 92.8 the value of those assets excluded under the AFDC state plan as 92.9 of July 16, 1996, as required by the Personal Responsibility and 92.10 Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 92.11 Number 104-193, for families and children, and the supplemental 92.12 security income program for aged, blind, and disabled persons, 92.13 with the following exceptions: 92.14 (a) Household goods and personal effects are not considered. 92.15 (b) Capital and operating assets of a trade or business 92.16 that the local agency determines are necessary to the person's 92.17 ability to earn an income are not considered. 92.18 (c) Motor vehicles are excluded to the same extent excluded 92.19 by the supplemental security income program. 92.20 (d) Assets designated as burial expenses are excluded to 92.21 the same extent excluded by the supplemental security income 92.22 program. 92.23 (e) Effective upon federal approval, for a person who no 92.24 longer qualifies as an employed person with a disability due to 92.25 loss of earnings, assets allowed while eligible for medical 92.26 assistance under section 256B.057, subdivision 9, are not 92.27 considered for 12 months, beginning with the first month of 92.28 ineligibility as an employed person with a disability, to the 92.29 extent that the person's total assets remain within the allowed 92.30 limits of section 256B.057, subdivision 9, paragraph (b). 92.31 Sec. 12. Minnesota Statutes 2000, section 256B.056, 92.32 subdivision 4, is amended to read: 92.33 Subd. 4. [INCOME.] (a) To be eligible for medical 92.34 assistance, a person eligible under section 256B.055, 92.35subdivisionsubdivisions 7, 7a, and 12,not receiving92.36supplemental security income program payments, andmay have 93.1 income up to the following specified percentages of the federal 93.2 poverty guidelines for the family size effective on April 1 of 93.3 each year: 93.4 (1) 80 percent, effective July 1, 2002; 93.5 (2) 90 percent, effective July 1, 2003; 93.6 (3) 100 percent, effective July 1, 2004. 93.7 Increases in benefits under title II of the Social Security Act 93.8 shall not be counted as income for purposes of this subdivision 93.9 until the first day of the second full month following 93.10 publication of the change in the federal poverty guidelines. 93.11 (b) To be eligible for medical assistance, families and 93.12 children may have an income up to 133-1/3 percent of the AFDC 93.13 income standard in effect under the July 16, 1996, AFDC state 93.14 plan. Effective July 1, 2000, the base AFDC standard in effect 93.15 on July 16, 1996, shall be increased by three percent. Effective 93.16 January 1, 2000, and each successive January, recipients of 93.17 supplemental security income may have an income up to the 93.18 supplemental security income standard in effect on that date. 93.19 (c) Effective July 1, 2002, to be eligible for medical 93.20 assistance, families and children may have an income up to 100 93.21 percent of the federal poverty guidelines for the family size 93.22 effective on April 1 of each year. 93.23 (d) In computing income to determine eligibility of persons 93.24 under paragraphs (a) to (c) who are not residents of long-term 93.25 care facilities, the commissioner shall disregard increases in 93.26 income as required by Public Law Numbers 94-566, section 503; 93.27 99-272; and 99-509. Veterans aid and attendance benefits and 93.28 Veterans Administration unusual medical expense payments are 93.29 considered income to the recipient. 93.30 Sec. 13. Minnesota Statutes 2000, section 256B.056, 93.31 subdivision 5, is amended to read: 93.32 Subd. 5. [EXCESS INCOME.] A person who has excess income 93.33 is eligible for medical assistance if the person has expenses 93.34 for medical care that are more than the amount of the person's 93.35 excess income, computed by deducting incurred medical expenses 93.36 from the excess income to reduce the excess to the income 94.1 standard specified in subdivision 4, except that if federal 94.2 authorization to use the standard in subdivision 4 is not 94.3 obtained, the medically needy standard for purposes of a 94.4 spenddown shall be 133 and 1/3 percent of the AFDC income 94.5 standard in effect under the July 16, 1996, AFDC state plan, 94.6 increased by three percent. The person shall elect to have the 94.7 medical expenses deducted at the beginning of a one-month budget 94.8 period or at the beginning of a six-month budget period. The 94.9 commissioner shall allow persons eligible for assistance on a 94.10 one-month spenddown basis under this subdivision to elect to pay 94.11 the monthly spenddown amount in advance of the month of 94.12 eligibility to the state agency in order to maintain eligibility 94.13 on a continuous basis. If the recipient does not pay the 94.14 spenddown amount on or before the 20th of the month, the 94.15 recipient is ineligible for this option for the following 94.16 month. The local agency shall code the Medicaid Management 94.17 Information System (MMIS) to indicate that the recipient has 94.18 elected this option. The state agency shall convey recipient 94.19 eligibility information relative to the collection of the 94.20 spenddown to providers through the Electronic Verification 94.21 System (EVS). A recipient electing advance payment must pay the 94.22 state agency the monthly spenddown amount on or before the 20th 94.23 of the month in order to be eligible for this option in the 94.24 following month. 94.25 Sec. 14. Minnesota Statutes 2000, section 256B.057, 94.26 subdivision 9, is amended to read: 94.27 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 94.28 assistance may be paid for a person who is employed and who: 94.29 (1) meets the definition of disabled under the supplemental 94.30 security income program; 94.31 (2) is at least 16 but less than 65 years of age; 94.32 (3) meets the asset limits in paragraph (b); and 94.33 (4) pays a premium, if required, under paragraph (c). 94.34 Any spousal income or assets shall be disregarded for purposes 94.35 of eligibility and premium determinations. 94.36 (b) For purposes of determining eligibility under this 95.1 subdivision, a person's assets must not exceed $20,000, 95.2 excluding: 95.3 (1) all assets excluded under section 256B.056; 95.4 (2) retirement accounts, including individual accounts, 95.5 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 95.6 (3) medical expense accounts set up through the person's 95.7 employer. 95.8 (c) A person whose earned and unearned income is equal to 95.9 or greater than200100 percent of federal poverty guidelines 95.10 for the applicable family size must pay a premium to be eligible 95.11 for medical assistance under this subdivision. The premium 95.12 shall beequal to ten percent ofbased on the person's gross 95.13 earned and unearned incomeabove 200 percent of federal poverty95.14guidelines forand the applicable family sizeup to the cost of95.15coverage, using a sliding fee scale established by the 95.16 commissioner which begins at one percent of income at 100 95.17 percent of the federal poverty guidelines and gradually 95.18 increases to 7.5 percent of income for those with incomes at or 95.19 above 300 percent of the federal poverty guidelines. 95.20 (d) A person's eligibility and premium shall be determined 95.21 by the local county agency. Premiums must be paid to the 95.22 commissioner. All premiums are dedicated to the commissioner. 95.23 (e) Any required premium shall be determined at application 95.24 and redetermined annually at recertification or when a change in 95.25 income or family size occurs. 95.26 (f) Premium payment is due upon notification from the 95.27 commissioner of the premium amount required. Premiums may be 95.28 paid in installments at the discretion of the commissioner. 95.29 (g) Nonpayment of the premium shall result in denial or 95.30 termination of medical assistance unless the person demonstrates 95.31 good cause for nonpayment. Good cause exists if the 95.32 requirements specified in Minnesota Rules, part 9506.0040, 95.33 subpart 7, items B to D, are met. Nonpayment shall include 95.34 payment with a returned, refused, or dishonored instrument. The 95.35 commissioner may require a guaranteed form of payment as the 95.36 only means to replace a returned, refused, or dishonored 96.1 instrument. 96.2[EFFECTIVE DATE.] This section is effective September 1, 96.3 2001. 96.4 Sec. 15. Minnesota Statutes 2000, section 256B.057, is 96.5 amended by adding a subdivision to read: 96.6 Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 96.7 CERVICAL CANCER.] (a) Medical assistance may be paid for a 96.8 person who: 96.9 (1) has been screened for breast or cervical cancer by the 96.10 Minnesota breast and cervical cancer control program, and 96.11 program funds have been used to pay for the person's screening; 96.12 (2) according to the person's treating health professional, 96.13 needs treatment, including diagnostic services necessary to 96.14 determine the extent and proper course of treatment, for breast 96.15 or cervical cancer, including precancerous conditions and early 96.16 stage cancer; 96.17 (3) meets the income eligibility guidelines for the 96.18 Minnesota breast and cervical cancer control program; 96.19 (4) is under age 65; 96.20 (5) is not otherwise eligible for medical assistance under 96.21 United States Code, title 42, section 1396(a)(10)(A)(i); and 96.22 (6) is not otherwise covered under creditable coverage, as 96.23 defined under United States Code, title 42, section 300gg(c). 96.24 (b) Medical assistance provided for an eligible person 96.25 under this subdivision shall be limited to services provided 96.26 during the period that the person receives treatment for breast 96.27 or cervical cancer. 96.28 (c) A person meeting the criteria in paragraph (a) is 96.29 eligible for medical assistance without meeting the eligibility 96.30 criteria relating to income and assets in section 256B.056, 96.31 subdivisions 1a to 5b. 96.32 Sec. 16. Minnesota Statutes 2000, section 256B.0625, 96.33 subdivision 3b, is amended to read: 96.34 Subd. 3b. [TELEMEDICINE CONSULTATIONS.](a)Medical 96.35 assistance covers telemedicine consultations. Telemedicine 96.36 consultations must be made via two-way, interactive video or 97.1 store-and-forward technology. Store-and-forward technology 97.2 includes telemedicine consultations that do not occur in real 97.3 time via synchronous transmissions, and that do not require a 97.4 face-to-face encounter with the patient for all or any part of 97.5 any such telemedicine consultation. The patient record must 97.6 include a written opinion from the consulting physician 97.7 providing the telemedicine consultation. A communication 97.8 between two physicians that consists solely of a telephone 97.9 conversation is not a telemedicine consultation. Coverage is 97.10 limited to three telemedicine consultations per recipient per 97.11 calendar week. Telemedicine consultations shall be paid at the 97.12 full allowable rate. 97.13(b) This subdivision expires July 1, 2001.97.14 Sec. 17. Minnesota Statutes 2000, section 256B.0625, is 97.15 amended by adding a subdivision to read: 97.16 Subd. 5a. [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY 97.17 SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.] (a) 97.18 [COVERAGE.] Medical assistance covers home-based intensive early 97.19 intervention behavior therapy for children with autism spectrum 97.20 disorders. Children with autism spectrum disorder, and their 97.21 custodial parents or foster parents, may access other covered 97.22 services to treat autism spectrum disorder, and are not required 97.23 to receive intensive early intervention behavior therapy 97.24 services under this subdivision. Intensive early intervention 97.25 behavior therapy does not include coverage for services to treat 97.26 developmental disorders of language, early onset psychosis, 97.27 Rett's disorder, selective mutism, social anxiety disorder, 97.28 stereotypic movement disorder, dementia, obsessive compulsive 97.29 disorder, schizoid personality disorder, avoidant personality 97.30 disorder, or reactive attachment disorder. If a child with 97.31 autism spectrum disorder is diagnosed to have one or more of 97.32 these conditions, intensive early intervention behavior therapy 97.33 includes coverage only for services necessary to treat the 97.34 autism spectrum disorder. 97.35 (b) [PURPOSE OF INTENSIVE EARLY INTERVENTION BEHAVIOR 97.36 THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to improve 98.1 the child's behavioral functioning, to prevent development of 98.2 challenging behaviors, to eliminate autistic behaviors, to 98.3 reduce the risk of out-of-home placement, and to establish 98.4 independent typical functioning in language and social 98.5 behavior. The procedures used to accomplish these goals are 98.6 based upon research in applied behavior analysis. 98.7 (c) [ELIGIBLE CHILDREN.] A child is eligible to initiate 98.8 IEIBTS if, the child meets the additional eligibility criteria 98.9 in paragraph (d) and in a diagnostic assessment by a mental 98.10 health professional who is not under the employ of the service 98.11 provider, the child: 98.12 (1) is found to have an autism spectrum disorder; 98.13 (2) has a current IQ of either untestable, or at least 30; 98.14 (3) if nonverbal, initiated behavior therapy by 42 months 98.15 of age; 98.16 (4) if verbal, initiated behavior therapy by 48 months of 98.17 age; or 98.18 (5) if having an IQ of at least 50, initiated behavior 98.19 therapy by 84 months of age. 98.20 To continue in IEIBTS, at least one of the child's custodial 98.21 parents or foster parents must participate in an average of at 98.22 least five hours of documented behavior therapy per week for six 98.23 months, and consistently implement behavior therapy 98.24 recommendations 24 hours a day. To continue after six-month 98.25 individualized treatment plan (ITP) reviews, the child must show 98.26 documented progress toward mastery of six-month benchmark 98.27 behavior objectives. The maximum number of months during which 98.28 services may be billed is 54. If significant progress towards 98.29 treatment goals has not been achieved after 24 months of 98.30 treatment, treatment must be discontinued. 98.31 (d) [ADDITIONAL ELIGIBILITY CRITERIA.] A child is eligible 98.32 to initiate IEIBTS if: 98.33 (1) in medical and diagnostic assessments by medical and 98.34 mental health professionals, it is determined that the child 98.35 does not have severe or profound mental retardation; 98.36 (2) an accurate assessment of the child's hearing has been 99.1 performed, including audiometry if the brain stem auditory 99.2 evokes response; 99.3 (3) a blood lead test has been performed prior to 99.4 initiation of treatment; and 99.5 (4) an EEG or neurologic evaluation is done, prior to 99.6 initiation of treatment, if the child has a history of staring 99.7 spells or developmental regression. 99.8 (e) [COVERED SERVICES.] The focus of IEIBTS must be to 99.9 treat the principal diagnostic features of the autism spectrum 99.10 disorder. All IEIBTS must be delivered by a team of 99.11 practitioners under the consistent supervision of a single 99.12 clinical supervisor. A mental health professional must develop 99.13 the ITP for IEIBTS. The ITP must include six-month benchmark 99.14 behavior objectives. All behavior therapy must be based upon 99.15 research in applied behavior analysis, with an emphasis upon 99.16 positive reinforcement of carefully task-analyzed skills for 99.17 optimum rates of progress. All behavior therapy must be 99.18 consistently applied and generalized throughout the 24-hour day 99.19 and seven-day week by all of the child's regular care 99.20 providers. When placing the child in school activities, a 99.21 majority of the peers must have no mental health diagnosis, and 99.22 the child must have sufficient social skills to succeed with 80 99.23 percent of the school activities. Reactive consequences, such 99.24 as redirection, correction, positive practice, or time-out, must 99.25 be used only when necessary to improve the child's success when 99.26 proactive procedures alone have not been effective. IEIBTS must 99.27 be delivered by a team of behavior therapy practitioners who are 99.28 employed under the direction of the same agency. The team may 99.29 deliver up to 200 billable hours per year of direct clinical 99.30 supervisor services, up to 750 billable hours per year of senior 99.31 behavior therapist services, and up to 1,800 billable hours per 99.32 year of direct behavior therapist services. A one-hour clinical 99.33 review meeting for the child, parents, and staff must be 99.34 scheduled 50 weeks a year, at which behavior therapy is reviewed 99.35 and planned. At least one-quarter of the annual clinical 99.36 supervisor billable hours shall consist of on-site clinical 100.1 meeting time. At least one-half of the annual senior behavior 100.2 therapist billable hours shall consist of direct services to the 100.3 child or parents. All of the behavioral therapist billable 100.4 hours shall consist of direct on-site services to the child or 100.5 parents. None of the senior behavior therapist billable hours 100.6 or behavior therapist billable hours shall consist of clinical 100.7 meeting time. If there is any regression of the autistic 100.8 spectrum disorder after 12 months of therapy, a neurologic 100.9 consultation must be performed. 100.10 (f) [PROVIDER QUALIFICATIONS.] The provider agency must be 100.11 capable of delivering consistent applied behavior analysis 100.12 (ABA)-based behavior therapy in the home. The site director of 100.13 the agency must be a mental health professional certified as a 100.14 behavior analyst by the Association for Behavior Analysis. Each 100.15 clinical supervisor must be certified as a behavior analyst by 100.16 the Association for Behavior Analysis. 100.17 (g) [SUPERVISION REQUIREMENTS.] (1) Each behavior therapist 100.18 practitioner must be continuously supervised while in the home 100.19 until the practitioner has mastered competencies for independent 100.20 practice. Each behavior therapist must have mastered three 100.21 credits of academic content and practice in an ABA sequence at 100.22 an accredited university. A college degree or minimum hours of 100.23 experience are not required. Each behavior therapist must 100.24 continue training through weekly direct observation by the 100.25 senior behavior therapist, through demonstrated performance in 100.26 clinical meetings with the clinical supervisor, and annual 100.27 training in ABA. 100.28 (2) Each senior behavior therapist practitioner must have 100.29 mastered the senior behavior therapy competencies, completed one 100.30 year of practice as a behavior therapist, and six months of 100.31 co-therapy training with another senior behavior therapist or 100.32 have an equivalent amount of experience in ABA. Each senior 100.33 behavior therapist must have mastered 12 credits of academic 100.34 content and practice in an ABA sequence at an accredited 100.35 university. Each senior behavior therapist must continue 100.36 training through demonstrated performance in clinical meetings 101.1 with the clinical supervisor, and annual training in ABA. 101.2 (3) Each clinical supervisor practitioner must have 101.3 mastered the clinical supervisor and family consultation 101.4 competencies, completed two years of practice as a senior 101.5 behavior therapist and one year of co-therapy training with 101.6 another clinical supervisor, or equivalent experience in ABA. 101.7 Each clinical supervisor must continue training through annual 101.8 training in ABA. 101.9 (h) [PLACE OF SERVICE.] IEIBTS are provided primarily in 101.10 the child's home and community. Services may be provided in the 101.11 child's natural school or preschool classroom, home of a 101.12 relative, natural recreational setting, or day care. 101.13 (i) [PRIOR AUTHORIZATION REQUIREMENTS.] Prior authorization 101.14 shall be required for services provided after 200 hours of 101.15 clinical supervisor, 750 hours of senior behavior therapist, or 101.16 1,800 hours of behavior therapist services per year. 101.17 (j) [PAYMENT RATES.] The following payment rates apply: 101.18 (1) for an IEIBTS clinical supervisor practitioner under 101.19 supervision of a mental health professional, the lower of the 101.20 submitted charge or $137 per hour unit; 101.21 (2) for an IEIBTS senior behavior therapist practitioner 101.22 under supervision of a mental health professional, the lower of 101.23 the submitted charge or $56 per hour unit; or 101.24 (3) for an IEIBTS behavior therapist practitioner under 101.25 supervision of a mental health professional, the lower of the 101.26 submitted charge or $19 per hour unit. 101.27 An IEIBTS practitioner may receive payment for travel time which 101.28 exceeds 50 minutes one-way. The maximum payment allowed will be 101.29 $0.51 per minute for up to a maximum of 300 hours per year. 101.30 For any week during which the above charges are made to 101.31 medical assistance, payments for the following services are 101.32 excluded: supervising mental health professional hours and 101.33 personal care attendant, home-based mental health, 101.34 family-community support, or mental health behavioral aide hours. 101.35 (k) [REPORT.] The commissioner shall collect evidence of 101.36 the effectiveness of intensive early intervention behavior 102.1 therapy services and present a report to the legislature by July 102.2 1, 2006. 102.3[EFFECTIVE DATE.] This section is effective January 1, 2002. 102.4 Sec. 18. Minnesota Statutes 2000, section 256B.0625, 102.5 subdivision 13, is amended to read: 102.6 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 102.7 except for fertility drugs when specifically used to enhance 102.8 fertility, if prescribed by a licensed practitioner and 102.9 dispensed by a licensed pharmacist, by a physician enrolled in 102.10 the medical assistance program as a dispensing physician, or by 102.11 a physician or a nurse practitioner employed by or under 102.12 contract with a community health board as defined in section 102.13 145A.02, subdivision 5, for the purposes of communicable disease 102.14 control. The commissioner, after receiving recommendations from 102.15 professional medical associations and professional pharmacist 102.16 associations, shall designate a formulary committee to advise 102.17 the commissioner on the names of drugs for which payment is 102.18 made, recommend a system for reimbursing providers on a set fee 102.19 or charge basis rather than the present system, and develop 102.20 methods encouraging use of generic drugs when they are less 102.21 expensive and equally effective as trademark drugs. The 102.22 formulary committee shall consist of nine members, four of whom 102.23 shall be physicians 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, three of whom 102.26 shall be pharmacists who are not employed by the department of 102.27 human services, and a majority of whose practice is for persons 102.28 paying privately or through health insurance, a consumer 102.29 representative, and a nursing home representative. Committee 102.30 members shall serve three-year terms and shall serve without 102.31 compensation. Members may be reappointed once. 102.32 (b) The commissioner shall establish a drug formulary. Its 102.33 establishment and publication shall not be subject to the 102.34 requirements of the Administrative Procedure Act, but the 102.35 formulary committee shall review and comment on the formulary 102.36 contents. The formulary committee shall review and recommend 103.1 drugs which require prior authorization. The formulary 103.2 committee may recommend drugs for prior authorization directly 103.3 to the commissioner, as long as opportunity for public input is 103.4 provided. Prior authorization may be requested by the 103.5 commissioner based on medical and clinical criteria before 103.6 certain drugs are eligible for payment. Before a drug may be 103.7 considered for prior authorization at the request of the 103.8 commissioner: 103.9 (1) the drug formulary committee must develop criteria to 103.10 be used for identifying drugs; the development of these criteria 103.11 is not subject to the requirements of chapter 14, but the 103.12 formulary committee shall provide opportunity for public input 103.13 in developing criteria; 103.14 (2) the drug formulary committee must hold a public forum 103.15 and receive public comment for an additional 15 days; and 103.16 (3) the commissioner must provide information to the 103.17 formulary committee on the impact that placing the drug on prior 103.18 authorization will have on the quality of patient care and 103.19 information regarding whether the drug is subject to clinical 103.20 abuse or misuse. Prior authorization may be required by the 103.21 commissioner before certain formulary drugs are eligible for 103.22 payment. The formulary shall not include: 103.23 (i) drugs or products for which there is no federal 103.24 funding; 103.25 (ii) over-the-counter drugs, except for antacids, 103.26 acetaminophen, family planning products, aspirin, insulin, 103.27 products for the treatment of lice, vitamins for adults with 103.28 documented vitamin deficiencies, vitamins for children under the 103.29 age of seven and pregnant or nursing women, and any other 103.30 over-the-counter drug identified by the commissioner, in 103.31 consultation with the drug formulary committee, as necessary, 103.32 appropriate, and cost-effective for the treatment of certain 103.33 specified chronic diseases, conditions or disorders, and this 103.34 determination shall not be subject to the requirements of 103.35 chapter 14; 103.36 (iii) anorectics, except that medically necessary 104.1 anorectics shall be covered for a recipient previously diagnosed 104.2 as having pickwickian syndrome and currently diagnosed as having 104.3 diabetes and being morbidly obese; 104.4 (iv) drugs for which medical value has not been 104.5 established; and 104.6 (v) drugs from manufacturers who have not signed a rebate 104.7 agreement with the Department of Health and Human Services 104.8 pursuant to section 1927 of title XIX of the Social Security Act. 104.9 The commissioner shall publish conditions for prohibiting 104.10 payment for specific drugs after considering the formulary 104.11 committee's recommendations. An honorarium of $100 per meeting 104.12 and reimbursement for mileage shall be paid to each committee 104.13 member in attendance. 104.14 (c) The basis for determining the amount of payment shall 104.15 be the lower of the actual acquisition costs of the drugs plus a 104.16 fixed dispensing fee; the maximum allowable cost set by the 104.17 federal government or by the commissioner plus the fixed 104.18 dispensing fee; or the usual and customary price charged to the 104.19 public. The pharmacy dispensing fee shall be $3.65, except that 104.20 the dispensing fee for intravenous solutions which must be 104.21 compounded by the pharmacist shall be $8 per bag, $14 per bag 104.22 for cancer chemotherapy products, and $30 per bag for total 104.23 parenteral nutritional products dispensed in one liter 104.24 quantities, or $44 per bag for total parenteral nutritional 104.25 products dispensed in quantities greater than one liter. Actual 104.26 acquisition cost includes quantity and other special discounts 104.27 except time and cash discounts. The actual acquisition cost of 104.28 a drug shall be estimated by the commissioner, at average 104.29 wholesale price minus nine percent, except that where a drug has 104.30 had its wholesale price reduced as a result of the actions of 104.31 the National Association of Medicaid Fraud Control Units, the 104.32 estimated actual acquisition cost shall be the reduced average 104.33 wholesale price, without the nine percent deduction. The 104.34 maximum allowable cost of a multisource drug may be set by the 104.35 commissioner and it shall be comparable to, but no higher than, 104.36 the maximum amount paid by other third-party payors in this 105.1 state who have maximum allowable cost programs. The 105.2 commissioner shall set maximum allowable costs for multisource 105.3 drugs that are not on the federal upper limit list as described 105.4 in United States Code, title 42, chapter 7, section 1396r-8(e), 105.5 the Social Security Act, and Code of Federal Regulations, title 105.6 42, part 447, section 447.332. Establishment of the amount of 105.7 payment for drugs shall not be subject to the requirements of 105.8 the Administrative Procedure Act. An additional dispensing fee 105.9 of $.30 may be added to the dispensing fee paid to pharmacists 105.10 for legend drug prescriptions dispensed to residents of 105.11 long-term care facilities when a unit dose blister card system, 105.12 approved by the department, is used. Under this type of 105.13 dispensing system, the pharmacist must dispense a 30-day supply 105.14 of drug. The National Drug Code (NDC) from the drug container 105.15 used to fill the blister card must be identified on the claim to 105.16 the department. The unit dose blister card containing the drug 105.17 must meet the packaging standards set forth in Minnesota Rules, 105.18 part 6800.2700, that govern the return of unused drugs to the 105.19 pharmacy for reuse. The pharmacy provider will be required to 105.20 credit the department for the actual acquisition cost of all 105.21 unused drugs that are eligible for reuse. Over-the-counter 105.22 medications must be dispensed in the manufacturer's unopened 105.23 package. The commissioner may permit the drug clozapine to be 105.24 dispensed in a quantity that is less than a 30-day supply. 105.25 Whenever a generically equivalent product is available, payment 105.26 shall be on the basis of the actual acquisition cost of the 105.27 generic drug, unless the prescriber specifically indicates 105.28 "dispense as written - brand necessary" on the prescription as 105.29 required by section 151.21, subdivision 2. 105.30 (d) For purposes of this subdivision, "multisource drugs" 105.31 means covered outpatient drugs, excluding innovator multisource 105.32 drugs for which there are two or more drug products, which: 105.33 (1) are related as therapeutically equivalent under the 105.34 Food and Drug Administration's most recent publication of 105.35 "Approved Drug Products with Therapeutic Equivalence 105.36 Evaluations"; 106.1 (2) are pharmaceutically equivalent and bioequivalent as 106.2 determined by the Food and Drug Administration; and 106.3 (3) are sold or marketed in Minnesota. 106.4 "Innovator multisource drug" means a multisource drug that was 106.5 originally marketed under an original new drug application 106.6 approved by the Food and Drug Administration. 106.7 (e) The basis for determining the amount of payment for 106.8 drugs administered in an outpatient setting shall be the lower 106.9 of the usual and customary cost submitted by the provider; the 106.10 average wholesale price minus five percent; or the maximum 106.11 allowable cost set by the federal government under United States 106.12 Code, title 42, chapter 7, section 1396r-8(e) and Code of 106.13 Federal Regulations, title 42, section 447.332, or by the 106.14 commissioner under paragraph (c). 106.15 Sec. 19. Minnesota Statutes 2000, section 256B.0625, 106.16 subdivision 13a, is amended to read: 106.17 Subd. 13a. [DRUG UTILIZATION REVIEW BOARD.] A nine-member 106.18 drug utilization review board is established. The board is 106.19 comprised of at least three but no more than four licensed 106.20 physicians actively engaged in the practice of medicine in 106.21 Minnesota; at least three licensed pharmacists actively engaged 106.22 in the practice of pharmacy in Minnesota; and one consumer 106.23 representative; the remainder to be made up of health care 106.24 professionals who are licensed in their field and have 106.25 recognized knowledge in the clinically appropriate prescribing, 106.26 dispensing, and monitoring of covered outpatient drugs. The 106.27 board shall be staffed by an employee of the department who 106.28 shall serve as an ex officio nonvoting member of the board. The 106.29 members of the board shall be appointed by the commissioner and 106.30 shall serve three-year terms. The members shall be selected 106.31 from lists submitted by professional associations. The 106.32 commissioner shall appoint the initial members of the board for 106.33 terms expiring as follows: three members for terms expiring 106.34 June 30, 1996; three members for terms expiring June 30, 1997; 106.35 and three members for terms expiring June 30, 1998. Members may 106.36 be reappointed once. The board shall annually elect a chair 107.1 from among the members. 107.2 The commissioner shall, with the advice of the board: 107.3 (1) implement a medical assistance retrospective and 107.4 prospective drug utilization review program as required by 107.5 United States Code, title 42, section 1396r-8(g)(3); 107.6 (2) develop and implement the predetermined criteria and 107.7 practice parameters for appropriate prescribing to be used in 107.8 retrospective and prospective drug utilization review; 107.9 (3) develop, select, implement, and assess interventions 107.10 for physicians, pharmacists, and patients that are educational 107.11 and not punitive in nature; 107.12 (4) establish a grievance and appeals process for 107.13 physicians and pharmacists under this section; 107.14 (5) publish and disseminate educational information to 107.15 physicians and pharmacists regarding the board and the review 107.16 program; 107.17 (6) adopt and implement procedures designed to ensure the 107.18 confidentiality of any information collected, stored, retrieved, 107.19 assessed, or analyzed by the board, staff to the board, or 107.20 contractors to the review program that identifies individual 107.21 physicians, pharmacists, or recipients; 107.22 (7) establish and implement an ongoing process to (i) 107.23 receive public comment regarding drug utilization review 107.24 criteria and standards, and (ii) consider the comments along 107.25 with other scientific and clinical information in order to 107.26 revise criteria and standards on a timely basis; and 107.27 (8) adopt any rules necessary to carry out this section. 107.28 The board may establish advisory committees. The 107.29 commissioner may contract with appropriate organizations to 107.30 assist the board in carrying out the board's duties. The 107.31 commissioner may enter into contracts for services to develop 107.32 and implement a retrospective and prospective review program. 107.33 The board shall report to the commissioner annually on the 107.34 date the Drug Utilization Review Annual Report is due to the 107.35 Health Care Financing Administration. This report is to cover 107.36 the preceding federal fiscal year. The commissioner shall make 108.1 the report available to the public upon request. The report 108.2 must include information on the activities of the board and the 108.3 program; the effectiveness of implemented interventions; 108.4 administrative costs; and any fiscal impact resulting from the 108.5 program. An honorarium of$50$100 per meeting and 108.6 reimbursement for mileage shall be paid to each board member in 108.7 attendance. 108.8 Sec. 20. Minnesota Statutes 2000, section 256B.0625, 108.9 subdivision 17, is amended to read: 108.10 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 108.11 covers transportation costs incurred solely for obtaining 108.12 emergency medical care or transportation costs incurred by 108.13 nonambulatory persons in obtaining emergency or nonemergency 108.14 medical care when paid directly to an ambulance company, common 108.15 carrier, or other recognized providers of transportation 108.16 services. For the purpose of this subdivision, a person who is 108.17 incapable of transport by taxicab or bus shall be considered to 108.18 be nonambulatory. 108.19 (b) Medical assistance covers special transportation, as 108.20 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 108.21 if the provider receives and maintains a current physician's 108.22 order by the recipient's attending physician certifying that the 108.23 recipient has a physical or mental impairment that would 108.24 prohibit the recipient from safely accessing and using a bus, 108.25 taxi, other commercial transportation, or private automobile. 108.26 Special transportation includes driver-assisted service to 108.27 eligible individuals. Driver-assisted service includes 108.28 passenger pickup at and return to the individual's residence or 108.29 place of business, assistance with admittance of the individual 108.30 to the medical facility, and assistance in passenger securement 108.31 or in securing of wheelchairs or stretchers in the vehicle. The 108.32 commissioner shall establish maximum medical assistance 108.33 reimbursement rates for special transportation services for 108.34 persons who need a wheelchairliftaccessible van or 108.35 stretcher-equipped vehicle and for those who do not need a 108.36 wheelchairliftaccessible van or stretcher-equipped vehicle. 109.1 The average of these two rates per trip must not exceed $15 for 109.2 the base rate and$1.20$1.50 per mile. Special transportation 109.3 provided tononambulatoryambulatory persons who do not need a 109.4 wheelchair lift van or stretcher-equipped vehicle, may be 109.5 reimbursed at a lower rate than special transportation provided 109.6 to persons who need a wheelchair lift van or stretcher-equipped 109.7 vehicle. 109.8 Sec. 21. 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 greater of: (1) the medical assistance 109.14 reimbursement rate in effect on June 30, 2000; or (2) the 109.15 current Medicare reimbursement rate for ambulance services. 109.16 Sec. 22. 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. 23. 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, paragraph (a) or 111.20 under an alternative payment methodology consistent with the 111.21 requirements of United States Code, title 42, section 1392a, 111.22 paragraph (a) and approved by the health care financing 111.23 administration. The alternative payment methodology shall be 111.24 100 percent of cost as determined according to Medicare cost 111.25 principles. 111.26 Sec. 24. Minnesota Statutes 2000, section 256B.0625, 111.27 subdivision 34, is amended to read: 111.28 Subd. 34. [INDIAN HEALTH SERVICES FACILITIES.] Medical 111.29 assistance payments and MinnesotaCare payments to facilities of 111.30 the Indian health service and facilities operated by a tribe or 111.31 tribal organization under funding authorized by United States 111.32 Code, title 25, sections 450f to 450n, or title III of the 111.33 Indian Self-Determination and Education Assistance Act, Public 111.34 Law Number 93-638, for enrollees who are eligible for federal 111.35 financial participation, shall be at the option of the facility 111.36 in accordance with the rate published by the United States 112.1 Assistant Secretary for Health under the authority of United 112.2 States Code, title 42, sections 248(a) and 249(b). General 112.3 assistance medical care payments to facilities of the Indian 112.4 health services and facilities operated by a tribe or tribal 112.5 organization for the provision of outpatient medical care 112.6 services billed after June 30, 1990, must be in accordance with 112.7 the general assistance medical care rates paid for the same 112.8 services when provided in a facility other than a facility of 112.9 the Indian health service or a facility operated by a tribe or 112.10 tribal organization. MinnesotaCare payments for enrollees who 112.11 are not eligible for federal financial participation at 112.12 facilities of the Indian Health Service and facilities operated 112.13 by a tribe or tribal organization for the provision of 112.14 outpatient medical services must be in accordance with the 112.15 medical assistance rates paid for the same services when 112.16 provided in a facility other than a facility of the Indian 112.17 Health Service or a facility operated by a tribe or tribal 112.18 organization. 112.19[EFFECTIVE DATE.] This section is effective the day 112.20 following final enactment. 112.21 Sec. 25. Minnesota Statutes 2000, section 256B.0635, 112.22 subdivision 1, is amended to read: 112.23 Subdivision 1. [INCREASED EMPLOYMENT.]Beginning January112.241, 1998(a) Until June 30, 2002, medical assistance may be paid 112.25 for persons who received MFIP-S or medical assistance for 112.26 families and children in at least three of six months preceding 112.27 the month in which the person became ineligible for MFIP-S or 112.28 medical assistance, if the ineligibility was due to an increase 112.29 in hours of employment or employment income or due to the loss 112.30 of an earned income disregard. In addition, to receive 112.31 continued assistance under this section, persons who received 112.32 medical assistance for families and children but did not receive 112.33 MFIP-S must have had income less than or equal to the assistance 112.34 standard for their family size under the state's AFDC plan in 112.35 effect as of July 16, 1996,as required by the Personal112.36Responsibility and Work Opportunity Reconciliation Act of 1996113.1(PRWORA), Public Law Number 104-193,increased by three percent 113.2 effective July 1, 2000, at the time medical assistance 113.3 eligibility began. A person who is eligible for extended 113.4 medical assistance is entitled to six months of assistance 113.5 without reapplication, unless the assistance unit ceases to 113.6 include a dependent child. For a person under 21 years of age, 113.7 medical assistance may not be discontinued within the six-month 113.8 period of extended eligibility until it has been determined that 113.9 the person is not otherwise eligible for medical assistance. 113.10 Medical assistance may be continued for an additional six months 113.11 if the person meets all requirements for the additional six 113.12 months, according to title XIX of the Social Security Act, as 113.13 amended by section 303 of the Family Support Act of 1988, Public 113.14 Law Number 100-485. 113.15 (b) Beginning July 1, 2002, medical assistance for families 113.16 and children may be paid for persons who were eligible under 113.17 section 256B.055, subdivision 3a, paragraph (b), in at least 113.18 three of six months preceding the month in which the person 113.19 became ineligible under that section if the ineligibility was 113.20 due to an increase in hours of employment or employment income 113.21 or due to the loss of an earned income disregard. A person who 113.22 is eligible for extended medical assistance is entitled to six 113.23 months of assistance without reapplication, unless the 113.24 assistance unit ceases to include a dependent child, except 113.25 medical assistance may not be discontinued for that dependent 113.26 child under 21 years of age within the six-month period of 113.27 extended eligibility until it has been determined that the 113.28 person is not otherwise eligible for medical assistance. 113.29 Medical assistance may be continued for an additional six months 113.30 if the person meets all requirements for the additional six 113.31 months, according to title XIX of the Social Security Act, as 113.32 amended by section 303 of the Family Support Act of 1988, Public 113.33 Law Number 100-485. 113.34[EFFECTIVE DATE.] This section is effective July 1, 2001. 113.35 Sec. 26. Minnesota Statutes 2000, section 256B.0635, 113.36 subdivision 2, is amended to read: 114.1 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.]Beginning114.2January 1, 1998(a) Until June 30, 2002, medical assistance may 114.3 be paid for persons who received MFIP-S or medical assistance 114.4 for families and children in at least three of the six months 114.5 preceding the month in which the person became ineligible for 114.6 MFIP-S or medical assistance, if the ineligibility was the 114.7 result of the collection of child or spousal support under part 114.8 D of title IV of the Social Security Act. In addition, to 114.9 receive continued assistance under this section, persons who 114.10 received medical assistance for families and children but did 114.11 not receive MFIP-S must have had income less than or equal to 114.12 the assistance standard for their family size under the state's 114.13 AFDC plan in effect as of July 16, 1996,as required by the114.14Personal Responsibility and Work Opportunity Reconciliation Act114.15of 1996 (PRWORA), Public Law Number 104-193increased by three 114.16 percent effective July 1, 2000, at the time medical assistance 114.17 eligibility began. A person who is eligible for extended 114.18 medical assistance under this subdivision is entitled to four 114.19 months of assistance without reapplication, unless the 114.20 assistance unit ceases to include a dependent child. For a114.21person under 21 years of age, except medical assistance may not 114.22 be discontinued for that dependent child under 21 years of age 114.23 within the four-month period of extended eligibility until it 114.24 has been determined that the person is not otherwise eligible 114.25 for medical assistance. 114.26 (b) Beginning July 1, 2002, medical assistance for families 114.27 and children may be paid for persons who were eligible under 114.28 section 256B.055, subdivision 3a, paragraph (b), in at least 114.29 three of the six months preceding the month in which the person 114.30 became ineligible under that section if the ineligibility was 114.31 the result of the collection of child or spousal support under 114.32 part D of title IV of the Social Security Act. A person who is 114.33 eligible for extended medical assistance under this subdivision 114.34 is entitled to four months of assistance without reapplication, 114.35 unless the assistance unit ceases to include a dependent child, 114.36 except medical assistance may not be discontinued for that 115.1 dependent child under 21 years of age within the four-month 115.2 period of extended eligibility until it has been determined that 115.3 the person is not otherwise eligible for medical assistance. 115.4[EFFECTIVE DATE.] This section is effective July 1, 2001. 115.5 Sec. 27. [256B.0637] [PRESUMPTIVE ELIGIBILITY FOR CERTAIN 115.6 PERSONS NEEDING TREATMENT FOR BREAST OR CERVICAL CANCER.] 115.7 Medical assistance is available during a presumptive 115.8 eligibility period for persons who meet the criteria in section 115.9 256B.057, subdivision 10. For purposes of this section, the 115.10 presumptive eligibility period begins on the date on which an 115.11 entity designated by the commissioner determines, based on 115.12 preliminary information, that the person meets the criteria in 115.13 section 256B.057, subdivision 10. The presumptive eligibility 115.14 period ends on the day on which a determination is made as to 115.15 the person's eligibility, except that if an application is not 115.16 submitted by the last day of the month following the month 115.17 during which the determination based on preliminary information 115.18 is made, the presumptive eligibility period ends on that last 115.19 day of the month. 115.20 Sec. 28. [256B.195] [HEALTH CARE SAFETY NET PRESERVATION.] 115.21 Subdivision 1. [INTERGOVERNMENTAL TRANSFERS AND RELATED 115.22 PAYMENTS.] (a) This section is contingent on federal approval of 115.23 the intergovernmental transfers and payments to safety net 115.24 hospitals authorized under this section. 115.25 (b) In addition to the percentage contribution paid by a 115.26 county under section 256B.19, subdivision 1, the governmental 115.27 units designated in this subdivision shall be responsible for an 115.28 additional portion of the nonfederal share of medical assistance 115.29 costs attributable to them. For purposes of this section, 115.30 "designated governmental unit" means Hennepin county, Ramsey 115.31 county, or the University of Minnesota. For purposes of this 115.32 section, "nonstate, government hospital" means Hennepin County 115.33 Medical Center, the successor or assignee to St. Paul-Ramsey 115.34 Medical Center as described in section 383A.91, or Fairview 115.35 University Medical Center. 115.36 (c) Effective July 1, 2001, the governmental units 116.1 designated in paragraph (a) shall in total transfer $2,833,333 116.2 on a monthly basis to the state Medicaid agency. The 116.3 commissioner shall allocate this assessment between the 116.4 governmental units based on the proportion of the Medicare upper 116.5 payment limit for each nonstate, government hospital located 116.6 within the governmental unit to the total Medicare upper payment 116.7 limit of all participating hospitals in paragraph (b). 116.8 (d) The commissioner shall distribute the proceeds of this 116.9 intergovernmental transfer, including the federal Medicaid 116.10 match, as follows: 116.11 (1) Proceeds may be no less than the amount of the 116.12 intergovernmental transfer in paragraph (c) multiplied by 1.75. 116.13 (2) The remaining proceeds provide funding for hospital 116.14 charity care aid under section 144.585. The commissioner of 116.15 human services shall work with the commissioner of health to 116.16 assure that hospital charity care aid payments are administered 116.17 in a manner that generates Medicaid matching funds. 116.18 (e) The successor or assignee to St. Paul-Ramsey Medical 116.19 Center shall transfer on a monthly basis to Ramsey county an 116.20 amount equal to the county assessment under paragraph (c). 116.21 Subd. 2. [DETERMINATION OF INTERGOVERNMENTAL TRANSFER 116.22 AMOUNTS.] Medicaid rate changes, including those required to 116.23 obtain federal financial participation under section 62J.692, 116.24 subdivision 8, enacted prior to the effective date of this 116.25 legislation, shall precede the determination of 116.26 intergovernmental transfer amounts determined in this section. 116.27 Participation in the intergovernmental transfer program shall 116.28 not result in the offset of any nonstate, government hospital's 116.29 receipt of Medicaid payment increases. 116.30 Subd. 3. [STATE PLAN AMENDMENTS.] The commissioner shall 116.31 amend the state Medicaid plan as necessary to implement this 116.32 section. 116.33 Subd. 4. [PROPORTIONATE ADJUSTMENTS.] (a) The commissioner 116.34 shall adjust the intergovernmental transfers under subdivision 116.35 1, paragraph (c), and the payments under subdivision 1, 116.36 paragraph (d), upon the approval of the designated governmental 117.1 unit named in subdivision 1, paragraph (b), based on the 117.2 commissioner's determination of Medicare upper payment limits, 117.3 hospital-specific federal limitations on disproportionate share 117.4 payments or to maximize additional federal reimbursements. 117.5 (b) In the event that: (i) federal approval is not 117.6 received for the total intergovernmental transfer amount 117.7 specified in subdivision 1, paragraph (d), or, (ii) federal 117.8 rules regarding the establishment of the 150 percent Medicare 117.9 upper payment limit, section 1102 of the Social Security Act, 117.10 United States Code, title 42, section 1302, enacted on March 13, 117.11 2001, are rescinded or, (iii) the federal 150 percent Medicare 117.12 upper payment limit is reduced to 100 percent, the amount of the 117.13 intergovernmental transfers and Medicaid payments to the 117.14 nonstate, government hospitals named in subdivision 1, paragraph 117.15 (b), shall be adjusted for each hospital based on the proportion 117.16 of each hospital's Medicaid inpatient hospital days to the total 117.17 Medicaid inpatient hospital days provided by all participating 117.18 hospitals. 117.19[EFFECTIVE DATE.] This section is effective July 1, 2001. 117.20 Sec. 29. Minnesota Statutes 2000, section 256B.69, 117.21 subdivision 4, is amended to read: 117.22 Subd. 4. [LIMITATION OF CHOICE.] The commissioner shall 117.23 develop criteria to determine when limitation of choice may be 117.24 implemented in the experimental counties. The criteria shall 117.25 ensure that all eligible individuals in the county have 117.26 continuing access to the full range of medical assistance 117.27 services as specified in subdivision 6. The commissioner shall 117.28 exempt the following persons from participation in the project, 117.29 in addition to those who do not meet the criteria for limitation 117.30 of choice: 117.31 (1) persons eligible for medical assistance according to 117.32 section 256B.055, subdivision 1; 117.33 (2) persons eligible for medical assistance due to 117.34 blindness or disability as determined by the social security 117.35 administration or the state medical review team, unless: 117.36 (i) they are 65 years of age or older,; or 118.1 (ii) they reside in Itasca county or they reside in a 118.2 county in which the commissioner conducts a pilot project under 118.3 a waiver granted pursuant to section 1115 of the Social Security 118.4 Act; 118.5 (3) recipients who currently have private coverage through 118.6 a health maintenance organization; 118.7 (4) recipients who are eligible for medical assistance by 118.8 spending down excess income for medical expenses other than the 118.9 nursing facility per diem expense; 118.10 (5) recipients who receive benefits under the Refugee 118.11 Assistance Program, established under United States Code, title 118.12 8, section 1522(e); 118.13 (6) children who are both determined to be severely 118.14 emotionally disturbed and receiving case management services 118.15 according to section 256B.0625, subdivision 20;and118.16 (7) adults who are both determined to be seriously and 118.17 persistently mentally ill and received case management services 118.18 according to section 256B.0625, subdivision 20; and 118.19 (8) persons eligible for medical assistance according to 118.20 section 256B.057, subdivision 10. 118.21 Children under age 21 who are in foster placement may enroll in 118.22 the project on an elective basis. Individuals excluded under 118.23 clauses (6) and (7) may choose to enroll on an elective basis. 118.24 The commissioner may allow persons with a one-month spenddown 118.25 who are otherwise eligible to enroll to voluntarily enroll or 118.26 remain enrolled, if they elect to prepay their monthly spenddown 118.27 to the state.Beginning on or after July 1, 1997,The 118.28 commissioner may require those individuals to enroll in the 118.29 prepaid medical assistance program who otherwise would have been 118.30 excluded under clauses (1)and, (3), and (8), and under 118.31 Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L. 118.32 Before limitation of choice is implemented, eligible individuals 118.33 shall be notified and after notification, shall be allowed to 118.34 choose only among demonstration providers. The commissioner may 118.35 assign an individual with private coverage through a health 118.36 maintenance organization, to the same health maintenance 119.1 organization for medical assistance coverage, if the health 119.2 maintenance organization is under contract for medical 119.3 assistance in the individual's county of residence. After 119.4 initially choosing a provider, the recipient is allowed to 119.5 change that choice only at specified times as allowed by the 119.6 commissioner. If a demonstration provider ends participation in 119.7 the project for any reason, a recipient enrolled with that 119.8 provider must select a new provider but may change providers 119.9 without cause once more within the first 60 days after 119.10 enrollment with the second provider. 119.11 Sec. 30. Minnesota Statutes 2000, section 256B.69, 119.12 subdivision 5, is amended to read: 119.13 Subd. 5. [PROSPECTIVE PER CAPITA PAYMENT.] The 119.14 commissioner shall establish the method and amount of payments 119.15 for services. The commissioner shall annually contract with 119.16 demonstration providers to provide services consistent with 119.17 these established methods and amounts for payment. Payment 119.18 rates established by the commissioner must be within the limits 119.19 of available appropriations. 119.20 If allowed by the commissioner, a demonstration provider 119.21 may contract with an insurer, health care provider, nonprofit 119.22 health service plan corporation, or the commissioner, to provide 119.23 insurance or similar protection against the cost of care 119.24 provided by the demonstration provider or to provide coverage 119.25 against the risks incurred by demonstration providers under this 119.26 section. The recipients enrolled with a demonstration provider 119.27 are a permissible group under group insurance laws and chapter 119.28 62C, the Nonprofit Health Service Plan Corporations Act. Under 119.29 this type of contract, the insurer or corporation may make 119.30 benefit payments to a demonstration provider for services 119.31 rendered or to be rendered to a recipient. Any insurer or 119.32 nonprofit health service plan corporation licensed to do 119.33 business in this state is authorized to provide this insurance 119.34 or similar protection. 119.35 Payments to providers participating in the project are 119.36 exempt from the requirements of sections 256.966 and 256B.03, 120.1 subdivision 2. The commissioner shall complete development of 120.2 capitation rates for payments before delivery of services under 120.3 this section is begun. For payments made during calendar year 120.4 1990 and later years, the commissioner shall contract with an 120.5 independent actuary to establish prepayment rates. 120.6 By January 15, 1996, the commissioner shall report to the 120.7 legislature on the methodology used to allocate to participating 120.8 counties available administrative reimbursement for advocacy and 120.9 enrollment costs. The report shall reflect the commissioner's 120.10 judgment as to the adequacy of the funds made available and of 120.11 the methodology for equitable distribution of the funds. The 120.12 commissioner must involve participating counties in the 120.13 development of the report. 120.14 Sec. 31. Minnesota Statutes 2000, section 256B.69, 120.15 subdivision 5b, is amended to read: 120.16 Subd. 5b. [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 120.17 prepaid medical assistance and general assistance medical care 120.18 program contract rates set by the commissioner under subdivision 120.19 5 and effective on or after January 1, 1998, capitation rates 120.20 for nonmetropolitan counties shall on a weighted average be no 120.21 less than 88 percent of the capitation rates for metropolitan 120.22 counties, excluding Hennepin county. The commissioner shall 120.23 make a pro rata adjustment in capitation rates paid to counties 120.24 other than nonmetropolitan counties in order to make this 120.25 provision budget neutral. 120.26 (b) For prepaid medical assistance program contract rates 120.27 set by the commissioner under subdivision 5 and effective on or 120.28 after January 1,20012002, capitation rates for nonmetropolitan 120.29 counties shall, on a weighted average, be no less than8995 120.30 percent of the capitation rates for metropolitan counties, 120.31 excluding Hennepin county. The commissioner shall make a pro 120.32 rata adjustment in capitation rates paid to Hennepin county in 120.33 order to make the portion of the increase between 89 and 95 120.34 percent budget neutral. 120.35 (c) This subdivision shall not affect the nongeographically 120.36 based risk adjusted rates established under section 62Q.03, 121.1 subdivision 5a, paragraph (f). 121.2 (d) The commissioner shall require prepaid health plans to 121.3 use all revenue received from the increase in capitation rates 121.4 for nonmetropolitan counties from 89 to no less than 95 percent 121.5 of the capitation rate for metropolitan counties, excluding 121.6 Hennepin county, to increase reimbursement rates, effective 121.7 January 1, 2002, for providers under contract with the prepaid 121.8 health plan to serve enrollees from nonmetropolitan counties. 121.9 Sec. 32. Minnesota Statutes 2000, section 256B.69, is 121.10 amended by adding a subdivision to read: 121.11 Subd. 6c. [DENTAL SERVICES DEMONSTRATION PROJECT.] The 121.12 commissioner shall establish a dental services demonstration 121.13 project in Crow Wing, Todd, Morrison, Wadena, and Cass counties 121.14 for provision of dental services to medical assistance, general 121.15 assistance medical care, and MinnesotaCare recipients. The 121.16 commissioner may contract on a prospective per capita payment 121.17 basis for these dental services with an organization licensed 121.18 under chapter 62C, 62D, or 62N in accordance with section 121.19 256B.037 or may establish and administer a fee-for-service 121.20 system for the reimbursement of dental services. 121.21[EFFECTIVE DATE.] This section is effective January 1, 2002. 121.22 Sec. 33. Minnesota Statutes 2000, section 256B.75, is 121.23 amended to read: 121.24 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 121.25 (a) For outpatient hospital facility fee payments for 121.26 services rendered on or after October 1, 1992, the commissioner 121.27 of human services shall pay the lower of (1) submitted charge, 121.28 or (2) 32 percent above the rate in effect on June 30, 1992, 121.29 except for those services for which there is a federal maximum 121.30 allowable payment. Effective for services rendered on or after 121.31 January 1, 2000, payment rates for nonsurgical outpatient 121.32 hospital facility fees and emergency room facility fees shall be 121.33 increased by eight percent over the rates in effect on December 121.34 31, 1999, except for those services for which there is a federal 121.35 maximum allowable payment. Services for which there is a 121.36 federal maximum allowable payment shall be paid at the lower of 122.1 (1) submitted charge, or (2) the federal maximum allowable 122.2 payment. Total aggregate payment for outpatient hospital 122.3 facility fee services shall not exceed the Medicare upper 122.4 limit. If it is determined that a provision of this section 122.5 conflicts with existing or future requirements of the United 122.6 States government with respect to federal financial 122.7 participation in medical assistance, the federal requirements 122.8 prevail. The commissioner may, in the aggregate, prospectively 122.9 reduce payment rates to avoid reduced federal financial 122.10 participation resulting from rates that are in excess of the 122.11 Medicare upper limitations. 122.12 (b) Notwithstanding paragraph (a), payment for outpatient, 122.13 emergency, and ambulatory surgery hospital facility fee services 122.14 for critical access hospitals designated under section 144.1483, 122.15 clause (11), shall be paid on a cost-based payment system that 122.16 is based on the cost-finding methods and allowable costs of the 122.17 Medicare program. 122.18 (c) Effective for services provided on or after July 1, 122.19 2002, rates that are based on the Medicare outpatient 122.20 prospective payment system shall be replaced by a budget neutral 122.21 prospective payment system that is derived using medical 122.22 assistance data. The department shall provide a proposal to the 122.23 2002 legislature to define and implement this provision. 122.24 Sec. 34. Minnesota Statutes 2000, section 256B.76, is 122.25 amended to read: 122.26 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 122.27 (a) Effective for services rendered on or after October 1, 122.28 1992, the commissioner shall make payments for physician 122.29 services as follows: 122.30 (1) payment for level one Health Care Finance 122.31 Administration's common procedural coding system (HCPCS) codes 122.32 titled "office and other outpatient services," "preventive 122.33 medicine new and established patient," "delivery, antepartum, 122.34 and postpartum care," "critical care,"Caesareancesarean 122.35 delivery and pharmacologic management provided to psychiatric 122.36 patients, and HCPCS level three codes for enhanced services for 123.1 prenatal high risk, shall be paid at the lower of (i) submitted 123.2 charges, or (ii) 25 percent above the rate in effect on June 30, 123.3 1992. If the rate on any procedure code within these categories 123.4 is different than the rate that would have been paid under the 123.5 methodology in section 256B.74, subdivision 2, then the larger 123.6 rate shall be paid; 123.7 (2) payments for all other services shall be paid at the 123.8 lower of (i) submitted charges, or (ii) 15.4 percent above the 123.9 rate in effect on June 30, 1992; 123.10 (3) all physician rates shall be converted from the 50th 123.11 percentile of 1982 to the 50th percentile of 1989, less the 123.12 percent in aggregate necessary to equal the above increases 123.13 except that payment rates for home health agency services shall 123.14 be the rates in effect on September 30, 1992; 123.15 (4) effective for services rendered on or after January 1, 123.16 2000, payment rates for physician and professional services 123.17 shall be increased by three percent over the rates in effect on 123.18 December 31, 1999, except for home health agency and family 123.19 planning agency services; and 123.20 (5) the increases in clause (4) shall be implemented 123.21 January 1, 2000, for managed care. 123.22 (b) Effective for services rendered on or after October 1, 123.23 1992, the commissioner shall make payments for dental services 123.24 as follows: 123.25 (1) dental services shall be paid at the lower of (i) 123.26 submitted charges, or (ii) 25 percent above the rate in effect 123.27 on June 30, 1992; 123.28 (2) dental rates shall be converted from the 50th 123.29 percentile of 1982 to the 50th percentile of 1989, less the 123.30 percent in aggregate necessary to equal the above increases; 123.31 (3) effective for services rendered on or after January 1, 123.32 2000, payment rates for dental services shall be increased by 123.33 three percent over the rates in effect on December 31, 1999; 123.34 (4) the commissioner shall award grants to community 123.35 clinics or other nonprofit community organizations, political 123.36 subdivisions, professional associations, or other organizations 124.1 that demonstrate the ability to provide dental services 124.2 effectively to public program recipients. Grants may be used to 124.3 fund the costs related to coordinating access for recipients, 124.4 developing and implementing patient care criteria, upgrading or 124.5 establishing new facilities, acquiring furnishings or equipment, 124.6 recruiting new providers, or other development costs that will 124.7 improve access to dental care in a region. In awarding grants, 124.8 the commissioner shall give priority to applicants that plan to 124.9 serve areas of the state in which the number of dental providers 124.10 is not currently sufficient to meet the needs of recipients of 124.11 public programs or uninsured individuals. The commissioner 124.12 shall consider the following in awarding the grants: (i) 124.13 potential to successfully increase access to an underserved 124.14 population; (ii) the ability to raise matching funds; (iii) the 124.15 long-term viability of the project to improve access beyond the 124.16 period of initial funding; (iv) the efficiency in the use of the 124.17 funding; and (v) the experience of the proposers in providing 124.18 services to the target population. 124.19 The commissioner shall monitor the grants and may terminate 124.20 a grant if the grantee does not increase dental access for 124.21 public program recipients. The commissioner shall consider 124.22 grants for the following: 124.23 (i) implementation of new programs or continued expansion 124.24 of current access programs that have demonstrated success in 124.25 providing dental services in underserved areas; 124.26 (ii) a pilot program for utilizing hygienists outside of a 124.27 traditional dental office to provide dental hygiene services; 124.28 and 124.29 (iii) a program that organizes a network of volunteer 124.30 dentists, establishes a system to refer eligible individuals to 124.31 volunteer dentists, and through that network provides donated 124.32 dental care services to public program recipients or uninsured 124.33 individuals. 124.34 (5) beginning October 1, 1999, the payment for tooth 124.35 sealants and fluoride treatments shall be the lower of (i) 124.36 submitted charge, or (ii) 80 percent of median 1997 charges;and125.1 (6) the increases listed in clauses (3) and (5) shall be 125.2 implemented January 1, 2000, for managed care; and 125.3 (7) effective for services provided on or after October 1, 125.4 2001, payment for diagnostic examinations and dental x-rays 125.5 provided to children under age 21 shall be the lower of (i) the 125.6 submitted charge, or (ii) 85 percent of median 1999 charges. 125.7 (c) Effective for dental services rendered on or after July 125.8 1, 2001, the commissioner may increase reimbursements to 125.9 dentists and dental clinics deemed by the commissioner to be 125.10 critical access dental providers. Reimbursement to a critical 125.11 access dental provider may be increased by not more than 50 125.12 percent above the reimbursement rate that would otherwise be 125.13 paid to the provider. Payments to health plan companies shall 125.14 be adjusted to reflect increased reimbursements to critical 125.15 access dental providers as approved by the commissioner. In 125.16 determining which dentists and dental clinics shall be deemed 125.17 critical access dental providers, the commissioner shall review: 125.18 (1) the utilization rate in the service area in which the 125.19 dentist or dental clinic operates for dental services to 125.20 patients covered by medical assistance, general assistance 125.21 medical care, or MinnesotaCare as their primary source of 125.22 coverage; 125.23 (2) the level of services provided by the dentist or dental 125.24 clinic to patients covered by medical assistance, general 125.25 assistance medical care, or MinnesotaCare as their primary 125.26 source of coverage; and 125.27 (3) whether the level of services provided by the dentist 125.28 or dental clinic is critical to maintaining adequate levels of 125.29 patient access within the service area. 125.30 In the absence of a critical access dental provider in a service 125.31 area, the commissioner may designate a dentist or dental clinic 125.32 as a critical access dental provider if the dentist or dental 125.33 clinic is willing to provide care to patients covered by medical 125.34 assistance, general assistance medical care, or MinnesotaCare at 125.35 a level which significantly increases access to dental care in 125.36 the service area. 126.1 (d) An entity that operates both a Medicare certified 126.2 comprehensive outpatient rehabilitation facility and a facility 126.3 which was certified prior to January 1, 1993, that is licensed 126.4 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 126.5 whom at least 33 percent of the clients receiving rehabilitation 126.6 services in the most recent calendar year are medical assistance 126.7 recipients, shall be reimbursed by the commissioner for 126.8 rehabilitation services at rates that are 38 percent greater 126.9 than the maximum reimbursement rate allowed under paragraph (a), 126.10 clause (2), when those services are (1) provided within the 126.11 comprehensive outpatient rehabilitation facility and (2) 126.12 provided to residents of nursing facilities owned by the entity. 126.13[EFFECTIVE DATE.] This section is effective the day 126.14 following final enactment. 126.15 Sec. 35. [256B.78] [MEDICAL ASSISTANCE DEMONSTRATION 126.16 PROJECT FOR FAMILY PLANNING SERVICES.] 126.17 (a) The commissioner of human services shall establish a 126.18 medical assistance demonstration project to determine whether 126.19 improved access to coverage of prepregnancy family planning 126.20 services reduces medical assistance and MFIP costs. 126.21 (b) This section is effective upon federal approval of the 126.22 demonstration project. 126.23 Sec. 36. Minnesota Statutes 2000, section 256D.03, 126.24 subdivision 3, is amended to read: 126.25 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 126.26 (a) General assistance medical care may be paid for any person 126.27 who is not eligible for medical assistance under chapter 256B, 126.28 including eligibility for medical assistance based on a 126.29 spenddown of excess income according to section 256B.056, 126.30 subdivision 5, or MinnesotaCare as defined in paragraph (b), 126.31 except as provided in paragraph (c); and: 126.32 (1) who is receiving assistance under section 256D.05, 126.33 except for families with children who are eligible under 126.34 Minnesota family investment program-statewide (MFIP-S), who is 126.35 having a payment made on the person's behalf under sections 126.36 256I.01 to 256I.06, or who resides in group residential housing 127.1 as defined in chapter 256I and can meet a spenddown using the 127.2 cost of remedial services received through group residential 127.3 housing; or 127.4 (2)(i) who is a resident of Minnesota; and whose equity in 127.5 assets is not in excess of $1,000 per assistance unit. Exempt 127.6 assets, the reduction of excess assets, and the waiver of excess 127.7 assets must conform to the medical assistance program in chapter 127.8 256B, with the following exception: the maximum amount of 127.9 undistributed funds in a trust that could be distributed to or 127.10 on behalf of the beneficiary by the trustee, assuming the full 127.11 exercise of the trustee's discretion under the terms of the 127.12 trust, must be applied toward the asset maximum; and 127.13 (ii) who has countable incomenot in excess of the127.14assistance standards established in section 256B.056,127.15subdivision 4that does not exceed 133 and 1/3 percent of the 127.16 AFDC income standard in effect under the July 16, 1996, AFDC 127.17 state plan, increased by three percent, or whose excess income 127.18 is spent down according to section 256B.056, subdivision 5, 127.19 using a six-month budget period. The method for calculating 127.20 earned income disregards and deductions for a person who resides 127.21 with a dependent child under age 21 shall follow section 127.22 256B.056, subdivision 1a. However, if a disregard of $30 and 127.23 one-third of the remainder has been applied to the wage earner's 127.24 income, the disregard shall not be applied again until the wage 127.25 earner's income has not been considered in an eligibility 127.26 determination for general assistance, general assistance medical 127.27 care, medical assistance, or MFIP-S for 12 consecutive months. 127.28 The earned income and work expense deductions for a person who 127.29 does not reside with a dependent child under age 21 shall be the 127.30 same as the method used to determine eligibility for a person 127.31 under section 256D.06, subdivision 1, except the disregard of 127.32 the first $50 of earned income is not allowed; 127.33 (3) who would be eligible for medical assistance except 127.34 that the person resides in a facility that is determined by the 127.35 commissioner or the federal Health Care Financing Administration 127.36 to be an institution for mental diseases; or 128.1 (4) who is ineligible for medical assistance under chapter 128.2 256B or general assistance medical care under any other 128.3 provision of this section, and is receiving care and 128.4 rehabilitation services from a nonprofit center established to 128.5 serve victims of torture. These individuals are eligible for 128.6 general assistance medical care only for the period during which 128.7 they are receiving services from the center. During this period 128.8 of eligibility, individuals eligible under this clause shall not 128.9 be required to participate in prepaid general assistance medical 128.10 care. 128.11 (b) Beginning January 1, 2000, applicants or recipients who 128.12 meet all eligibility requirements of MinnesotaCare as defined in 128.13 sections 256L.01 to 256L.16, and are: 128.14 (i) adults with dependent children under 21 whose gross 128.15 family income is equal to or less than 275 percent of the 128.16 federal poverty guidelines; or 128.17 (ii) adults without children with earned income and whose 128.18 family gross income is between 75 percent of the federal poverty 128.19 guidelines and the amount set by section 256L.04, subdivision 7, 128.20 shall be terminated from general assistance medical care upon 128.21 enrollment in MinnesotaCare. 128.22 (c) For services rendered on or after July 1, 1997, 128.23 eligibility is limited to one month prior to application if the 128.24 person is determined eligible in the prior month. A 128.25 redetermination of eligibility must occur every 12 months. 128.26 Beginning January 1, 2000, Minnesota health care program 128.27 applications completed by recipients and applicants who are 128.28 persons described in paragraph (b), may be returned to the 128.29 county agency to be forwarded to the department of human 128.30 services or sent directly to the department of human services 128.31 for enrollment in MinnesotaCare. If all other eligibility 128.32 requirements of this subdivision are met, eligibility for 128.33 general assistance medical care shall be available in any month 128.34 during which a MinnesotaCare eligibility determination and 128.35 enrollment are pending. Upon notification of eligibility for 128.36 MinnesotaCare, notice of termination for eligibility for general 129.1 assistance medical care shall be sent to an applicant or 129.2 recipient. If all other eligibility requirements of this 129.3 subdivision are met, eligibility for general assistance medical 129.4 care shall be available until enrollment in MinnesotaCare 129.5 subject to the provisions of paragraph (e). 129.6 (d) The date of an initial Minnesota health care program 129.7 application necessary to begin a determination of eligibility 129.8 shall be the date the applicant has provided a name, address, 129.9 and social security number, signed and dated, to the county 129.10 agency or the department of human services. If the applicant is 129.11 unable to provide an initial application when health care is 129.12 delivered due to a medical condition or disability, a health 129.13 care provider may act on the person's behalf to complete the 129.14 initial application. The applicant must complete the remainder 129.15 of the application and provide necessary verification before 129.16 eligibility can be determined. The county agency must assist 129.17 the applicant in obtaining verification if necessary. On the 129.18 basis of information provided on the completed application, an 129.19 applicant who meets the following criteria shall be determined 129.20 eligible beginning in the month of application: 129.21 (1) has gross income less than 90 percent of the applicable 129.22 income standard; 129.23 (2) has liquid assets that total within $300 of the asset 129.24 standard; 129.25 (3) does not reside in a long-term care facility; and 129.26 (4) meets all other eligibility requirements. 129.27 The applicant must provide all required verifications within 30 129.28 days' notice of the eligibility determination or eligibility 129.29 shall be terminated. 129.30 (e) County agencies are authorized to use all automated 129.31 databases containing information regarding recipients' or 129.32 applicants' income in order to determine eligibility for general 129.33 assistance medical care or MinnesotaCare. Such use shall be 129.34 considered sufficient in order to determine eligibility and 129.35 premium payments by the county agency. 129.36 (f) General assistance medical care is not available for a 130.1 person in a correctional facility unless the person is detained 130.2 by law for less than one year in a county correctional or 130.3 detention facility as a person accused or convicted of a crime, 130.4 or admitted as an inpatient to a hospital on a criminal hold 130.5 order, and the person is a recipient of general assistance 130.6 medical care at the time the person is detained by law or 130.7 admitted on a criminal hold order and as long as the person 130.8 continues to meet other eligibility requirements of this 130.9 subdivision. 130.10 (g) General assistance medical care is not available for 130.11 applicants or recipients who do not cooperate with the county 130.12 agency to meet the requirements of medical assistance. General 130.13 assistance medical care is limited to payment of emergency 130.14 services only for applicants or recipients as described in 130.15 paragraph (b), whose MinnesotaCare coverage is denied or 130.16 terminated for nonpayment of premiums as required by sections 130.17 256L.06 and 256L.07. 130.18 (h) In determining the amount of assets of an individual, 130.19 there shall be included any asset or interest in an asset, 130.20 including an asset excluded under paragraph (a), that was given 130.21 away, sold, or disposed of for less than fair market value 130.22 within the 60 months preceding application for general 130.23 assistance medical care or during the period of eligibility. 130.24 Any transfer described in this paragraph shall be presumed to 130.25 have been for the purpose of establishing eligibility for 130.26 general assistance medical care, unless the individual furnishes 130.27 convincing evidence to establish that the transaction was 130.28 exclusively for another purpose. For purposes of this 130.29 paragraph, the value of the asset or interest shall be the fair 130.30 market value at the time it was given away, sold, or disposed 130.31 of, less the amount of compensation received. For any 130.32 uncompensated transfer, the number of months of ineligibility, 130.33 including partial months, shall be calculated by dividing the 130.34 uncompensated transfer amount by the average monthly per person 130.35 payment made by the medical assistance program to skilled 130.36 nursing facilities for the previous calendar year. The 131.1 individual shall remain ineligible until this fixed period has 131.2 expired. The period of ineligibility may exceed 30 months, and 131.3 a reapplication for benefits after 30 months from the date of 131.4 the transfer shall not result in eligibility unless and until 131.5 the period of ineligibility has expired. The period of 131.6 ineligibility begins in the month the transfer was reported to 131.7 the county agency, or if the transfer was not reported, the 131.8 month in which the county agency discovered the transfer, 131.9 whichever comes first. For applicants, the period of 131.10 ineligibility begins on the date of the first approved 131.11 application. 131.12 (i) When determining eligibility for any state benefits 131.13 under this subdivision, the income and resources of all 131.14 noncitizens shall be deemed to include their sponsor's income 131.15 and resources as defined in the Personal Responsibility and Work 131.16 Opportunity Reconciliation Act of 1996, title IV, Public Law 131.17 Number 104-193, sections 421 and 422, and subsequently set out 131.18 in federal rules. 131.19 (j)(1) An undocumented noncitizen or a nonimmigrant is 131.20 ineligible for general assistance medical care other than 131.21 emergency services. For purposes of this subdivision, a 131.22 nonimmigrant is an individual in one or more of the classes 131.23 listed in United States Code, title 8, section 1101(a)(15), and 131.24 an undocumented noncitizen is an individual who resides in the 131.25 United States without the approval or acquiescence of the 131.26 Immigration and Naturalization Service. 131.27 (2) This paragraph does not apply to a child under age 18, 131.28 to a Cuban or Haitian entrant as defined in Public Law Number 131.29 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 131.30 aged, blind, or disabled as defined in Code of Federal 131.31 Regulations, title 42, sections 435.520, 435.530, 435.531, 131.32 435.540, and 435.541, or effective October 1, 1998, to an 131.33 individual eligible for general assistance medical care under 131.34 paragraph (a), clause (4), who cooperates with the Immigration 131.35 and Naturalization Service to pursue any applicable immigration 131.36 status, including citizenship, that would qualify the individual 132.1 for medical assistance with federal financial participation. 132.2 (k) For purposes of paragraphs (g) and (j), "emergency 132.3 services" has the meaning given in Code of Federal Regulations, 132.4 title 42, section 440.255(b)(1), except that it also means 132.5 services rendered because of suspected or actual pesticide 132.6 poisoning. 132.7 (l) Notwithstanding any other provision of law, a 132.8 noncitizen who is ineligible for medical assistance due to the 132.9 deeming of a sponsor's income and resources, is ineligible for 132.10 general assistance medical care. 132.11 Sec. 37. Minnesota Statutes 2000, section 256D.03, 132.12 subdivision 4, is amended to read: 132.13 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 132.14 For a person who is eligible under subdivision 3, paragraph (a), 132.15 clause (3), general assistance medical care covers, except as 132.16 provided in paragraph (c): 132.17 (1) inpatient hospital services; 132.18 (2) outpatient hospital services; 132.19 (3) services provided by Medicare certified rehabilitation 132.20 agencies; 132.21 (4) prescription drugs and other products recommended 132.22 through the process established in section 256B.0625, 132.23 subdivision 13; 132.24 (5) equipment necessary to administer insulin and 132.25 diagnostic supplies and equipment for diabetics to monitor blood 132.26 sugar level; 132.27 (6) eyeglasses and eye examinations provided by a physician 132.28 or optometrist; 132.29 (7) hearing aids; 132.30 (8) prosthetic devices; 132.31 (9) laboratory and X-ray services; 132.32 (10) physician's services; 132.33 (11) medical transportation; 132.34 (12) chiropractic services as covered under the medical 132.35 assistance program; 132.36 (13) podiatric services; 133.1 (14) dental services; 133.2 (15) outpatient services provided by a mental health center 133.3 or clinic that is under contract with the county board and is 133.4 established under section 245.62; 133.5 (16) day treatment services for mental illness provided 133.6 under contract with the county board; 133.7 (17) prescribed medications for persons who have been 133.8 diagnosed as mentally ill as necessary to prevent more 133.9 restrictive institutionalization; 133.10 (18) psychological services, medical supplies and 133.11 equipment, and Medicare premiums, coinsurance and deductible 133.12 payments; 133.13 (19) medical equipment not specifically listed in this 133.14 paragraph when the use of the equipment will prevent the need 133.15 for costlier services that are reimbursable under this 133.16 subdivision; 133.17 (20) services performed by a certified pediatric nurse 133.18 practitioner, a certified family nurse practitioner, a certified 133.19 adult nurse practitioner, a certified obstetric/gynecological 133.20 nurse practitioner, a certified neonatal nurse practitioner, or 133.21 a certified geriatric nurse practitioner in independent 133.22 practice, if (1) the service is otherwise covered under this 133.23 chapter as a physician service, (2) the service provided on an 133.24 inpatient basis is not included as part of the cost for 133.25 inpatient services included in the operating payment rate, and 133.26 (3) the service is within the scope of practice of the nurse 133.27 practitioner's license as a registered nurse, as defined in 133.28 section 148.171; 133.29 (21) services of a certified public health nurse or a 133.30 registered nurse practicing in a public health nursing clinic 133.31 that is a department of, or that operates under the direct 133.32 authority of, a unit of government, if the service is within the 133.33 scope of practice of the public health nurse's license as a 133.34 registered nurse, as defined in section 148.171; and 133.35 (22) telemedicine consultations, to the extent they are 133.36 covered under section 256B.0625, subdivision 3b. 134.1 (b) Except as provided in paragraph (c), for a recipient 134.2 who is eligible under subdivision 3, paragraph (a), clause (1) 134.3 or (2), general assistance medical care covers the services 134.4 listed in paragraph (a) with the exception of special 134.5 transportation services. 134.6 (c) Gender reassignment surgery and related services are 134.7 not covered services under this subdivision unless the 134.8 individual began receiving gender reassignment services prior to 134.9 July 1, 1995. 134.10 (d) In order to contain costs, the commissioner of human 134.11 services shall select vendors of medical care who can provide 134.12 the most economical care consistent with high medical standards 134.13 and shall where possible contract with organizations on a 134.14 prepaid capitation basis to provide these services. The 134.15 commissioner shall consider proposals by counties and vendors 134.16 for prepaid health plans, competitive bidding programs, block 134.17 grants, or other vendor payment mechanisms designed to provide 134.18 services in an economical manner or to control utilization, with 134.19 safeguards to ensure that necessary services are provided. 134.20 Before implementing prepaid programs in counties with a county 134.21 operated or affiliated public teaching hospital or a hospital or 134.22 clinic operated by the University of Minnesota, the commissioner 134.23 shall consider the risks the prepaid program creates for the 134.24 hospital and allow the county or hospital the opportunity to 134.25 participate in the program in a manner that reflects the risk of 134.26 adverse selection and the nature of the patients served by the 134.27 hospital, provided the terms of participation in the program are 134.28 competitive with the terms of other participants considering the 134.29 nature of the population served. Payment for services provided 134.30 pursuant to this subdivision shall be as provided to medical 134.31 assistance vendors of these services under sections 256B.02, 134.32 subdivision 8, and 256B.0625. For payments made during fiscal 134.33 year 1990 and later years, the commissioner shall consult with 134.34 an independent actuary in establishing prepayment rates, but 134.35 shall retain final control over the rate methodology. Payment 134.36 rates established by the commissioner must be within the limits 135.1 of available appropriations. Notwithstanding the provisions of 135.2 subdivision 3, an individual who becomes ineligible for general 135.3 assistance medical care because of failure to submit income 135.4 reports or recertification forms in a timely manner, shall 135.5 remain enrolled in the prepaid health plan and shall remain 135.6 eligible for general assistance medical care coverage through 135.7 the last day of the month in which the enrollee became 135.8 ineligible for general assistance medical care. 135.9 (e) There shall be no copayment required of any recipient 135.10 of benefits for any services provided under this subdivision. A 135.11 hospital receiving a reduced payment as a result of this section 135.12 may apply the unpaid balance toward satisfaction of the 135.13 hospital's bad debts. 135.14 (f) Any county may, from its own resources, provide medical 135.15 payments for which state payments are not made. 135.16 (g) Chemical dependency services that are reimbursed under 135.17 chapter 254B must not be reimbursed under general assistance 135.18 medical care. 135.19 (h) The maximum payment for new vendors enrolled in the 135.20 general assistance medical care program after the base year 135.21 shall be determined from the average usual and customary charge 135.22 of the same vendor type enrolled in the base year. 135.23 (i) The conditions of payment for services under this 135.24 subdivision are the same as the conditions specified in rules 135.25 adopted under chapter 256B governing the medical assistance 135.26 program, unless otherwise provided by statute or rule. 135.27 Sec. 38. Minnesota Statutes 2000, section 256J.31, 135.28 subdivision 12, is amended to read: 135.29 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 135.30 participant who is not in vendor payment status may discontinue 135.31 receipt of the cash assistance portion of the MFIP assistance 135.32 grant and retain eligibility for child care assistance under 135.33 section 119B.05and for medical assistance under sections135.34256B.055, subdivision 3a, and 256B.0635. For the months a 135.35 participant chooses to discontinue the receipt of the cash 135.36 portion of the MFIP grant, the assistance unit accrues months of 136.1 eligibility to be applied toward eligibility for child care 136.2 under section 119B.05and for medical assistance under sections136.3256B.055, subdivision 3a, and 256B.0635. 136.4[EFFECTIVE DATE.] This section is effective July 1, 2002. 136.5 Sec. 39. Minnesota Statutes 2000, section 256K.03, 136.6 subdivision 1, is amended to read: 136.7 Subdivision 1. [NOTIFICATION OF PROGRAM.] Except for the 136.8 provisions in this section, the provisions for the MFIP 136.9 application process shall be followed. Within two days after 136.10 receipt of a completed combined application form, the county 136.11 agency must refer to the provider the applicant who meets the 136.12 conditions under section 256K.02, and notify the applicant in 136.13 writing of the program including the following provisions: 136.14 (1) notification that, as part of the application process, 136.15 applicants are required to attend orientation, to be followed 136.16 immediately by a job search; 136.17 (2) the program provider, the date, time, and location of 136.18 the scheduled program orientation; 136.19 (3) the procedures for qualifying for and receiving 136.20 benefits under the program; 136.21 (4) the immediate availability of supportive services, 136.22 including, but not limited to, child care, transportation, 136.23medical assistance,and other work-related aid; and 136.24 (5) the rights, responsibilities, and obligations of 136.25 participants in the program, including, but not limited to, the 136.26 grounds for exemptions and deferrals, the consequences for 136.27 refusing or failing to participate fully, and the appeal process. 136.28[EFFECTIVE DATE.] This section is effective July 1, 2002. 136.29 Sec. 40. Minnesota Statutes 2000, section 256K.07, is 136.30 amended to read: 136.31 256K.07 [ELIGIBILITY FOR FOOD STAMPS, MEDICAL ASSISTANCE,136.32 AND CHILD CARE.] 136.33 The participant shall be treated as an MFIP recipient for 136.34 food stamps, medical assistance,and child care eligibility 136.35 purposes. The participant who leaves the program as a result of 136.36 increased earnings from employment shall be eligible for 137.1transitional medical assistance andchild care without regard to 137.2 MFIP receipt in three of the six months preceding ineligibility. 137.3[EFFECTIVE DATE.] This section is effective July 1, 2002. 137.4 Sec. 41. Minnesota Statutes 2000, section 256L.06, 137.5 subdivision 3, is amended to read: 137.6 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 137.7 Premiums are dedicated to the commissioner for MinnesotaCare. 137.8 (b) The commissioner shall develop and implement procedures 137.9 to: (1) require enrollees to report changes in income; (2) 137.10 adjust sliding scale premium payments, based upon changes in 137.11 enrollee income; and (3) disenroll enrollees from MinnesotaCare 137.12 for failure to pay required premiums. Failure to pay includes 137.13 payment with a dishonored check, a returned automatic bank 137.14 withdrawal, or a refused credit card or debit card payment. The 137.15 commissioner may demand a guaranteed form of payment, including 137.16 a cashier's check or a money order, as the only means to replace 137.17 a dishonored, returned, or refused payment. 137.18 (c) Premiums are calculated on a calendar month basis and 137.19 may be paid on a monthly, quarterly, or annual basis, with the 137.20 first payment due upon notice from the commissioner of the 137.21 premium amount required. The commissioner shall inform 137.22 applicants and enrollees of these premium payment options. 137.23 Premium payment is required before enrollment is complete and to 137.24 maintain eligibility in MinnesotaCare. 137.25 (d) Nonpayment of the premium will result in disenrollment 137.26 from the planwithin one calendar month after the due date137.27 effective for the calendar month for which the premium was due. 137.28 Persons disenrolled for nonpayment or who voluntarily terminate 137.29 coverage from the program may not reenroll until four calendar 137.30 months have elapsed. Persons disenrolled for nonpayment who pay 137.31 all past due premiums as well as current premiums due, including 137.32 premiums due for the period of disenrollment, within 20 days of 137.33 disenrollment, shall be reenrolled retroactively to the first 137.34 day of disenrollment. Persons disenrolled for nonpayment or who 137.35 voluntarily terminate coverage from the program may not reenroll 137.36 for four calendar months unless the person demonstrates good 138.1 cause for nonpayment. Good cause does not exist if a person 138.2 chooses to pay other family expenses instead of the premium. 138.3 The commissioner shall define good cause in rule. 138.4[EFFECTIVE DATE.] This section is effective July 1, 2002. 138.5 Sec. 42. Minnesota Statutes 2000, section 256L.12, 138.6 subdivision 9, is amended to read: 138.7 Subd. 9. [RATE SETTING.] Rates will be prospective, per 138.8 capita, where possible. The commissioner may allow health plans 138.9 to arrange for inpatient hospital services on a risk or nonrisk 138.10 basis. The commissioner shall consult with an independent 138.11 actuary to determine appropriate rates. Rates established by 138.12 the commissioner must be within the limits of available 138.13 appropriations. 138.14 Sec. 43. Minnesota Statutes 2000, section 256L.12, is 138.15 amended by adding a subdivision to read: 138.16 Subd. 11. [COVERAGE AT INDIAN HEALTH SERVICE 138.17 FACILITIES.] For American Indian enrollees of MinnesotaCare, 138.18 MinnesotaCare shall cover health care services provided at 138.19 Indian Health Service facilities and facilities operated by a 138.20 tribe or tribal organization under funding authorized by United 138.21 States Code, title 25, sections 450f to 450n, or title III of 138.22 the Indian Self-Determination and Education Act, Public Law 138.23 Number 93-638, if those services would otherwise be covered 138.24 under section 256L.03. Payments for services provided under 138.25 this subdivision shall be made on a fee-for-service basis, and 138.26 may, at the option of the tribe or organization, be made at the 138.27 rates authorized under sections 256.969, subdivision 16, and 138.28 256B.0625, subdivision 34, for those MinnesotaCare enrollees 138.29 eligible for coverage at medical assistance rates. For purposes 138.30 of this subdivision, "American Indian" has the meaning given to 138.31 persons to whom services will be provided for in the Code of 138.32 Federal Regulations, title 42, section 36.12. 138.33 Sec. 44. Minnesota Statutes 2000, section 256L.16, is 138.34 amended to read: 138.35 256L.16 [PAYMENT RATES; SERVICES FOR FAMILIES AND CHILDREN 138.36 UNDER THE MINNESOTACARE HEALTH CARE REFORM WAIVER.] 139.1 Section 256L.11, subdivision 2, shall not apply to services 139.2 provided tochildrenfamilies with children who are eligibleto139.3receive expanded servicesaccording to section256L.03,139.4subdivision 1a256L.04, subdivision 1, paragraph (a). 139.5 Sec. 45. Laws 1995, chapter 178, article 2, section 36, is 139.6 amended to read: 139.7 Sec. 36. [EMPOWERMENT ZONES; ADMINISTRATIVE SIMPLIFICATION 139.8 OF WELFARE LAWS.] 139.9 (a) The commissioner of human services shall make 139.10 recommendations to effectuate the changes in federal laws and 139.11 regulations, state laws and rules, and the state plan to improve 139.12 the administrative efficiency of the aid to families with 139.13 dependent children, general assistance, work readiness, family 139.14 general assistance, medical assistance, general assistance 139.15 medical care, and food stamp programs. At a minimum, the 139.16 following administrative standards and procedures must be 139.17 changed. 139.18 The commissioner shall: 139.19 (1) require income or eligibility reviews no more 139.20 frequently than annually for cases in which income is normally 139.21 invariant, as in aid to families with dependent children cases 139.22 where the only source of household income is Supplemental Social 139.23 Security Income; 139.24 (2) permit households to report income annually when the 139.25 source of income is excluded, such as a minor's earnings; 139.26 (3)require income or eligibility reviews no more139.27frequently than annually for extended medical assistance cases;139.28(4)require income or eligibility reviews no more 139.29 frequently than annually for a medical assistance postpartum 139.30 client, where the client previously had eligibility under a 139.31 different basis prior to pregnancy or if other household members 139.32 have eligibility with the same income/basis that applies to the 139.33 client; 139.34(5)(4) permit all income or eligibility reviews for foster 139.35 care medical assistance cases to use the short application form; 139.36 and 140.1(6)(5) make dependent care expenses declaratory for 140.2 medical assistance; and140.3(7) permit households to only report gifts worth $100 or140.4more per month. 140.5 (b) The county's administrative savings resulting from 140.6 these changes may be allocated to fund any lawful purpose. 140.7 (c) The recommendations must be provided in a report to the 140.8 chairs of the appropriate legislative committees by August 1, 140.9 1995. The recommendations must include a list of the 140.10 administrative standards and procedures that require approval by 140.11 the federal government before implementation, and also which 140.12 administrative simplification standards and procedures may be 140.13 implemented by a county prior to receiving a federal waiver. 140.14 (d) The commissioner shall seek the necessary waivers from 140.15 the federal government as soon as possible to implement the 140.16 administrative simplification standards and procedures. 140.17 Sec. 46. Laws 1999, chapter 245, article 4, section 110, 140.18 is amended to read: 140.19 Sec. 110. [PROGRAMS FOR SENIOR CITIZENS.] 140.20 The commissioner of human services shall study the 140.21 eligibility criteria of and benefits provided to persons age 65 140.22 and over through the array of cash assistance and health care 140.23 programs administered by the department, and the extent to which 140.24 these programs can be combined, simplified, or coordinated to 140.25 reduce administrative costs and improve access. The 140.26 commissioner shall also study potential barriers to enrollment 140.27 for low-income seniors who would otherwise deplete resources 140.28 necessary to maintain independent community living. At a 140.29 minimum, the study must include an evaluation of asset 140.30 requirements and enrollment sites. The commissioner shall 140.31 report study findings and recommendations to the legislature by 140.32JuneSeptember 30, 2001. 140.33 Sec. 47. [NOTICE OF NEW PREMIUM SCHEDULE.] 140.34 The commissioner of human services shall provide medical 140.35 assistance enrollees subject to premiums as employed persons 140.36 with disabilities with prior notice of the new premium schedule 141.1 established under the section 13 amendment to section 256B.057, 141.2 subdivision 9, paragraph (c). This notice must be provided at 141.3 least two months before the month in which the first premium 141.4 payment under the new schedule is due. 141.5 Sec. 48. [MEDICATION THERAPY MANAGEMENT PILOT PROGRAM.] 141.6 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 141.7 services, in consultation with the advisory committee 141.8 established under subdivision 2, shall implement, beginning July 141.9 1, 2001, a two-year medication therapy management pilot program 141.10 for medical assistance enrollees. Medication therapy management 141.11 must be provided by teams of physicians and pharmacists working 141.12 in collaborative practice, as defined in Minnesota Statutes, 141.13 section 151.01, subdivision 27, clause (5), to help patients use 141.14 medications safely and effectively. The commissioner may enroll 141.15 individual pharmacists who participate in the pilot program as 141.16 medical assistance providers and shall seek to ensure that 141.17 participating pharmacists represent all geographic regions of 141.18 the state. 141.19 Subd. 2. [ADVISORY COMMITTEE.] The commissioner shall 141.20 establish a ten-member medication therapy management advisory 141.21 committee, to advise the commissioner in the implementation and 141.22 administration of the program and the development of eligibility 141.23 criteria for enrollees and providers and requirements for 141.24 collaborative practice agreements. The committee shall be 141.25 comprised of: two licensed physicians; two licensed 141.26 pharmacists; two consumer representatives; three members with 141.27 expertise in the area of medication therapy management, who may 141.28 be licensed physicians or licensed pharmacists; and a 141.29 representative of the commissioner, who shall serve as an 141.30 ex-officio nonvoting member. In appointing members who are not 141.31 consumer representatives, the commissioner shall consider 141.32 recommendations of associations representing pharmacy and 141.33 medical practitioners. The committee is governed by section 141.34 15.059, except that committee members do not receive 141.35 compensation or reimbursement for expenses. 141.36 Subd. 3. [EVALUATION.] The commissioner shall evaluate the 142.1 cost-effectiveness of the pilot program and its effect on 142.2 patient outcomes and quality of care, and shall report to the 142.3 legislature by December 15, 2003. The commissioner may contract 142.4 with a vendor to conduct the evaluation. 142.5 Sec. 49. [REGULATORY SIMPLIFICATION FOR STATE HEALTH CARE 142.6 PROGRAM PROVIDERS.] 142.7 The commissioner of human services, in consultation with 142.8 providers participating in state health care programs, shall 142.9 identify nonfinancial barriers to increased provider enrollment 142.10 and provider retention in state health care programs, and shall 142.11 implement procedures to address these barriers. Areas to be 142.12 examined by the commissioner shall include, but are not limited 142.13 to, regulatory complexity and inconsistencies between state 142.14 health care programs, provider requirements, provision of 142.15 technical assistance to providers, responsiveness to provider 142.16 inquiries and complaints, claims processing turnaround times, 142.17 and policies for rejecting provider claims. The commissioner 142.18 shall report to the legislature by February 15, 2002, on any 142.19 changes to the administration of state health care programs that 142.20 will be implemented as a result of the study, and present 142.21 recommendations for any necessary changes in state law. 142.22 Sec. 50. [REPEALER.] 142.23 (a) Minnesota Statutes 2000, section 256B.037, subdivision 142.24 5, is repealed effective January 1, 2002. 142.25 (b) Minnesota Statutes 2000, section 256B.0635, subdivision 142.26 3, is repealed effective July 1, 2002. 142.27 ARTICLE 3 142.28 CONTINUING CARE AND HOME CARE 142.29 Section 1. Minnesota Statutes 2000, section 245A.13, 142.30 subdivision 7, is amended to read: 142.31 Subd. 7. [RATE RECOMMENDATION.] The commissioner of human 142.32 services may review rates of a residential program participating 142.33 in the medical assistance program which is in receivership and 142.34 that has needs or deficiencies documented by the department of 142.35 health or the department of human services. If the commissioner 142.36 of human services determines that a review of the rate 143.1 established undersection 256B.501sections 256B.5012 and 143.2 256B.5013 is needed, the commissioner shall: 143.3 (1) review the order or determination that cites the 143.4 deficiencies or needs; and 143.5 (2) determine the need for additional staff, additional 143.6 annual hours by type of employee, and additional consultants, 143.7 services, supplies, equipment, repairs, or capital assets 143.8 necessary to satisfy the needs or deficiencies. 143.9 Sec. 2. Minnesota Statutes 2000, section 245A.13, 143.10 subdivision 8, is amended to read: 143.11 Subd. 8. [ADJUSTMENT TO THE RATE.] Upon review of rates 143.12 under subdivision 7, the commissioner may adjust the residential 143.13 program's payment rate. The commissioner shall review the 143.14 circumstances, together with the residentialprogram cost report143.15 program's most recent income and expense report, to determine 143.16 whether or not the deficiencies or needs can be corrected or met 143.17 by reallocating residential program staff, costs, revenues, 143.18 or any other resources includinganyinvestments, efficiency143.19incentives, or allowances. If the commissioner determines that 143.20 any deficiency cannot be corrected or the need cannot be met 143.21 with the payment rate currently being paid, the commissioner 143.22 shall determine the payment rate adjustment by dividing the 143.23 additional annual costs established during the commissioner's 143.24 review by the residential program's actual resident days from 143.25 the most recentdesk-audited costincome and expense report or 143.26 the estimated resident days in the projected receivership 143.27 period. The payment rate adjustmentmust meet the conditions in143.28Minnesota Rules, parts 9553.0010 to 9553.0080, andremains in 143.29 effect during the period of the receivership or until another 143.30 date set by the commissioner. Upon the subsequent sale, 143.31 closure, or transfer of the residential program, the 143.32 commissioner may recover amounts that were paid as payment rate 143.33 adjustments under this subdivision. This recovery shall be 143.34 determined through a review of actual costs and resident days in 143.35 the receivership period. The costs the commissioner finds to be 143.36 allowable shall be divided by the actual resident days for the 144.1 receivership period. This rate shall be compared to the rate 144.2 paid throughout the receivership period, with the difference, 144.3 multiplied by resident days, being the amount to be repaid to 144.4 the commissioner. Allowable costs shall be determined by the 144.5 commissioner as those ordinary, necessary, and related to 144.6 resident care by prudent and cost-conscious management. The 144.7 buyer or transferee shall repay this amount to the commissioner 144.8 within 60 days after the commissioner notifies the buyer or 144.9 transferee of the obligation to repay. This provision does not 144.10 limit the liability of the seller to the commissioner pursuant 144.11 to section 256B.0641. 144.12 Sec. 3. Minnesota Statutes 2000, section 252.275, 144.13 subdivision 4b, is amended to read: 144.14 Subd. 4b. [GUARANTEED FLOOR.] Each countywith an original144.15allocation for the preceding year that is equal to or less than144.16the guaranteed floor minimum index shall have a guaranteed floor144.17equal to its original allocation for the preceding year. Each144.18county with an original allocation for the preceding year that144.19is greater than the guaranteed floor minimum indexshall have a 144.20 guaranteed floor equal to the lesser of clause (1) or (2): 144.21 (1) the county's original allocation for the preceding 144.22 year; or 144.23 (2) 70 percent of the county's reported expenditures 144.24 eligible for reimbursement during the 12 months ending on June 144.25 30 of the preceding calendar year. 144.26For calendar year 1993, the guaranteed floor minimum index144.27shall be $20,000. For each subsequent year, the index shall be144.28adjusted by the projected change in the average value in the144.29United States Department of Labor Bureau of Labor Statistics144.30consumer price index (all urban) for that year.144.31 Notwithstanding this subdivision, no county shall be 144.32 allocated a guaranteed floor of less than $1,000. 144.33 When the amount of funds available for allocation is less 144.34 than the amount available in the previous year, each county's 144.35 previous year allocation shall be reduced in proportion to the 144.36 reduction in the statewide funding, to establish each county's 145.1 guaranteed floor. 145.2 Sec. 4. Minnesota Statutes 2000, section 254B.02, 145.3 subdivision 3, is amended to read: 145.4 Subd. 3. [RESERVE ACCOUNT.] The commissioner shall 145.5 allocate money from the reserve account to counties that, during 145.6 the current fiscal year, have met or exceeded the base level of 145.7 expenditures for eligible chemical dependency services from 145.8 local money. The commissioner shall establish the base level 145.9 for fiscal year 1988 as the amount of local money used for 145.10 eligible services in calendar year 1986. In later years, the 145.11 base level must be increased in the same proportion as state 145.12 appropriations to implement Laws 1986, chapter 394, sections 8 145.13 to 20, are increased. The base level must be decreased if the 145.14 fund balance from which allocations are made under section 145.15 254B.02, subdivision 1, is decreased in later years. The local 145.16 match rate for the reserve account is the same rate as applied 145.17 to the initial allocation. Reserve account payments must not be 145.18 included when calculating the county adjustments made according 145.19 to subdivision 2. For counties providing medical assistance or 145.20 general assistance medical care through managed care plans on 145.21 January 1, 1996, the base year is fiscal year 1995. For 145.22 counties beginning provision of managed care after January 1, 145.23 1996, the base year is the most recent fiscal year before 145.24 enrollment in managed care begins. For counties providing 145.25 managed care, the base level will be increased or decreased in 145.26 proportion to changes in the fund balance from which allocations 145.27 are made under subdivision 2, but will be additionally increased 145.28 or decreased in proportion to the change in county adjusted 145.29 population made in subdivision 1, paragraphs (b) and 145.30 (c). Effective July 1, 2001, funds deposited in the reserve 145.31 account in excess of those needed to meet obligations for 145.32 services provided during the biennium under this section and 145.33 sections 254B.06 and 254B.09 shall cancel to the general fund. 145.34 Sec. 5. Minnesota Statutes 2000, section 254B.03, 145.35 subdivision 1, is amended to read: 145.36 Subdivision 1. [LOCAL AGENCY DUTIES.] (a) Every local 146.1 agency shall provide chemical dependency services to persons 146.2 residing within its jurisdiction who meet criteria established 146.3 by the commissioner for placement in a chemical dependency 146.4 residential or nonresidential treatment service. Chemical 146.5 dependency money must be administered by the local agencies 146.6 according to law and rules adopted by the commissioner under 146.7 sections 14.001 to 14.69. 146.8 (b) In order to contain costs, the county board shall, with 146.9 the approval of the commissioner of human services, select 146.10 eligible vendors of chemical dependency services who can provide 146.11 economical and appropriate treatment. Unless the local agency 146.12 is a social services department directly administered by a 146.13 county or human services board, the local agency shall not be an 146.14 eligible vendor under section 254B.05. The commissioner may 146.15 approve proposals from county boards to provide services in an 146.16 economical manner or to control utilization, with safeguards to 146.17 ensure that necessary services are provided. If a county 146.18 implements a demonstration or experimental medical services 146.19 funding plan, the commissioner shall transfer the money as 146.20 appropriate. If a county selects a vendor located in another 146.21 state, the county shall ensure that the vendor is in compliance 146.22 with the rules governing licensure of programs located in the 146.23 state. 146.24 (c) The calendar year19982002 rate for vendors may not 146.25 increase more thanthreetwo percent above the rate approved in 146.26 effect on January 1,19972001. The calendar year19992003 146.27 rate for vendors may not increase more thanthreetwo percent 146.28 above the rate in effect on January 1,19982002. The calendar 146.29 years 2004 and 2005 rates may not exceed the rate in effect on 146.30 January 1, 2003. 146.31 (d) A culturally specific vendor that provides assessments 146.32 under a variance under Minnesota Rules, part 9530.6610, shall be 146.33 allowed to provide assessment services to persons not covered by 146.34 the variance. 146.35 Sec. 6. Minnesota Statutes 2000, section 254B.04, 146.36 subdivision 1, is amended to read: 147.1 Subdivision 1. [ELIGIBILITY.] (a) Persons eligible for 147.2 benefits under Code of Federal Regulations, title 25, part 20, 147.3 persons eligible for medical assistance benefits under sections 147.4 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, 147.5 or who meet the income standards of section 256B.056, 147.6 subdivision 4, and persons eligible for general assistance 147.7 medical care under section 256D.03, subdivision 3, are entitled 147.8 to chemical dependency fund services. State money appropriated 147.9 for this paragraph must be placed in a separate account 147.10 established for this purpose. 147.11 Persons with dependent children who are determined to be in 147.12 need of chemical dependency treatment pursuant to an assessment 147.13 under section 626.556, subdivision 10, or a case plan under 147.14 section 260C.201, subdivision 6, or 260C.212, shall be assisted 147.15 by the local agency to access needed treatment services. 147.16 Treatment services must be appropriate for the individual or 147.17 family, which may include long-term care treatment or treatment 147.18 in a facility that allows the dependent children to stay in the 147.19 treatment facility. The county shall pay for out-of-home 147.20 placement costs, if applicable. 147.21 (b) A person not entitled to services under paragraph (a), 147.22 but with family income that is less than the 1997 federal 147.23 poverty guidelines equivalent of 60 percent of the state median 147.24 income for a family of like size and composition, shall be 147.25 eligible to receive chemical dependency fund services within the 147.26 limit of fundsavailable after persons entitled to services147.27under paragraph (a) have been servedappropriated for this group 147.28 for the fiscal year. If notified by the state agency of limited 147.29 funds, a county must give preferential treatment to persons with 147.30 dependent children who are in need of chemical dependency 147.31 treatment pursuant to an assessment under section 626.556, 147.32 subdivision 10, or a case plan under section 260C.201, 147.33 subdivision 6, or 260C.212. A county may spend money from its 147.34 own sources to serve persons under this paragraph. State money 147.35 appropriated for this paragraph must be placed in a separate 147.36 account established for this purpose. 148.1 (c) Persons whose income is between the 1997 federal 148.2 poverty guidelines equivalent of 60 percent and 115 percent of 148.3 the state median income shall be eligible for chemical 148.4 dependency services on a sliding fee basis, within the limit of 148.5 fundsavailable, after persons entitled to services under148.6paragraph (a) and persons eligible for services under paragraph148.7(b) have been servedappropriated for this group for the fiscal 148.8 year. Persons eligible under this paragraph must contribute to 148.9 the cost of services according to the sliding fee scale 148.10 established under subdivision 3. A county may spend money from 148.11 its own sources to provide services to persons under this 148.12 paragraph. State money appropriated for this paragraph must be 148.13 placed in a separate account established for this purpose. 148.14 Sec. 7. Minnesota Statutes 2000, section 254B.09, is 148.15 amended by adding a subdivision to read: 148.16 Subd. 8. [PAYMENTS TO IMPROVE SERVICES TO AMERICAN 148.17 INDIANS.] The commissioner may set rates for chemical dependency 148.18 services according to the American Indian Health Improvement 148.19 Act, Public Law Number 94-437, for eligible vendors. These 148.20 rates shall supersede rates set in county purchase of service 148.21 agreements when payments are made on behalf of clients eligible 148.22 according to Public Law Number 94-437. 148.23 Sec. 8. Minnesota Statutes 2000, section 256.01, is 148.24 amended by adding a subdivision to read: 148.25 Subd. 19. [GRANTS FOR CASE MANAGEMENT SERVICES TO PERSONS 148.26 WITH HIV OR AIDS.] The commissioner may award grants to eligible 148.27 vendors for the development, implementation, and evaluation of 148.28 case management services for individuals infected with the human 148.29 immunodeficiency virus. HIV/AIDs case management services will 148.30 be provided to increase access to cost effective health care 148.31 services, to reduce the risk of HIV transmission, to ensure that 148.32 basic client needs are met, and to increase client access to 148.33 needed community supports or services. 148.34 Sec. 9. Minnesota Statutes 2000, section 256.476, 148.35 subdivision 1, is amended to read: 148.36 Subdivision 1. [PURPOSE AND GOALS.] The commissioner of 149.1 human services shall establish a consumer support grant 149.2 programto assistfor individuals with functional limitations 149.3 and their familiesin purchasing and securing supports which the149.4individuals need to live as independently and productively in149.5the community as possiblewho wish to purchase and secure their 149.6 own supports. The commissioner and local agencies shall jointly 149.7 develop an implementation plan which must include a way to 149.8 resolve the issues related to county liability. The program 149.9 shall: 149.10 (1) make support grants available to individuals or 149.11 families as an effective alternative to existing programs and 149.12 services, such as the developmental disability family support 149.13 program,the alternative care program,personal care attendant 149.14 services, home health aide services, and private duty nursing 149.15facilityservices; 149.16 (2) provide consumers more control, flexibility, and 149.17 responsibility overthe needed supportstheir services and 149.18 supports; 149.19 (3) promote local program management and decision making; 149.20 and 149.21 (4) encourage the use of informal and typical community 149.22 supports. 149.23 Sec. 10. Minnesota Statutes 2000, section 256.476, 149.24 subdivision 2, is amended to read: 149.25 Subd. 2. [DEFINITIONS.] For purposes of this section, the 149.26 following terms have the meanings given them: 149.27 (a) "County board" means the county board of commissioners 149.28 for the county of financial responsibility as defined in section 149.29 256G.02, subdivision 4, or its designated representative. When 149.30 a human services board has been established under sections 149.31 402.01 to 402.10, it shall be considered the county board for 149.32 the purposes of this section. 149.33 (b) "Family" means the person's birth parents, adoptive 149.34 parents or stepparents, siblings or stepsiblings, children or 149.35 stepchildren, grandparents, grandchildren, niece, nephew, aunt, 149.36 uncle, or spouse. For the purposes of this section, a family 150.1 member is at least 18 years of age. 150.2 (c) "Functional limitations" means the long-term inability 150.3 to perform an activity or task in one or more areas of major 150.4 life activity, including self-care, understanding and use of 150.5 language, learning, mobility, self-direction, and capacity for 150.6 independent living. For the purpose of this section, the 150.7 inability to perform an activity or task results from a mental, 150.8 emotional, psychological, sensory, or physical disability, 150.9 condition, or illness. 150.10 (d) "Informed choice" means a voluntary decision made by 150.11 the person or the person's legal representative, after becoming 150.12 familiarized with the alternatives to: 150.13 (1) select a preferred alternative from a number of 150.14 feasible alternatives; 150.15 (2) select an alternative which may be developed in the 150.16 future; and 150.17 (3) refuse any or all alternatives. 150.18 (e) "Local agency" means the local agency authorized by the 150.19 county board to carry out the provisions of this section. 150.20 (f) "Person" or "persons" means a person or persons meeting 150.21 the eligibility criteria in subdivision 3. 150.22 (g) "Authorized representative" means an individual 150.23 designated by the person or their legal representative to act on 150.24 their behalf. This individual may be a family member, guardian, 150.25 representative payee, or other individual designated by the 150.26 person or their legal representative, if any, to assist in 150.27 purchasing and arranging for supports. For the purposes of this 150.28 section, an authorized representative is at least 18 years of 150.29 age. 150.30 (h) "Screening" means the screening of a person's service 150.31 needs under sections 256B.0911 and 256B.092. 150.32 (i) "Supports" means services, care, aids,home150.33 environmental modifications, or assistance purchased by the 150.34 person or the person's family. Examples of supports include 150.35 respite care, assistance with daily living, andadaptive aids150.36 assistive technology. For the purpose of this section, 151.1 notwithstanding the provisions of section 144A.43, supports 151.2 purchased under the consumer support program are not considered 151.3 home care services. 151.4 (j) "Program of origination" means the program the 151.5 individual transferred from when approved for the consumer 151.6 support grant program. 151.7 Sec. 11. Minnesota Statutes 2000, section 256.476, 151.8 subdivision 3, is amended to read: 151.9 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 151.10 is eligible to apply for a consumer support grant if the person 151.11 meets all of the following criteria: 151.12 (1) the person is eligible for and has been approved to 151.13 receive services under medical assistance as determined under 151.14 sections 256B.055 and 256B.056or the person is eligible for and151.15has been approved to receive services under alternative care151.16services as determined under section 256B.0913or the person has 151.17 been approved to receive a grant under the developmental 151.18 disability family support program under section 252.32; 151.19 (2) the person is able to direct and purchase the person's 151.20 own care and supports, or the person has a family member, legal 151.21 representative, or other authorized representative who can 151.22 purchase and arrange supports on the person's behalf; 151.23 (3) the person has functional limitations, requires ongoing 151.24 supports to live in the community, and is at risk of or would 151.25 continue institutionalization without such supports; and 151.26 (4) the person will live in a home. For the purpose of 151.27 this section, "home" means the person's own home or home of a 151.28 person's family member. These homes are natural home settings 151.29 and are not licensed by the department of health or human 151.30 services. 151.31 (b) Persons may not concurrently receive a consumer support 151.32 grant if they are: 151.33 (1) receiving home and community-based services under 151.34 United States Code, title 42, section 1396h(c); personal care 151.35 attendant and home health aide services under section 256B.0625; 151.36 a developmental disability family support grant; or alternative 152.1 care services under section 256B.0913; or 152.2 (2) residing in an institutional or congregate care setting. 152.3 (c) A person or person's family receiving a consumer 152.4 support grant shall not be charged a fee or premium by a local 152.5 agency for participating in the program. 152.6 (d) The commissioner may limit the participation ofnursing152.7facility residents, residents of intermediate care facilities152.8for persons with mental retardation, and therecipients of 152.9 services from federal waiver programs in the consumer support 152.10 grant program if the participation of these individuals will 152.11 result in an increase in the cost to the state. 152.12 (e) The commissioner shall establish a budgeted 152.13 appropriation each fiscal year for the consumer support grant 152.14 program. The number of individuals participating in the program 152.15 will be adjusted so the total amount allocated to counties does 152.16 not exceed the amount of the budgeted appropriation. The 152.17 budgeted appropriation will be adjusted annually to accommodate 152.18 changes in demand for the consumer support grants. 152.19 Sec. 12. Minnesota Statutes 2000, section 256.476, 152.20 subdivision 4, is amended to read: 152.21 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 152.22 county board may choose to participate in the consumer support 152.23 grant program. If a county board chooses to participate in the 152.24 program, the local agency shall establish written procedures and 152.25 criteria to determine the amount and use of support grants. 152.26 These procedures must include, at least, the availability of 152.27 respite care, assistance with daily living, and adaptive aids. 152.28 The local agency may establish monthly or annual maximum amounts 152.29 for grants and procedures where exceptional resources may be 152.30 required to meet the health and safety needs of the person on a 152.31 time-limited basis, however, the total amount awarded to each 152.32 individual may not exceed the limits established in subdivision 152.33 5, paragraph (f). 152.34 (b) Support grants to a person or a person's family will be 152.35 provided through a monthly subsidy payment and be in the form of 152.36 cash, voucher, or direct county payment to vendor. Support 153.1 grant amounts must be determined by the local agency. Each 153.2 service and item purchased with a support grant must meet all of 153.3 the following criteria: 153.4 (1) it must be over and above the normal cost of caring for 153.5 the person if the person did not have functional limitations; 153.6 (2) it must be directly attributable to the person's 153.7 functional limitations; 153.8 (3) it must enable the person or the person's family to 153.9 delay or prevent out-of-home placement of the person; and 153.10 (4) it must be consistent with the needs identified in the 153.11 service plan, when applicable. 153.12 (c) Items and services purchased with support grants must 153.13 be those for which there are no other public or private funds 153.14 available to the person or the person's family. Fees assessed 153.15 to the person or the person's family for health and human 153.16 services are not reimbursable through the grant. 153.17 (d) In approving or denying applications, the local agency 153.18 shall consider the following factors: 153.19 (1) the extent and areas of the person's functional 153.20 limitations; 153.21 (2) the degree of need in the home environment for 153.22 additional support; and 153.23 (3) the potential effectiveness of the grant to maintain 153.24 and support the person in the family environment or the person's 153.25 own home. 153.26 (e) At the time of application to the program or screening 153.27 for other services, the person or the person's family shall be 153.28 provided sufficient information to ensure an informed choice of 153.29 alternatives by the person, the person's legal representative, 153.30 if any, or the person's family. The application shall be made 153.31 to the local agency and shall specify the needs of the person 153.32 and family, the form and amount of grant requested, the items 153.33 and services to be reimbursed, and evidence of eligibility for 153.34 medical assistanceor alternative care program. 153.35 (f) Upon approval of an application by the local agency and 153.36 agreement on a support plan for the person or person's family, 154.1 the local agency shall make grants to the person or the person's 154.2 family. The grant shall be in an amount for the direct costs of 154.3 the services or supports outlined in the service agreement. 154.4 (g) Reimbursable costs shall not include costs for 154.5 resources already available, such as special education classes, 154.6 day training and habilitation, case management, other services 154.7 to which the person is entitled, medical costs covered by 154.8 insurance or other health programs, or other resources usually 154.9 available at no cost to the person or the person's family. 154.10 (h) The state of Minnesota, the county boards participating 154.11 in the consumer support grant program, or the agencies acting on 154.12 behalf of the county boards in the implementation and 154.13 administration of the consumer support grant program shall not 154.14 be liable for damages, injuries, or liabilities sustained 154.15 through the purchase of support by the individual, the 154.16 individual's family, or the authorized representative under this 154.17 section with funds received through the consumer support grant 154.18 program. Liabilities include but are not limited to: workers' 154.19 compensation liability, the Federal Insurance Contributions Act 154.20 (FICA), or the Federal Unemployment Tax Act (FUTA). For 154.21 purposes of this section, participating county boards and 154.22 agencies acting on behalf of county boards are exempt from the 154.23 provisions of section 268.04. 154.24 Sec. 13. Minnesota Statutes 2000, section 256.476, 154.25 subdivision 5, is amended to read: 154.26 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 154.27 For the purpose of transferring persons to the consumer support 154.28 grant program from specific programs or services, such as the 154.29 developmental disability family support program andalternative154.30care program,personal careattendantassistant services, home 154.31 health aide services, ornursing facilityprivate duty nursing 154.32 services, the amount of funds transferred by the commissioner 154.33 between the developmental disability family support program 154.34 account,the alternative care account,the medical assistance 154.35 account, or the consumer support grant account shall be based on 154.36 each county's participation in transferring persons to the 155.1 consumer support grant program from those programs and services. 155.2 (b) At the beginning of each fiscal year, county 155.3 allocations for consumer support grants shall be based on: 155.4 (1) the number of persons to whom the county board expects 155.5 to provide consumer supports grants; 155.6 (2) their eligibility for current program and services; 155.7 (3) the amount of nonfederal dollars expended on those 155.8 individuals for those programs and services or, in situations 155.9 where an individual is unable to obtain the support needed from 155.10 the program of origination due to the unavailability of service 155.11 providers at the time or the location where the supports are 155.12 needed, the allocation will be based on the county's best 155.13 estimate of the nonfederal dollars that would have been expended 155.14 if the services had been available; and 155.15 (4) projected dates when persons will start receiving 155.16 grants. County allocations shall be adjusted periodically by 155.17 the commissioner based on the actual transfer of persons or 155.18 service openings, and the nonfederal dollars associated with 155.19 those persons or service openings, to the consumer support grant 155.20 program. 155.21 (c) The amount of funds transferred by the commissioner 155.22 fromthe alternative care account andthe medical assistance 155.23 account for an individual may be changed if it is determined by 155.24 the county or its agent that the individual's need for support 155.25 has changed. 155.26 (d) The authority to utilize funds transferred to the 155.27 consumer support grant account for the purposes of implementing 155.28 and administering the consumer support grant program will not be 155.29 limited or constrained by the spending authority provided to the 155.30 program of origination. 155.31 (e) The commissionershallmay use up to five percent of 155.32 each county's allocation, as adjusted, for payments to that 155.33 county for administrative expenses, to be paid as a 155.34 proportionate addition to reported direct service expenditures. 155.35 (f) Except as provided in this paragraph, the county 155.36 allocation for each individual or individual's family cannot 156.1 exceed 80 percent of the total nonfederal dollars expended on 156.2 the individual by the program of origination except for the 156.3 developmental disabilities family support grant program which 156.4 can be approved up to 100 percent of the nonfederal dollars and 156.5 in situations as described in paragraph (b), clause (3). In 156.6 situations where exceptional need exists or the individual's 156.7 need for support increases, up to 100 percent of the nonfederal 156.8 dollars expended by the consumer's program of origination may be 156.9 allocated to the county. Allocations that exceed 80 percent of 156.10 the nonfederal dollars expended on the individual by the program 156.11 of origination must be approved by the commissioner. The 156.12 remainder of the amount expended on the individual by the 156.13 program of origination will be used in the following 156.14 proportions: half will be made available to the consumer 156.15 support grant program and participating counties for consumer 156.16 training, resource development, and other costs, and half will 156.17 be returned to the state general fund. 156.18 (g) The commissioner may recover, suspend, or withhold 156.19 payments if the county board, local agency, or grantee does not 156.20 comply with the requirements of this section. 156.21 (h) Grant funds unexpended by consumers shall return to the 156.22 state once a year. The annual return of unexpended grant funds 156.23 shall occur in the quarter following the end of the state fiscal 156.24 year. 156.25 Sec. 14. Minnesota Statutes 2000, section 256.476, 156.26 subdivision 8, is amended to read: 156.27 Subd. 8. [COMMISSIONER RESPONSIBILITIES.] The commissioner 156.28 shall: 156.29 (1) transfer and allocate funds pursuant to this section; 156.30 (2) determine allocations based on projected and actual 156.31 local agency use; 156.32 (3) monitor and oversee overall program spending; 156.33 (4) evaluate the effectiveness of the program; 156.34 (5) provide training and technical assistance for local 156.35 agencies and consumers to help identify potential applicants to 156.36 the program; and 157.1 (6) develop guidelines for local agency program 157.2 administration and consumer information; and. 157.3(7) apply for a federal waiver or take any other action157.4necessary to maximize federal funding for the program by157.5September 1, 1999.157.6 Sec. 15. Minnesota Statutes 2000, section 256B.0625, 157.7 subdivision 7, is amended to read: 157.8 Subd. 7. [PRIVATE DUTY NURSING.] Medical assistance covers 157.9 private duty nursing services in a recipient's home. Recipients 157.10 who are authorized to receive private duty nursing services in 157.11 their home may use approved hours outside of the home during 157.12 hours when normal life activities take them outside of their 157.13 homeand when, without the provision of private duty nursing,157.14their health and safety would be jeopardized. To use private 157.15 duty nursing services at school, the recipient or responsible 157.16 party must provide written authorization in the care plan 157.17 identifying the chosen provider and the daily amount of services 157.18 to be used at school. Medical assistance does not cover private 157.19 duty nursing services for residents of a hospital, nursing 157.20 facility, intermediate care facility, or a health care facility 157.21 licensed by the commissioner of health, except as authorized in 157.22 section 256B.64 for ventilator-dependent recipients in hospitals 157.23 or unless a resident who is otherwise eligible is on leave from 157.24 the facility and the facility either pays for the private duty 157.25 nursing services or forgoes the facility per diem for the leave 157.26 days that private duty nursing services are used. Total hours 157.27 of service and payment allowed for services outside the home 157.28 cannot exceed that which is otherwise allowed in an in-home 157.29 setting according to section 256B.0627. All private duty 157.30 nursing services must be provided according to the limits 157.31 established under section 256B.0627. Private duty nursing 157.32 services may not be reimbursed if the nurse is thespouse of the157.33recipient or the parent orfoster care provider of a recipient 157.34 who is under age 18, or the recipient's legal guardian. 157.35 Sec. 16. Minnesota Statutes 2000, section 256B.0625, 157.36 subdivision 19a, is amended to read: 158.1 Subd. 19a. [PERSONAL CARE ASSISTANT SERVICES.] Medical 158.2 assistance covers personal care assistant services in a 158.3 recipient's home. To qualify for personal care assistant 158.4 services, recipients or responsible parties must be able to 158.5 identify the recipient's needs, direct and evaluate task 158.6 accomplishment, and provide for health and safety. Approved 158.7 hours may be used outside the home when normal life activities 158.8 take them outside the homeand when, without the provision of158.9personal care, their health and safety would be jeopardized. To 158.10 use personal care assistant services at school, the recipient or 158.11 responsible party must provide written authorization in the care 158.12 plan identifying the chosen provider and the daily amount of 158.13 services to be used at school. Total hours for services, 158.14 whether actually performed inside or outside the recipient's 158.15 home, cannot exceed that which is otherwise allowed for personal 158.16 care assistant services in an in-home setting according to 158.17 section 256B.0627. Medical assistance does not cover personal 158.18 care assistant services for residents of a hospital, nursing 158.19 facility, intermediate care facility, health care facility 158.20 licensed by the commissioner of health, or unless a resident who 158.21 is otherwise eligible is on leave from the facility and the 158.22 facility either pays for the personal care assistant services or 158.23 forgoes the facility per diem for the leave days that personal 158.24 care assistant services are used. All personal care services 158.25 must be provided according to section 256B.0627. Personal 158.26 care assistant services may not be reimbursed if the personal 158.27 care assistant is the spouse or legal guardian of the recipient 158.28 or the parent of a recipient under age 18, or the responsible 158.29 party or the foster care provider of a recipient who cannot 158.30 direct the recipient's own care unless, in the case of a foster 158.31 care provider, a county or state case manager visits the 158.32 recipient as needed, but not less than every six months, to 158.33 monitor the health and safety of the recipient and to ensure the 158.34 goals of the care plan are met. Parents of adult recipients, 158.35 adult children of the recipient or adult siblings of the 158.36 recipient may be reimbursed for personal care assistant services 159.1if they are not the recipient's legal guardian and, if they are 159.2 granted a waiver under section 256B.0627.Until July 1, 2001,159.3andNotwithstanding the provisions of section 256B.0627, 159.4 subdivision 4, paragraph (b), clause (4), the noncorporate legal 159.5 guardian or conservator of an adult, who is not the responsible 159.6 party and not the personal care provider organization, may be 159.7 granted a hardship waiver under section 256B.0627, to be 159.8 reimbursed to provide personal care assistant services to the 159.9 recipient, and shall not be considered to have a service 159.10 provider interest for purposes of participation on the screening 159.11 team under section 256B.092, subdivision 7. 159.12 Sec. 17. Minnesota Statutes 2000, section 256B.0625, 159.13 subdivision 19c, is amended to read: 159.14 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 159.15 personal care assistant services provided by an individual who 159.16 is qualified to provide the services according to subdivision 159.17 19a and section 256B.0627, where the services are prescribed by 159.18 a physician in accordance with a plan of treatment and are 159.19 supervised by the recipientunder the fiscal agent option159.20according to section 256B.0627, subdivision 10,or a qualified 159.21 professional. "Qualified professional" means a mental health 159.22 professional as defined in section 245.462, subdivision 18, or 159.23 245.4871, subdivision 27; or a registered nurse as defined in 159.24 sections 148.171 to 148.285. As part of the assessment, the 159.25 county public health nurse willconsult withassist the 159.26 recipient or responsible partyandto identify the most 159.27 appropriate person to provide supervision of the personal care 159.28 assistant. The qualified professional shall perform the duties 159.29 described in Minnesota Rules, part 9505.0335, subpart 4. 159.30 Sec. 18. Minnesota Statutes 2000, section 256B.0625, 159.31 subdivision 20, is amended to read: 159.32 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 159.33 extent authorized by rule of the state agency, medical 159.34 assistance covers case management services to persons with 159.35 serious and persistent mental illness and children with severe 159.36 emotional disturbance. Services provided under this section 160.1 must meet the relevant standards in sections 245.461 to 160.2 245.4888, the Comprehensive Adult and Children's Mental Health 160.3 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 160.4 9505.0322, excluding subpart 10. 160.5 (b) Entities meeting program standards set out in rules 160.6 governing family community support services as defined in 160.7 section 245.4871, subdivision 17, are eligible for medical 160.8 assistance reimbursement for case management services for 160.9 children with severe emotional disturbance when these services 160.10 meet the program standards in Minnesota Rules, parts 9520.0900 160.11 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 160.12 (c) Medical assistance and MinnesotaCare payment for mental 160.13 health case management shall be made on a monthly basis. In 160.14 order to receive payment for an eligible child, the provider 160.15 must document at least a face-to-face contact with the child, 160.16 the child's parents, or the child's legal representative. To 160.17 receive payment for an eligible adult, the provider must 160.18 document: 160.19 (1) at least a face-to-face contact with the adult or the 160.20 adult's legal representative; or 160.21 (2) at least a telephone contact with the adult or the 160.22 adult's legal representative and document a face-to-face contact 160.23 with the adult or the adult's legal representative within the 160.24 preceding two months. 160.25 (d) Payment for mental health case management provided by 160.26 county or state staff shall be based on the monthly rate 160.27 methodology under section 256B.094, subdivision 6, paragraph 160.28 (b), with separate rates calculated for child welfare and mental 160.29 health, and within mental health, separate rates for children 160.30 and adults. 160.31 (e) Payment for mental health case management provided by 160.32 county-contracted vendors shall be based on a monthly rate 160.33 negotiated by the host county. The negotiated rate must not 160.34 exceed the rate charged by the vendor for the same service to 160.35 other payers. If the service is provided by a team of 160.36 contracted vendors, the county may negotiate a team rate with a 161.1 vendor who is a member of the team. The team shall determine 161.2 how to distribute the rate among its members. No reimbursement 161.3 received by contracted vendors shall be returned to the county, 161.4 except to reimburse the county for advance funding provided by 161.5 the county to the vendor. 161.6 (f) If the service is provided by a team which includes 161.7 contracted vendors and county or state staff, the costs for 161.8 county or state staff participation in the team shall be 161.9 included in the rate for county-provided services. In this 161.10 case, the contracted vendor and the county may each receive 161.11 separate payment for services provided by each entity in the 161.12 same month. In order to prevent duplication of services, the 161.13 county must document, in the recipient's file, the need for team 161.14 case management and a description of the roles of the team 161.15 members. 161.16 (g) The commissioner shall calculate the nonfederal share 161.17 of actual medical assistance and general assistance medical care 161.18 payments for each county, based on the higher of calendar year 161.19 1995 or 1996, by service date, project that amount forward to 161.20 1999, and transfer one-half of the result from medical 161.21 assistance and general assistance medical care to each county's 161.22 mental health grants under sections 245.4886 and 256E.12 for 161.23 calendar year 1999. The annualized minimum amount added to each 161.24 county's mental health grant shall be $3,000 per year for 161.25 children and $5,000 per year for adults. The commissioner may 161.26 reduce the statewide growth factor in order to fund these 161.27 minimums. The annualized total amount transferred shall become 161.28 part of the base for future mental health grants for each county. 161.29 (h) Any net increase in revenue to the county as a result 161.30 of the change in this section must be used to provide expanded 161.31 mental health services as defined in sections 245.461 to 161.32 245.4888, the Comprehensive Adult and Children's Mental Health 161.33 Acts, excluding inpatient and residential treatment. For 161.34 adults, increased revenue may also be used for services and 161.35 consumer supports which are part of adult mental health projects 161.36 approved under Laws 1997, chapter 203, article 7, section 25. 162.1 For children, increased revenue may also be used for respite 162.2 care and nonresidential individualized rehabilitation services 162.3 as defined in section 245.492, subdivisions 17 and 23. 162.4 "Increased revenue" has the meaning given in Minnesota Rules, 162.5 part 9520.0903, subpart 3. 162.6 (i) Notwithstanding section 256B.19, subdivision 1, the 162.7 nonfederal share of costs for mental health case management 162.8 shall be provided by the recipient's county of responsibility, 162.9 as defined in sections 256G.01 to 256G.12, from sources other 162.10 than federal funds or funds used to match other federal funds. 162.11 (j) The commissioner may suspend, reduce, or terminate the 162.12 reimbursement to a provider that does not meet the reporting or 162.13 other requirements of this section. The county of 162.14 responsibility, as defined in sections 256G.01 to 256G.12, is 162.15 responsible for any federal disallowances. The county may share 162.16 this responsibility with its contracted vendors. 162.17 (k) The commissioner shall set aside a portion of the 162.18 federal funds earned under this section to repay the special 162.19 revenue maximization account under section 256.01, subdivision 162.20 2, clause (15). The repayment is limited to: 162.21 (1) the costs of developing and implementing this section; 162.22 and 162.23 (2) programming the information systems. 162.24 (l) Notwithstanding section 256.025, subdivision 2, 162.25 payments to counties for case management expenditures under this 162.26 section shall only be made from federal earnings from services 162.27 provided under this section. Payments to contracted vendors 162.28 shall include both the federal earnings and the county share. 162.29 (m) Notwithstanding section 256B.041, county payments for 162.30 the cost of mental health case management services provided by 162.31 county or state staff shall not be made to the state treasurer. 162.32 For the purposes of mental health case management services 162.33 provided by county or state staff under this section, the 162.34 centralized disbursement of payments to counties under section 162.35 256B.041 consists only of federal earnings from services 162.36 provided under this section. 163.1 (n) Case management services under this subdivision do not 163.2 include therapy, treatment, legal, or outreach services. 163.3 (o) If the recipient is a resident of a nursing facility, 163.4 intermediate care facility, or hospital, and the recipient's 163.5 institutional care is paid by medical assistance, payment for 163.6 case management services under this subdivision is limited to 163.7 the last30180 days of the recipient's residency in that 163.8 facility and may not exceed more thantwosix months in a 163.9 calendar year. 163.10 (p) Payment for case management services under this 163.11 subdivision shall not duplicate payments made under other 163.12 program authorities for the same purpose. 163.13 (q) By July 1, 2000, the commissioner shall evaluate the 163.14 effectiveness of the changes required by this section, including 163.15 changes in number of persons receiving mental health case 163.16 management, changes in hours of service per person, and changes 163.17 in caseload size. 163.18 (r) For each calendar year beginning with the calendar year 163.19 2001, the annualized amount of state funds for each county 163.20 determined under paragraph (g) shall be adjusted by the county's 163.21 percentage change in the average number of clients per month who 163.22 received case management under this section during the fiscal 163.23 year that ended six months prior to the calendar year in 163.24 question, in comparison to the prior fiscal year. 163.25 (s) For counties receiving the minimum allocation of $3,000 163.26 or $5,000 described in paragraph (g), the adjustment in 163.27 paragraph (r) shall be determined so that the county receives 163.28 the higher of the following amounts: 163.29 (1) a continuation of the minimum allocation in paragraph 163.30 (g); or 163.31 (2) an amount based on that county's average number of 163.32 clients per month who received case management under this 163.33 section during the fiscal year that ended six months prior to 163.34 the calendar year in question, in comparison to the prior fiscal 163.35 year, times the average statewide grant per person per month for 163.36 counties not receiving the minimum allocation. 164.1 (t) The adjustments in paragraphs (r) and (s) shall be 164.2 calculated separately for children and adults. 164.3 Sec. 19. Minnesota Statutes 2000, section 256B.0625, is 164.4 amended by adding a subdivision to read: 164.5 Subd. 43. [TARGETED CASE MANAGEMENT.] For purposes of 164.6 subdivisions 43a to 43h, the following terms have the meanings 164.7 given them: 164.8 (1) "Home care service recipients" means those individuals 164.9 receiving the following services under section 256B.0627: 164.10 skilled nursing visits, home health aide visits, private duty 164.11 nursing, personal care assistants, or therapies provided through 164.12 a home health agency. 164.13 (2) "Home care targeted case management" means the 164.14 provision of targeted case management services for the purpose 164.15 of assisting home care service recipients to gain access to 164.16 needed services and supports so that they may remain in the 164.17 community. 164.18 (3) "Institutions" means hospitals, consistent with Code of 164.19 Federal Regulations, title 42, section 440.10; regional 164.20 treatment center inpatient services, consistent with section 164.21 245.474; nursing facilities; and intermediate care facilities 164.22 for persons with mental retardation. 164.23 (4) "Relocation targeted case management" means the 164.24 provision of targeted case management services for the purpose 164.25 of assisting recipients to gain access to needed services and 164.26 supports if they choose to move from an institution to the 164.27 community. Relocation targeted case management may be provided 164.28 during the last 180 consecutive days of an eligible recipient's 164.29 institutional stay. 164.30 (5) "Targeted case management" means case management 164.31 services provided to help recipients gain access to needed 164.32 medical, social, educational, and other services and supports. 164.33 Sec. 20. Minnesota Statutes 2000, section 256B.0625, is 164.34 amended by adding a subdivision to read: 164.35 Subd. 43a. [ELIGIBILITY.] The following persons are 164.36 eligible for relocation targeted case management or home care 165.1 targeted case management: 165.2 (1) medical assistance eligible persons residing in 165.3 institutions who choose to move into the community are eligible 165.4 for relocation targeted case management services; and 165.5 (2) medical assistance eligible persons receiving home care 165.6 services, who are not eligible for any other medical assistance 165.7 reimbursable case management service, are eligible for home care 165.8 targeted case management services beginning January 1, 2003. 165.9 Sec. 21. Minnesota Statutes 2000, section 256B.0625, is 165.10 amended by adding a subdivision to read: 165.11 Subd. 43b. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 165.12 QUALIFICATIONS.] The following qualifications and certification 165.13 standards must be met by providers of relocation targeted case 165.14 management: 165.15 (a) The commissioner must certify each provider of 165.16 relocation targeted case management before enrollment. The 165.17 certification process shall examine the provider's ability to 165.18 meet the requirements in this subdivision and other federal and 165.19 state requirements of this service. A certified relocation 165.20 targeted case management provider may subcontract with another 165.21 provider to deliver relocation targeted case management 165.22 services. Subcontracted providers must demonstrate the ability 165.23 to provide the services outlined in subdivision 43d. 165.24 (b) A relocation targeted case management provider is an 165.25 enrolled medical assistance provider who is determined by the 165.26 commissioner to have all of the following characteristics: 165.27 (1) the legal authority to provide public welfare under 165.28 sections 393.01, subdivision 7; and 393.07, or a federally 165.29 recognized Indian tribe; 165.30 (2) the demonstrated capacity and experience to provide the 165.31 components of case management to coordinate and link community 165.32 resources needed by the eligible population; 165.33 (3) the administrative capacity and experience to serve the 165.34 target population for whom it will provide services and ensure 165.35 quality of services under state and federal requirements; 165.36 (4) the legal authority to provide complete investigative 166.1 and protective services under section 626.556, subdivision 10, 166.2 and child welfare and foster care services under section 393.07, 166.3 subdivisions 1 and 2, or a federally recognized Indian tribe; 166.4 (5) a financial management system that provides accurate 166.5 documentation of services and costs under state and federal 166.6 requirements; and 166.7 (6) the capacity to document and maintain individual case 166.8 records under state and federal requirements. 166.9 A provider of targeted case management under subdivision 20 may 166.10 be deemed a certified provider of relocation targeted case 166.11 management. 166.12 Sec. 22. Minnesota Statutes 2000, section 256B.0625, is 166.13 amended by adding a subdivision to read: 166.14 Subd. 43c. [HOME CARE TARGETED CASE MANAGEMENT PROVIDER 166.15 QUALIFICATIONS.] The following qualifications and certification 166.16 standards must be met by providers of home care targeted case 166.17 management. 166.18 (a) The commissioner must certify each provider of home 166.19 care targeted case management before enrollment. The 166.20 certification process shall examine the provider's ability to 166.21 meet the requirements in this subdivision and other state and 166.22 federal requirements of this service. 166.23 (b) A home care targeted case management provider is an 166.24 enrolled medical assistance provider who has a minimum of a 166.25 bachelor's degree or a license in a health or human services 166.26 field, and is determined by the commissioner to have all of the 166.27 following characteristics: 166.28 (1) the demonstrated capacity and experience to provide the 166.29 components of case management to coordinate and link community 166.30 resources needed by the eligible population; 166.31 (2) the administrative capacity and experience to serve the 166.32 target population for whom it will provide services and ensure 166.33 quality of services under state and federal requirements; 166.34 (3) a financial management system that provides accurate 166.35 documentation of services and costs under state and federal 166.36 requirements; 167.1 (4) the capacity to document and maintain individual case 167.2 records under state and federal requirements; and 167.3 (5) the capacity to coordinate with county administrative 167.4 functions. 167.5 Sec. 23. Minnesota Statutes 2000, section 256B.0625, is 167.6 amended by adding a subdivision to read: 167.7 Subd. 43d. [ELIGIBLE SERVICES.] Services eligible for 167.8 medical assistance reimbursement as targeted case management 167.9 include: 167.10 (1) assessment of the recipient's need for targeted case 167.11 management services; 167.12 (2) development, completion, and regular review of a 167.13 written individual service plan, which is based upon the 167.14 assessment of the recipient's needs and choices, and which will 167.15 ensure access to medical, social, educational, and other related 167.16 services and supports; 167.17 (3) routine contact or communication with the recipient, 167.18 recipient's family, primary caregiver, legal representative, 167.19 substitute care provider, service providers, or other relevant 167.20 persons identified as necessary to the development or 167.21 implementation of the goals of the individual service plan; 167.22 (4) coordinating referrals for, and the provision of, case 167.23 management services for the recipient with appropriate service 167.24 providers, consistent with section 1902(a)(23) of the Social 167.25 Security Act; 167.26 (5) coordinating and monitoring the overall service 167.27 delivery to ensure quality of services, appropriateness, and 167.28 continued need; 167.29 (6) completing and maintaining necessary documentation that 167.30 supports and verifies the activities in this subdivision; 167.31 (7) traveling to conduct a visit with the recipient or 167.32 other relevant person necessary to develop or implement the 167.33 goals of the individual service plan; and 167.34 (8) coordinating with the institution discharge planner in 167.35 the 180-day period before the recipient's discharge. 167.36 Sec. 24. Minnesota Statutes 2000, section 256B.0625, is 168.1 amended by adding a subdivision to read: 168.2 Subd. 43e. [TIME LINES.] The following time lines must be 168.3 met for assigning a case manager: 168.4 (1) for relocation targeted case management, an eligible 168.5 recipient must be assigned a case manager who visits the person 168.6 within 20 working days of requesting a case manager from their 168.7 county of financial responsibility as determined under chapter 168.8 256G. If a county agency does not provide case management 168.9 services as required, the recipient may, after written notice to 168.10 the county agency, obtain targeted relocation case management 168.11 services from a home care targeted case management provider, as 168.12 defined in subdivision 43c; and 168.13 (2) for home care targeted case management, an eligible 168.14 recipient must be assigned a case manager within 20 working days 168.15 of requesting a case manager from a home care targeted case 168.16 management provider, as defined in subdivision 43c. 168.17 Sec. 25. Minnesota Statutes 2000, section 256B.0625, is 168.18 amended by adding a subdivision to read: 168.19 Subd. 43f. [EVALUATION.] The commissioner shall evaluate 168.20 the delivery of targeted case management, including, but not 168.21 limited to, access to case management services, consumer 168.22 satisfaction with case management services, and quality of case 168.23 management services. 168.24 Sec. 26. Minnesota Statutes 2000, section 256B.0625, is 168.25 amended by adding a subdivision to read: 168.26 Subd. 43g. [CONTACT DOCUMENTATION.] The case manager must 168.27 document each face-to-face and telephone contact with the 168.28 recipient and others involved in the recipient's individual 168.29 service plan. 168.30 Sec. 27. Minnesota Statutes 2000, section 256B.0625, is 168.31 amended by adding a subdivision to read: 168.32 Subd. 43h. [PAYMENT RATES.] The commissioner shall set 168.33 payment rates for targeted case management under this 168.34 subdivision. Case managers may bill according to the following 168.35 criteria: 168.36 (1) for relocation targeted case management, case managers 169.1 may bill for direct case management activities, including 169.2 face-to-face and telephone contacts, in the 180 days preceding 169.3 an eligible recipient's discharge from an institution; 169.4 (2) for home care targeted case management, case managers 169.5 may bill for direct case management activities, including 169.6 face-to-face and telephone contacts; and 169.7 (3) billings for targeted case management services under 169.8 this subdivision shall not duplicate payments made under other 169.9 program authorities for the same purpose. 169.10 Sec. 28. Minnesota Statutes 2000, section 256B.0627, 169.11 subdivision 1, is amended to read: 169.12 Subdivision 1. [DEFINITION.] (a) "Activities of daily 169.13 living" includes eating, toileting, grooming, dressing, bathing, 169.14 transferring, mobility, and positioning. 169.15 (b) "Assessment" means a review and evaluation of a 169.16 recipient's need for home care services conducted in person. 169.17 Assessments for private duty nursing shall be conducted by a 169.18 registered private duty nurse. Assessments for home health 169.19 agency services shall be conducted by a home health agency 169.20 nurse. Assessments for personal care assistant services shall 169.21 be conducted by the county public health nurse or a certified 169.22 public health nurse under contract with the county. A 169.23 face-to-face assessment must include: documentation of health 169.24 status, determination of need, evaluation of service 169.25 effectiveness, identification of appropriate services, service 169.26 plan development or modification, coordination of services, 169.27 referrals and follow-up to appropriate payers and community 169.28 resources, completion of required reports, recommendation of 169.29 service authorization, and consumer education. Once the need 169.30 for personal care assistant services is determined under this 169.31 section, the county public health nurse or certified public 169.32 health nurse under contract with the county is responsible for 169.33 communicating this recommendation to the commissioner and the 169.34 recipient. A face-to-face assessment for personal 169.35 care assistant services is conducted on those recipients who 169.36 have never had a county public health nurse assessment. A 170.1 face-to-face assessment must occur at least annually or when 170.2 there is a significant change in the recipient's condition or 170.3 when there is a change in the need for personal care assistant 170.4 services. A service update may substitute for the annual 170.5 face-to-face assessment when there is not a significant change 170.6 in recipient condition or a change in the need for personal care 170.7 assistant service. A service update or review for temporary 170.8 increase includes a review of initial baseline data, evaluation 170.9 of service effectiveness, redetermination of service need, 170.10 modification of service plan and appropriate referrals, update 170.11 of initial forms, obtaining service authorization, and on going 170.12 consumer education. Assessments for medical assistance home 170.13 care services for mental retardation or related conditions and 170.14 alternative care services for developmentally disabled home and 170.15 community-based waivered recipients may be conducted by the 170.16 county public health nurse to ensure coordination and avoid 170.17 duplication. Assessments must be completed on forms provided by 170.18 the commissioner within 30 days of a request for home care 170.19 services by a recipient or responsible party. 170.20(b)(c) "Care plan" means a written description of personal 170.21 care assistant services developed by the qualified 170.22 professional or the recipient's physician with the recipient or 170.23 responsible party to be used by the personal care assistant with 170.24 a copy provided to the recipient or responsible party. 170.25 (d) "Complex and regular private duty nursing care" means, 170.26 effective July 1, 2001: 170.27 (1) complex care is private duty nursing provided to 170.28 recipients who are ventilator dependent or for whom a physician 170.29 has certified that were it not for private duty nursing the 170.30 recipient would meet the criteria for inpatient hospital 170.31 intensive care unit (ICU) level of care; and 170.32 (2) regular care is private duty nursing provided to all 170.33 other recipients. 170.34 (e) "Health-related functions" means functions that can be 170.35 delegated or assigned by a licensed health care professional 170.36 under state law to be performed by a personal care attendant. 171.1(c)(f) "Home care services" means a health service, 171.2 determined by the commissioner as medically necessary, that is 171.3 ordered by a physician and documented in a service plan that is 171.4 reviewed by the physician at least once every6260 days for the 171.5 provision of home health services, or private duty nursing, or 171.6 at least once every 365 days for personal care. Home care 171.7 services are provided to the recipient at the recipient's 171.8 residence that is a place other than a hospital or long-term 171.9 care facility or as specified in section 256B.0625. 171.10 (g) "Instrumental activities of daily living" includes meal 171.11 planning and preparation, managing finances, shopping for food, 171.12 clothing, and other essential items, performing essential 171.13 household chores, communication by telephone and other media, 171.14 and getting around and participating in the community. 171.15(d)(h) "Medically necessary" has the meaning given in 171.16 Minnesota Rules, parts 9505.0170 to 9505.0475. 171.17(e)(i) "Personal care assistant" means a person who: 171.18 (1) is at least 18 years old, except for persons 16 to 18 171.19 years of age who participated in a related school-based job 171.20 training program or have completed a certified home health aide 171.21 competency evaluation; 171.22 (2) is able to effectively communicate with the recipient 171.23 and personal care provider organization; 171.24 (3) effective July 1, 1996, has completed one of the 171.25 training requirements as specified in Minnesota Rules, part 171.26 9505.0335, subpart 3, items A to D; 171.27 (4) has the ability to, and provides covered personal care 171.28 assistant services according to the recipient's care plan, 171.29 responds appropriately to recipient needs, and reports changes 171.30 in the recipient's condition to the supervising qualified 171.31 professional or physician; 171.32 (5) is not a consumer of personal care assistant services; 171.33 and 171.34 (6) is subject to criminal background checks and procedures 171.35 specified in section 245A.04. 171.36(f)(j) "Personal care provider organization" means an 172.1 organization enrolled to provide personal care assistant 172.2 services under the medical assistance program that complies with 172.3 the following: (1) owners who have a five percent interest or 172.4 more, and managerial officials are subject to a background study 172.5 as provided in section 245A.04. This applies to currently 172.6 enrolled personal care provider organizations and those agencies 172.7 seeking enrollment as a personal care provider organization. An 172.8 organization will be barred from enrollment if an owner or 172.9 managerial official of the organization has been convicted of a 172.10 crime specified in section 245A.04, or a comparable crime in 172.11 another jurisdiction, unless the owner or managerial official 172.12 meets the reconsideration criteria specified in section 245A.04; 172.13 (2) the organization must maintain a surety bond and liability 172.14 insurance throughout the duration of enrollment and provides 172.15 proof thereof. The insurer must notify the department of human 172.16 services of the cancellation or lapse of policy; and (3) the 172.17 organization must maintain documentation of services as 172.18 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 172.19 as evidence of compliance with personal care assistant training 172.20 requirements. 172.21(g)(k) "Responsible party" means an individual residing 172.22 with a recipient of personal care assistant services who is 172.23 capable of providing the supportive care necessary to assist the 172.24 recipient to live in the community, is at least 18 years old, 172.25 and is not a personal care assistant. Responsible parties who 172.26 are parents of minors or guardians of minors or incapacitated 172.27 persons may delegate the responsibility to another adult during 172.28 a temporary absence of at least 24 hours but not more than six 172.29 months. The person delegated as a responsible party must be 172.30 able to meet the definition of responsible party, except that 172.31 the delegated responsible party is required to reside with the 172.32 recipient only while serving as the responsible party. Foster 172.33 care license holders may be designated the responsible party for 172.34 residents of the foster care home if case management is provided 172.35 as required in section 256B.0625, subdivision 19a. For persons 172.36 who, as of April 1, 1992, are sharing personal care assistant 173.1 services in order to obtain the availability of 24-hour 173.2 coverage, an employee of the personal care provider organization 173.3 may be designated as the responsible party if case management is 173.4 provided as required in section 256B.0625, subdivision 19a. 173.5(h)(l) "Service plan" means a written description of the 173.6 services needed based on the assessment developed by the nurse 173.7 who conducts the assessment together with the recipient or 173.8 responsible party. The service plan shall include a description 173.9 of the covered home care services, frequency and duration of 173.10 services, and expected outcomes and goals. The recipient and 173.11 the provider chosen by the recipient or responsible party must 173.12 be given a copy of the completed service plan within 30 calendar 173.13 days of the request for home care services by the recipient or 173.14 responsible party. 173.15(i)(m) "Skilled nurse visits" are provided in a 173.16 recipient's residence under a plan of care or service plan that 173.17 specifies a level of care which the nurse is qualified to 173.18 provide. These services are: 173.19 (1) nursing services according to the written plan of care 173.20 or service plan and accepted standards of medical and nursing 173.21 practice in accordance with chapter 148; 173.22 (2) services which due to the recipient's medical condition 173.23 may only be safely and effectively provided by a registered 173.24 nurse or a licensed practical nurse; 173.25 (3) assessments performed only by a registered nurse; and 173.26 (4) teaching and training the recipient, the recipient's 173.27 family, or other caregivers requiring the skills of a registered 173.28 nurse or licensed practical nurse. 173.29 (n) "Telehomecare" means the use of telecommunications 173.30 technology by a home health care professional to deliver home 173.31 health care services, within the professional's scope of 173.32 practice, to a patient located at a site other than the site 173.33 where the practitioner is located. 173.34 Sec. 29. Minnesota Statutes 2000, section 256B.0627, 173.35 subdivision 2, is amended to read: 173.36 Subd. 2. [SERVICES COVERED.] Home care services covered 174.1 under this section include: 174.2 (1) nursing services under section 256B.0625, subdivision 174.3 6a; 174.4 (2) private duty nursing services under section 256B.0625, 174.5 subdivision 7; 174.6 (3) home healthaideservices under section 256B.0625, 174.7 subdivision 6a; 174.8 (4) personal care assistant services under section 174.9 256B.0625, subdivision 19a; 174.10 (5) supervision of personal care assistant services 174.11 provided by a qualified professional under section 256B.0625, 174.12 subdivision 19a; 174.13 (6)consultingqualified professional of personal care 174.14 assistant services under the fiscalagentintermediary option as 174.15 specified in subdivision 10; 174.16 (7) face-to-face assessments by county public health nurses 174.17 for services under section 256B.0625, subdivision 19a; and 174.18 (8) service updates and review of temporary increases for 174.19 personal care assistant services by the county public health 174.20 nurse for services under section 256B.0625, subdivision 19a. 174.21 Sec. 30. Minnesota Statutes 2000, section 256B.0627, 174.22 subdivision 4, is amended to read: 174.23 Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The 174.24 personal care assistant services that are eligible for payment 174.25 arethe following:services and supports furnished to an 174.26 individual, as needed, to assist in accomplishing activities of 174.27 daily living; instrumental activities of daily living; 174.28 health-related functions through hands-on assistance, 174.29 supervision, and cuing; and redirection and intervention for 174.30 behavior including observation and monitoring. 174.31 (b) Payment for services will be made within the limits 174.32 approved using the prior authorized process established in 174.33 subdivision 5. 174.34 (c) The amount and type of services authorized shall be 174.35 based on an assessment of the recipient's needs in these areas: 174.36 (1) bowel and bladder care; 175.1 (2) skin care to maintain the health of the skin; 175.2 (3) repetitive maintenance range of motion, muscle 175.3 strengthening exercises, and other tasks specific to maintaining 175.4 a recipient's optimal level of function; 175.5 (4) respiratory assistance; 175.6 (5) transfers and ambulation; 175.7 (6) bathing, grooming, and hairwashing necessary for 175.8 personal hygiene; 175.9 (7) turning and positioning; 175.10 (8) assistance with furnishing medication that is 175.11 self-administered; 175.12 (9) application and maintenance of prosthetics and 175.13 orthotics; 175.14 (10) cleaning medical equipment; 175.15 (11) dressing or undressing; 175.16 (12) assistance with eating and meal preparation and 175.17 necessary grocery shopping; 175.18 (13) accompanying a recipient to obtain medical diagnosis 175.19 or treatment; 175.20 (14) assisting, monitoring, or prompting the recipient to 175.21 complete the services in clauses (1) to (13); 175.22 (15) redirection, monitoring, and observation that are 175.23 medically necessary and an integral part of completing the 175.24 personal care assistant services described in clauses (1) to 175.25 (14); 175.26 (16) redirection and intervention for behavior, including 175.27 observation and monitoring; 175.28 (17) interventions for seizure disorders, including 175.29 monitoring and observation if the recipient has had a seizure 175.30 that requires intervention within the past three months; 175.31 (18) tracheostomy suctioning using a clean procedure if the 175.32 procedure is properly delegated by a registered nurse. Before 175.33 this procedure can be delegated to a personal care assistant, a 175.34 registered nurse must determine that the tracheostomy suctioning 175.35 can be accomplished utilizing a clean rather than a sterile 175.36 procedure and must ensure that the personal care assistant has 176.1 been taught the proper procedure; and 176.2 (19) incidental household services that are an integral 176.3 part of a personal care service described in clauses (1) to (18). 176.4 For purposes of this subdivision, monitoring and observation 176.5 means watching for outward visible signs that are likely to 176.6 occur and for which there is a covered personal care service or 176.7 an appropriate personal care intervention. For purposes of this 176.8 subdivision, a clean procedure refers to a procedure that 176.9 reduces the numbers of microorganisms or prevents or reduces the 176.10 transmission of microorganisms from one person or place to 176.11 another. A clean procedure may be used beginning 14 days after 176.12 insertion. 176.13(b)(d) The personal care assistant services that are not 176.14 eligible for payment are the following: 176.15 (1) services not ordered by the physician; 176.16 (2) assessments by personal care assistant provider 176.17 organizations or by independently enrolled registered nurses; 176.18 (3) services that are not in the service plan; 176.19 (4) services provided by the recipient's spouse, legal 176.20 guardian for an adult or child recipient, or parent of a 176.21 recipient under age 18; 176.22 (5) services provided by a foster care provider of a 176.23 recipient who cannot direct the recipient's own care, unless 176.24 monitored by a county or state case manager under section 176.25 256B.0625, subdivision 19a; 176.26 (6) services provided by the residential or program license 176.27 holder in a residence for more than four persons; 176.28 (7) services that are the responsibility of a residential 176.29 or program license holder under the terms of a service agreement 176.30 and administrative rules; 176.31 (8) sterile procedures; 176.32 (9) injections of fluids into veins, muscles, or skin; 176.33 (10) services provided by parents of adult recipients, 176.34 adult children, or siblings of the recipient, unless these 176.35 relatives meet one of the following hardship criteria and the 176.36 commissioner waives this requirement: 177.1 (i) the relative resigns from a part-time or full-time job 177.2 to provide personal care for the recipient; 177.3 (ii) the relative goes from a full-time to a part-time job 177.4 with less compensation to provide personal care for the 177.5 recipient; 177.6 (iii) the relative takes a leave of absence without pay to 177.7 provide personal care for the recipient; 177.8 (iv) the relative incurs substantial expenses by providing 177.9 personal care for the recipient; or 177.10 (v) because of labor conditions, special language needs, or 177.11 intermittent hours of care needed, the relative is needed in 177.12 order to provide an adequate number of qualified personal care 177.13 assistants to meet the medical needs of the recipient; 177.14 (11) homemaker services that are not an integral part of a 177.15 personal care assistant services; 177.16 (12) home maintenance, or chore services; 177.17 (13) services not specified under paragraph (a); and 177.18 (14) services not authorized by the commissioner or the 177.19 commissioner's designee. 177.20 (e) The recipient or responsible party may choose to 177.21 supervise the personal care assistant or to have a qualified 177.22 professional, as defined in section 256B.0625, subdivision 19c, 177.23 provide the supervision. As required under section 256B.0625, 177.24 subdivision 19c, the county public health nurse, as a part of 177.25 the assessment, will assist the recipient or responsible party 177.26 to identify the most appropriate person to provide supervision 177.27 of the personal care assistant. Health-related delegated tasks 177.28 performed by the personal care assistant will be under the 177.29 supervision of a qualified professional or the direction of the 177.30 recipient's physician. If the recipient has a qualified 177.31 professional, Minnesota Rules, part 9505.0335, subpart 4, 177.32 applies. 177.33 Sec. 31. Minnesota Statutes 2000, section 256B.0627, 177.34 subdivision 5, is amended to read: 177.35 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 177.36 payments for home care services shall be limited according to 178.1 this subdivision. 178.2 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 178.3 recipient may receive the following home care services during a 178.4 calendar year: 178.5 (1) up to two face-to-face assessments to determine a 178.6 recipient's need for personal care assistant services; 178.7 (2) one service update done to determine a recipient's need 178.8 for personal care assistant services; and 178.9 (3) up tofivenine skilled nurse visits. 178.10 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 178.11 services above the limits in paragraph (a) must receive the 178.12 commissioner's prior authorization, except when: 178.13 (1) the home care services were required to treat an 178.14 emergency medical condition that if not immediately treated 178.15 could cause a recipient serious physical or mental disability, 178.16 continuation of severe pain, or death. The provider must 178.17 request retroactive authorization no later than five working 178.18 days after giving the initial service. The provider must be 178.19 able to substantiate the emergency by documentation such as 178.20 reports, notes, and admission or discharge histories; 178.21 (2) the home care services were provided on or after the 178.22 date on which the recipient's eligibility began, but before the 178.23 date on which the recipient was notified that the case was 178.24 opened. Authorization will be considered if the request is 178.25 submitted by the provider within 20 working days of the date the 178.26 recipient was notified that the case was opened; 178.27 (3) a third-party payor for home care services has denied 178.28 or adjusted a payment. Authorization requests must be submitted 178.29 by the provider within 20 working days of the notice of denial 178.30 or adjustment. A copy of the notice must be included with the 178.31 request; 178.32 (4) the commissioner has determined that a county or state 178.33 human services agency has made an error; or 178.34 (5) the professional nurse determines an immediate need for 178.35 up to 40 skilled nursing or home health aide visits per calendar 178.36 year and submits a request for authorization within 20 working 179.1 days of the initial service date, and medical assistance is 179.2 determined to be the appropriate payer. 179.3 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 179.4 authorization will be evaluated according to the same criteria 179.5 applied to prior authorization requests. 179.6 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 179.7 section 256B.0627, subdivision 1, paragraph (a), shall be 179.8 conducted initially, and at least annually thereafter, in person 179.9 with the recipient and result in a completed service plan using 179.10 forms specified by the commissioner. Within 30 days of 179.11 recipient or responsible party request for home care services, 179.12 the assessment, the service plan, and other information 179.13 necessary to determine medical necessity such as diagnostic or 179.14 testing information, social or medical histories, and hospital 179.15 or facility discharge summaries shall be submitted to the 179.16 commissioner. For personal care assistant services: 179.17 (1) The amount and type of service authorized based upon 179.18 the assessment and service plan will follow the recipient if the 179.19 recipient chooses to change providers. 179.20 (2) If the recipient's medical need changes, the 179.21 recipient's provider may assess the need for a change in service 179.22 authorization and request the change from the county public 179.23 health nurse. Within 30 days of the request, the public health 179.24 nurse will determine whether to request the change in services 179.25 based upon the provider assessment, or conduct a home visit to 179.26 assess the need and determine whether the change is appropriate. 179.27 (3) To continue to receive personal care assistant services 179.28 after the first year, the recipient or the responsible party, in 179.29 conjunction with the public health nurse, may complete a service 179.30 update on forms developed by the commissioner according to 179.31 criteria and procedures in subdivision 1. 179.32 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 179.33 commissioner's designee, shall review the assessment, service 179.34 update, request for temporary services, service plan, and any 179.35 additional information that is submitted. The commissioner 179.36 shall, within 30 days after receiving a complete request, 180.1 assessment, and service plan, authorize home care services as 180.2 follows: 180.3 (1) [HOME HEALTH SERVICES.] All home health services 180.4 provided by alicensed nurse or ahome health aide must be prior 180.5 authorized by the commissioner or the commissioner's designee. 180.6 Prior authorization must be based on medical necessity and 180.7 cost-effectiveness when compared with other care options. When 180.8 home health services are used in combination with personal care 180.9 and private duty nursing, the cost of all home care services 180.10 shall be considered for cost-effectiveness. The commissioner 180.11 shall limitnurse andhome health aide visits to no more than 180.12 one visit each per day. The commissioner, or the commissioner's 180.13 designee, may authorize up to two skilled nurse visits per day. 180.14 (2) [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal 180.15 care assistant services and supervision by a qualified 180.16 professional, if requested by the recipient, must be prior 180.17 authorized by the commissioner or the commissioner's designee 180.18 except for the assessments established in paragraph (a). The 180.19 amount of personal care assistant services authorized must be 180.20 based on the recipient's home care rating. A child may not be 180.21 found to be dependent in an activity of daily living if because 180.22 of the child's age an adult would either perform the activity 180.23 for the child or assist the child with the activity and the 180.24 amount of assistance needed is similar to the assistance 180.25 appropriate for a typical child of the same age. Based on 180.26 medical necessity, the commissioner may authorize: 180.27 (A) up to two times the average number of direct care hours 180.28 provided in nursing facilities for the recipient's comparable 180.29 case mix level; or 180.30 (B) up to three times the average number of direct care 180.31 hours provided in nursing facilities for recipients who have 180.32 complex medical needs or are dependent in at least seven 180.33 activities of daily living and need physical assistance with 180.34 eating or have a neurological diagnosis; or 180.35 (C) up to 60 percent of the average reimbursement rate, as 180.36 of July 1, 1991, for care provided in a regional treatment 181.1 center for recipients who have Level I behavior, plus any 181.2 inflation adjustment as provided by the legislature for personal 181.3 care service; or 181.4 (D) up to the amount the commissioner would pay, as of July 181.5 1, 1991, plus any inflation adjustment provided for home care 181.6 services, for care provided in a regional treatment center for 181.7 recipients referred to the commissioner by a regional treatment 181.8 center preadmission evaluation team. For purposes of this 181.9 clause, home care services means all services provided in the 181.10 home or community that would be included in the payment to a 181.11 regional treatment center; or 181.12 (E) up to the amount medical assistance would reimburse for 181.13 facility care for recipients referred to the commissioner by a 181.14 preadmission screening team established under section 256B.0911 181.15 or 256B.092; and 181.16 (F) a reasonable amount of time for the provision of 181.17 supervision by a qualified professional of personal 181.18 care assistant services, if a qualified professional is 181.19 requested by the recipient or responsible party. 181.20 (ii) The number of direct care hours shall be determined 181.21 according to the annual cost report submitted to the department 181.22 by nursing facilities. The average number of direct care hours, 181.23 as established by May 1, 1992, shall be calculated and 181.24 incorporated into the home care limits on July 1, 1992. These 181.25 limits shall be calculated to the nearest quarter hour. 181.26 (iii) The home care rating shall be determined by the 181.27 commissioner or the commissioner's designee based on information 181.28 submitted to the commissioner by the county public health nurse 181.29 on forms specified by the commissioner. The home care rating 181.30 shall be a combination of current assessment tools developed 181.31 under sections 256B.0911 and 256B.501 with an addition for 181.32 seizure activity that will assess the frequency and severity of 181.33 seizure activity and with adjustments, additions, and 181.34 clarifications that are necessary to reflect the needs and 181.35 conditions of recipients who need home care including children 181.36 and adults under 65 years of age. The commissioner shall 182.1 establish these forms and protocols under this section and shall 182.2 use an advisory group, including representatives of recipients, 182.3 providers, and counties, for consultation in establishing and 182.4 revising the forms and protocols. 182.5 (iv) A recipient shall qualify as having complex medical 182.6 needs if the care required is difficult to perform and because 182.7 of recipient's medical condition requires more time than 182.8 community-based standards allow or requires more skill than 182.9 would ordinarily be required and the recipient needs or has one 182.10 or more of the following: 182.11 (A) daily tube feedings; 182.12 (B) daily parenteral therapy; 182.13 (C) wound or decubiti care; 182.14 (D) postural drainage, percussion, nebulizer treatments, 182.15 suctioning, tracheotomy care, oxygen, mechanical ventilation; 182.16 (E) catheterization; 182.17 (F) ostomy care; 182.18 (G) quadriplegia; or 182.19 (H) other comparable medical conditions or treatments the 182.20 commissioner determines would otherwise require institutional 182.21 care. 182.22 (v) A recipient shall qualify as having Level I behavior if 182.23 there is reasonable supporting evidence that the recipient 182.24 exhibits, or that without supervision, observation, or 182.25 redirection would exhibit, one or more of the following 182.26 behaviors that cause, or have the potential to cause: 182.27 (A) injury to the recipient's own body; 182.28 (B) physical injury to other people; or 182.29 (C) destruction of property. 182.30 (vi) Time authorized for personal care relating to Level I 182.31 behavior in subclause (v), items (A) to (C), shall be based on 182.32 the predictability, frequency, and amount of intervention 182.33 required. 182.34 (vii) A recipient shall qualify as having Level II behavior 182.35 if the recipient exhibits on a daily basis one or more of the 182.36 following behaviors that interfere with the completion of 183.1 personal care assistant services under subdivision 4, paragraph 183.2 (a): 183.3 (A) unusual or repetitive habits; 183.4 (B) withdrawn behavior; or 183.5 (C) offensive behavior. 183.6 (viii) A recipient with a home care rating of Level II 183.7 behavior in subclause (vii), items (A) to (C), shall be rated as 183.8 comparable to a recipient with complex medical needs under 183.9 subclause (iv). If a recipient has both complex medical needs 183.10 and Level II behavior, the home care rating shall be the next 183.11 complex category up to the maximum rating under subclause (i), 183.12 item (B). 183.13 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 183.14 nursing services shall be prior authorized by the commissioner 183.15 or the commissioner's designee. Prior authorization for private 183.16 duty nursing services shall be based on medical necessity and 183.17 cost-effectiveness when compared with alternative care options. 183.18 The commissioner may authorize medically necessary private duty 183.19 nursing services in quarter-hour units when: 183.20 (i) the recipient requires more individual and continuous 183.21 care than can be provided during a nurse visit; or 183.22 (ii) the cares are outside of the scope of services that 183.23 can be provided by a home health aide or personal care assistant. 183.24 The commissioner may authorize: 183.25 (A) up to two times the average amount of direct care hours 183.26 provided in nursing facilities statewide for case mix 183.27 classification "K" as established by the annual cost report 183.28 submitted to the department by nursing facilities in May 1992; 183.29 (B) private duty nursing in combination with other home 183.30 care services up to the total cost allowed under clause (2); 183.31 (C) up to 16 hours per day if the recipient requires more 183.32 nursing than the maximum number of direct care hours as 183.33 established in item (A) and the recipient meets the hospital 183.34 admission criteria established under Minnesota Rules, parts 183.359505.05009505.0501 to 9505.0540. 183.36 The commissioner may authorize up to 16 hours per day of 184.1 medically necessary private duty nursing services or up to 24 184.2 hours per day of medically necessary private duty nursing 184.3 services until such time as the commissioner is able to make a 184.4 determination of eligibility for recipients who are 184.5 cooperatively applying for home care services under the 184.6 community alternative care program developed under section 184.7 256B.49, or until it is determined by the appropriate regulatory 184.8 agency that a health benefit plan is or is not required to pay 184.9 for appropriate medically necessary health care services. 184.10 Recipients or their representatives must cooperatively assist 184.11 the commissioner in obtaining this determination. Recipients 184.12 who are eligible for the community alternative care program may 184.13 not receive more hours of nursing under this section than would 184.14 otherwise be authorized under section 256B.49. 184.15 Beginning July 1, 2001, private duty nursing services shall 184.16 be authorized for complex and regular care according to 184.17 subdivision 1. 184.18 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 184.19 ventilator-dependent, the monthly medical assistance 184.20 authorization for home care services shall not exceed what the 184.21 commissioner would pay for care at the highest cost hospital 184.22 designated as a long-term hospital under the Medicare program. 184.23 For purposes of this clause, home care services means all 184.24 services provided in the home that would be included in the 184.25 payment for care at the long-term hospital. 184.26 "Ventilator-dependent" means an individual who receives 184.27 mechanical ventilation for life support at least six hours per 184.28 day and is expected to be or has been dependent for at least 30 184.29 consecutive days. 184.30 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 184.31 or the commissioner's designee shall determine the time period 184.32 for which a prior authorization shall be effective. If the 184.33 recipient continues to require home care services beyond the 184.34 duration of the prior authorization, the home care provider must 184.35 request a new prior authorization. Under no circumstances, 184.36 other than the exceptions in paragraph (b), shall a prior 185.1 authorization be valid prior to the date the commissioner 185.2 receives the request or for more than 12 months. A recipient 185.3 who appeals a reduction in previously authorized home care 185.4 services may continue previously authorized services, other than 185.5 temporary services under paragraph (h), pending an appeal under 185.6 section 256.045. The commissioner must provide a detailed 185.7 explanation of why the authorized services are reduced in amount 185.8 from those requested by the home care provider. 185.9 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 185.10 the commissioner's designee shall determine the medical 185.11 necessity of home care services, the level of caregiver 185.12 according to subdivision 2, and the institutional comparison 185.13 according to this subdivision, the cost-effectiveness of 185.14 services, and the amount, scope, and duration of home care 185.15 services reimbursable by medical assistance, based on the 185.16 assessment, primary payer coverage determination information as 185.17 required, the service plan, the recipient's age, the cost of 185.18 services, the recipient's medical condition, and diagnosis or 185.19 disability. The commissioner may publish additional criteria 185.20 for determining medical necessity according to section 256B.04. 185.21 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 185.22 The agency nurse, the independently enrolled private duty nurse, 185.23 or county public health nurse may request a temporary 185.24 authorization for home care services by telephone. The 185.25 commissioner may approve a temporary level of home care services 185.26 based on the assessment, and service or care plan information, 185.27 and primary payer coverage determination information as required. 185.28 Authorization for a temporary level of home care services 185.29 including nurse supervision is limited to the time specified by 185.30 the commissioner, but shall not exceed 45 days, unless extended 185.31 because the county public health nurse has not completed the 185.32 required assessment and service plan, or the commissioner's 185.33 determination has not been made. The level of services 185.34 authorized under this provision shall have no bearing on a 185.35 future prior authorization. 185.36 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 186.1 Home care services provided in an adult or child foster care 186.2 setting must receive prior authorization by the department 186.3 according to the limits established in paragraph (a). 186.4 The commissioner may not authorize: 186.5 (1) home care services that are the responsibility of the 186.6 foster care provider under the terms of the foster care 186.7 placement agreement and administrative rules; 186.8 (2) personal care assistant services when the foster care 186.9 license holder is also the personal care provider or personal 186.10 care assistant unless the recipient can direct the recipient's 186.11 own care, or case management is provided as required in section 186.12 256B.0625, subdivision 19a; 186.13 (3) personal care assistant services when the responsible 186.14 party is an employee of, or under contract with, or has any 186.15 direct or indirect financial relationship with the personal care 186.16 provider or personal care assistant, unless case management is 186.17 provided as required in section 256B.0625, subdivision 19a; or 186.18 (4) personal care assistant and private duty nursing 186.19 services when the number of foster care residents is greater 186.20 than four unless the county responsible for the recipient's 186.21 foster placement made the placement prior to April 1, 1992, 186.22 requests that personal care assistant and private duty nursing 186.23 services be provided, and case management is provided as 186.24 required in section 256B.0625, subdivision 19a. 186.25 Sec. 32. Minnesota Statutes 2000, section 256B.0627, 186.26 subdivision 7, is amended to read: 186.27 Subd. 7. [NONCOVERED HOME CARE SERVICES.] The following 186.28 home care services are not eligible for payment under medical 186.29 assistance: 186.30 (1) skilled nurse visits for the sole purpose of 186.31 supervision of the home health aide; 186.32 (2) a skilled nursing visit: 186.33 (i) only for the purpose of monitoring medication 186.34 compliance with an established medication program for a 186.35 recipient; or 186.36 (ii) to administer or assist with medication 187.1 administration, including injections, prefilling syringes for 187.2 injections, or oral medication set-up of an adult recipient, 187.3 when as determined and documented by the registered nurse, the 187.4 need can be met by an available pharmacy or the recipient is 187.5 physically and mentally able to self-administer or prefill a 187.6 medication; 187.7 (3) home care services to a recipient who is eligible for 187.8 covered servicesincluding hospice, if elected by the recipient,187.9 under the Medicare program or any other insurance held by the 187.10 recipient; 187.11 (4) services to other members of the recipient's household; 187.12 (5) a visit made by a skilled nurse solely to train other 187.13 home health agency workers; 187.14 (6) any home care service included in the daily rate of the 187.15 community-based residential facility where the recipient is 187.16 residing; 187.17 (7) nursing and rehabilitation therapy services that are 187.18 reasonably accessible to a recipient outside the recipient's 187.19 place of residence, excluding the assessment, counseling and 187.20 education, and personal assistant care; 187.21 (8) any home health agency service, excluding personal care 187.22 assistant services and private duty nursing services, which are 187.23 performed in a place other than the recipient's residence; and 187.24 (9) Medicare evaluation or administrative nursing visits on 187.25 dual-eligible recipients that do not qualify for Medicare visit 187.26 billing. 187.27 Sec. 33. Minnesota Statutes 2000, section 256B.0627, 187.28 subdivision 8, is amended to read: 187.29 Subd. 8. [SHARED PERSONAL CARE ASSISTANT SERVICES.] (a) 187.30 Medical assistance payments for shared personal care assistance 187.31 services shall be limited according to this subdivision. 187.32 (b) Recipients of personal care assistant services may 187.33 share staff and the commissioner shall provide a rate system for 187.34 shared personal care assistant services. For two persons 187.35 sharing services, the rate paid to a provider shall not exceed 187.36 1-1/2 times the rate paid for serving a single individual, and 188.1 for three persons sharing services, the rate paid to a provider 188.2 shall not exceed twice the rate paid for serving a single 188.3 individual. These rates apply only to situations in which all 188.4 recipients were present and received shared services on the date 188.5 for which the service is billed. No more than three persons may 188.6 receive shared services from a personal care assistant in a 188.7 single setting. 188.8 (c) Shared service is the provision of personal 188.9 care assistant services by a personal care assistant to two or 188.10 three recipients at the same time and in the same setting. For 188.11 the purposes of this subdivision, "setting" means: 188.12 (1) the home or foster care home of one of the individual 188.13 recipients; or 188.14 (2) a child care program in which all recipients served by 188.15 one personal care assistant are participating, which is licensed 188.16 under chapter 245A or operated by a local school district or 188.17 private school; or 188.18 (3) outside the home or foster care home of one of the 188.19 recipients when normal life activities take the recipients 188.20 outside the home. 188.21 The provisions of this subdivision do not apply when a 188.22 personal care assistant is caring for multiple recipients in 188.23 more than one setting. 188.24 (d) The recipient or the recipient's responsible party, in 188.25 conjunction with the county public health nurse, shall determine: 188.26 (1) whether shared personal care assistant services is an 188.27 appropriate option based on the individual needs and preferences 188.28 of the recipient; and 188.29 (2) the amount of shared services allocated as part of the 188.30 overall authorization of personal care assistant services. 188.31 The recipient or the responsible party, in conjunction with 188.32 the supervising qualified professional, if a qualified 188.33 professional is requested by any one of the recipients or 188.34 responsible parties, shall arrange the setting and grouping of 188.35 shared services based on the individual needs and preferences of 188.36 the recipients. Decisions on the selection of recipients to 189.1 share services must be based on the ages of the recipients, 189.2 compatibility, and coordination of their care needs. 189.3 (e) The following items must be considered by the recipient 189.4 or the responsible party and the supervising qualified 189.5 professional, if a qualified professional has been requested by 189.6 any one of the recipients or responsible parties, and documented 189.7 in the recipient's health service record: 189.8 (1) the additional qualifications needed by the personal 189.9 care assistant to provide care to several recipients in the same 189.10 setting; 189.11 (2) the additional training and supervision needed by the 189.12 personal care assistant to ensure that the needs of the 189.13 recipient are met appropriately and safely. The provider must 189.14 provide on-site supervision by a qualified professional within 189.15 the first 14 days of shared services, and monthly thereafter, if 189.16 supervision by a qualified provider has been requested by any 189.17 one of the recipients or responsible parties; 189.18 (3) the setting in which the shared services will be 189.19 provided; 189.20 (4) the ongoing monitoring and evaluation of the 189.21 effectiveness and appropriateness of the service and process 189.22 used to make changes in service or setting; and 189.23 (5) a contingency plan which accounts for absence of the 189.24 recipient in a shared services setting due to illness or other 189.25 circumstances and staffing contingencies. 189.26 (f) The provider must offer the recipient or the 189.27 responsible party the option of shared or one-on-one personal 189.28 care assistant services. The recipient or the responsible party 189.29 can withdraw from participating in a shared services arrangement 189.30 at any time. 189.31 (g) In addition to documentation requirements under 189.32 Minnesota Rules, part 9505.2175, a personal care provider must 189.33 meet documentation requirements for shared personal care 189.34 assistant services and must document the following in the health 189.35 service record for each individual recipient sharing services: 189.36 (1) permission by the recipient or the recipient's 190.1 responsible party, if any, for the maximum number of shared 190.2 services hours per week chosen by the recipient; 190.3 (2) permission by the recipient or the recipient's 190.4 responsible party, if any, for personal care assistant services 190.5 provided outside the recipient's residence; 190.6 (3) permission by the recipient or the recipient's 190.7 responsible party, if any, for others to receive shared services 190.8 in the recipient's residence; 190.9 (4) revocation by the recipient or the recipient's 190.10 responsible party, if any, of the shared service authorization, 190.11 or the shared service to be provided to others in the 190.12 recipient's residence, or the shared service to be provided 190.13 outside the recipient's residence; 190.14 (5) supervision of the shared personal care assistant 190.15 services by the qualified professional, if a qualified 190.16 professional is requested by one of the recipients or 190.17 responsible parties, including the date, time of day, number of 190.18 hours spent supervising the provision of shared services, 190.19 whether the supervision was face-to-face or another method of 190.20 supervision, changes in the recipient's condition, shared 190.21 services scheduling issues and recommendations; 190.22 (6) documentation by the qualified professional, if a 190.23 qualified professional is requested by one of the recipients or 190.24 responsible parties, of telephone calls or other discussions 190.25 with the personal care assistant regarding services being 190.26 provided to the recipient who has requested the supervision; and 190.27 (7) daily documentation of the shared services provided by 190.28 each identified personal care assistant including: 190.29 (i) the names of each recipient receiving shared services 190.30 together; 190.31 (ii) the setting for the shared services, including the 190.32 starting and ending times that the recipient received shared 190.33 services; and 190.34 (iii) notes by the personal care assistant regarding 190.35 changes in the recipient's condition, problems that may arise 190.36 from the sharing of services, scheduling issues, care issues, 191.1 and other notes as required by the qualified professional, if a 191.2 qualified professional is requested by one of the recipients or 191.3 responsible parties. 191.4 (h) Unless otherwise provided in this subdivision, all 191.5 other statutory and regulatory provisions relating to personal 191.6 care assistant services apply to shared services. 191.7 (i) In the event that supervision by a qualified 191.8 professional has been requested by one or more recipients, but 191.9 not by all of the recipients, the supervision duties of the 191.10 qualified professional shall be limited to only those recipients 191.11 who have requested the supervision. 191.12 Nothing in this subdivision shall be construed to reduce 191.13 the total number of hours authorized for an individual recipient. 191.14 Sec. 34. Minnesota Statutes 2000, section 256B.0627, 191.15 subdivision 10, is amended to read: 191.16 Subd. 10. [FISCALAGENTINTERMEDIARY OPTION AVAILABLE FOR 191.17 PERSONAL CARE ASSISTANT SERVICES.] (a)"Fiscal agent option" is191.18an option that allows the recipient to:191.19(1) use a fiscal agent instead of a personal care provider191.20organization;191.21(2) supervise the personal care assistant; and191.22(3) use a consulting professional.191.23 The commissioner may allow a recipient of personal care 191.24 assistant services to use a fiscalagentintermediary to assist 191.25 the recipient in paying and accounting for medically necessary 191.26 covered personal care assistant services authorized in 191.27 subdivision 4 and within the payment parameters of subdivision 191.28 5. Unless otherwise provided in this subdivision, all other 191.29 statutory and regulatory provisions relating to personal care 191.30 assistant services apply to a recipient using the fiscalagent191.31 intermediary option. 191.32 (b) The recipient or responsible party shall: 191.33 (1)hire, and terminate the personal care assistant and191.34consulting professional, with the fiscal agentrecruit, hire, 191.35 and terminate a qualified professional, if a qualified 191.36 professional is requested by the recipient or responsible party; 192.1 (2)recruit the personal care assistant and consulting192.2professional and orient and train the personal care assistant in192.3areas that do not require professional delegation as determined192.4by the county public health nurseverify and document the 192.5 credentials of the qualified professional, if a qualified 192.6 professional is requested by the recipient or responsible party; 192.7 (3)supervise and evaluate the personal care assistant in192.8areas that do not require professional delegation as determined192.9in the assessment;192.10(4) cooperate with a consultingdevelop a service plan 192.11 based on physician orders and public health nurse assessment 192.12 with the assistance of a qualified professionaland implement192.13recommendations pertaining to the health and safety of the192.14recipient, if a qualified professional is requested by the 192.15 recipient or responsible party, that addresses the health and 192.16 safety of the recipient; 192.17(5) hire a qualified professional to train and supervise192.18the performance of delegated tasks done by(4) recruit, hire, 192.19 and terminate the personal care assistant; 192.20(6) monitor services and verify in writing the hours worked192.21by the personal care assistant and the consulting(5) orient and 192.22 train the personal care assistant with assistance as needed from 192.23 the qualified professional; 192.24(7) develop and revise a care plan with assistance from a192.25consulting(6) supervise and evaluate the personal care 192.26 assistant with assistance as needed from the recipient's 192.27 physician or the qualified professional; 192.28(8) verify and document the credentials of the consulting192.29 (7) monitor and verify in writing and report to the fiscal 192.30 intermediary the number of hours worked by the personal care 192.31 assistant and the qualified professional; and 192.32(9)(8) enter into a written agreement, as specified in 192.33 paragraph (f). 192.34 (c) The duties of the fiscalagentintermediary shall be to: 192.35 (1) bill the medical assistance program for personal care 192.36 assistant andconsultingqualified professional services; 193.1 (2) request and secure background checks on personal care 193.2 assistants andconsultingqualified professionals according to 193.3 section 245A.04; 193.4 (3) pay the personal care assistant andconsulting193.5 qualified professional based on actual hours of services 193.6 provided; 193.7 (4) withhold and pay all applicable federal and state 193.8 taxes; 193.9 (5) verify anddocumentkeep records of hours worked by the 193.10 personal care assistant andconsultingqualified professional; 193.11 (6) make the arrangements and pay unemployment insurance, 193.12 taxes, workers' compensation, liability insurance, and other 193.13 benefits, if any; 193.14 (7) enroll in the medical assistance program as a fiscal 193.15agentintermediary; and 193.16 (8) enter into a written agreement as specified in 193.17 paragraph (f) before services are provided. 193.18 (d) The fiscalagentintermediary: 193.19 (1) may not be related to the recipient,consulting193.20 qualified professional, or the personal care assistant; 193.21 (2) must ensure arm's length transactions with the 193.22 recipient and personal care assistant; and 193.23 (3) shall be considered a joint employer of the personal 193.24 care assistant andconsultingqualified professional to the 193.25 extent specified in this section. 193.26 The fiscalagentintermediary or owners of the entity that 193.27 provides fiscalagentintermediary services under this 193.28 subdivision must pass a criminal background check as required in 193.29 section 256B.0627, subdivision 1, paragraph (e). 193.30 (e) If the recipient or responsible party requests a 193.31 qualified professional, theconsultingqualified professional 193.32 providing assistance to the recipient shall meet the 193.33 qualifications specified in section 256B.0625, subdivision 19c. 193.34 Theconsultingqualified professional shall assist the recipient 193.35 in developing and revising a plan to meet the 193.36 recipient'sassessedneeds,and supervise the performance of194.1delegated tasks, as determined by the public health nurseas 194.2 assessed by the public health nurse. In performing this 194.3 function, theconsultingqualified professional must visit the 194.4 recipient in the recipient's home at least once annually. 194.5 Theconsultingqualified professional must reportto the local194.6county public health nurse concerns relating to the health and194.7safety of the recipient, andany suspected abuse, neglect, or 194.8 financial exploitation of the recipient to the appropriate 194.9 authorities. 194.10 (f) The fiscalagentintermediary, recipient or responsible 194.11 party, personal care assistant, andconsultingqualified 194.12 professional shall enter into a written agreement before 194.13 services are started. The agreement shall include: 194.14 (1) the duties of the recipient, qualified professional, 194.15 personal care assistant, and fiscal agent based on paragraphs 194.16 (a) to (e); 194.17 (2) the salary and benefits for the personal care assistant 194.18 andthose providing professional consultationthe qualified 194.19 professional; 194.20 (3) the administrative fee of the fiscalagentintermediary 194.21 and services paid for with that fee, including background check 194.22 fees; 194.23 (4) procedures to respond to billing or payment complaints; 194.24 and 194.25 (5) procedures for hiring and terminating the personal care 194.26 assistant andthose providing professional consultationthe 194.27 qualified professional. 194.28 (g) The rates paid for personal care assistant services, 194.29 qualified professionalassistanceservices, and fiscalagency194.30 intermediary services under this subdivision shall be the same 194.31 rates paid for personal care assistant services and qualified 194.32 professional services under subdivision 2 respectively. Except 194.33 for the administrative fee of the fiscalagentintermediary 194.34 specified in paragraph (f), the remainder of the rates paid to 194.35 the fiscalagentintermediary must be used to pay for the salary 194.36 and benefits for the personal care assistant orthose providing195.1professional consultationthe qualified professional. 195.2 (h) As part of the assessment defined in subdivision 1, the 195.3 following conditions must be met to use or continue use of a 195.4 fiscalagentintermediary: 195.5 (1) the recipient must be able to direct the recipient's 195.6 own care, or the responsible party for the recipient must be 195.7 readily available to direct the care of the personal care 195.8 assistant; 195.9 (2) the recipient or responsible party must be 195.10 knowledgeable of the health care needs of the recipient and be 195.11 able to effectively communicate those needs; 195.12 (3) a face-to-face assessment must be conducted by the 195.13 local county public health nurse at least annually, or when 195.14 there is a significant change in the recipient's condition or 195.15 change in the need for personal care assistant services. The195.16county public health nurse shall determine the services that195.17require professional delegation, if any, and the amount and195.18frequency of related supervision; 195.19 (4) the recipient cannot select the shared services option 195.20 as specified in subdivision 8; and 195.21 (5) parties must be in compliance with the written 195.22 agreement specified in paragraph (f). 195.23 (i) The commissioner shall deny, revoke, or suspend the 195.24 authorization to use the fiscalagentintermediary option if: 195.25 (1) it has been determined by theconsultingqualified 195.26 professional or local county public health nurse that the use of 195.27 this option jeopardizes the recipient's health and safety; 195.28 (2) the parties have failed to comply with the written 195.29 agreement specified in paragraph (f); or 195.30 (3) the use of the option has led to abusive or fraudulent 195.31 billing for personal care assistant services. 195.32 The recipient or responsible party may appeal the 195.33 commissioner's action according to section 256.045. The denial, 195.34 revocation, or suspension to use the fiscalagentintermediary 195.35 option shall not affect the recipient's authorized level of 195.36 personal care assistant services as determined in subdivision 5. 196.1 Sec. 35. Minnesota Statutes 2000, section 256B.0627, 196.2 subdivision 11, is amended to read: 196.3 Subd. 11. [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 196.4 Medical assistance payments for shared private duty nursing 196.5 services by a private duty nurse shall be limited according to 196.6 this subdivision. For the purposes of this section, "private 196.7 duty nursing agency" means an agency licensed under chapter 144A 196.8 to provide private duty nursing services. 196.9 (b) Recipients of private duty nursing services may share 196.10 nursing staff and the commissioner shall provide a rate 196.11 methodology for shared private duty nursing. For two persons 196.12 sharing nursing care, the rate paid to a provider shall not 196.13 exceed 1.5 times thenonwaiveredregular private duty nursing 196.14 rates paid for serving a single individualwho is not ventilator196.15dependent,by a registered nurse or licensed practical nurse. 196.16 These rates apply only to situations in which both recipients 196.17 are present and receive shared private duty nursing care on the 196.18 date for which the service is billed. No more than two persons 196.19 may receive shared private duty nursing services from a private 196.20 duty nurse in a single setting. 196.21 (c) Shared private duty nursing care is the provision of 196.22 nursing services by a private duty nurse to two recipients at 196.23 the same time and in the same setting. For the purposes of this 196.24 subdivision, "setting" means: 196.25 (1) the home or foster care home of one of the individual 196.26 recipients; or 196.27 (2) a child care program licensed under chapter 245A or 196.28 operated by a local school district or private school; or 196.29 (3) an adult day care service licensed under chapter 245A; 196.30 or 196.31 (4) outside the home or foster care home of one of the 196.32 recipients when normal life activities take the recipients 196.33 outside the home. 196.34 This subdivision does not apply when a private duty nurse 196.35 is caring for multiple recipients in more than one setting. 196.36 (d) The recipient or the recipient's legal representative, 197.1 and the recipient's physician, in conjunction with the home 197.2 health care agency, shall determine: 197.3 (1) whether shared private duty nursing care is an 197.4 appropriate option based on the individual needs and preferences 197.5 of the recipient; and 197.6 (2) the amount of shared private duty nursing services 197.7 authorized as part of the overall authorization of nursing 197.8 services. 197.9 (e) The recipient or the recipient's legal representative, 197.10 in conjunction with the private duty nursing agency, shall 197.11 approve the setting, grouping, and arrangement of shared private 197.12 duty nursing care based on the individual needs and preferences 197.13 of the recipients. Decisions on the selection of recipients to 197.14 share services must be based on the ages of the recipients, 197.15 compatibility, and coordination of their care needs. 197.16 (f) The following items must be considered by the recipient 197.17 or the recipient's legal representative and the private duty 197.18 nursing agency, and documented in the recipient's health service 197.19 record: 197.20 (1) the additional training needed by the private duty 197.21 nurse to provide care to two recipients in the same setting and 197.22 to ensure that the needs of the recipients are met appropriately 197.23 and safely; 197.24 (2) the setting in which the shared private duty nursing 197.25 care will be provided; 197.26 (3) the ongoing monitoring and evaluation of the 197.27 effectiveness and appropriateness of the service and process 197.28 used to make changes in service or setting; 197.29 (4) a contingency plan which accounts for absence of the 197.30 recipient in a shared private duty nursing setting due to 197.31 illness or other circumstances; 197.32 (5) staffing backup contingencies in the event of employee 197.33 illness or absence; and 197.34 (6) arrangements for additional assistance to respond to 197.35 urgent or emergency care needs of the recipients. 197.36 (g) The provider must offer the recipient or responsible 198.1 party the option of shared or one-on-one private duty nursing 198.2 services. The recipient or responsible party can withdraw from 198.3 participating in a shared service arrangement at any time. 198.4 (h) The private duty nursing agency must document the 198.5 following in the health service record for each individual 198.6 recipient sharing private duty nursing care: 198.7 (1) permission by the recipient or the recipient's legal 198.8 representative for the maximum number of shared nursing care 198.9 hours per week chosen by the recipient; 198.10 (2) permission by the recipient or the recipient's legal 198.11 representative for shared private duty nursing services provided 198.12 outside the recipient's residence; 198.13 (3) permission by the recipient or the recipient's legal 198.14 representative for others to receive shared private duty nursing 198.15 services in the recipient's residence; 198.16 (4) revocation by the recipient or the recipient's legal 198.17 representative of the shared private duty nursing care 198.18 authorization, or the shared care to be provided to others in 198.19 the recipient's residence, or the shared private duty nursing 198.20 services to be provided outside the recipient's residence; and 198.21 (5) daily documentation of the shared private duty nursing 198.22 services provided by each identified private duty nurse, 198.23 including: 198.24 (i) the names of each recipient receiving shared private 198.25 duty nursing services together; 198.26 (ii) the setting for the shared services, including the 198.27 starting and ending times that the recipient received shared 198.28 private duty nursing care; and 198.29 (iii) notes by the private duty nurse regarding changes in 198.30 the recipient's condition, problems that may arise from the 198.31 sharing of private duty nursing services, and scheduling and 198.32 care issues. 198.33 (i) Unless otherwise provided in this subdivision, all 198.34 other statutory and regulatory provisions relating to private 198.35 duty nursing services apply to shared private duty nursing 198.36 services. 199.1 Nothing in this subdivision shall be construed to reduce 199.2 the total number of private duty nursing hours authorized for an 199.3 individual recipient under subdivision 5. 199.4 Sec. 36. Minnesota Statutes 2000, section 256B.0627, is 199.5 amended by adding a subdivision to read: 199.6 Subd. 13. [CONSUMER-DIRECTED HOME CARE DEMONSTRATION 199.7 PROJECT.] (a) Upon the receipt of federal waiver authority, the 199.8 commissioner shall implement a consumer-directed home care 199.9 demonstration project. The consumer-directed home care 199.10 demonstration project must demonstrate and evaluate the outcomes 199.11 of a consumer-directed service delivery alternative to improve 199.12 access, increase consumer control and accountability over 199.13 available resources, and enable the use of supports that are 199.14 more individualized and cost-effective for eligible medical 199.15 assistance recipients receiving certain medical assistance home 199.16 care services. The consumer-directed home care demonstration 199.17 project will be administered locally by county agencies, tribal 199.18 governments, or administrative entities under contract with the 199.19 state in regions where counties choose not to provide this 199.20 service. 199.21 (b) Grant awards for persons who have been receiving 199.22 medical assistance covered personal care, home health aide, or 199.23 private duty nursing services for a period of 12 consecutive 199.24 months or more prior to enrollment in the consumer-directed home 199.25 care demonstration project will be established on a case-by-case 199.26 basis using historical service expenditure data. An average 199.27 monthly expenditure for each continuing enrollee will be 199.28 calculated based on historical expenditures made on behalf of 199.29 the enrollee for personal care, home health aide, or private 199.30 duty nursing services during the 12 month period directly prior 199.31 to enrollment in the project. The grant award will equal 90 199.32 percent of the average monthly expenditure. 199.33 (c) Grant awards for project enrollees who have been 199.34 receiving medical assistance covered personal care, home health 199.35 aide, or private duty nursing services for a period of less than 199.36 12 consecutive months prior to project enrollment will be 200.1 calculated on a case-by-case basis using the service 200.2 authorization in place at the time of enrollment. The total 200.3 number of units of personal care, home health aide, or private 200.4 duty nursing services the enrollee has been authorized to 200.5 receive will be converted to the total cost of the authorized 200.6 services in a given month using the statewide average service 200.7 payment rates. To determine an estimated monthly expenditure, 200.8 the total authorized monthly personal care, home health aide or 200.9 private duty nursing service costs will be reduced by a 200.10 percentage rate equivalent to the difference between the 200.11 statewide average service authorization and the statewide 200.12 average utilization rate for each of the services by medical 200.13 assistance eligibles during the most recent fiscal year for 200.14 which 12 months of data is available. The grant award will 200.15 equal 90 percent of the estimated monthly expenditure. 200.16 (d) The state of Minnesota, county agencies, tribal 200.17 governments, or administrative entities under contract with the 200.18 state that participate in the implementation and administration 200.19 of the consumer-directed home care demonstration project, shall 200.20 not be liable for damages, injuries, or liabilities sustained 200.21 through the purchase of support by the individual, the 200.22 individual's family, or the authorized representative under this 200.23 section with funds received through the consumer-directed home 200.24 care demonstration project. Liabilities include but are not 200.25 limited to: workers' compensation liability, the Federal 200.26 Insurance Contributions Act (FICA), or the Federal Unemployment 200.27 Tax Act (FUTA). 200.28 Sec. 37. Minnesota Statutes 2000, section 256B.0627, is 200.29 amended by adding a subdivision to read: 200.30 Subd. 14. [TELEHOMECARE; SKILLED NURSE VISITS.] Medical 200.31 assistance covers skilled nurse visits according to section 200.32 256B.0625, subdivision 6a, provided via telehomecare, for 200.33 services which do not require hands-on care between the home 200.34 care nurse and recipient. The provision of telehomecare must be 200.35 made via live, two-way interactive audiovisual technology and 200.36 may be augmented by utilizing store-and-forward technologies. 201.1 Store-and-forward technology includes telehomecare services that 201.2 do not occur in real time via synchronous transmissions, and 201.3 that do not require a face-to-face encounter with the recipient 201.4 for all or any part of any such telehomecare visit. 201.5 Individually identifiable patient data obtained through 201.6 real-time or store-and-forward technology must be maintained in 201.7 a confidential manner. If the video is used for research, 201.8 training, or other purposes unrelated to the care of the 201.9 patient, the identity of the patient must be concealed. A 201.10 communication between the home care nurse and recipient that 201.11 consists solely of a telephone conversation, facsimile, 201.12 electronic mail, or a consultation between two health care 201.13 practitioners, is not to be considered a telehomecare visit. 201.14 Multiple daily skilled nurse visits provided via telehomecare 201.15 are allowed. Coverage of telehomecare is limited to two visits 201.16 per day. All skilled nurse visits provided via telehomecare 201.17 must be prior authorized by the commissioner or the 201.18 commissioner's designee and will be covered at the same 201.19 allowable rate as skilled nurse visits provided in-person. 201.20 Sec. 38. Minnesota Statutes 2000, section 256B.0627, is 201.21 amended by adding a subdivision to read: 201.22 Subd. 15. [THERAPIES THROUGH HOME HEALTH AGENCIES.] (a) 201.23 [PHYSICAL THERAPY.] Medical assistance covers physical therapy 201.24 and related services, including specialized maintenance 201.25 therapy. Services provided by a physical therapy assistant 201.26 shall be reimbursed at the same rate as services performed by a 201.27 physical therapist when the services of the physical therapy 201.28 assistant are provided under the direction of a physical 201.29 therapist who is on the premises. Services provided by a 201.30 physical therapy assistant that are provided under the direction 201.31 of a physical therapist who is not on the premises shall be 201.32 reimbursed at 65 percent of the physical therapist rate. 201.33 Direction of the physical therapy assistant must be provided by 201.34 the physical therapist as described in Minnesota Rules, part 201.35 9505.0390, subpart 1, item B. The physical therapist and 201.36 physical therapist assistant may not both bill for services 202.1 provided to a recipient on the same day. 202.2 (b) [OCCUPATIONAL THERAPY.] Medical assistance covers 202.3 occupational therapy and related services, including specialized 202.4 maintenance therapy. Services provided by an occupational 202.5 therapy assistant shall be reimbursed at the same rate as 202.6 services performed by an occupational therapist when the 202.7 services of the occupational therapy assistant are provided 202.8 under the direction of the occupational therapist who is on the 202.9 premises. Services provided by an occupational therapy 202.10 assistant under the direction of an occupational therapist who 202.11 is not on the premises shall be reimbursed at 65 percent of the 202.12 occupational therapist rate. Direction of the occupational 202.13 therapy assistant must be provided by the occupational therapist 202.14 as described in Minnesota Rules, part 9505.0390, subpart 1, item 202.15 B. The occupational therapist and occupational therapist 202.16 assistant may not both bill for services provided to a recipient 202.17 on the same day. 202.18 Sec. 39. Minnesota Statutes 2000, section 256B.0627, is 202.19 amended by adding a subdivision to read: 202.20 Subd. 16. [HARDSHIP CRITERIA; PRIVATE DUTY NURSING.] (a) 202.21 Payment is allowed for extraordinary services that require 202.22 specialized nursing skills and are provided by parents of minor 202.23 children, spouses, and legal guardians who are providing private 202.24 duty nursing care under the following conditions: 202.25 (1) the provision of these services is not legally required 202.26 of the parents, spouses, or legal guardians; 202.27 (2) the services are necessary to prevent hospitalization 202.28 of the recipient; and 202.29 (3) the recipient is eligible for state plan home care or a 202.30 home and community-based waiver and one of the following 202.31 hardship criteria are met: 202.32 (i) the parent, spouse, or legal guardian resigns from a 202.33 part-time or full-time job to provide nursing care for the 202.34 recipient; or 202.35 (ii) the parent, spouse, or legal guardian goes from a 202.36 full-time to a part-time job with less compensation to provide 203.1 nursing care for the recipient; or 203.2 (iii) the parent, spouse, or legal guardian takes a leave 203.3 of absence without pay to provide nursing care for the 203.4 recipient; or 203.5 (iv) because of labor conditions, special language needs, 203.6 or intermittent hours of care needed, the parent, spouse, or 203.7 legal guardian is needed in order to provide adequate private 203.8 duty nursing services to meet the medical needs of the recipient. 203.9 (b) Private duty nursing may be provided by a parent, 203.10 spouse, or legal guardian who is a nurse licensed in Minnesota. 203.11 Private duty nursing services provided by a parent, spouse, or 203.12 legal guardian cannot be used in lieu of nursing services 203.13 covered and available under liable third-party payers, including 203.14 Medicare. The private duty nursing provided by a parent, 203.15 spouse, or legal guardian must be included in the service plan. 203.16 Authorized skilled nursing services provided by the parent, 203.17 spouse, or legal guardian may not exceed 50 percent of the total 203.18 approved nursing hours, or eight hours per day, whichever is 203.19 less, up to a maximum of 40 hours per week. Nothing in this 203.20 subdivision precludes the parent's, spouse's, or legal 203.21 guardian's obligation of assuming the nonreimbursed family 203.22 responsibilities of emergency backup caregiver and primary 203.23 caregiver. 203.24 (c) A parent or a spouse may not be paid to provide private 203.25 duty nursing care if the parent or spouse fails to pass a 203.26 criminal background check according to section 245A.04, or if it 203.27 has been determined by the home health agency, the case manager, 203.28 or the physician that the private duty nursing care provided by 203.29 the parent, spouse, or legal guardian is unsafe. 203.30 Sec. 40. Minnesota Statutes 2000, section 256B.0627, is 203.31 amended by adding a subdivision to read: 203.32 Subd. 17. [QUALITY ASSURANCE PLAN FOR PERSONAL CARE 203.33 ASSISTANT SERVICES.] The commissioner shall establish a quality 203.34 assurance plan for personal care assistant services that 203.35 includes: 203.36 (1) performance-based provider agreements; 204.1 (2) meaningful consumer input, which may include consumer 204.2 surveys, that measure the extent to which participants receive 204.3 the services and supports described in the individual plan and 204.4 participant satisfaction with such services and supports; 204.5 (3) ongoing monitoring of the health and well-being of 204.6 consumers; and 204.7 (4) an ongoing public process for development, 204.8 implementation, and review of the quality assurance plan. 204.9 Sec. 41. Minnesota Statutes 2000, section 256B.0911, is 204.10 amended by adding a subdivision to read: 204.11 Subd. 4a. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 204.12 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 204.13 ensure that individuals with disabilities or chronic illness are 204.14 served in the most integrated setting appropriate to their needs 204.15 and have the necessary information to make informed choices 204.16 about home and community-based service options. 204.17 (b) Individuals under 65 years of age who are admitted to a 204.18 nursing facility from a hospital must be screened prior to 204.19 admission as outlined in subdivision 4. 204.20 (c) Individuals under 65 years of age who are admitted to 204.21 nursing facilities with only a telephone screening must receive 204.22 a face-to-face assessment from the long-term care consultation 204.23 team member of the county in which the facility is located or 204.24 from the recipient's county case manager within 20 working days 204.25 of admission. 204.26 (d) At the face-to-face assessment, the long-term care 204.27 consultation team member or county case manager must perform the 204.28 activities required under subdivision 3. 204.29 (e) For individuals under 21 years of age, the screening or 204.30 assessment which recommends nursing facility admission must be 204.31 approved by the commissioner before the individual is admitted 204.32 to the nursing facility. 204.33 (f) In the event that an individual under 65 years of age 204.34 is admitted to a nursing facility on an emergency basis, the 204.35 county must be notified of the admission on the next working 204.36 day, and a face-to-face assessment as described in paragraph (c) 205.1 must be conducted within 20 working days of admission. 205.2 (g) At the face-to-face assessment, the long-term care 205.3 consultation team member or the case manager must present 205.4 information about home and community-based options so the 205.5 individual can make informed choices. If the individual chooses 205.6 home and community-based services, the long-term care 205.7 consultation team member or case manager must complete a written 205.8 relocation plan within 20 working days of the visit. The plan 205.9 shall describe the services needed to move out of the facility 205.10 and a time line for the move which is designed to ensure a 205.11 smooth transition to the individual's home and community. 205.12 (h) An individual under 65 years of age residing in a 205.13 nursing facility shall receive a face-to-face assessment at 205.14 least every 12 months to review the person's service choices and 205.15 available alternatives unless the individual indicates, in 205.16 writing, that annual visits are not desired. In this case, the 205.17 individual must receive a face-to-face assessment at least once 205.18 every 36 months for the same purposes. 205.19 (i) Notwithstanding the provisions of subdivision 6, the 205.20 commissioner may pay county agencies directly for face-to-face 205.21 assessments for individuals who are eligible for medical 205.22 assistance, under 65 years of age, and being considered for 205.23 placement or residing in a nursing facility. 205.24 Sec. 42. Minnesota Statutes 2000, section 256B.0916, 205.25 subdivision 1, is amended to read: 205.26 Subdivision 1. [REDUCTION OF WAITING LIST.] (a) The 205.27 legislature recognizes that as of January 1, 1999, 3,300 persons 205.28 with mental retardation or related conditions have been screened 205.29 and determined eligible for the home and community-based waiver 205.30 services program for persons with mental retardation or related 205.31 conditions. Many wait for several years before receiving 205.32 service. 205.33 (b) The waiting list for this program shall be reduced or 205.34 eliminated by June 30, 2003. In order to reduce the number of 205.35 eligible persons waiting for identified services provided 205.36 through the home and community-based waiver for persons with 206.1 mental retardation or related conditions, during the period from 206.2 July 1, 1999, to June 30, 2003, funding shall be increased to 206.3 add 100 additional eligible persons each year beyond the 206.4 February 1999 medical assistance forecast. 206.5 (c) The commissioner shall allocate resources in such a 206.6 manner as to use all resources budgeted during a biennium for 206.7 the home and community-based waiver for persons with mental 206.8 retardation or related conditions according to the priorities 206.9 listed in subdivision 2, paragraph (b), and then to serve other 206.10 persons on the waiting list. Resources allocated for a fiscal 206.11 year to serve persons affected by public and private sector 206.12 ICF/MR closures, but not expected to be expended for that 206.13 purpose, must be reallocated within that fiscal year to serve 206.14 other persons on the waiting list, and the number of waiver 206.15 diversion slots shall be adjusted accordingly. 206.16 (d) For fiscal year 2001, at least one-half of the increase 206.17 in funding over the previous year provided in the February 1999 206.18 medical assistance forecast for the home and community-based 206.19 waiver for persons with mental retardation and related 206.20 conditions, including changes made by the 1999 legislature, must 206.21 be used to serve persons who are not affected by public and 206.22 private sector ICF/MR closures. 206.23 (e) The commissioner of finance shall not reduce the 206.24 expenditure forecast for a biennium for which appropriations 206.25 have been made, if at the time of the forecast there is a 206.26 waiting list for waiver services for persons with mental 206.27 retardation or related conditions who need services within the 206.28 next 30 months. Funds that would have resulted from a projected 206.29 reduction in expenditures must be used by the commissioner of 206.30 human services to serve persons with developmental disabilities 206.31 through the home and community-based waiver for persons with 206.32 mental retardation or related conditions. 206.33 Sec. 43. Minnesota Statutes 2000, section 256B.0916, is 206.34 amended by adding a subdivision to read: 206.35 Subd. 6a. [STATEWIDE AVAILABILITY OF CONSUMER-DIRECTED 206.36 COMMUNITY SUPPORT SERVICES.] (a) The commissioner shall submit 207.1 to the federal Health Care Financing Administration by August 1, 207.2 2001, an amendment to the home and community-based waiver for 207.3 persons with mental retardation or related conditions to make 207.4 consumer-directed community support services available in every 207.5 county of the state by January 1, 2002. 207.6 (b) If a county declines to meet the requirements for 207.7 provision of consumer-directed community supports, the 207.8 commissioner shall contract with another county, a group of 207.9 counties, or a private agency to plan for and administer 207.10 consumer-directed community supports in that county. 207.11 (c) The state of Minnesota, county agencies, tribal 207.12 governments, or administrative entities under contract to 207.13 participate in the implementation and administration of the home 207.14 and community-based waiver for persons with mental retardation 207.15 or a related condition, shall not be liable for damages, 207.16 injuries, or liabilities sustained through the purchase of 207.17 support by the individual, the individual's family, or the 207.18 authorized representative with funds received through the 207.19 consumer-directed community support service under this section. 207.20 Liabilities include but are not limited to: workers' 207.21 compensation liability, the Federal Insurance Contributions Act 207.22 (FICA), or the Federal Unemployment Tax Act (FUTA). 207.23 Sec. 44. Minnesota Statutes 2000, section 256B.0916, 207.24 subdivision 7, is amended to read: 207.25 Subd. 7. [ANNUAL REPORT BY COMMISSIONER.] Beginning 207.26October 1, 1999, and each October 1November 1, 2001, and each 207.27 November 1 thereafter, the commissioner shall issue an annual 207.28 report on county and state use of available resources for the 207.29 home and community-based waiver for persons with mental 207.30 retardation or related conditions. For each county or county 207.31 partnership, the report shall include: 207.32 (1) the amount of funds allocated but not used; 207.33 (2) the county specific allowed reserve amount approved and 207.34 used; 207.35 (3) the number, ages, and living situations of individuals 207.36 screened and waiting for services; 208.1 (4) the urgency of need for services to begin within one, 208.2 two, or more than two years for each individual; 208.3 (5) the services needed; 208.4 (6) the number of additional persons served by approval of 208.5 increased capacity within existing allocations; 208.6 (7) results of action by the commissioner to streamline 208.7 administrative requirements and improve county resource 208.8 management; and 208.9 (8) additional action that would decrease the number of 208.10 those eligible and waiting for waivered services. 208.11 The commissioner shall specify intended outcomes for the program 208.12 and the degree to which these specified outcomes are attained. 208.13 Sec. 45. Minnesota Statutes 2000, section 256B.0916, 208.14 subdivision 9, is amended to read: 208.15 Subd. 9. [LEGAL REPRESENTATIVE PARTICIPATION EXCEPTION.] 208.16 The commissioner, in cooperation with representatives of 208.17 counties, service providers, service recipients, family members, 208.18 legal representatives and advocates, shall develop criteria to 208.19 allow legal representatives to be reimbursed for providing 208.20 specific support services to meet the person's needs when a plan 208.21 which assures health and safety has been agreed upon and carried 208.22 out by the legal representative, the person, and the county. 208.23 Legal representatives providing support underconsumer-directed208.24community support services pursuant to section 256B.092,208.25subdivision 4,the home and community-based waiver for persons 208.26 with mental retardation or related conditions or the consumer 208.27 support grant program pursuant to section256B.092, subdivision208.287256.476, shall not be considered to have a direct or indirect 208.29 service provider interest under section 256B.092, subdivision 7, 208.30 if a health and safety plan which meets the criteria established 208.31 has been agreed upon and implemented. ByOctober 1, 1999August 208.32 1, 2001, the commissioner shall submit, for federal approval, 208.33 amendments to allow legal representatives to provide support and 208.34 receive reimbursement under theconsumer-directed community208.35support services section of thehome and community-based waiver 208.36 plan. 209.1 Sec. 46. Minnesota Statutes 2000, section 256B.092, 209.2 subdivision 2a, is amended to read: 209.3 Subd. 2a. [MEDICAL ASSISTANCE FOR CASE MANAGEMENT 209.4 ACTIVITIES UNDER THE STATE PLAN MEDICAID OPTION.] (a) Upon 209.5 receipt of federal approval, the commissioner shall make 209.6 payments toapproved vendorscounties, private individuals, and 209.7 agencies enrolled as providers of case management services 209.8 participating in the medical assistance program to reimburse 209.9 costs for providing case management service activities to 209.10 medical assistance eligible persons with mental retardation or a 209.11 related condition, in accordance with the state Medicaid plan, 209.12 the home and community-based waiver for persons with mental 209.13 retardation and related conditions plan, and federal 209.14 requirementsand limitations. 209.15 (b) The commissioner shall ensure that each eligible person 209.16 is given a choice of county and private agency case management 209.17 service providers. Case management service providers are 209.18 prohibited from providing any other service to the person 209.19 receiving case management services. 209.20 Sec. 47. Minnesota Statutes 2000, section 256B.092, 209.21 subdivision 5, is amended to read: 209.22 Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall 209.23 apply for any federal waivers necessary to secure, to the extent 209.24 allowed by law, federal financial participation under United 209.25 States Code, title 42, sections 1396 et seq., as amended, for 209.26 the provision of services to persons who, in the absence of the 209.27 services, would need the level of care provided in a regional 209.28 treatment center or a community intermediate care facility for 209.29 persons with mental retardation or related conditions. The 209.30 commissioner may seek amendments to the waivers or apply for 209.31 additional waivers under United States Code, title 42, sections 209.32 1396 et seq., as amended, to contain costs. The commissioner 209.33 shall ensure that payment for the cost of providing home and 209.34 community-based alternative services under the federal waiver 209.35 plan shall not exceed the cost of intermediate care services 209.36 including day training and habilitation services that would have 210.1 been provided without the waivered services. 210.2 (b) The commissioner, in administering home and 210.3 community-based waivers for persons with mental retardation and 210.4 related conditions, shall ensure that day services for eligible 210.5 persons are not provided by the person's residential service 210.6 provider, unless the person or the person's legal representative 210.7 is offered a choice of providers and agrees in writing to 210.8 provision of day services by the residential service provider. 210.9 The individual service plan for individuals who choose to have 210.10 their residential service provider provide their day services 210.11 must describe how health, safety, and protection needs will be 210.12 met by frequent and regular contact with persons other than the 210.13 residential service provider. 210.14 Sec. 48. Minnesota Statutes 2000, section 256B.093, 210.15 subdivision 3, is amended to read: 210.16 Subd. 3. [TRAUMATIC BRAIN INJURY PROGRAM DUTIES.] The 210.17 department shall fund administrative case management under this 210.18 subdivision using medical assistance administrative funds. The 210.19 traumatic brain injury program duties include: 210.20 (1) recommending to the commissioner in consultation with 210.21 the medical review agent according to Minnesota Rules, parts 210.22 9505.0500 to 9505.0540, the approval or denial of medical 210.23 assistance funds to pay for out-of-state placements for 210.24 traumatic brain injury services and in-state traumatic brain 210.25 injury services provided by designated Medicare long-term care 210.26 hospitals; 210.27 (2) coordinating the traumatic brain injury home and 210.28 community-based waiver; 210.29 (3)approving traumatic brain injury waiver eligibility or210.30care plans or both;210.31(4)providing ongoing technical assistance and consultation 210.32 to county and facility case managers to facilitate care plan 210.33 development for appropriate, accessible, and cost-effective 210.34 medical assistance services; 210.35(5)(4) providing technical assistance to promote statewide 210.36 development of appropriate, accessible, and cost-effective 211.1 medical assistance services and related policy; 211.2(6)(5) providing training and outreach to facilitate 211.3 access to appropriate home and community-based services to 211.4 prevent institutionalization; 211.5(7)(6) facilitating appropriate admissions, continued stay 211.6 review, discharges, and utilization review for neurobehavioral 211.7 hospitals and other specialized institutions; 211.8(8)(7) providing technical assistance on the use of prior 211.9 authorization of home care services and coordination of these 211.10 services with other medical assistance services; 211.11(9)(8) developing a system for identification of nursing 211.12 facility and hospital residents with traumatic brain injury to 211.13 assist in long-term planning for medical assistance services. 211.14 Factors will include, but are not limited to, number of 211.15 individuals served, length of stay, services received, and 211.16 barriers to community placement; and 211.17(10)(9) providing information, referral, and case 211.18 consultation to access medical assistance services for 211.19 recipients without a county or facility case manager. Direct 211.20 access to this assistance may be limited due to the structure of 211.21 the program. 211.22 Sec. 49. Minnesota Statutes 2000, section 256B.095, is 211.23 amended to read: 211.24 256B.095 [THREE-YEARQUALITY ASSURANCEPILOTPROJECT 211.25 ESTABLISHED.] 211.26 Effective July 1, 1998, an alternative quality assurance 211.27 licensing systempilotproject for programs for persons with 211.28 developmental disabilities is established in Dodge, Fillmore, 211.29 Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 211.30 Wabasha, and Winona counties for the purpose of improving the 211.31 quality of services provided to persons with developmental 211.32 disabilities. A county, at its option, may choose to have all 211.33 programs for persons with developmental disabilities located 211.34 within the county licensed under chapter 245A using standards 211.35 determined under the alternative quality assurance licensing 211.36 systempilotproject or may continue regulation of these 212.1 programs under the licensing system operated by the 212.2 commissioner. Thepilotproject expires on June 30,20012005. 212.3 Sec. 50. Minnesota Statutes 2000, section 256B.0951, 212.4 subdivision 1, is amended to read: 212.5 Subdivision 1. [MEMBERSHIP.] The region 10 quality 212.6 assurance commission is established. The commission consists of 212.7 at least 14 but not more than 21 members as follows: at least 212.8 three but not more than five members representing advocacy 212.9 organizations; at least three but not more than five members 212.10 representing consumers, families, and their legal 212.11 representatives; at least three but not more than five members 212.12 representing service providers; at least three but not more than 212.13 five members representing counties; and the commissioner of 212.14 human services or the commissioner's designee. Initial 212.15 membership of the commission shall be recruited and approved by 212.16 the region 10 stakeholders group. Prior to approving the 212.17 commission's membership, the stakeholders group shall provide to 212.18 the commissioner a list of the membership in the stakeholders 212.19 group, as of February 1, 1997, a brief summary of meetings held 212.20 by the group since July 1, 1996, and copies of any materials 212.21 prepared by the group for public distribution. The first 212.22 commission shall establish membership guidelines for the 212.23 transition and recruitment of membership for the commission's 212.24 ongoing existence. Members of the commission who do not receive 212.25 a salary or wages from an employer for time spent on commission 212.26 duties may receive a per diem payment when performing commission 212.27 duties and functions. All members may be reimbursed for 212.28 expenses related to commission activities. Notwithstanding the 212.29 provisions of section 15.059, subdivision 5, the commission 212.30 expires on June 30,20012005. 212.31 Sec. 51. Minnesota Statutes 2000, section 256B.0951, 212.32 subdivision 3, is amended to read: 212.33 Subd. 3. [COMMISSION DUTIES.] (a) By October 1, 1997, the 212.34 commission, in cooperation with the commissioners of human 212.35 services and health, shall do the following: (1) approve an 212.36 alternative quality assurance licensing system based on the 213.1 evaluation of outcomes; (2) approve measurable outcomes in the 213.2 areas of health and safety, consumer evaluation, education and 213.3 training, providers, and systems that shall be evaluated during 213.4 the alternative licensing process; and (3) establish variable 213.5 licensure periods not to exceed three years based on outcomes 213.6 achieved. For purposes of this subdivision, "outcome" means the 213.7 behavior, action, or status of a person that can be observed or 213.8 measured and can be reliably and validly determined. 213.9 (b) By January 15, 1998, the commission shall approve, in 213.10 cooperation with the commissioner of human services, a training 213.11 program for members of the quality assurance teams established 213.12 under section 256B.0952, subdivision 4. 213.13 (c) The commission and the commissioner shall establish an 213.14 ongoing review process for the alternative quality assurance 213.15 licensing system. The review shall take into account the 213.16 comprehensive nature of the alternative system, which is 213.17 designed to evaluate the broad spectrum of licensed and 213.18 unlicensed entities that provide services to clients, as 213.19 compared to the current licensing system. 213.20 (d) The commission shall contract with an independent 213.21 entity to conduct a financial review of the alternative quality 213.22 assurancepilotproject. The review shall take into account the 213.23 comprehensive nature of the alternative system, which is 213.24 designed to evaluate the broad spectrum of licensed and 213.25 unlicensed entities that provide services to clients, as 213.26 compared to the current licensing system. The review shall 213.27 include an evaluation of possible budgetary savings within the 213.28 department of human services as a result of implementation of 213.29 the alternative quality assurancepilotproject. If a federal 213.30 waiver is approved under subdivision 7, the financial review 213.31 shall also evaluate possible savings within the department of 213.32 health. This review must be completed by December 15, 2000. 213.33 (e) The commission shall submit a report to the legislature 213.34 by January 15, 2001, on the results of the review process for 213.35 the alternative quality assurancepilotproject, a summary of 213.36 the results of the independent financial review, and a 214.1 recommendation on whether thepilotproject should be extended 214.2 beyond June 30, 2001. 214.3 (f) The commissioner, in consultation with the commission, 214.4 shall examine the feasibility of expanding the project to other 214.5 populations or geographic areas and identify barriers to 214.6 expansion. The commissioner shall report findings and 214.7 recommendations to the legislature by December 15, 2004. 214.8 Sec. 52. Minnesota Statutes 2000, section 256B.0951, 214.9 subdivision 4, is amended to read: 214.10 Subd. 4. [COMMISSION'S AUTHORITY TO RECOMMEND VARIANCES OF 214.11 LICENSING STANDARDS.] The commission may recommend to the 214.12 commissioners of human services and health variances from the 214.13 standards governing licensure of programs for persons with 214.14 developmental disabilities in order to improve the quality of 214.15 services by implementing an alternative developmental 214.16 disabilities licensing system if the commission determines that 214.17 the alternative licensing system does not adversely affect the 214.18 health or safety of persons being served by the licensed program 214.19 nor compromise the qualifications of staff to provide services. 214.20 Sec. 53. Minnesota Statutes 2000, section 256B.0951, 214.21 subdivision 5, is amended to read: 214.22 Subd. 5. [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 214.23 safety standards, rights, or procedural protections under 214.24 sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 214.25 3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 214.26 and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 214.27 subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 214.28 procedures for the monitoring of psychotropic medications shall 214.29 not be varied under the alternative licensing systempilot214.30 project. The commission may make recommendations to the 214.31 commissioners of human services and health or to the legislature 214.32 regarding alternatives to or modifications of the rules and 214.33 procedures referenced in this subdivision. 214.34 Sec. 54. Minnesota Statutes 2000, section 256B.0951, 214.35 subdivision 7, is amended to read: 214.36 Subd. 7. [WAIVER OF RULES.] The commissioner of health may 215.1 exempt residents of intermediate care facilities for persons 215.2 with mental retardation (ICFs/MR) who participate in the 215.3 three-year quality assurance pilot project established in 215.4 section 256B.095 from the requirements of Minnesota Rules, 215.5 chapter 4665, upon approval by the federal government of a 215.6 waiver of federal certification requirements for ICFs/MR.The215.7commissioners of health and human services shall apply for any215.8necessary waivers as soon as practicable and shall submit the215.9concept paper to the federal government by June 1, 1998.215.10 Sec. 55. Minnesota Statutes 2000, section 256B.0951, is 215.11 amended by adding a subdivision to read: 215.12 Subd. 8. [FEDERAL WAIVER.] The commissioner of human 215.13 services shall seek federal authority to waive provisions of 215.14 intermediate care facilities for persons with mental retardation 215.15 (ICFs/MR) regulations to enable the demonstration and evaluation 215.16 of the alternative quality assurance system for ICFs/MR under 215.17 the project. The commissioner of human services shall apply for 215.18 any necessary waivers as soon as practicable. 215.19 Sec. 56. Minnesota Statutes 2000, section 256B.0951, is 215.20 amended by adding a subdivision to read: 215.21 Subd. 9. [EVALUATION.] The commission, in consultation 215.22 with the commissioner of human services, shall conduct an 215.23 evaluation of the alternative quality assurance system, and 215.24 present a report to the commissioner by June 30, 2004. 215.25 Sec. 57. Minnesota Statutes 2000, section 256B.0952, 215.26 subdivision 1, is amended to read: 215.27 Subdivision 1. [NOTIFICATION.]By January 15, 1998, each215.28affected county shall notify the commission and the215.29commissioners of human services and health as to whether it215.30chooses to implement on July 1, 1998, the alternative licensing215.31system for the pilot project. A county that does not implement215.32the alternative licensing system on July 1, 1998, may give215.33notice to the commission and the commissioners by January 15,215.341999, or January 15, 2000, that it will implement the215.35alternative licensing system on the following July 1. A county215.36that implements the alternative licensing system commits to216.1participate until June 30, 2001.For each year of the project, 216.2 region 10 counties shall give notice to the commission and 216.3 commissioners of human services and health by March 15 of intent 216.4 to join the quality assurance alternative licensing system, 216.5 effective July 1 of that year. A county choosing to participate 216.6 in the alternative licensing system commits to participate until 216.7 June 30, 2005. Counties participating in the quality assurance 216.8 alternative licensing system as of January 1, 2001, shall notify 216.9 the commission and the commissioners of human services and 216.10 health by March 15, 2001, of intent to continue participation. 216.11 Counties that elect to continue participation must participate 216.12 in the alternative licensing system until June 30, 2005. 216.13 Sec. 58. Minnesota Statutes 2000, section 256B.0952, 216.14 subdivision 4, is amended to read: 216.15 Subd. 4. [APPOINTMENT OF QUALITY ASSURANCE MANAGER.] (a) A 216.16 county or group of counties that chooses to participate in the 216.17 alternative licensing system shall designate a quality assurance 216.18 manager and shall establish quality assurance teams in 216.19 accordance with subdivision 5. The manager shall recruit, 216.20 train, and assign duties to the quality assurance team members. 216.21 In assigning team members to conduct the quality assurance 216.22 process at a facility, program, or service, the manager shall 216.23 take into account the size of the service provider, the number 216.24 of services to be reviewed, the skills necessary for team 216.25 members to complete the process, and other relevant factors. 216.26 The manager shall ensure that no team member has a financial, 216.27 personal, or family relationship with the facility, program, or 216.28 service being reviewed or with any clients of the facility, 216.29 program, or service. 216.30 (b) Quality assurance teams shall report the findings of 216.31 their quality assurance reviews to the quality assurance manager. 216.32 The quality assurance manager shall provide the report from the 216.33 quality assurance team to the county and, upon request, to the 216.34 commissioners of human services and health, and shall provide a 216.35 summary of the report to the quality assurance review council. 216.36 Sec. 59. Minnesota Statutes 2000, section 256B.49, is 217.1 amended by adding a subdivision to read: 217.2 Subd. 11. [AUTHORITY.] (a) The commissioner is authorized 217.3 to apply for home and community-based service waivers, as 217.4 authorized under section 1915(c) of the Social Security Act to 217.5 serve persons under the age of 65 who are determined to require 217.6 the level of care provided in a nursing home and persons who 217.7 require the level of care provided in a hospital. The 217.8 commissioner shall apply for the home and community-based 217.9 waivers in order to: (i) promote the support of persons with 217.10 disabilities in the most integrated settings; (ii) expand the 217.11 availability of services for persons who are eligible for 217.12 medical assistance; (iii) promote cost-effective options to 217.13 institutional care; and (iv) obtain federal financial 217.14 participation. 217.15 (b) The provision of waivered services to medical 217.16 assistance recipients with disabilities shall comply with the 217.17 requirements outlined in the federally approved applications for 217.18 home and community-based services and subsequent amendments, 217.19 including provision of services according to a service plan 217.20 designed to meet the needs of the individual. For purposes of 217.21 this section, the approved home and community-based application 217.22 is considered the necessary federal requirement. 217.23 (c) The commissioner shall provide interested persons 217.24 serving on agency advisory committees and task forces, and 217.25 others upon request, with notice of, and an opportunity to 217.26 comment on, any changes or amendments to the federally approved 217.27 applications for home and community-based waivers, prior to 217.28 their submission to the federal health care financing 217.29 administration. 217.30 (d) The commissioner shall seek approval, as authorized 217.31 under section 1915(c) of the Social Security Act, to allow 217.32 medical assistance eligibility under this section for children 217.33 under age 21 without deeming of parental income or assets. 217.34 (e) The commissioner shall seek approval, as authorized 217.35 under section 1915(c) of the Social Act, to allow medical 217.36 assistance eligibility under this section for individuals under 218.1 age 65 without deeming the spouse's income or assets. 218.2 Sec. 60. Minnesota Statutes 2000, section 256B.49, is 218.3 amended by adding a subdivision to read: 218.4 Subd. 12. [INFORMED CHOICE.] Persons who are determined 218.5 likely to require the level of care provided in a nursing 218.6 facility or hospital shall be informed of the home and 218.7 community-based support alternatives to the provision of 218.8 inpatient hospital services or nursing facility services. Each 218.9 person must be given the choice of either institutional or home 218.10 and community-based services, using the provisions described in 218.11 section 256B.77, subdivision 2, paragraph (p). 218.12 Sec. 61. Minnesota Statutes 2000, section 256B.49, is 218.13 amended by adding a subdivision to read: 218.14 Subd. 13. [CASE MANAGEMENT.] (a) Each recipient of a home 218.15 and community-based waiver shall be provided case management 218.16 services by qualified vendors as described in the federally 218.17 approved waiver application. The case management service 218.18 activities provided will include: 218.19 (1) assessing the needs of the individual within 20 working 218.20 days of a recipient's request; 218.21 (2) developing the written individual service plan within 218.22 ten working days after the assessment is completed; 218.23 (3) informing the recipient or the recipient's legal 218.24 guardian or conservator of service options; 218.25 (4) assisting the recipient in the identification of 218.26 potential service providers; 218.27 (5) assisting the recipient to access services; 218.28 (6) coordinating, evaluating, and monitoring of the 218.29 services identified in the service plan; 218.30 (7) completing the annual reviews of the service plan; and 218.31 (8) informing the recipient or legal representative of the 218.32 right to have assessments completed and service plans developed 218.33 within specified time periods, and to appeal county action or 218.34 inaction under section 256.045, subdivision 3. 218.35 (b) The case manager may delegate certain aspects of the 218.36 case management service activities to another individual 219.1 provided there is oversight by the case manager. The case 219.2 manager may not delegate those aspects which require 219.3 professional judgment including assessments, reassessments, and 219.4 care plan development. 219.5 Sec. 62. Minnesota Statutes 2000, section 256B.49, is 219.6 amended by adding a subdivision to read: 219.7 Subd. 14. [ASSESSMENT AND REASSESSMENT.] (a) Assessments 219.8 of each recipient's strengths, informal support systems, and 219.9 need for services shall be completed within 20 working days of 219.10 the recipient's request. Reassessment of each recipient's 219.11 strengths, support systems, and need for services shall be 219.12 conducted at least every 12 months and at other times when there 219.13 has been a significant change in the recipient's functioning. 219.14 (b) Persons with mental retardation or a related condition 219.15 who apply for services under the nursing facility level waiver 219.16 programs shall be screened for the appropriate level of care 219.17 according to section 256B.092. 219.18 (c) Recipients who are found eligible for home and 219.19 community-based services under this section before their 65th 219.20 birthday may remain eligible for these services after their 65th 219.21 birthday if they continue to meet all other eligibility factors. 219.22 Sec. 63. Minnesota Statutes 2000, section 256B.49, is 219.23 amended by adding a subdivision to read: 219.24 Subd. 15. [INDIVIDUALIZED SERVICE PLAN.] Each recipient of 219.25 home and community-based waivered services shall be provided a 219.26 copy of the written service plan which: 219.27 (1) is developed and signed by the recipient within ten 219.28 working days of the completion of the assessment; 219.29 (2) meets the assessed needs of the recipient; 219.30 (3) reasonably ensures the health and safety of the 219.31 recipient; 219.32 (4) promotes independence; 219.33 (5) allows for services to be provided in the most 219.34 integrated settings; and 219.35 (6) provides for an informed choice, as defined in section 219.36 256B.77, subdivision 2, paragraph (p), of service and support 220.1 providers. 220.2 Sec. 64. Minnesota Statutes 2000, section 256B.49, is 220.3 amended by adding a subdivision to read: 220.4 Subd. 16. [SERVICES AND SUPPORTS.] (a) Services and 220.5 supports included in the home and community-based waivers for 220.6 persons with disabilities shall meet the requirements set out in 220.7 United States Code, title 42, section 1396n. The services and 220.8 supports, which are offered as alternatives to institutional 220.9 care, shall promote consumer choice, community inclusion, 220.10 self-sufficiency, and self-determination. 220.11 (b) Beginning January 1, 2003, the commissioner shall 220.12 simplify and improve access to home and community-based waivered 220.13 services, to the extent possible, through the establishment of a 220.14 common service menu that is available to eligible recipients 220.15 regardless of age, disability type, or waiver program. 220.16 (c) Consumer directed community support services shall be 220.17 offered as an option to all persons eligible for services under 220.18 subdivision 11, by January 1, 2002. 220.19 (d) Services and supports shall be arranged and provided 220.20 consistent with individualized written plans of care for 220.21 eligible waiver recipients. 220.22 (e) The state of Minnesota and county agencies that 220.23 administer home and community-based waivered services for 220.24 persons with disabilities, shall not be liable for damages, 220.25 injuries, or liabilities sustained through the purchase of 220.26 supports by the individual, the individual's family, or the 220.27 authorized representative with funds received through the 220.28 consumer-directed community support service under this section. 220.29 Liabilities include but are not limited to: workers' 220.30 compensation liability, the Federal Insurance Contributions Act 220.31 (FICA), or the Federal Unemployment Tax Act (FUTA). 220.32 Sec. 65. 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 July 1, 2001, 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. 222.8 Sec. 66. Minnesota Statutes 2000, section 256B.49, is 222.9 amended by adding a subdivision to read: 222.10 Subd. 18. [PAYMENTS.] The commissioner shall reimburse 222.11 approved vendors from the medical assistance account for the 222.12 costs of providing home and community-based services to eligible 222.13 recipients using the invoice processing procedures of the 222.14 Medicaid management information system (MMIS). Recipients will 222.15 be screened and authorized for services according to the 222.16 federally approved waiver application and its subsequent 222.17 amendments. 222.18 Sec. 67. Minnesota Statutes 2000, section 256B.49, is 222.19 amended by adding a subdivision to read: 222.20 Subd. 19. [HEALTH AND WELFARE.] The commissioner of human 222.21 services shall take the necessary safeguards to protect the 222.22 health and welfare of individuals provided services under the 222.23 waiver. 222.24 Sec. 68. Minnesota Statutes 2000, section 256B.49, is 222.25 amended by adding a subdivision to read: 222.26 Subd. 20. [TRAUMATIC BRAIN INJURY AND RELATED CONDITIONS.] 222.27 The commissioner shall seek to amend the traumatic brain injury 222.28 waiver to include, as eligible persons, individuals with an 222.29 acquired or degenerative disease diagnosis where cognitive 222.30 impairment is present, such as multiple sclerosis. 222.31 Sec. 69. Minnesota Statutes 2000, section 256B.69, 222.32 subdivision 23, is amended to read: 222.33 Subd. 23. [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES; 222.34 ELDERLY AND DISABLED PERSONS.] (a) The commissioner may 222.35 implement demonstration projects to create alternative 222.36 integrated delivery systems for acute and long-term care 223.1 services to elderly persons and persons with disabilities as 223.2 defined in section 256B.77, subdivision 7a, that provide 223.3 increased coordination, improve access to quality services, and 223.4 mitigate future cost increases. The commissioner may seek 223.5 federal authority to combine Medicare and Medicaid capitation 223.6 payments for the purpose of such demonstrations. Medicare funds 223.7 and services shall be administered according to the terms and 223.8 conditions of the federal waiver and demonstration provisions. 223.9 For the purpose of administering medical assistance funds, 223.10 demonstrations under this subdivision are subject to 223.11 subdivisions 1 to 22. The provisions of Minnesota Rules, parts 223.12 9500.1450 to 9500.1464, apply to these demonstrations, with the 223.13 exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, 223.14 subpart 1, items B and C, which do not apply to persons 223.15 enrolling in demonstrations under this section. An initial open 223.16 enrollment period may be provided. Persons who disenroll from 223.17 demonstrations under this subdivision remain subject to 223.18 Minnesota Rules, parts 9500.1450 to 9500.1464. When a person is 223.19 enrolled in a health plan under these demonstrations and the 223.20 health plan's participation is subsequently terminated for any 223.21 reason, the person shall be provided an opportunity to select a 223.22 new health plan and shall have the right to change health plans 223.23 within the first 60 days of enrollment in the second health 223.24 plan. Persons required to participate in health plans under 223.25 this section who fail to make a choice of health plan shall not 223.26 be randomly assigned to health plans under these demonstrations. 223.27 Notwithstanding section 256L.12, subdivision 5, and Minnesota 223.28 Rules, part 9505.5220, subpart 1, item A, if adopted, for the 223.29 purpose of demonstrations under this subdivision, the 223.30 commissioner may contract with managed care organizations, 223.31 including counties, to serve only elderly persons eligible for 223.32 medical assistance, elderly and disabled persons, or disabled 223.33 persons only. For persons with primary diagnoses of mental 223.34 retardation or a related condition, serious and persistent 223.35 mental illness, or serious emotional disturbance, the 223.36 commissioner must ensure that the county authority has approved 224.1 the demonstration and contracting design. Enrollment in these 224.2 projects for persons with disabilities shall be voluntaryuntil224.3July 1, 2001. The commissioner shall not implement any 224.4 demonstration project under this subdivision for persons with 224.5 primary diagnoses of mental retardation or a related condition, 224.6 serious and persistent mental illness, or serious emotional 224.7 disturbance, without approval of the county board of the county 224.8 in which the demonstration is being implemented. 224.9 Before implementation of a demonstration project for 224.10 disabled persons, the commissioner must provide information to 224.11 appropriate committees of the house of representatives and 224.12 senate and must involve representatives of affected disability 224.13 groups in the design of the demonstration projects. 224.14 (b) A nursing facility reimbursed under the alternative 224.15 reimbursement methodology in section 256B.434 may, in 224.16 collaboration with a hospital, clinic, or other health care 224.17 entity provide services under paragraph (a). The commissioner 224.18 shall amend the state plan and seek any federal waivers 224.19 necessary to implement this paragraph. 224.20 Sec. 70. Minnesota Statutes 2000, section 256D.35, is 224.21 amended by adding a subdivision to read: 224.22 Subd. 11a. [INSTITUTION.] "Institution" means: a 224.23 hospital, consistent with Code of Federal Regulations, title 42, 224.24 section 440.10; regional treatment center inpatient services; a 224.25 nursing facility; and an intermediate care facility for persons 224.26 with mental retardation. 224.27 Sec. 71. Minnesota Statutes 2000, section 256D.35, is 224.28 amended by adding a subdivision to read: 224.29 Subd. 18a. [SHELTER COSTS.] "Shelter costs" means: rent, 224.30 manufactured home lot rentals; monthly principal, interest, 224.31 insurance premiums, and property taxes due for mortgages or 224.32 contract for deed costs; costs for utilities, including heating, 224.33 cooling, electricity, water, and sewerage; garbage collection 224.34 fees; and the basic service fee for one telephone. 224.35 Sec. 72. Minnesota Statutes 2000, section 256D.44, 224.36 subdivision 5, is amended to read: 225.1 Subd. 5. [SPECIAL NEEDS.] In addition to the state 225.2 standards of assistance established in subdivisions 1 to 4, 225.3 payments are allowed for the following special needs of 225.4 recipients of Minnesota supplemental aid who are not residents 225.5 of a nursing home, a regional treatment center, or a group 225.6 residential housing facility. 225.7 (a) The county agency shall pay a monthly allowance for 225.8 medically prescribed diets payable under the Minnesota family 225.9 investment program if the cost of those additional dietary needs 225.10 cannot be met through some other maintenance benefit. 225.11 (b) Payment for nonrecurring special needs must be allowed 225.12 for necessary home repairs or necessary repairs or replacement 225.13 of household furniture and appliances using the payment standard 225.14 of the AFDC program in effect on July 16, 1996, for these 225.15 expenses, as long as other funding sources are not available. 225.16 (c) A fee for guardian or conservator service is allowed at 225.17 a reasonable rate negotiated by the county or approved by the 225.18 court. This rate shall not exceed five percent of the 225.19 assistance unit's gross monthly income up to a maximum of $100 225.20 per month. If the guardian or conservator is a member of the 225.21 county agency staff, no fee is allowed. 225.22 (d) The county agency shall continue to pay a monthly 225.23 allowance of $68 for restaurant meals for a person who was 225.24 receiving a restaurant meal allowance on June 1, 1990, and who 225.25 eats two or more meals in a restaurant daily. The allowance 225.26 must continue until the person has not received Minnesota 225.27 supplemental aid for one full calendar month or until the 225.28 person's living arrangement changes and the person no longer 225.29 meets the criteria for the restaurant meal allowance, whichever 225.30 occurs first. 225.31 (e) A fee of ten percent of the recipient's gross income or 225.32 $25, whichever is less, is allowed for representative payee 225.33 services provided by an agency that meets the requirements under 225.34 SSI regulations to charge a fee for representative payee 225.35 services. This special need is available to all recipients of 225.36 Minnesota supplemental aid regardless of their living 226.1 arrangement. 226.2 (f) Notwithstanding the language in this subdivision, an 226.3 amount equal to the maximum allotment authorized by the federal 226.4 Food Stamp Program for a single individual which is in effect on 226.5 the first day of January of the previous year will be added to 226.6 the standards of assistance established in subdivisions 1 to 4 226.7 for individuals under the age of 65 who are relocating from an 226.8 institution and who are shelter needy. An eligible individual 226.9 who receives this benefit prior to age 65 may continue to 226.10 receive the benefit after the age of 65. 226.11 "Shelter needy" means that the assistance unit incurs 226.12 monthly shelter costs that exceed 40 percent of the assistance 226.13 unit's gross income before the application of this special needs 226.14 standard. "Gross income" for the purposes of this section is 226.15 the applicant's or recipient's income as defined in section 226.16 256D.35, subdivision 10, or the standard specified in 226.17 subdivision 3, whichever is greater. A recipient of a federal 226.18 or state housing subsidy, that limits shelter costs to a 226.19 percentage of gross income, shall not be considered shelter 226.20 needy for purposes of this paragraph. 226.21 Sec. 73. Minnesota Statutes 2000, section 256I.05, 226.22 subdivision 1e, is amended to read: 226.23 Subd. 1e. [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.] 226.24 Notwithstanding the provisions of subdivisions 1a and 1c, 226.25 beginning July 1,19992001, a county agency shall negotiate a 226.26 supplementary rate in addition to the rate specified in 226.27 subdivision 1, equal to25125 percent of the amount specified 226.28 in subdivision 1a, including any legislatively authorized 226.29 inflationary adjustments, for a group residential housing 226.30 provider that: 226.31 (1) is located in Hennepin county and has had a group 226.32 residential housing contract with the county since June 1996; 226.33 (2) operates in three separate locations a56-bed71-bed 226.34 facility,aand two 40-bedfacility, and a 30-bed facility226.35 facilities; and 226.36 (3) serves a chemically dependent clientele, providing 24 227.1 hours per day supervision and limiting a resident's maximum 227.2 length of stay to 13 months out of a consecutive 24-month period. 227.3 Sec. 74. [256I.07] [RESPITE CARE PILOT PROJECT FOR FAMILY 227.4 ADULT FOSTER CARE PROVIDERS.] 227.5 Subdivision 1. [PROGRAM ESTABLISHED.] The state recognizes 227.6 the importance of developing and maintaining quality family 227.7 foster care resources. In order to accomplish that goal, the 227.8 commissioner shall establish a two-year respite care pilot 227.9 project for family adult foster care providers in three 227.10 counties. This pilot project is intended to provide support to 227.11 caregivers of adult foster care residents. The commissioner 227.12 shall establish a pilot project to accomplish the provisions in 227.13 subdivisions 2 to 4. 227.14 Subd. 2. [ELIGIBILITY.] A family adult foster care home 227.15 provider as defined under section 144D.01, subdivision 7, who 227.16 has been licensed for six months is eligible for 30 days of 227.17 respite care per calendar year. In cases of emergency, a county 227.18 social services agency may waive the six-month licensing 227.19 requirement. In order to be eligible to receive respite payment 227.20 from group residential housing and alternative care, a provider 227.21 must take time off away from their foster care residents. 227.22 Subd. 3. [PAYMENT STRUCTURE.] (a) The payment for respite 227.23 care for an adult foster care resident eligible for only group 227.24 residential housing shall be based on the current monthly group 227.25 residential housing base room and board rate and the current 227.26 maximum monthly group residential housing difficulty of care 227.27 rate. 227.28 (b) The payment for respite care for an adult foster care 227.29 resident eligible for alternative care funds shall be based on 227.30 the resident's alternative care foster care rate. 227.31 (c) The payment for respite care for an adult foster care 227.32 resident eligible for Medicaid home and community-based services 227.33 waiver funds shall be based on the group residential housing 227.34 base room and board rate. 227.35 (d) The total amount available to pay for respite care for 227.36 a family adult foster care provider shall be based on the number 228.1 of residents currently served in the foster care home and the 228.2 source of funding used to pay for each resident's foster care. 228.3 Respite care must be paid for on a per diem basis and for a full 228.4 day. 228.5 Subd. 4. [PRIVATE PAY RESIDENTS.] Payment for respite care 228.6 for private pay foster care residents must be arranged between 228.7 the provider and the resident or the resident's family. 228.8 Sec. 75. Laws 1999, chapter 152, section 1, is amended to 228.9 read: 228.10 Section 1. [TASK FORCE.] 228.11 A day training and habilitation task force is established. 228.12 Task force membership shall consist of representatives of the 228.13 commissioner of human services, counties, service consumers, and 228.14 vendors of day training and habilitation as defined in Minnesota 228.15 Statutes, section 252.41, subdivision 9, including at least one 228.16 representative from each association representing day training 228.17 and habilitation vendors. Appointments to the task force shall 228.18 be made by the commissioner of human services and technical 228.19 assistance shall be provided by the department of human services. 228.20 Sec. 76. Laws 1999, chapter 152, section 4, is amended to 228.21 read: 228.22 Sec. 4. [REPORT.] 228.23 The task force shall present a report recommending a new 228.24 payment rate structure to the legislature by January 15, 2000, 228.25 and shall make recommendations to the commissioner of human 228.26 services regarding the implementation of the pilot project for 228.27 the individualized payment rate structure, so the pilot project 228.28 can be implemented by July 1, 2002, as required in section 77. 228.29 The task force expires onMarch 15, 2000December 30, 2003. 228.30 Sec. 77. [DAY TRAINING AND HABILITATION PAYMENT STRUCTURE 228.31 PILOT PROJECT.] 228.32 Subdivision 1. [INDIVIDUALIZED PAYMENT RATE 228.33 STRUCTURE.] Notwithstanding Minnesota Statutes, sections 228.34 252.451, subdivision 5; and 252.46; and Minnesota Rules, part 228.35 9525.1290, subpart 1, items A and B, the commissioner of human 228.36 services shall initiate a pilot project and phase-in for the 229.1 individualized payment rate structure described in this section 229.2 and section 78. The pilot project shall include actual 229.3 transfers of funds, not simulated transfers. The pilot project 229.4 may include all or some of the vendors in up to eight counties, 229.5 with no more than two counties from the seven-county 229.6 Minneapolis-St. Paul metropolitan area. Following initiation of 229.7 the pilot project, the commissioner shall phase in 229.8 implementation of the individualized payment rate structure to 229.9 the remaining counties and vendors according to the 229.10 implementation plan developed by the task force. The pilot and 229.11 phase-in shall not extend over more than 18 months and shall be 229.12 completed by December 31, 2003. 229.13 Subd. 2. [SUNSET.] The pilot project shall sunset upon 229.14 implementation of a new statewide rate structure according to 229.15 the implementation plan developed by the task force described in 229.16 subdivision 3, in its report to the legislature on December 1, 229.17 2001. The rates of vendors participating in the pilot project 229.18 must be modified to be consistent with the new statewide rate 229.19 structure, as implemented. 229.20 Subd. 3. [TASK FORCE RESPONSIBILITIES.] The day training 229.21 and habilitation task force established under Laws 1999, chapter 229.22 152, section 4, shall evaluate the pilot project authorized 229.23 under subdivision 1, and by December 1, 2001, shall report to 229.24 the legislature with an implementation plan, which shall address 229.25 how and when the pilot project individualized payment rate 229.26 structure will be implemented statewide, shall ensure that 229.27 vendors that wish to maintain their current per diem rate may do 229.28 so within the new payment system, and shall identify criteria 229.29 that would halt statewide implementation if vendors or clients 229.30 were adversely affected by the new payment rate structure, and 229.31 with recommendations for any amendments that should be made 229.32 before statewide implementation. These recommendations shall be 229.33 made in a report to the chairs of the house health and human 229.34 services policy and finance committees and the senate health and 229.35 family security committee and finance division. 229.36 Subd. 4. [RATE SETTING.] (a) The rate structure under this 230.1 section is intended to allow a county to authorize an individual 230.2 rate for each client in the vendor's program based on the needs 230.3 and expected outcomes of the individual client. Rates shall be 230.4 based on an authorized package of services for each individual 230.5 over a typical time frame. Rates may be established across 230.6 multiple sites run by a single vendor. 230.7 (b) With county concurrence, a vendor shall establish up to 230.8 four levels of service, A through D, based on the intensity of 230.9 services provided to an individual client of day training and 230.10 habilitation services. Service level A shall be the highest 230.11 intensity of services, marked primarily, but not exclusively, by 230.12 a one-to-one client-to-staff ratio. Service level D shall be 230.13 the lowest intensity of services. The county shall document the 230.14 vendor's description of the type and amount of services 230.15 associated with each service level. 230.16 (c) For each vendor, a county board shall establish a 230.17 dollar value for one hour of service at each of the service 230.18 levels defined in paragraph (b). In establishing these values 230.19 for existing vendors transitioning from the payment rate 230.20 structure under Minnesota Statutes, section 252.46, subdivision 230.21 1, the county board shall follow the formula and guidelines 230.22 developed by the day training and habilitation task force under 230.23 paragraph (e). 230.24 (d) A vendor may elect to maintain a single transportation 230.25 rate or may elect to establish up to five types of 230.26 transportation services: public transportation, public special 230.27 transportation, nonambulatory transportation, out-of-service 230.28 area transportation, and ambulatory transportation. For vendors 230.29 that elect to establish multiple transportation services, the 230.30 county board shall establish a dollar value for a round trip on 230.31 each type of transportation service offered through the vendor. 230.32 With vendor concurrence, the county may also establish a uniform 230.33 one-way trip value for some or all of the transportation service 230.34 types. 230.35 (e) The county board shall ensure that the vendor 230.36 translates the vendor's existing program and transportation 231.1 rates to the rates and values in the pilot project by using the 231.2 conversion calculations for services and transportation approved 231.3 by the day training and habilitation task force established 231.4 under Laws 1999, chapter 152, and included in the task force's 231.5 recommendations to the legislature. The conversion calculation 231.6 may be amended by the task force with the approval of the 231.7 commissioner and any amendments shall become effective upon 231.8 notification to the pilot project counties from the 231.9 commissioner. The calculation shall take the total 231.10 reimbursement dollars available to the vendor and divide by the 231.11 units of service expected at each service level and of each 231.12 transportation type. In determining the total reimbursement 231.13 dollars available to a vendor, the vendor shall multiply the 231.14 vendor's current per diem rate for both services and 231.15 transportation, including any new rate increases, by the 231.16 vendor's actual utilization for the year prior to implementation 231.17 of the pilot project. Vendors shall be allowed to allocate 231.18 available reimbursement dollars between service and 231.19 transportation before the vendor's service level and 231.20 transportation values are calculated. After translating its 231.21 existing service and transportation rates to the service level 231.22 and transportation values under the pilot, the vendor shall 231.23 project its expected reimbursement income using the expected 231.24 service and transportation packages for its existing clients, 231.25 based on current service authorizations. If the projected 231.26 reimbursement income is less than the vendor would have received 231.27 under the payment structure of Minnesota Statutes, section 231.28 252.46, the vendor and the county, with the approval of the 231.29 commissioner, shall adjust the vendor's service level and 231.30 transportation values to eliminate the shortfall. The 231.31 commissioner shall report all adjustments to the day training 231.32 and habilitation task force for consideration of possible 231.33 modifications to the pilot project individualized payment rate 231.34 structure. 231.35 Subd. 5. [INDIVIDUAL RATE AUTHORIZATION.] (a) As part of 231.36 its annual authorization of services for each client under 232.1 Minnesota Statutes, section 252.44, paragraph (a), clause (1), 232.2 and Minnesota Rules, part 9525.0016, subpart 12, the county 232.3 shall authorize and document a service package and a 232.4 transportation package as follows: 232.5 (1) the service package shall include the amount and type 232.6 of services at each applicable service level to be provided to 232.7 the client over a package period. An individual client may 232.8 receive services at multiple service levels over the course of 232.9 the package period. The service package rate shall be the sum 232.10 of the amount of services at each level over the package period, 232.11 multiplied by the dollar value for each service level; 232.12 (2) the transportation package shall include the amount and 232.13 type of transportation services to be provided to the client 232.14 over the package period. The transportation package rate shall 232.15 be the sum of the amount of transportation services, multiplied 232.16 by the dollar value associated with the type of transportation 232.17 service authorized for the client; 232.18 (3) the package period shall be established by the county, 232.19 and may be one week, two weeks, or one month; and 232.20 (4) the individual rate authorization may be reviewed and 232.21 modified by the county at any time and must be reviewed and 232.22 reauthorized by the county at least annually. 232.23 (b) For vendors with rates established under this section, 232.24 a service day under Minnesota Statutes, sections 245B.06 and 232.25 252.44, includes any day in which a client receives any 232.26 reimbursable service from a vendor or attends employment 232.27 arranged by the vendor. 232.28 Subd. 6. [BILLING FOR SERVICES.] The vendor shall bill 232.29 for, and shall be reimbursed for, the service package rate and 232.30 transportation package rate for the package period as authorized 232.31 by the county for each client in the vendor's program. The 232.32 length of the package period shall not affect the timing or 232.33 frequency of vendors' submissions of claims for payment under 232.34 the Medicaid Management Information System II (MMIS) or its 232.35 successors. 232.36 Subd. 7. [NOTIFICATION OF CHANGE IN CLIENT NEEDS.] The 233.1 vendor shall notify an individual client's case manager if the 233.2 vendor has knowledge of a material change in the client's needs 233.3 that may indicate a need for a change in service authorization. 233.4 Factors that would require such notice include, but are not 233.5 limited to, significant changes in medical status, residential 233.6 placement, attendance patterns, behavioral needs, or skill 233.7 functioning. The vendor shall notify the case manager as soon 233.8 as possible but no later than 30 calendar days after becoming 233.9 aware of the change in needs. The service authorization for the 233.10 client shall not change until the county authorizes a new 233.11 service and transportation package for the client in accordance 233.12 with the provisions in Minnesota Statutes, section 256B.092. 233.13 Sec. 78. [COUNTY BOARD RESPONSIBILITIES.] 233.14 For each vendor with rates established under section 77, 233.15 the county board shall document the vendor's description of the 233.16 type and amount of services associated with each service level, 233.17 the vendor's service level values, the vendor's transportation 233.18 values, and the package period that will be used to determine 233.19 the rate for each individual client. The county shall establish 233.20 a package period of one week, two weeks, or one month. 233.21 Sec. 79. [STUDY OF DAY TRAINING AND HABILITATION VENDOR 233.22 RATES.] 233.23 The commissioner shall identify the vendors with the lowest 233.24 rates or underfunded programs in the state and make 233.25 recommendations to reconcile the discrepancies prior to the 233.26 implementation of the individualized payment rate structure 233.27 described in sections 77 and 78. 233.28 Sec. 80. [FEDERAL APPROVAL.] 233.29 The commissioner shall seek any amendments to the state 233.30 Medicaid plan and any waivers necessary to permit implementation 233.31 of section 77 within the timelines specified. 233.32 Sec. 81. [SEMI-INDEPENDENT LIVING SERVICES (SILS) STUDY.] 233.33 The commissioner of human services, in consultation with 233.34 county representatives and other interested persons, shall 233.35 develop recommendations revising the funding methodology for 233.36 SILS as defined in Minnesota Statutes, section 252.275, 234.1 subdivisions 3, 4, 4b, and 4c, and report by January 15, 2002, 234.2 to the chair of the house of representatives health and human 234.3 services finance committee and the chairs of the senate health, 234.4 human services, and corrections budget division. 234.5 Sec. 82. [WAIVER REQUEST REGARDING SPOUSAL INCOME.] 234.6 By September 1, 2001, the commissioner of human services 234.7 shall seek federal approval to allow recipients of home and 234.8 community-based waivers authorized under Minnesota Statutes, 234.9 section 256B.49, to choose either a waiver of deeming of spousal 234.10 income or the spousal impoverishment protections authorized 234.11 under United States Code, title 42, section 1396r-5, with the 234.12 addition of the group residential housing rate set according to 234.13 Minnesota Statutes, section 256I.03, subdivision 5, to the 234.14 personal needs allowance authorized by Minnesota Statutes, 234.15 section 256B.0575. 234.16 Sec. 83. [PROGRAM OPTIONS FOR CERTAIN PERSONS WITH 234.17 DEVELOPMENTAL DISABILITIES.] 234.18 (a) The commissioner of human services shall ensure that 234.19 services continue to be available to persons with developmental 234.20 disabilities who were covered by social services supplemental 234.21 grants prior to July 1, 2001. Services shall be provided in 234.22 priority order as follows: 234.23 (1) to the extent possible, the commissioner shall 234.24 establish for these persons targeted slots under the home and 234.25 community-based waivered services program for persons with 234.26 mental retardation or related conditions; 234.27 (2) persons accommodated under clause (1) shall, if 234.28 eligible, receive room and board services through group 234.29 residential housing under Minnesota Statutes, chapter 256I; and 234.30 (3) any remaining persons shall continue to receive 234.31 services through community social services supplemental grants 234.32 to the affected counties. 234.33 (b) This section applies only to individuals receiving 234.34 services under social services supplemental grants as of June 234.35 30, 2001. 234.36 Sec. 84. [FEDERAL APPROVAL.] 235.1 The commissioner of human services, by September 1, 2001, 235.2 shall request any federal approval and plan amendments necessary 235.3 to implement the choice of case manager provision in section 235.4 256B.092, subdivision 2a, paragraph (b). 235.5 Sec. 85. [FEDERAL WAIVER REQUESTS.] 235.6 The commissioner of human services shall submit to the 235.7 federal Health Care Financing Administration by September 1, 235.8 2001, a request for a home and community-based services waiver 235.9 for day services, including: community inclusion, supported 235.10 employment, and day training and habilitation services defined 235.11 in Minnesota Statutes, section 252.41, subdivision 3, clause 235.12 (1), for persons eligible for the waiver under Minnesota 235.13 Statutes, section 256B.092. 235.14 Sec. 86. [REPEALER.] 235.15 (a) Minnesota Statutes 2000, sections 256B.0951, 235.16 subdivision 6; and 256E.06, subdivision 2b, are repealed. 235.17 (b) Minnesota Statutes 2000, sections 145.9245; 256.476, 235.18 subdivision 7; 256B.0912; 256B.0915, subdivisions 3a, 3b, and 235.19 3c; and 256B.49, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10, 235.20 are repealed. 235.21 (c) Laws 1995, chapter 178, article 2, section 48, 235.22 subdivision 6, is repealed. 235.23 (d) Minnesota Rules, parts 9505.2455; 9505.2458; 9505.2460; 235.24 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 235.25 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 235.26 9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 235.27 9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 235.28 9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 235.29 9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 235.30 9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 235.31 9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 235.32 9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 235.33 9505.3660; and 9505.3670, are repealed. 235.34 ARTICLE 4 235.35 CONSUMER INFORMATION AND ASSISTANCE 235.36 AND COMMUNITY-BASED CARE 236.1 Section 1. [144A.35] [EXPANSION OF BED DISTRIBUTION STUDY 236.2 AND CREATION OF CRITICAL ACCESS SITES.] 236.3 Subdivision 1. [OLDER ADULT SERVICES DISTRIBUTION 236.4 STUDY.] The commissioner of health, in coordination with the 236.5 commissioner of human services, shall monitor and analyze the 236.6 distribution of older adult services, including, but not limited 236.7 to, nursing home beds, senior housing, housing with services 236.8 units, and home and community-based services in the different 236.9 geographic areas of the state. The study shall include an 236.10 analysis of the impact of amendments to the nursing home 236.11 moratorium law which would allow for transfers of nursing home 236.12 beds within the state. The commissioner of health shall submit 236.13 to the legislature, beginning January 15, 2002, and each January 236.14 15 thereafter, an assessment of the distribution of long-term 236.15 health care services by geographic area, with particular 236.16 attention to service deficits or problems, the designation of 236.17 critical access service sites, and corrective action plans. 236.18 Subd. 2. [CRITICAL ACCESS SERVICE SITE.] "Critical access 236.19 service site" shall include nursing homes, senior housing, 236.20 housing with services, and home and community-based services 236.21 that are certified by the state as necessary providers of health 236.22 care services to a specific geographic area. For purposes of 236.23 this requirement, a "necessary provider of health care services" 236.24 is a provider that is: 236.25 (1) located more than 20 miles, defined as official mileage 236.26 as reported by the Minnesota department of transportation, from 236.27 the next nearest long-term health care provider; 236.28 (2) the sole long-term health care provider in the county; 236.29 or 236.30 (3) a long-term health care provider located in a medically 236.31 underserved area or health professional shortage area. 236.32 Subd. 3. [IDENTIFICATION OF CRITICAL ACCESS SERVICE 236.33 SITES.] Based on the results of the analysis completed in 236.34 subdivision 1, the commissioners of health and human services 236.35 shall identify and designate long-term health care providers as 236.36 critical access service sites. 237.1 Subd. 4. [CRITICAL ACCESS SERVICE SITES.] The commissioner 237.2 of health, in consultation with the commissioner of human 237.3 services, shall: 237.4 (1) develop and implement specific waivers to regulations 237.5 governing health care personnel scope of duties, physical plant 237.6 requirements, and location of community-based services, to 237.7 address critical access service site older adult service needs; 237.8 (2) identify payment barriers to the continued operation of 237.9 older adult services in critical access service sites, and 237.10 provide recommendations on changes to reimbursement rates to 237.11 facilitate the continued operation of these services. 237.12 Sec. 2. Minnesota Statutes 2000, section 256.973, is 237.13 amended by adding a subdivision to read: 237.14 Subd. 6. [GRANTS FOR HOME-SHARING PROGRAMS.] Grants 237.15 awarded for home-sharing programs under this section shall be 237.16 awarded through a request for proposals process every two years 237.17 according to criteria developed by the commissioner. In 237.18 awarding grants, the commissioner shall not give priority to an 237.19 applicant solely because the applicant has previously received a 237.20 grant under this section. Nothing under this subdivision shall 237.21 prohibit the commissioner from evaluating the performance of a 237.22 home-sharing program receiving a grant under this section and 237.23 allocating funds based on the evaluation. 237.24 Sec. 3. Minnesota Statutes 2000, section 256.975, is 237.25 amended by adding a subdivision to read: 237.26 Subd. 7. [CONSUMER INFORMATION AND ASSISTANCE; SENIOR 237.27 LINKAGE.] (a) The Minnesota board on aging shall operate a 237.28 statewide information and assistance service to aid older 237.29 Minnesotans and their families in making informed choices about 237.30 long-term care options and health care benefits. Language 237.31 services to persons with limited English language skills may be 237.32 made available. The service, known as Senior LinkAge Line, must 237.33 be available during business hours through a statewide toll-free 237.34 number and must also be available through the Internet. 237.35 (b) The service must assist older adults, caregivers, and 237.36 providers in accessing information about choices in long-term 238.1 care services that are purchased through private providers or 238.2 available through public options. The service must: 238.3 (1) develop a comprehensive database that includes detailed 238.4 listings in both consumer- and provider-oriented formats; 238.5 (2) make the database accessible on the Internet and 238.6 through other telecommunication and media-related tools; 238.7 (3) link callers to interactive long-term care screening 238.8 tools and make these tools available through the Internet by 238.9 integrating the tools with the database; 238.10 (4) develop community education materials with a focus on 238.11 planning for long-term care and evaluating independent living, 238.12 housing, and service options; 238.13 (5) conduct an outreach campaign to assist older adults and 238.14 their caregivers in finding information on the Internet and 238.15 through other means of communication; 238.16 (6) implement a messaging system for overflow callers and 238.17 respond to these callers by the next business day; 238.18 (7) link callers with county human services and other 238.19 providers to receive more in-depth assistance and consultation 238.20 related to long-term care options; and 238.21 (8) link callers with quality profiles for nursing 238.22 facilities and other providers developed by the commissioner of 238.23 health. 238.24 (c) The Minnesota board on aging shall conduct an 238.25 evaluation of the effectiveness of the statewide information and 238.26 assistance, and submit this evaluation to the legislature by 238.27 December 1, 2002. The evaluation must include an analysis of 238.28 funding adequacy, gaps in service delivery, continuity in 238.29 information between the service and identified linkages, and 238.30 potential use of private funding to enhance the service. 238.31 Sec. 4. [256.9754] [COMMUNITY SERVICES DEVELOPMENT GRANTS 238.32 PROGRAM.] 238.33 Subdivision 1. [DEFINITIONS.] For purposes of this 238.34 section, the following terms have the meanings given. 238.35 (a) "Community" means a town, township, city, or targeted 238.36 neighborhood within a city, or a consortium of towns, townships, 239.1 cities, or targeted neighborhoods within cities. 239.2 (b) "Older adult services" means any services available 239.3 under the elderly waiver program or alternative care grant 239.4 programs; nursing facility services; transportation services; 239.5 respite services; and other community-based services identified 239.6 as necessary either to maintain lifestyle choices for older 239.7 Minnesotans, or to promote independence. 239.8 (c) "Older adult" refers to individuals 65 years of age and 239.9 older. 239.10 Subd. 2. [CREATION.] The community services development 239.11 grants program is created under the administration of the 239.12 commissioner of human services. 239.13 Subd. 3. [PROVISION OF GRANTS.] The commissioner shall 239.14 make grants available to communities, providers of older adult 239.15 services identified in subdivision 1, or to a consortium of 239.16 providers of older adult services, to establish older adult 239.17 services. Grants may be provided for capital and other costs 239.18 including, but not limited to, start-up and training costs, 239.19 equipment, and supplies related to older adult services or other 239.20 residential or service alternatives to nursing facility care. 239.21 Grants may also be made to renovate current buildings, provide 239.22 transportation services, fund programs that would allow older 239.23 adults or disabled individuals to stay in their own homes by 239.24 sharing a home, fund programs that coordinate and manage formal 239.25 and informal services to older adults in their homes to enable 239.26 them to live as independently as possible in their own homes as 239.27 an alternative to nursing home care, or expand state-funded 239.28 programs in the area. 239.29 Subd. 4. [ELIGIBILITY.] Grants may be awarded only to 239.30 communities and providers or to a consortium of providers that 239.31 have a local match of 50 percent of the costs for the project in 239.32 the form of donations, local tax dollars, in-kind donations, 239.33 fundraising, or other local matches. 239.34 Subd. 5. [GRANT PREFERENCE.] The commissioner of human 239.35 services may award grants to the extent grant funds are 239.36 available and to the extent applications are approved by the 240.1 commissioner. Denial of approval of an application in one year 240.2 does not preclude submission of an application in a subsequent 240.3 year. The maximum grant amount is limited to $750,000. 240.4 Sec. 5. Minnesota Statutes 2000, section 256B.0911, 240.5 subdivision 1, is amended to read: 240.6 Subdivision 1. [PURPOSE AND GOAL.] (a) The purpose ofthe240.7preadmission screening programlong-term care consultation 240.8 services is to assist persons with long-term or chronic care 240.9 needs in making long-term care decisions and selecting options 240.10 that meet their needs and reflect their preferences. The 240.11 availability of, and access to, information and other types of 240.12 assistance is also intended to prevent or delay certified 240.13 nursing facility placementsby assessing applicants and240.14residents and offering cost-effective alternatives appropriate240.15for the person's needsand to provide transition assistance 240.16 after admission. Further, the goal ofthe programthese 240.17 services is to contain costs associated with unnecessary 240.18 certified nursing facility admissions. The commissioners of 240.19 human services and health shall seek to maximize use of 240.20 available federal and state funds and establish the broadest 240.21 program possible within the funding available. 240.22 (b) These services must be coordinated with services 240.23 provided under sections 256.975, subdivision 7, and 256.9772, 240.24 and with services provided by other public and private agencies 240.25 in the community to offer a variety of cost-effective 240.26 alternatives to persons with disabilities and elderly persons. 240.27 The county agency providing long-term care consultation services 240.28 shall encourage the use of volunteers from families, religious 240.29 organizations, social clubs, and similar civic and service 240.30 organizations to provide community-based services. 240.31 Sec. 6. Minnesota Statutes 2000, section 256B.0911, is 240.32 amended by adding a subdivision to read: 240.33 Subd. 1a. [DEFINITIONS.] For purposes of this section, the 240.34 following definitions apply: 240.35 (a) "Long-term care consultation services" means: 240.36 (1) providing information and education to the general 241.1 public regarding availability of the services authorized under 241.2 this section; 241.3 (2) an intake process that provides access to the services 241.4 described in this section; 241.5 (3) assessment of the health, psychological, and social 241.6 needs of referred individuals; 241.7 (4) assistance in identifying services needed to maintain 241.8 an individual in the least restrictive environment; 241.9 (5) providing recommendations on cost-effective community 241.10 services that are available to the individual; 241.11 (6) development of an individual's community support plan; 241.12 (7) providing information regarding eligibility for 241.13 Minnesota health care programs; 241.14 (8) preadmission screening to determine the need for a 241.15 nursing facility level of care; 241.16 (9) preliminary determination of Minnesota health care 241.17 programs eligibility for individuals who need a nursing facility 241.18 level of care, with appropriate referrals for final 241.19 determination; 241.20 (10) providing recommendations for nursing facility 241.21 placement when there are no cost-effective community services 241.22 available; and 241.23 (11) assistance to transition people back to community 241.24 settings after facility admission. 241.25 (b) "Minnesota health care programs" means the medical 241.26 assistance program under chapter 256B, the alternative care 241.27 program under section 256B.0913, and the prescription drug 241.28 program under section 256.955. 241.29 Sec. 7. Minnesota Statutes 2000, section 256B.0911, 241.30 subdivision 3, is amended to read: 241.31 Subd. 3. [PERSONS RESPONSIBLE FOR CONDUCTING THE241.32PREADMISSION SCREENINGLONG-TERM CARE CONSULTATION TEAM.] (a) A 241.33local screeninglong-term care consultation team shall be 241.34 established by the county board of commissioners. Each local 241.35screeningconsultation team shall consist ofscreeners who are a241.36 at least one social worker andaat least one public health 242.1 nurse from their respective county agencies. The board may 242.2 designate public health or social services as the lead agency 242.3 for long-term care consultation services. If a county does not 242.4 have a public health nurse available, it may request approval 242.5 from the commissioner to assign a county registered nurse with 242.6 at least one year experience in home care to participate on the 242.7 team.The screening team members must confer regarding the most242.8appropriate care for each individual screened.Two or more 242.9 counties may collaborate to establish a joint localscreening242.10 consultation team or teams. 242.11 (b)In assessing a person's needs, screeners shall have a242.12physician available for consultation and shall consider the242.13assessment of the individual's attending physician, if any. The242.14individual's physician shall be included if the physician242.15chooses to participate. Other personnel may be included on the242.16team as deemed appropriate by the county agencies.The team is 242.17 responsible for providing long-term care consultation services 242.18 to all persons located in the county who request the services, 242.19 regardless of eligibility for Minnesota health care programs. 242.20 Sec. 8. Minnesota Statutes 2000, section 256B.0911, is 242.21 amended by adding a subdivision to read: 242.22 Subd. 3a. [ASSESSMENT AND SUPPORT PLANNING.] (a) Persons 242.23 requesting assessment, services planning, or other assistance 242.24 intended to support community-based living must be visited by a 242.25 long-term care consultation team within ten working days after 242.26 the date on which an assessment was requested or recommended. 242.27 Assessments must be conducted according to paragraphs (b) to (g). 242.28 (b) The county may utilize a team of either the social 242.29 worker or public health nurse, or both, to conduct the 242.30 assessment in a face-to-face interview. The consultation team 242.31 members must confer regarding the most appropriate care for each 242.32 individual screened or assessed. 242.33 (c) The long-term care consultation team must assess the 242.34 health and social needs of the person, using an assessment form 242.35 provided by the commissioner of human services. 242.36 (d) The team must conduct the assessment in a face-to-face 243.1 interview with the person being assessed and the person's legal 243.2 representative, if applicable. 243.3 (e) The team must provide the person, or the person's legal 243.4 representative, with written recommendations for facility- or 243.5 community-based services. The team must document that the most 243.6 cost-effective alternatives available were offered to the 243.7 individual. For purposes of this requirement, "cost-effective 243.8 alternatives" means community services and living arrangements 243.9 that cost the same as or less than nursing facility care. 243.10 (f) If the person chooses to use community-based services, 243.11 the team must provide the person or the person's legal 243.12 representative with a written community support plan, regardless 243.13 of whether the individual is eligible for Minnesota health care 243.14 programs. The person may request assistance in developing a 243.15 community support plan without participating in a complete 243.16 assessment. 243.17 (g) The team must give the person receiving assessment or 243.18 support planning, or the person's legal representative, 243.19 materials supplied by the commissioner of human services 243.20 containing the following information: 243.21 (1) the purpose of preadmission screening and assessment; 243.22 (2) information about Minnesota health care programs; 243.23 (3) the person's freedom to accept or reject the 243.24 recommendations of the team; 243.25 (4) the person's right to confidentiality under the 243.26 Minnesota Government Data Practices Act, chapter 13; and 243.27 (5) the person's right to appeal the decision regarding the 243.28 need for nursing facility level of care or the county's final 243.29 decisions regarding public programs eligibility according to 243.30 section 256.045, subdivision 3. 243.31 Sec. 9. Minnesota Statutes 2000, section 256B.0911, is 243.32 amended by adding a subdivision to read: 243.33 Subd. 3b. [TRANSITION ASSISTANCE.] (a) A long-term care 243.34 consultation team shall provide assistance to persons residing 243.35 in a nursing facility, hospital, regional treatment center, or 243.36 intermediate care facility for persons with mental retardation 244.1 who request or are referred for such assistance. Transition 244.2 assistance must include assessment, community support plan 244.3 development, referrals to Minnesota health care programs, and 244.4 referrals to programs that provide assistance with housing. 244.5 (b) The county shall develop transition processes with 244.6 institutional social workers and discharge planners to ensure 244.7 that: 244.8 (1) persons admitted to facilities receive information 244.9 about transition assistance that is available; 244.10 (2) the assessment is completed for persons within ten 244.11 working days of the date of request or recommendation for 244.12 assessment; and 244.13 (3) there is a plan for transition and follow-up for the 244.14 individual's return to the community. The plan must require 244.15 notification of other local agencies when a person who may 244.16 require assistance is screened by one county for admission to a 244.17 facility located in another county. 244.18 (c) If a person who is eligible for a Minnesota health care 244.19 program is admitted to a nursing facility, the nursing facility 244.20 must include a consultation team member or the case manager in 244.21 the discharge planning process. 244.22 Sec. 10. Minnesota Statutes 2000, section 256B.0911, is 244.23 amended by adding a subdivision to read: 244.24 Subd. 4a. [PREADMISSION SCREENING ACTIVITIES RELATED TO 244.25 NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid 244.26 certified nursing facilities, including certified boarding care 244.27 facilities, must be screened prior to admission regardless of 244.28 income, assets, or funding sources for nursing facility care, 244.29 except as described in subdivision 4b. The purpose of the 244.30 screening is to determine the need for nursing facility level of 244.31 care as described in paragraph (d) and to complete activities 244.32 required under federal law related to mental illness and mental 244.33 retardation as outlined in paragraph (b). 244.34 (b) A person who has a diagnosis or possible diagnosis of 244.35 mental illness, mental retardation, or a related condition must 244.36 receive a preadmission screening before admission regardless of 245.1 the exemptions outlined in subdivision 4b, paragraph (b), to 245.2 identify the need for further evaluation and specialized 245.3 services, unless the admission prior to screening is authorized 245.4 by the local mental health authority or the local developmental 245.5 disabilities case manager, or unless authorized by the county 245.6 agency according to Public Law Number 101-508. 245.7 The following criteria apply to the preadmission screening: 245.8 (1) the county must use forms and criteria developed by the 245.9 commissioner of human services to identify persons who require 245.10 referral for further evaluation and determination of the need 245.11 for specialized services; and 245.12 (2) the evaluation and determination of the need for 245.13 specialized services must be done by: 245.14 (i) a qualified independent mental health professional, for 245.15 persons with a primary or secondary diagnosis of a serious 245.16 mental illness; or 245.17 (ii) a qualified mental retardation professional, for 245.18 persons with a primary or secondary diagnosis of mental 245.19 retardation or related conditions. For purposes of this 245.20 requirement, a qualified mental retardation professional must 245.21 meet the standards for a qualified mental retardation 245.22 professional under Code of Federal Regulations, title 42, 245.23 section 483.430. 245.24 (c) The local county mental health authority or the state 245.25 mental retardation authority under Public Laws Numbers 100-203 245.26 and 101-508 may prohibit admission to a nursing facility if the 245.27 individual does not meet the nursing facility level of care 245.28 criteria or needs specialized services as defined in Public Laws 245.29 Numbers 100-203 and 101-508. For purposes of this section, 245.30 "specialized services" for a person with mental retardation or a 245.31 related condition means active treatment as that term is defined 245.32 under Code of Federal Regulations, title 42, section 483.440, 245.33 paragraph (a), clause (1). 245.34 (d) The determination of the need for nursing facility 245.35 level of care must be made according to criteria developed by 245.36 the commissioner of human services. In assessing a person's 246.1 needs, consultation team members shall have a physician 246.2 available for consultation and shall consider the assessment of 246.3 the individual's attending physician, if any. The individual's 246.4 physician must be included if the physician chooses to 246.5 participate. Other personnel may be included on the team as 246.6 deemed appropriate by the county. 246.7 Sec. 11. Minnesota Statutes 2000, section 256B.0911, is 246.8 amended by adding a subdivision to read: 246.9 Subd. 4b. [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 246.10 Exemptions from the federal screening requirements outlined in 246.11 subdivision 4a, paragraphs (b) and (c), are limited to: 246.12 (1) a person who, having entered an acute care facility 246.13 from a certified nursing facility, is returning to a certified 246.14 nursing facility; and 246.15 (2) a person transferring from one certified nursing 246.16 facility in Minnesota to another certified nursing facility in 246.17 Minnesota. 246.18 (b) Persons who are exempt from preadmission screening for 246.19 purposes of level of care determination include: 246.20 (1) persons described in paragraph (a); 246.21 (2) an individual who has a contractual right to have 246.22 nursing facility care paid for indefinitely by the veterans' 246.23 administration; 246.24 (3) an individual enrolled in a demonstration project under 246.25 section 256B.69, subdivision 8, at the time of application to a 246.26 nursing facility; 246.27 (4) an individual currently being served under the 246.28 alternative care program or under a home and community-based 246.29 services waiver authorized under section 1915(c) of the federal 246.30 Social Security Act; and 246.31 (5) individuals admitted to a certified nursing facility 246.32 for a short-term stay, which is expected to be 14 days or less 246.33 in duration based upon a physician's certification, and who have 246.34 been assessed and approved for nursing facility admission within 246.35 the previous six months. This exemption applies only if the 246.36 consultation team member determines at the time of the initial 247.1 assessment of the six-month period that it is appropriate to use 247.2 the nursing facility for short-term stays and that there is an 247.3 adequate plan of care for return to the home or community-based 247.4 setting. If a stay exceeds 14 days, the individual must be 247.5 referred no later than the first county working day following 247.6 the 14th resident day for a screening, which must be completed 247.7 within five working days of the referral. The payment 247.8 limitations in subdivision 7 apply to an individual found at 247.9 screening to not meet the level of care criteria for admission 247.10 to a certified nursing facility. 247.11 (c) Persons admitted to a Medicaid-certified nursing 247.12 facility from the community on an emergency basis as described 247.13 in paragraph (d) or from an acute care facility on a nonworking 247.14 day must be screened the first working day after admission. 247.15 (d) Emergency admission to a nursing facility prior to 247.16 screening is permitted when all of the following conditions are 247.17 met: 247.18 (1) a person is admitted from the community to a certified 247.19 nursing or certified boarding care facility during county 247.20 nonworking hours; 247.21 (2) a physician has determined that delaying admission 247.22 until preadmission screening is completed would adversely affect 247.23 the person's health and safety; 247.24 (3) there is a recent precipitating event that precludes 247.25 the client from living safely in the community, such as 247.26 sustaining an injury, sudden onset of acute illness, or a 247.27 caregiver's inability to continue to provide care; 247.28 (4) the attending physician has authorized the emergency 247.29 placement and has documented the reason that the emergency 247.30 placement is recommended; and 247.31 (5) the county is contacted on the first working day 247.32 following the emergency admission. 247.33 Transfer of a patient from an acute care hospital to a nursing 247.34 facility is not considered an emergency except for a person who 247.35 has received hospital services in the following situations: 247.36 hospital admission for observation, care in an emergency room 248.1 without hospital admission, or following hospital 24-hour bed 248.2 care. 248.3 Sec. 12. Minnesota Statutes 2000, section 256B.0911, is 248.4 amended by adding a subdivision to read: 248.5 Subd. 4c. [SCREENING REQUIREMENTS.] (a) A person may be 248.6 screened for nursing facility admission by telephone or in a 248.7 face-to-face screening interview. Consultation team members 248.8 shall identify each individual's needs using the following 248.9 categories: 248.10 (1) the person needs no face-to-face screening interview to 248.11 determine the need for nursing facility level of care based on 248.12 information obtained from other health care professionals; 248.13 (2) the person needs an immediate face-to-face screening 248.14 interview to determine the need for nursing facility level of 248.15 care and complete activities required under subdivision 4a; or 248.16 (3) the person may be exempt from screening requirements as 248.17 outlined in subdivision 4b, but will need transitional 248.18 assistance after admission or in-person follow-along after a 248.19 return home. 248.20 (b) Persons admitted on a nonemergency basis to a 248.21 Medicaid-certified nursing facility must be screened prior to 248.22 admission. 248.23 (c) The long-term care consultation team shall recommend a 248.24 case mix classification for persons admitted to a certified 248.25 nursing facility when sufficient information is received to make 248.26 that classification. The nursing facility is authorized to 248.27 conduct all case mix assessments for persons who have been 248.28 screened prior to admission for whom the county did not 248.29 recommend a case mix classification. The nursing facility is 248.30 authorized to conduct all case mix assessments for persons 248.31 admitted to the facility prior to a preadmission screening. The 248.32 county retains the responsibility of distributing appropriate 248.33 case mix forms to the nursing facility. 248.34 (d) The county screening or intake activity must include 248.35 processes to identify persons who may require transition 248.36 assistance as described in subdivision 3b. 249.1 Sec. 13. Minnesota Statutes 2000, section 256B.0911, 249.2 subdivision 5, is amended to read: 249.3 Subd. 5. [SIMPLIFICATION OF FORMSADMINISTRATIVE 249.4 ACTIVITY.] The commissioner shall minimize the number of forms 249.5 required in thepreadmission screening processprovision of 249.6 long-term care consultation services and shall limit the 249.7 screening document to items necessary forcarecommunity support 249.8 plan approval, reimbursement, program planning, evaluation, and 249.9 policy development. 249.10 Sec. 14. Minnesota Statutes 2000, section 256B.0911, 249.11 subdivision 6, is amended to read: 249.12 Subd. 6. [PAYMENT FORPREADMISSION SCREENINGLONG-TERM 249.13 CARE CONSULTATION SERVICES.] (a) The totalscreeningpayment for 249.14 each county must be paid monthly by certified nursing facilities 249.15 in the county. The monthly amount to be paid by each nursing 249.16 facility for each fiscal year must be determined by dividing the 249.17 county's annual allocation forscreeningslong-term care 249.18 consultation services by 12 to determine the monthly payment and 249.19 allocating the monthly payment to each nursing facility based on 249.20 the number of licensed beds in the nursing facility. Payments 249.21 to counties in which there is no certified nursing facility must 249.22 be made by increasing the payment rate of the two facilities 249.23 located nearest to the county seat. 249.24 (b) The commissioner shall include the total annual payment 249.25for screeningdetermined under paragraph (a) for each nursing 249.26 facility according to section 256B.431, subdivision 2b, 249.27 paragraph (g), 256B.434, or 256B.435. 249.28 (c) Payments forscreening activitieslong-term care 249.29 consultation services are available to the county or counties to 249.30 cover staff salaries and expenses to provide thescreening249.31functionservices described in subdivision 1a. Thelead agency249.32 county shall employ, or contract with other agencies to employ, 249.33 within the limits of available funding, sufficient personnel 249.34 toconduct the preadmission screening activityprovide long-term 249.35 care consultation services while meeting the state's long-term 249.36 care outcomes and objectives as defined in section 256B.0917, 250.1 subdivision 1. Thelocal agencycounty shall be accountable for 250.2 meeting local objectives as approved by the commissioner in the 250.3 CSSA biennial plan. 250.4 (d) Notwithstanding section 256B.0641, overpayments 250.5 attributable to payment of the screening costs under the medical 250.6 assistance program may not be recovered from a facility. 250.7 (e) The commissioner of human services shall amend the 250.8 Minnesota medical assistance plan to include reimbursement for 250.9 the localscreeningconsultation teams. 250.10 (f) The county may bill, as case management services, 250.11 assessments, support planning, and follow-along provided to 250.12 persons determined to be eligible for case management under 250.13 Minnesota health care programs. No individual or family member 250.14 shall be charged for an initial assessment or initial support 250.15 plan development provided under subdivision 3a or 3b. 250.16 Sec. 15. Minnesota Statutes 2000, section 256B.0911, 250.17 subdivision 7, is amended to read: 250.18 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 250.19 (a) Medical assistance reimbursement for nursing facilities 250.20 shall be authorized for a medical assistance recipient only if a 250.21 preadmission screening has been conducted prior to admission or 250.22 thelocalcountyagencyhas authorized an exemption. Medical 250.23 assistance reimbursement for nursing facilities shall not be 250.24 provided for any recipient who the local screener has determined 250.25 does not meet the level of care criteria for nursing facility 250.26 placement or, if indicated, has not had a level IIPASARROBRA 250.27 evaluation as required under the federal Omnibus Reconciliation 250.28 Act of 1987 completed unless an admission for a recipient with 250.29 mental illness is approved by the local mental health authority 250.30 or an admission for a recipient with mental retardation or 250.31 related condition is approved by the state mental retardation 250.32 authority. 250.33 (b) The nursing facility must not bill a person who is not 250.34 a medical assistance recipient for resident days that preceded 250.35 the date of completion of screening activities as required under 250.36 subdivisions 4a, 4b, and 4c. The nursing facility must include 251.1 unreimbursed resident days in the nursing facility resident day 251.2 totals reported to the commissioner. 251.3 (c) The commissioner shall make a request to the health 251.4 care financing administration for a waiver allowing screening 251.5 team approval of Medicaid payments for certified nursing 251.6 facility care. An individual has a choice and makes the final 251.7 decision between nursing facility placement and community 251.8 placement after the screening team's recommendation, except as 251.9 provided inparagraphs (b) and (c)subdivision 4a, paragraph (c). 251.10(c) The local county mental health authority or the state251.11mental retardation authority under Public Law Numbers 100-203251.12and 101-508 may prohibit admission to a nursing facility, if the251.13individual does not meet the nursing facility level of care251.14criteria or needs specialized services as defined in Public Law251.15Numbers 100-203 and 101-508. For purposes of this section,251.16"specialized services" for a person with mental retardation or a251.17related condition means "active treatment" as that term is251.18defined in Code of Federal Regulations, title 42, section251.19483.440(a)(1).251.20(e) Appeals from the screening team's recommendation or the251.21county agency's final decision shall be made according to251.22section 256.045, subdivision 3.251.23 Sec. 16. Minnesota Statutes 2000, section 256B.0913, 251.24 subdivision 1, is amended to read: 251.25 Subdivision 1. [PURPOSE AND GOALS.] The purpose of the 251.26 alternative care program is to provide funding foror access to251.27 home and community-based services forfrailelderly persons, in 251.28 order to limit nursing facility placements. The program is 251.29 designed to supportfrailelderly persons in their desire to 251.30 remain in the community as independently and as long as possible 251.31 and to support informal caregivers in their efforts to provide 251.32 care forfrailelderly people. Further, the goals of the 251.33 program are: 251.34 (1) to contain medical assistance expenditures byproviding251.35 funding care in the communityat a cost the same or less than251.36nursing facility costs; and 252.1 (2) to maintain the moratorium on new construction of 252.2 nursing home beds. 252.3 Sec. 17. Minnesota Statutes 2000, section 256B.0913, 252.4 subdivision 2, is amended to read: 252.5 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 252.6 services are available toall frail olderMinnesotans. This252.7includes:252.8(1) persons who are receiving medical assistance and served252.9under the medical assistance program or the Medicaid waiver252.10program;252.11(2) personsage 65 or older who are not eligible for 252.12 medical assistance without a spenddown or waiver obligation but 252.13 who would be eligible for medical assistance within 180 days of 252.14 admission to a nursing facility andserved undersubject to 252.15 subdivisions 4 to 13; and252.16(3) persons who are paying for their services out-of-pocket. 252.17 Sec. 18. Minnesota Statutes 2000, section 256B.0913, 252.18 subdivision 4, is amended to read: 252.19 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 252.20 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 252.21 under the alternative care program is available to persons who 252.22 meet the following criteria: 252.23 (1) the person has beenscreened by the county screening252.24team or, if previously screened and served under the alternative252.25care program, assessed by the local county social worker or252.26public health nursedetermined by a community assessment under 252.27 section 256B.0911, to be a person who would require the level of 252.28 care provided in a nursing facility, but for the provision of 252.29 services under the alternative care program; 252.30 (2) the person is age 65 or older; 252.31 (3) the person would befinanciallyeligible for medical 252.32 assistance within 180 days of admission to a nursing facility; 252.33 (4) the personmeets the asset transfer requirements ofis 252.34 not ineligible for the medical assistance program due to an 252.35 asset transfer penalty; 252.36 (5)the screening team would recommend nursing facility253.1admission or continued stay for the person if alternative care253.2services were not available;253.3(6)the person needs services that are notavailable at253.4that time in the countyfunded through othercounty,state,or 253.5 federal fundingsources; and 253.6(7)(6) the monthly cost of the alternative care services 253.7 funded by the program for this person does not exceed 75 percent 253.8 of the statewideaverage monthly medical assistance payment for253.9nursing facility care at the individual's case mix253.10classificationweighted average monthly nursing facility rate of 253.11 the case mix resident class to which the individual alternative 253.12 care client would be assigned under Minnesota Rules, parts 253.13 9549.0050 to 9549.0059, less the recipient's maintenance needs 253.14 allowance as described in section 256B.0915, subdivision 1d, 253.15 paragraph (a), until the first day of the state fiscal year in 253.16 which the resident assessment system, under section 256B.437, 253.17 for nursing home rate determination is implemented. Effective 253.18 on the first day of the state fiscal year in which a resident 253.19 assessment system, under section 256B.437, for nursing home rate 253.20 determination is implemented and the first day of each 253.21 subsequent state fiscal year, the monthly cost of alternative 253.22 care services for this person shall not exceed the alternative 253.23 care monthly cap for the case mix resident class to which the 253.24 alternative care client would be assigned under Minnesota Rules, 253.25 parts 9549.0050 to 9549.0059, which was in effect on the last 253.26 day of the previous state fiscal year, and adjusted by the 253.27 greater of any legislatively adopted home and community-based 253.28 services cost-of-living percentage increase or any legislatively 253.29 adopted statewide percent rate increase for nursing facilities. 253.30 This monthly limit does not prohibit the alternative care client 253.31 from payment for additional services, but in no case may the 253.32 cost of additional services purchased under this section exceed 253.33 the difference between the client's monthly service limit 253.34 defined under section 256B.0915, subdivision 3, and the 253.35 alternative care program monthly service limit defined in this 253.36 paragraph. If medical supplies and equipment oradaptations254.1 environmental modifications are or will be purchased for an 254.2 alternative care services recipient, the costs may be prorated 254.3 on a monthly basisthroughout the year in which they are254.4purchasedfor up to 12 consecutive months beginning with the 254.5 month of purchase. If the monthly cost of a recipient's other 254.6 alternative care services exceeds the monthly limit established 254.7 in this paragraph, the annual cost of the alternative care 254.8 services shall be determined. In this event, the annual cost of 254.9 alternative care services shall not exceed 12 times the monthly 254.10 limitcalculateddescribed in this paragraph. 254.11 (b)Individuals who meet the criteria in paragraph (a) and254.12who have been approved for alternative care funding are called254.13180-day eligible clients.254.14(c) The statewide average payment for nursing facility care254.15is the statewide average monthly nursing facility rate in effect254.16on July 1 of the fiscal year in which the cost is incurred, less254.17the statewide average monthly income of nursing facility254.18residents who are age 65 or older and who are medical assistance254.19recipients in the month of March of the previous fiscal year.254.20This monthly limit does not prohibit the 180-day eligible client254.21from paying for additional services needed or desired.254.22(d) In determining the total costs of alternative care254.23services for one month, the costs of all services funded by the254.24alternative care program, including supplies and equipment, must254.25be included.254.26(e)Alternative care funding under this subdivision is not 254.27 available for a person who is a medical assistance recipient or 254.28 who would be eligible for medical assistance without a 254.29 spenddown, unless authorized by the commissioneror waiver 254.30 obligation. A person whose initial application for medical 254.31 assistance is being processed may be served under the 254.32 alternative care program for a period up to 60 days. If the 254.33 individual is found to be eligible for medical assistance,the254.34county must billmedical assistance must be billed for services 254.35 payable under the federally approved elderly waiver plan and 254.36 delivered from the date the individual was found eligible 255.1 forservices reimbursable underthe federally approved elderly 255.2 waiverprogramplan. Notwithstanding this provision, upon 255.3 federal approval, alternative care funds may not be used to pay 255.4 for any service the cost of which is payable by medical 255.5 assistance or which is used by a recipient to meet a medical 255.6 assistance income spenddown or waiver obligation. 255.7(f)(c) Alternative care funding is not available for a 255.8 person who resides in a licensed nursing homeor, certified 255.9 boarding care home, hospital, or intermediate care facility, 255.10 except for case management services which arebeingprovided in 255.11 support of the discharge planning process to a nursing home 255.12 resident or certified boarding care home resident who is 255.13 ineligible for case management funded by medical assistance. 255.14 Sec. 19. Minnesota Statutes 2000, section 256B.0913, 255.15 subdivision 5, is amended to read: 255.16 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 255.17 Alternative care funding may be used for payment of costs of: 255.18 (1) adult foster care; 255.19 (2) adult day care; 255.20 (3) home health aide; 255.21 (4) homemaker services; 255.22 (5) personal care; 255.23 (6) case management; 255.24 (7) respite care; 255.25 (8) assisted living; 255.26 (9) residential care services; 255.27 (10) care-related supplies and equipment; 255.28 (11) meals delivered to the home; 255.29 (12) transportation; 255.30 (13) skilled nursing; 255.31 (14) chore services; 255.32 (15) companion services; 255.33 (16) nutrition services; 255.34 (17) training for direct informal caregivers; 255.35 (18) telemedicine devices to monitor recipients in their 255.36 own homes as an alternative to hospital care, nursing home care, 256.1 or home visits;and256.2 (19) other servicesincludingwhich includes discretionary 256.3 funds and direct cash payments to clients,approved by the256.4county agencyfollowing approval by the commissioner, subject to 256.5 the provisions of paragraph(m)(j). Total annual payments for " 256.6 other services" for all clients within a county may not exceed 256.7 either ten percent of that county's annual alternative care 256.8 program base allocation or $5,000, whichever is greater. In no 256.9 case shall this amount exceed the county's total annual 256.10 alternative care program base allocation; and 256.11 (20) environmental modifications. 256.12 (b) The county agency must ensure that the funds are not 256.13 usedonly to supplement and notto supplant services available 256.14 through other public assistance or services programs. 256.15 (c) Unless specified in statute, the service definitions 256.16 and standards for alternative care services shall be the same as 256.17 the service definitions and standardsdefinedspecified in the 256.18 federally approved elderly waiver plan. Except for the county 256.19 agencies' approval of direct cash payments to clients as 256.20 described in paragraph (j) or for a provider of supplies and 256.21 equipment when the monthly cost of the supplies and equipment is 256.22 less than $250, persons or agencies must be employed by or under 256.23 a contract with the county agency or the public health nursing 256.24 agency of the local board of health in order to receive funding 256.25 under the alternative care program. Supplies and equipment may 256.26 be purchased from a non-Medicaid certified vendor if the cost 256.27 for the item is less than that of a Medicaid vendor. 256.28 (d) The adult foster care rate shall be considered a 256.29 difficulty of care payment and shall not include room and 256.30 board. The adult foster caredailyrate shall be negotiated 256.31 between the county agency and the foster care provider.The256.32rate established under this section shall not exceed 75 percent256.33of the state average monthly nursing home payment for the case256.34mix classification to which the individual receiving foster care256.35is assigned, and it must allow for other alternative care256.36services to be authorized by the case manager.The alternative 257.1 care payment for the foster care service in combination with the 257.2 payment for other alternative care services, including case 257.3 management, must not exceed the limit specified in subdivision 257.4 4, paragraph (a), clause (6). 257.5 (e) Personal care servicesmay be provided by a personal257.6care provider organization.must meet the service standards 257.7 defined in the federally approved elderly waiver plan, except 257.8 that a county agency may contract with a client's relativeof257.9the clientwho meets the relative hardship waiver requirement as 257.10 defined in section 256B.0627, subdivision 4, paragraph (b), 257.11 clause (10), to provide personal care services, but must ensure257.12nursingif the county agency ensures supervision of this service 257.13 by a registered nurse or mental health practitioner.Covered257.14personal care services defined in section 256B.0627, subdivision257.154, must meet applicable standards in Minnesota Rules, part257.169505.0335.257.17 (f)A county may use alternative care funds to purchase257.18medical supplies and equipment without prior approval from the257.19commissioner when: (1) there is no other funding source; (2)257.20the supplies and equipment are specified in the individual's257.21care plan as medically necessary to enable the individual to257.22remain in the community according to the criteria in Minnesota257.23Rules, part 9505.0210, item A; and (3) the supplies and257.24equipment represent an effective and appropriate use of257.25alternative care funds. A county may use alternative care funds257.26to purchase supplies and equipment from a non-Medicaid certified257.27vendor if the cost for the items is less than that of a Medicaid257.28vendor. A county is not required to contract with a provider of257.29supplies and equipment if the monthly cost of the supplies and257.30equipment is less than $250.257.31(g)For purposes of this section, residential care services 257.32 are services which are provided to individuals living in 257.33 residential care homes. Residential care homes are currently 257.34 licensed as board and lodging establishments and are registered 257.35 with the department of health as providing special 257.36 services under section 157.17 and are not subject to 258.1 registration under chapter 144D. Residential care services are 258.2 defined as "supportive services" and "health-related services." 258.3 "Supportive services" means the provision of up to 24-hour 258.4 supervision and oversight. Supportive services includes: (1) 258.5 transportation, when provided by the residential carecenter258.6 home only; (2) socialization, when socialization is part of the 258.7 plan of care, has specific goals and outcomes established, and 258.8 is not diversional or recreational in nature; (3) assisting 258.9 clients in setting up meetings and appointments; (4) assisting 258.10 clients in setting up medical and social services; (5) providing 258.11 assistance with personal laundry, such as carrying the client's 258.12 laundry to the laundry room. Assistance with personal laundry 258.13 does not include any laundry, such as bed linen, that is 258.14 included in the room and board rate. "Health-related services" 258.15 are limited to minimal assistance with dressing, grooming, and 258.16 bathing and providing reminders to residents to take medications 258.17 that are self-administered or providing storage for medications, 258.18 if requested. Individuals receiving residential care services 258.19 cannot receive homemaking services funded under this section. 258.20(h)(g) For the purposes of this section, "assisted living" 258.21 refers to supportive services provided by a single vendor to 258.22 clients who reside in the same apartment building of three or 258.23 more units which are not subject to registration under chapter 258.24 144D and are licensed by the department of health as a class A 258.25 home care provider or a class E home care provider. Assisted 258.26 living services are defined as up to 24-hour supervision, and 258.27 oversight, supportive services as defined in clause (1), 258.28 individualized home care aide tasks as defined in clause (2), 258.29 and individualized home management tasks as defined in clause 258.30 (3) provided to residents of a residential center living in 258.31 their units or apartments with a full kitchen and bathroom. A 258.32 full kitchen includes a stove, oven, refrigerator, food 258.33 preparation counter space, and a kitchen utensil storage 258.34 compartment. Assisted living services must be provided by the 258.35 management of the residential center or by providers under 258.36 contract with the management or with the county. 259.1 (1) Supportive services include: 259.2 (i) socialization, when socialization is part of the plan 259.3 of care, has specific goals and outcomes established, and is not 259.4 diversional or recreational in nature; 259.5 (ii) assisting clients in setting up meetings and 259.6 appointments; and 259.7 (iii) providing transportation, when provided by the 259.8 residential center only. 259.9Individuals receiving assisted living services will not259.10receive both assisted living services and homemaking services.259.11Individualized means services are chosen and designed259.12specifically for each resident's needs, rather than provided or259.13offered to all residents regardless of their illnesses,259.14disabilities, or physical conditions.259.15 (2) Home care aide tasks means: 259.16 (i) preparing modified diets, such as diabetic or low 259.17 sodium diets; 259.18 (ii) reminding residents to take regularly scheduled 259.19 medications or to perform exercises; 259.20 (iii) household chores in the presence of technically 259.21 sophisticated medical equipment or episodes of acute illness or 259.22 infectious disease; 259.23 (iv) household chores when the resident's care requires the 259.24 prevention of exposure to infectious disease or containment of 259.25 infectious disease; and 259.26 (v) assisting with dressing, oral hygiene, hair care, 259.27 grooming, and bathing, if the resident is ambulatory, and if the 259.28 resident has no serious acute illness or infectious disease. 259.29 Oral hygiene means care of teeth, gums, and oral prosthetic 259.30 devices. 259.31 (3) Home management tasks means: 259.32 (i) housekeeping; 259.33 (ii) laundry; 259.34 (iii) preparation of regular snacks and meals; and 259.35 (iv) shopping. 259.36 Individuals receiving assisted living services shall not 260.1 receive both assisted living services and homemaking services. 260.2 Individualized means services are chosen and designed 260.3 specifically for each resident's needs, rather than provided or 260.4 offered to all residents regardless of their illnesses, 260.5 disabilities, or physical conditions. Assisted living services 260.6 as defined in this section shall not be authorized in boarding 260.7 and lodging establishments licensed according to sections 260.8 157.011 and 157.15 to 157.22. 260.9(i)(h) For establishments registered under chapter 144D, 260.10 assisted living services under this section means either the 260.11 services describedand licensedin paragraph (g) and delivered 260.12 by a class E home care provider licensed by the department of 260.13 health or the services described under section 144A.4605 and 260.14 delivered by an assisted living home care provider or a class A 260.15 home care provider licensed by the commissioner of health. 260.16(j) For the purposes of this section, reimbursement(i) 260.17 Payment for assisted living services and residential care 260.18 services shall be a monthly rate negotiated and authorized by 260.19 the county agency based on an individualized service plan for 260.20 each resident and may not cover direct rent or food costs.The260.21rate260.22 (1) The individualized monthly negotiated payment for 260.23 assisted living services as described in paragraph (g) or (h), 260.24 and residential care services as described in paragraph (f), 260.25 shall not exceed the nonfederal share in effect on July 1 of the 260.26 state fiscal year for which the rate limit is being calculated 260.27 of the greater of either the statewide or any of the geographic 260.28 groups' weighted average monthlymedical assistancenursing 260.29 facility payment rate of the case mix resident class to which 260.30 the180-dayalternative care eligible client would be assigned 260.31 under Minnesota Rules, parts 9549.0050 to 9549.0059,unless the260.32 less the maintenance needs allowance as described in subdivision 260.33 1d, paragraph (a), until the first day of the state fiscal year 260.34 in which a resident assessment system, under section 256B.437, 260.35 of nursing home rate determination is implemented. Effective on 260.36 the first day of the state fiscal year in which a resident 261.1 assessment system, under section 256B.437, of nursing home rate 261.2 determination is implemented and the first day of each 261.3 subsequent state fiscal year, the individualized monthly 261.4 negotiated payment for the services described in this clause 261.5 shall not exceed the limit described in this clause which was in 261.6 effect on the last day of the previous state fiscal year and 261.7 which has been adjusted by the greater of any legislatively 261.8 adopted home and community-based services cost-of-living 261.9 percentage increase or any legislatively adopted statewide 261.10 percent rate increase for nursing facilities. 261.11 (2) The individualized monthly negotiated payment for 261.12 assisted living servicesare provided by a home caredescribed 261.13 under section 144A.4605 and delivered by a provider licensed by 261.14 the department of health as a class A home care provider or an 261.15 assisted living home care provider andareprovided in a 261.16 building that is registered as a housing with services 261.17 establishment under chapter 144D and that provides 24-hour 261.18 supervision in combination with the payment for other 261.19 alternative care services, including case management, must not 261.20 exceed the limit specified in subdivision 4, paragraph (a), 261.21 clause (6). 261.22(k) For purposes of this section, companion services are261.23defined as nonmedical care, supervision and oversight, provided261.24to a functionally impaired adult. Companions may assist the261.25individual with such tasks as meal preparation, laundry and261.26shopping, but do not perform these activities as discrete261.27services. The provision of companion services does not entail261.28hands-on medical care. Providers may also perform light261.29housekeeping tasks which are incidental to the care and261.30supervision of the recipient. This service must be approved by261.31the case manager as part of the care plan. Companion services261.32must be provided by individuals or organizations who are under261.33contract with the local agency to provide the service. Any261.34person related to the waiver recipient by blood, marriage or261.35adoption cannot be reimbursed under this service. Persons261.36providing companion services will be monitored by the case262.1manager.262.2(l) For purposes of this section, training for direct262.3informal caregivers is defined as a classroom or home course of262.4instruction which may include: transfer and lifting skills,262.5nutrition, personal and physical cares, home safety in a home262.6environment, stress reduction and management, behavioral262.7management, long-term care decision making, care coordination262.8and family dynamics. The training is provided to an informal262.9unpaid caregiver of a 180-day eligible client which enables the262.10caregiver to deliver care in a home setting with high levels of262.11quality. The training must be approved by the case manager as262.12part of the individual care plan. Individuals, agencies, and262.13educational facilities which provide caregiver training and262.14education will be monitored by the case manager.262.15(m)(j) A county agency may make payment from their 262.16 alternative care program allocation for "other services" 262.17provided to an alternative care program recipient if those262.18services prevent, shorten, or delay institutionalization. These262.19services maywhich include use of "discretionary funds" for 262.20 services that are not otherwise defined in this section and 262.21 direct cash payments to therecipientclient for the purpose of 262.22 purchasing therecipient'sservices. The following provisions 262.23 apply to payments under this paragraph: 262.24 (1) a cash payment to a client under this provision cannot 262.25 exceed 80 percent of the monthly payment limit for that client 262.26 as specified in subdivision 4, paragraph (a), clause(7)(6); 262.27 (2) a county may not approve any cash payment for a client 262.28 who meets either of the following: 262.29 (i) has been assessed as having a dependency in 262.30 orientation, unless the client has an authorized 262.31 representativeunder section 256.476, subdivision 2, paragraph262.32(g), or for a client who. An "authorized representative" means 262.33 an individual who is at least 18 years of age and is designated 262.34 by the person or the person's legal representative to act on the 262.35 person's behalf. This individual may be a family member, 262.36 guardian, representative payee, or other individual designated 263.1 by the person or the person's legal representative, if any, to 263.2 assist in purchasing and arranging for supports; or 263.3 (ii) is concurrently receiving adult foster care, 263.4 residential care, or assisted living services; 263.5 (3)any service approved under this section must be a263.6service which meets the purpose and goals of the program as263.7listed in subdivision 1;263.8(4) cash payments must also meet the criteria of and are263.9governed by the procedures and liability protection established263.10in section 256.476, subdivision 4, paragraphs (b) through (h),263.11and recipients of cash grants must meet the requirements in263.12section 256.476, subdivision 10; andcash payments to a person 263.13 or a person's family will be provided through a monthly payment 263.14 and be in the form of cash, voucher, or direct county payment to 263.15 vendor. Fees or premiums assessed to the person for eligibility 263.16 for health and human services are not reimbursable through this 263.17 service option. Services and goods purchased through cash 263.18 payments must be identified in the person's individualized care 263.19 plan and must meet all of the following criteria: 263.20 (i) they must be over and above the normal cost of caring 263.21 for the person if the person did not have functional 263.22 limitations; 263.23 (ii) they must be directly attributable to the person's 263.24 functional limitations; 263.25 (iii) they must have the potential to be effective at 263.26 meeting the goals of the program; 263.27 (iv) they must be consistent with the needs identified in 263.28 the individualized service plan. The service plan shall specify 263.29 the needs of the person and family, the form and amount of 263.30 payment, the items and services to be reimbursed, and the 263.31 arrangements for management of the individual grant; and 263.32 (v) the person, the person's family, or the legal 263.33 representative shall be provided sufficient information to 263.34 ensure an informed choice of alternatives. The local agency 263.35 shall document this information in the person's care plan, 263.36 including the type and level of expenditures to be reimbursed; 264.1 (4) the county, lead agency under contract, or tribal 264.2 government under contract to administer the alternative care 264.3 program shall not be liable for damages, injuries, or 264.4 liabilities sustained through the purchase of direct supports or 264.5 goods by the person, the person's family, or the authorized 264.6 representative with funds received through the cash payments 264.7 under this section. Liabilities include, but are not limited 264.8 to, workers' compensation, the Federal Insurance Contributions 264.9 Act (FICA), or the Federal Unemployment Tax Act (FUTA); 264.10 (5) persons receiving grants under this section shall have 264.11 the following responsibilities: 264.12 (i) spend the grant money in a manner consistent with their 264.13 individualized service plan with the local agency; 264.14 (ii) notify the local agency of any necessary changes in 264.15 the grant-expenditures; 264.16 (iii) arrange and pay for supports; and 264.17 (iv) inform the local agency of areas where they have 264.18 experienced difficulty securing or maintaining supports; and 264.19(5)(6) the county shall report client outcomes, services, 264.20 and costs under this paragraph in a manner prescribed by the 264.21 commissioner. 264.22 (k) Upon implementation of direct cash payments to clients 264.23 under this section, any person determined eligible for the 264.24 alternative care program who chooses a cash payment approved by 264.25 the county agency shall receive the cash payment under this 264.26 section and not under section 256.476 unless the person was 264.27 receiving a consumer support grant under section 256.476 before 264.28 implementation of direct cash payments under this section. 264.29 Sec. 20. Minnesota Statutes 2000, section 256B.0913, 264.30 subdivision 6, is amended to read: 264.31 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] The 264.32 alternative care program is administered by the county agency. 264.33 This agency is the lead agency responsible for the local 264.34 administration of the alternative care program as described in 264.35 this section. However, it may contract with the public health 264.36 nursing service to be the lead agency. The commissioner may 265.1 contract with federally recognized Indian tribes with a 265.2 reservation in Minnesota to serve as the lead agency responsible 265.3 for the local administration of the alternative care program as 265.4 described in the contract. 265.5 Sec. 21. Minnesota Statutes 2000, section 256B.0913, 265.6 subdivision 7, is amended to read: 265.7 Subd. 7. [CASE MANAGEMENT.] Providers of case management 265.8 services for persons receiving services funded by the 265.9 alternative care program must meet the qualification 265.10 requirements and standards specified in section 256B.0915, 265.11 subdivision 1b. The case manager mustensure the health and265.12safety of the individual client andnot approve alternative care 265.13 funding for a client in any setting in which the case manager 265.14 cannot reasonably ensure the client's health and safety. The 265.15 case manager is responsible for the cost-effectiveness of the 265.16 alternative care individual care plan and must not approve any 265.17 care plan in which the cost of services funded by alternative 265.18 care and client contributions exceeds the limit specified in 265.19 section 256B.0915, subdivision 3, paragraph (b). The county may 265.20 allow a case manager employed by the county to delegate certain 265.21 aspects of the case management activity to another individual 265.22 employed by the county provided there is oversight of the 265.23 individual by the case manager. The case manager may not 265.24 delegate those aspects which require professional judgment 265.25 including assessments, reassessments, and care plan development. 265.26 Sec. 22. Minnesota Statutes 2000, section 256B.0913, 265.27 subdivision 8, is amended to read: 265.28 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 265.29 case manager shall implement the plan of care for each180-day265.30eligiblealternative care client and ensure that a client's 265.31 service needs and eligibility are reassessed at least every 12 265.32 months. The plan shall include any services prescribed by the 265.33 individual's attending physician as necessary to allow the 265.34 individual to remain in a community setting. In developing the 265.35 individual's care plan, the case manager should include the use 265.36 of volunteers from families and neighbors, religious 266.1 organizations, social clubs, and civic and service organizations 266.2 to support the formal home care services. The county shall be 266.3 held harmless for damages or injuries sustained through the use 266.4 of volunteers under this subdivision including workers' 266.5 compensation liability.The lead agency shall provide266.6documentation to the commissioner verifying that the266.7individual's alternative care is not available at that time266.8through any other public assistance or service program.The 266.9 lead agency shall provide documentation in each individual's 266.10 plan of care and, if requested, to the commissioner that the 266.11 most cost-effective alternatives available have been offered to 266.12 the individual and that the individual was free to choose among 266.13 available qualified providers, both public and private. The 266.14 case manager must give the individual a ten-day written notice 266.15 of any decrease in or termination of alternative care services. 266.16 (b) If the county administering alternative care services 266.17 is different than the county of financial responsibility, the 266.18 care plan may be implemented without the approval of the county 266.19 of financial responsibility. 266.20 Sec. 23. Minnesota Statutes 2000, section 256B.0913, 266.21 subdivision 9, is amended to read: 266.22 Subd. 9. [CONTRACTING PROVISIONS FOR PROVIDERS.]The lead266.23agency shall document to the commissioner that the agency made266.24reasonable efforts to inform potential providers of the266.25anticipated need for services under the alternative care program266.26or waiver programs under sections 256B.0915 and 256B.49,266.27including a minimum of 14 days' written advance notice of the266.28opportunity to be selected as a service provider and an annual266.29public meeting with providers to explain and review the criteria266.30for selection. The lead agency shall also document to the266.31commissioner that the agency allowed potential providers an266.32opportunity to be selected to contract with the county agency.266.33Funds reimbursed to counties under this subdivisionAlternative 266.34 care funds paid to service providers are subject to audit by the 266.35 commissioner for fiscal and utilization control. 266.36 The lead agency must select providers for contracts or 267.1 agreements using the following criteria and other criteria 267.2 established by the county: 267.3 (1) the need for the particular services offered by the 267.4 provider; 267.5 (2) the population to be served, including the number of 267.6 clients, the length of time services will be provided, and the 267.7 medical condition of clients; 267.8 (3) the geographic area to be served; 267.9 (4) quality assurance methods, including appropriate 267.10 licensure, certification, or standards, and supervision of 267.11 employees when needed; 267.12 (5) rates for each service and unit of service exclusive of 267.13 county administrative costs; 267.14 (6) evaluation of services previously delivered by the 267.15 provider; and 267.16 (7) contract or agreement conditions, including billing 267.17 requirements, cancellation, and indemnification. 267.18 The county must evaluate its own agency services under the 267.19 criteria established for other providers.The county shall267.20provide a written statement of the reasons for not selecting267.21providers.267.22 Sec. 24. Minnesota Statutes 2000, section 256B.0913, 267.23 subdivision 10, is amended to read: 267.24 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 267.25 appropriation for fiscal years 1992 and beyond shall cover 267.26 only180-dayalternative care eligible clients. Prior to July 1 267.27 of each year, the commissioner shall allocate to county agencies 267.28 the state funds available for alternative care for persons 267.29 eligible under subdivision 2. 267.30 (b)Prior to July 1 of each year, the commissioner shall267.31allocate to county agencies the state funds available for267.32alternative care for persons eligible under subdivision 2. The267.33allocation for fiscal year 1992 shall be calculated using a base267.34that is adjusted to exclude the medical assistance share of267.35alternative care expenditures. The adjusted base is calculated267.36by multiplying each county's allocation for fiscal year 1991 by268.1the percentage of county alternative care expenditures for268.2180-day eligible clients. The percentage is determined based on268.3expenditures for services rendered in fiscal year 1989 or268.4calendar year 1989, whichever is greater.The adjusted base for 268.5 each county is the county's current fiscal year base allocation 268.6 plus any targeted funds approved during the current fiscal 268.7 year. Calculations for paragraphs (c) and (d) are to be made as 268.8 follows: for each county, the determination of alternative care 268.9 program expenditures shall be based on payments for services 268.10 rendered from April 1 through March 31 in the base year, to the 268.11 extent that claims have been submitted and paid by June 1 of 268.12 that year. 268.13 (c) If thecountyalternative care program expendituresfor268.14180-day eligible clientsas defined in paragraph (b) are 95 268.15 percent or more ofitsthe county's adjusted base allocation, 268.16 the allocation for the next fiscal year is 100 percent of the 268.17 adjusted base, plus inflation to the extent that inflation is 268.18 included in the state budget. 268.19 (d) If thecountyalternative care program expendituresfor268.20180-day eligible clientsas defined in paragraph (b) are less 268.21 than 95 percent ofitsthe county's adjusted base allocation, 268.22 the allocation for the next fiscal year is the adjusted base 268.23 allocation less the amount of unspent funds below the 95 percent 268.24 level. 268.25 (e)For fiscal year 1992 only, a county may receive an268.26increased allocation if annualized service costs for the month268.27of May 1991 for 180-day eligible clients are greater than the268.28allocation otherwise determined. A county may apply for this268.29increase by reporting projected expenditures for May to the268.30commissioner by June 1, 1991. The amount of the allocation may268.31exceed the amount calculated in paragraph (b). The projected268.32expenditures for May must be based on actual 180-day eligible268.33client caseload and the individual cost of clients' care plans.268.34If a county does not report its expenditures for May, the amount268.35in paragraph (c) or (d) shall be used.268.36(f) Calculations for paragraphs (c) and (d) are to be made269.1as follows: for each county, the determination of expenditures269.2shall be based on payments for services rendered from April 1269.3through March 31 in the base year, to the extent that claims269.4have been submitted by June 1 of that year. Calculations for269.5paragraphs (c) and (d) must also include the funds transferred269.6to the consumer support grant program for clients who have269.7transferred to that program from April 1 through March 31 in the269.8base year.269.9(g) For the biennium ending June 30, 2001, the allocation269.10of state funds to county agencies shall be calculated as269.11described in paragraphs (c) and (d).If the annual legislative 269.12 appropriation for the alternative care program is inadequate to 269.13 fund the combined county allocations forfiscal year 2000 or269.142001a biennium, the commissioner shall distribute to each 269.15 county the entire annual appropriation as that county's 269.16 percentage of the computed base as calculated inparagraph269.17(f)paragraphs (c) and (d). 269.18 Sec. 25. Minnesota Statutes 2000, section 256B.0913, 269.19 subdivision 11, is amended to read: 269.20 Subd. 11. [TARGETED FUNDING.] (a) The purpose of targeted 269.21 funding is to make additional money available to counties with 269.22 the greatest need. Targeted funds are not intended to be 269.23 distributed equitably among all counties, but rather, allocated 269.24 to those with long-term care strategies that meet state goals. 269.25 (b) The funds available for targeted funding shall be the 269.26 total appropriation for each fiscal year minus county 269.27 allocations determined under subdivision 10 as adjusted for any 269.28 inflation increases provided in appropriations for the biennium. 269.29 (c) The commissioner shall allocate targeted funds to 269.30 counties that demonstrate to the satisfaction of the 269.31 commissioner that they have developed feasible plans to increase 269.32 alternative care spending. In making targeted funding 269.33 allocations, the commissioner shall use the following priorities: 269.34 (1) counties that received a lower allocation in fiscal 269.35 year 1991 than in fiscal year 1990. Counties remain in this 269.36 priority until they have been restored to their fiscal year 1990 270.1 level plus inflation; 270.2 (2) counties that sustain a base allocation reduction for 270.3 failure to spend 95 percent of the allocation if they 270.4 demonstrate that the base reduction should be restored; 270.5 (3) counties that propose projects to divert community 270.6 residents from nursing home placement or convert nursing home 270.7 residents to community living; and 270.8 (4) counties that can otherwise justify program growth by 270.9 demonstrating the existence of waiting lists, demographically 270.10 justified needs, or other unmet needs. 270.11 (d) Counties that would receive targeted funds according to 270.12 paragraph (c) must demonstrate to the commissioner's 270.13 satisfaction that the funds would be appropriately spent by 270.14 showing how the funds would be used to further the state's 270.15 alternative care goals as described in subdivision 1, and that 270.16 the county has the administrative and service delivery 270.17 capability to use them. 270.18 (e) The commissioner shall request applicationsby June 1270.19each year, for county agencies to applyfor targeted funds by 270.20 November 1 of each year. The counties selected for targeted 270.21 funds shall be notified of the amount of their additional 270.22 fundingby August 1 of each year. Targeted funds allocated to a 270.23 county agency in one year shall be treated as part of the 270.24 county's base allocation for that year in determining 270.25 allocations for subsequent years. No reallocations between 270.26 counties shall be made. 270.27(f) The allocation for each year after fiscal year 1992270.28shall be determined using the previous fiscal year's allocation,270.29including any targeted funds, as the base and then applying the270.30criteria under subdivision 10, paragraphs (c), (d), and (f), to270.31the current year's expenditures.270.32 Sec. 26. Minnesota Statutes 2000, section 256B.0913, 270.33 subdivision 12, is amended to read: 270.34 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 270.35 all180-dayalternative care eligible clients to help pay for 270.36 the cost of participating in the program. The amount of the 271.1 premium for the alternative care client shall be determined as 271.2 follows: 271.3 (1) when the alternative care client's income less 271.4 recurring and predictable medical expenses is greater than the 271.5medical assistance income standardrecipient's maintenance needs 271.6 allowance as defined in section 256B.0915, subdivision 1d, 271.7 paragraph (a), but less than 150 percent of the federal poverty 271.8 guideline effective on July 1 of the state fiscal year in which 271.9 the premium is being computed, and total assets are less than 271.10 $10,000, the fee is zero; 271.11 (2) when the alternative care client's income less 271.12 recurring and predictable medical expenses is greater than 150 271.13 percent of the federal poverty guideline effective on July 1 of 271.14 the state fiscal year in which the premium is being computed, 271.15 and total assets are less than $10,000, the fee is 25 percent of 271.16 the cost of alternative care services or the difference between 271.17 150 percent of the federal poverty guideline effective on July 1 271.18 of the state fiscal year in which the premium is being computed 271.19 and the client's income less recurring and predictable medical 271.20 expenses, whichever is less; and 271.21 (3) when the alternative care client's total assets are 271.22 greater than $10,000, the fee is 25 percent of the cost of 271.23 alternative care services. 271.24 For married persons, total assets are defined as the total 271.25 marital assets less the estimated community spouse asset 271.26 allowance, under section 256B.059, if applicable. For married 271.27 persons, total income is defined as the client's income less the 271.28 monthly spousal allotment, under section 256B.058. 271.29 All alternative care services except case management shall 271.30 be included in the estimated costs for the purpose of 271.31 determining 25 percent of the costs. 271.32 The monthly premium shall be calculated based on the cost 271.33 of the first full month of alternative care services and shall 271.34 continue unaltered until the next reassessment is completed or 271.35 at the end of 12 months, whichever comes first. Premiums are 271.36 due and payable each month alternative care services are 272.1 received unless the actual cost of the services is less than the 272.2 premium. 272.3 (b) The fee shall be waived by the commissioner when: 272.4 (1) a person who is residing in a nursing facility is 272.5 receiving case management only; 272.6 (2) a person is applying for medical assistance; 272.7 (3) a married couple is requesting an asset assessment 272.8 under the spousal impoverishment provisions; 272.9 (4)a person is a medical assistance recipient, but has272.10been approved for alternative care-funded assisted living272.11services;272.12(5)a person is found eligible for alternative care, but is 272.13 not yet receiving alternative care services; or 272.14(6)(5) a person's fee under paragraph (a) is less than $25. 272.15 (c) The county agency must record in the state's receivable 272.16 system the client's assessed premium amount or the reason the 272.17 premium has been waived. The commissioner will bill and collect 272.18 the premium from the clientand forward the amounts collected to272.19the commissioner in the manner and at the times prescribed by272.20the commissioner. Money collected must be deposited in the 272.21 general fund and is appropriated to the commissioner for the 272.22 alternative care program. The client must supply the county 272.23 with the client's social security number at the time of 272.24 application.If a client fails or refuses to pay the premium272.25due,The county shall supply the commissioner with the client's 272.26 social security number and other information the commissioner 272.27 requires to collect the premium from the client. The 272.28 commissioner shall collect unpaid premiums using the Revenue 272.29 Recapture Act in chapter 270A and other methods available to the 272.30 commissioner. The commissioner may require counties to inform 272.31 clients of the collection procedures that may be used by the 272.32 state if a premium is not paid. 272.33 (d) The commissioner shall begin to adopt emergency or 272.34 permanent rules governing client premiums within 30 days after 272.35 July 1, 1991, including criteria for determining when services 272.36 to a client must be terminated due to failure to pay a premium. 273.1 Sec. 27. Minnesota Statutes 2000, section 256B.0913, 273.2 subdivision 13, is amended to read: 273.3 Subd. 13. [COUNTY BIENNIAL PLAN.] The county biennial plan 273.4 forthe preadmission screening programlong-term care 273.5 consultation under section 256B.0911, the alternative care 273.6 program under this section, and waivers for the elderly under 273.7 section 256B.0915,and waivers for the disabled under section273.8256B.49,shall be incorporated into the biennial Community 273.9 Social Services Act plan and shall meet the regulations and 273.10 timelines of that plan.This county biennial plan shall include:273.11(1) information on the administration of the preadmission273.12screening program;273.13(2) information on the administration of the home and273.14community-based services waivers for the elderly under section273.15256B.0915, and for the disabled under section 256B.49; and273.16(3) information on the administration of the alternative273.17care program.273.18 Sec. 28. Minnesota Statutes 2000, section 256B.0913, 273.19 subdivision 14, is amended to read: 273.20 Subd. 14. [REIMBURSEMENTPAYMENT AND RATE ADJUSTMENTS.] (a) 273.21ReimbursementPayment forexpenditures for theprovided 273.22 alternative care services as approved by the client's case 273.23 manager shall be through the invoice processing procedures of 273.24 the department's Medicaid Management Information System (MMIS). 273.25 To receivereimbursementpayment, the county or vendor must 273.26 submit invoices within 12 months following the date of service. 273.27 The county agency and its vendors under contract shall not be 273.28 reimbursed for services which exceed the county allocation. 273.29 (b)If a county collects less than 50 percent of the client273.30premiums due under subdivision 12, the commissioner may withhold273.31up to three percent of the county's final alternative care273.32program allocation determined under subdivisions 10 and 11.273.33(c)The county shall negotiate individual rates with 273.34 vendors and maybe reimbursedauthorize service payment for 273.35 actual costs up tothe greater ofthe county's current approved 273.36 rateor 60 percent of the maximum rate in fiscal year 1994 and274.165 percent of the maximum rate in fiscal year 1995 for each274.2alternative care service. Notwithstanding any other rule or 274.3 statutory provision to the contrary, the commissioner shall not 274.4 be authorized to increase rates by an annual inflation factor, 274.5 unless so authorized by the legislature. 274.6(d)(c)On July 1, 1993, the commissioner shall increase274.7the maximum rate for home delivered meals to $4.50 per meal.To 274.8 improve access to community services and eliminate payment 274.9 disparities between the alternative care program and the elderly 274.10 waiver program, the commissioner shall establish statewide 274.11 maximum service rate limits and eliminate county-specific 274.12 service rate limits. 274.13 (1) Effective July 1, 2001, for service rate limits, except 274.14 those in subdivision 5, paragraphs (d) and (j), the rate limit 274.15 for each service shall be the greater of the alternative care 274.16 statewide maximum rate or the elderly waiver statewide maximum 274.17 rate. 274.18 (2) Counties may negotiate individual service rates with 274.19 vendors for actual costs up to the statewide maximum service 274.20 rate limit. 274.21 Sec. 29. Minnesota Statutes 2000, section 256B.0915, 274.22 subdivision 1d, is amended to read: 274.23 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 274.24 RESOURCES FOR ELDERLY WAIVER.](a)Notwithstanding the 274.25 provisions of section 256B.056, the commissioner shall make the 274.26 following amendment to the medical assistance elderly waiver 274.27 program effective July 1, 1999, or upon federal approval, 274.28 whichever is later. 274.29 A recipient's maintenance needs will be an amount equal to 274.30 the Minnesota supplemental aid equivalent rate as defined in 274.31 section 256I.03, subdivision 5, plus the medical assistance 274.32 personal needs allowance as defined in section 256B.35, 274.33 subdivision 1, paragraph (a), when applying posteligibility 274.34 treatment of income rules to the gross income of elderly waiver 274.35 recipients, except for individuals whose income is in excess of 274.36 the special income standard according to Code of Federal 275.1 Regulations, title 42, section 435.236. Recipient maintenance 275.2 needs shall be adjusted under this provision each July 1. 275.3(b) The commissioner of human services shall secure275.4approval of additional elderly waiver slots sufficient to serve275.5persons who will qualify under the revised income standard275.6described in paragraph (a) before implementing section275.7256B.0913, subdivision 16.275.8(c) In implementing this subdivision, the commissioner275.9shall consider allowing persons who would otherwise be eligible275.10for the alternative care program but would qualify for the275.11elderly waiver with a spenddown to remain on the alternative275.12care program.275.13 Sec. 30. Minnesota Statutes 2000, section 256B.0915, 275.14 subdivision 3, is amended to read: 275.15 Subd. 3. [LIMITS OF CASES, RATES,REIMBURSEMENTPAYMENTS, 275.16 AND FORECASTING.] (a) The number of medical assistance waiver 275.17 recipients that a county may serve must be allocated according 275.18 to the number of medical assistance waiver cases open on July 1 275.19 of each fiscal year. Additional recipients may be served with 275.20 the approval of the commissioner. 275.21 (b) The monthly limit for the cost of waivered services to 275.22 an individual elderly waiver client shall be thestatewide275.23average paymentweighted average monthly nursing facility rate 275.24 of the case mix resident class to which the elderly waiver 275.25 client would be assigned underthe medical assistance case mix275.26reimbursement system.Minnesota Rules, parts 9549.0050 to 275.27 9549.0059, less the recipient's maintenance needs allowance as 275.28 described in subdivision 1d, paragraph (a), until the first day 275.29 of the state fiscal year in which the resident assessment system 275.30 as described in section 256B.437 for nursing home rate 275.31 determination is implemented. Effective on the first day of the 275.32 state fiscal year in which the resident assessment system as 275.33 described in section 256B.437 for nursing home rate 275.34 determination is implemented and the first day of each 275.35 subsequent state fiscal year, the monthly limit for the cost of 275.36 waivered services to an individual elderly waiver client shall 276.1 be the rate of the case mix resident class to which the waiver 276.2 client would be assigned under Minnesota Rules, parts 9549.0050 276.3 to 9549.0059, in effect on the last day of the previous state 276.4 fiscal year, adjusted by the greater of any legislatively 276.5 adopted home and community-based services cost-of-living 276.6 percentage increase or any legislatively adopted statewide 276.7 percent rate increase for nursing facilities. 276.8 (c) If extended medical supplies and equipment or 276.9adaptationsenvironmental modifications are or will be purchased 276.10 for an elderly waiverservices recipientclient, the costs may 276.11 be proratedon a monthly basis throughout the year in which they276.12are purchasedfor up to 12 consecutive months beginning with the 276.13 month of purchase. If the monthly cost of a recipient'sother276.14 waivered services exceeds the monthly limit established inthis276.15 paragraph (b), the annual cost oftheall waivered services 276.16 shall be determined. In this event, the annual cost of all 276.17 waivered services shall not exceed 12 times the monthly 276.18 limitcalculated in this paragraph. The statewide average276.19payment rate is calculated by determining the statewide average276.20monthly nursing home rate, effective July 1 of the fiscal year276.21in which the cost is incurred, less the statewide average276.22monthly income of nursing home residents who are age 65 or276.23older, and who are medical assistance recipients in the month of276.24March of the previous state fiscal year. The annual cost276.25divided by 12 of elderly or disabled waivered servicesof 276.26 waivered services as described in paragraph (b). 276.27 (d) For a person who is a nursing facility resident at the 276.28 time of requesting a determination of eligibility for elderlyor276.29disabledwaivered servicesshall be the greater of the monthly276.30payment for: (i), a monthly conversion limit for the cost of 276.31 elderly waivered services may be requested. The monthly 276.32 conversion limit for the cost of elderly waiver services shall 276.33 be the resident class assigned under Minnesota Rules, parts 276.34 9549.0050 to 9549.0059, for that resident in the nursing 276.35 facility where the resident currently resides; or (ii) the276.36statewide average payment of the case mix resident class to277.1which the resident would be assigned under the medical277.2assistance case mix reimbursement system, provided thatuntil 277.3 July 1 of the state fiscal year in which the resident assessment 277.4 system as described in section 256B.437 for nursing home rate 277.5 determination is implemented. Effective on July 1 of the state 277.6 fiscal year in which the resident assessment system as described 277.7 in section 256B.437 for nursing home rate determination is 277.8 implemented, the monthly conversion limit for the cost of 277.9 elderly waiver services shall be the per diem nursing facility 277.10 rate as determined by the resident assessment system as 277.11 described in section 256B.437 for that resident in the nursing 277.12 facility where the resident currently resides multiplied by 365 277.13 and divided by 12, less the recipient's maintenance needs 277.14 allowance as described in subdivision 1d. The limit under this 277.15 clause only applies to persons discharged from a nursing 277.16 facility after a minimum 30-day stay and found eligible for 277.17 waivered services on or after July 1, 1997. The following costs 277.18 must be included in determining the total monthly costs for the 277.19 waiver client: 277.20 (1) cost of all waivered services, including extended 277.21 medical supplies and equipment and environmental modifications; 277.22 and 277.23 (2) cost of skilled nursing, home health aide, and personal 277.24 care services reimbursable by medical assistance. 277.25(c)(e) Medical assistance funding for skilled nursing 277.26 services, private duty nursing, home health aide, and personal 277.27 care services for waiver recipients must be approved by the case 277.28 manager and included in the individual care plan. 277.29(d) For both the elderly waiver and the nursing facility277.30disabled waiver, a county may purchase extended supplies and277.31equipment without prior approval from the commissioner when277.32there is no other funding source and the supplies and equipment277.33are specified in the individual's care plan as medically277.34necessary to enable the individual to remain in the community277.35according to the criteria in Minnesota Rules, part 9505.0210,277.36items A and B.(f) A county is not required to contract with a 278.1 provider of supplies and equipment if the monthly cost of the 278.2 supplies and equipment is less than $250. 278.3(e)(g) The adult foster caredailyratefor the elderly278.4and disabled waiversshall be considered a difficulty of care 278.5 payment and shall not include room and board. The adult foster 278.6 care service rate shall be negotiated between the county agency 278.7 and the foster care provider.The rate established under this278.8section shall not exceed the state average monthly nursing home278.9payment for the case mix classification to which the individual278.10receiving foster care is assigned; the rate must allow for other278.11waiver and medical assistance home care services to be278.12authorized by the case manager.The elderly waiver payment for 278.13 the foster care service in combination with the payment for all 278.14 other elderly waiver services, including case management, must 278.15 not exceed the limit specified in paragraph (b). 278.16(f) The assisted living and residential care service rates278.17for elderly and community alternatives for disabled individuals278.18(CADI) waivers shall be made to the vendor as a monthly rate278.19negotiated with the county agency based on an individualized278.20service plan for each resident. The rate shall not exceed the278.21nonfederal share of the greater of either the statewide or any278.22of the geographic groups' weighted average monthly medical278.23assistance nursing facility payment rate of the case mix278.24resident class to which the elderly or disabled client would be278.25assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,278.26unless the services are provided by a home care provider278.27licensed by the department of health and are provided in a278.28building that is registered as a housing with services278.29establishment under chapter 144D and that provides 24-hour278.30supervision. For alternative care assisted living projects278.31established under Laws 1988, chapter 689, article 2, section278.32256, monthly rates may not exceed 65 percent of the greater of278.33either the statewide or any of the geographic groups' weighted278.34average monthly medical assistance nursing facility payment rate278.35for the case mix resident class to which the elderly or disabled278.36client would be assigned under Minnesota Rules, parts 9549.0050279.1to 9549.0059. The rate may not cover direct rent or food costs.279.2 (h) Payment for assisted living service shall be a monthly 279.3 rate negotiated and authorized by the county agency based on an 279.4 individualized service plan for each resident and may not cover 279.5 direct rent or food costs. 279.6 (1) The individualized monthly negotiated payment for 279.7 assisted living services as described in section 256B.0913, 279.8 subdivision 5, paragraph (g) or (h), and residential care 279.9 services as described in section 256B.0913, subdivision 5, 279.10 paragraph (f), shall not exceed the nonfederal share, in effect 279.11 on July 1 of the state fiscal year for which the rate limit is 279.12 being calculated, of the greater of either the statewide or any 279.13 of the geographic groups' weighted average monthly nursing 279.14 facility rate of the case mix resident class to which the 279.15 elderly waiver eligible client would be assigned under Minnesota 279.16 Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 279.17 allowance as described in subdivision 1d, paragraph (a), until 279.18 the July 1 of the state fiscal year in which the resident 279.19 assessment system as described in section 256B.437 for nursing 279.20 home rate determination is implemented. Effective on July 1 of 279.21 the state fiscal year in which the resident assessment system as 279.22 described in section 256B.437 for nursing home rate 279.23 determination is implemented and July 1 of each subsequent state 279.24 fiscal year, the individualized monthly negotiated payment for 279.25 the services described in this clause shall not exceed the limit 279.26 described in this clause which was in effect on June 30 of the 279.27 previous state fiscal year and which has been adjusted by the 279.28 greater of any legislatively adopted home and community-based 279.29 services cost-of-living percentage increase or any legislatively 279.30 adopted statewide percent rate increase for nursing facilities. 279.31 (2) The individualized monthly negotiated payment for 279.32 assisted living services described in section 144A.4605 and 279.33 delivered by a provider licensed by the department of health as 279.34 a class A home care provider or an assisted living home care 279.35 provider and provided in a building that is registered as a 279.36 housing with services establishment under chapter 144D and that 280.1 provides 24-hour supervision in combination with the payment for 280.2 other elderly waiver services, including case management, must 280.3 not exceed the limit specified in paragraph (b). 280.4(g)(i) The county shall negotiate individual service rates 280.5 with vendors and maybe reimbursedauthorize payment for actual 280.6 costs up to thegreater of thecounty's current approved rateor280.760 percent of the maximum rate in fiscal year 1994 and 65280.8percent of the maximum rate in fiscal year 1995 for each service280.9within each program. Persons or agencies must be employed by or 280.10 under a contract with the county agency or the public health 280.11 nursing agency of the local board of health in order to receive 280.12 funding under the elderly waiver program, except as a provider 280.13 of supplies and equipment when the monthly cost of the supplies 280.14 and equipment is less than $250. 280.15(h) On July 1, 1993, the commissioner shall increase the280.16maximum rate for home-delivered meals to $4.50 per meal.280.17(i)(j) Reimbursement for the medical assistance recipients 280.18 under the approved waiver shall be made from the medical 280.19 assistance account through the invoice processing procedures of 280.20 the department's Medicaid Management Information System (MMIS), 280.21 only with the approval of the client's case manager. The budget 280.22 for the state share of the Medicaid expenditures shall be 280.23 forecasted with the medical assistance budget, and shall be 280.24 consistent with the approved waiver. 280.25 (k) To improve access to community services and eliminate 280.26 payment disparities between the alternative care program and the 280.27 elderly waiver, the commissioner shall establish statewide 280.28 maximum service rate limits and eliminate county-specific 280.29 service rate limits. 280.30 (1) Effective July 1, 2001, for service rate limits, except 280.31 those described or defined in paragraphs (g) and (h), the rate 280.32 limit for each service shall be the greater of the alternative 280.33 care statewide maximum rate or the elderly waiver statewide 280.34 maximum rate. 280.35 (2) Counties may negotiate individual service rates with 280.36 vendors for actual costs up to the statewide maximum service 281.1 rate limit. 281.2(j)(l) Beginning July 1, 1991, the state shall reimburse 281.3 counties according to the payment schedule in section 256.025 281.4 for the county share of costs incurred under this subdivision on 281.5 or after January 1, 1991, for individuals who are receiving 281.6 medical assistance. 281.7(k) For the community alternatives for disabled individuals281.8waiver, and nursing facility disabled waivers, county may use281.9waiver funds for the cost of minor adaptations to a client's281.10residence or vehicle without prior approval from the281.11commissioner if there is no other source of funding and the281.12adaptation:281.13(1) is necessary to avoid institutionalization;281.14(2) has no utility apart from the needs of the client; and281.15(3) meets the criteria in Minnesota Rules, part 9505.0210,281.16items A and B.281.17For purposes of this subdivision, "residence" means the client's281.18own home, the client's family residence, or a family foster281.19home. For purposes of this subdivision, "vehicle" means the281.20client's vehicle, the client's family vehicle, or the client's281.21family foster home vehicle.281.22(l) The commissioner shall establish a maximum rate unit281.23for baths provided by an adult day care provider that are not281.24included in the provider's contractual daily or hourly rate.281.25This maximum rate must equal the home health aide extended rate281.26and shall be paid for baths provided to clients served under the281.27elderly and disabled waivers.281.28 Sec. 31. Minnesota Statutes 2000, section 256B.0915, 281.29 subdivision 5, is amended to read: 281.30 Subd. 5. [REASSESSMENTS FOR WAIVER CLIENTS.] A 281.31 reassessment of a client served under the elderlyor disabled281.32 waiver must be conducted at least every 12 months and at other 281.33 times when the case manager determines that there has been 281.34 significant change in the client's functioning. This may 281.35 include instances where the client is discharged from the 281.36 hospital. 282.1 Sec. 32. Minnesota Statutes 2000, section 256B.0917, 282.2 subdivision 7, is amended to read: 282.3 Subd. 7. [CONTRACT.] (a) The commissioner of human 282.4 services shall execute a contract with Living at Home/Block 282.5 Nurse Program, Inc. (LAH/BN, Inc.). The contract shall require 282.6 LAH/BN, Inc. to: 282.7 (1) develop criteria for and award grants to establish 282.8 community-based organizations that will implement 282.9 living-at-home/block nurse programs throughout the state; 282.10 (2) award grants to enablecurrentliving-at-home/block 282.11 nurse programs to continue to implement the combined 282.12 living-at-home/block nurse program model; 282.13 (3) serve as a state technical assistance center to assist 282.14 and coordinate the living-at-home/block nurse programs 282.15 established; and 282.16 (4) manage contracts with individual living-at-home/block 282.17 nurse programs. 282.18 (b) The contract shall be effective July 1, 1997, and 282.19 section 16B.17 shall not apply. 282.20 Sec. 33. [256B.0918] [DEVELOPMENT AND PURPOSE OF MEDICAL 282.21 ASSISTANCE PILOT PROJECT ON SENIOR SERVICES.] 282.22 Subdivision 1. [DEVELOPMENT AND PURPOSE.] The commissioner 282.23 of human services shall develop a medical assistance pilot 282.24 project on senior services to determine how converting the 282.25 delivery of housing, supportive services, and health care for 282.26 seniors into a flexible voucher program will impact public 282.27 expenditures for older adult service care and provide an 282.28 alternative way to purchase services based on consumer choice. 282.29 Subd. 2. [FEDERAL WAIVER AUTHORITY.] The commissioner 282.30 shall apply for any necessary federal waivers or approvals to 282.31 implement this pilot project. The commissioner shall submit the 282.32 waiver request no later than April 15, 2002. 282.33 Subd. 3. [REPORT.] The commissioner shall report to the 282.34 legislature by January 15, 2003, on approval of waivers 282.35 requested. Upon federal approval, the commissioner shall seek 282.36 legislative authorization to implement the pilot project. Once 283.1 the pilot project is implemented, participating communities and 283.2 the commissioner of human services shall collaborate to prepare 283.3 and issue an annual report each December 1 to the appropriate 283.4 committee chairs in the senate and house on: (1) the use of 283.5 state resources, including other funds leveraged for this 283.6 initiative; (2) the status of individuals being served in the 283.7 pilot project; and (3) the cost-effectiveness of the pilot 283.8 project. The commissioner shall provide data that may be needed 283.9 to evaluate the pilot project to communities that request the 283.10 data. 283.11 Subd. 4. [SUNSET.] This section sunsets June 30, 2008. 283.12 Sec. 34. [SERVICE ACCESS STUDY.] 283.13 By February 15, 2002, the commissioner of human services 283.14 shall submit to the legislature recommendations for creating 283.15 coordinated service access at the county agency level for both 283.16 publicly subsidized and nonsubsidized long-term care services 283.17 and housing options. The report must: 283.18 (1) include a plan to coordinate public funding streams to 283.19 allow low-income, privately paying consumers to purchase 283.20 services through a sliding fee scale; and 283.21 (2) evaluate the feasibility of statewide implementation, 283.22 based upon an evaluation of public cost, consumer preferences 283.23 and satisfaction, and other relevant factors. 283.24 Sec. 35. [RESPITE CARE.] 283.25 The Minnesota board on aging shall report to the 283.26 legislature by February 1, 2002, on the provision of in-home and 283.27 out-of-home respite care services on a sliding scale basis under 283.28 the federal Older Americans Act. 283.29 Sec. 36. [REPEALER.] 283.30 Minnesota Statutes 2000, sections 256B.0911, subdivisions 283.31 2, 2a, 4, 8, and 9; and 256B.0913, subdivisions 3, 15a, 15b, 283.32 15c, and 16; Minnesota Rules, parts 9505.2390; 9505.2395; 283.33 9505.2396; 9505.2400; 9505.2405; 9505.2410; 9505.2413; 283.34 9505.2415; 9505.2420; 9505.2425; 9505.2426; 9505.2430; 283.35 9505.2435; 9505.2440; 9505.2445; 9505.2450; 9505.2455; 283.36 9505.2458; 9505.2460; 9505.2465; 9505.2470; 9505.2473; 284.1 9505.2475; 9505.2480; 9505.2485; 9505.2486; 9505.2490; 284.2 9505.2495; 9505.2496; and 9505.2500, are repealed. 284.3 ARTICLE 5 284.4 LONG-TERM CARE REFORM AND REIMBURSEMENT 284.5 Section 1. [144.0724] [RESIDENT REIMBURSEMENT 284.6 CLASSIFICATION.] 284.7 Subdivision 1. [RESIDENT REIMBURSEMENT 284.8 CLASSIFICATIONS.] The commissioner of health shall establish 284.9 resident reimbursement classifications based upon the 284.10 assessments of residents of nursing homes and boarding care 284.11 homes conducted under this section and according to section 284.12 256B.437. The reimbursement classifications established under 284.13 this section shall be implemented after June 30, 2002, but no 284.14 later than January 1, 2003. 284.15 Subd. 2. [DEFINITIONS.] For purposes of this section, the 284.16 following terms have the meanings given. 284.17 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 284.18 date" means the last day of the minimum data set observation 284.19 period. The date sets the designated endpoint of the common 284.20 observation period, and all minimum data set items refer back in 284.21 time from that point. 284.22 (b) [CASE MIX INDEX.] "Case mix index" means the weighting 284.23 factors assigned to the RUG-III classifications. 284.24 (c) [INDEX MAXIMIZATION.] "Index maximization" means 284.25 classifying a resident who could be assigned to more than one 284.26 category, to the category with the highest case mix index. 284.27 (d) [MINIMUM DATA SET.] "Minimum data set" means the 284.28 assessment instrument specified by the Health Care Financing 284.29 Administration and designated by the Minnesota department of 284.30 health. 284.31 (e) [REPRESENTATIVE.] "Representative" means a person who 284.32 is the resident's guardian or conservator, the person authorized 284.33 to pay the nursing home expenses of the resident, a 284.34 representative of the nursing home ombudsman's office whose 284.35 assistance has been requested, or any other individual 284.36 designated by the resident. 285.1 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 285.2 utilization groups" or "RUG" means the system for grouping a 285.3 nursing facility's residents according to their clinical and 285.4 functional status identified in data supplied by the facility's 285.5 minimum data set. 285.6 Subd. 3. [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] (a) 285.7 Resident reimbursement classifications shall be based on the 285.8 minimum data set, version 2.0 assessment instrument, or its 285.9 successor version mandated by the Health Care Financing 285.10 Administration that nursing facilities are required to complete 285.11 for all residents. The commissioner of health shall establish 285.12 resident classes according to the 34 group, resource utilization 285.13 groups, version III or RUG-III model. Resident classes must be 285.14 established based on the individual items on the minimum data 285.15 set and must be completed according to the facility manual for 285.16 case mix classification issued by the Minnesota department of 285.17 health. The facility manual for case mix classification shall 285.18 be drafted by the Minnesota department of health and presented 285.19 to the chairs of health and human services legislative 285.20 committees by December 31, 2001. 285.21 (b) Each resident must be classified based on the 285.22 information from the minimum data set according to general 285.23 domains in clauses (1) to (7): 285.24 (1) extensive services where a resident requires 285.25 intravenous feeding or medications, suctioning, tracheostomy 285.26 care, or is on a ventilator or respirator; 285.27 (2) rehabilitation where a resident requires physical, 285.28 occupational, or speech therapy; 285.29 (3) special care where a resident has cerebral palsy; 285.30 quadriplegia; multiple sclerosis; pressure ulcers; fever with 285.31 vomiting, weight loss, or dehydration; tube feeding and aphasia; 285.32 or is receiving radiation therapy; 285.33 (4) clinically complex status where a resident has burns, 285.34 coma, septicemia, pneumonia, internal bleeding, chemotherapy, 285.35 wounds, kidney failure, urinary tract infections, oxygen, or 285.36 transfusions; 286.1 (5) impaired cognition where a resident has poor cognitive 286.2 performance; 286.3 (6) behavior problems where a resident exhibits wandering, 286.4 has hallucinations, or is physically or verbally abusive toward 286.5 others, unless the resident's other condition would place the 286.6 resident in other categories; and 286.7 (7) reduced physical functioning where a resident has no 286.8 special clinical conditions. 286.9 (c) The commissioner of health shall establish resident 286.10 classification according to a 34 group model based on the 286.11 information on the minimum data set and within the general 286.12 domains listed in paragraph (b), clauses (1) to (7). Detailed 286.13 descriptions of each resource utilization group shall be defined 286.14 in the facility manual for case mix classification issued by the 286.15 Minnesota department of health. The 34 groups are described as 286.16 follows: 286.17 (1) SE3: requires four or five extensive services; 286.18 (2) SE2: requires two or three extensive services; 286.19 (3) SE1: requires one extensive service; 286.20 (4) RAD: requires rehabilitation services and is dependent 286.21 in activity of daily living (ADL) at a count of 17 or 18; 286.22 (5) RAC: requires rehabilitation services and ADL count is 286.23 14 to 16; 286.24 (6) RAB: requires rehabilitation services and ADL count is 286.25 ten to 13; 286.26 (7) RAA: requires rehabilitation services and ADL count is 286.27 four to nine; 286.28 (8) SSC: requires special care and ADL count is 17 or 18; 286.29 (9) SSB: requires special care and ADL count is 15 or 16; 286.30 (10) SSA: requires special care and ADL count is seven to 286.31 14; 286.32 (11) CC2: clinically complex with depression and ADL count 286.33 is 17 or 18; 286.34 (12) CC1: clinically complex with no depression and ADL 286.35 count is 17 or 18; 286.36 (13) CB2: clinically complex with depression and ADL count 287.1 is 12 to 16; 287.2 (14) CB1: clinically complex with no depression and ADL 287.3 count is 12 to 16; 287.4 (15) CA2: clinically complex with depression and ADL count 287.5 is four to 11; 287.6 (16) CA1: clinically complex with no depression and ADL 287.7 count is four to 11; 287.8 (17) IB2: impaired cognition with nursing rehabilitation 287.9 and ADL count is six to ten; 287.10 (18) IB1: impaired cognition with no nursing 287.11 rehabilitation and ADL count is six to ten; 287.12 (19) IA2: impaired cognition with nursing rehabilitation 287.13 and ADL count is four or five; 287.14 (20) IA1: impaired cognition with no nursing 287.15 rehabilitation and ADL count is four or five; 287.16 (21) BB2: behavior problems with nursing rehabilitation 287.17 and ADL count is six to ten; 287.18 (22) BB1: behavior problems with no nursing rehabilitation 287.19 and ADL count is six to ten; 287.20 (23) BA2: behavior problems with nursing rehabilitation 287.21 and ADL count is four to five; 287.22 (24) BA1: behavior problems with no nursing rehabilitation 287.23 and ADL count is four to five; 287.24 (25) PE2: reduced physical functioning with nursing 287.25 rehabilitation and ADL count is 16 to 18; 287.26 (26) PE1: reduced physical functioning with no nursing 287.27 rehabilitation and ADL count is 16 to 18; 287.28 (27) PD2: reduced physical functioning with nursing 287.29 rehabilitation and ADL count is 11 to 15; 287.30 (28) PD1: reduced physical functioning with no nursing 287.31 rehabilitation and ADL count is 11 to 15; 287.32 (29) PC2: reduced physical functioning with nursing 287.33 rehabilitation and ADL count is nine or ten; 287.34 (30) PC1: reduced physical functioning with no nursing 287.35 rehabilitation and ADL count is nine or ten; 287.36 (31) PB2: reduced physical functioning with nursing 288.1 rehabilitation and ADL count is six to eight; 288.2 (32) PB1: reduced physical functioning with no nursing 288.3 rehabilitation and ADL count is six to eight; 288.4 (33) PA2: reduced physical functioning with nursing 288.5 rehabilitation and ADL count is four or five; and 288.6 (34) PA1: reduced physical functioning with no nursing 288.7 rehabilitation and ADL count is four or five. 288.8 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) A facility 288.9 must conduct and electronically submit to the commissioner of 288.10 health case mix assessments that conform with the assessment 288.11 schedule defined by the Code of Federal Regulations, title 42, 288.12 section 483.20, and published by the United States Department of 288.13 Health and Human Services, Health Care Financing Administration, 288.14 in the Long Term Care Assessment Instrument User's Manual, 288.15 version 2.0, October 1995, and subsequent clarifications made in 288.16 the Long-Term Care Assessment Instrument Questions and Answers, 288.17 version 2.0, August 1996. The commissioner of health may 288.18 substitute successor manuals or question and answer documents 288.19 published by the United States Department of Health and Human 288.20 Services, Health Care Financing Administration, to replace or 288.21 supplement the current version of the manual or document. 288.22 (b) The assessments used to determine a case mix 288.23 classification for reimbursement include the following: 288.24 (1) a new admission assessment must be completed by day 14 288.25 following admission; 288.26 (2) an annual assessment must be completed within 366 days 288.27 of the last comprehensive assessment; 288.28 (3) a significant change assessment must be completed 288.29 within 14 days of the identification of a significant change; 288.30 and 288.31 (4) the second quarterly assessment following either a new 288.32 admission assessment, an annual assessment, or a significant 288.33 change assessment. Each quarterly assessment must be completed 288.34 within 92 days of the previous assessment. 288.35 Subd. 5. [SHORT STAYS.] (a) A facility must submit to the 288.36 commissioner of health an initial admission assessment for all 289.1 residents who stay in the facility less than 14 days. 289.2 (b) Notwithstanding the admission assessment requirements 289.3 of paragraph (a), a facility may elect to accept a default rate 289.4 with a case mix index of 1.0 for all facility residents who stay 289.5 less than 14 days in lieu of submitting an initial assessment. 289.6 Facilities may make this election to be effective on the day of 289.7 implementation of the revised case mix system. 289.8 (c) After implementation of the revised case mix system, 289.9 nursing facilities must elect one of the options described in 289.10 paragraphs (a) and (b) on the annual report to the commissioner 289.11 of human services filed for each report year ending September 289.12 30. The election shall be effective on the following July 1. 289.13 (d) For residents who are admitted or readmitted and leave 289.14 the facility on a frequent basis and for whom readmission is 289.15 expected, the resident may be discharged on an extended leave 289.16 status. This status does not require reassessment each time the 289.17 resident returns to the facility unless a significant change in 289.18 the resident's status has occurred since the last assessment. 289.19 The case mix classification for these residents is determined by 289.20 the facility election made in paragraphs (a) and (b). 289.21 Subd. 6. [PENALTIES FOR LATE OR NONSUBMISSION.] A facility 289.22 that fails to complete or submit an assessment for a RUG-III 289.23 classification within seven days of the time requirements in 289.24 subdivisions 4 and 5 is subject to a reduced rate for that 289.25 resident. The reduced rate shall be the lowest rate for that 289.26 facility. The reduced rate is effective on the day of admission 289.27 for new admission assessments or on the day that the assessment 289.28 was due for all other assessments and continues in effect until 289.29 the first day of the month following the date of submission of 289.30 the resident's assessment. 289.31 Subd. 7. [NOTICE OF RESIDENT REIMBURSEMENT 289.32 CLASSIFICATION.] (a) A facility must elect between the options 289.33 in clauses (1) and (2) to provide notice to a resident of the 289.34 resident's case mix classification. 289.35 (1) The commissioner of health shall provide to a nursing 289.36 facility a notice for each resident of the reimbursement 290.1 classification established under subdivision 1. The notice must 290.2 inform the resident of the classification that was assigned, the 290.3 opportunity to review the documentation supporting the 290.4 classification, the opportunity to obtain clarification from the 290.5 commissioner, and the opportunity to request a reconsideration 290.6 of the classification. The commissioner must send notice of 290.7 resident classification by first class mail. A nursing facility 290.8 is responsible for the distribution of the notice to each 290.9 resident, to the person responsible for the payment of the 290.10 resident's nursing home expenses, or to another person 290.11 designated by the resident. This notice must be distributed 290.12 within three working days after the facility's receipt of the 290.13 notice from the commissioner of health. 290.14 (2) A facility may choose to provide a classification 290.15 notice, as prescribed by the commissioner of health, to a 290.16 resident upon receipt of the confirmation of the case mix 290.17 classification calculated by a facility or a corrected case mix 290.18 classification as indicated on the final validation report from 290.19 the commissioner. A nursing facility is responsible for the 290.20 distribution of the notice to each resident, to the person 290.21 responsible for the payment of the resident's nursing home 290.22 expenses, or to another person designated by the resident. This 290.23 notice must be distributed within three working days after the 290.24 facility's receipt of the validation report from the 290.25 commissioner. If a facility elects this option, the 290.26 commissioner of health shall provide the facility with a list of 290.27 residents and their case mix classifications as determined by 290.28 the commissioner. A nursing facility may make this election to 290.29 be effective on the day of implementation of the revised case 290.30 mix system. 290.31 (3) After implementation of the revised case mix system, a 290.32 nursing facility shall elect a notice of resident reimbursement 290.33 classification procedure as described in clause (1) or (2) on 290.34 the annual report to the commissioner of human services filed 290.35 for each report year ending September 30. The election will be 290.36 effective the following July 1. 291.1 (b) If a facility submits a correction to an assessment 291.2 conducted under subdivision 3 that results in a change in case 291.3 mix classification, the facility shall give written notice to 291.4 the resident or the resident's representative about the item 291.5 that was corrected and the reason for the correction. The 291.6 notice of corrected assessment may be provided at the same time 291.7 that the resident or resident's representative is provided the 291.8 resident's corrected notice of classification. 291.9 Subd. 8. [REQUEST FOR RECONSIDERATION OF RESIDENT 291.10 CLASSIFICATIONS.] (a) The resident, or resident's 291.11 representative, or the nursing facility or boarding care home 291.12 may request that the commissioner of health reconsider the 291.13 assigned reimbursement classification. The request for 291.14 reconsideration must be submitted in writing to the commissioner 291.15 within 30 days of the day the resident or the resident's 291.16 representative receives the resident classification notice. The 291.17 request for reconsideration must include the name of the 291.18 resident, the name and address of the facility in which the 291.19 resident resides, the reasons for the reconsideration, the 291.20 requested classification changes, and documentation supporting 291.21 the requested classification. The documentation accompanying 291.22 the reconsideration request is limited to documentation which 291.23 establishes that the needs of the resident at the time of the 291.24 assessment justify a classification which is different than the 291.25 classification established by the commissioner of health. 291.26 (b) Upon request, the nursing facility must give the 291.27 resident or the resident's representative a copy of the 291.28 assessment form and the other documentation that was given to 291.29 the commissioner of health to support the assessment findings. 291.30 The nursing facility shall also provide access to and a copy of 291.31 other information from the resident's record that has been 291.32 requested by or on behalf of the resident to support a 291.33 resident's reconsideration request. A copy of any requested 291.34 material must be provided within three working days of receipt 291.35 of a written request for the information. If a facility fails 291.36 to provide the material within this time, it is subject to the 292.1 issuance of a correction order and penalty assessment under 292.2 sections 144.653 and 144A.10. Notwithstanding those sections, 292.3 any correction order issued under this subdivision must require 292.4 that the nursing facility immediately comply with the request 292.5 for information and that as of the date of the issuance of the 292.6 correction order, the facility shall forfeit to the state a $100 292.7 fine for the first day of noncompliance, and an increase in the 292.8 $100 fine by $50 increments for each day the noncompliance 292.9 continues. 292.10 (c) In addition to the information required under 292.11 paragraphs (a) and (b), a reconsideration request from a nursing 292.12 facility must contain the following information: (i) the date 292.13 the reimbursement classification notices were received by the 292.14 facility; (ii) the date the classification notices were 292.15 distributed to the resident or the resident's representative; 292.16 and (iii) a copy of a notice sent to the resident or to the 292.17 resident's representative. This notice must inform the resident 292.18 or the resident's representative that a reconsideration of the 292.19 resident's classification is being requested, the reason for the 292.20 request, that the resident's rate will change if the request is 292.21 approved by the commissioner, the extent of the change, that 292.22 copies of the facility's request and supporting documentation 292.23 are available for review, and that the resident also has the 292.24 right to request a reconsideration. If the facility fails to 292.25 provide the required information with the reconsideration 292.26 request, the request must be denied, and the facility may not 292.27 make further reconsideration requests on that specific 292.28 reimbursement classification. 292.29 (d) Reconsideration by the commissioner must be made by 292.30 individuals not involved in reviewing the assessment, audit, or 292.31 reconsideration that established the disputed classification. 292.32 The reconsideration must be based upon the initial assessment 292.33 and upon the information provided to the commissioner under 292.34 paragraphs (a) and (b). If necessary for evaluating the 292.35 reconsideration request, the commissioner may conduct on-site 292.36 reviews. Within 15 working days of receiving the request for 293.1 reconsideration, the commissioner shall affirm or modify the 293.2 original resident classification. The original classification 293.3 must be modified if the commissioner determines that the 293.4 assessment resulting in the classification did not accurately 293.5 reflect the needs or assessment characteristics of the resident 293.6 at the time of the assessment. The resident and the nursing 293.7 facility or boarding care home shall be notified within five 293.8 working days after the decision is made. A decision by the 293.9 commissioner under this subdivision is the final administrative 293.10 decision of the agency for the party requesting reconsideration. 293.11 (e) The resident classification established by the 293.12 commissioner shall be the classification that applies to the 293.13 resident while the request for reconsideration is pending. 293.14 (f) The commissioner may request additional documentation 293.15 regarding a reconsideration necessary to make an accurate 293.16 reconsideration determination. 293.17 Subd. 9. [AUDIT AUTHORITY.] (a) The commissioner shall 293.18 audit the accuracy of resident assessments performed under 293.19 section 256B.437 through desk audits, on-site review of 293.20 residents and their records, and interviews with staff and 293.21 families. The commissioner shall reclassify a resident if the 293.22 commissioner determines that the resident was incorrectly 293.23 classified. 293.24 (b) The commissioner is authorized to conduct on-site 293.25 audits on an unannounced basis. 293.26 (c) A facility must grant the commissioner access to 293.27 examine the medical records relating to the resident assessments 293.28 selected for audit under this subdivision. The commissioner may 293.29 also observe and speak to facility staff and residents. 293.30 (d) The commissioner shall consider documentation under the 293.31 time frames for coding items on the minimum data set as set out 293.32 in the Resident Assessment Instrument Manual published by the 293.33 Health Care Financing Administration. 293.34 (e) The commissioner shall develop an audit selection 293.35 procedure that includes the following factors: 293.36 (1) The commissioner may target facilities that demonstrate 294.1 an atypical pattern of scoring minimum data set items, 294.2 nonsubmission of assessments, late submission of assessments, or 294.3 a previous history of audit changes of greater than 35 percent. 294.4 The commissioner shall select at least 20 percent of the most 294.5 current assessments submitted to the state for audit. Audits of 294.6 assessments selected in the targeted facilities must focus on 294.7 the factors leading to the audit. If the number of targeted 294.8 assessments selected does not meet the threshold of 20 percent 294.9 of the facility residents, then a stratified sample of the 294.10 remainder of assessments shall be drawn to meet the quota. If 294.11 the total change exceeds 35 percent, the commissioner may 294.12 conduct an expanded audit up to 100 percent of the remaining 294.13 current assessments. 294.14 (2) Facilities that are not a part of the targeted group 294.15 shall be placed in a general pool from which facilities will be 294.16 selected on a random basis for audit. Every facility shall be 294.17 audited annually. If a facility has two successive audits in 294.18 which the percentage of change is five percent or less and the 294.19 facility has not been the subject of a targeted audit in the 294.20 past 36 months, the facility may be audited biannually. A 294.21 stratified sample of 15 percent of the most current assessments 294.22 shall be selected for audit. If more than 20 percent of the 294.23 RUGS-III classifications after the audit are changed, the audit 294.24 shall be expanded to a second 15 percent sample. If the total 294.25 change between the first and second samples exceed 35 percent, 294.26 the commissioner may expand the audit to all of the remaining 294.27 assessments. 294.28 (3) If a facility qualifies for an expanded audit, the 294.29 commissioner may audit the facility again within six months. If 294.30 a facility has two expanded audits within a 24-month period, 294.31 that facility will be audited at least every six months for the 294.32 next 18 months. 294.33 (4) The commissioner may conduct special audits if the 294.34 commissioner determines that circumstances exist that could 294.35 alter or affect the validity of case mix classifications of 294.36 residents. These circumstances include, but are not limited to, 295.1 the following: 295.2 (i) frequent changes in the administration or management of 295.3 the facility; 295.4 (ii) an unusually high percentage of residents in a 295.5 specific case mix classification; 295.6 (iii) a high frequency in the number of reconsideration 295.7 requests received from a facility; 295.8 (iv) frequent adjustments of case mix classifications as 295.9 the result of reconsiderations or audits; 295.10 (v) a criminal indictment alleging provider fraud; or 295.11 (vi) other similar factors that relate to a facility's 295.12 ability to conduct accurate assessments. 295.13 (f) Within 15 working days of completing the audit process, 295.14 the commissioner shall mail the written results of the audit to 295.15 the facility, along with a written notice for each resident 295.16 affected to be forwarded by the facility. The notice must 295.17 contain the resident's classification and a statement informing 295.18 the resident, the resident's authorized representative, and the 295.19 facility of their right to review the commissioner's documents 295.20 supporting the classification and to request a reconsideration 295.21 of the classification. This notice must also include the 295.22 address and telephone number of the area nursing home ombudsman. 295.23 Subd. 10. [TRANSITION.] After implementation of this 295.24 section, reconsiderations requested for classifications made 295.25 under section 144.0722, subdivision 1, shall be determined under 295.26 section 144.0722, subdivision 3. 295.27 Sec. 2. Minnesota Statutes 2000, section 144A.071, 295.28 subdivision 1, is amended to read: 295.29 Subdivision 1. [FINDINGS.] The legislature declares that a 295.30 moratorium on the licensure and medical assistance certification 295.31 of new nursing home beds and construction projects that 295.32 exceed$750,000$1,000,000 is necessary to control nursing home 295.33 expenditure growth and enable the state to meet the needs of its 295.34 elderly by providing high quality services in the most 295.35 appropriate manner along a continuum of care. 295.36 Sec. 3. Minnesota Statutes 2000, section 144A.071, 296.1 subdivision 1a, is amended to read: 296.2 Subd. 1a. [DEFINITIONS.] For purposes of sections 144A.071 296.3 to 144A.073, the following terms have the meanings given them: 296.4 (a) "attached fixtures" has the meaning given in Minnesota 296.5 Rules, part 9549.0020, subpart 6. 296.6 (b) "buildings" has the meaning given in Minnesota Rules, 296.7 part 9549.0020, subpart 7. 296.8 (c) "capital assets" has the meaning given in section 296.9 256B.421, subdivision 16. 296.10 (d) "commenced construction" means that all of the 296.11 following conditions were met: the final working drawings and 296.12 specifications were approved by the commissioner of health; the 296.13 construction contracts were let; a timely construction schedule 296.14 was developed, stipulating dates for beginning, achieving 296.15 various stages, and completing construction; and all zoning and 296.16 building permits were applied for. 296.17 (e) "completion date" means the date on which a certificate 296.18 of occupancy is issued for a construction project, or if a 296.19 certificate of occupancy is not required, the date on which the 296.20 construction project is available for facility use. 296.21 (f) "construction" means any erection, building, 296.22 alteration, reconstruction, modernization, or improvement 296.23 necessary to comply with the nursing home licensure rules. 296.24 (g) "construction project" means: 296.25 (1) a capital asset addition to, or replacement of a 296.26 nursing home or certified boarding care home that results in new 296.27 space or the remodeling of or renovations to existing facility 296.28 space; 296.29 (2) the remodeling or renovation of existing facility space 296.30 the use of which is modified as a result of the project 296.31 described in clause (1). This existing space and the project 296.32 described in clause (1) must be used for the functions as 296.33 designated on the construction plans on completion of the 296.34 project described in clause (1) for a period of not less than 24 296.35 months; or 296.36 (3) capital asset additions or replacements that are 297.1 completed within 12 months before or after the completion date 297.2 of the project described in clause (1). 297.3 (h) "new licensed" or "new certified beds" means: 297.4 (1) newly constructed beds in a facility or the 297.5 construction of a new facility that would increase the total 297.6 number of licensed nursing home beds or certified boarding care 297.7 or nursing home beds in the state; or 297.8 (2) newly licensed nursing home beds or newly certified 297.9 boarding care or nursing home beds that result from remodeling 297.10 of the facility that involves relocation of beds but does not 297.11 result in an increase in the total number of beds, except when 297.12 the project involves the upgrade of boarding care beds to 297.13 nursing home beds, as defined in section 144A.073, subdivision 297.14 1. "Remodeling" includes any of the type of conversion, 297.15 renovation, replacement, or upgrading projects as defined in 297.16 section 144A.073, subdivision 1. 297.17 (i) "project construction costs" means the cost of the 297.18 facility capital asset additions, replacements, renovations, or 297.19 remodeling projects, construction site preparation costs, and 297.20 related soft costs. Project construction costsalsoinclude the 297.21 cost of any remodeling or renovation of existing facility space 297.22 which is modified as a result of the construction 297.23 project. Project construction costs also includes the cost of 297.24 new technology implemented as part of the construction project. 297.25 (j) "technology" means information systems or devices that 297.26 make documentation, charting, and staff time more efficient or 297.27 encourage and allow for care through alternative settings 297.28 including, but not limited to, touch screens, monitors, 297.29 hand-helds, swipe cards, motion detectors, pagers, telemedicine, 297.30 medication dispensers, and equipment to monitor vital signs and 297.31 self-injections, and to observe skin and other conditions. 297.32 Sec. 4. Minnesota Statutes 2000, section 144A.071, 297.33 subdivision 2, is amended to read: 297.34 Subd. 2. [MORATORIUM.] The commissioner of health, in 297.35 coordination with the commissioner of human services, shall deny 297.36 each request for new licensed or certified nursing home or 298.1 certified boarding care beds except as provided in subdivision 3 298.2 or 4a, or section 144A.073. "Certified bed" means a nursing 298.3 home bed or a boarding care bed certified by the commissioner of 298.4 health for the purposes of the medical assistance program, under 298.5 United States Code, title 42, sections 1396 et seq. 298.6 The commissioner of human services, in coordination with 298.7 the commissioner of health, shall deny any request to issue a 298.8 license under section 252.28 and chapter 245A to a nursing home 298.9 or boarding care home, if that license would result in an 298.10 increase in the medical assistance reimbursement amount. 298.11 In addition, the commissioner of health must not approve 298.12 any construction project whose cost exceeds$750,000$1,000,000 298.13 unless: 298.14 (a) any construction costs exceeding$750,000$1,000,000 298.15 are not added to the facility's appraised value and are not 298.16 included in the facility's payment rate for reimbursement under 298.17 the medical assistance program; or 298.18 (b) the project: 298.19 (1) has been approved through the process described in 298.20 section 144A.073; 298.21 (2) meets an exception in subdivision 3 or 4a; 298.22 (3) is necessary to correct violations of state or federal 298.23 law issued by the commissioner of health; 298.24 (4) is necessary to repair or replace a portion of the 298.25 facility that was damaged by fire, lightning, groundshifts, or 298.26 other such hazards, including environmental hazards, provided 298.27 that the provisions of subdivision 4a, clause (a), are met; 298.28 (5) as of May 1, 1992, the facility has submitted to the 298.29 commissioner of health written documentation evidencing that the 298.30 facility meets the "commenced construction" definition as 298.31 specified in subdivision 1a, clause (d), or that substantial 298.32 steps have been taken prior to April 1, 1992, relating to the 298.33 construction project. "Substantial steps" require that the 298.34 facility has made arrangements with outside parties relating to 298.35 the construction project and include the hiring of an architect 298.36 or construction firm, submission of preliminary plans to the 299.1 department of health or documentation from a financial 299.2 institution that financing arrangements for the construction 299.3 project have been made; or 299.4 (6) is being proposed by a licensed nursing facility that 299.5 is not certified to participate in the medical assistance 299.6 program and will not result in new licensed or certified beds. 299.7 Prior to the final plan approval of any construction 299.8 project, the commissioner of health shall be provided with an 299.9 itemized cost estimate for the project construction costs. If a 299.10 construction project is anticipated to be completed in phases, 299.11 the total estimated cost of all phases of the project shall be 299.12 submitted to the commissioner and shall be considered as one 299.13 construction project. Once the construction project is 299.14 completed and prior to the final clearance by the commissioner, 299.15 the total project construction costs for the construction 299.16 project shall be submitted to the commissioner. If the final 299.17 project construction cost exceeds the dollar threshold in this 299.18 subdivision, the commissioner of human services shall not 299.19 recognize any of the project construction costs or the related 299.20 financing costs in excess of this threshold in establishing the 299.21 facility's property-related payment rate. 299.22 The dollar thresholds for construction projects are as 299.23 follows: for construction projects other than those authorized 299.24 in clauses (1) to (6), the dollar threshold 299.25 is$750,000$1,000,000. For projects authorized after July 1, 299.26 1993, under clause (1), the dollar threshold is the cost 299.27 estimate submitted with a proposal for an exception under 299.28 section 144A.073, plus inflation as calculated according to 299.29 section 256B.431, subdivision 3f, paragraph (a). For projects 299.30 authorized under clauses (2) to (4), the dollar threshold is the 299.31 itemized estimate project construction costs submitted to the 299.32 commissioner of health at the time of final plan approval, plus 299.33 inflation as calculated according to section 256B.431, 299.34 subdivision 3f, paragraph (a). 299.35 The commissioner of health shall adopt rules to implement 299.36 this section or to amend the emergency rules for granting 300.1 exceptions to the moratorium on nursing homes under section 300.2 144A.073. 300.3 Sec. 5. Minnesota Statutes 2000, section 144A.071, 300.4 subdivision 4a, is amended to read: 300.5 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 300.6 best interest of the state to ensure that nursing homes and 300.7 boarding care homes continue to meet the physical plant 300.8 licensing and certification requirements by permitting certain 300.9 construction projects. Facilities should be maintained in 300.10 condition to satisfy the physical and emotional needs of 300.11 residents while allowing the state to maintain control over 300.12 nursing home expenditure growth. 300.13 The commissioner of health in coordination with the 300.14 commissioner of human services, may approve the renovation, 300.15 replacement, upgrading, or relocation of a nursing home or 300.16 boarding care home, under the following conditions: 300.17 (a) to license or certify beds in a new facility 300.18 constructed to replace a facility or to make repairs in an 300.19 existing facility that was destroyed or damaged after June 30, 300.20 1987, by fire, lightning, or other hazard provided: 300.21 (i) destruction was not caused by the intentional act of or 300.22 at the direction of a controlling person of the facility; 300.23 (ii) at the time the facility was destroyed or damaged the 300.24 controlling persons of the facility maintained insurance 300.25 coverage for the type of hazard that occurred in an amount that 300.26 a reasonable person would conclude was adequate; 300.27 (iii) the net proceeds from an insurance settlement for the 300.28 damages caused by the hazard are applied to the cost of the new 300.29 facility or repairs; 300.30 (iv) the new facility is constructed on the same site as 300.31 the destroyed facility or on another site subject to the 300.32 restrictions in section 144A.073, subdivision 5; 300.33 (v) the number of licensed and certified beds in the new 300.34 facility does not exceed the number of licensed and certified 300.35 beds in the destroyed facility; and 300.36 (vi) the commissioner determines that the replacement beds 301.1 are needed to prevent an inadequate supply of beds. 301.2 Project construction costs incurred for repairs authorized under 301.3 this clause shall not be considered in the dollar threshold 301.4 amount defined in subdivision 2; 301.5 (b) to license or certify beds that are moved from one 301.6 location to another within a nursing home facility, provided the 301.7 total costs of remodeling performed in conjunction with the 301.8 relocation of beds does not exceed$750,000$1,000,000; 301.9 (c) to license or certify beds in a project recommended for 301.10 approval under section 144A.073; 301.11 (d) to license or certify beds that are moved from an 301.12 existing state nursing home to a different state facility, 301.13 provided there is no net increase in the number of state nursing 301.14 home beds; 301.15 (e) to certify and license as nursing home beds boarding 301.16 care beds in a certified boarding care facility if the beds meet 301.17 the standards for nursing home licensure, or in a facility that 301.18 was granted an exception to the moratorium under section 301.19 144A.073, and if the cost of any remodeling of the facility does 301.20 not exceed$750,000$1,000,000. If boarding care beds are 301.21 licensed as nursing home beds, the number of boarding care beds 301.22 in the facility must not increase beyond the number remaining at 301.23 the time of the upgrade in licensure. The provisions contained 301.24 in section 144A.073 regarding the upgrading of the facilities do 301.25 not apply to facilities that satisfy these requirements; 301.26 (f) to license and certify up to 40 beds transferred from 301.27 an existing facility owned and operated by the Amherst H. Wilder 301.28 Foundation in the city of St. Paul to a new unit at the same 301.29 location as the existing facility that will serve persons with 301.30 Alzheimer's disease and other related disorders. The transfer 301.31 of beds may occur gradually or in stages, provided the total 301.32 number of beds transferred does not exceed 40. At the time of 301.33 licensure and certification of a bed or beds in the new unit, 301.34 the commissioner of health shall delicense and decertify the 301.35 same number of beds in the existing facility. As a condition of 301.36 receiving a license or certification under this clause, the 302.1 facility must make a written commitment to the commissioner of 302.2 human services that it will not seek to receive an increase in 302.3 its property-related payment rate as a result of the transfers 302.4 allowed under this paragraph; 302.5 (g) to license and certify nursing home beds to replace 302.6 currently licensed and certified boarding care beds which may be 302.7 located either in a remodeled or renovated boarding care or 302.8 nursing home facility or in a remodeled, renovated, newly 302.9 constructed, or replacement nursing home facility within the 302.10 identifiable complex of health care facilities in which the 302.11 currently licensed boarding care beds are presently located, 302.12 provided that the number of boarding care beds in the facility 302.13 or complex are decreased by the number to be licensed as nursing 302.14 home beds and further provided that, if the total costs of new 302.15 construction, replacement, remodeling, or renovation exceed ten 302.16 percent of the appraised value of the facility or $200,000, 302.17 whichever is less, the facility makes a written commitment to 302.18 the commissioner of human services that it will not seek to 302.19 receive an increase in its property-related payment rate by 302.20 reason of the new construction, replacement, remodeling, or 302.21 renovation. The provisions contained in section 144A.073 302.22 regarding the upgrading of facilities do not apply to facilities 302.23 that satisfy these requirements; 302.24 (h) to license as a nursing home and certify as a nursing 302.25 facility a facility that is licensed as a boarding care facility 302.26 but not certified under the medical assistance program, but only 302.27 if the commissioner of human services certifies to the 302.28 commissioner of health that licensing the facility as a nursing 302.29 home and certifying the facility as a nursing facility will 302.30 result in a net annual savings to the state general fund of 302.31 $200,000 or more; 302.32 (i) to certify, after September 30, 1992, and prior to July 302.33 1, 1993, existing nursing home beds in a facility that was 302.34 licensed and in operation prior to January 1, 1992; 302.35 (j) to license and certify new nursing home beds to replace 302.36 beds in a facility acquired by the Minneapolis community 303.1 development agency as part of redevelopment activities in a city 303.2 of the first class, provided the new facility is located within 303.3 three miles of the site of the old facility. Operating and 303.4 property costs for the new facility must be determined and 303.5 allowed under section 256B.431 or 256B.434; 303.6 (k) to license and certify up to 20 new nursing home beds 303.7 in a community-operated hospital and attached convalescent and 303.8 nursing care facility with 40 beds on April 21, 1991, that 303.9 suspended operation of the hospital in April 1986. The 303.10 commissioner of human services shall provide the facility with 303.11 the same per diem property-related payment rate for each 303.12 additional licensed and certified bed as it will receive for its 303.13 existing 40 beds; 303.14 (l) to license or certify beds in renovation, replacement, 303.15 or upgrading projects as defined in section 144A.073, 303.16 subdivision 1, so long as the cumulative total costs of the 303.17 facility's remodeling projects do not 303.18 exceed$750,000$1,000,000; 303.19 (m) to license and certify beds that are moved from one 303.20 location to another for the purposes of converting up to five 303.21 four-bed wards to single or double occupancy rooms in a nursing 303.22 home that, as of January 1, 1993, was county-owned and had a 303.23 licensed capacity of 115 beds; 303.24 (n) to allow a facility that on April 16, 1993, was a 303.25 106-bed licensed and certified nursing facility located in 303.26 Minneapolis to layaway all of its licensed and certified nursing 303.27 home beds. These beds may be relicensed and recertified in a 303.28 newly-constructed teaching nursing home facility affiliated with 303.29 a teaching hospital upon approval by the legislature. The 303.30 proposal must be developed in consultation with the interagency 303.31 committee on long-term care planning. The beds on layaway 303.32 status shall have the same status as voluntarily delicensed and 303.33 decertified beds, except that beds on layaway status remain 303.34 subject to the surcharge in section 256.9657. This layaway 303.35 provision expires July 1, 1998; 303.36 (o) to allow a project which will be completed in 304.1 conjunction with an approved moratorium exception project for a 304.2 nursing home in southern Cass county and which is directly 304.3 related to that portion of the facility that must be repaired, 304.4 renovated, or replaced, to correct an emergency plumbing problem 304.5 for which a state correction order has been issued and which 304.6 must be corrected by August 31, 1993; 304.7 (p) to allow a facility that on April 16, 1993, was a 304.8 368-bed licensed and certified nursing facility located in 304.9 Minneapolis to layaway, upon 30 days prior written notice to the 304.10 commissioner, up to 30 of the facility's licensed and certified 304.11 beds by converting three-bed wards to single or double 304.12 occupancy. Beds on layaway status shall have the same status as 304.13 voluntarily delicensed and decertified beds except that beds on 304.14 layaway status remain subject to the surcharge in section 304.15 256.9657, remain subject to the license application and renewal 304.16 fees under section 144A.07 and shall be subject to a $100 per 304.17 bed reactivation fee. In addition, at any time within three 304.18 years of the effective date of the layaway, the beds on layaway 304.19 status may be: 304.20 (1) relicensed and recertified upon relocation and 304.21 reactivation of some or all of the beds to an existing licensed 304.22 and certified facility or facilities located in Pine River, 304.23 Brainerd, or International Falls; provided that the total 304.24 project construction costs related to the relocation of beds 304.25 from layaway status for any facility receiving relocated beds 304.26 may not exceed the dollar threshold provided in subdivision 2 304.27 unless the construction project has been approved through the 304.28 moratorium exception process under section 144A.073; 304.29 (2) relicensed and recertified, upon reactivation of some 304.30 or all of the beds within the facility which placed the beds in 304.31 layaway status, if the commissioner has determined a need for 304.32 the reactivation of the beds on layaway status. 304.33 The property-related payment rate of a facility placing 304.34 beds on layaway status must be adjusted by the incremental 304.35 change in its rental per diem after recalculating the rental per 304.36 diem as provided in section 256B.431, subdivision 3a, paragraph 305.1 (c). The property-related payment rate for a facility 305.2 relicensing and recertifying beds from layaway status must be 305.3 adjusted by the incremental change in its rental per diem after 305.4 recalculating its rental per diem using the number of beds after 305.5 the relicensing to establish the facility's capacity day 305.6 divisor, which shall be effective the first day of the month 305.7 following the month in which the relicensing and recertification 305.8 became effective. Any beds remaining on layaway status more 305.9 than three years after the date the layaway status became 305.10 effective must be removed from layaway status and immediately 305.11 delicensed and decertified; 305.12 (q) to license and certify beds in a renovation and 305.13 remodeling project to convert 12 four-bed wards into 24 two-bed 305.14 rooms, expand space, and add improvements in a nursing home 305.15 that, as of January 1, 1994, met the following conditions: the 305.16 nursing home was located in Ramsey county; had a licensed 305.17 capacity of 154 beds; and had been ranked among the top 15 305.18 applicants by the 1993 moratorium exceptions advisory review 305.19 panel. The total project construction cost estimate for this 305.20 project must not exceed the cost estimate submitted in 305.21 connection with the 1993 moratorium exception process; 305.22 (r) to license and certify up to 117 beds that are 305.23 relocated from a licensed and certified 138-bed nursing facility 305.24 located in St. Paul to a hospital with 130 licensed hospital 305.25 beds located in South St. Paul, provided that the nursing 305.26 facility and hospital are owned by the same or a related 305.27 organization and that prior to the date the relocation is 305.28 completed the hospital ceases operation of its inpatient 305.29 hospital services at that hospital. After relocation, the 305.30 nursing facility's status under section 256B.431, subdivision 305.31 2j, shall be the same as it was prior to relocation. The 305.32 nursing facility's property-related payment rate resulting from 305.33 the project authorized in this paragraph shall become effective 305.34 no earlier than April 1, 1996. For purposes of calculating the 305.35 incremental change in the facility's rental per diem resulting 305.36 from this project, the allowable appraised value of the nursing 306.1 facility portion of the existing health care facility physical 306.2 plant prior to the renovation and relocation may not exceed 306.3 $2,490,000; 306.4 (s) to license and certify two beds in a facility to 306.5 replace beds that were voluntarily delicensed and decertified on 306.6 June 28, 1991; 306.7 (t) to allow 16 licensed and certified beds located on July 306.8 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 306.9 facility in Minneapolis, notwithstanding the licensure and 306.10 certification after July 1, 1995, of the Minneapolis facility as 306.11 a 147-bed nursing home facility after completion of a 306.12 construction project approved in 1993 under section 144A.073, to 306.13 be laid away upon 30 days' prior written notice to the 306.14 commissioner. Beds on layaway status shall have the same status 306.15 as voluntarily delicensed or decertified beds except that they 306.16 shall remain subject to the surcharge in section 256.9657. The 306.17 16 beds on layaway status may be relicensed as nursing home beds 306.18 and recertified at any time within five years of the effective 306.19 date of the layaway upon relocation of some or all of the beds 306.20 to a licensed and certified facility located in Watertown, 306.21 provided that the total project construction costs related to 306.22 the relocation of beds from layaway status for the Watertown 306.23 facility may not exceed the dollar threshold provided in 306.24 subdivision 2 unless the construction project has been approved 306.25 through the moratorium exception process under section 144A.073. 306.26 The property-related payment rate of the facility placing 306.27 beds on layaway status must be adjusted by the incremental 306.28 change in its rental per diem after recalculating the rental per 306.29 diem as provided in section 256B.431, subdivision 3a, paragraph 306.30 (c). The property-related payment rate for the facility 306.31 relicensing and recertifying beds from layaway status must be 306.32 adjusted by the incremental change in its rental per diem after 306.33 recalculating its rental per diem using the number of beds after 306.34 the relicensing to establish the facility's capacity day 306.35 divisor, which shall be effective the first day of the month 306.36 following the month in which the relicensing and recertification 307.1 became effective. Any beds remaining on layaway status more 307.2 than five years after the date the layaway status became 307.3 effective must be removed from layaway status and immediately 307.4 delicensed and decertified; 307.5 (u) to license and certify beds that are moved within an 307.6 existing area of a facility or to a newly constructed addition 307.7 which is built for the purpose of eliminating three- and 307.8 four-bed rooms and adding space for dining, lounge areas, 307.9 bathing rooms, and ancillary service areas in a nursing home 307.10 that, as of January 1, 1995, was located in Fridley and had a 307.11 licensed capacity of 129 beds; 307.12 (v) to relocate 36 beds in Crow Wing county and four beds 307.13 from Hennepin county to a 160-bed facility in Crow Wing county, 307.14 provided all the affected beds are under common ownership; 307.15 (w) to license and certify a total replacement project of 307.16 up to 49 beds located in Norman county that are relocated from a 307.17 nursing home destroyed by flood and whose residents were 307.18 relocated to other nursing homes. The operating cost payment 307.19 rates for the new nursing facility shall be determined based on 307.20 the interim and settle-up payment provisions of Minnesota Rules, 307.21 part 9549.0057, and the reimbursement provisions of section 307.22 256B.431, except that subdivision 26, paragraphs (a) and (b), 307.23 shall not apply until the second rate year after the settle-up 307.24 cost report is filed. Property-related reimbursement rates 307.25 shall be determined under section 256B.431, taking into account 307.26 any federal or state flood-related loans or grants provided to 307.27 the facility; 307.28 (x) to license and certify a total replacement project of 307.29 up to 129 beds located in Polk county that are relocated from a 307.30 nursing home destroyed by flood and whose residents were 307.31 relocated to other nursing homes. The operating cost payment 307.32 rates for the new nursing facility shall be determined based on 307.33 the interim and settle-up payment provisions of Minnesota Rules, 307.34 part 9549.0057, and the reimbursement provisions of section 307.35 256B.431, except that subdivision 26, paragraphs (a) and (b), 307.36 shall not apply until the second rate year after the settle-up 308.1 cost report is filed. Property-related reimbursement rates 308.2 shall be determined under section 256B.431, taking into account 308.3 any federal or state flood-related loans or grants provided to 308.4 the facility; 308.5 (y) to license and certify beds in a renovation and 308.6 remodeling project to convert 13 three-bed wards into 13 two-bed 308.7 rooms and 13 single-bed rooms, expand space, and add 308.8 improvements in a nursing home that, as of January 1, 1994, met 308.9 the following conditions: the nursing home was located in 308.10 Ramsey county, was not owned by a hospital corporation, had a 308.11 licensed capacity of 64 beds, and had been ranked among the top 308.12 15 applicants by the 1993 moratorium exceptions advisory review 308.13 panel. The total project construction cost estimate for this 308.14 project must not exceed the cost estimate submitted in 308.15 connection with the 1993 moratorium exception process; 308.16 (z) to license and certify up to 150 nursing home beds to 308.17 replace an existing 285 bed nursing facility located in St. 308.18 Paul. The replacement project shall include both the renovation 308.19 of existing buildings and the construction of new facilities at 308.20 the existing site. The reduction in the licensed capacity of 308.21 the existing facility shall occur during the construction 308.22 project as beds are taken out of service due to the construction 308.23 process. Prior to the start of the construction process, the 308.24 facility shall provide written information to the commissioner 308.25 of health describing the process for bed reduction, plans for 308.26 the relocation of residents, and the estimated construction 308.27 schedule. The relocation of residents shall be in accordance 308.28 with the provisions of law and rule; 308.29 (aa) to allow the commissioner of human services to license 308.30 an additional 36 beds to provide residential services for the 308.31 physically handicapped under Minnesota Rules, parts 9570.2000 to 308.32 9570.3400, in a 198-bed nursing home located in Red Wing, 308.33 provided that the total number of licensed and certified beds at 308.34 the facility does not increase; 308.35 (bb) to license and certify a new facility in St. Louis 308.36 county with 44 beds constructed to replace an existing facility 309.1 in St. Louis county with 31 beds, which has resident rooms on 309.2 two separate floors and an antiquated elevator that creates 309.3 safety concerns for residents and prevents nonambulatory 309.4 residents from residing on the second floor. The project shall 309.5 include the elimination of three- and four-bed rooms; 309.6 (cc) to license and certify four beds in a 16-bed certified 309.7 boarding care home in Minneapolis to replace beds that were 309.8 voluntarily delicensed and decertified on or before March 31, 309.9 1992. The licensure and certification is conditional upon the 309.10 facility periodically assessing and adjusting its resident mix 309.11 and other factors which may contribute to a potential 309.12 institution for mental disease declaration. The commissioner of 309.13 human services shall retain the authority to audit the facility 309.14 at any time and shall require the facility to comply with any 309.15 requirements necessary to prevent an institution for mental 309.16 disease declaration, including delicensure and decertification 309.17 of beds, if necessary;or309.18 (dd) to license and certify 72 beds in an existing facility 309.19 in Mille Lacs county with 80 beds as part of a renovation 309.20 project. The renovation must include construction of an 309.21 addition to accommodate ten residents with beginning and 309.22 midstage dementia in a self-contained living unit; creation of 309.23 three resident households where dining, activities, and support 309.24 spaces are located near resident living quarters; designation of 309.25 four beds for rehabilitation in a self-contained area; 309.26 designation of 30 private rooms; and other improvements.; 309.27 (ee) to license and certify beds in a facility that has 309.28 undergone replacement or remodeling as part of a planned closure 309.29 under section 256B.437; 309.30 (ff) to license and certify a total replacement project of 309.31 up to 124 beds located in Wilkin county that are in need of 309.32 relocation from a nursing home substantially destroyed by 309.33 flood. The operating cost payment rates for the new nursing 309.34 facility shall be determined based on the interim and settle-up 309.35 payment provisions of Minnesota Rules, part 9549.0057, and the 309.36 reimbursement provisions of section 256B.431, except that 310.1 section 256B.431, subdivision 26, paragraphs (a) and (b), shall 310.2 not apply until the second rate year after the settle-up cost 310.3 report is filed. Property-related reimbursement rates shall be 310.4 determined under section 256B.431, taking into account any 310.5 federal or state flood-related loans or grants provided to the 310.6 facility; 310.7 (gg) to allow the commissioner of human services to license 310.8 an additional nine beds to provide residential services for the 310.9 physically handicapped under Minnesota Rules, parts 9570.2000 to 310.10 9570.3400, in a 215-bed nursing home located in Duluth, provided 310.11 that the total number of licensed and certified beds at the 310.12 facility does not increase; 310.13 (hh) to license and certify up to 120 new nursing facility 310.14 beds to replace beds in a facility in Anoka county, which was 310.15 licensed for 98 beds as of July 1, 2000, provided the new 310.16 facility is located within four miles of the existing facility 310.17 and is in Anoka county. Operating and property rates shall be 310.18 determined and allowed under section 256B.431 and Minnesota 310.19 Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 310.20 256B.435. The provisions of section 256B.431, subdivision 26, 310.21 paragraphs (a) and (b), do not apply until the second rate year 310.22 following settle-up; or 310.23 (ii) to transfer up to 98 beds of a 129-licensed bed 310.24 facility located in Anoka county that, as of March 25, 2001, is 310.25 in the active process of closing, to a 122-licensed bed 310.26 nonprofit nursing facility located in the city of Columbia 310.27 Heights or its affiliate. The transfer is effective when the 310.28 receiving facility notifies the commissioner in writing of the 310.29 number of beds accepted. The commissioner shall place all 310.30 transferred beds on layaway status held in the name of the 310.31 receiving facility. The layaway adjustment provisions of 310.32 section 256B.431, subdivision 30, do not apply to this layaway. 310.33 The receiving facility may only remove the beds from layaway for 310.34 recertification and relicensure at the receiving facility's 310.35 current site, or at a newly constructed facility located in 310.36 Anoka county. The receiving facility must receive statutory 311.1 authorization before removing these beds from layaway. 311.2 Sec. 6. Minnesota Statutes 2000, section 144A.073, 311.3 subdivision 2, is amended to read: 311.4 Subd. 2. [REQUEST FOR PROPOSALS.] At the authorization by 311.5 the legislature of additional medical assistance expenditures 311.6 for exceptions to the moratorium on nursing homes, the 311.7 interagency committee shall publish in the State Register a 311.8 request for proposals for nursing home projects to be licensed 311.9 or certified under section 144A.071, subdivision 4a, clause 311.10 (c). The public notice of this funding and the request for 311.11 proposals must specify how the approval criteria will be 311.12 prioritized by the advisory review panel, the interagency 311.13 long-term care planning committee, and the commissioner. The 311.14 notice must describe the information that must accompany a 311.15 request and state that proposals must be submitted to the 311.16 interagency committee within 90 days of the date of 311.17 publication. The notice must include the amount of the 311.18 legislative appropriation available for the additional costs to 311.19 the medical assistance program of projects approved under this 311.20 section. If no money is appropriated for a year, the 311.21 interagency committee shall publish a notice to that effect, and 311.22 no proposals shall be requested. If money is appropriated, the 311.23 interagency committee shall initiate the application and review 311.24 process described in this section at least twice each biennium 311.25 and up to four times each biennium, according to dates 311.26 established by rule. Authorized funds shall be allocated 311.27 proportionally to the number of processes. Funds not encumbered 311.28 by an earlier process within a biennium shall carry forward to 311.29 subsequent iterations of the process. Authorization for 311.30 expenditures does not carry forward into the following 311.31 biennium. To be considered for approval, a proposal must 311.32 include the following information: 311.33 (1) whether the request is for renovation, replacement, 311.34 upgrading, conversion, or relocation; 311.35 (2) a description of the problem the project is designed to 311.36 address; 312.1 (3) a description of the proposed project; 312.2 (4) an analysis of projected costs of the nursing facility 312.3 proposal, which are not required to exceed the cost threshold 312.4 referred to in section 144A.071, subdivision 1, to be considered 312.5 under this section, including initial construction and 312.6 remodeling costs; site preparation costs; technology costs; 312.7 financing costs, including the current estimated long-term 312.8 financing costs of the proposal, which consists of estimates of 312.9 the amount and sources of money, reserves if required under the 312.10 proposed funding mechanism, annual payments schedule, interest 312.11 rates, length of term, closing costs and fees, insurance costs, 312.12 and any completed marketing study or underwriting review; and 312.13 estimated operating costs during the first two years after 312.14 completion of the project; 312.15 (5) for proposals involving replacement of all or part of a 312.16 facility, the proposed location of the replacement facility and 312.17 an estimate of the cost of addressing the problem through 312.18 renovation; 312.19 (6) for proposals involving renovation, an estimate of the 312.20 cost of addressing the problem through replacement; 312.21 (7) the proposed timetable for commencing construction and 312.22 completing the project; 312.23 (8) a statement of any licensure or certification issues, 312.24 such as certification survey deficiencies; 312.25 (9) the proposed relocation plan for current residents if 312.26 beds are to be closed so that the department of human services 312.27 can estimate the total costs of a proposal; and 312.28 (10) other information required by permanent rule of the 312.29 commissioner of health in accordance with subdivisions 4 and 8. 312.30 Sec. 7. Minnesota Statutes 2000, section 144A.073, 312.31 subdivision 4, is amended to read: 312.32 Subd. 4. [CRITERIA FOR REVIEW.] The following criteria 312.33 shall be used in a consistent manner to compare, evaluate, and 312.34 rank all proposals submitted. Except for the criteria specified 312.35 in clause (3), the application of criteria listed under this 312.36 subdivision shall not reflect any distinction based on the 313.1 geographic location of the proposed project: 313.2 (1) the extent to which the proposal furthers state 313.3 long-term care goals,including the goals stated in section313.4144A.31, andincluding the goal of enhancing the availability 313.5 and use of alternative care services and the goal of reducing 313.6 the number of long-term care resident rooms with more than two 313.7 beds; 313.8 (2) the proposal's long-term effects on state costs 313.9 including the cost estimate of the project according to section 313.10 144A.071, subdivision 5a; 313.11 (3) the extent to which the proposal promotes equitable 313.12 access to long-term care services in nursing homes through 313.13 redistribution of the nursing home bed supply, as measured by 313.14 the number of beds relative to the population 85 or older, 313.15 projected to the year 2000 by the state demographer, and 313.16 according to items (i) to (iv): 313.17 (i) reduce beds in counties where the supply is high, 313.18 relative to the statewide mean, and increase beds in counties 313.19 where the supply is low, relative to the statewide mean; 313.20 (ii) adjust the bed supply so as to create the greatest 313.21 benefits in improving the distribution of beds; 313.22 (iii) adjust the existing bed supply in counties so that 313.23 the bed supply in a county moves toward the statewide mean; and 313.24 (iv) adjust the existing bed supply so that the 313.25 distribution of beds as projected for the year 2020 would be 313.26 consistent with projected need, based on the methodology 313.27 outlined in the interagency long-term care committee's1993313.28 nursing home bed distribution study; 313.29 (4) the extent to which the project improves conditions 313.30 that affect the health or safety of residents, such as narrow 313.31 corridors, narrow door frames, unenclosed fire exits, and wood 313.32 frame construction, and similar provisions contained in fire and 313.33 life safety codes and licensure and certification rules; 313.34 (5) the extent to which the project improves conditions 313.35 that affect the comfort or quality of life of residents in a 313.36 facility or the ability of the facility to provide efficient 314.1 care, such as a relatively high number of residents in a room; 314.2 inadequate lighting or ventilation; poor access to bathing or 314.3 toilet facilities; a lack of available ancillary space for 314.4 dining rooms, day rooms, or rooms used for other activities; 314.5 problems relating to heating, cooling, or energy efficiency; 314.6 inefficient location of nursing stations; narrow corridors; or 314.7 other provisions contained in the licensure and certification 314.8 rules; 314.9 (6) the extent to which the applicant demonstrates the 314.10 delivery of quality care, as defined in state and federal 314.11 statutes and rules, to residents as evidenced by the two most 314.12 recent state agency certification surveys and the applicants' 314.13 response to those surveys; 314.14 (7) the extent to which the project removes the need for 314.15 waivers or variances previously granted by either the licensing 314.16 agency, certifying agency, fire marshal, or local government 314.17 entity;and314.18 (8) the extent to which the project increases the number of 314.19 private or single bed rooms; and 314.20 (9) other factors that may be developed in permanent rule 314.21 by the commissioner of health that evaluate and assess how the 314.22 proposed project will further promote or protect the health, 314.23 safety, comfort, treatment, or well-being of the facility's 314.24 residents. 314.25 Sec. 8. [144A.185] [DEFINITIONS.] 314.26 Subdivision 1. [APPLICABILITY.] For purposes of sections 314.27 144A.185 to 144A.1887, the terms defined in this section have 314.28 the meanings given them. 314.29 Subd. 2. [CLOSURE.] "Closure" means the cessation of 314.30 operations of a nursing home and the delicensure or 314.31 decertification of all beds within the facility. 314.32 Subd. 3. [CURTAILMENT, REDUCTION, OR CHANGE IN 314.33 OPERATIONS.] "Curtailment, reduction, or change in operations" 314.34 means any change in operations or services that would result in 314.35 or encourage the relocation of residents. 314.36 Subd. 4. [FACILITY.] "Facility" means a licensed nursing 315.1 home or a certified boarding care home licensed according to 315.2 sections 144.50 to 144.56. 315.3 Subd. 5. [LICENSEE.] "Licensee" means the owner of the 315.4 facility or the owner's designee or the commissioner of health 315.5 for a facility in receivership. 315.6 Subd. 6. [LOCAL AGENCY.] "Local agency" means a county or 315.7 a multicounty social service agency authorized under section 315.8 393.01 as the agency responsible for providing social services 315.9 for the county in which the facility is located. 315.10 Subd. 7. [PLAN.] "Plan" means a process developed under 315.11 section 144A.186 for the closure or curtailment, reduction, or 315.12 change in operations of a facility and for the subsequent 315.13 relocation of residents. 315.14 Subd. 8. [RELOCATION.] "Relocation" means the discharge of 315.15 a resident and movement of the resident to another facility or 315.16 living arrangement as a result of a closure or curtailment, 315.17 reduction, or change in operations of a facility. 315.18 Sec. 9. [144A.1855] [INITIAL NOTICE.] 315.19 Subdivision 1. [NOTIFICATION; PARTIES.] A licensee shall 315.20 notify the following parties in writing when there is an intent 315.21 to close or curtail, reduce, or change operations which would 315.22 result in or encourage the relocation of residents: 315.23 (1) the commissioner of health; 315.24 (2) the commissioner of human services; 315.25 (3) the local agency; 315.26 (4) the office of the ombudsman for older Minnesotans; and 315.27 (5) the office of the ombudsman for mental health and 315.28 mental retardation. 315.29 Subd. 2. [NOTICE REQUIREMENTS.] The written notice shall 315.30 include the names, telephone numbers, fax numbers, and e-mail 315.31 addresses of the persons in the facility who are responsible for 315.32 coordinating the facility's efforts in the planning process and 315.33 the number of residents potentially affected by the closure or 315.34 curtailment, reduction, or change in operations. 315.35 Sec. 10. [144A.186] [PLANNING PROCESS.] 315.36 Subdivision 1. [LOCAL AGENCY REQUIREMENTS.] (a) A local 316.1 agency, within five working days of receiving an initial notice 316.2 from a licensee according to section 144A.1855, shall provide 316.3 all parties identified in section 144A.1855, subdivision 1, with 316.4 the names, telephone numbers, fax numbers, and e-mail addresses 316.5 of those persons who are responsible for coordinating local 316.6 agency efforts in the planning process. 316.7 (b) Within ten working days of receipt of the notice under 316.8 paragraph (a), the local agency and licensee shall meet to 316.9 develop the relocation plan under subdivision 2. The local 316.10 agency shall inform the departments of health and human 316.11 services, the office of the ombudsman for older Minnesotans, and 316.12 the office of the ombudsman for mental health and mental 316.13 retardation of the date, time, and location of the meeting so 316.14 that their representatives may attend. The relocation plan must 316.15 be completed within 45 days, but may be completed earlier 316.16 according to a schedule agreed to by all parties. 316.17 Subd. 2. [RELOCATION PLAN.] (a) The plan shall: 316.18 (1) identify the expected date of closure or curtailment, 316.19 reduction, or change in operations; 316.20 (2) outline the process for public notification of the 316.21 closure or curtailment, reduction, or change in operations; 316.22 (3) outline the process to ensure 60-day advance written 316.23 notice to residents, family members, and designated 316.24 representatives of residents; 316.25 (4) present an aggregate description of the resident 316.26 population remaining to be relocated and the population's needs; 316.27 (5) outline the individual resident assessment process to 316.28 be used; 316.29 (6) identify an inventory of available relocation options, 316.30 including home and community-based services; 316.31 (7) identify a timeline for submission of the list required 316.32 under section 144A.1865, subdivision 3; and 316.33 (8) identify a schedule for each element of the plan. 316.34 (b) All parties to the plan shall refrain from any public 316.35 notification of the intent to close or curtail, reduce, or 316.36 change operations until a relocation plan has been established. 317.1 Sec. 11. [144A.1865] [REQUIREMENTS OF LICENSEE.] 317.2 Subdivision 1. [RELOCATION.] The licensee shall provide 317.3 for the safe, orderly, and appropriate relocation of residents. 317.4 The licensee and facility staff shall cooperate with 317.5 representatives from the local agency, the departments of health 317.6 and human services, the office of the ombudsman for older 317.7 Minnesotans, and the office of the ombudsman for mental health 317.8 and mental retardation in planning for and implementing the 317.9 relocation of residents. 317.10 Subd. 2. [INTERDISCIPLINARY TEAM.] The licensee shall 317.11 establish an interdisciplinary team responsible for coordinating 317.12 and implementing the plan under section 144A.186, subdivision 317.13 2. The interdisciplinary team shall include representatives 317.14 from the local agency, the office of the ombudsman for older 317.15 Minnesotans, facility staff who provide direct care services to 317.16 the residents, and the facility administration. 317.17 Subd. 3. [RESIDENT LISTS.] The licensee shall provide a 317.18 list to the local agency that includes the following information 317.19 on each resident to be relocated: 317.20 (1) name; 317.21 (2) date of birth; 317.22 (3) social security number; 317.23 (4) medical assistance ID number; 317.24 (5) all diagnoses; and 317.25 (6) name of and contact information for the resident's 317.26 family or other designated representative. 317.27 Subd. 4. [CONSULTATION WITH LOCAL AGENCY.] The licensee 317.28 shall consult with the local agency on the availability and 317.29 development of resources and in the resident relocation process. 317.30[EFFECTIVE DATE.] This section is effective the day 317.31 following final enactment. 317.32 Sec. 12. [144A.187] [RESIDENT AND PHYSICIAN NOTICE.] 317.33 Subdivision 1. [RESIDENT NOTICE REQUIRED.] (a) At least 60 317.34 days before the proposed date of closure or curtailment, 317.35 reduction, or change in operations as agreed to in the plan 317.36 under section 144A.186, the licensee shall send a written notice 318.1 of closure or curtailment, reduction, or change in operations to 318.2 each resident being relocated, the resident's family member or 318.3 designated representative, and the resident's attending 318.4 physician. 318.5 (b) The notice must include: 318.6 (1) the date of the proposed closure or curtailment, 318.7 reduction, or change in operations; 318.8 (2) the name, address, telephone number, fax number, and 318.9 e-mail address of the individuals in the facility responsible 318.10 for providing assistance and information; 318.11 (3) a notice of upcoming meetings for residents, families 318.12 and designated representatives, and resident and family councils 318.13 to discuss the relocation of residents; 318.14 (4) the name, address, and telephone number of the local 318.15 agency contact person; 318.16 (5) the name, address, and telephone number of the office 318.17 of the ombudsman for older Minnesotans and the office of the 318.18 ombudsman for mental health and mental retardation; and 318.19 (6) a notice of resident rights during discharge and 318.20 relocation. 318.21 (c) The notice to residents must comply with all applicable 318.22 state and federal requirements for notice of transfer or 318.23 discharge of nursing home residents. 318.24 Subd. 2. [MEDICAL INFORMATION REQUEST.] The licensee shall 318.25 request the attending physician to furnish the licensee with, or 318.26 arrange for the release of, any medical information needed to 318.27 update a resident's medical records and to prepare transfer 318.28 forms and discharge summaries. 318.29 Sec. 13. [144A.1875] [RELOCATION OF RESIDENTS.] 318.30 Subdivision 1. [PREPARATION; PLACEMENT INFORMATION.] A 318.31 licensee shall provide sufficient preparation to residents to 318.32 ensure safe, orderly, and appropriate discharge and relocation. 318.33 The facility is responsible for assisting residents in finding 318.34 placement within the resident's desired geographic location 318.35 using the Senior LinkAge database of the department of human 318.36 services. By January 1, 2002, Senior LinkAge line shall make 319.1 available via a Web site the name, address, and telephone and 319.2 fax numbers of each facility with available beds, the 319.3 certification level of the available beds, the types of services 319.4 available, and the number of beds that are available as updated 319.5 daily by the licensee. The Web site shall include the 319.6 information required by section 256.975, subdivision 7, 319.7 paragraph (b), clause (1), and home and community-based services 319.8 and other options for individuals with special needs. The 319.9 licensee must provide residents, their families or designated 319.10 representatives, the office of the ombudsman for older 319.11 Minnesotans, the office of the ombudsman for mental health and 319.12 mental retardation, and the local agency with the toll-free 319.13 number and Web site address for the Senior LinkAge line. 319.14 Subd. 2. [RESIDENT AND FAMILY MEETINGS.] After preparing 319.15 the plan according to section 144A.186, the licensee shall 319.16 conduct meetings with residents, families and designated 319.17 representatives, and resident and family councils to notify them 319.18 of the process for resident relocation. Representatives from 319.19 the local agency, the office of the ombudsman for older 319.20 Minnesotans, the office of the ombudsman for mental health and 319.21 mental retardation, the departments of health and human services 319.22 shall receive advance notice of these meetings. 319.23 Subd. 3. [PERSONAL PROPERTY.] (a) The licensee shall 319.24 update the inventory of residents' personal possessions and 319.25 provide a copy of the final inventory to each resident and the 319.26 resident's family or designated representative prior to the 319.27 relocation of the resident. The licensee is responsible for the 319.28 timely transfer of a resident's possessions for all relocations 319.29 within the state and within a 50-mile radius of the facility for 319.30 relocations outside the state. 319.31 (b) The licensee shall complete a final accounting of 319.32 personal funds held in trust by the licensee and provide a copy 319.33 of the accounting to each resident and the resident's family or 319.34 designated representative. The licensee is responsible for the 319.35 timely transfer of all personal funds held in trust by the 319.36 licensee. 320.1 Subd. 4. [SITE VISITS.] The licensee is responsible for 320.2 assisting residents desiring to make site visits to facilities 320.3 or other placements to which the resident may be relocated, 320.4 unless it is medically inadvisable, as documented by the 320.5 attending physician in the resident's care record. The licensee 320.6 shall provide, or make arrangements for, transportation for site 320.7 visits to facilities or other placements within a 50-mile radius. 320.8 Subd. 5. [FINAL NOTICE OF RELOCATION.] (a) Before 320.9 relocating a resident, the licensee shall provide a final 320.10 written notice to the resident, the resident's family or 320.11 designated representative, and the resident's attending 320.12 physician. 320.13 (b) The final written notice shall: 320.14 (1) be provided seven days before the relocation of a 320.15 resident, unless the resident agrees to waive the resident's 320.16 right to advance notice; and 320.17 (2) identify the date of the anticipated relocation and the 320.18 location to which the resident is being relocated. 320.19 Subd. 6. [ADMINISTRATIVE DUTIES.] (a) All administrative 320.20 duties of the licensee under subdivisions 1, 2, 4, and 5 must be 320.21 completed before relocation of a resident. 320.22 (b) The licensee is responsible for providing the receiving 320.23 facility or other health, housing, or care entity with a 320.24 complete and accurate resident record, including information on 320.25 family members, designated representatives, guardians, social 320.26 service caseworkers, and other contact information. The record 320.27 must also include all information necessary to provide 320.28 appropriate medical care and social services, including, but not 320.29 limited to, information on preadmission screening, Level I and 320.30 Level II screening, minimum data set and all other assessments, 320.31 resident diagnosis, behavior, and medication. 320.32 (c) For residents with special care needs, the licensee 320.33 shall consult with the receiving facility or other placement 320.34 entity and provide staff training or other preparation as needed 320.35 to assist in providing for the special needs. 320.36 (d) The licensee shall assist residents with the transfer 321.1 or reconnection of telephone service. The licensee shall bear 321.2 all costs associated with reestablishing telephone service. 321.3 Subd. 7. [TRANSPORTATION; CONTINUITY OF CARE.] The 321.4 licensee shall make arrangements or provide for the 321.5 transportation of residents to the new facility or placement 321.6 within the state or within a 50-mile radius for relocations 321.7 outside the state. The licensee shall provide a staff person to 321.8 accompany the resident during transportation, upon request of 321.9 the resident, the resident's family, or designated 321.10 representative. The discharge and relocation of residents must 321.11 comply with all applicable state and federal requirements and 321.12 must be conducted in a safe, orderly, and appropriate manner. 321.13 The licensee must ensure that there is no disruption in 321.14 providing meals, medications, or treatments of a resident during 321.15 the relocation process. 321.16 Sec. 14. [144A.1885] [RELOCATION REPORTS.] 321.17 (a) Beginning the week following development of the initial 321.18 relocation plan under section 144A.186, the licensee shall 321.19 submit weekly status reports to the commissioners of health and 321.20 human services, or their designees, and to the local agency. 321.21 (b) The first status report must identify the relocation 321.22 plan developed under section 144A.186, the interdisciplinary 321.23 team members, and the number of residents to be relocated. 321.24 (c) Subsequent status reports must note any modifications 321.25 to the relocation plan, any change of interdisciplinary team 321.26 members or number of residents relocated, the placement 321.27 destination to which residents have been relocated, and the 321.28 number of residents remaining to be relocated. Subsequent 321.29 status reports must also identify issues or problems encountered 321.30 during the relocation process and the resolution of these issues. 321.31 Sec. 15. [144A.1886] [REQUIREMENTS OF LOCAL AGENCY.] 321.32 Subdivision 1. [MEETING; REPRESENTATION.] (a) The local 321.33 agency with the licensee shall convene a meeting to develop a 321.34 plan according to section 144A.186, subdivision 1, paragraph (b). 321.35 (b) The local agency shall designate a representative to 321.36 the interdisciplinary team established by the licensee 322.1 responsible for coordinating the relocation efforts. 322.2 Subd. 2. [RESOURCE.] (a) The local agency shall serve as a 322.3 resource in the relocation process. 322.4 (b) Concurrent with the notice sent to residents from the 322.5 licensee according to section 144A.187, subdivision 1, the local 322.6 agency shall provide written notice to residents, family 322.7 members, and designated representatives describing: 322.8 (1) the local agency's role in the relocation process and 322.9 in the follow-up to relocation; 322.10 (2) a local agency contact name, address, and telephone 322.11 number; and 322.12 (3) the name, address, and telephone number of the office 322.13 of the ombudsman for older Minnesotans and the office of the 322.14 ombudsman for mental health and mental retardation. 322.15 (c) The local agency is responsible for the safe and 322.16 orderly relocation of residents in cases where an emergent need 322.17 arises or when the licensee has abrogated the licensee's 322.18 responsibilities under the relocation plan. 322.19 Subd. 3. [COORDINATION; OVERSIGHT.] (a) The local agency 322.20 shall meet with appropriate facility staff to coordinate any 322.21 assistance. Coordination shall include participating in group 322.22 meetings with residents, family members, and designated 322.23 representatives to explain the transfer or relocation process. 322.24 (b) The local agency shall monitor compliance with all 322.25 components of the relocation plan. When the licensee is not in 322.26 compliance, the local agency shall notify the commissioners of 322.27 health and human services. 322.28 (c) Except as requested by the resident, family member, or 322.29 designated representative and within the parameters of the 322.30 Vulnerable Adults Act, the local agency may halt a relocation 322.31 that it deems inappropriate or dangerous to the health or safety 322.32 of a resident. 322.33 Subd. 4. [FOLLOW-UP REVIEW.] (a) A member of the local 322.34 agency staff shall visit residents relocated within 100 miles of 322.35 the county within 30 days after a relocation. Local agency 322.36 staff shall interview the resident and family member or 323.1 designated representative or shall observe the resident on-site, 323.2 or both, and review and discuss pertinent medical or social 323.3 records with appropriate facility staff to assess the adjustment 323.4 of the resident to the new placement, recommend services or 323.5 methods to meet any special needs of the resident, and identify 323.6 residents at risk. 323.7 (b) The local agency may conduct subsequent follow-up 323.8 visits in cases where the adjustment of the resident to the new 323.9 placement is in question. 323.10 (c) Within 60 days of the completion of the follow-up 323.11 visits, the local agency shall submit a written summary of the 323.12 follow-up work to the commissioners of health and human 323.13 services, in a manner approved by the commissioners. 323.14 (d) The local agency shall submit a report of any issues 323.15 that may require further review or monitoring to the 323.16 commissioner of health. 323.17 Sec. 16. [144A.1887] [FUNDING.] 323.18 (a) Within 60 days of a nursing home ceasing operations, 323.19 the commissioner of human services shall reimburse nursing homes 323.20 that are reimbursed under sections 256B.431, 256B.434, and 323.21 256B.435 for operating costs incurred by the nursing home during 323.22 the closure process. The amount to be reimbursed to the nursing 323.23 home shall be determined by applying paragraphs (b) to (f). 323.24 (b) The facility shall provide the commissioner of human 323.25 services with the nursing home's operating costs for the time 323.26 period of 30 days prior to the notice specified under section 323.27 144A.16, to 30 days after the nursing home's closure. 323.28 (c) The nursing home shall provide the commissioner of 323.29 human services with the number of medical assistance, Medicare, 323.30 private pay, and other resident days for the period referenced 323.31 in paragraph (b) by the 11 case mix categories. 323.32 (d) The commissioner of human services shall calculate a 323.33 nursing home closure rate by dividing the facility operating 323.34 costs in paragraph (b) by the total resident days in paragraph 323.35 (c). 323.36 (e) The total closure costs attributable to medical 324.1 assistance shall be determined by multiplying the nursing home 324.2 closure rate in paragraph (d) by the medical assistance days 324.3 provided by the nursing facility in paragraph (c). 324.4 (f) The amount to be reimbursed to the nursing home is 324.5 equal to the total closure costs in paragraph (e) minus the sum 324.6 of the nursing facility's 11 operating rates times their 324.7 respective number of medical assistance days by case mix as 324.8 referenced in paragraph (c). 324.9 Sec. 17. [144A.36] [TRANSITION PLANNING GRANTS.] 324.10 Subdivision 1. [DEFINITIONS.] "Eligible nursing home" 324.11 means any nursing home licensed under sections 144A.01 to 324.12 144A.16 and certified by the appropriate authority under United 324.13 States Code, title 42, sections 1396-1396p, to participate as a 324.14 vendor in the medical assistance program established under 324.15 chapter 256B. 324.16 Subd. 2. [GRANTS AUTHORIZED.] (a) The commissioner shall 324.17 establish a program of transition planning grants to assist 324.18 eligible nursing homes in implementing the provisions in 324.19 paragraphs (b) and (c). 324.20 (b) Transition planning grants may be used by nursing homes 324.21 to develop strategic plans which identify the appropriate 324.22 institutional and noninstitutional settings necessary to meet 324.23 the older adult service needs of the community. 324.24 (c) At a minimum, a strategic plan must consist of: 324.25 (1) a needs assessment to determine what older adult 324.26 services are needed and desired by the community; 324.27 (2) an assessment of the appropriate settings in which to 324.28 provide needed older adult services; 324.29 (3) an assessment identifying currently available services 324.30 and their settings in the community; and 324.31 (4) a transition plan to achieve the needed outcome 324.32 identified by the assessment. 324.33 Subd. 3. [ALLOCATION OF GRANTS.] (a) Eligible nursing 324.34 homes must apply to the commissioner no later than September 1 324.35 of each fiscal year for grants awarded in that fiscal year. A 324.36 grant shall be awarded upon signing of a grant contract. 325.1 (b) The commissioner must make a final decision on the 325.2 funding of each application within 60 days of the deadline for 325.3 receiving applications. 325.4 Subd. 4. [EVALUATION.] The commissioner shall evaluate the 325.5 overall effectiveness of the grant program. The commissioner 325.6 may collect, from the nursing homes receiving grants, the 325.7 information necessary to evaluate the grant program. 325.8 Information related to the financial condition of individual 325.9 nursing homes shall be classified as nonpublic data. 325.10 Sec. 18. [144A.37] [ALTERNATIVE NURSING HOME SURVEY 325.11 PROCESS.] 325.12 Subdivision 1. [ALTERNATIVE NURSING HOME SURVEY 325.13 SCHEDULES.] (a) The commissioner of health shall implement 325.14 alternative procedures for the nursing home survey process as 325.15 authorized under this section. 325.16 (b) These alternative survey process procedures seek to: 325.17 (1) use department resources more effectively and efficiently to 325.18 target problem areas; (2) use other existing or new mechanisms 325.19 to provide objective assessments of quality and to measure 325.20 quality improvement; (3) provide for frequent collaborative 325.21 interaction of facility staff and surveyors rather than a 325.22 punitive approach; and (4) reward a nursing home that has 325.23 performed very well by extending intervals between full surveys. 325.24 (c) The commissioner shall pursue changes in federal law 325.25 necessary to accomplish this process and shall apply for any 325.26 necessary federal waivers or approval. If a federal waiver is 325.27 approved, the commissioner shall promptly submit, to the house 325.28 and senate committees with jurisdiction over health and human 325.29 services policy and finance, fiscal estimates for implementing 325.30 the alternative survey process waiver. The commissioner shall 325.31 also pursue any necessary federal law changes during the 107th 325.32 Congress. 325.33 (d) The alternative nursing home survey schedule and 325.34 related educational activities shall not be implemented until 325.35 funding is appropriated by the legislature. 325.36 Subd. 2. [SURVEY INTERVALS.] The commissioner of health 326.1 must extend the time period between standard surveys up to 30 326.2 months based on the criteria established in subdivision 4. In 326.3 using the alternative survey schedule, the requirement for the 326.4 statewide average to not exceed 12 months does not apply. 326.5 Subd. 3. [COMPLIANCE HISTORY.] The commissioner shall 326.6 develop a process for identifying the survey cycles for skilled 326.7 nursing facilities based upon the compliance history of the 326.8 facility. This process can use a range of months for survey 326.9 intervals. At a minimum, the process must be based on 326.10 information from the last two survey cycles and shall take into 326.11 consideration any deficiencies issued as the result of a survey 326.12 or a complaint investigation during the interval. A skilled 326.13 nursing facility with a finding of substandard quality of care 326.14 or a finding of immediate jeopardy is not entitled to a survey 326.15 interval greater than 12 months. The commissioner shall alter 326.16 the survey cycle for a specific skilled nursing facility based 326.17 on findings identified through the completion of a survey, a 326.18 monitoring visit, or a complaint investigation. The 326.19 commissioner must also take into consideration information other 326.20 than the facility's compliance history. 326.21 Subd. 4. [CRITERIA FOR SURVEY INTERVAL 326.22 CLASSIFICATION.] (a) The commissioner shall provide public 326.23 notice of the classification process and shall identify the 326.24 selected survey cycles for each skilled nursing facility. The 326.25 classification system must be based on an analysis of the 326.26 findings made during the past two standard survey intervals, but 326.27 it only takes one survey or complaint finding to modify the 326.28 interval. 326.29 (b) The commissioner shall also take into consideration 326.30 information obtained from residents and family members in each 326.31 skilled nursing facility and from other sources such as 326.32 employees and ombudsmen in determining the appropriate survey 326.33 intervals for facilities. 326.34 Subd. 5. [REQUIRED MONITORING.] (a) The commissioner shall 326.35 conduct at least one monitoring visit on an annual basis for 326.36 every skilled nursing facility which has been selected for a 327.1 survey cycle greater than 12 months. The commissioner shall 327.2 develop protocols for the monitoring visits which shall be less 327.3 extensive than the requirements for a standard survey. The 327.4 commissioner shall use the criteria in paragraph (b) to 327.5 determine whether additional monitoring visits to a facility 327.6 will be required. 327.7 (b) The criteria shall include, but not be limited to, the 327.8 following: 327.9 (1) changes in ownership, administration of the facility, 327.10 or direction of the facility's nursing service; 327.11 (2) changes in the facility's quality indicators which 327.12 might evidence a decline in the facility's quality of care; 327.13 (3) reductions in staffing or an increase in the 327.14 utilization of temporary nursing personnel; and 327.15 (4) complaint information or other information that 327.16 identifies potential concerns for the quality of the care and 327.17 services provided in the skilled nursing facility. 327.18 Subd. 6. [SURVEY REQUIREMENTS FOR FACILITIES NOT APPROVED 327.19 FOR EXTENDED SURVEY INTERVALS.] The commissioner shall establish 327.20 a process for surveying and monitoring of facilities which 327.21 require a survey interval of less than 15 months. This 327.22 information shall identify the steps that the commissioner must 327.23 take to monitor the facility in addition to the standard survey. 327.24 Subd. 7. [IMPACT ON SURVEY AGENCY'S BUDGET.] The 327.25 implementation of an alternative survey process for the state 327.26 must not result in any reduction of funding that would have been 327.27 provided to the state survey agency for survey and enforcement 327.28 activity based upon the completion of full standard surveys for 327.29 each skilled nursing facility in the state. 327.30 Subd. 8. [EDUCATIONAL ACTIVITIES.] The commissioner shall 327.31 expand the state survey agency's ability to conduct training and 327.32 educational efforts for skilled nursing facilities, residents 327.33 and family members, residents and family councils, long-term 327.34 care ombudsman programs, and the general public. 327.35 Subd. 9. [EVALUATION.] The commissioner shall develop a 327.36 process for the evaluation of the effectiveness of an 328.1 alternative survey process conducted under this section. 328.2[EFFECTIVE DATE.] This section is effective the day 328.3 following final enactment. 328.4 Sec. 19. [144A.38] [INNOVATIONS IN QUALITY DEMONSTRATION 328.5 GRANTS.] 328.6 Subdivision 1. [PROGRAM ESTABLISHED.] The commissioner of 328.7 health and the commissioner of human services shall establish a 328.8 long-term care grant program that demonstrates best practices 328.9 and innovation for long-term care service delivery and housing. 328.10 The grants must fund demonstrations that create new means and 328.11 models for serving the elderly or demonstrate creativity in 328.12 service provision through the scope of their program or service. 328.13 Subd. 2. [ELIGIBILITY.] Grants may only be made to those 328.14 who provide direct service or housing to the elderly within the 328.15 state. Grants may only be made for projects that show 328.16 innovations and measurable improvement in resident care, quality 328.17 of life, use of technology, or customer satisfaction. 328.18 Subd. 3. [AWARDING OF GRANTS.] (a) Applications for grants 328.19 must be made to the commissioners on forms prescribed by the 328.20 commissioners. 328.21 (b) The commissioners shall review applications and award 328.22 grants based on the following criteria: 328.23 (1) improvement in direct care to residents; 328.24 (2) increase in efficiency through the use of technology; 328.25 (3) increase in quality of care through the use of 328.26 technology; 328.27 (4) increase in the access and delivery of service; 328.28 (5) enhancement of nursing staff training; 328.29 (6) the effectiveness of the project as a demonstration; 328.30 and 328.31 (7) the immediate transferability of the project to scale. 328.32 (c) In reviewing applications and awarding grants, the 328.33 commissioners shall consult with long-term care providers, 328.34 consumers of long-term care, long-term care researchers, and 328.35 staff of other state agencies. 328.36 (d) Grants for eligible projects may not exceed $100,000. 329.1 Sec. 20. [144A.39] [LONG-TERM CARE QUALITY PROFILES.] 329.2 Subdivision l. [DEVELOPMENT AND IMPLEMENTATION OF QUALITY 329.3 PROFILES.] (a) The commissioner of health and the commissioner 329.4 of human services shall develop and implement a quality profile 329.5 system for nursing facilities and, beginning not later than July 329.6 1, 2003, other providers of long-term care services, except when 329.7 the quality profile system would duplicate requirements under 329.8 sections 256B.5011 and 256B.5013. The system must be developed 329.9 and implemented to the extent possible without the collection of 329.10 new data. To the extent possible, the system must incorporate 329.11 or be coordinated with information on quality maintained by area 329.12 agencies on aging, long-term care trade associations, and other 329.13 entities. The system must be designed to provide information on 329.14 quality: 329.15 (1) to consumers and their families to facilitate informed 329.16 choices of service providers; 329.17 (2) to providers to enable them to measure the results of 329.18 their quality improvement efforts and compare quality 329.19 achievements with other service providers; and 329.20 (3) to public and private purchasers of long-term care 329.21 services to enable them to purchase high-quality care. 329.22 (b) The system must be developed in consultation with the 329.23 long-term care task force, area agencies on aging, and 329.24 representatives of consumers, providers, and labor unions. 329.25 Within the limits of available appropriations, the commissioners 329.26 may employ consultants to assist with this project. 329.27 Subd. 2. [QUALITY MEASUREMENT TOOLS.] The commissioners 329.28 shall identify and apply existing quality measurement tools to: 329.29 (1) emphasize quality of care and its relationship to 329.30 quality of life; and 329.31 (2) address the needs of various users of long-term care 329.32 services, including, but not limited to, short-stay residents, 329.33 persons with behavioral problems, persons with dementia, and 329.34 persons who are members of minority groups. 329.35 The tools must be identified and applied, to the extent 329.36 possible, without requiring providers to supply information 330.1 beyond current state and federal requirements. 330.2 Subd. 3. [CONSUMER SURVEYS.] Following identification of 330.3 the quality measurement tool, the commissioners shall conduct 330.4 surveys of long-term care service consumers to develop quality 330.5 profiles of providers. To the extent possible, surveys must be 330.6 conducted face-to-face by state employees or contractors. At 330.7 the discretion of the commissioners, surveys may be conducted by 330.8 telephone or by provider staff. Surveys must be conducted 330.9 periodically to update quality profiles of individual service 330.10 providers. 330.11 Subd. 4. [DISSEMINATION OF QUALITY PROFILES.] By July 1, 330.12 2002, the commissioners shall implement a system to disseminate 330.13 the quality profiles developed from consumer surveys using the 330.14 quality measurement tool. Profiles must be disseminated to the 330.15 Senior LinkAge line and to consumers, providers, and purchasers 330.16 of long-term care services through all feasible printed and 330.17 electronic outlets. The commissioners shall conduct a public 330.18 awareness campaign to inform potential users regarding profile 330.19 contents and potential uses. 330.20 Sec. 21. Minnesota Statutes 2000, section 256B.431, 330.21 subdivision 17, is amended to read: 330.22 Subd. 17. [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.] 330.23 (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3, 330.24 for rate periods beginning on October 1, 1992, and for rate 330.25 years beginning after June 30, 1993, a nursing facility that (1) 330.26 has completed a construction project approved under section 330.27 144A.071, subdivision 4a, clause (m); (2) has completed a 330.28 construction project approved under section 144A.071, 330.29 subdivision 4a, and effective after June 30, 1995; or (3) has 330.30 completed a renovation, replacement, or upgrading project 330.31 approved under the moratorium exception process in section 330.32 144A.073 shall be reimbursed for costs directly identified to 330.33 that project as provided in subdivision 16 and this subdivision. 330.34 (b) Notwithstanding Minnesota Rules, part 9549.0060, 330.35 subparts 5, item A, subitems (1) and (3), and 7, item D, 330.36 allowable interest expense on debt shall include: 331.1 (1) interest expense on debt related to the cost of 331.2 purchasing or replacing depreciable equipment, excluding 331.3 vehicles, not to exceed six percent of the total historical cost 331.4 of the project; and 331.5 (2) interest expense on debt related to financing or 331.6 refinancing costs, including costs related to points, loan 331.7 origination fees, financing charges, legal fees, and title 331.8 searches; and issuance costs including bond discounts, bond 331.9 counsel, underwriter's counsel, corporate counsel, printing, and 331.10 financial forecasts. Allowable debt related to items in this 331.11 clause shall not exceed seven percent of the total historical 331.12 cost of the project. To the extent these costs are financed, 331.13 the straight-line amortization of the costs in this clause is 331.14 not an allowable cost; and 331.15 (3) interest on debt incurred for the establishment of a 331.16 debt reserve fund, net of the interest earned on the debt 331.17 reserve fund. 331.18 (c) Debt incurred for costs under paragraph (b) is not 331.19 subject to Minnesota Rules, part 9549.0060, subpart 5, item A, 331.20 subitem (5) or (6). 331.21 (d) The incremental increase in a nursing facility's rental 331.22 rate, determined under Minnesota Rules, parts 9549.0010 to 331.23 9549.0080, and this section, resulting from the acquisition of 331.24 allowable capital assets, and allowable debt and interest 331.25 expense under this subdivision shall be added to its 331.26 property-related payment rate and shall be effective on the 331.27 first day of the month following the month in which the 331.28 moratorium project was completed. 331.29 (e) Notwithstanding subdivision 3f, paragraph (a), for rate 331.30 periods beginning on October 1, 1992, and for rate years 331.31 beginning after June 30, 1993, the replacement-costs-new per bed 331.32 limit to be used in Minnesota Rules, part 9549.0060, subpart 4, 331.33 item B, for a nursing facility that has completed a renovation, 331.34 replacement, or upgrading project that has been approved under 331.35 the moratorium exception process in section 144A.073, or that 331.36 has completed an addition to or replacement of buildings, 332.1 attached fixtures, or land improvements for which the total 332.2 historical cost exceeds the lesser of $150,000 or ten percent of 332.3 the most recent appraised value, must be $47,500 per licensed 332.4 bed in multiple-bed rooms and $71,250 per licensed bed in a 332.5 single-bed room. These amounts must be adjusted annually as 332.6 specified in subdivision 3f, paragraph (a), beginning January 1, 332.7 1993. 332.8 (f) For purposes of this paragraph, a total replacement 332.9 means the complete replacement of the nursing facility's 332.10 physical plant through the construction of a new physical plant, 332.11 the transfer of the nursing facility's license from one physical 332.12 plant location to another, or a new building addition to 332.13 relocate beds from three- and four-bed wards. For total 332.14 replacement projects completed on or after July 1, 1992, the 332.15 commissioner shall compute the incremental change in the nursing 332.16 facility's rental per diem, for rate years beginning on or after 332.17 July 1, 1995, by replacing its appraised value, including the 332.18 historical capital asset costs, and the capital debt and 332.19 interest costs with the new nursing facility's allowable capital 332.20 asset costs and the related allowable capital debt and interest 332.21 costs. If the new nursing facility has decreased its licensed 332.22 capacity, the aggregate investment per bed limit in subdivision 332.23 3a, paragraph (c), shall apply. If the new nursing facility has 332.24 retained a portion of the original physical plant for nursing 332.25 facility usage, then a portion of the appraised value prior to 332.26 the replacement must be retained and included in the calculation 332.27 of the incremental change in the nursing facility's rental per 332.28 diem. For purposes of this part, the original nursing facility 332.29 means the nursing facility prior to the total replacement 332.30 project. The portion of the appraised value to be retained 332.31 shall be calculated according to clauses (1) to (3): 332.32 (1) The numerator of the allocation ratio shall be the 332.33 square footage of the area in the original physical plant which 332.34 is being retained for nursing facility usage. 332.35 (2) The denominator of the allocation ratio shall be the 332.36 total square footage of the original nursing facility physical 333.1 plant. 333.2 (3) Each component of the nursing facility's allowable 333.3 appraised value prior to the total replacement project shall be 333.4 multiplied by the allocation ratio developed by dividing clause 333.5 (1) by clause (2). 333.6 In the case of either type of total replacement as 333.7 authorized under section 144A.071 or 144A.073, the provisions of 333.8 this subdivision shall also apply. For purposes of the 333.9 moratorium exception authorized under section 144A.071, 333.10 subdivision 4a, paragraph (s), if the total replacement involves 333.11 the renovation and use of an existing health care facility 333.12 physical plant, the new allowable capital asset costs and 333.13 related debt and interest costs shall include first the 333.14 allowable capital asset costs and related debt and interest 333.15 costs of the renovation, to which shall be added the allowable 333.16 capital asset costs of the existing physical plant prior to the 333.17 renovation, and if reported by the facility, the related 333.18 allowable capital debt and interest costs. 333.19 (g) Notwithstanding Minnesota Rules, part 9549.0060, 333.20 subpart 11, item C, subitem (2), for a total replacement, as 333.21 defined in paragraph (f), authorized under section 144A.071 or 333.22 144A.073 after July 1, 1999, or any building project that is a 333.23 relocation, renovation, upgrading, or conversionauthorized333.24under section 144A.073,completed on or after July 1, 2001, the 333.25 replacement-costs-new per bed limit shall be $74,280 per 333.26 licensed bed in multiple-bed rooms, $92,850 per licensed bed in 333.27 semiprivate rooms with a fixed partition separating the resident 333.28 beds, and $111,420 per licensed bed in single rooms. Minnesota 333.29 Rules, part 9549.0060, subpart 11, item C, subitem (2), does not 333.30 apply. These amounts must be adjusted annually as specified in 333.31 subdivision 3f, paragraph (a), beginning January 1, 2000. 333.32 (h) For a total replacement, as defined in paragraph (f), 333.33 authorized under section 144A.073 for a 96-bed nursing home in 333.34 Carlton county, the replacement-costs-new per bed limit shall be 333.35 $74,280 per licensed bed in multiple-bed rooms, $92,850 per 333.36 licensed bed in semiprivate rooms with a fixed partition 334.1 separating the resident's beds, and $111,420 per licensed bed in 334.2 a single room. Minnesota Rules, part 9549.0060, subpart 11, 334.3 item C, subitem (2), does not apply. The resulting maximum 334.4 allowable replacement-costs-new multiplied by 1.25 shall 334.5 constitute the project's dollar threshold for purposes of 334.6 application of the limit set forth in section 144A.071, 334.7 subdivision 2. The commissioner of health may waive the 334.8 requirements of section 144A.073, subdivision 3b, paragraph (b), 334.9 clause (2), on the condition that the other requirements of that 334.10 paragraph are met. 334.11 (i) For a renovation authorized under section 144A.073 for 334.12 a 65-bed nursing home in St. Louis county, the incremental 334.13 increase in rental rate for purposes of paragraph (d) shall be 334.14 $8.16, and the total replacement cost, allowable appraised 334.15 value, allowable debt, and allowable interest shall be increased 334.16 according to the incremental increase. 334.17 (j) For a total replacement, as defined in paragraph (f), 334.18 authorized under section 144A.073 involving a new building 334.19 addition that relocates beds from three-bed wards for an 80-bed 334.20 nursing home in Redwood county, the replacement-costs-new per 334.21 bed limit shall be $74,280 per licensed bed for multiple-bed 334.22 rooms; $92,850 per licensed bed for semiprivate rooms with a 334.23 fixed partition separating the beds; and $111,420 per licensed 334.24 bed for single rooms. These amounts shall be adjusted annually, 334.25 beginning January 1, 2001. Minnesota Rules, part 9549.0060, 334.26 subpart 11, item C, subitem (2), does not apply. The resulting 334.27 maximum allowable replacement-costs-new multiplied by 1.25 shall 334.28 constitute the project's dollar threshold for purposes of 334.29 application of the limit set forth in section 144A.071, 334.30 subdivision 2. The commissioner of health may waive the 334.31 requirements of section 144A.073, subdivision 3b, paragraph (b), 334.32 clause (2), on the condition that the other requirements of that 334.33 paragraph are met. 334.34 Sec. 22. Minnesota Statutes 2000, section 256B.431, is 334.35 amended by adding a subdivision to read: 334.36 Subd. 31. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 335.1 years beginning on or after July 1, 2001, the total payment rate 335.2 for a facility reimbursed under this section, section 256B.434, 335.3 or any other section for the first 90 days after admission shall 335.4 be: 335.5 (1) for the first 30 paid days, the rate shall be 120 335.6 percent of the facility's medical assistance rate for each case 335.7 mix class; and 335.8 (2) for the next 60 days after the first 30 paid days, the 335.9 rate shall be 110 percent of the facility's medical assistance 335.10 rate for each case mix class. 335.11 (b) Beginning with the 91st paid day after admission, the 335.12 payment rate shall be the rate otherwise determined under this 335.13 section, section 256B.434, or any other section. 335.14 (c) This subdivision applies to admissions occurring on or 335.15 after July 1, 2001. 335.16 Sec. 23. Minnesota Statutes 2000, section 256B.431, is 335.17 amended by adding a subdivision to read: 335.18 Subd. 32. [NURSING FACILITY RATE INCREASES BEGINNING JULY 335.19 1, 2001, AND JULY 1, 2002.] For the rate years beginning July 1, 335.20 2001, and July 1, 2002, the commissioner shall provide to each 335.21 nursing facility reimbursed under this section or section 335.22 256B.434 an adjustment equal to 3.0 percent of the total 335.23 operating payment rate. The operating payment rates in effect 335.24 on June 30, 2001, and June 30, 2002, respectively, shall include 335.25 the adjustment in subdivision 2i, paragraph (c). 335.26 Sec. 24. Minnesota Statutes 2000, section 256B.431, is 335.27 amended by adding a subdivision to read: 335.28 Subd. 33. [ADDITIONAL INCREASES FOR LOW RATE METROPOLITAN 335.29 AREA FACILITIES.] After the calculation of the increase for the 335.30 rate year beginning July 1, 2001, in subdivision 32, the 335.31 commissioner must provide for special increases to facilities 335.32 determined to be the lowest rate facilities in state development 335.33 region 11, as defined in section 462.385. Within this region, 335.34 the commissioner shall identify the median nursing facility rate 335.35 by case mix category for all nursing facilities under section 335.36 256B.431 or 256B.434. Nursing home rates that are below the 336.1 median for case mix class A must be adjusted to the set of case 336.2 mix rates for the facility at the median for case mix class A. 336.3 Sec. 25. Minnesota Statutes 2000, section 256B.431, is 336.4 amended by adding a subdivision to read: 336.5 Subd. 34. [RATE FLOOR FOR FACILITIES LOCATED OUTSIDE THE 336.6 METROPOLITAN AREA.] (a) For the rate year beginning July 1, 336.7 2001, the commissioner shall adjust operating costs per diem for 336.8 nursing facilities located outside of state development region 336.9 11, as defined in section 462.385, reimbursed under this section 336.10 and sections 256B.434 and 256B.435, as provided in this 336.11 subdivision. 336.12 (b) For each nursing facility, the commissioner shall 336.13 compare the operating costs per diem listed in this paragraph to 336.14 the operating costs per diem the facility would otherwise 336.15 receive for the July 1, 2001, rate year after provision of any 336.16 other rate increases required by this chapter. 336.17 Case mix classification Operating costs per diem 336.18 A $ 67.02 336.19 B $ 73.00 336.20 C $ 79.77 336.21 D $ 85.94 336.22 E $ 92.32 336.23 F $ 92.72 336.24 G $ 98.13 336.25 H $108.40 336.26 I $112.03 336.27 J $117.67 336.28 K $129.55 336.29 (c) If a facility's total reimbursement for operating 336.30 costs, using the case mix classification operating costs per 336.31 diem listed in paragraph (b), is greater than the total 336.32 reimbursement for operating costs the facility would otherwise 336.33 receive, the commissioner shall calculate operating costs per 336.34 diem for that facility for the rate year beginning July 1, 2001, 336.35 using the case mix classification operating costs per diem 336.36 listed in paragraph (b). 337.1 (d) If a facility's total reimbursement for operating 337.2 costs, using the case mix classification costs per diem listed 337.3 in paragraph (b), is less than the total reimbursement for 337.4 operating costs the facility would otherwise receive, the 337.5 commissioner shall reimburse that facility for the rate year 337.6 beginning July 1, 2001, as provided in this section, section 337.7 256B.434, or 256B.435, whichever is applicable, and shall not 337.8 calculate operating costs per diem for that facility using the 337.9 case mix classification operating costs per diem listed in 337.10 paragraph (b). 337.11 Sec. 26. Minnesota Statutes 2000, section 256B.431, is 337.12 amended by adding a subdivision to read: 337.13 Subd. 35. [EXCLUSION OF RAW FOOD COST ADJUSTMENT.] For 337.14 rate years beginning on or after July 1, 2001, in calculating a 337.15 nursing facility's operating cost per diem for the purposes of 337.16 constructing an array, determining a median, or otherwise 337.17 performing a statistical measure of nursing facility payment 337.18 rates to be used to determine future rate increases under this 337.19 section, section 256B.434, or any other section, the 337.20 commissioner shall exclude adjustments for raw food costs under 337.21 subdivision 2b, paragraph (h), that are related to providing 337.22 special diets based on religious beliefs. 337.23 Sec. 27. Minnesota Statutes 2000, section 256B.434, 337.24 subdivision 4, is amended to read: 337.25 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 337.26 nursing facilities which have their payment rates determined 337.27 under this section rather than section 256B.431, the 337.28 commissioner shall establish a rate under this subdivision. The 337.29 nursing facility must enter into a written contract with the 337.30 commissioner. 337.31 (b) A nursing facility's case mix payment rate for the 337.32 first rate year of a facility's contract under this section is 337.33 the payment rate the facility would have received under section 337.34 256B.431. 337.35 (c) A nursing facility's case mix payment rates for the 337.36 second and subsequent years of a facility's contract under this 338.1 section are the previous rate year's contract payment rates plus 338.2 an inflation adjustment and, for facilities reimbursed under 338.3 this section or section 256B.431, an adjustment to include the 338.4 cost of any increase in health department licensing fees for the 338.5 facility taking effect on or after July 1, 2001. The index for 338.6 the inflation adjustment must be based on the change in the 338.7 Consumer Price Index-All Items (United States City average) 338.8 (CPI-U) forecasted by Data Resources, Inc., as forecasted in the 338.9 fourth quarter of the calendar year preceding the rate year. 338.10 The inflation adjustment must be based on the 12-month period 338.11 from the midpoint of the previous rate year to the midpoint of 338.12 the rate year for which the rate is being determined. For the 338.13 rate years beginning on July 1, 1999,andJuly 1, 2000, July 1, 338.14 2001, and July 1, 2002, this paragraph shall apply only to the 338.15 property-related payment rate, except that adjustments to 338.16 include the cost of any increase in health department licensing 338.17 fees taking effect on or after July 1, 2001, shall be provided. 338.18 In determining the amount of the property-related payment rate 338.19 adjustment under this paragraph, the commissioner shall 338.20 determine the proportion of the facility's rates that are 338.21 property-related based on the facility's most recent cost report. 338.22 (d) The commissioner shall develop additional 338.23 incentive-based payments of up to five percent above the 338.24 standard contract rate for achieving outcomes specified in each 338.25 contract. The specified facility-specific outcomes must be 338.26 measurable and approved by the commissioner. The commissioner 338.27 may establish, for each contract, various levels of achievement 338.28 within an outcome. After the outcomes have been specified the 338.29 commissioner shall assign various levels of payment associated 338.30 with achieving the outcome. Any incentive-based payment cancels 338.31 if there is a termination of the contract. In establishing the 338.32 specified outcomes and related criteria the commissioner shall 338.33 consider the following state policy objectives: 338.34 (1) improved cost effectiveness and quality of life as 338.35 measured by improved clinical outcomes; 338.36 (2) successful diversion or discharge to community 339.1 alternatives; 339.2 (3) decreased acute care costs; 339.3 (4) improved consumer satisfaction; 339.4 (5) the achievement of quality; or 339.5 (6) any additional outcomes proposed by a nursing facility 339.6 that the commissioner finds desirable. 339.7 Sec. 28. Minnesota Statutes 2000, section 256B.434, is 339.8 amended by adding a subdivision to read: 339.9 Subd. 4c. [FACILITY RATE INCREASES EFFECTIVE JANUARY 1, 339.10 2002.] For the rate period beginning January 1, 2002, and for 339.11 the rate year beginning July 1, 2002, a nursing facility in 339.12 Morrison county licensed for 83 beds shall receive an increase 339.13 of $2.54 in each case mix payment rate to offset property tax 339.14 payments due as a result of the facility's conversion from 339.15 nonprofit to for-profit status. The increases under this 339.16 subdivision shall be added following the determination under 339.17 this chapter of the payment rate for the rate year beginning 339.18 July 1, 2001, and shall be included in the facility's total 339.19 payment rates for the purposes of determining future rates under 339.20 this section or any other section. 339.21 Sec. 29. Minnesota Statutes 2000, section 256B.434, is 339.22 amended by adding a subdivision to read: 339.23 Subd. 4d. [FACILITY RATE INCREASES EFFECTIVE JULY 1, 339.24 2001.] For the rate year beginning July 1, 2001, a nursing 339.25 facility in Hennepin county licensed for 302 beds shall receive 339.26 an increase of 29 cents in each case mix payment rate to correct 339.27 an error in the cost-reporting system that occurred prior to the 339.28 date that the facility entered the alternative payment 339.29 demonstration project. The increases under this subdivision 339.30 shall be added following the determination under this chapter of 339.31 the payment rate for the rate year beginning July 1, 2001, and 339.32 shall be included in the facility's total payment rates for the 339.33 purposes of determining future rates under this section or any 339.34 other section. 339.35 Sec. 30. Minnesota Statutes 2000, section 256B.434, is 339.36 amended by adding a subdivision to read: 340.1 Subd. 4e. [RATE INCREASE EFFECTIVE JULY 1, 2001.] A 340.2 nursing facility in Anoka county licensed for 98 beds as of July 340.3 1, 2000, shall receive an increase of $10 in each case mix rate 340.4 for the rate year beginning July 1, 2001. The increases under 340.5 this subdivision shall be added following the determination 340.6 under this chapter of the payment rate for the rate year 340.7 beginning July 1, 2001, and shall be included in the facility's 340.8 total payment rate for purposes of determining future rates 340.9 under this section or any other section through June 30, 2004. 340.10 Sec. 31. [256B.437] [IMPLEMENTATION OF A CASE MIX SYSTEM 340.11 FOR NURSING FACILITIES BASED ON THE MINIMUM DATA SET.] 340.12 Subdivision 1. [SCOPE.] This section establishes the 340.13 method and criteria used to determine resident reimbursement 340.14 classifications based upon the assessments of residents of 340.15 nursing homes and boarding care homes whose payment rates are 340.16 established under section 256B.431, 256B.434, or 256B.435. 340.17 Resident reimbursement classifications shall be established 340.18 according to the 34 group, resource utilization groups, version 340.19 III or RUG-III model as described in section 144.0724. 340.20 Reimbursement classifications established under this section 340.21 shall be implemented after June 30, 2002, but no later than 340.22 January 1, 2003. 340.23 Subd. 2. [DEFINITIONS.] For purposes of this section, the 340.24 following terms have the meanings given. 340.25 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 340.26 date" has the meaning given in section 144.0724, subdivision 2, 340.27 paragraph (a). 340.28 (b) [CASE MIX INDEX.] "Case mix index" has the meaning 340.29 given in section 144.0724, subdivision 2, paragraph (b). 340.30 (c) [INDEX MAXIMIZATION.] "Index maximization" has the 340.31 meaning given in section 144.0724, subdivision 2, paragraph (c). 340.32 (d) [MINIMUM DATA SET.] "Minimum data set" has the meaning 340.33 given in section 144.0724, subdivision 2, paragraph (d). 340.34 (e) [REPRESENTATIVE.] "Representative" has the meaning 340.35 given in section 144.0724, subdivision 2, paragraph (e). 340.36 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 341.1 utilization groups" or "RUG" has the meaning given in section 341.2 144.0724, subdivision 2, paragraph (f). 341.3 Subd. 3. [CASE MIX INDICES.] (a) The commissioner of human 341.4 services shall assign a case mix index to each resident class 341.5 based on the Health Care Financing Administration's staff time 341.6 measurement study and adjusted for Minnesota-specific wage 341.7 indices. The case mix indices assigned to each resident class 341.8 shall be published in the Minnesota State Register at least 120 341.9 days prior to the implementation of the 34 group, RUG-III 341.10 resident classification system. 341.11 (b) An index maximization approach shall be used to 341.12 classify residents. 341.13 (c) After implementation of the revised case mix system, 341.14 the commissioner of human services may annually rebase case mix 341.15 indices and base rates using more current data on average wage 341.16 rates and staff time measurement studies. This rebasing shall 341.17 be calculated under subdivision 7, paragraph (b). The 341.18 commissioner shall publish in the Minnesota State Register 341.19 adjusted case mix indices at least 45 days prior to the 341.20 effective date of the adjusted case mix indices. 341.21 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) Nursing 341.22 facilities shall conduct and submit case mix assessments 341.23 according to the schedule established by the commissioner of 341.24 health under section 144.0724, subdivisions 4 and 5. 341.25 (b) The resident reimbursement classifications established 341.26 under section 144.0724, subdivision 3, shall be effective the 341.27 day of admission for new admission assessments. The effective 341.28 date for significant change assessments shall be the assessment 341.29 reference date. The effective date for annual and second 341.30 quarterly assessments shall be the first day of the month 341.31 following assessment reference date. 341.32 Subd. 5. [NOTICE OF RESIDENT REIMBURSEMENT 341.33 CLASSIFICATION.] Nursing facilities shall provide notice to a 341.34 resident of the resident's case mix classification according to 341.35 procedures established by the commissioner of health under 341.36 section 144.0724, subdivision 7. 342.1 Subd. 6. [RECONSIDERATION OF RESIDENT CLASSIFICATION.] Any 342.2 request for reconsideration of a resident classification must be 342.3 made under section 144.0724, subdivision 8. 342.4 Subd. 7. [RATE DETERMINATION UPON TRANSITION TO RUG-III 342.5 PAYMENT RATES.] (a) The commissioner of human services shall 342.6 determine payment rates at the time of transition to the RUG 342.7 based payment model in a facility-specific, budget-neutral 342.8 manner. The case mix indices as defined in subdivision 3 shall 342.9 be used to allocate the case mix adjusted component of total 342.10 payment across all case mix groups. To transition from the 342.11 current calculation methodology to the RUG based methodology, 342.12 the commissioner of health shall report to the commissioner of 342.13 human services the resident days classified according to the 342.14 categories defined in subdivision 3 for the 12-month reporting 342.15 period ending September 30, 2001, for each nursing facility. 342.16 The commissioner of human services shall use this data to 342.17 compute the standardized days for the reporting period under the 342.18 RUG system. 342.19 (b) The commissioner of human services shall determine the 342.20 case mix adjusted component of the rate as follows: 342.21 (1) determine the case mix portion of the 11 case mix rates 342.22 in effect on June 30, 2002, or the 34 case mix rates in effect 342.23 on or after June 30, 2003; 342.24 (2) multiply each amount in clause (1) by the number of 342.25 resident days assigned to each group for the reporting period 342.26 ending September 30, 2001, or the most recent year for which 342.27 data is available; 342.28 (3) compute the sum of the amounts in clause (2); 342.29 (4) determine the total RUG standardized days for the 342.30 reporting period ending September 30, 2001, or the most recent 342.31 year for which data is available using new indices calculated 342.32 under subdivision 3, paragraph (c); 342.33 (5) divide the amount in clause (3) by the amount in clause 342.34 (4) which shall be the average case mix adjusted component of 342.35 the rate under the RUG method; and 342.36 (6) multiply this average rate by the case mix weight in 343.1 subdivision 3 for each RUG group. 343.2 (c) The noncase mix component will be allocated to each RUG 343.3 group as a constant amount to determine the transition payment 343.4 rate. Any other rate adjustments that are effective on or after 343.5 July 1, 2002, shall be applied to the transition rates 343.6 determined under this section. 343.7 Sec. 32. [256B.4371] [NURSING FACILITY VOLUNTARY CLOSURES 343.8 AND PLANNING AND DEVELOPMENT OF COMMUNITY-BASED ALTERNATIVES.] 343.9 Subdivision 1. [DEFINITIONS.] (a) The definitions in this 343.10 subdivision apply to subdivisions 2 to 9. 343.11 (b) "Closure" means the cessation of operations of a 343.12 nursing facility and delicensure and decertification of all beds 343.13 within the facility. 343.14 (c) "Commencement of closure" means the date on which 343.15 residents and designated representatives are notified of a 343.16 planned closure according to sections 144A.185 to 144A.1887 as 343.17 part of an approved closure plan. 343.18 (d) "Completion of closure" means the date on which the 343.19 final resident of the nursing facility or nursing facilities 343.20 designated for closure in an approved closure plan is discharged 343.21 from the facility or facilities. 343.22 (e) "Closure plan" means a plan to close a nursing facility 343.23 and reallocate the resulting savings to provide planned closure 343.24 rate adjustments at other facilities. 343.25 (f) "Partial closure" means the delicensure and 343.26 decertification of a portion of the beds within the facility. 343.27 (g) "Planned closure rate adjustment" means an increase in 343.28 a nursing facility's operating rates resulting from a partial 343.29 planned closure of a facility or a planned closure of another 343.30 facility. 343.31 Subd. 2. [PLANNING AND DEVELOPMENT OF COMMUNITY BASED 343.32 SERVICES.] (a) The commissioner of human services shall 343.33 establish a process to adjust the capacity and distribution of 343.34 long-term care services to equalize the supply and demand for 343.35 different types of services. This process must include 343.36 community planning, expansion or establishment of needed 344.1 services, and analysis of voluntary nursing facility closures. 344.2 (b) The purpose of this process is to support the planning 344.3 and development of community-based services. This process must 344.4 support early intervention, advocacy, and consumer protection 344.5 while providing resources and incentives for expanded county 344.6 planning and for nursing facilities to transition to meet 344.7 community needs. 344.8 (c) The process shall support and facilitate expansion of 344.9 community-based services under the county-administered 344.10 alternative care program under section 256B.0913 and waivers for 344.11 elderly under section 256B.0915, including the development of 344.12 supportive services such as housing and transportation. The 344.13 process shall utilize community assessments and planning 344.14 developed for the community health services plan and plan update 344.15 and for the community social services act plan. 344.16 (d) The addendum to the biennial plan shall be submitted 344.17 annually, beginning in 2001, and shall include recommendations 344.18 for development of community-based services. Both planning and 344.19 implementation shall be implemented within the amount of funding 344.20 made available to the county board for these purposes. 344.21 (e) The commissioner of health and the commissioner of 344.22 human services, as appropriate, shall provide available data 344.23 necessary for the county, including but not limited to data on 344.24 nursing facility bed distribution, housing with services 344.25 options, the closure of nursing facilities that occur outside of 344.26 the planned closure process, and approval of planned closures in 344.27 the county and contiguous counties. 344.28 (f) The plan, within the funding allocated, shall: 344.29 (1) identify the need for services based on demographic 344.30 data, service availability, caseload information, and provider 344.31 information; 344.32 (2) involve providers, consumers, cities, townships, 344.33 businesses, and area agencies on aging in the planning process; 344.34 (3) address the availability of alternative care and 344.35 elderly waiver services for eligible recipients; 344.36 (4) address the development of other supportive services, 345.1 such as transit, housing, and workforce and economic 345.2 development; and 345.3 (5) estimate the cost and timelines for development. 345.4 (g) The biennial plan addendum shall be coordinated with 345.5 the county mental health plan for inclusion in the community 345.6 health services plan and included as an addendum to the 345.7 community social services plan. 345.8 (h) The county board having financial responsibility for 345.9 persons present in another county shall cooperate with that 345.10 county for planning and development of services. 345.11 (i) The county board shall cooperate in planning and 345.12 development of community based services with other counties, as 345.13 necessary, and coordinate planning for long-term care services 345.14 that involve more than one county, within the funding allocated 345.15 for these purposes. 345.16 (j) The commissioners of health and human services, in 345.17 cooperation with county boards, shall report to the legislature 345.18 by February 1 of each year, beginning February 1, 2002, 345.19 regarding the development of community based services, 345.20 transition or closure of nursing facilities, and consumer 345.21 outcomes achieved, as documented by each county and reported to 345.22 the commissioner by December 31 of each year. 345.23 (k) The process established by the commissioner of human 345.24 services shall ensure: 345.25 (1) that counties consider multicounty service areas in 345.26 developing services that may impact delivery efficiencies; and 345.27 (2) review and comment by the area agencies on aging, 345.28 regional development commissions, where they exist, and other 345.29 planning agencies of the biennial plan addendum. 345.30 Subd. 3. [REQUEST FOR APPLICATIONS FOR PLANNED CLOSURE OF 345.31 NURSING FACILITIES.] (a) By July 15, 2001, the commissioner of 345.32 human services shall implement and announce a program for 345.33 closure or partial closure of nursing facilities. Names and 345.34 identifying information provided in response to the announcement 345.35 shall remain private unless approved, according to the timelines 345.36 established in the plan. The announcement must specify: 346.1 (1) the criteria that will be used by the interagency 346.2 long-term care planning committee established under section 346.3 144A.31 and the commissioner to approve or reject applications; 346.4 (2) a requirement for the submission of a letter of intent 346.5 before the submission of an application; 346.6 (3) the information that must accompany an application; 346.7 (4) a schedule for letters of intent, applications, and 346.8 consideration of applications for a minimum of four review 346.9 processes to be conducted before June 30, 2003; and 346.10 (5) that applications may combine planned closure rate 346.11 adjustments with moratorium exception funding, in which case a 346.12 single application may serve both purposes. 346.13 Between October 1, 2001, and June 30, 2003, the commissioner 346.14 shall approve planned closures of at least 5,140 nursing 346.15 facility beds, with no more than 2,070 approved for closure 346.16 prior to July 1, 2002, less the number of licensed beds in 346.17 facilities that close during the same time period without 346.18 approved closure plans or have notified the commissioner of 346.19 health of their intent to close without an approved closure plan. 346.20 (b) A facility or facilities reimbursed under section 346.21 256B.431, 256B.434, or 256B.435 with a closure plan approved by 346.22 the commissioner under subdivision 6 may assign a planned 346.23 closure rate adjustment to another facility that is not closing 346.24 or facilities that are not closing, or in the case of a partial 346.25 closure, to the facility undertaking the partial closure. A 346.26 facility may also elect to have a planned closure rate 346.27 adjustment shared equally by the five nursing facilities with 346.28 the lowest total operating payment rates in the state 346.29 development region, designated under section 462.385, in which 346.30 the facility receiving the planned closure rate adjustment is 346.31 located. The planned closure rate adjustment must be calculated 346.32 under subdivision 7. A planned closure rate adjustment under 346.33 this section is effective on the first day of the month 346.34 following completion of closure of all facilities designated for 346.35 closure in the application and becomes part of the nursing 346.36 facility's total operating payment rate. 347.1 Applicants may use the planned closure rate adjustment to 347.2 allow for a property payment for a new nursing facility or an 347.3 addition to an existing nursing facility. Applications approved 347.4 under this paragraph are exempt from other requirements for 347.5 moratorium exceptions under section 144A.073, subdivisions 2 and 347.6 3. 347.7 Facilities without a closure plan, or whose closure plan is 347.8 not approved by the commissioner, are not eligible for a planned 347.9 closure rate adjustment under subdivision 7. However, the 347.10 commissioner shall calculate the amount the facility would have 347.11 received under subdivision 7 and shall use this amount to 347.12 provide equal rate adjustments to the five nursing facilities 347.13 with the lowest total operating payment rates in the state 347.14 development region, designated under section 462.385, in which 347.15 the facility is located. 347.16 (c) To be considered for approval, an application must 347.17 include: 347.18 (1) a description of the proposed closure plan, which must 347.19 include identification of the facility or facilities to receive 347.20 a planned closure rate adjustment and the amount and timing of a 347.21 planned closure rate adjustment proposed for each facility; 347.22 (2) the proposed timetable for any proposed closure, 347.23 including the proposed dates for announcement to residents, 347.24 commencement of closure, and completion of closure; 347.25 (3) the proposed relocation plan for current residents of 347.26 any facility designated for closure. The proposed relocation 347.27 plan must be designed to comply with all applicable state and 347.28 federal statutes and regulations, including, but not limited to, 347.29 section 144A.16 and Minnesota Rules, parts 4655.6810 to 347.30 4655.6830, 4658.1600 to 4658.1690, and 9546.0010 to 9546.0060; 347.31 (4) a description of the relationship between the nursing 347.32 facility that is proposed for closure and the nursing facility 347.33 or facilities proposed to receive the planned closure rate 347.34 adjustment. If these facilities are not under common ownership, 347.35 copies of any contracts, purchase agreements, or other documents 347.36 establishing a relationship or proposed relationship must be 348.1 provided; 348.2 (5) documentation, in a format approved by the 348.3 commissioner, that all the nursing facilities receiving a 348.4 planned closure rate adjustment under the plan have accepted 348.5 joint and several liability for recovery of overpayments under 348.6 section 256B.0641, subdivision 2, for the facilities designated 348.7 for closure under the plan; and 348.8 (6) an explanation of how the application coordinates with 348.9 planning efforts under subdivision 2. 348.10 (d) The application must address the criteria listed in 348.11 subdivision 4. 348.12 Subd. 4. [CRITERIA FOR REVIEW OF APPLICATION.] In 348.13 reviewing and approving closure proposals, the commissioner 348.14 shall consider, but not be limited to, the following criteria: 348.15 (1) improved quality of care and quality of life for 348.16 consumers; 348.17 (2) closure of a nursing facility that has a poor physical 348.18 plant; 348.19 (3) the existence of excess nursing facility beds, measured 348.20 in terms of beds per thousand persons aged 85 or older. The 348.21 excess must be measured in reference to: 348.22 (i) the county in which the facility is located; 348.23 (ii) the county and all contiguous counties; 348.24 (iii) the region in which the facility is located; or 348.25 (iv) the facility's service area. 348.26 The facility shall indicate in its proposal the area it believes 348.27 is appropriate for this measurement. A facility in a county 348.28 that is in the lowest quartile of counties with reference to 348.29 beds per thousand persons aged 85 or older is not in an area of 348.30 excess capacity; 348.31 (4) low-occupancy rates, provided that the unoccupied beds 348.32 are not the result of a personnel shortage. In analyzing 348.33 occupancy rates, the commissioner shall examine waiting lists in 348.34 the applicant facility and at facilities in the surrounding 348.35 area, as determined under clause (3); 348.36 (5) evidence of a community planning process to determine 349.1 what services are needed and ensure that needed services are 349.2 established; 349.3 (6) innovative use of reinvestment funds; 349.4 (7) innovative use planned for the closed facility's 349.5 physical plant; 349.6 (8) evidence that the proposal serves the interests of the 349.7 state; and 349.8 (9) evidence of other factors that affect the viability of 349.9 the facility, including excessive nursing pool costs. 349.10 Subd. 5. [REVIEW AND APPROVAL OF PROPOSALS.] (a) The 349.11 interagency long-term care planning committee may recommend that 349.12 the commissioner of human services grant approval, within the 349.13 limits established in subdivision 3, paragraph (a), to 349.14 applications that satisfy the requirements of this section. The 349.15 interagency committee may appoint an advisory review panel 349.16 composed of representatives of counties, SAIL projects, 349.17 consumers, and providers to review proposals and provide 349.18 comments and recommendations to the committee. The 349.19 commissioners of human services and health shall provide staff 349.20 and technical assistance to the committee for the review and 349.21 analysis of proposals. The commissioners of human services and 349.22 health shall jointly approve or disapprove an application within 349.23 30 days after receiving the committee's recommendations. 349.24 (b) Approval of a planned closure expires 18 months after 349.25 approval by the commissioner of human services, unless 349.26 commencement of closure has begun. 349.27 (c) The commissioner of human services may change any 349.28 provision of the application to which all parties agree. 349.29 Subd. 6. [PLANNED CLOSURE RATE ADJUSTMENT.] The 349.30 commissioner of human services shall calculate the amount of the 349.31 planned closure rate adjustment available under subdivision 3, 349.32 paragraph (b), according to clauses (1) to (4): 349.33 (1) the amount available is the net reduction of nursing 349.34 facility beds multiplied by $2,080; 349.35 (2) the total number of beds in the nursing facility 349.36 receiving the planned closure rate adjustment must be 350.1 identified; 350.2 (3) capacity days are determined by multiplying the number 350.3 determined under clause (2) by 365; and 350.4 (4) the planned closure rate adjustment is the amount 350.5 available in clause (1), divided by capacity days determined 350.6 under clause (3). 350.7 Subd. 7. [OTHER RATE ADJUSTMENTS.] Facilities receiving 350.8 planned closure rate adjustments remain eligible for any 350.9 applicable rate adjustments provided under section 256B.431, 350.10 256B.434, or any other section. 350.11 Subd. 8. [COUNTY COSTS.] The commissioner of human 350.12 services shall allocate up to $500 per nursing facility bed that 350.13 is closing, within the limits of the appropriation specified for 350.14 this purpose, to be used for relocation costs incurred by 350.15 counties for planned closures under this section or resident 350.16 relocation under sections 144A.185 to 144A.1887. To be eligible 350.17 for this allocation, a county in which a nursing facility closes 350.18 must provide to the commissioner a detailed statement in a form 350.19 provided by the commissioner of additional costs, not to exceed 350.20 $500 per bed closed, that are directly incurred related to the 350.21 county's required role in the relocation process. 350.22 Sec. 33. Minnesota Statutes 2000, section 256B.501, is 350.23 amended by adding a subdivision to read: 350.24 Subd. 14. [ICF/MR RATE INCREASES BEGINNING JULY 1, 2001, 350.25 AND JULY 1, 2002.] (a) For the rate periods beginning July 1, 350.26 2001, and July 1, 2002, the commissioner shall make available to 350.27 each facility reimbursed under this section, section 256B.5011, 350.28 and Laws 1993, First Special Session chapter 1, article 4, 350.29 section 11, an adjustment to the total operating payment rate of 350.30 3.0 percent. 350.31 (b) For each facility, the commissioner shall determine the 350.32 payment rate adjustment using the percentage specified in 350.33 paragraph (a) multiplied by the total operating payment rate in 350.34 effect on the last day of the prior rate year, and dividing the 350.35 resulting amount by the facility's actual resident days. The 350.36 total operating payment rate shall include the adjustment 351.1 provided in subdivision 12. 351.2 (c) Any facility whose payment rates are governed by 351.3 closure agreements, receivership agreements, or Minnesota Rules, 351.4 part 9553.0075, is not eligible for an adjustment otherwise 351.5 granted under this subdivision. 351.6 Sec. 34. Minnesota Statutes 2000, section 256B.76, is 351.7 amended to read: 351.8 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 351.9 (a) Effective for services rendered on or after October 1, 351.10 1992, the commissioner shall make payments for physician 351.11 services as follows: 351.12 (1) payment for level one Health Care Finance 351.13 Administration's common procedural coding system (HCPCS) codes 351.14 titled "office and other outpatient services," "preventive 351.15 medicine new and established patient," "delivery, antepartum, 351.16 and postpartum care," "critical care,"Caesareancesarean 351.17 delivery and pharmacologic management provided to psychiatric 351.18 patients, and HCPCS level three codes for enhanced services for 351.19 prenatal high risk, shall be paid at the lower of (i) submitted 351.20 charges, or (ii) 25 percent above the rate in effect on June 30, 351.21 1992. If the rate on any procedure code within these categories 351.22 is different than the rate that would have been paid under the 351.23 methodology in section 256B.74, subdivision 2, then the larger 351.24 rate shall be paid; 351.25 (2) payments for all other services shall be paid at the 351.26 lower of (i) submitted charges, or (ii) 15.4 percent above the 351.27 rate in effect on June 30, 1992; 351.28 (3) all physician rates shall be converted from the 50th 351.29 percentile of 1982 to the 50th percentile of 1989, less the 351.30 percent in aggregate necessary to equal the above increases 351.31 except that payment rates for home health agency services shall 351.32 be the rates in effect on September 30, 1992; 351.33 (4) effective for services rendered on or after January 1, 351.34 2000, payment rates for physician and professional services 351.35 shall be increased by three percent over the rates in effect on 351.36 December 31, 1999, except for home health agency and family 352.1 planning agency services; and 352.2 (5) the increases in clause (4) shall be implemented 352.3 January 1, 2000, for managed care. 352.4 (b) Effective for services rendered on or after October 1, 352.5 1992, the commissioner shall make payments for dental services 352.6 as follows: 352.7 (1) dental services shall be paid at the lower of (i) 352.8 submitted charges, or (ii) 25 percent above the rate in effect 352.9 on June 30, 1992; 352.10 (2) dental rates shall be converted from the 50th 352.11 percentile of 1982 to the 50th percentile of 1989, less the 352.12 percent in aggregate necessary to equal the above increases; 352.13 (3) effective for services rendered on or after January 1, 352.14 2000, payment rates for dental services shall be increased by 352.15 three percent over the rates in effect on December 31, 1999; 352.16 (4) the commissioner shall award grants to community 352.17 clinics or other nonprofit community organizations, political 352.18 subdivisions, professional associations, or other organizations 352.19 that demonstrate the ability to provide dental services 352.20 effectively to public program recipients. Grants may be used to 352.21 fund the costs related to coordinating access for recipients, 352.22 developing and implementing patient care criteria, upgrading or 352.23 establishing new facilities, acquiring furnishings or equipment, 352.24 recruiting new providers, or other development costs that will 352.25 improve access to dental care in a region. In awarding grants, 352.26 the commissioner shall give priority to applicants that plan to 352.27 serve areas of the state in which the number of dental providers 352.28 is not currently sufficient to meet the needs of recipients of 352.29 public programs or uninsured individuals. The commissioner 352.30 shall consider the following in awarding the grants: (i) 352.31 potential to successfully increase access to an underserved 352.32 population; (ii) the ability to raise matching funds; (iii) the 352.33 long-term viability of the project to improve access beyond the 352.34 period of initial funding; (iv) the efficiency in the use of the 352.35 funding; and (v) the experience of the proposers in providing 352.36 services to the target population. 353.1 The commissioner shall monitor the grants and may terminate 353.2 a grant if the grantee does not increase dental access for 353.3 public program recipients. The commissioner shall consider 353.4 grants for the following: 353.5 (i) implementation of new programs or continued expansion 353.6 of current access programs that have demonstrated success in 353.7 providing dental services in underserved areas; 353.8 (ii) a pilot program for utilizing hygienists outside of a 353.9 traditional dental office to provide dental hygiene services; 353.10 and 353.11 (iii) a program that organizes a network of volunteer 353.12 dentists, establishes a system to refer eligible individuals to 353.13 volunteer dentists, and through that network provides donated 353.14 dental care services to public program recipients or uninsured 353.15 individuals. 353.16 (5) beginning October 1, 1999, the payment for tooth 353.17 sealants and fluoride treatments shall be the lower of (i) 353.18 submitted charge, or (ii) 80 percent of median 1997 charges; and 353.19 (6) the increases listed in clauses (3) and (5) shall be 353.20 implemented January 1, 2000, for managed care. 353.21 (c) An entity that operates both a Medicare certified 353.22 comprehensive outpatient rehabilitation facility and a facility 353.23 which was certified prior to January 1, 1993, that is licensed 353.24 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 353.25 whom at least 33 percent of the clients receiving rehabilitation 353.26 services and mental health services in the most recent calendar 353.27 year are medical assistance recipients, shall be reimbursed by 353.28 the commissioner for rehabilitation services and mental health 353.29 services at rates that are 38 percent greater than the maximum 353.30 reimbursement rate allowed under paragraph (a), clause (2), when 353.31 those services are (1) provided within the comprehensive 353.32 outpatient rehabilitation facility and (2) provided to residents 353.33 of nursing facilities owned by the entity. 353.34 Sec. 35. Laws 1995, chapter 207, article 3, section 21, as 353.35 amended by Laws 1999, chapter 245, article 3, section 43, is 353.36 amended to read: 354.1 Sec. 21. [FACILITY CERTIFICATION.] 354.2 (a) Notwithstanding Minnesota Statutes, section 252.291, 354.3 subdivisions 1 and 2, the commissioner of health shall inspect 354.4 to certify a large community-based facility currently licensed 354.5 under Minnesota Rules, parts 9525.0215 to 9525.0355, for more 354.6 than 16 beds and located in Northfield. The facility may be 354.7 certified for up to 44 beds. The commissioner of health must 354.8 inspect to certify the facility as soon as possible after the 354.9 effective date of this section. The commissioner of human 354.10 services shall work with the facility and affected counties to 354.11 relocate any current residents of the facility who do not meet 354.12 the admission criteria for an ICF/MR. Until January 1, 1999, in 354.13 order to fund the ICF/MR services and relocations of current 354.14 residents authorized, the commissioner of human services may 354.15 transfer on a quarterly basis to the medical assistance account 354.16 from each affected county's community social service allocation, 354.17 an amount equal to the state share of medical assistance 354.18 reimbursement for the residential and day habilitation services 354.19 funded by medical assistance and provided to clients for whom 354.20 the county is financially responsible. 354.21 (b) After January 1, 1999, the commissioner of human 354.22 services shall fund the services under the state medical 354.23 assistance program and may transfer on a quarterly basis to the 354.24 medical assistance account from each affected county's community 354.25 social service allocation, an amount equal to one-half of the 354.26 state share of medical assistance reimbursement for the 354.27 residential and day habilitation services funded by medical 354.28 assistance and provided to clients for whom the county is 354.29 financially responsible. 354.30 (c) Effective July 1, 2001, the commissioner of human 354.31 services shall fund the entire state share of medical assistance 354.32 reimbursement for the residential and day habilitation services 354.33 funded by medical assistance and provided to clients for whom 354.34 counties are financially responsible from the medical assistance 354.35 account, and shall not make any transfer from the community 354.36 social service allocations of affected counties. 355.1 (d) For nonresidents of Minnesota seeking admission to the 355.2 facility, Rice county shall be notified in order to assure that 355.3 appropriate funding is guaranteed from their state or country of 355.4 residence. 355.5 Sec. 36. Laws 1999, chapter 245, article 3, section 45, as 355.6 amended by Laws 2000, chapter 312, section 3, is amended to read: 355.7 Sec. 45. [STATE LICENSURE CONFLICTS WITH FEDERAL 355.8 REGULATIONS.] 355.9 (a) Notwithstanding the provisions of Minnesota Rules, part 355.10 4658.0520, an incontinent resident must be checked according to 355.11 a specific time interval written in the resident's care plan. 355.12 The resident's attending physician must authorize in writing any 355.13 interval longer than two hours unless the resident, if 355.14 competent, or a family member or legally appointed conservator, 355.15 guardian, or health care agent of a resident who is not 355.16 competent, agrees in writing to waive physician involvement in 355.17 determining this interval. 355.18 (b) This section expires July 1,20012003. 355.19 Sec. 37. [DEVELOPMENT OF NEW NURSING FACILITY 355.20 REIMBURSEMENT SYSTEM.] 355.21 (a) The commissioner of human services shall develop and 355.22 report to the legislature by January 15, 2003, a system to 355.23 replace the current nursing facility reimbursement system 355.24 established under Minnesota Statutes, sections 256B.431, 355.25 256B.434, and 256B.435. 355.26 (b) The system must be developed in consultation with the 355.27 long-term care task force and with representatives of consumers, 355.28 providers, and labor unions. Within the limits of available 355.29 appropriations, the commissioner may employ consultants to 355.30 assist with this project. 355.31 (c) The new reimbursement system must: 355.32 (1) provide incentives to enhance quality of life and 355.33 quality of care; 355.34 (2) recognize cost differences in the care of different 355.35 types of populations, including subacute care and dementia care; 355.36 (3) establish rates that are sufficient without being 356.1 excessive; 356.2 (4) be affordable for the state and for private-pay 356.3 residents; 356.4 (5) be sensitive to changing conditions in the long-term 356.5 care environment; 356.6 (6) avoid creating access problems related to insufficient 356.7 funding; 356.8 (7) allow providers maximum flexibility in their business 356.9 operations; 356.10 (8) recognize the need for capital investment to improve 356.11 physical plants; and 356.12 (9) provide incentives for the development and use of 356.13 private rooms. 356.14 (d) Notwithstanding Minnesota Statutes, section 256B.435, 356.15 the commissioner must not implement a performance-based 356.16 contracting system for nursing facilities prior to July 1, 2003. 356.17 The commissioner shall continue to reimburse nursing facilities 356.18 under Minnesota Statutes, section 256B.431 or 256B.434, until 356.19 otherwise directed by law. 356.20 (e) The commissioner of human services, in consultation 356.21 with the commissioner of health, shall conduct or contract for a 356.22 time study to determine staff time being spent on various case 356.23 mix categories; recommend adjustments to the case mix weights 356.24 based on the time study data; and determine whether current 356.25 staffing standards are adequate for providing quality care based 356.26 on professional best practice and consumer experience. If the 356.27 commissioner determines the current standards are inadequate, 356.28 the commissioner shall determine an appropriate staffing 356.29 standard for the various case mix categories and the financial 356.30 implications of phasing into this standard over the next four 356.31 years. 356.32 Sec. 38. [REPORT ON STANDARDS FOR SUBACUTE CARE FACILITY 356.33 LICENSURE.] 356.34 By January 15, 2003, the commissioner of health shall 356.35 submit a report to the legislature on implementation of a 356.36 licensure program for subacute care. This report must include: 357.1 (1) definitions of subacute care and applicability of the 357.2 proposed licensure program to various types of licensed 357.3 facilities; 357.4 (2) an analysis of whether specific standards for subacute 357.5 levels of care need to be developed and the potential for 357.6 increased costs for existing providers of subacute care; 357.7 (3) recommendations on the applicability of the nursing 357.8 home moratorium law to the licensure of subacute care facilities 357.9 or programs; 357.10 (4) identification of federal regulations guiding the 357.11 provision of subacute care and whether further state standards 357.12 are needed; and 357.13 (5) identification of current and potential reimbursement 357.14 for subacute care under Medicare, Medicaid, or managed care 357.15 programs. 357.16 Sec. 39. [REGULATORY FLEXIBILITY.] 357.17 (a) By July 1, 2001, the commissioners of health and human 357.18 services shall: 357.19 (1) develop a summary of federal nursing facility and 357.20 community long-term care regulations that hamper state 357.21 flexibility and place burdens on the goal of achieving 357.22 high-quality care and optimum outcomes for consumers of 357.23 services; and 357.24 (2) share this summary with the legislature, other states, 357.25 national groups that advocate for state interests with Congress, 357.26 and the Minnesota congressional delegation. 357.27 (b) The commissioners shall conduct ongoing follow-up with 357.28 the entities to which this summary is provided and with the 357.29 health care financing administration to achieve maximum 357.30 regulatory flexibility, including the possibility of pilot 357.31 projects to demonstrate regulatory flexibility on less than a 357.32 statewide basis. 357.33 Sec. 40. [REPORT.] 357.34 By January 15, 2003, the commissioner of health and the 357.35 commissioner of human services shall report to the senate health 357.36 and family security committee and the house health and human 358.1 services policy committee on the number of closures that have 358.2 taken place under Minnesota Statutes, section 256B.437, and any 358.3 other nursing facility closures that may have taken place, 358.4 alternatives to nursing facility care that have been developed, 358.5 any problems with access to long-term care services that have 358.6 resulted, and any recommendations for continuation of the 358.7 regional long-term care planning process and the closure process 358.8 after June 30, 2003. 358.9 Sec. 41. [NURSING ASSISTANT; HOME HEALTH AIDE CURRICULUM.] 358.10 By January 1, 2003, the commissioner of health, in 358.11 consultation with long-term care consumers, advocates, unions, 358.12 and trade associations, shall present to the chairs of the 358.13 legislative committees dealing with health care policy 358.14 recommendations for updating the nursing assistant and home 358.15 health aide curriculum (1998 edition) to help students learn 358.16 front-line survival skills that support job motivation and 358.17 satisfaction. These skills include, but are not limited to, 358.18 working with challenging behaviors, communication skills, stress 358.19 management including the impact of personal life stress in the 358.20 work setting, building relationships with families, cultural 358.21 competencies, and working with death and dying. 358.22 Sec. 42. [EVALUATION OF REPORTING REQUIREMENTS.] 358.23 The commissioners of human services and health, in 358.24 consultation with interested parties, shall evaluate long-term 358.25 care provider reporting requirements, balancing the need for 358.26 public accountability with the need to reduce unnecessary 358.27 paperwork, and shall eliminate unnecessary reporting 358.28 requirements, seeking any necessary changes in federal and state 358.29 law. The commissioners shall present a progress report by 358.30 February 1, 2002, to the chairs of the house and senate 358.31 committees with jurisdiction over health and human services 358.32 policy and finance. 358.33 Sec. 43. [NURSING FACILITY MULTIPLE SCLEROSIS PILOT 358.34 PROJECT.] 358.35 (a) For the period from July 1, 2001, to June 30, 2003, the 358.36 commissioner of human services shall establish and implement a 359.1 pilot project to contract with nursing facilities eligible to 359.2 receive medical assistance payments that, at the time of 359.3 enrollment in the pilot project, serve ten or more persons with 359.4 a diagnosis of multiple sclerosis. The commissioner shall 359.5 negotiate a payment rate with eligible facilities to provide 359.6 services to persons with multiple sclerosis that must not exceed 359.7 150 percent of the person's case mix classification payment rate 359.8 for that facility. The commissioner may contract with up to six 359.9 nursing facilities. 359.10 (b) Facilities may enroll in the pilot project between July 359.11 1, 2001, and December 31, 2001. 359.12 (c) The commissioner shall evaluate the additional payments 359.13 made under the pilot project to determine if the adjustment 359.14 enables participating facilities to adequately meet the needs 359.15 for individual care and specialized programming, including 359.16 programs to meet psychosocial, physiological, and case 359.17 management needs, without incurring financial losses. The 359.18 commissioner of human services, in consultation with the 359.19 commissioner of health, shall report to the legislature by 359.20 January 15, 2003, on the results of the project and with a 359.21 recommendation on whether the project should be made permanent. 359.22 (d) The negotiated adjustment shall not affect the payment 359.23 rate charged to private paying residents under the provisions of 359.24 Minnesota Statutes, section 256B.48, subdivision 1. 359.25 Sec. 44. [MINIMUM STAFFING STANDARDS REPORT.] 359.26 By January 15, 2002, the commissioner of health and the 359.27 commissioner of human services shall report to the legislature 359.28 on whether they should translate the minimum nurse staffing 359.29 requirement in Minnesota Statutes, section 144A.04, subdivision 359.30 7, paragraph (a), upon the transition to the RUG-III 359.31 classification system, or whether they should establish 359.32 different time-based standards, and how to accomplish either. 359.33 Sec. 45. [REPEALER.] 359.34 Minnesota Statutes 2000, sections 144.0721, subdivision 1, 359.35 and 256B.434, subdivision 5, are repealed. 359.36 ARTICLE 6 360.1 WORK FORCE 360.2 Section 1. Minnesota Statutes 2000, section 144.1464, is 360.3 amended to read: 360.4 144.1464 [SUMMER HEALTH CARE INTERNS.] 360.5 Subdivision 1. [SUMMER INTERNSHIPS.] The commissioner of 360.6 health, through a contract with a nonprofit organization as 360.7 required by subdivision 4, shall award grants to hospitalsand, 360.8 clinics, nursing facilities, and home care providers to 360.9 establish a secondary and post-secondary summer health care 360.10 intern program. The purpose of the program is to expose 360.11 interested secondary and post-secondary pupils to various 360.12 careers within the health care profession. 360.13 Subd. 2. [CRITERIA.] (a) The commissioner, through the 360.14 organization under contract, shall award grants to 360.15 hospitalsand, clinics, nursing facilities, and home care 360.16 providers that agree to: 360.17 (1) provide secondary and post-secondary summer health care 360.18 interns with formal exposure to the health care profession; 360.19 (2) provide an orientation for the secondary and 360.20 post-secondary summer health care interns; 360.21 (3) pay one-half the costs of employing the secondary and 360.22 post-secondary summer health care intern, based on an overall360.23hourly wage that is at least the minimum wage but does not360.24exceed $6 an hour; 360.25 (4) interview and hire secondary and post-secondary pupils 360.26 for a minimum of six weeks and a maximum of 12 weeks; and 360.27 (5) employ at least one secondary student for each 360.28 post-secondary student employed, to the extent that there are 360.29 sufficient qualifying secondary student applicants. 360.30 (b) In order to be eligible to be hired as a secondary 360.31 summer health intern by a hospitalor, clinic, nursing facility, 360.32 or home care provider, a pupil must: 360.33 (1) intend to complete high school graduation requirements 360.34 and be between the junior and senior year of high school; and 360.35 (2) be from a school district in proximity to the facility;360.36and361.1(3) provide the facility with a letter of recommendation361.2from a health occupations or science educator. 361.3 (c) In order to be eligible to be hired as a post-secondary 361.4 summer health care intern by a hospital or clinic, a pupil must: 361.5 (1) intend to complete a health care training program or a 361.6 two-year or four-year degree program and be planning on 361.7 enrolling in or be enrolled in that training program or degree 361.8 program; and 361.9 (2) be enrolled in a Minnesota educational institution or 361.10 be a resident of the state of Minnesota; priority must be given 361.11 to applicants from a school district or an educational 361.12 institution in proximity to the facility; and361.13(3) provide the facility with a letter of recommendation361.14from a health occupations or science educator. 361.15 (d) Hospitalsand, clinics, nursing facilities, and home 361.16 care providers awarded grants may employ pupils as secondary and 361.17 post-secondary summer health care interns beginning on or after 361.18 June 15, 1993, if they agree to pay the intern, during the 361.19 period before disbursement of state grant money, with money 361.20 designated as the facility's 50 percent contribution towards 361.21 internship costs. 361.22 Subd. 3. [GRANTS.] The commissioner, through the 361.23 organization under contract, shall award separate grants to 361.24 hospitalsand, clinics, nursing facilities, and home care 361.25 providers meeting the requirements of subdivision 2. The grants 361.26 must be used to pay one-half of the costs of employing secondary 361.27 and post-secondary pupils in a hospitalor, clinic, nursing 361.28 facility, or home care setting during the course of the 361.29 program. No more than 50 percent of the participants may be 361.30 post-secondary students, unless the program does not receive 361.31 enough qualified secondary applicants per fiscal year. No more 361.32 than five pupils may be selected from any secondary or 361.33 post-secondary institution to participate in the program and no 361.34 more than one-half of the number of pupils selected may be from 361.35 the seven-county metropolitan area. 361.36 Subd. 4. [CONTRACT.] The commissioner shall contract with 362.1 a statewide, nonprofit organization representing facilities at 362.2 which secondary and post-secondary summer health care interns 362.3 will serve, to administer the grant program established by this 362.4 section. Grant funds that are not used in one fiscal year may 362.5 be carried over to the next fiscal year. The organization 362.6 awarded the grant shall provide the commissioner with any 362.7 information needed by the commissioner to evaluate the program, 362.8 in the form and at the times specified by the commissioner. 362.9 Sec. 2. [144.1499] [PROMOTION OF HEALTH CARE AND LONG-TERM 362.10 CARE CAREERS.] 362.11 The commissioner of health, in consultation with an 362.12 organization representing health care employers, long-term care 362.13 employers, and educational institutions, may make grants to 362.14 qualifying consortia as defined in section 116L.11, subdivision 362.15 4, for intergenerational programs to encourage middle and high 362.16 school students to work and volunteer in health care and 362.17 long-term care settings. To qualify for a grant under this 362.18 section, a consortium shall: 362.19 (1) develop a health and long-term care careers curriculum 362.20 that provides career exploration and training in national skill 362.21 standards for health care and long-term care and that is 362.22 consistent with Minnesota graduation standards and other related 362.23 requirements; 362.24 (2) offer programs for high school students that provide 362.25 training in health and long-term care careers with credits that 362.26 articulate into post-secondary programs; and 362.27 (3) provide technical support to the participating health 362.28 care and long-term care employer to enable the use of the 362.29 employer's facilities and programs for K-12 health and long-term 362.30 care careers education. 362.31 Sec. 3. Minnesota Statutes 2000, section 144A.62, 362.32 subdivision 1, is amended to read: 362.33 Subdivision 1. [ASSISTANCE WITH EATING AND DRINKING.] (a) 362.34 Upon federal approval, a nursing home may employ resident 362.35 attendants to assist with the activities authorized under 362.36 subdivision 2. The resident attendantwill notshall be counted 363.1 in the minimum staffing requirements under section 144A.04, 363.2 subdivision 7. 363.3 (b) The commissioner shall submit byMayJuly 15,2000363.4 2001, a new request for a federal waiver necessary to implement 363.5 this section. 363.6 Sec. 4. Minnesota Statutes 2000, section 144A.62, 363.7 subdivision 2, is amended to read: 363.8 Subd. 2. [DEFINITION.] (a) "Resident attendant" means an 363.9 individual who assists residentsin a nursing homewiththeone 363.10 or more of the following activitiesof eating and drinking: 363.11 (1) eating and drinking; and 363.12 (2) transporting. 363.13 (b) A resident attendant does not include an individual who: 363.14 (1) is a licensed health professional or a registered 363.15 dietitian; 363.16 (2) volunteers without monetary compensation; or 363.17 (3) is a registered nursing assistant. 363.18 Sec. 5. Minnesota Statutes 2000, section 144A.62, 363.19 subdivision 3, is amended to read: 363.20 Subd. 3. [REQUIREMENTS.] (a) A nursing home may not use on 363.21 a full-time or other paid basis any individual as a resident 363.22 attendant in the nursing home unless the individual: 363.23 (1) has completed a training and competency evaluation 363.24 program encompassing thetasksactivities in subdivision 2 that 363.25 the individual provides; 363.26 (2) is competent to providefeeding and hydration services363.27 those activities; and 363.28 (3) is under the supervision of the director of nursing. 363.29 (b) A nursing home may not use a current employee as a 363.30 resident attendant unless the employee satisfies the 363.31 requirements of paragraph (a) and volunteers to be used in that 363.32 capacity. 363.33 Sec. 6. Minnesota Statutes 2000, section 144A.62, 363.34 subdivision 4, is amended to read: 363.35 Subd. 4. [EVALUATION.] The training and competency 363.36 evaluation program may be facility based. It must include, at a 364.1 minimum, the training and competency standards foreating and364.2drinking assistancethe specific activities the attendant will 364.3 be conducting contained in the nursing assistant training 364.4 curriculum. 364.5 Sec. 7. Minnesota Statutes 2000, section 148.212, is 364.6 amended to read: 364.7 148.212 [TEMPORARY PERMIT.] 364.8 Upon receipt of the applicable licensure or reregistration 364.9 fee and permit fee, and in accordance with rules of the board, 364.10 the board may issue a nonrenewable temporary permit to practice 364.11 professional or practical nursing to an applicant for licensure 364.12 or reregistration who is not the subject of a pending 364.13 investigation or disciplinary action, nor disqualified for any 364.14 other reason, under the following circumstances: 364.15 (a) The applicant for licensure by examination under 364.16 section 148.211, subdivision 1, has graduated from an approved 364.17 nursing program within the 60 days preceding board receipt of an 364.18 affidavit of graduation or transcript and has been authorized by 364.19 the board to write the licensure examination for the first time 364.20 in the United States. The permit holder must practice 364.21 professional or practical nursing under the direct supervision 364.22 of a registered nurse. The permit is valid from the date of 364.23 issue until the date the board takes action on the application 364.24 or for 60 days whichever occurs first. 364.25 (b) The applicant for licensure by endorsement under 364.26 section 148.211, subdivision 2, is currently licensed to 364.27 practice professional or practical nursing in another state, 364.28 territory, or Canadian province. The permit is valid from 364.29 submission of a proper request until the date of board action on 364.30 the application. 364.31 (c) The applicant for licensure by endorsement under 364.32 section 148.211, subdivision 2, or for reregistration under 364.33 section 148.231, subdivision 5, is currently registered in a 364.34 formal, structured refresher course or its equivalent for nurses 364.35 that includes clinical practice. 364.36 (d) The applicant for licensure by examination under 365.1 section 148.211, subdivision 1, as a registered nurse has been 365.2 issued a commission on graduates of foreign nurse schools 365.3 certificate, has completed all requirements for licensure except 365.4 the licensing examination, and has been authorized by the board 365.5 to write the licensure examination for the first time in the 365.6 United States. The permit holder must practice professional 365.7 nursing under the direct supervision of a registered nurse. The 365.8 permit is valid from the date of issue until the date the board 365.9 takes action on the application or for 60 days, whichever occurs 365.10 first. 365.11 ARTICLE 7 365.12 REGULATION OF SUPPLEMENTAL 365.13 NURSING SERVICES AGENCIES 365.14 Section 1. [144A.70] [REGISTRATION OF SUPPLEMENTAL NURSING 365.15 SERVICES AGENCIES; DEFINITIONS.] 365.16 Subdivision 1. [SCOPE.] As used in sections 144A.70 to 365.17 144A.74, the terms defined in this section have the meanings 365.18 given them. 365.19 Subd. 2. [COMMISSIONER.] "Commissioner" means the 365.20 commissioner of health. 365.21 Subd. 3. [CONTROLLING PERSON.] "Controlling person" means 365.22 a business entity, officer, program administrator, or director 365.23 whose responsibilities include the direction of the management 365.24 or policies of a supplemental nursing services agency. 365.25 Controlling person also means an individual who, directly or 365.26 indirectly, beneficially owns an interest in a corporation, 365.27 partnership, or other business association that is a controlling 365.28 person. 365.29 Subd. 4. [HEALTH CARE FACILITY.] "Health care facility" 365.30 means a hospital, boarding care home, or outpatient surgical 365.31 center licensed under sections 144.50 to 144.58, a nursing home 365.32 or home care agency licensed under this chapter, a residential 365.33 care home, or a board and lodging establishment that is 365.34 registered to provide supportive or health supervision services 365.35 under section 157.17. 365.36 Subd. 5. [PERSON.] "Person" includes an individual, firm, 366.1 corporation, partnership, or association. 366.2 Subd. 6. [SUPPLEMENTAL NURSING SERVICES 366.3 AGENCY.] "Supplemental nursing services agency" means a person, 366.4 firm, corporation, partnership, or association engaged for hire 366.5 in the business of providing or procuring temporary employment 366.6 in health care facilities for nurses, nursing assistants, nurse 366.7 aides, and orderlies. Supplemental nursing services agency does 366.8 not include an individual who only engages in providing the 366.9 individual's services on a temporary basis to health care 366.10 facilities. Supplemental nursing services agency also does not 366.11 include any nursing services agency that is limited to providing 366.12 temporary nursing personnel solely to one or more health care 366.13 facilities owned or operated by the same person, firm, 366.14 corporation, or partnership. 366.15 Sec. 2. [144A.71] [SUPPLEMENTAL NURSING SERVICES AGENCY 366.16 REGISTRATION.] 366.17 Subdivision 1. [DUTY TO REGISTER.] A person who operates a 366.18 supplemental nursing services agency shall register the agency 366.19 with the commissioner. Each separate location of the business 366.20 of a supplemental nursing services agency shall register the 366.21 agency with the commissioner. Each separate location of the 366.22 business of a supplemental nursing services agency shall have a 366.23 separate registration. 366.24 Subd. 2. [APPLICATION INFORMATION AND FEE.] The 366.25 commissioner shall establish forms and procedures for processing 366.26 each supplemental nursing services agency registration 366.27 application. An application for a supplemental nursing services 366.28 agency registration must include at least the following: 366.29 (1) the names and addresses of the owner or owners of the 366.30 supplemental nursing services agency; 366.31 (2) if the owner is a corporation, copies of its articles 366.32 of incorporation and current bylaws, together with the names and 366.33 addresses of its officers and directors; 366.34 (3) any other relevant information that the commissioner 366.35 determines is necessary to properly evaluate an application for 366.36 registration; and 367.1 (4) the annual registration fee for a supplemental nursing 367.2 services agency, which is $891. 367.3 Subd. 3. [REGISTRATION NOT TRANSFERABLE.] A registration 367.4 issued by the commissioner according to this section is 367.5 effective for a period of one year from the date of its issuance 367.6 unless the registration is revoked or suspended under section 367.7 144A.72, subdivision 2, or unless the supplemental nursing 367.8 services agency is sold or ownership or management is 367.9 transferred. When a supplemental nursing services agency is 367.10 sold or ownership or management is transferred, the registration 367.11 of the agency must be voided and the new owner or operator may 367.12 apply for a new registration. 367.13 Sec. 3. [144A.72] [REGISTRATION REQUIREMENTS.] 367.14 The commissioner shall require that, as a condition of 367.15 registration: 367.16 (1) the supplemental nursing services agency shall document 367.17 that each temporary employee provided to health care facilities 367.18 currently meets the minimum licensing, training, and continuing 367.19 education standards for the position in which the employee will 367.20 be working; 367.21 (2) the supplemental nursing services agency shall comply 367.22 with all pertinent requirements relating to the health and other 367.23 qualifications of personnel employed in health care facilities; 367.24 (3) the supplemental nursing services agency must not 367.25 restrict in any manner the employment opportunities of its 367.26 employees; 367.27 (4) the supplemental nursing services agency, when 367.28 supplying temporary employees to a health care facility, and 367.29 when requested by the facility to do so, shall agree that at 367.30 least 30 percent of the total personnel hours supplied are 367.31 during night, holiday, or weekend shifts; 367.32 (5) the supplemental nursing services agency shall carry 367.33 medical malpractice insurance to insure against the loss, 367.34 damage, or expense incident to a claim arising out of the death 367.35 or injury of any person as the result of negligence or 367.36 malpractice in the provision of health care services by the 368.1 supplemental nursing services agency or by any employee of the 368.2 agency; and 368.3 (6) the supplemental nursing services agency must not, in 368.4 any contract with any employee or health care facility, require 368.5 the payment of liquidated damages, employment fees, or other 368.6 compensation should the employee be hired as a permanent 368.7 employee of a health care facility. 368.8 Sec. 4. [144A.73] [COMPLAINT SYSTEM.] 368.9 The commissioner shall establish a system for reporting 368.10 complaints against a supplemental nursing services agency or its 368.11 employees. Complaints may be made by any member of the public. 368.12 Written complaints must be forwarded to the employer of each 368.13 person against whom a complaint is made. The employer shall 368.14 promptly report to the commissioner any corrective action taken. 368.15 Sec. 5. [144A.74] [MAXIMUM CHARGES.] 368.16 A supplemental nursing services agency must not bill or 368.17 receive payments from a nursing home licensed under this chapter 368.18 at a rate higher than 150 percent of the weighted average wage 368.19 rate for the applicable employee classification for the 368.20 geographic group to which the nursing home is assigned under 368.21 chapter 256B. The weighted average wage rates must be 368.22 determined by the commissioner of human services and reported to 368.23 the commissioner of health on an annual basis. Facilities shall 368.24 provide information necessary to determine weighted average wage 368.25 rates to the commissioner of human services in a format 368.26 requested by the commissioner. The maximum rate must include 368.27 all charges for administrative fees, contract fees, or other 368.28 special charges in addition to the hourly rates for the 368.29 temporary nursing pool personnel supplied to a nursing home. 368.30 Sec. 6. Minnesota Statutes 2000, section 245A.04, 368.31 subdivision 3, is amended to read: 368.32 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 368.33 (a) Before the commissioner issues a license, the commissioner 368.34 shall conduct a study of the individuals specified in paragraph 368.35(c)(d), clauses (1) to (5), according to rules of the 368.36 commissioner. 369.1 Beginning January 1, 1997, the commissioner shall also 369.2 conduct a study of employees providing direct contact services 369.3 for nonlicensed personal care provider organizations described 369.4 in paragraph(c)(d), clause (5). 369.5 The commissioner shall recover the cost of these background 369.6 studies through a fee of no more than $12 per study charged to 369.7 the personal care provider organization. The fees collected 369.8 under this paragraph are appropriated to the commissioner for 369.9 the purpose of conducting background studies. 369.10 Beginning August 1, 1997, the commissioner shall conduct 369.11 all background studies required under this chapter for adult 369.12 foster care providers who are licensed by the commissioner of 369.13 human services and registered under chapter 144D. The 369.14 commissioner shall conduct these background studies in 369.15 accordance with this chapter. The commissioner shall initiate a 369.16 pilot project to conduct up to 5,000 background studies under 369.17 this chapter in programs with joint licensure as home and 369.18 community-based services and adult foster care for people with 369.19 developmental disabilities when the license holder does not 369.20 reside in the foster care residence. 369.21 (b) Beginning July 1, 1998, the commissioner shall conduct 369.22 a background study on individuals specified in 369.23 paragraph(c)(d), clauses (1) to (5), who perform direct 369.24 contact services in a nursing home or a home care agency 369.25 licensed under chapter 144A or a boarding care home licensed 369.26 under sections 144.50 to 144.58, when the subject of the study 369.27 resides outside Minnesota; the study must be at least as 369.28 comprehensive as that of a Minnesota resident and include a 369.29 search of information from the criminal justice data 369.30 communications network in the state where the subject of the 369.31 study resides. 369.32 (c) Beginning August 1, 2001, the commissioner shall 369.33 conduct all background studies required under this chapter and 369.34 initiated by supplemental nursing services agencies registered 369.35 under chapter 144A. Studies for the agencies must be initiated 369.36 annually by each agency. The commissioner shall conduct the 370.1 background studies according to this chapter. The commissioner 370.2 shall recover the cost of the background studies through a fee 370.3 of no more than $8 per study, charged to the supplemental 370.4 nursing services agency. The fees collected under this 370.5 paragraph are appropriated to the commissioner for the purpose 370.6 of conducting background studies. 370.7 (d) The applicant, license holder,theregistrant, bureau 370.8 of criminal apprehension,thecommissioner of health, and county 370.9 agencies, after written notice to the individual who is the 370.10 subject of the study, shall help with the study by giving the 370.11 commissioner criminal conviction data and reports about the 370.12 maltreatment of adults substantiated under section 626.557 and 370.13 the maltreatment of minors in licensed programs substantiated 370.14 under section 626.556. The individuals to be studied shall 370.15 include: 370.16 (1) the applicant; 370.17 (2) persons over the age of 13 living in the household 370.18 where the licensed program will be provided; 370.19 (3) current employees or contractors of the applicant who 370.20 will have direct contact with persons served by the facility, 370.21 agency, or program; 370.22 (4) volunteers or student volunteers who have direct 370.23 contact with persons served by the program to provide program 370.24 services, if the contact is not directly supervised by the 370.25 individuals listed in clause (1) or (3); and 370.26 (5) any person who, as an individual or as a member of an 370.27 organization, exclusively offers, provides, or arranges for 370.28 personal care assistant services under the medical assistance 370.29 program as authorized under sections 256B.04, subdivision 16, 370.30 and 256B.0625, subdivision 19a. 370.31 The juvenile courts shall also help with the study by 370.32 giving the commissioner existing juvenile court records on 370.33 individuals described in clause (2) relating to delinquency 370.34 proceedings held within either the five years immediately 370.35 preceding the application or the five years immediately 370.36 preceding the individual's 18th birthday, whichever time period 371.1 is longer. The commissioner shall destroy juvenile records 371.2 obtained pursuant to this subdivision when the subject of the 371.3 records reaches age 23. 371.4 For purposes of this section and Minnesota Rules, part 371.5 9543.3070, a finding that a delinquency petition is proven in 371.6 juvenile court shall be considered a conviction in state 371.7 district court. 371.8 For purposes of this subdivision, "direct contact" means 371.9 providing face-to-face care, training, supervision, counseling, 371.10 consultation, or medication assistance to persons served by a 371.11 program. For purposes of this subdivision, "directly supervised" 371.12 means an individual listed in clause (1), (3), or (5) is within 371.13 sight or hearing of a volunteer to the extent that the 371.14 individual listed in clause (1), (3), or (5) is capable at all 371.15 times of intervening to protect the health and safety of the 371.16 persons served by the program who have direct contact with the 371.17 volunteer. 371.18 A study of an individual in clauses (1) to (5) shall be 371.19 conducted at least upon application for initial license or 371.20 registration and reapplication for a license or registration. 371.21 The commissioner is not required to conduct a study of an 371.22 individual at the time of reapplication for a license or if the 371.23 individual has been continuously affiliated with a foster care 371.24 provider licensed by the commissioner of human services and 371.25 registered under chapter 144D, other than a family day care or 371.26 foster care license, if: (i) a study of the individual was 371.27 conducted either at the time of initial licensure or when the 371.28 individual became affiliated with the license holder; (ii) the 371.29 individual has been continuously affiliated with the license 371.30 holder since the last study was conducted; and (iii) the 371.31 procedure described in paragraph(d)(e) has been implemented 371.32 and was in effect continuously since the last study was 371.33 conducted. For the purposes of this section, a physician 371.34 licensed under chapter 147 is considered to be continuously 371.35 affiliated upon the license holder's receipt from the 371.36 commissioner of health or human services of the physician's 372.1 background study results. For individuals who are required to 372.2 have background studies under clauses (1) to (5) and who have 372.3 been continuously affiliated with a foster care provider that is 372.4 licensed in more than one county, criminal conviction data may 372.5 be shared among those counties in which the foster care programs 372.6 are licensed. A county agency's receipt of criminal conviction 372.7 data from another county agency shall meet the criminal data 372.8 background study requirements of this section. 372.9 The commissioner may also conduct studies on individuals 372.10 specified in clauses (3) and (4) when the studies are initiated 372.11 by: 372.12 (i) personnel pool agencies; 372.13 (ii) temporary personnel agencies; 372.14 (iii) educational programs that train persons by providing 372.15 direct contact services in licensed programs; and 372.16 (iv) professional services agencies that are not licensed 372.17 and which contract with licensed programs to provide direct 372.18 contact services or individuals who provide direct contact 372.19 services. 372.20 Studies on individuals in items (i) to (iv) must be 372.21 initiated annually by these agencies, programs, and 372.22 individuals. Except for personal care provider 372.23 organizations and supplemental nursing services agencies, no 372.24 applicant, license holder, or individual who is the subject of 372.25 the study shall pay any fees required to conduct the study. 372.26 (1) At the option of the licensed facility, rather than 372.27 initiating another background study on an individual required to 372.28 be studied who has indicated to the licensed facility that a 372.29 background study by the commissioner was previously completed, 372.30 the facility may make a request to the commissioner for 372.31 documentation of the individual's background study status, 372.32 provided that: 372.33 (i) the facility makes this request using a form provided 372.34 by the commissioner; 372.35 (ii) in making the request the facility informs the 372.36 commissioner that either: 373.1 (A) the individual has been continuously affiliated with a 373.2 licensed facility since the individual's previous background 373.3 study was completed, or since October 1, 1995, whichever is 373.4 shorter; or 373.5 (B) the individual is affiliated only with a personnel pool 373.6 agency, a temporary personnel agency, an educational program 373.7 that trains persons by providing direct contact services in 373.8 licensed programs, or a professional services agency that is not 373.9 licensed and which contracts with licensed programs to provide 373.10 direct contact services or individuals who provide direct 373.11 contact services; and 373.12 (iii) the facility provides notices to the individual as 373.13 required in paragraphs (a) to(d)(e), and that the facility is 373.14 requesting written notification of the individual's background 373.15 study status from the commissioner. 373.16 (2) The commissioner shall respond to each request under 373.17 paragraph (1) with a written or electronic notice to the 373.18 facility and the study subject. If the commissioner determines 373.19 that a background study is necessary, the study shall be 373.20 completed without further request from a licensed agency or 373.21 notifications to the study subject. 373.22 (3) When a background study is being initiated by a 373.23 licensed facility or a foster care provider that is also 373.24 registered under chapter 144D, a study subject affiliated with 373.25 multiple licensed facilities may attach to the background study 373.26 form a cover letter indicating the additional facilities' names, 373.27 addresses, and background study identification numbers. When 373.28 the commissioner receives such notices, each facility identified 373.29 by the background study subject shall be notified of the study 373.30 results. The background study notice sent to the subsequent 373.31 agencies shall satisfy those facilities' responsibilities for 373.32 initiating a background study on that individual. 373.33(d)(e) If an individual who is affiliated with a program 373.34 or facility regulated by the department of human services or 373.35 department of health or who is affiliated with a nonlicensed 373.36 personal care provider organization, is convicted of a crime 374.1 constituting a disqualification under subdivision 3d, the 374.2 probation officer or corrections agent shall notify the 374.3 commissioner of the conviction. The commissioner, in 374.4 consultation with the commissioner of corrections, shall develop 374.5 forms and information necessary to implement this paragraph and 374.6 shall provide the forms and information to the commissioner of 374.7 corrections for distribution to local probation officers and 374.8 corrections agents. The commissioner shall inform individuals 374.9 subject to a background study that criminal convictions for 374.10 disqualifying crimes will be reported to the commissioner by the 374.11 corrections system. A probation officer, corrections agent, or 374.12 corrections agency is not civilly or criminally liable for 374.13 disclosing or failing to disclose the information required by 374.14 this paragraph. Upon receipt of disqualifying information, the 374.15 commissioner shall provide the notifications required in 374.16 subdivision 3a, as appropriate to agencies on record as having 374.17 initiated a background study or making a request for 374.18 documentation of the background study status of the individual. 374.19 This paragraph does not apply to family day care and child 374.20 foster care programs. 374.21(e)(f) The individual who is the subject of the study must 374.22 provide the applicant or license holder with sufficient 374.23 information to ensure an accurate study including the 374.24 individual's first, middle, and last name; home address, city, 374.25 county, and state of residence for the past five years; zip 374.26 code; sex; date of birth; and driver's license number. The 374.27 applicant or license holder shall provide this information about 374.28 an individual in paragraph(c)(d), clauses (1) to (5), on forms 374.29 prescribed by the commissioner. By January 1, 2000, for 374.30 background studies conducted by the department of human 374.31 services, the commissioner shall implement a system for the 374.32 electronic transmission of: (1) background study information to 374.33 the commissioner; and (2) background study results to the 374.34 license holder. The commissioner may request additional 374.35 information of the individual, which shall be optional for the 374.36 individual to provide, such as the individual's social security 375.1 number or race. 375.2(f)(g) Except for child foster care, adult foster care, 375.3 and family day care homes, a study must include information 375.4 related to names of substantiated perpetrators of maltreatment 375.5 of vulnerable adults that has been received by the commissioner 375.6 as required under section 626.557, subdivision 9c, paragraph 375.7 (i), and the commissioner's records relating to the maltreatment 375.8 of minors in licensed programs, information from juvenile courts 375.9 as required in paragraph(c)(d) for persons listed in paragraph 375.10(c)(d), clause (2), and information from the bureau of criminal 375.11 apprehension. For child foster care, adult foster care, and 375.12 family day care homes, the study must include information from 375.13 the county agency's record of substantiated maltreatment of 375.14 adults, and the maltreatment of minors, information from 375.15 juvenile courts as required in paragraph(c)(d) for persons 375.16 listed in paragraph(c)(d), clause (2), and information from 375.17 the bureau of criminal apprehension. The commissioner may also 375.18 review arrest and investigative information from the bureau of 375.19 criminal apprehension, the commissioner of health, a county 375.20 attorney, county sheriff, county agency, local chief of police, 375.21 other states, the courts, or the Federal Bureau of Investigation 375.22 if the commissioner has reasonable cause to believe the 375.23 information is pertinent to the disqualification of an 375.24 individual listed in paragraph(c)(d), clauses (1) to (5). The 375.25 commissioner is not required to conduct more than one review of 375.26 a subject's records from the Federal Bureau of Investigation if 375.27 a review of the subject's criminal history with the Federal 375.28 Bureau of Investigation has already been completed by the 375.29 commissioner and there has been no break in the subject's 375.30 affiliation with the license holder who initiated the background 375.31 studies. 375.32 When the commissioner has reasonable cause to believe that 375.33 further pertinent information may exist on the subject, the 375.34 subject shall provide a set of classifiable fingerprints 375.35 obtained from an authorized law enforcement agency. For 375.36 purposes of requiring fingerprints, the commissioner shall be 376.1 considered to have reasonable cause under, but not limited to, 376.2 the following circumstances: 376.3 (1) information from the bureau of criminal apprehension 376.4 indicates that the subject is a multistate offender; 376.5 (2) information from the bureau of criminal apprehension 376.6 indicates that multistate offender status is undetermined; or 376.7 (3) the commissioner has received a report from the subject 376.8 or a third party indicating that the subject has a criminal 376.9 history in a jurisdiction other than Minnesota. 376.10(g)(h) An applicant'sor, license holder's, or 376.11 registrant's failure or refusal to cooperate with the 376.12 commissioner is reasonable cause to disqualify a subject, deny a 376.13 license application or immediately suspend, suspend, or revoke a 376.14 license or registration. Failure or refusal of an individual to 376.15 cooperate with the study is just cause for denying or 376.16 terminating employment of the individual if the individual's 376.17 failure or refusal to cooperate could cause the applicant's 376.18 application to be denied or the license holder's license to be 376.19 immediately suspended, suspended, or revoked. 376.20(h)(i) The commissioner shall not consider an application 376.21 to be complete until all of the information required to be 376.22 provided under this subdivision has been received. 376.23(i)(j) No person in paragraph(c)(d), clause (1), (2), 376.24 (3), (4), or (5), who is disqualified as a result of this 376.25 section may be retained by the agency in a position involving 376.26 direct contact with persons served by the program. 376.27(j)(k) Termination of persons in paragraph(c)(d), clause 376.28 (1), (2), (3), (4), or (5), made in good faith reliance on a 376.29 notice of disqualification provided by the commissioner shall 376.30 not subject the applicant or license holder to civil liability. 376.31(k)(l) The commissioner may establish records to fulfill 376.32 the requirements of this section. 376.33(l)(m) The commissioner may not disqualify an individual 376.34 subject to a study under this section because that person has, 376.35 or has had, a mental illness as defined in section 245.462, 376.36 subdivision 20. 377.1(m)(n) An individual subject to disqualification under 377.2 this subdivision has the applicable rights in subdivision 3a, 377.3 3b, or 3c. 377.4(n)(o) For the purposes of background studies completed by 377.5 tribal organizations performing licensing activities otherwise 377.6 required of the commissioner under this chapter, after obtaining 377.7 consent from the background study subject, tribal licensing 377.8 agencies shall have access to criminal history data in the same 377.9 manner as county licensing agencies and private licensing 377.10 agencies under this chapter. 377.11 Sec. 7. [REPORT ON SUPPLEMENTAL NURSING SERVICES AGENCY 377.12 USE.] 377.13 Beginning July 1, 2001, through June 30, 2003, the 377.14 commissioner of human services shall require nursing facilities 377.15 and other providers of long-term care services to report 377.16 semiannually on the use of supplemental nursing services, in the 377.17 form and manner specified by the commissioner. The information 377.18 reported must include, but is not limited to: 377.19 (1) number of hours worked by supplemental nursing services 377.20 personnel, by job classification, for each month; 377.21 (2) payments to supplemental nursing services agencies, on 377.22 a per hour worked basis, by job classification, for each month; 377.23 and 377.24 (3) percentage of total monthly work hours provided by 377.25 supplemental nursing services agency personnel, by job 377.26 classification, for each shift and for weekdays and weekends. 377.27 ARTICLE 8 377.28 LONG-TERM CARE INSURANCE 377.29 Section 1. Minnesota Statutes 2000, section 62A.48, 377.30 subdivision 4, is amended to read: 377.31 Subd. 4. [LOSS RATIO.] The anticipated loss ratio for 377.32 long-term care policies must not be less than 65 percent for 377.33 policies issued on a group basis or 60 percent for policies 377.34 issued on an individual or mass-market basis. This subdivision 377.35 does not apply to policies issued on or after January 1, 2002, 377.36 that comply with sections 62S.021 and 62S.081. 378.1[EFFECTIVE DATE.] This section is effective the day 378.2 following final enactment. 378.3 Sec. 2. Minnesota Statutes 2000, section 62A.48, is 378.4 amended by adding a subdivision to read: 378.5 Subd. 10. [REGULATION OF PREMIUMS AND PREMIUM 378.6 INCREASES.] Policies issued under sections 62A.46 to 62A.56 on 378.7 or after January 1, 2002, must comply with sections 62S.021, 378.8 62S.081, 62S.265, and 62S.266 to the same extent as policies 378.9 issued under chapter 62S. 378.10[EFFECTIVE DATE.] This section is effective the day 378.11 following final enactment. 378.12 Sec. 3. Minnesota Statutes 2000, section 62A.48, is 378.13 amended by adding a subdivision to read: 378.14 Subd. 11. [NONFORFEITURE BENEFITS.] Policies issued under 378.15 sections 62A.46 to 62A.56 on or after January 1, 2002, must 378.16 comply with section 62S.02, subdivision 2, to the same extent as 378.17 policies issued under chapter 62S. 378.18[EFFECTIVE DATE.] This section is effective the day 378.19 following final enactment. 378.20 Sec. 4. Minnesota Statutes 2000, section 62S.01, is 378.21 amended by adding a subdivision to read: 378.22 Subd. 13a. [EXCEPTIONAL INCREASE.] (a) "Exceptional 378.23 increase" means only those premium rate increases filed by an 378.24 insurer as exceptional for which the commissioner determines 378.25 that the need for the premium rate increase is justified due to 378.26 changes in laws or rules applicable to long-term care coverage 378.27 in this state, or due to increased and unexpected utilization 378.28 that affects the majority of insurers of similar products. 378.29 (b) Except as provided in section 62S.265, exceptional 378.30 increases are subject to the same requirements as other premium 378.31 rate schedule increases. The commissioner may request a review 378.32 by an independent actuary or a professional actuarial body of 378.33 the basis for a request that an increase be considered an 378.34 exceptional increase. The commissioner, in determining that the 378.35 necessary basis for an exceptional increase exists, shall also 378.36 determine any potential offsets to higher claims costs. 379.1[EFFECTIVE DATE.] This section is effective the day 379.2 following final enactment. 379.3 Sec. 5. Minnesota Statutes 2000, section 62S.01, is 379.4 amended by adding a subdivision to read: 379.5 Subd. 17a. [INCIDENTAL.] "Incidental," as used in section 379.6 62S.265, subdivision 10, means that the value of the long-term 379.7 care benefits provided is less than ten percent of the total 379.8 value of the benefits provided over the life of the policy. 379.9 These values must be measured as of the date of issue. 379.10[EFFECTIVE DATE.] This section is effective the day 379.11 following final enactment. 379.12 Sec. 6. Minnesota Statutes 2000, section 62S.01, is 379.13 amended by adding a subdivision to read: 379.14 Subd. 23a. [QUALIFIED ACTUARY.] "Qualified actuary" means 379.15 a member in good standing of the American Academy of Actuaries. 379.16[EFFECTIVE DATE.] This section is effective the day 379.17 following final enactment. 379.18 Sec. 7. Minnesota Statutes 2000, section 62S.01, is 379.19 amended by adding a subdivision to read: 379.20 Subd. 25a. [SIMILAR POLICY FORMS.] "Similar policy forms" 379.21 means all of the long-term care insurance policies and 379.22 certificates issued by an insurer in the same long-term care 379.23 benefit classification as the policy form being considered. 379.24 Certificates of groups that meet the definition in section 379.25 62S.01, subdivision 15, clause (1), are not considered similar 379.26 to certificates or policies otherwise issued as long-term care 379.27 insurance, but are similar to other comparable certificates with 379.28 the same long-term care benefit classifications. For purposes 379.29 of determining similar policy forms, long-term care benefit 379.30 classifications are defined as follows: institutional long-term 379.31 care benefits only, noninstitutional long-term care benefits 379.32 only, or comprehensive long-term care benefits. 379.33[EFFECTIVE DATE.] This section is effective the day 379.34 following final enactment. 379.35 Sec. 8. [62S.021] [LONG-TERM CARE INSURANCE; INITIAL 379.36 FILING.] 380.1 Subdivision 1. [APPLICABILITY.] This section applies to 380.2 any long-term care policy issued in this state on or after 380.3 January 1, 2002, under this chapter or sections 62A.46 to 62A.56. 380.4 Subd. 2. [REQUIRED SUBMISSION TO COMMISSIONER.] An insurer 380.5 shall provide the following information to the commissioner 30 380.6 days prior to making a long-term care insurance form available 380.7 for sale: 380.8 (1) a copy of the disclosure documents required in section 380.9 62S.081; and 380.10 (2) an actuarial certification consisting of at least the 380.11 following: 380.12 (i) a statement that the initial premium rate schedule is 380.13 sufficient to cover anticipated costs under moderately adverse 380.14 experience and that the premium rate schedule is reasonably 380.15 expected to be sustainable over the life of the form with no 380.16 future premium increases anticipated; 380.17 (ii) a statement that the policy design and coverage 380.18 provided have been reviewed and taken into consideration; 380.19 (iii) a statement that the underwriting and claims 380.20 adjudication processes have been reviewed and taken into 380.21 consideration; and 380.22 (iv) a complete description of the basis for contract 380.23 reserves that are anticipated to be held under the form, to 380.24 include: 380.25 (A) sufficient detail or sample calculations provided so as 380.26 to have a complete depiction of the reserve amounts to be held; 380.27 (B) a statement that the assumptions used for reserves 380.28 contain reasonable margins for adverse experience; 380.29 (C) a statement that the net valuation premium for renewal 380.30 years does not increase, except for attained-age rating where 380.31 permitted; 380.32 (D) a statement that the difference between the gross 380.33 premium and the net valuation premium for renewal years is 380.34 sufficient to cover expected renewal expenses, or if such a 380.35 statement cannot be made, a complete description of the 380.36 situations in which this does not occur. An aggregate 381.1 distribution of anticipated issues may be used as long as the 381.2 underlying gross premiums maintain a reasonably consistent 381.3 relationship. If the gross premiums for certain age groups 381.4 appear to be inconsistent with this requirement, the 381.5 commissioner may request a demonstration under item (i) based on 381.6 a standard age distribution; and 381.7 (E) either a statement that the premium rate schedule is 381.8 not less than the premium rate schedule for existing similar 381.9 policy forms also available from the insurer except for 381.10 reasonable differences attributable to benefits, or a comparison 381.11 of the premium schedules for similar policy forms that are 381.12 currently available from the insurer with an explanation of the 381.13 differences. 381.14 Subd. 3. [ACTUARIAL DEMONSTRATION.] The commissioner may 381.15 request an actuarial demonstration that benefits are reasonable 381.16 in relation to premiums. The actuarial demonstration must 381.17 include either premium and claim experience on similar policy 381.18 forms, adjusted for any premium or benefit differences, relevant 381.19 and credible data from other studies, or both. If the 381.20 commissioner asks for additional information under this 381.21 subdivision, the 30-day time limit in subdivision 2 does not 381.22 include the time during which the insurer is preparing the 381.23 requested information. 381.24[EFFECTIVE DATE.] This section is effective the day 381.25 following final enactment. 381.26 Sec. 9. [62S.081] [REQUIRED DISCLOSURE OF RATING PRACTICES 381.27 TO CONSUMERS.] 381.28 Subdivision 1. [APPLICATION.] This section applies as 381.29 follows: 381.30 (a) Except as provided in paragraph (b), this section 381.31 applies to any long-term care policy or certificate issued in 381.32 this state on or after January 1, 2002. 381.33 (b) For certificates issued on or after the effective date 381.34 of this section under a policy of group long-term care insurance 381.35 as defined in section 62S.01, subdivision 15, that was in force 381.36 on the effective date of this section, this section applies on 382.1 the policy anniversary following June 30, 2002. 382.2 Subd. 2. [REQUIRED DISCLOSURES.] Other than policies for 382.3 which no applicable premium rate or rate schedule increases can 382.4 be made, insurers shall provide all of the information listed in 382.5 this subdivision to the applicant at the time of application or 382.6 enrollment, unless the method of application does not allow for 382.7 delivery at that time; in this case, an insurer shall provide 382.8 all of the information listed in this subdivision to the 382.9 applicant no later than at the time of delivery of the policy or 382.10 certificate: 382.11 (1) a statement that the policy may be subject to rate 382.12 increases in the future; 382.13 (2) an explanation of potential future premium rate 382.14 revisions and the policyholder's or certificate holder's option 382.15 in the event of a premium rate revision; 382.16 (3) the premium rate or rate schedules applicable to the 382.17 applicant that will be in effect until a request is made for an 382.18 increase; 382.19 (4) a general explanation of applying premium rate or rate 382.20 schedule adjustments that must include: 382.21 (i) a description of when premium rate or rate schedule 382.22 adjustments will be effective, for example the next anniversary 382.23 date or the next billing date; and 382.24 (ii) the right to a revised premium rate or rate schedule 382.25 as provided in clause (3) if the premium rate or rate schedule 382.26 is changed; and 382.27 (5)(i) information regarding each premium rate increase on 382.28 this policy form or similar policy forms over the past ten years 382.29 for this state or any other state that, at a minimum, identifies: 382.30 (A) the policy forms for which premium rates have been 382.31 increased; 382.32 (B) the calendar years when the form was available for 382.33 purchase; and 382.34 (C) the amount or percent of each increase. The percentage 382.35 may be expressed as a percentage of the premium rate prior to 382.36 the increase and may also be expressed as minimum and maximum 383.1 percentages if the rate increase is variable by rating 383.2 characteristics; 383.3 (ii) the insurer may, in a fair manner, provide additional 383.4 explanatory information related to the rate increases; 383.5 (iii) an insurer has the right to exclude from the 383.6 disclosure premium rate increases that apply only to blocks of 383.7 business acquired from other nonaffiliated insurers or the 383.8 long-term care policies acquired from other nonaffiliated 383.9 insurers when those increases occurred prior to the acquisition; 383.10 (iv) if an acquiring insurer files for a rate increase on a 383.11 long-term care policy form acquired from nonaffiliated insurers 383.12 or a block of policy forms acquired from nonaffiliated insurers 383.13 on or before the later of the effective date of this section, or 383.14 the end of a 24-month period following the acquisition of the 383.15 block of policies, the acquiring insurer may exclude that rate 383.16 increase from the disclosure. However, the nonaffiliated 383.17 selling company must include the disclosure of that rate 383.18 increase according to item (i); and 383.19 (v) if the acquiring insurer in item (iv) files for a 383.20 subsequent rate increase, even within the 24-month period, on 383.21 the same policy form acquired from nonaffiliated insurers or 383.22 block of policy forms acquired from nonaffiliated insurers 383.23 referenced in item (iv), the acquiring insurer shall make all 383.24 disclosures required by this subdivision, including disclosure 383.25 of the earlier rate increase referenced in item (iv). 383.26 Subd. 3. [ACKNOWLEDGMENT.] An applicant shall sign an 383.27 acknowledgment at the time of application, unless the method of 383.28 application does not allow for signature at that time, that the 383.29 insurer made the disclosure required under subdivision 2. If, 383.30 due to the method of application, the applicant cannot sign an 383.31 acknowledgment at the time of application, the applicant shall 383.32 sign no later than at the time of delivery of the policy or 383.33 certificate. 383.34 Subd. 4. [FORMS.] An insurer shall use the forms in 383.35 Appendices B and F of the Long-term Care Insurance Model 383.36 Regulation adopted by the National Association of Insurance 384.1 Commissioners to comply with the requirements of subdivisions 1 384.2 and 2. 384.3 Subd. 5. [NOTICE OF INCREASE.] An insurer shall provide 384.4 notice of an upcoming premium rate schedule increase, after the 384.5 increase has been approved by the commissioner, to all 384.6 policyholders or certificate holders, if applicable, at least 45 384.7 days prior to the implementation of the premium rate schedule 384.8 increase by the insurer. The notice must include the 384.9 information required by subdivision 2 when the rate increase is 384.10 implemented. 384.11[EFFECTIVE DATE.] This section is effective the day 384.12 following final enactment. 384.13 Sec. 10. Minnesota Statutes 2000, section 62S.26, is 384.14 amended to read: 384.15 62S.26 [LOSS RATIO.] 384.16 (a) The minimum loss ratio must be at least 60 percent, 384.17 calculated in a manner which provides for adequate reserving of 384.18 the long-term care insurance risk. In evaluating the expected 384.19 loss ratio, the commissioner shall give consideration to all 384.20 relevant factors, including: 384.21 (1) statistical credibility of incurred claims experience 384.22 and earned premiums; 384.23 (2) the period for which rates are computed to provide 384.24 coverage; 384.25 (3) experienced and projected trends; 384.26 (4) concentration of experience within early policy 384.27 duration; 384.28 (5) expected claim fluctuation; 384.29 (6) experience refunds, adjustments, or dividends; 384.30 (7) renewability features; 384.31 (8) all appropriate expense factors; 384.32 (9) interest; 384.33 (10) experimental nature of the coverage; 384.34 (11) policy reserves; 384.35 (12) mix of business by risk classification; and 384.36 (13) product features such as long elimination periods, 385.1 high deductibles, and high maximum limits. 385.2 (b) This section does not apply to policies or certificates 385.3 that are subject to sections 62S.021, 62S.081, and 62S.265, and 385.4 that comply with those sections. 385.5[EFFECTIVE DATE.] This section is effective the day 385.6 following final enactment. 385.7 Sec. 11. [62S.265] [PREMIUM RATE SCHEDULE INCREASES.] 385.8 Subdivision 1. [APPLICABILITY.] (a) Except as provided in 385.9 paragraph (b), this section applies to any long-term care policy 385.10 or certificate issued in this state on or after January 1, 2002, 385.11 under this chapter or sections 62A.46 to 62A.56. 385.12 (b) For certificates issued on or after the effective date 385.13 of this section under a group long-term care insurance policy as 385.14 defined in section 62S.01, subdivision 15, issued under this 385.15 chapter, that was in force on the effective date of this 385.16 section, this section applies on the policy anniversary 385.17 following June 30, 2002. 385.18 Subd. 2. [NOTICE.] An insurer shall file a requested 385.19 premium rate schedule increase, including an exceptional 385.20 increase, to the commissioner for prior approval at least 60 385.21 days prior to the notice to the policyholders and shall include: 385.22 (1) all information required by section 62S.081; 385.23 (2) certification by a qualified actuary that: 385.24 (i) if the requested premium rate schedule increase is 385.25 implemented and the underlying assumptions, which reflect 385.26 moderately adverse conditions, are realized, no further premium 385.27 rate schedule increases are anticipated; and 385.28 (ii) the premium rate filing complies with this section; 385.29 (3) an actuarial memorandum justifying the rate schedule 385.30 change request that includes: 385.31 (i) lifetime projections of earned premiums and incurred 385.32 claims based on the filed premium rate schedule increase and the 385.33 method and assumptions used in determining the projected values, 385.34 including reflection of any assumptions that deviate from those 385.35 used for pricing other forms currently available for sale; 385.36 (A) annual values for the five years preceding and the 386.1 three years following the valuation date must be provided 386.2 separately; 386.3 (B) the projections must include the development of the 386.4 lifetime loss ratio, unless the rate increase is an exceptional 386.5 increase; 386.6 (C) the projections must demonstrate compliance with 386.7 subdivision 3; and 386.8 (D) for exceptional increases, the projected experience 386.9 must be limited to the increases in claims expenses attributable 386.10 to the approved reasons for the exceptional increase and, if the 386.11 commissioner determines that offsets to higher claim costs may 386.12 exist, the insurer shall use appropriate net projected 386.13 experience; 386.14 (ii) disclosure of how reserves have been incorporated in 386.15 this rate increase whenever the rate increase will trigger 386.16 contingent benefit upon lapse; 386.17 (iii) disclosure of the analysis performed to determine why 386.18 a rate adjustment is necessary, which pricing assumptions were 386.19 not realized and why, and what other actions taken by the 386.20 company have been relied upon by the actuary; 386.21 (iv) a statement that policy design, underwriting, and 386.22 claims adjudication practices have been taken into 386.23 consideration; and 386.24 (v) if it is necessary to maintain consistent premium rates 386.25 for new certificates and certificates receiving a rate increase, 386.26 the insurer shall file composite rates reflecting projections of 386.27 new certificates; 386.28 (4) a statement that renewal premium rate schedules are not 386.29 greater than new business premium rate schedules except for 386.30 differences attributable to benefits, unless sufficient 386.31 justification is provided to the commissioner; and 386.32 (5) sufficient information for review and approval of the 386.33 premium rate schedule increase by the commissioner. 386.34 Subd. 3. [REQUIREMENTS PERTAINING TO RATE INCREASES.] All 386.35 premium rate schedule increases must be determined according to 386.36 the following requirements: 387.1 (1) exceptional increases must provide that 70 percent of 387.2 the present value of projected additional premiums from the 387.3 exceptional increase will be returned to policyholders in 387.4 benefits; 387.5 (2) premium rate schedule increases must be calculated so 387.6 that the sum of the accumulated value of incurred claims, 387.7 without the inclusion of active life reserves, and the present 387.8 value of future projected incurred claims, without the inclusion 387.9 of active life reserves, will not be less than the sum of the 387.10 following: 387.11 (i) the accumulated value of the initial earned premium 387.12 times 58 percent; 387.13 (ii) 85 percent of the accumulated value of prior premium 387.14 rate schedule increases on an earned basis; 387.15 (iii) the present value of future projected initial earned 387.16 premiums times 58 percent; and 387.17 (iv) 85 percent of the present value of future projected 387.18 premiums not in item (iii) on an earned basis; 387.19 (3) if a policy form has both exceptional and other 387.20 increases, the values in clause (2), items (ii) and (iv), must 387.21 also include 70 percent for exceptional rate increase amounts; 387.22 and 387.23 (4) all present and accumulated values used to determine 387.24 rate increases must use the maximum valuation interest rate for 387.25 contract reserves permitted for valuation of whole life 387.26 insurance policies issued in this state on the same date. The 387.27 actuary shall disclose as part of the actuarial memorandum the 387.28 use of any appropriate averages. 387.29 Subd. 4. [PROJECTIONS.] For each rate increase that is 387.30 implemented, the insurer shall file for approval by the 387.31 commissioner updated projections, as described in subdivision 2, 387.32 clause (3), item (i), annually for the next three years and 387.33 include a comparison of actual results to projected values. The 387.34 commissioner may extend the period to greater than three years 387.35 if actual results are not consistent with projected values from 387.36 prior projections. For group insurance policies that meet the 388.1 conditions in subdivision 11, the projections required by this 388.2 subdivision must be provided to the policyholder in lieu of 388.3 filing with the commissioner. 388.4 Subd. 5. [LIFETIME PROJECTIONS.] If any premium rate in 388.5 the revised premium rate schedule is greater than 200 percent of 388.6 the comparable rate in the initial premium schedule, lifetime 388.7 projections, as described in subdivision 2, clause (3), item 388.8 (i), must be filed for approval by the commissioner every five 388.9 years following the end of the required period in subdivision 388.10 4. For group insurance policies that meet the conditions in 388.11 subdivision 11, the projections required by this subdivision 388.12 must be provided to the policyholder in lieu of filing with the 388.13 commissioner. 388.14 Subd. 6. [EFFECT OF ACTUAL EXPERIENCE.] (a) If the 388.15 commissioner has determined that the actual experience following 388.16 a rate increase does not adequately match the projected 388.17 experience and that the current projections under moderately 388.18 adverse conditions demonstrate that incurred claims will not 388.19 exceed proportions of premiums specified in subdivision 3, the 388.20 commissioner may require the insurer to implement any of the 388.21 following: 388.22 (1) premium rate schedule adjustments; or 388.23 (2) other measures to reduce the difference between the 388.24 projected and actual experience. 388.25 (b) In determining whether the actual experience adequately 388.26 matches the projected experience, consideration must be given to 388.27 subdivision 2, clause (3), item (v), if applicable. 388.28 Subd. 7. [CONTINGENT BENEFIT UPON LAPSE.] If the majority 388.29 of the policies or certificates to which the increase is 388.30 applicable are eligible for the contingent benefit upon lapse, 388.31 the insurer shall file: 388.32 (1) a plan, subject to commissioner approval, for improved 388.33 administration or claims processing designed to eliminate the 388.34 potential for further deterioration of the policy form requiring 388.35 further premium rate schedule increases, or both, or a 388.36 demonstration that appropriate administration and claims 389.1 processing have been implemented or are in effect; otherwise, 389.2 the commissioner may impose the condition in subdivision 8, 389.3 paragraph (b); and 389.4 (2) the original anticipated lifetime loss ratio, and the 389.5 premium rate schedule increase that would have been calculated 389.6 according to subdivision 3 had the greater of the original 389.7 anticipated lifetime loss ratio or 58 percent been used in the 389.8 calculations described in subdivision 3, clause (2), items (i) 389.9 and (iii). 389.10 Subd. 8. [PROJECTED LAPSE RATES.] (a) For a rate increase 389.11 filing that meets the following criteria, the commissioner shall 389.12 review, for all policies included in the filing, the projected 389.13 lapse rates and past lapse rates during the 12 months following 389.14 each increase to determine if significant adverse lapsation has 389.15 occurred or is anticipated: 389.16 (1) the rate increase is not the first rate increase 389.17 requested for the specific policy form or forms; 389.18 (2) the rate increase is not an exceptional increase; and 389.19 (3) the majority of the policies or certificates to which 389.20 the increase is applicable are eligible for the contingent 389.21 benefit upon lapse. 389.22 (b) If significant adverse lapsation has occurred, is 389.23 anticipated in the filing, or is evidenced in the actual results 389.24 as presented in the updated projections provided by the insurer 389.25 following the requested rate increase, the commissioner may 389.26 determine that a rate spiral exists. Following the 389.27 determination that a rate spiral exists, the commissioner may 389.28 require the insurer to offer, without underwriting, to all 389.29 in-force insureds subject to the rate increase, the option to 389.30 replace existing coverage with one or more reasonably comparable 389.31 products being offered by the insurer or its affiliates. The 389.32 offer must: 389.33 (1) be subject to the approval of the commissioner; 389.34 (2) be based upon actuarially sound principles, but not be 389.35 based upon attained age; and 389.36 (3) provide that maximum benefits under any new policy 390.1 accepted by an insured will be reduced by comparable benefits 390.2 already paid under the existing policy. 390.3 (c) The insurer shall maintain the experience of all the 390.4 replacement insureds separate from the experience of insureds 390.5 originally issued the policy forms. In the event of a request 390.6 for a rate increase on the policy form, the rate increase must 390.7 be limited to the lesser of the maximum rate increase determined 390.8 based on the combined experience and the maximum rate increase 390.9 determined based only upon the experience of the insureds 390.10 originally issued the form plus ten percent. 390.11 Subd. 9. [PERSISTENT PRACTICE OF INADEQUATE INITIAL 390.12 RATES.] If the commissioner determines that the insurer has 390.13 exhibited a persistent practice of filing inadequate initial 390.14 premium rates for long-term care insurance, the commissioner 390.15 may, in addition to the provisions of subdivision 8, take either 390.16 of the following actions: 390.17 (1) prohibit the insurer from filing and marketing 390.18 comparable coverage for a period of up to five years; or 390.19 (2) prohibit the insurer from offering all other similar 390.20 coverages and limit the insurer's marketing of new applications 390.21 for the products that are subject to recent premium rate 390.22 schedule increases. 390.23 Subd. 10. [INCIDENTAL LONG-TERM CARE 390.24 BENEFITS.] Subdivisions 1 to 9 do not apply to policies for 390.25 which the long-term care benefits provided by the policy are 390.26 incidental, as defined in section 62S.01, subdivision 17a, if 390.27 the policy complies with all of the following provisions: 390.28 (1) the interest credited internally to determine cash 390.29 value accumulations, including long-term care, if any, are 390.30 guaranteed not to be less than the minimum guaranteed interest 390.31 rate for cash value accumulations without long-term care set 390.32 forth in the policy; 390.33 (2) the portion of the policy that provides insurance 390.34 benefits other than long-term care coverage meets the 390.35 nonforfeiture requirements as applicable in any of the following: 390.36 (i) for life insurance, section 61A.25; 391.1 (ii) for individual deferred annuities, section 61A.245; 391.2 and 391.3 (iii) for variable annuities, section 61A.21; 391.4 (3) the policy meets the disclosure requirements of 391.5 sections 62S.10 and 62S.11 if the policy is governed by chapter 391.6 62S and of section 62A.50 if the policy is governed by sections 391.7 62A.46 to 62A.56; 391.8 (4) the portion of the policy that provides insurance 391.9 benefits other than long-term care coverage meets the 391.10 requirements as applicable in the following: 391.11 (i) policy illustrations to the extent required by state 391.12 law applicable to life insurance; 391.13 (ii) disclosure requirements in state law applicable to 391.14 annuities; and 391.15 (iii) disclosure requirements applicable to variable 391.16 annuities; and 391.17 (5) an actuarial memorandum is filed with the commissioner 391.18 that includes: 391.19 (i) a description of the basis on which the long-term care 391.20 rates were determined; 391.21 (ii) a description of the basis for the reserves; 391.22 (iii) a summary of the type of policy, benefits, 391.23 renewability, general marketing method, and limits on ages of 391.24 issuance; 391.25 (iv) a description and a table of each actuarial assumption 391.26 used. For expenses, an insurer must include percent of premium 391.27 dollars per policy and dollars per unit of benefits, if any; 391.28 (v) a description and a table of the anticipated policy 391.29 reserves and additional reserves to be held in each future year 391.30 for active lives; 391.31 (vi) the estimated average annual premium per policy and 391.32 the average issue age; 391.33 (vii) a statement as to whether underwriting is performed 391.34 at the time of application. The statement must indicate whether 391.35 underwriting is used and, if used, the statement must include a 391.36 description of the type or types of underwriting used, such as 392.1 medical underwriting or functional assessment underwriting. 392.2 Concerning a group policy, the statement must indicate whether 392.3 the enrollee or any dependent will be underwritten and when 392.4 underwriting occurs; and 392.5 (viii) a description of the effect of the long-term care 392.6 policy provision on the required premiums, nonforfeiture values, 392.7 and reserves on the underlying insurance policy, both for active 392.8 lives and those in long-term care claim status. 392.9 Subd. 11. [LARGE GROUP POLICIES.] Subdivisions 6 and 9 do 392.10 not apply to group long-term care insurance policies as defined 392.11 in section 62S.01, subdivision 15, where: 392.12 (1) the policies insure 250 or more persons, and the 392.13 policyholder has 5,000 or more eligible employees of a single 392.14 employer; or 392.15 (2) the policyholder, and not the certificate holders, pays 392.16 a material portion of the premium, which is not less than 20 392.17 percent of the total premium for the group in the calendar year 392.18 prior to the year in which a rate increase is filed. 392.19[EFFECTIVE DATE.] This section is effective the day 392.20 following final enactment. 392.21 Sec. 12. [62S.266] [NONFORFEITURE BENEFIT REQUIREMENT.] 392.22 Subdivision 1. [APPLICABILITY.] This section does not 392.23 apply to life insurance policies or riders containing 392.24 accelerated long-term care benefits. 392.25 Subd. 2. [REQUIREMENT.] An insurer must offer each 392.26 prospective policyholder a nonforfeiture benefit in compliance 392.27 with the following requirements: 392.28 (1) a policy or certificate offered with nonforfeiture 392.29 benefits must have coverage elements, eligibility, benefit 392.30 triggers, and benefit length that are the same as coverage to be 392.31 issued without nonforfeiture benefits. The nonforfeiture 392.32 benefit included in the offer must be the benefit described in 392.33 subdivision 5; and 392.34 (2) the offer must be in writing if the nonforfeiture 392.35 benefit is not otherwise described in the outline of coverage or 392.36 other materials given to the prospective policyholder. 393.1 Subd. 3. [EFFECT OF REJECTION OF OFFER.] If the offer 393.2 required to be made under subdivision 2 is rejected, the insurer 393.3 shall provide the contingent benefit upon lapse described in 393.4 this section. 393.5 Subd. 4. [CONTINGENT BENEFIT UPON LAPSE.] (a) After 393.6 rejection of the offer required under subdivision 2, for 393.7 individual and group policies without nonforfeiture benefits 393.8 issued after the effective date of this section, the insurer 393.9 shall provide a contingent benefit upon lapse. 393.10 (b) If a group policyholder elects to make the 393.11 nonforfeiture benefit an option to the certificate holder, a 393.12 certificate shall provide either the nonforfeiture benefit or 393.13 the contingent benefit upon lapse. 393.14 (c) The contingent benefit on lapse must be triggered every 393.15 time an insurer increases the premium rates to a level which 393.16 results in a cumulative increase of the annual premium equal to 393.17 or exceeding the percentage of the insured's initial annual 393.18 premium based on the insured's issue age provided in this 393.19 paragraph, and the policy or certificate lapses within 120 days 393.20 of the due date of the premium increase. Unless otherwise 393.21 required, policyholders shall be notified at least 30 days prior 393.22 to the due date of the premium reflecting the rate increase. 393.23 Triggers for a Substantial Premium Increase 393.24 Percent Increase 393.25 Issue Age Over Initial Premium 393.26 29 and Under 200 393.27 30-34 190 393.28 35-39 170 393.29 40-44 150 393.30 45-49 130 393.31 50-54 110 393.32 55-59 90 393.33 60 70 393.34 61 66 393.35 62 62 393.36 63 58 394.1 64 54 394.2 65 50 394.3 66 48 394.4 67 46 394.5 68 44 394.6 69 42 394.7 70 40 394.8 71 38 394.9 72 36 394.10 73 34 394.11 74 32 394.12 75 30 394.13 76 28 394.14 77 26 394.15 78 24 394.16 79 22 394.17 80 20 394.18 81 19 394.19 82 18 394.20 83 17 394.21 84 16 394.22 85 15 394.23 86 14 394.24 87 13 394.25 88 12 394.26 89 11 394.27 90 and over 10 394.28 (d) On or before the effective date of a substantial 394.29 premium increase as defined in paragraph (c), the insurer shall: 394.30 (1) offer to reduce policy benefits provided by the current 394.31 coverage without the requirement of additional underwriting so 394.32 that required premium payments are not increased; 394.33 (2) offer to convert the coverage to a paid-up status with 394.34 a shortened benefit period according to the terms of subdivision 394.35 5. This option may be elected at any time during the 120-day 394.36 period referenced in paragraph (c); and 395.1 (3) notify the policyholder or certificate holder that a 395.2 default or lapse at any time during the 120-day period 395.3 referenced in paragraph (c) is deemed to be the election of the 395.4 offer to convert in clause (2). 395.5 Subd. 5. [NONFORFEITURE BENEFITS; REQUIREMENTS.] (a) 395.6 Benefits continued as nonforfeiture benefits, including 395.7 contingent benefits upon lapse, must be as described in this 395.8 subdivision. 395.9 (b) For purposes of this subdivision, "attained age rating" 395.10 is defined as a schedule of premiums starting from the issue 395.11 date which increases with age at least one percent per year 395.12 prior to age 50, and at least three percent per year beyond age 395.13 50. 395.14 (c) For purposes of this subdivision, the nonforfeiture 395.15 benefit must be of a shortened benefit period providing paid-up, 395.16 long-term care insurance coverage after lapse. The same 395.17 benefits, amounts, and frequency in effect at the time of lapse, 395.18 but not increased thereafter, will be payable for a qualifying 395.19 claim, but the lifetime maximum dollars or days of benefits must 395.20 be determined as specified in paragraph (d). 395.21 (d) The standard nonforfeiture credit is equal to 100 395.22 percent of the sum of all premiums paid, including the premiums 395.23 paid prior to any changes in benefits. The insurer may offer 395.24 additional shortened benefit period options, so long as the 395.25 benefits for each duration equal or exceed the standard 395.26 nonforfeiture credit for that duration. However, the minimum 395.27 nonforfeiture credit must not be less than 30 times the daily 395.28 nursing home benefit at the time of lapse. In either event, the 395.29 calculation of the nonforfeiture credit is subject to the 395.30 limitation of this subdivision. 395.31 (e) The nonforfeiture benefit must begin not later than the 395.32 end of the third year following the policy or certificate issue 395.33 date. The contingent benefit upon lapse must be effective 395.34 during the first three years as well as thereafter. 395.35 (f) Notwithstanding paragraph (e), for a policy or 395.36 certificate with attained age rating, the nonforfeiture benefit 396.1 must begin on the earlier of: 396.2 (1) the end of the tenth year following the policy or 396.3 certificate issue date; or 396.4 (2) the end of the second year following the date the 396.5 policy or certificate is no longer subject to attained age 396.6 rating. 396.7 (g) Nonforfeiture credits may be used for all care and 396.8 services qualifying for benefits under the terms of the policy 396.9 or certificate, up to the limits specified in the policy or 396.10 certificate. 396.11 Subd. 6. [BENEFIT LIMIT.] All benefits paid by the insurer 396.12 while the policy or certificate is in premium-paying status and 396.13 in the paid-up status will not exceed the maximum benefits which 396.14 would be payable if the policy or certificate had remained in 396.15 premium-paying status. 396.16 Subd. 7. [MINIMUM BENEFITS; INDIVIDUAL AND GROUP 396.17 POLICIES.] There must be no difference in the minimum 396.18 nonforfeiture benefits as required under this section for group 396.19 and individual policies. 396.20 Subd. 8. [APPLICATION; EFFECTIVE DATES.] This section 396.21 becomes effective January 1, 2002, and applies as follows: 396.22 (a) Except as provided in paragraph (b), this section 396.23 applies to any long-term care policy issued in this state on or 396.24 after the effective date of this section. 396.25 (b) For certificates issued on or after the effective date 396.26 of this section, under a group long-term care insurance policy 396.27 that was in force on the effective date of this section, the 396.28 provisions of this section do not apply. 396.29 Subd. 9. [EFFECT ON LOSS RATIO.] Premiums charged for a 396.30 policy or certificate containing nonforfeiture benefits or a 396.31 contingent benefit on lapse are subject to the loss ratio 396.32 requirements of section 62A.48, subdivision 4, or 62S.26, 396.33 treating the policy as a whole, except for policies or 396.34 certificates that are subject to sections 62S.021, 62S.081, and 396.35 62S.265 and that comply with those sections. 396.36 Subd. 10. [PURCHASED BLOCKS OF BUSINESS.] To determine 397.1 whether contingent nonforfeiture upon lapse provisions are 397.2 triggered under subdivision 4, paragraph (c), a replacing 397.3 insurer that purchased or otherwise assumed a block or blocks of 397.4 long-term care insurance policies from another insurer shall 397.5 calculate the percentage increase based on the initial annual 397.6 premium paid by the insured when the policy was first purchased 397.7 from the original insurer. 397.8 Subd. 11. [LEVEL PREMIUM CONTRACTS.] A nonforfeiture 397.9 benefit for qualified long-term care insurance contracts that 397.10 are level premium contracts must be offered that meets the 397.11 following requirements: 397.12 (1) the nonforfeiture provision must be appropriately 397.13 captioned; 397.14 (2) the nonforfeiture provision must provide a benefit 397.15 available in the event of a default in the payment of any 397.16 premiums and must state that the amount of the benefit may be 397.17 adjusted subsequent to being initially granted only as necessary 397.18 to reflect changes in claims, persistency, and interest as 397.19 reflected in changes in rates for premium paying contracts 397.20 approved by the commissioner for the same contract form; and 397.21 (3) the nonforfeiture provision must provide at least one 397.22 of the following: 397.23 (i) reduced paid-up insurance; 397.24 (ii) extended term insurance; 397.25 (iii) shortened benefit period; or 397.26 (iv) other similar offerings approved by the commissioner. 397.27[EFFECTIVE DATE.] This section is effective the day 397.28 following final enactment. 397.29 Sec. 13. Minnesota Statutes 2000, section 256.975, is 397.30 amended by adding a subdivision to read: 397.31 Subd. 8. [PROMOTION OF LONG-TERM CARE INSURANCE.] The 397.32 Minnesota board on aging, either directly or through contract, 397.33 shall promote the provision of employer-sponsored, long-term 397.34 care insurance. The board shall encourage private and public 397.35 sector employers to make long-term care insurance available to 397.36 employees, provide interested employers with information on the 398.1 long-term care insurance product offered to state employees, and 398.2 provide technical assistance to employers in designing long-term 398.3 care insurance products and contacting companies offering 398.4 long-term care insurance products. 398.5 Sec. 14. [256B.0571] [LONG-TERM CARE PARTNERSHIP.] 398.6 Subdivision 1. [DEFINITIONS.] For purposes of this 398.7 section, the following terms have the meanings given them. 398.8 (a) "Home care service" means care described in section 398.9 144A.43. 398.10 (b) "Long-term care insurance" means a policy described in 398.11 section 62S.01. 398.12 (c) "Medical assistance" means the program of medical 398.13 assistance established under section 256B.01. 398.14 (d) "Nursing home" means nursing home as described in 398.15 section 144A.01. 398.16 (e) "Partnership policy" means a long-term care insurance 398.17 policy that meets the requirements under chapter 62S. 398.18 (f) "Partnership program" means the Minnesota partnership 398.19 for long-term care program established under this section. 398.20 Subd. 2. [PARTNERSHIP PROGRAM.] (a) Subject to federal 398.21 waiver approval, the commissioner of human services, along with 398.22 the commissioner of commerce, shall establish the Minnesota 398.23 partnership for long-term care program to provide for the 398.24 financing of long-term care through a combination of private 398.25 insurance and medical assistance. 398.26 (b) An individual who meets the requirements in paragraph 398.27 (c) is eligible to participate in the partnership program. 398.28 (c) The individual must: 398.29 (1) be a Minnesota resident; 398.30 (2) purchase a partnership policy that is delivered, issued 398.31 for delivery, or renewed on or after the effective date of this 398.32 section, and maintains the partnership policy in effect 398.33 throughout the period of participation in the partnership 398.34 program; and 398.35 (3) exhaust the minimum benefits under the partnership 398.36 policy as described in this section. Benefits received under a 399.1 long-term care insurance policy before the effective date of 399.2 this section do not count toward the exhaustion of benefits 399.3 required in this subdivision. 399.4 Subd. 3. [MEDICAL ASSISTANCE ELIGIBILITY.] (a) Upon 399.5 application of an individual who meets the requirements 399.6 described in subdivision 2, the commissioner of human services 399.7 shall determine the individual's eligibility for medical 399.8 assistance according to paragraphs (b) and (c). 399.9 (b) After disregarding financial assets exempted under 399.10 medical assistance eligibility requirements, the department 399.11 shall disregard an additional amount of financial assets equal 399.12 to the dollar amount of coverage under the partnership policy. 399.13 (c) The department shall consider the individual's income 399.14 according to medical assistance eligibility requirements. 399.15 Subd. 4. [FEDERAL APPROVAL.] (a) The commissioner of human 399.16 services shall seek appropriate amendments to the medical 399.17 assistance state plan and shall apply for any necessary waiver 399.18 of medical assistance requirements by the federal Health Care 399.19 Financing Administration to implement the partnership program. 399.20 The state shall not implement the partnership program unless the 399.21 provisions in paragraphs (b) and (c) apply. 399.22 (b) The commissioner shall seek any necessary federal 399.23 waiver of medical assistance requirements. 399.24 (c) Individuals who receive medical assistance under this 399.25 section are exempt from estate recovery requirements under 399.26 section 1917, title XIX of the federal Social Security Act, 399.27 United States Code, title 42, section 1396p. 399.28 Subd. 5. [APPROVED POLICIES.] (a) A partnership policy 399.29 must meet all of the requirements in paragraphs (b) to (h). 399.30 (b) Minimum coverage shall be for a period of not less than 399.31 three years and for a dollar amount equal to 36 months of 399.32 nursing home care at the minimum daily benefit rate determined 399.33 and adjusted under paragraph (c). The policy shall provide for 399.34 home health care benefits to be substituted for nursing home 399.35 care benefits on the basis of two home health care days for one 399.36 nursing home care day. 400.1 (c) Minimum daily benefits shall be $130 for nursing home 400.2 care or $65 for home care. These minimum daily benefit amounts 400.3 shall be adjusted by the department on October 1 of each year, 400.4 based on the health care index used under medical assistance for 400.5 nursing home rate setting. Adjusted minimum daily benefit 400.6 amounts shall be rounded to the nearest whole dollar. 400.7 (d) The insured shall be entitled to designate a third 400.8 party to receive notice if the policy is about to lapse for 400.9 nonpayment of premium, and an additional 30-day grace period for 400.10 payment of premium shall be granted following notification to 400.11 that person. 400.12 (e) The policy must cover all of the following services: 400.13 (1) nursing home stay; 400.14 (2) home care service; 400.15 (3) care management; and 400.16 (4) up to 14 days of nursing care in a hospital while the 400.17 individual is waiting for long-term care placement. 400.18 (f) Payment for service under paragraph (e), clause (4), 400.19 must not exceed the daily benefit amount for nursing home care. 400.20 (g) A partnership policy must offer both options in 400.21 paragraph (h) for an adjusted premium. 400.22 (h) The options are: 400.23 (1) an elimination period of not more than 100 days; and 400.24 (2) nonforfeiture benefits for applicants between the ages 400.25 of 18 and 75. 400.26 ARTICLE 9 400.27 MENTAL HEALTH AND CIVIL COMMITMENT 400.28 Section 1. [145.56] [SUICIDE PREVENTION.] 400.29 Subdivision 1. [PUBLIC HEALTH GOAL; SUICIDE PREVENTION 400.30 PLAN.] The commissioner of health shall make suicide prevention 400.31 an important public health goal of the state and shall conduct 400.32 suicide prevention activities to accomplish that goal using an 400.33 evidence-based, public health approach focused on prevention. 400.34 The commissioner shall refine, coordinate, and implement the 400.35 state's suicide prevention plan, in collaboration with assigned 400.36 staff from the department of human services; the department of 401.1 public safety; the department of children, families, and 401.2 learning; and appropriate agencies, organizations, and 401.3 institutions in the community. 401.4 Subd. 2. [COMMUNITY-BASED PROGRAMS.] (a) The commissioner 401.5 shall establish a grant program consistent with the policy goals 401.6 of this section to fund: 401.7 (1) community-based programs to provide education, 401.8 outreach, and advocacy services to populations who may be at 401.9 risk for suicide; 401.10 (2) community-based programs that educate natural community 401.11 helpers and gatekeepers, such as family members, spiritual 401.12 leaders, coaches, and business owners, employers, and coworkers, 401.13 on how to prevent suicide by encouraging help-seeking behaviors; 401.14 and 401.15 (3) community-based programs to provide evidence-based 401.16 suicide prevention and intervention education to school staff, 401.17 parents, and students in kindergarten through grade 12. 401.18 (b) Education to populations at risk for suicide and to 401.19 community helpers and gatekeepers must include information on 401.20 the symptoms of depression and other psychiatric illnesses, the 401.21 warning signs of suicide, skills for preventing suicides, and 401.22 making or seeking effective referrals to intervention and 401.23 community resources. 401.24 Subd. 3. [WORKPLACE AND PROFESSIONAL EDUCATION.] (a) The 401.25 commissioner shall promote the use of employee assistance and 401.26 workplace programs to support employees with depression and 401.27 other psychiatric illnesses and substance abuse disorders, and 401.28 refer them to services. In promoting these programs, the 401.29 commissioner shall collaborate with employer and professional 401.30 associations, unions, and safety councils. 401.31 (b) The commissioner shall provide training and technical 401.32 assistance to local public health and other community-based 401.33 professionals to provide for integrated implementation of best 401.34 practices for preventing suicides. 401.35 Subd. 4. [COLLECTING AND REPORTING SUICIDE DATA.] The 401.36 commissioner shall coordinate with federal, regional, local, and 402.1 other state agencies to collect, analyze, and annually issue a 402.2 public report on Minnesota-specific data on suicide and suicidal 402.3 behaviors. 402.4 Subd. 5. [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The 402.5 commissioner shall conduct periodic evaluations of the impact of 402.6 and outcomes from implementation of the state's suicide 402.7 prevention plan and each of the activities specified in this 402.8 section. By July 1, 2002, and July 1 of each even-numbered year 402.9 thereafter, the commissioner shall report the results of these 402.10 evaluations to the chairs of the policy and finance committees 402.11 in the house and senate with jurisdiction over health and human 402.12 services issues. 402.13 Sec. 2. Minnesota Statutes 2000, section 245.462, 402.14 subdivision 8, is amended to read: 402.15 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 402.16 treatment services," or "day treatment program" means a 402.17 structured program of treatment and care provided to an adult in 402.18 or by: (1) a hospital accredited by the joint commission on 402.19 accreditation of health organizations and licensed under 402.20 sections 144.50 to 144.55; (2) a community mental health center 402.21 under section 245.62; or (3) an entity that is under contract 402.22 with the county board to operate a program that meets the 402.23 requirements of section 245.4712, subdivision 2, and Minnesota 402.24 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 402.25 group psychotherapy and other intensive therapeutic services 402.26 that are provided at least one day a week by a multidisciplinary 402.27 staff under the clinical supervision of a mental health 402.28 professional. Day treatment may include education and 402.29 consultation provided to families and other individuals as part 402.30 of the treatment process. The services are aimed at stabilizing 402.31 the adult's mental health status, providing mental health 402.32 services, and developing and improving the adult's independent 402.33 living and socialization skills. The goal of day treatment is 402.34 to reduce or relieve mental illness and to enable the adult to 402.35 live in the community. Day treatment services are not a part of 402.36 inpatient or residential treatment services. Day treatment 403.1 services are distinguished from day care by their structured 403.2 therapeutic program of psychotherapy services. The commissioner 403.3 may limit medical assistance reimbursement for day treatment to 403.4 15 hours per week per person instead of the three hours per day 403.5 per person specified in Minnesota Rules, part 9505.0323, subpart 403.6 15. 403.7 Sec. 3. Minnesota Statutes 2000, section 245.462, 403.8 subdivision 18, is amended to read: 403.9 Subd. 18. [MENTAL HEALTH PROFESSIONAL.] "Mental health 403.10 professional" means a person providing clinical services in the 403.11 treatment of mental illness who is qualified in at least one of 403.12 the following ways: 403.13 (1) in psychiatric nursing: a registered nurse who is 403.14 licensed under sections 148.171 to 148.285, and who is certified 403.15 as a clinical specialist in adult psychiatric and mental health 403.16 nursing by a national nurse certification organization or who 403.17 has a master's degree in nursing or one of the behavioral 403.18 sciences or related fields from an accredited college or 403.19 university or its equivalent, with at least 4,000 hours of 403.20 post-master's supervised experience in the delivery of clinical 403.21 services in the treatment of mental illness; 403.22 (2) in clinical social work: a person licensed as an 403.23 independent clinical social worker under section 148B.21, 403.24 subdivision 6, or a person with a master's degree in social work 403.25 from an accredited college or university, with at least 4,000 403.26 hours of post-master's supervised experience in the delivery of 403.27 clinical services in the treatment of mental illness; 403.28 (3) in psychology:a psychologistan individual licensed 403.29 by the board of psychology under sections 148.88 to 148.98 who 403.30 has stated to the board of psychology competencies in the 403.31 diagnosis and treatment of mental illness; 403.32 (4) in psychiatry: a physician licensed under chapter 147 403.33 and certified by the American board of psychiatry and neurology 403.34 or eligible for board certification in psychiatry; 403.35 (5) in marriage and family therapy: the mental health 403.36 professional must be a marriage and family therapist licensed 404.1 under sections 148B.29 to 148B.39 with at least two years of 404.2 post-master's supervised experience in the delivery of clinical 404.3 services in the treatment of mental illness; or 404.4 (6) in allied fields: a person with a master's degree from 404.5 an accredited college or university in one of the behavioral 404.6 sciences or related fields, with at least 4,000 hours of 404.7 post-master's supervised experience in the delivery of clinical 404.8 services in the treatment of mental illness. 404.9 Sec. 4. Minnesota Statutes 2000, section 245.462, is 404.10 amended by adding a subdivision to read: 404.11 Subd. 25a. [SIGNIFICANT IMPAIRMENT IN FUNCTIONING.] 404.12 "Significant impairment in functioning" means a condition, 404.13 including significant suicidal ideation or thoughts of harming 404.14 self or others, which harmfully affects, recurrently or 404.15 consistently, a person's activities of daily living in 404.16 employment, housing, family, and social relationships, or 404.17 education. 404.18 Sec. 5. Minnesota Statutes 2000, section 245.4871, 404.19 subdivision 10, is amended to read: 404.20 Subd. 10. [DAY TREATMENT SERVICES.] "Day treatment," "day 404.21 treatment services," or "day treatment program" means a 404.22 structured program of treatment and care provided to a child in: 404.23 (1) an outpatient hospital accredited by the joint 404.24 commission on accreditation of health organizations and licensed 404.25 under sections 144.50 to 144.55; 404.26 (2) a community mental health center under section 245.62; 404.27 (3) an entity that is under contract with the county board 404.28 to operate a program that meets the requirements of section 404.29 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 404.30 9505.0475; or 404.31 (4) an entity that operates a program that meets the 404.32 requirements of section 245.4884, subdivision 2, and Minnesota 404.33 Rules, parts 9505.0170 to 9505.0475, that is under contract with 404.34 an entity that is under contract with a county board. 404.35 Day treatment consists of group psychotherapy and other 404.36 intensive therapeutic services that are provided for a minimum 405.1 three-hour time block by a multidisciplinary staff under the 405.2 clinical supervision of a mental health professional. Day 405.3 treatment may include education and consultation provided to 405.4 families and other individuals as an extension of the treatment 405.5 process. The services are aimed at stabilizing the child's 405.6 mental health status, and developing and improving the child's 405.7 daily independent living and socialization skills. Day 405.8 treatment services are distinguished from day care by their 405.9 structured therapeutic program of psychotherapy services. Day 405.10 treatment services are not a part of inpatient hospital or 405.11 residential treatment services. Day treatment services for a 405.12 child are an integrated set of education, therapy, and family 405.13 interventions. 405.14 A day treatment service must be available to a child at 405.15 least five days a week throughout the year and must be 405.16 coordinated with, integrated with, or part of an education 405.17 program offered by the child's school. 405.18 Sec. 6. Minnesota Statutes 2000, section 245.4871, 405.19 subdivision 27, is amended to read: 405.20 Subd. 27. [MENTAL HEALTH PROFESSIONAL.] "Mental health 405.21 professional" means a person providing clinical services in the 405.22 diagnosis and treatment of children's emotional disorders. A 405.23 mental health professional must have training and experience in 405.24 working with children consistent with the age group to which the 405.25 mental health professional is assigned. A mental health 405.26 professional must be qualified in at least one of the following 405.27 ways: 405.28 (1) in psychiatric nursing, the mental health professional 405.29 must be a registered nurse who is licensed under sections 405.30 148.171 to 148.285 and who is certified as a clinical specialist 405.31 in child and adolescent psychiatric or mental health nursing by 405.32 a national nurse certification organization or who has a 405.33 master's degree in nursing or one of the behavioral sciences or 405.34 related fields from an accredited college or university or its 405.35 equivalent, with at least 4,000 hours of post-master's 405.36 supervised experience in the delivery of clinical services in 406.1 the treatment of mental illness; 406.2 (2) in clinical social work, the mental health professional 406.3 must be a person licensed as an independent clinical social 406.4 worker under section 148B.21, subdivision 6, or a person with a 406.5 master's degree in social work from an accredited college or 406.6 university, with at least 4,000 hours of post-master's 406.7 supervised experience in the delivery of clinical services in 406.8 the treatment of mental disorders; 406.9 (3) in psychology, the mental health professional must bea406.10psychologistan individual licensed by the board of psychology 406.11 under sections 148.88 to 148.98 who has stated to the board of 406.12 psychology competencies in the diagnosis and treatment of mental 406.13 disorders; 406.14 (4) in psychiatry, the mental health professional must be a 406.15 physician licensed under chapter 147 and certified by the 406.16 American board of psychiatry and neurology or eligible for board 406.17 certification in psychiatry; 406.18 (5) in marriage and family therapy, the mental health 406.19 professional must be a marriage and family therapist licensed 406.20 under sections 148B.29 to 148B.39 with at least two years of 406.21 post-master's supervised experience in the delivery of clinical 406.22 services in the treatment of mental disorders or emotional 406.23 disturbances; or 406.24 (6) in allied fields, the mental health professional must 406.25 be a person with a master's degree from an accredited college or 406.26 university in one of the behavioral sciences or related fields, 406.27 with at least 4,000 hours of post-master's supervised experience 406.28 in the delivery of clinical services in the treatment of 406.29 emotional disturbances. 406.30 Sec. 7. Minnesota Statutes 2000, section 245.4876, 406.31 subdivision 1, is amended to read: 406.32 Subdivision 1. [CRITERIA.] Children's mental health 406.33 services required by sections 245.487 to 245.4888 must be: 406.34 (1) based, when feasible, on research findings; 406.35 (2) based on individual clinical, cultural, and ethnic 406.36 needs, and other special needs of the children being served; 407.1 (3) delivered in a manner that improves family functioning 407.2 when clinically appropriate; 407.3 (4) provided in the most appropriate, least restrictive 407.4 setting that meets the requirements in subdivision 1a, and that 407.5 is available to the county board to meet the child's treatment 407.6 needs; 407.7 (5) accessible to all age groups of children; 407.8 (6) appropriate to the developmental age of the child being 407.9 served; 407.10 (7) delivered in a manner that provides accountability to 407.11 the child for the quality of service delivered and continuity of 407.12 services to the child during the years the child needs services 407.13 from the local system of care; 407.14 (8) provided by qualified individuals as required in 407.15 sections 245.487 to 245.4888; 407.16 (9) coordinated with children's mental health services 407.17 offered by other providers; 407.18 (10) provided under conditions that protect the rights and 407.19 dignity of the individuals being served; and 407.20 (11) provided in a manner and setting most likely to 407.21 facilitate progress toward treatment goals. 407.22 Sec. 8. Minnesota Statutes 2000, section 245.4876, is 407.23 amended by adding a subdivision to read: 407.24 Subd. 1a. [APPROPRIATE SETTING TO RECEIVE SERVICES.] A 407.25 child must be provided with mental health services in the least 407.26 restrictive setting that is appropriate to the needs and current 407.27 condition of the individual child. For a child to receive 407.28 mental health services in a residential treatment or acute care 407.29 hospital inpatient setting, the family may not be required to 407.30 demonstrate that services were first provided in a less 407.31 restrictive setting and that the child failed to make progress 407.32 toward or meet treatment goals in the less restrictive setting. 407.33 Sec. 9. Minnesota Statutes 2000, section 245.4885, 407.34 subdivision 1, is amended to read: 407.35 Subdivision 1. [SCREENING REQUIRED.] The county board 407.36 shall, prior to admission, except in the case of emergency 408.1 admission, screen all children referred for treatment of severe 408.2 emotional disturbance to a residential treatment facility or 408.3 informally admitted to a regional treatment center if public 408.4 funds are used to pay for the services. The county board shall 408.5 also screen all children admitted to an acute care hospital for 408.6 treatment of severe emotional disturbance if public funds other 408.7 than reimbursement under chapters 256B and 256D are used to pay 408.8 for the services. If a child is admitted to a residential 408.9 treatment facility or acute care hospital for emergency 408.10 treatment or held for emergency care by a regional treatment 408.11 center under section 253B.05, subdivision 1, screening must 408.12 occur within three working days of admission. Screening shall 408.13 determine whether the proposed treatment: 408.14 (1) is necessary; 408.15 (2) is appropriate to the child's individual treatment 408.16 needs; 408.17 (3) cannot be effectively provided in the child's home; and 408.18 (4) provides a length of stay as short as possible 408.19 consistent with the individual child's need. 408.20 When a screening is conducted, the county board may not 408.21 determine that referral or admission to a residential treatment 408.22 facility or acute care hospital is not appropriate solely 408.23 because services were not first provided to the child in a less 408.24 restrictive setting and the child failed to make progress toward 408.25 or meet treatment goals in the less restrictive setting. 408.26 Screening shall include both a diagnostic assessment and a 408.27 functional assessment which evaluates family, school, and 408.28 community living situations. If a diagnostic assessment or 408.29 functional assessment has been completed by a mental health 408.30 professional within 180 days, a new diagnostic or functional 408.31 assessment need not be completed unless in the opinion of the 408.32 current treating mental health professional the child's mental 408.33 health status has changed markedly since the assessment was 408.34 completed. The child's parent shall be notified if an 408.35 assessment will not be completed and of the reasons. A copy of 408.36 the notice shall be placed in the child's file. Recommendations 409.1 developed as part of the screening process shall include 409.2 specific community services needed by the child and, if 409.3 appropriate, the child's family, and shall indicate whether or 409.4 not these services are available and accessible to the child and 409.5 family. 409.6 During the screening process, the child, child's family, or 409.7 child's legal representative, as appropriate, must be informed 409.8 of the child's eligibility for case management services and 409.9 family community support services and that an individual family 409.10 community support plan is being developed by the case manager, 409.11 if assigned. 409.12 Screening shall be in compliance with section 256F.07 or 409.13 260C.212, whichever applies. Wherever possible, the parent 409.14 shall be consulted in the screening process, unless clinically 409.15 inappropriate. 409.16 The screening process, and placement decision, and 409.17 recommendations for mental health services must be documented in 409.18 the child's record. 409.19 An alternate review process may be approved by the 409.20 commissioner if the county board demonstrates that an alternate 409.21 review process has been established by the county board and the 409.22 times of review, persons responsible for the review, and review 409.23 criteria are comparable to the standards in clauses (1) to (4). 409.24 Sec. 10. Minnesota Statutes 2000, section 245.4886, 409.25 subdivision 1, is amended to read: 409.26 Subdivision 1. [STATEWIDE PROGRAM; ESTABLISHMENT.] The 409.27 commissioner shall establish a statewide program to assist 409.28 counties in providing services to children with severe emotional 409.29 disturbance as defined in section 245.4871, subdivision 15, and 409.30 their families; and to young adults meeting the criteria for 409.31 transition services in section 245.4875, subdivision 8, and 409.32 their families. Services must be designed to help each child to 409.33 function and remain with the child's family in the community. 409.34 Transition services to eligible young adults must be designed to 409.35 foster independent living in the community. The commissioner 409.36 shall make grants to counties to establish, operate, or contract 410.1 with private providers to provide the following services in the 410.2 following order of priority when these cannot be reimbursed 410.3 under section 256B.0625: 410.4 (1) family community support services including crisis 410.5 placement and crisis respite care as specified in section 410.6 245.4871, subdivision 17; 410.7 (2) case management services as specified in section 410.8 245.4871, subdivision 3; 410.9 (3) day treatment services as specified in section 410.10 245.4871, subdivision 10; 410.11 (4) professional home-based family treatment as specified 410.12 in section 245.4871, subdivision 31; and 410.13 (5) therapeutic support of foster care as specified in 410.14 section 245.4871, subdivision 34. 410.15 Funding appropriated beginning July 1, 1991, must be used 410.16 by county boards to provide family community support services 410.17 and case management services. Additional services shall be 410.18 provided in the order of priority as identified in this 410.19 subdivision. 410.20 Sec. 11. Minnesota Statutes 2000, section 245.99, 410.21 subdivision 4, is amended to read: 410.22 Subd. 4. [ADMINISTRATION OF CRISIS HOUSING ASSISTANCE.] 410.23 The commissioner may contract with organizations or government 410.24 units experienced in housing assistance to operate the program 410.25 under this section. This program is not an entitlement. The 410.26 commissioner may take any of the following steps whenever the 410.27 commissioner projects that funds will be inadequate to meet 410.28 demand in a given fiscal year: 410.29 (1) transfer funds from mental health grants in the same 410.30 appropriation; and 410.31 (2) impose statewide restrictions as to the type and amount 410.32 of assistance available to each recipient under this program 410.33 including reducing the income eligibility level, limiting 410.34 reimbursement to a percentage of each recipient's costs, 410.35 limiting housing assistance to 60 days per recipient, or closing 410.36 the program for the remainder of the fiscal year. 411.1 Sec. 12. Minnesota Statutes 2000, section 256.969, 411.2 subdivision 3a, is amended to read: 411.3 Subd. 3a. [PAYMENTS.] Acute care hospital billings under 411.4 the medical assistance program must not be submitted until the 411.5 recipient is discharged. However, the commissioner shall 411.6 establish monthly interim payments for inpatient hospitals that 411.7 have individual patient lengths of stay over 30 days regardless 411.8 of diagnostic category. Except as provided in section 256.9693, 411.9 medical assistance reimbursement for treatment of mental illness 411.10 shall be reimbursed based on diagnostic classifications.The411.11commissioner may selectively contract with hospitals for411.12services within the diagnostic categories relating to mental411.13illness and chemical dependency under competitive bidding when411.14reasonable geographic access by recipients can be assured. No411.15physician shall be denied the privilege of treating a recipient411.16required to use a hospital under contract with the commissioner,411.17as long as the physician meets credentialing standards of the411.18individual hospital.Individual hospital payments established 411.19 under this section and sections 256.9685, 256.9686, and 411.20 256.9695, in addition to third party and recipient liability, 411.21 for discharges occurring during the rate year shall not exceed, 411.22 in aggregate, the charges for the medical assistance covered 411.23 inpatient services paid for the same period of time to the 411.24 hospital. This payment limitation shall be calculated 411.25 separately for medical assistance and general assistance medical 411.26 care services. The limitation on general assistance medical 411.27 care shall be effective for admissions occurring on or after 411.28 July 1, 1991. Services that have rates established under 411.29 subdivision 11 or 12, must be limited separately from other 411.30 services. After consulting with the affected hospitals, the 411.31 commissioner may consider related hospitals one entity and may 411.32 merge the payment rates while maintaining separate provider 411.33 numbers. The operating and property base rates per admission or 411.34 per day shall be derived from the best Medicare and claims data 411.35 available when rates are established. The commissioner shall 411.36 determine the best Medicare and claims data, taking into 412.1 consideration variables of recency of the data, audit 412.2 disposition, settlement status, and the ability to set rates in 412.3 a timely manner. The commissioner shall notify hospitals of 412.4 payment rates by December 1 of the year preceding the rate 412.5 year. The rate setting data must reflect the admissions data 412.6 used to establish relative values. Base year changes from 1981 412.7 to the base year established for the rate year beginning January 412.8 1, 1991, and for subsequent rate years, shall not be limited to 412.9 the limits ending June 30, 1987, on the maximum rate of increase 412.10 under subdivision 1. The commissioner may adjust base year 412.11 cost, relative value, and case mix index data to exclude the 412.12 costs of services that have been discontinued by the October 1 412.13 of the year preceding the rate year or that are paid separately 412.14 from inpatient services. Inpatient stays that encompass 412.15 portions of two or more rate years shall have payments 412.16 established based on payment rates in effect at the time of 412.17 admission unless the date of admission preceded the rate year in 412.18 effect by six months or more. In this case, operating payment 412.19 rates for services rendered during the rate year in effect and 412.20 established based on the date of admission shall be adjusted to 412.21 the rate year in effect by the hospital cost index. 412.22[EFFECTIVE DATE.] This section is effective July 1, 2002. 412.23 Sec. 13. [256.9693] [CONTINUING CARE PROGRAM FOR PERSONS 412.24 WITH MENTAL ILLNESS.] 412.25 The commissioner shall establish a continuing care benefit 412.26 program for persons with mental illness, in which persons with 412.27 mental illness may obtain acute care hospital inpatient 412.28 treatment for mental illness for up to 45 days beyond that 412.29 allowed by section 256.969. Persons with mental illness who are 412.30 eligible for medical assistance may obtain inpatient treatment 412.31 under this program in hospital beds for which the commissioner 412.32 contracts under this section. The commissioner may selectively 412.33 contract with hospitals to provide this benefit through 412.34 competitive bidding when reasonable geographic access by 412.35 recipients can be assured. Payments under this section shall 412.36 not affect payments under section 256.969. The commissioner may 413.1 contract externally with a utilization review organization to 413.2 authorize persons with mental illness to access the continuing 413.3 care benefit program. The commissioner, as part of the 413.4 contracts with hospitals, shall establish admission criteria to 413.5 allow persons with mental illness to access the continuing care 413.6 benefit program. If a court orders acute care hospital 413.7 inpatient treatment for mental illness for a person, the person 413.8 may obtain the treatment under the continuing care benefit 413.9 program. The commissioner shall not require, as part of the 413.10 admission criteria, any commitment or petition under chapter 413.11 253B as a condition of accessing the program. This benefit is 413.12 not available for people who are also eligible for Medicare and 413.13 who have not exhausted their annual or lifetime inpatient 413.14 psychiatric benefit under Medicare. If a recipient is enrolled 413.15 in a prepaid plan, this program is included in the plan's 413.16 coverage. 413.17[EFFECTIVE DATE.] This section is effective July 1, 2002. 413.18 Sec. 14. [256B.0623] [ADULT REHABILITATIVE MENTAL HEALTH 413.19 SERVICES.] 413.20 Subdivision 1. [SCOPE.] Medical assistance covers adult 413.21 rehabilitative mental health services as defined in subdivision 413.22 2, subject to federal approval, if provided to recipients as 413.23 defined in subdivision 3 and provided by a qualified provider 413.24 entity meeting the standards in this section and by a qualified 413.25 individual provider working within the provider's scope of 413.26 practice and identified in the recipient's individual treatment 413.27 plan as defined in section 245.462, subdivision 14, and if 413.28 determined to be medically necessary according to section 62Q.53. 413.29 Subd. 2. [DEFINITIONS.] For purposes of this section, the 413.30 following terms have the meanings given them. 413.31 (a) "Adult rehabilitative mental health services" means 413.32 mental health services which are rehabilitative and enable the 413.33 recipient to develop and enhance psychiatric stability, social 413.34 competencies, personal and emotional adjustment, and independent 413.35 living and community skills, when these abilities are impaired 413.36 by the symptoms of mental illness. Adult rehabilitative mental 414.1 health services are also appropriate when provided to enable a 414.2 recipient to retain stability and functioning, if the recipient 414.3 would be at risk of significant functional decompensation or 414.4 more restrictive service settings without these services. 414.5 (1) Adult rehabilitative mental health services instruct, 414.6 assist, and support the recipient in areas such as: 414.7 interpersonal communication skills, community resource 414.8 utilization and integration skills, crisis assistance, relapse 414.9 prevention skills, health care directives, budgeting and 414.10 shopping skills, healthy lifestyle skills and practices, cooking 414.11 and nutrition skills, transportation skills, medication 414.12 education and monitoring, mental illness symptom management 414.13 skills, household management skills, employment-related skills, 414.14 and transition to community living services. 414.15 (2) These services shall be provided to the recipient on a 414.16 one-to-one basis in the recipient's home or another community 414.17 setting or in groups. 414.18 (b) "Medication education services" means services provided 414.19 individually or in groups which focus on educating the recipient 414.20 about mental illness and symptoms; the role and effects of 414.21 medications in treating symptoms of mental illness; and the side 414.22 effects of medications. Medication education is coordinated 414.23 with medication management services, and does not duplicate it. 414.24 Medication education services are provided by physicians, 414.25 pharmacists, or registered nurses. 414.26 (c) "Transition to community living services" means 414.27 services which maintain continuity of contact between the 414.28 rehabilitation services provider and the recipient and which 414.29 facilitate discharge from a hospital, residential treatment 414.30 program under Minnesota Rules, chapter 9505, board and lodging 414.31 facility, or nursing home. Transition to community living 414.32 services are not intended to provide other areas of adult 414.33 rehabilitative mental health services. 414.34 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 414.35 individual who: 414.36 (1) is age 18 or older; 415.1 (2) is diagnosed with a medical condition, such as mental 415.2 illness or traumatic brain injury, for which adult 415.3 rehabilitative mental health services are needed; 415.4 (3) has substantial disability and functional impairment in 415.5 three or more of the areas listed in section 245.462, 415.6 subdivision 11a, so that self-sufficiency is markedly reduced; 415.7 and 415.8 (4) has had a recent diagnostic assessment by a qualified 415.9 professional that documents adult rehabilitative mental health 415.10 services are medically necessary to address identified 415.11 disability and functional impairments and individual recipient 415.12 goals. 415.13 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) The provider 415.14 entity must be: 415.15 (1) a county operated entity certified by the state; or 415.16 (2) a noncounty entity certified by the entity's host 415.17 county. 415.18 (b) The certification process is a determination as to 415.19 whether the entity meets the standards in this subdivision. The 415.20 certification must specify which adult rehabilitative mental 415.21 health services the entity is qualified to provide. 415.22 (c) If an entity seeks to provide services outside its host 415.23 county, it must obtain additional certification from each county 415.24 in which it will provide services. The additional certification 415.25 must be based on the adequacy of the entity's knowledge of that 415.26 county's local health and human service system, and the ability 415.27 of the entity to coordinate its services with the other services 415.28 available in that county. 415.29 (d) Recertification must occur at least every two years. 415.30 (e) The commissioner may intervene at any time and 415.31 decertify providers with cause. The decertification is subject 415.32 to appeal to the state. A county board may recommend that the 415.33 state decertify a provider for cause. 415.34 (f) The adult rehabilitative mental health services 415.35 provider entity must meet the following standards: 415.36 (1) have capacity to recruit, hire, manage, and train 416.1 mental health professionals, mental health practitioners, and 416.2 mental health rehabilitation workers; 416.3 (2) have adequate administrative ability to ensure 416.4 availability of services; 416.5 (3) ensure adequate preservice and inservice training for 416.6 staff; 416.7 (4) ensure that mental health professionals, mental health 416.8 practitioners, and mental health rehabilitation workers are 416.9 skilled in the delivery of the specific adult rehabilitative 416.10 mental health services provided to the individual eligible 416.11 recipient; 416.12 (5) ensure that staff is capable of implementing culturally 416.13 specific services that are culturally competent and appropriate 416.14 as determined by the recipient's culture, beliefs, values, and 416.15 language as identified in the individual treatment plan; 416.16 (6) ensure enough flexibility in service delivery to 416.17 respond to the changing and intermittent care needs of a 416.18 recipient as identified by the recipient and the individual 416.19 treatment plan; 416.20 (7) ensure that the mental health professional or mental 416.21 health practitioner, who is under the clinical supervision of a 416.22 mental health professional, involved in a recipient's services 416.23 participates in the development of the individual treatment 416.24 plan; 416.25 (8) assist the recipient in arranging needed crisis 416.26 assessment, intervention, and stabilization services; 416.27 (9) ensure that services are coordinated with other 416.28 recipient mental health services providers and the county mental 416.29 health authority and the federally recognized American Indian 416.30 authority and necessary others after obtaining the consent of 416.31 the recipient. Services must also be coordinated with the 416.32 recipient's case manager or care coordinator, if the recipient 416.33 is receiving case management or care coordination services; 416.34 (10) develop and maintain recipient files, individual 416.35 treatment plans, and contact charting; 416.36 (11) develop and maintain staff training and personnel 417.1 files; 417.2 (12) submit information as required by the state; 417.3 (13) establish and maintain a quality assurance plan to 417.4 evaluate the outcome of services provided; 417.5 (14) keep all necessary records required by law; 417.6 (15) deliver services as required by section 245.461; 417.7 (16) comply with all applicable laws; 417.8 (17) be an enrolled Medicaid provider; 417.9 (18) maintain a quality assurance plan to determine 417.10 specific service outcomes and the recipient's satisfaction with 417.11 services; and 417.12 (19) develop and maintain written policies and procedures 417.13 regarding service provision and administration of the provider 417.14 entity. 417.15 (g) The commissioner shall develop statewide procedures for 417.16 provider certification, including timelines for counties to 417.17 certify qualified providers. 417.18 Subd. 5. [QUALIFICATIONS OF PROVIDER STAFF.] Adult 417.19 rehabilitative mental health services must be provided by 417.20 qualified individual provider staff of a certified provider 417.21 entity. Individual provider staff must be qualified under one 417.22 of the following criteria: 417.23 (1) a mental health professional as defined in section 417.24 245.462, subdivision 18, clauses (1) to (5); 417.25 (2) a mental health practitioner as defined in section 417.26 245.462, subdivision 17. The mental health practitioner must 417.27 work under the clinical supervision of a mental health 417.28 professional; or 417.29 (3) a mental health rehabilitation worker. A mental health 417.30 rehabilitation worker means a staff person working under the 417.31 direction of a mental health practitioner or mental health 417.32 professional, and under the clinical supervision of a mental 417.33 health professional in the implementation of rehabilitative 417.34 mental health services as identified in the recipient's 417.35 individual treatment plan; and who: 417.36 (i) is at least 21 years of age; 418.1 (ii) has a high school diploma or equivalent; 418.2 (iii) has successfully completed 30 hours of training 418.3 during the past two years in all of the following areas: 418.4 recipient rights, recipient-centered individual treatment 418.5 planning, behavioral terminology, mental illness, co-occurring 418.6 mental illness and substance abuse, psychotropic medications and 418.7 side effects, functional assessment, local community resources, 418.8 adult vulnerability, recipient confidentiality; and 418.9 (iv) meets the qualifications in (A) or (B): 418.10 (A) has an associate of arts degree in one of the 418.11 behavioral sciences or human services, or is a registered nurse 418.12 without a bachelor's degree, or who within the previous ten 418.13 years has: 418.14 (1) three years of personal life experience with serious 418.15 and persistent mental illness; 418.16 (2) three years of life experience as a primary caregiver 418.17 to an adult with a serious mental illness or traumatic brain 418.18 injury; or 418.19 (3) 4,000 hours of supervised paid work experience in the 418.20 delivery of mental health services to adults with a serious 418.21 mental illness or traumatic brain injury; or 418.22 (B)(1) be fluent in the non-English language or competent 418.23 in the culture of the ethnic group to which at least 50 percent 418.24 of the mental health rehabilitation worker's clients belong; 418.25 (2) receives during the first 2,000 hours of work, monthly 418.26 documented individual clinical supervision by a mental health 418.27 professional; 418.28 (3) has 18 hours of documented field supervision by a 418.29 mental health professional or practitioner during the first 160 418.30 hours of contact work with recipients, and at least six hours of 418.31 field supervision quarterly during the following year; 418.32 (4) has review and cosignature of charting of recipient 418.33 contacts during field supervision by a mental health 418.34 professional or practitioner; and 418.35 (5) has 40 hours of additional continuing education on 418.36 mental health topics during the first year of employment. 419.1 Subd. 6. [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 419.2 health rehabilitation workers must receive ongoing continuing 419.3 education training of at least 30 hours every two years in areas 419.4 of mental illness and mental health services and other areas 419.5 specific to the population being served. Mental health 419.6 rehabilitation workers must also be subject to the ongoing 419.7 direction and clinical supervision standards in paragraphs (c) 419.8 and (d). 419.9 (b) Mental health practitioners must receive ongoing 419.10 continuing education training as required by their professional 419.11 license; or if the practitioner is not licensed, the 419.12 practitioner must receive ongoing continuing education training 419.13 of at least 30 hours every two years in areas of mental illness 419.14 and mental health services. Mental health practitioners must 419.15 meet the ongoing clinical supervision standards in paragraph (c). 419.16 (c) A mental health professional providing clinical 419.17 supervision of staff delivering adult rehabilitative mental 419.18 health services must provide the following guidance: 419.19 (1) review the information in the recipient's file; 419.20 (2) review and approve initial and updates of individual 419.21 treatment plans; 419.22 (3) meet with mental health rehabilitation workers and 419.23 practitioners, individually or in small groups, at least monthly 419.24 to discuss treatment topics of interest to the workers and 419.25 practitioners; 419.26 (4) meet with mental health rehabilitation workers and 419.27 practitioners, individually or in small groups, at least monthly 419.28 to discuss treatment plans of recipients, and approve by 419.29 signature and document in the recipient's file any resulting 419.30 plan updates; 419.31 (5) meet at least twice a month with the directing mental 419.32 health practitioner, if there is one, to review needs of the 419.33 adult rehabilitative mental health services program, review 419.34 staff on-site observations and evaluate mental health 419.35 rehabilitation workers, plan staff training, review program 419.36 evaluation and development, and consult with the directing 420.1 practitioner; 420.2 (6) be available for urgent consultation as the individual 420.3 recipient needs or the situation necessitates; and 420.4 (7) provide clinical supervision by full- or part-time 420.5 mental health professionals employed by or under contract with 420.6 the provider entity. 420.7 (d) An adult rehabilitative mental health services provider 420.8 entity must have a treatment director who is a mental health 420.9 practitioner or mental health professional. The treatment 420.10 director must ensure the following: 420.11 (1) while delivering direct services to recipients, a newly 420.12 hired mental health rehabilitation worker must be directly 420.13 observed delivering services to recipients by the mental health 420.14 practitioner or mental health professional for at least six 420.15 hours per 40 hours worked during the first 160 hours that the 420.16 mental health rehabilitation worker works; 420.17 (2) the mental health rehabilitation worker must receive 420.18 ongoing on-site direct service observation by a mental health 420.19 professional or mental health practitioner for at least six 420.20 hours for every six months of employment; 420.21 (3) progress notes are reviewed from on-site service 420.22 observation prepared by the mental health rehabilitation worker 420.23 and mental health practitioner for accuracy and consistency with 420.24 actual recipient contact and the individual treatment plan and 420.25 goals; 420.26 (4) immediate availability by phone or in person for 420.27 consultation by a mental health professional or a mental health 420.28 practitioner to the mental health rehabilitation services worker 420.29 during service provision; 420.30 (5) oversee the identification of changes in individual 420.31 recipient treatment strategies, revise the plan and communicate 420.32 treatment instructions and methodologies as appropriate to 420.33 ensure that treatment is implemented correctly; 420.34 (6) model service practices which: respect the recipient, 420.35 include the recipient in planning and implementation of the 420.36 individual treatment plan, recognize the recipient's strengths, 421.1 collaborate and coordinate with other involved parties and 421.2 providers; 421.3 (7) ensure that mental health practitioners and mental 421.4 health rehabilitation workers are able to effectively 421.5 communicate with the recipients, significant others, and 421.6 providers; and 421.7 (8) oversee the record of the results of on-site 421.8 observation and charting evaluation and corrective actions taken 421.9 to modify the work of the mental health practitioners and mental 421.10 health rehabilitation workers. 421.11 (e) A mental health practitioner who is providing treatment 421.12 direction for a provider entity must receive supervision at 421.13 least monthly from a mental health professional to: 421.14 (1) identify and plan for general needs of the recipient 421.15 population served; 421.16 (2) identify and plan to address provider entity program 421.17 needs and effectiveness; 421.18 (3) identify and plan provider entity staff training and 421.19 personnel needs and issues; and 421.20 (4) plan, implement, and evaluate provider entity quality 421.21 improvement programs. 421.22 Subd. 7. [PERSONNEL FILE.] The adult rehabilitative mental 421.23 health services provider entity must maintain a personnel file 421.24 on each staff. Each file must contain: 421.25 (1) an annual performance review; 421.26 (2) a summary of on-site service observations and charting 421.27 review; 421.28 (3) a criminal background check of all direct service 421.29 staff; 421.30 (4) evidence of academic degree and qualifications; 421.31 (5) a copy of professional license; 421.32 (6) any job performance recognition and disciplinary 421.33 actions; 421.34 (7) any individual staff written input into own personnel 421.35 file; 421.36 (8) all clinical supervision provided; and 422.1 (9) documentation of compliance with continuing education 422.2 requirements. 422.3 Subd. 8. [DIAGNOSTIC ASSESSMENT.] Providers of adult 422.4 rehabilitative mental health services must complete a diagnostic 422.5 assessment as defined in section 245.462, subdivision 9, within 422.6 five days after the recipient's second visit or within 30 days 422.7 after intake, whichever occurs first. In cases where a 422.8 diagnostic assessment is available that reflects the recipient's 422.9 current status, and has been completed within 180 days preceding 422.10 admission, an update must be completed. An update shall include 422.11 a written summary by a mental health professional of the 422.12 recipient's current mental health status and service needs. If 422.13 the recipient's mental health status has changed significantly 422.14 since the adult's most recent diagnostic assessment, a new 422.15 diagnostic assessment is required. 422.16 Subd. 9. [FUNCTIONAL ASSESSMENT.] Providers of adult 422.17 rehabilitative mental health services must complete a written 422.18 functional assessment as defined in section 245.462, subdivision 422.19 11a, for each recipient. The functional assessment must be 422.20 completed within 30 days of intake, and reviewed and updated at 422.21 least every six months after it is developed, unless there is a 422.22 significant change in the functioning of the recipient. If 422.23 there is a significant change in functioning, the assessment 422.24 must be updated. A single functional assessment can meet case 422.25 management and adult rehabilitative mental health services 422.26 requirements, if agreed to by the recipient. Unless the 422.27 recipient refuses, the recipient must have significant 422.28 participation in the development of the functional assessment. 422.29 Subd. 10. [INDIVIDUAL TREATMENT PLAN.] All providers of 422.30 adult rehabilitative mental health services must develop and 422.31 implement an individual treatment plan for each recipient. The 422.32 provisions in clauses (1) and (2) apply: 422.33 (1) Individual treatment plan means a plan of intervention, 422.34 treatment, and services for an individual recipient written by a 422.35 mental health professional or by a mental health practitioner 422.36 under the clinical supervision of a mental health professional. 423.1 The individual treatment plan must be based on diagnostic and 423.2 functional assessments. To the extent possible, the development 423.3 and implementation of a treatment plan must be a collaborative 423.4 process involving the recipient, and with the permission of the 423.5 recipient, the recipient's family and others in the recipient's 423.6 support system. Providers of adult rehabilitative mental health 423.7 services must develop the individual treatment plan within 30 423.8 calendar days of intake. The treatment plan must be updated at 423.9 least every six months thereafter, or more often when there is 423.10 significant change in the recipient's situation or functioning, 423.11 or in services or service methods to be used, or at the request 423.12 of the recipient or the recipient's legal guardian. 423.13 (2) The individual treatment plan must include: 423.14 (i) a list of problems identified in the assessment; 423.15 (ii) the recipient's strengths and resources; 423.16 (iii) concrete, measurable goals to be achieved, including 423.17 time frames for achievement; 423.18 (iv) specific objectives directed toward the achievement of 423.19 each one of the goals; 423.20 (v) documentation of participants in the treatment planning. 423.21 The recipient, if possible, must be a participant. The 423.22 recipient or the recipient's legal guardian must sign the 423.23 treatment plan, or documentation must be provided why this was 423.24 not possible. A copy of the plan must be given to the recipient 423.25 or legal guardian. Referral to formal services must be 423.26 arranged, including specific providers where applicable; 423.27 (vi) cultural considerations, resources, and needs of the 423.28 recipient must be included; 423.29 (vii) planned frequency and type of services must be 423.30 initiated; and 423.31 (viii) clear progress notes on outcome of goals. 423.32 (3) The individual community support plan defined in 423.33 section 245.462, subdivision 12, may serve as the individual 423.34 treatment plan if there is involvement of a mental health case 423.35 manager, and with the approval of the recipient. The individual 423.36 community support plan must include the criteria in clause (2). 424.1 Subd. 11. [RECIPIENT FILE.] Providers of adult 424.2 rehabilitative mental health services must maintain a file for 424.3 each recipient that contains the following information: 424.4 (1) diagnostic assessment or verification of its location, 424.5 that is current and that was reviewed by a mental health 424.6 professional who is employed by or under contract with the 424.7 provider entity; 424.8 (2) functional assessments; 424.9 (3) individual treatment plans signed by the recipient and 424.10 the mental health professional, or if the recipient refused to 424.11 sign the plan, the date and reason stated by the recipient as to 424.12 why the recipient would not sign the plan; 424.13 (4) recipient history; 424.14 (5) signed release forms; 424.15 (6) recipient health information and current medications; 424.16 (7) emergency contacts for the recipient; 424.17 (8) case records which document the date of service, the 424.18 place of service delivery, signature of the person providing the 424.19 service, nature, extent and units of service, and place of 424.20 service delivery; 424.21 (9) contacts, direct or by telephone, with recipient's 424.22 family or others, other providers, or other resources for 424.23 service coordination; 424.24 (10) summary of recipient case reviews by staff; and 424.25 (11) written information by the recipient that the 424.26 recipient requests be included in the file. 424.27 Subd. 12. [ADDITIONAL REQUIREMENTS.] (a) Providers of 424.28 adult rehabilitative mental health services must comply with the 424.29 requirements relating to referrals for case management in 424.30 section 245.467, subdivision 4. 424.31 (b) Adult rehabilitative mental health services are 424.32 provided for most recipients in the recipient's home and 424.33 community. Services may also be provided at the home of a 424.34 relative or significant other, job site, psychosocial clubhouse, 424.35 drop-in center, social setting, classroom, or other places in 424.36 the community. Except for "transition to community services," 425.1 the place of service does not include a regional treatment 425.2 center, nursing home, residential treatment facility licensed 425.3 under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36), 425.4 or an acute care hospital. 425.5 (c) Adult rehabilitative mental health services may be 425.6 provided in group settings if appropriate to each participating 425.7 recipient's needs and treatment plan. A group is defined as two 425.8 to ten clients, at least one of whom is a recipient, who is 425.9 concurrently receiving a service which is identified in this 425.10 section. The service and group must be specified in the 425.11 recipient's treatment plan. No more than two qualified staff 425.12 may bill Medicaid for services provided to the same group of 425.13 recipients. If two adult rehabilitative mental health workers 425.14 bill for recipients in the same group session, they must each 425.15 bill for different recipients. 425.16 Subd. 13. [EXCLUDED SERVICES.] The following services are 425.17 excluded from reimbursement as adult rehabilitative mental 425.18 health services: 425.19 (1) recipient transportation services; 425.20 (2) a service provided and billed by a provider who is not 425.21 enrolled to provide adult rehabilitative mental health service; 425.22 (3) adult rehabilitative mental health services performed 425.23 by volunteers; 425.24 (4) provider performance of household tasks, chores, or 425.25 related activities, such as laundering clothes, moving the 425.26 recipient's household, housekeeping, and grocery shopping for 425.27 the recipient; 425.28 (5) direct billing of time spent "on call" when not 425.29 delivering services to recipients; 425.30 (6) activities which are primarily social or recreational 425.31 in nature, rather than rehabilitative, for the individual 425.32 recipient, as determined by the individual's needs and treatment 425.33 plan; 425.34 (7) job-specific skills services, such as on-the-job 425.35 training; 425.36 (8) provider service time included in case management 426.1 reimbursement; 426.2 (9) outreach services to potential recipients; 426.3 (10) a mental health service that is not medically 426.4 necessary; and 426.5 (11) any services provided by a hospital, board and 426.6 lodging, or residential facility to an individual who is a 426.7 patient in or resident of that facility. 426.8 Subd. 14. [BILLING WHEN SERVICES ARE PROVIDED BY QUALIFIED 426.9 STATE STAFF.] When rehabilitative services are provided by 426.10 qualified state staff who are assigned to pilot projects under 426.11 section 245.4661, the county or other local entity to which the 426.12 qualified state staff are assigned may consider these staff part 426.13 of the local provider entity for which certification is sought 426.14 under this section, and may bill the medical assistance program 426.15 for qualifying services provided by the qualified state staff. 426.16 Notwithstanding section 256.025, subdivision 2, payments for 426.17 services provided by state staff who are assigned to adult 426.18 mental health initiatives shall only be made from federal funds. 426.19 Sec. 15. [256B.0624] [ADULT MENTAL HEALTH CRISIS RESPONSE 426.20 SERVICES.] 426.21 Subdivision 1. [SCOPE.] Medical assistance covers adult 426.22 mental health crisis response services as defined in subdivision 426.23 2, paragraphs (c) to (e), subject to federal approval, if 426.24 provided to a recipient as defined in subdivision 3 and provided 426.25 by a qualified provider entity as defined in this section and by 426.26 a qualified individual provider working within the provider's 426.27 scope of practice and as defined in this subdivision and 426.28 identified in the recipient's individual crisis treatment plan 426.29 as defined in subdivision 10 and if determined to be medically 426.30 necessary. 426.31 Subd. 2. [DEFINITIONS.] For purposes of this section, the 426.32 following terms have the meanings given them. 426.33 (a) "Mental health crisis" is an adult behavioral, 426.34 emotional, or psychiatric situation which, but for the provision 426.35 of crisis response services, would likely result in 426.36 significantly reduced levels of functioning in primary 427.1 activities of daily living, or in an emergency situation, or in 427.2 the placement of the recipient in a more restrictive setting, 427.3 including, but not limited to, inpatient hospitalization. 427.4 (b) "Mental health emergency" is an adult behavioral, 427.5 emotional, or psychiatric situation which causes an immediate 427.6 need for mental health services and is consistent with section 427.7 62Q.55. 427.8 A mental health crisis or emergency is determined for 427.9 medical assistance service reimbursement by a physician, a 427.10 mental health professional, or crisis mental health practitioner 427.11 with input from the recipient whenever possible. 427.12 (c) "Mental health crisis assessment" means an immediate 427.13 face-to-face assessment by a physician, a mental health 427.14 professional, or mental health practitioner under the clinical 427.15 supervision of a mental health professional, following a 427.16 screening that suggests that the adult may be experiencing a 427.17 mental health crisis or mental health emergency situation. 427.18 (d) "Mental health mobile crisis intervention services" 427.19 means face-to-face, short-term intensive mental health services 427.20 initiated during a mental health crisis or mental health 427.21 emergency to help the recipient cope with immediate stressors, 427.22 identify and utilize available resources and strengths, and 427.23 begin to return to the recipient's baseline level of functioning. 427.24 (1) This service is provided on-site by a mobile crisis 427.25 intervention team outside of an inpatient hospital setting. 427.26 Mental health mobile crisis intervention services must be 427.27 available 24 hours a day, seven days a week. 427.28 (2) The initial screening must consider other available 427.29 services to determine which service intervention would best 427.30 address the recipient's needs and circumstances. 427.31 (3) The mobile crisis intervention team must be available 427.32 to meet promptly face-to-face with a person in mental health 427.33 crisis or emergency in a community setting. 427.34 (4) The intervention must consist of a mental health crisis 427.35 assessment and a crisis treatment plan. 427.36 (5) The treatment plan must include recommendations for any 428.1 needed crisis stabilization services for the recipient. 428.2 (e) "Mental health crisis stabilization services" means 428.3 individualized mental health services provided to a recipient 428.4 following crisis intervention services which are designed to 428.5 restore the recipient to the recipient's prior functional 428.6 level. Mental health crisis stabilization services may be 428.7 provided in the recipient's home, the home of a family member or 428.8 friend of the recipient, another community setting, or a 428.9 short-term supervised, licensed residential program. Mental 428.10 health crisis stabilization does not include partial 428.11 hospitalization or day treatment. 428.12 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 428.13 individual who: 428.14 (1) is age 18 or older; 428.15 (2) is screened as possibly experiencing a mental health 428.16 crisis or emergency where a mental health crisis assessment is 428.17 needed; and 428.18 (3) is assessed as experiencing a mental health crisis or 428.19 emergency, and mental health crisis intervention or crisis 428.20 intervention and stabilization services are determined to be 428.21 medically necessary. 428.22 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A provider 428.23 entity is an entity that meets the standards listed in paragraph 428.24 (b) and: 428.25 (1) is a county board operated entity; or 428.26 (2) is a provider entity that is under contract with the 428.27 county board in the county where the potential crisis or 428.28 emergency is occurring. To provide services under this section, 428.29 the provider entity must directly provide the services; or if 428.30 services are subcontracted, the provider entity must maintain 428.31 responsibility for services and billing. 428.32 (b) The adult mental health crisis response services 428.33 provider entity must meet the following standards: 428.34 (1) has the capacity to recruit, hire, and manage and train 428.35 mental health professionals, practitioners, and rehabilitation 428.36 workers; 429.1 (2) has adequate administrative ability to ensure 429.2 availability of services; 429.3 (3) is able to ensure adequate preservice and in-service 429.4 training; 429.5 (4) is able to ensure that staff providing these services 429.6 are skilled in the delivery of mental health crisis response 429.7 services to recipients; 429.8 (5) is able to ensure that staff are capable of 429.9 implementing culturally specific treatment identified in the 429.10 individual treatment plan that is meaningful and appropriate as 429.11 determined by the recipient's culture, beliefs, values, and 429.12 language; 429.13 (6) is able to ensure enough flexibility to respond to the 429.14 changing intervention and care needs of a recipient as 429.15 identified by the recipient during the service partnership 429.16 between the recipient and providers; 429.17 (7) is able to ensure that mental health professionals and 429.18 mental health practitioners have the communication tools and 429.19 procedures to communicate and consult promptly about crisis 429.20 assessment and interventions as services occur; 429.21 (8) is able to coordinate these services with county 429.22 emergency services and mental health crisis services; 429.23 (9) is able to ensure that mental health crisis assessment 429.24 and mobile crisis intervention services are available 24 hours a 429.25 day, seven days a week; 429.26 (10) is able to ensure that services are coordinated with 429.27 other mental health service providers, county mental health 429.28 authorities, or federally recognized American Indian authorities 429.29 and others as necessary, with the consent of the adult. 429.30 Services must also be coordinated with the recipient's case 429.31 manager if the adult is receiving case management services; 429.32 (11) is able to ensure that crisis intervention services 429.33 are provided in a manner consistent with sections 245.461 to 429.34 245.486; 429.35 (12) is able to submit information as required by the 429.36 state; 430.1 (13) maintains staff training and personnel files; 430.2 (14) is able to establish and maintain a quality assurance 430.3 and evaluation plan to evaluate the outcomes of services and 430.4 recipient satisfaction; 430.5 (15) is able to keep records as required by applicable 430.6 laws; 430.7 (16) is able to comply with all applicable laws and 430.8 statutes; 430.9 (17) is an enrolled medical assistance provider; and 430.10 (18) develops and maintains written policies and procedures 430.11 regarding service provision and administration of the provider 430.12 entity including safety of staff and recipients in high risk 430.13 situations. 430.14 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF 430.15 QUALIFICATIONS.] For provision of adult mental health mobile 430.16 crisis intervention services, a mobile crisis intervention team 430.17 is comprised of at least two mental health professionals as 430.18 defined in section 245.462, subdivision 18, clauses (1) to (5), 430.19 or a combination of at least one mental health professional and 430.20 one mental health practitioner as defined in section 245.462, 430.21 subdivision 17, with the required mental health crisis training 430.22 and under the clinical supervision of a mental health 430.23 professional on the team. The team must have at least two 430.24 people with at least one member providing on-site crisis 430.25 intervention services when needed. Team members must be 430.26 experienced in mental health assessment, crisis intervention 430.27 techniques, and clinical decision-making under emergency 430.28 conditions and have knowledge of local services and resources. 430.29 The team must recommend and coordinate the team's services with 430.30 appropriate local resources such as the county social services 430.31 agency, mental health services, and local law enforcement when 430.32 necessary. 430.33 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 430.34 INTERVENTION TREATMENT PLANNING.] (a) Prior to initiating mobile 430.35 crisis intervention services, a screening of the potential 430.36 crisis situation must be conducted. The screening may use the 431.1 resources of crisis assistance and emergency services as defined 431.2 in sections 245.462, subdivision 6, and 245.469, subdivisions 1 431.3 and 2. The screening must gather information, determine whether 431.4 a crisis situation exists, identify parties involved, and 431.5 determine an appropriate response. 431.6 (b) If a crisis exists, a crisis assessment must be 431.7 completed. A crisis assessment evaluates any immediate needs 431.8 for which emergency services are needed and, as time permits, 431.9 the recipient's current life situation, sources of stress, 431.10 mental health problems and symptoms, strengths, cultural 431.11 considerations, support network, vulnerabilities, and current 431.12 functioning. 431.13 (c) If the crisis assessment determines mobile crisis 431.14 intervention services are needed, the intervention services must 431.15 be provided promptly. As opportunity presents during the 431.16 intervention, at least two members of the mobile crisis 431.17 intervention team must confer directly or by telephone about the 431.18 assessment, treatment plan, and actions taken and needed. At 431.19 least one of the team members must be on-site providing crisis 431.20 intervention services. If providing on-site crisis intervention 431.21 services, a mental health practitioner must seek clinical 431.22 supervision as required in subdivision 8. 431.23 (d) The mobile crisis intervention team must develop an 431.24 initial, brief crisis treatment plan as soon as appropriate but 431.25 no later than 24 hours after the initial face-to-face 431.26 intervention. The plan must address the needs and problems 431.27 noted in the crisis assessment and include measurable short-term 431.28 goals, cultural considerations, and frequency and type of 431.29 services to be provided to achieve the goals and reduce or 431.30 eliminate the crisis. The treatment plan must be updated as 431.31 needed to reflect current goals and services. 431.32 (e) The team must document which short-term goals have been 431.33 met, and when no further crisis intervention services are 431.34 required. 431.35 (f) If the recipient's crisis is stabilized, but the 431.36 recipient needs a referral to other services, the team must 432.1 provide referrals to these services. If the recipient has a 432.2 case manager, planning for other services must be coordinated 432.3 with the case manager. 432.4 Subd. 7. [CRISIS STABILIZATION SERVICES.] (a) Crisis 432.5 stabilization services must be provided by qualified staff of a 432.6 crisis stabilization services provider entity and must meet the 432.7 following standards: 432.8 (1) a crisis stabilization treatment plan must be developed 432.9 which meets the criteria in subdivision 11; 432.10 (2) staff must be qualified as defined in subdivision 8; 432.11 and 432.12 (3) services must be delivered according to the treatment 432.13 plan and include face-to-face contact with the recipient by 432.14 qualified staff for further assessment, help with referrals, 432.15 updating of the crisis stabilization treatment plan, supportive 432.16 counseling, skills training, and collaboration with other 432.17 service providers in the community. 432.18 (b) If crisis stabilization services are provided in a 432.19 supervised, licensed residential setting, the recipient must be 432.20 contacted face-to-face daily by a qualified mental health 432.21 practitioner or mental health professional. The program must 432.22 have 24-hour-a-day residential staffing which may include staff 432.23 who do not meet the qualifications in subdivision 8. The 432.24 residential staff must have 24-hour-a-day immediate direct or 432.25 telephone access to a qualified mental health professional or 432.26 practitioner. 432.27 (c) If crisis stabilization services are provided in a 432.28 supervised, licensed residential setting that serves no more 432.29 than four adult residents, and no more than two are recipients 432.30 of crisis stabilization services, the residential staff must 432.31 include, for at least eight hours per day, at least one 432.32 individual who meets the qualifications in subdivision 8. 432.33 (d) If crisis stabilization services are provided in a 432.34 supervised, licensed residential setting that serves more than 432.35 four adult residents, and one or more are recipients of crisis 432.36 stabilization services, the residential staff must include, for 433.1 24 hours a day, at least one individual who meets the 433.2 qualifications in subdivision 8. During the first 48 hours that 433.3 a recipient is in the residential program, the residential 433.4 program must have at least two staff working 24 hours a day. 433.5 Staffing levels may be adjusted thereafter according to the 433.6 needs of the recipient as specified in the crisis stabilization 433.7 treatment plan. 433.8 Subd. 8. [ADULT CRISIS STABILIZATION STAFF 433.9 QUALIFICATIONS.] (a) Adult mental health crisis stabilization 433.10 services must be provided by qualified individual staff of a 433.11 qualified provider entity. Individual provider staff must have 433.12 the following qualifications: 433.13 (1) be a mental health professional as defined in section 433.14 245.462, subdivision 18, clauses (1) to (5); 433.15 (2) be a mental health practitioner as defined in section 433.16 245.462, subdivision 17. The mental health practitioner must 433.17 work under the clinical supervision of a mental health 433.18 professional; or 433.19 (3) be a mental health rehabilitation worker who meets the 433.20 criteria in section 256B.0623, subdivision 5, clause (3); works 433.21 under the direction of a mental health practitioner as defined 433.22 in section 245.462, subdivision 17, or under direction of a 433.23 mental health professional; and works under the clinical 433.24 supervision of a mental health professional. 433.25 (b) Mental health practitioners and mental health 433.26 rehabilitation workers must have completed at least 30 hours of 433.27 training in crisis intervention and stabilization during the 433.28 past two years. 433.29 Subd. 9. [SUPERVISION.] Mental health practitioners may 433.30 provide crisis assessment and mobile crisis intervention 433.31 services if the following clinical supervision requirements are 433.32 met: 433.33 (1) the mental health provider entity must accept full 433.34 responsibility for the services provided; 433.35 (2) the mental health professional of the provider entity, 433.36 who is an employee or under contract with the provider entity, 434.1 must be available by phone or in person for clinical 434.2 supervision; 434.3 (3) the mental health professional is consulted, in person 434.4 or by phone, during the first three hours when a mental health 434.5 practitioner provides on-site service; 434.6 (4) the mental health professional must: 434.7 (i) review and approve of the tentative crisis assessment 434.8 and crisis treatment plan; 434.9 (ii) document the consultation; and 434.10 (iii) sign the crisis assessment and treatment plan within 434.11 the next business day; 434.12 (5) if the mobile crisis intervention services continue 434.13 into a second calendar day, a mental health professional must 434.14 contact the recipient face-to-face on the second day to provide 434.15 services and update the crisis treatment plan; and 434.16 (6) the on-site observation must be documented in the 434.17 recipient's record and signed by the mental health professional. 434.18 Subd. 10. [RECIPIENT FILE.] Providers of mobile crisis 434.19 intervention or crisis stabilization services must maintain a 434.20 file for each recipient containing the following information: 434.21 (1) individual crisis treatment plans signed by the 434.22 recipient, mental health professional, and mental health 434.23 practitioner who developed the crisis treatment plan, or if the 434.24 recipient refused to sign the plan, the date and reason stated 434.25 by the recipient as to why the recipient would not sign the 434.26 plan; 434.27 (2) signed release forms; 434.28 (3) recipient health information and current medications; 434.29 (4) emergency contacts for the recipient; 434.30 (5) case records which document the date of service, place 434.31 of service delivery, signature of the person providing the 434.32 service, and the nature, extent, and units of service. Direct 434.33 or telephone contact with the recipient's family or others 434.34 should be documented; 434.35 (6) required clinical supervision by mental health 434.36 professionals; 435.1 (7) summary of the recipient's case reviews by staff; and 435.2 (8) any written information by the recipient that the 435.3 recipient wants in the file. 435.4 Documentation in the file must comply with all requirements of 435.5 the commissioner. 435.6 Subd. 11. [TREATMENT PLAN.] The individual crisis 435.7 stabilization treatment plan must include, at a minimum: 435.8 (1) a list of problems identified in the assessment; 435.9 (2) a list of the recipient's strengths and resources; 435.10 (3) concrete, measurable short-term goals and tasks to be 435.11 achieved, including time frames for achievement; 435.12 (4) specific objectives directed toward the achievement of 435.13 each one of the goals; 435.14 (5) documentation of the participants involved in the 435.15 service planning. The recipient, if possible, must be a 435.16 participant. The recipient or the recipient's legal guardian 435.17 must sign the service plan or documentation must be provided why 435.18 this was not possible. A copy of the plan must be given to the 435.19 recipient and the recipient's legal guardian. The plan should 435.20 include services arranged, including specific providers where 435.21 applicable; 435.22 (6) planned frequency and type of services initiated; 435.23 (7) a crisis response action plan if a crisis should occur; 435.24 (8) clear progress notes on outcome of goals; 435.25 (9) a written plan must be completed within 24 hours of 435.26 beginning services with the recipient; and 435.27 (10) a treatment plan must be developed by a mental health 435.28 professional or mental health practitioner under the clinical 435.29 supervision of a mental health professional. The mental health 435.30 professional must approve and sign all treatment plans. 435.31 Subd. 12. [EXCLUDED SERVICES.] The following services are 435.32 excluded from reimbursement under this section: 435.33 (1) room and board services; 435.34 (2) services delivered to a recipient while admitted to an 435.35 inpatient hospital; 435.36 (3) recipient transportation costs may be covered under 436.1 other medical assistance provisions, but transportation services 436.2 are not an adult mental health crisis response service; 436.3 (4) services provided and billed by a provider who is not 436.4 enrolled under medical assistance to provide adult mental health 436.5 crisis response services; 436.6 (5) services performed by volunteers; 436.7 (6) direct billing of time spent "on call" when not 436.8 delivering services to a recipient; 436.9 (7) provider service time included in case management 436.10 reimbursement. When a provider is eligible to provide more than 436.11 one type of medical assistance service, the recipient must have 436.12 a choice of provider for each service, unless otherwise provided 436.13 for by law; 436.14 (8) outreach services to potential recipients; and 436.15 (9) a mental health service that is not medically necessary. 436.16 Sec. 16. Minnesota Statutes 2000, section 256B.0625, 436.17 subdivision 20, is amended to read: 436.18 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 436.19 extent authorized by rule of the state agency, medical 436.20 assistance covers case management services to persons with 436.21 serious and persistent mental illness and children with severe 436.22 emotional disturbance. Services provided under this section 436.23 must meet the relevant standards in sections 245.461 to 436.24 245.4888, the Comprehensive Adult and Children's Mental Health 436.25 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 436.26 9505.0322, excluding subpart 10. 436.27 (b) Entities meeting program standards set out in rules 436.28 governing family community support services as defined in 436.29 section 245.4871, subdivision 17, are eligible for medical 436.30 assistance reimbursement for case management services for 436.31 children with severe emotional disturbance when these services 436.32 meet the program standards in Minnesota Rules, parts 9520.0900 436.33 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 436.34 (c) Medical assistance and MinnesotaCare payment for mental 436.35 health case management shall be made on a monthly basis. In 436.36 order to receive payment for an eligible child, the provider 437.1 must document at least a face-to-face contact with the child, 437.2 the child's parents, or the child's legal representative. To 437.3 receive payment for an eligible adult, the provider must 437.4 document: 437.5 (1) at least a face-to-face contact with the adult or the 437.6 adult's legal representative; or 437.7 (2) at least a telephone contact with the adult or the 437.8 adult's legal representative and document a face-to-face contact 437.9 with the adult or the adult's legal representative within the 437.10 preceding two months. 437.11 (d) Payment for mental health case management provided by 437.12 county or state staff shall be based on the monthly rate 437.13 methodology under section 256B.094, subdivision 6, paragraph 437.14 (b), with separate rates calculated for child welfare and mental 437.15 health, and within mental health, separate rates for children 437.16 and adults. 437.17 (e) Payment for mental health case management provided by 437.18 Indian health services or by agencies operated by Indian tribes 437.19 may be made according to this section or other relevant 437.20 federally approved rate setting methodology. 437.21 (f) Payment for mental health case management provided by 437.22county-contractedvendors who contract with a county or Indian 437.23 tribe shall be based on a monthly rate negotiated by the host 437.24 county or tribe. The negotiated rate must not exceed the rate 437.25 charged by the vendor for the same service to other payers. If 437.26 the service is provided by a team of contracted vendors, the 437.27 county or tribe may negotiate a team rate with a vendor who is a 437.28 member of the team. The team shall determine how to distribute 437.29 the rate among its members. No reimbursement received by 437.30 contracted vendors shall be returned to the county or tribe, 437.31 except to reimburse the county or tribe for advance funding 437.32 provided by the county or tribe to the vendor. 437.33(f)(g) If the service is provided by a team which includes 437.34 contracted vendors, tribal staff, and county or state staff, the 437.35 costs for county or state staff participation in the team shall 437.36 be included in the rate for county-provided services. In this 438.1 case, the contracted vendor, the tribal agency, and the county 438.2 may each receive separate payment for services provided by each 438.3 entity in the same month. In order to prevent duplication of 438.4 services,the countyeach entity must document, in the 438.5 recipient's file, the need for team case management and a 438.6 description of the roles of the team members. 438.7(g)(h) The commissioner shall calculate the nonfederal 438.8 share of actual medical assistance and general assistance 438.9 medical care payments for each county, based on the higher of 438.10 calendar year 1995 or 1996, by service date, project that amount 438.11 forward to 1999, and transfer one-half of the result from 438.12 medical assistance and general assistance medical care to each 438.13 county's mental health grants under sections 245.4886 and 438.14 256E.12 for calendar year 1999. The annualized minimum amount 438.15 added to each county's mental health grant shall be $3,000 per 438.16 year for children and $5,000 per year for adults. The 438.17 commissioner may reduce the statewide growth factor in order to 438.18 fund these minimums. The annualized total amount transferred 438.19 shall become part of the base for future mental health grants 438.20 for each county. 438.21(h)(i) Any net increase in revenue to the county or tribe 438.22 as a result of the change in this section must be used to 438.23 provide expanded mental health services as defined in sections 438.24 245.461 to 245.4888, the Comprehensive Adult and Children's 438.25 Mental Health Acts, excluding inpatient and residential 438.26 treatment. For adults, increased revenue may also be used for 438.27 services and consumer supports which are part of adult mental 438.28 health projects approved under Laws 1997, chapter 203, article 438.29 7, section 25. For children, increased revenue may also be used 438.30 for respite care and nonresidential individualized 438.31 rehabilitation services as defined in section 245.492, 438.32 subdivisions 17 and 23. "Increased revenue" has the meaning 438.33 given in Minnesota Rules, part 9520.0903, subpart 3. 438.34(i)(j) Notwithstanding section 256B.19, subdivision 1, the 438.35 nonfederal share of costs for mental health case management 438.36 shall be provided by the recipient's county of responsibility, 439.1 as defined in sections 256G.01 to 256G.12, from sources other 439.2 than federal funds or funds used to match other federal 439.3 funds. If the service is provided by a tribal agency, the 439.4 nonfederal share, if any, shall be provided by the recipient's 439.5 tribe. 439.6(j)(k) The commissioner may suspend, reduce, or terminate 439.7 the reimbursement to a provider that does not meet the reporting 439.8 or other requirements of this section. The county of 439.9 responsibility, as defined in sections 256G.01 to 256G.12, or, 439.10 if applicable, the tribal agency, is responsible for any federal 439.11 disallowances. The county or tribe may share this 439.12 responsibility with its contracted vendors. 439.13(k)(l) The commissioner shall set aside a portion of the 439.14 federal funds earned under this section to repay the special 439.15 revenue maximization account under section 256.01, subdivision 439.16 2, clause (15). The repayment is limited to: 439.17 (1) the costs of developing and implementing this section; 439.18 and 439.19 (2) programming the information systems. 439.20(l)(m) Notwithstanding section 256.025, subdivision 2, 439.21 payments to counties and tribal agencies for case management 439.22 expenditures under this section shall only be made from federal 439.23 earnings from services provided under this section. Payments to 439.24contractedcounty-contracted vendors shall include both the 439.25 federal earnings and the county share. 439.26(m)(n) Notwithstanding section 256B.041, county payments 439.27 for the cost of mental health case management services provided 439.28 by county or state staff shall not be made to the state 439.29 treasurer. For the purposes of mental health case management 439.30 services provided by county or state staff under this section, 439.31 the centralized disbursement of payments to counties under 439.32 section 256B.041 consists only of federal earnings from services 439.33 provided under this section. 439.34(n)(o) Case management services under this subdivision do 439.35 not include therapy, treatment, legal, or outreach services. 439.36(o)(p) If the recipient is a resident of a nursing 440.1 facility, intermediate care facility, or hospital, and the 440.2 recipient's institutional care is paid by medical assistance, 440.3 payment for case management services under this subdivision is 440.4 limited to the last 30 days of the recipient's residency in that 440.5 facility and may not exceed more than two months in a calendar 440.6 year. 440.7(p)(q) Payment for case management services under this 440.8 subdivision shall not duplicate payments made under other 440.9 program authorities for the same purpose. 440.10(q)(r) By July 1, 2000, the commissioner shall evaluate 440.11 the effectiveness of the changes required by this section, 440.12 including changes in number of persons receiving mental health 440.13 case management, changes in hours of service per person, and 440.14 changes in caseload size. 440.15(r)(s) For each calendar year beginning with the calendar 440.16 year 2001, the annualized amount of state funds for each county 440.17 determined under paragraph(g)(h) shall be adjusted by the 440.18 county's percentage change in the average number of clients per 440.19 month who received case management under this section during the 440.20 fiscal year that ended six months prior to the calendar year in 440.21 question, in comparison to the prior fiscal year. 440.22(s)(t) For counties receiving the minimum allocation of 440.23 $3,000 or $5,000 described in paragraph(g)(h), the adjustment 440.24 in paragraph(r)(s) shall be determined so that the county 440.25 receives the higher of the following amounts: 440.26 (1) a continuation of the minimum allocation in paragraph 440.27(g)(h); or 440.28 (2) an amount based on that county's average number of 440.29 clients per month who received case management under this 440.30 section during the fiscal year that ended six months prior to 440.31 the calendar year in question,in comparison to the prior fiscal440.32year,times the average statewide grant per person per month for 440.33 counties not receiving the minimum allocation. 440.34(t)(u) The adjustments in paragraphs(r) and(s) and (t) 440.35 shall be calculated separately for children and adults. 440.36 Sec. 17. Minnesota Statutes 2000, section 256B.0625, is 441.1 amended by adding a subdivision to read: 441.2 Subd. 43. [APPEAL PROCESS.] If a county contract or 441.3 certification is required to enroll as an authorized provider of 441.4 mental health services under medical assistance, and if a county 441.5 refuses to grant the necessary contract or certification, the 441.6 provider may appeal the county decision to the commissioner. A 441.7 recipient may initiate an appeal on behalf of a provider who has 441.8 been denied certification. The commissioner shall determine 441.9 whether the provider meets applicable standards under state laws 441.10 and rules based on an independent review of the facts, including 441.11 comments from the county review. If the commissioner finds that 441.12 the provider meets the applicable standards, the commissioner 441.13 shall enroll the provider as an authorized provider. The 441.14 commissioner shall develop procedures for providers and 441.15 recipients to appeal a county decision to refuse to enroll a 441.16 provider. After the commissioner makes a decision regarding an 441.17 appeal, the county, provider, or recipient may request that the 441.18 commissioner reconsider the commissioner's initial decision. The 441.19 commissioner's reconsideration decision is final and not subject 441.20 to further appeal. 441.21 Sec. 18. Minnesota Statutes 2000, section 256B.0625, is 441.22 amended by adding a subdivision to read: 441.23 Subd. 44. [MENTAL HEALTH PROVIDER TRAVEL TIME.] Medical 441.24 assistance covers provider travel time if a recipient's 441.25 individual treatment plan requires the provision of mental 441.26 health services outside of the provider's normal place of 441.27 business. This does not include any travel time which is 441.28 included in other billable services, and is only covered when 441.29 the mental health service being provided to a recipient is 441.30 covered under medical assistance. 441.31 Sec. 19. [256B.761] [REIMBURSEMENT FOR MENTAL HEALTH 441.32 SERVICES.] 441.33 Payment for medication management provided to psychiatric 441.34 patients, outpatient mental health services, day treatment 441.35 services, home-based mental health services, and family 441.36 community support services shall be paid at: 442.1 (1) for services rendered on or after July 1, 2001, and 442.2 before July 1, 2002, the lower of (i) submitted charges, or (ii) 442.3 the 73rd percentile of the 50th percentile of 1999 charges; and 442.4 (2) for services rendered on or after July 1, 2002, the 442.5 lower of (i) submitted charges, or (ii) the 75th percentile of 442.6 the 50th percentile of 1999 charges. 442.7 Sec. 20. [299A.76] [SUICIDE STATISTICS.] 442.8 (a) The commissioner of public safety shall not: 442.9 (1) include any statistics on committing suicide or 442.10 attempting suicide in any compilation of crime statistics 442.11 published by the commissioner; or 442.12 (2) label as a crime statistic, any data on committing 442.13 suicide or attempting suicide. 442.14 (b) This section does not apply to the crimes of aiding 442.15 suicide under section 609.215, subdivision 1, or aiding 442.16 attempted suicide under section 609.215, subdivision 2, or to 442.17 statistics directly related to the commission of a crime. 442.18 Sec. 21. [NOTICE REGARDING ESTABLISHMENT OF CONTINUING 442.19 CARE BENEFIT PROGRAM.] 442.20 When the continuing care benefit program for persons with 442.21 mental illness under Minnesota Statutes, section 256.9693 is 442.22 established, the commissioner of human services shall notify 442.23 counties, health plan companies with prepaid medical assistance 442.24 contracts, health care providers, and enrollees of the benefit 442.25 program through bulletins, workshops, and other meetings. 442.26[EFFECTIVE DATE.] This section is effective July 1, 2002. 442.27 Sec. 22. [STUDY; LENGTH OF STAY FOR MEDICARE-ELIGIBLE 442.28 PERSONS.] 442.29 The commissioner of human services shall study and make 442.30 recommendations on how Medicare-eligible persons with mental 442.31 illness may obtain acute care hospital inpatient treatment for 442.32 mental illness for a length of stay beyond that allowed by the 442.33 diagnostic classifications for mental illness according to 442.34 Minnesota Statutes, section 256.969, subdivision 3a. The study 442.35 and recommendations shall be reported to the legislature by 442.36 January 15, 2002. 443.1 Sec. 23. [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT 443.2 RESIDENTIAL SERVICES GRANTS.] 443.3 The commissioner of human services shall review funding 443.4 methods for adult residential services grants under Minnesota 443.5 Rules, parts 9535.2000 to 9535.3000, and shall develop a payment 443.6 system that takes into account client difficulty of care as 443.7 manifested by client physical, mental, or behavioral 443.8 conditions. The payment system must provide reimbursement for 443.9 education, consultation, and support services provided to 443.10 families and other individuals as an extension of the treatment 443.11 process. The commissioner shall present recommendations and 443.12 draft legislation for an adult residential services payment 443.13 system to the legislature by January 15, 2002. The 443.14 recommendations must address whether additional funding for 443.15 adult residential services grants is necessary for the provision 443.16 of high quality services under a payment reimbursement system. 443.17 ARTICLE 10 443.18 ASSISTANCE PROGRAMS 443.19 Section 1. Minnesota Statutes 2000, section 256.01, 443.20 subdivision 18, is amended to read: 443.21 Subd. 18. [IMMIGRATION STATUS VERIFICATIONS.] (a) 443.22 Notwithstanding any waiver of this requirement by the secretary 443.23 of the United States Department of Health and Human Services, 443.24 effective July 1, 2001, the commissioner shall utilize the 443.25 Systematic Alien Verification for Entitlements (SAVE) program to 443.26 conduct immigration status verifications: 443.27 (1) as required under United States Code, title 8, section 443.28 1642; 443.29 (2) for all applicants for food assistance benefits, 443.30 whether under the federal food stamp program, the MFIP or work 443.31 first program, or the Minnesota food assistance program; 443.32 (3) for all applicants for general assistance medical care, 443.33 except assistance for an emergency medical condition, for 443.34 immunization with respect to an immunizable disease, or for 443.35 testing and treatment of symptoms of a communicable disease; and 443.36 (4) for all applicants for general assistance, Minnesota 444.1 supplemental aid, MinnesotaCare, or group residential housing, 444.2 when the benefits provided by these programs would fall under 444.3 the definition of "federal public benefit" under United States 444.4 Code, title 8, section 1642, if federal funds were used to pay 444.5 for all or part of the benefits. 444.6The commissioner shall report to the Immigration and444.7Naturalization Service all undocumented persons who have been444.8identified through application verification procedures or by the444.9self-admission of an applicant for assistance. Reports made444.10under this subdivision must comply with the requirements of444.11section 411A of the Social Security Act, as amended, and United444.12States Code, title 8, section 1644.444.13 (b) The commissioner shall comply with the reporting 444.14 requirements under United States Code, title 42, section 611a, 444.15 and any federal regulation or guidance adopted under that law. 444.16 Sec. 2. [256J.021] [SEPARATE STATE PROGRAM FOR USE OF 444.17 STATE MONEY.] 444.18 Beginning October 1, 2001, and each year thereafter, the 444.19 commissioner of human services must treat financial assistance 444.20 expenditures made to or on behalf of any minor child under 444.21 section 256J.02, subdivision 2, clause (1), who is a resident of 444.22 this state under section 256J.12, and who is part of a 444.23 two-parent eligible household as expenditures under a separately 444.24 funded state program and report those expenditures to the 444.25 federal Department of Health and Human Services as separate 444.26 state program expenditures under Code of Federal Regulations, 444.27 title 45, section 263.5. 444.28 Sec. 3. Minnesota Statutes 2000, section 256J.09, 444.29 subdivision 1, is amended to read: 444.30 Subdivision 1. [WHERE TO APPLY.] To apply for assistance a 444.31 person mustapply for assistance atsubmit a signed application 444.32 to the county agency in the county where that person lives. 444.33 Sec. 4. Minnesota Statutes 2000, section 256J.09, 444.34 subdivision 2, is amended to read: 444.35 Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 444.36 INFORMATION.] When a person inquires about assistance, a county 445.1 agency mustinform a person who inquires about assistance about: 445.2 (1) explain the eligibility requirementsfor assistanceof, 445.3 and how to apply for, diversionary assistance, including445.4diversionary assistance andas provided in section 256J.47; 445.5 emergency assistance.as provided in section 256J.48; MFIP as 445.6 provided in section 256J.10; or any other assistance for which 445.7 the person may be eligible; and 445.8A county agency must(2) offer the person brochures 445.9 developed or approved by the commissioner that describe how to 445.10 apply for assistance. 445.11 Sec. 5. Minnesota Statutes 2000, section 256J.09, 445.12 subdivision 3, is amended to read: 445.13 Subd. 3. [SUBMITTING THE APPLICATION FORM.] (a) A county 445.14 agency must offer, in person or by mail, the application forms 445.15 prescribed by the commissioner as soon as a person makes a 445.16 written or oral inquiry. At that time, the county agency must: 445.17 (1) inform the person that assistance begins with the date 445.18 the signed application is received by the county agency or the 445.19 date all eligibility criteria are met, whichever is later. The445.20county agency must; 445.21 (2) inform theapplicantperson that any delay in 445.22 submitting the application will reduce the amount of assistance 445.23 paid for the month of application. A county agency must; 445.24 (3) inform a person that the person may submit the 445.25 application before an interviewappointment. To apply for445.26assistance, a person must submit a signed application to the445.27county agency.; 445.28 (4) explain the information that will be verified during 445.29 the application process by the county agency as provided in 445.30 section 256J.32; 445.31 (5) inform a person about the county agency's average 445.32 application processing time and explain how the application will 445.33 be processed under subdivision 5; 445.34 (6) explain how to contact the county agency if a person's 445.35 application information changes and how to withdraw the 445.36 application; 446.1 (7) inform a person that the next step in the application 446.2 process is an interview and what a person must do if the 446.3 application is approved including, but not limited to, attending 446.4 orientation under section 256J.45 and complying with employment 446.5 and training services requirements in sections 256J.52 to 446.6 256J.55; 446.7 (8) explain the child care and transportation services that 446.8 are available under paragraph (c) to enable caregivers to attend 446.9 the interview, screening, and orientation; and 446.10 (9) identify any language barriers and arrange for 446.11 translation assistance during appointments, including, but not 446.12 limited to, screening under subdivision 3a, orientation under 446.13 section 256J.45, and the initial assessment under section 446.14 256J.52. 446.15 (b) Upon receipt of a signed application, the county agency 446.16 must stamp the date of receipt on the face of the application. 446.17 The county agency must process the application within the time 446.18 period required under subdivision 5. An applicant may withdraw 446.19 the application at any time by giving written or oral notice to 446.20 the county agency. The county agency must issue a written 446.21 notice confirming the withdrawal. The notice must inform the 446.22 applicant of the county agency's understanding that the 446.23 applicant has withdrawn the application and no longer wants to 446.24 pursue it. When, within ten days of the date of the agency's 446.25 notice, an applicant informs a county agency, in writing, that 446.26 the applicant does not wish to withdraw the application, the 446.27 county agency must reinstate the application and finish 446.28 processing the application. 446.29 (c) Upon a participant's request, the county agency must 446.30 arrange for transportation and child care or reimburse the 446.31 participant for transportation and child care expenses necessary 446.32 to enable participants to attend the screening under subdivision 446.33 3a and orientation under section 256J.45. 446.34 Sec. 6. Minnesota Statutes 2000, section 256J.09, is 446.35 amended by adding a subdivision to read: 446.36 Subd. 3a. [SCREENING.] The county agency, or at county 447.1 option, the county's employment and training service provider as 447.2 defined in section 256J.49, must screen each applicant to 447.3 determine immediate needs and to determine if the applicant may 447.4 be eligible for: 447.5 (1) another program that is not partially funded through 447.6 the federal temporary assistance to needy families block grant 447.7 under Title I of Public Law Number 104-193, including the 447.8 expedited issuance of food stamps under section 256J.28, 447.9 subdivision 1. If the applicant may be eligible for another 447.10 program, a county caseworker must provide the appropriate 447.11 referral to the program; 447.12 (2) the diversionary assistance program under section 447.13 256J.47; or 447.14 (3) the emergency assistance program under section 256J.48. 447.15 Sec. 7. Minnesota Statutes 2000, section 256J.09, is 447.16 amended by adding a subdivision to read: 447.17 Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 447.18 If the applicant is not diverted from applying for MFIP, and if 447.19 the applicant meets the MFIP eligibility requirements, then a 447.20 county agency must: 447.21 (1) identify an applicant who is under the age of 20 and 447.22 explain to the applicant the assessment procedures and 447.23 employment plan requirements for minor parents under section 447.24 256J.54; 447.25 (2) explain to the applicant the eligibility criteria for 447.26 an exemption under the family violence provisions in section 447.27 256J.52, subdivision 6, and explain what an applicant should do 447.28 to develop an alternative employment plan; 447.29 (3) determine if an applicant qualifies for an exemption 447.30 under section 256J.56 from employment and training services 447.31 requirements, explain how a person should report to the county 447.32 agency any status changes, and explain that an applicant who is 447.33 exempt may volunteer to participate in employment and training 447.34 services; 447.35 (4) for applicants who are not exempt from the requirement 447.36 to attend orientation, arrange for an orientation under section 448.1 256J.45 and an initial assessment under section 256J.52; 448.2 (5) inform an applicant who is not exempt from the 448.3 requirement to attend orientation that failure to attend the 448.4 orientation is considered an occurrence of noncompliance with 448.5 program requirements and will result in an imposition of a 448.6 sanction under section 256J.46; and 448.7 (6) explain how to contact the county agency if an 448.8 applicant has questions about compliance with program 448.9 requirements. 448.10 Sec. 8. Minnesota Statutes 2000, section 256J.15, is 448.11 amended by adding a subdivision to read: 448.12 Subd. 3. [ELIGIBILITY AFTER DISQUALIFICATION DUE TO 448.13 NONCOMPLIANCE.] (a) An applicant who is a member of an 448.14 assistance unit that was disqualified from receiving MFIP under 448.15 section 256J.46, subdivision 1, paragraph (d), clause (3), and 448.16 who applies for MFIP assistance within six months of the date of 448.17 the disqualification is considered to be a new applicant for 448.18 purposes of the property limitations under section 256J.20 and, 448.19 at county option, the payment of assistance provisions under 448.20 section 256J.24, subdivision 8. The county agency must also use 448.21 the initial income test under section 256J.21, subdivision 3, in 448.22 determining the applicant's eligibility for assistance. 448.23 (b) Notwithstanding section 256J.24, subdivisions 5 to 7 448.24 and 9, for an applicant who is eligible for MFIP under this 448.25 subdivision, the residual amount of the grant, after making any 448.26 applicable vendor payments for shelter and utility costs, if 448.27 any, must be reduced by ten percent of the applicable MFIP 448.28 standard of need for an assistance unit of the same size for 448.29 each of the first six months on MFIP before the residual amount 448.30 of the grant is paid to the assistance unit. 448.31 (c) A participant who is disqualified from MFIP a second or 448.32 subsequent time and who is eligible for MFIP under this 448.33 subdivision is considered to have a third occurrence of 448.34 noncompliance and must be sanctioned under section 256J.46, 448.35 subdivision 1, paragraph (d), clause (2), for the first six 448.36 months on MFIP under this subdivision. 449.1 Sec. 9. Minnesota Statutes 2000, section 256J.24, 449.2 subdivision 10, is amended to read: 449.3 Subd. 10. [MFIP EXIT LEVEL.](a) In state fiscal years449.42000 and 2001,The commissioner shall adjust the MFIP earned 449.5 income disregard to ensure that most participants do not lose 449.6 eligibility for MFIP until their income reaches at least 120 449.7 percent of the federal poverty guidelines in effect in October 449.8 of each fiscal year. The adjustment to the disregard shall be 449.9 based on a household size of three, and the resulting earned 449.10 income disregard percentage must be applied to all household 449.11 sizes. The adjustment under this subdivision must be 449.12 implemented at the same time as the October food stamp 449.13 cost-of-living adjustment is reflected in the food portion of 449.14 MFIP transitional standard as required under subdivision 5a. 449.15(b) In state fiscal year 2002 and thereafter, the earned449.16income disregard percentage must be the same as the percentage449.17implemented in October 2000.449.18 Sec. 10. Minnesota Statutes 2000, section 256J.26, 449.19 subdivision 1, is amended to read: 449.20 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 449.21 Applicants or participants who have been convicted of a drug 449.22 offense committed after July 1, 1997, may, if otherwise 449.23 eligible, receive MFIP benefits subject to the following 449.24 conditions: 449.25 (1) Benefits for the entire assistance unit must be paid in 449.26 vendor form for shelter and utilities during any time the 449.27 applicant is part of the assistance unit. 449.28 (2) The convicted applicant or participant shall be subject 449.29 to random drug testing as a condition of continued eligibility 449.30 and following any positive test for an illegal controlled 449.31 substance is subject to the following sanctions: 449.32 (i) for failing a drug test the first time, the 449.33participant's grant shall be reduced by ten percent of the MFIP449.34standard of need, prior to making vendor payments for shelter449.35and utility costs; or449.36(ii) for failing a drug test two or more times, the450.1 residual amount of the participant's grant after making vendor 450.2 payments for shelter and utility costs, if any, must be reduced 450.3 by an amount equal to 30 percent of the MFIP standard of 450.4 need for an assistance unit of the same size. When a sanction 450.5 under this subdivision is in effect, the job counselor must 450.6 attempt to meet with the person face-to-face. During the 450.7 face-to-face meeting, the job counselor must explain the 450.8 consequences of a subsequent drug test failure and inform the 450.9 participant of the right to appeal the sanction under section 450.10 256J.40. If a face-to-face meeting is not possible, the county 450.11 agency must send the participant a notice of adverse action as 450.12 provided in section 256J.31, subdivisions 4 and 5, and must 450.13 include the information required in the face-to-face meeting; or 450.14 (ii) for failing a drug test two times, the participant is 450.15 permanently disqualified from receiving MFIP assistance, both 450.16 the cash and food portions. The assistance unit's MFIP grant 450.17 must be reduced by the amount which would have otherwise been 450.18 made available to the disqualified participant. 450.19 Disqualification under this item does not make a participant 450.20 ineligible for food stamps. Before a disqualification under 450.21 this provision is imposed, the job counselor must attempt to 450.22 meet with the participant face-to-face. During the face-to-face 450.23 meeting, the job counselor must identify other resources that 450.24 may be available to the participant to meet the needs of the 450.25 family and inform the participant of the right to appeal the 450.26 disqualification under section 256J.40. If a face-to-face 450.27 meeting is not possible, the county agency must send the 450.28 participant a notice of adverse action as provided in section 450.29 256J.31, subdivisions 4 and 5, and must include the information 450.30 required in the face-to-face meeting. 450.31 (3) A participant who failsan initiala drug test the 450.32 first time and is under a sanction due to other MFIP program 450.33 requirements is considered to have more than one occurrence of 450.34 noncompliance and is subject to the applicable level of sanction 450.35in clause (2)(ii)as specified under section 256J.46, 450.36 subdivision 1, paragraph (d). 451.1 (b) Applicants requesting only food stamps or participants 451.2 receiving only food stamps, who have been convicted of a drug 451.3 offense that occurred after July 1, 1997, may, if otherwise 451.4 eligible, receive food stamps if the convicted applicant or 451.5 participant is subject to random drug testing as a condition of 451.6 continued eligibility. Following a positive test for an illegal 451.7 controlled substance, the applicant is subject to the following 451.8 sanctions: 451.9 (1) for failing a drug test the first time,food stamps451.10shall be reduced by ten percent of the applicable food stamp451.11allotment; and451.12(2) for failing a drug test two or more times,food stamps 451.13 shall be reduced by an amount equal to 30 percent of the 451.14 applicable food stamp allotment. When a sanction under this 451.15 clause is in effect, a job counselor must attempt to meet with 451.16 the person face-to-face. During the face-to-face meeting, a job 451.17 counselor must explain the consequences of a subsequent drug 451.18 test failure and inform the participant of the right to appeal 451.19 the sanction under section 256J.40. If a face-to-face meeting 451.20 is not possible, a county agency must send the participant a 451.21 notice of adverse action as provided in section 256J.31, 451.22 subdivisions 4 and 5, and must include the information required 451.23 in the face-to-face meeting; and 451.24 (2) for failing a drug test two times, the participant is 451.25 permanently disqualified from receiving food stamps. Before a 451.26 disqualification under this provision is imposed, a job 451.27 counselor must attempt to meet with the participant 451.28 face-to-face. During the face-to-face meeting, the job 451.29 counselor must identify other resources that may be available to 451.30 the participant to meet the needs of the family and inform the 451.31 participant of the right to appeal the disqualification under 451.32 section 256J.40. If a face-to-face meeting is not possible, a 451.33 county agency must send the participant a notice of adverse 451.34 action as provided in section 256J.31, subdivisions 4 and 5, and 451.35 must include the information required in the face-to-face 451.36 meeting. 452.1 (c) For the purposes of this subdivision, "drug offense" 452.2 means an offense that occurred after July 1, 1997, of sections 452.3 152.021 to 152.025, 152.0261, or 152.096. Drug offense also 452.4 means a conviction in another jurisdiction of the possession, 452.5 use, or distribution of a controlled substance, or conspiracy to 452.6 commit any of these offenses, if the offense occurred after July 452.7 1, 1997, and the conviction is a felony offense in that 452.8 jurisdiction, or in the case of New Jersey, a high misdemeanor. 452.9 Sec. 11. Minnesota Statutes 2000, section 256J.31, 452.10 subdivision 4, is amended to read: 452.11 Subd. 4. [PARTICIPANT'S RIGHT TO NOTICE.] A county agency 452.12 must give a participant written notice of all adverse actions 452.13 affecting the participant including payment reductions, 452.14 suspensions, terminations, and use of protective, vendor, or 452.15 two-party payments. The notice of adverse action must be on a 452.16 form prescribed or approved by the commissioner, must be 452.17 understandable at a seventh grade reading level, and must be 452.18 mailed to the last known mailing address provided by the 452.19 participant. A notice written in English must include the 452.20 department of human services language block and must be sent to 452.21 every applicable participant. The county agency must state on 452.22 the notice of adverse action the action it intends to take, the 452.23 reasons for the action, the participant's right to appeal the 452.24 action, the conditions under which assistance can be continued 452.25 pending an appeal decision, and the related consequences of the 452.26 action. 452.27 Sec. 12. Minnesota Statutes 2000, section 256J.32, 452.28 subdivision 7a, is amended to read: 452.29 Subd. 7a. [REQUIREMENT TO REPORT TO IMMIGRATION AND 452.30 NATURALIZATION SERVICES.]Notwithstanding subdivision 7,452.31effective July 1, 2001, the commissioner shall report to the452.32Immigration and Naturalization Services all undocumented persons452.33who have been identified through application verification452.34procedures or by the self-admission of an applicant for452.35assistance. Reports made under this subdivision must comply452.36with the requirements of section 411A of the Social Security453.1Act, as amended, and United States Code, title 8, section 1644.453.2 The commissioner shall comply with the reporting requirements 453.3 under United States Code, title 42, section 611a, and any 453.4 federal regulation or guidance adopted under that law. 453.5 Sec. 13. Minnesota Statutes 2000, section 256J.42, is 453.6 amended by adding a subdivision to read: 453.7 Subd. 6. [CASE REVIEW.] (a) Within 180 days before the end 453.8 of the participant's 60th month on MFIP, the county agency or 453.9 job counselor must review the participant's case to determine if 453.10 the employment plan is still appropriate, or if the participant 453.11 is exempt under section 256J.56 from the employment and training 453.12 services component, and attempt to meet with the participant 453.13 face-to-face. 453.14 (b) During the face-to-face meeting, a county agency or the 453.15 job counselor must: 453.16 (1) inform the participant how many months of counted 453.17 assistance the participant has accrued and when the participant 453.18 is expected to reach the 60th month; 453.19 (2) explain the hardship extension criteria under section 453.20 256J.425 and what the participant should do if the participant 453.21 thinks a hardship extension applies; 453.22 (3) identify other resources that may be available to the 453.23 participant to meet the needs of the family; and 453.24 (4) inform the participant of the right to appeal the case 453.25 closure under section 256J.40. 453.26 (c) If a face-to-face meeting is not possible, the county 453.27 agency must send the participant a notice of adverse action as 453.28 provided in section 256J.31, subdivisions 4 and 5. 453.29 (d) Before a participant's case is closed under this 453.30 section, the county must ensure that: 453.31 (1) the case has been reviewed by the job counselor's 453.32 supervisor or the review team designated in the county's 453.33 approved local service unit plan to determine if the criteria 453.34 for a hardship extension, if requested, were applied 453.35 appropriately; and 453.36 (2) the county agency or the job counselor attempted to 454.1 meet with the participant face-to-face. 454.2 Sec. 14. [256J.425] [HARDSHIP EXTENSIONS.] 454.3 Subdivision 1. [ELIGIBILITY.] An assistance unit subject 454.4 to the time limit under section 256J.42, subdivision 1, in which 454.5 any participant has received 60 counted months of assistance is 454.6 not eligible to receive months of assistance beyond the first 60 454.7 months under a hardship extension, if the participant is not in 454.8 compliance. If there is more than one participant in the 454.9 household, each participant must be in compliance to be eligible 454.10 for a hardship extension. For purposes of determining 454.11 eligibility for a hardship extension, a participant is in 454.12 compliance in any month that the participant has not been 454.13 sanctioned under section 256J.46, subdivision 1, or under 454.14 256J.26, subdivision 1. 454.15 Subd. 2. [ILL OR INCAPACITATED PARTICIPANTS; DEPENDENT 454.16 HOUSEHOLD MEMBER.] (a) An assistance unit subject to the time 454.17 limit in section 256J.42, subdivision 1, in which any 454.18 participant has received 60 counted months of assistance, is 454.19 eligible to receive months of assistance under a hardship 454.20 extension if the participant belongs to any of the following 454.21 groups: 454.22 (1) participants who are suffering from a professionally 454.23 certified illness, injury, or incapacity which is expected to 454.24 continue for more than 30 days and which prevents the person 454.25 from obtaining or retaining employment and who are following the 454.26 treatment recommendations of the health care provider certifying 454.27 the illness, injury, or incapacity; 454.28 (2) participants whose presence in the home is required 454.29 because of the professionally certified illness or incapacity of 454.30 another member in the assistance unit, a relative in the 454.31 household, or a foster child in the household and the illness or 454.32 incapacity is expected to continue for more than 30 days; or 454.33 (3) caregivers with a child or an adult in the household 454.34 who meets the disability or medical criteria for home care 454.35 services under section 256B.0627, subdivision 1, paragraph (c), 454.36 or a home and community-based waiver services program under 455.1 chapter 256B, or meets the criteria for severe emotional 455.2 disturbance under section 245.4871, subdivision 6, or for 455.3 serious and persistent mental illness under section 245.462, 455.4 subdivision 20, paragraph (c). Caregivers in this category are 455.5 presumed to be prevented from obtaining or retaining employment. 455.6 (b) An assistance unit receiving assistance under a 455.7 hardship extension under this subdivision may continue to 455.8 receive assistance under MFIP as long as the participant meets 455.9 the criteria in paragraph (a), clause (1), (2), or (3). A 455.10 county agency or job counselor must, on a quarterly basis, 455.11 review the case file of an assistance unit receiving assistance 455.12 under this subdivision to determine if the participant still 455.13 meets the criteria in paragraph (a), clause (1), (2), or (3). 455.14 Subd. 3. [CERTAIN HARD-TO-EMPLOY PARTICIPANTS.] (a) An 455.15 assistance unit subject to the time limit in section 256J.42, 455.16 subdivision 1, in which any participant has received 60 counted 455.17 months of assistance, is eligible to receive months of 455.18 assistance under a hardship extension if the participant belongs 455.19 to any of the following groups: 455.20 (1) a person who is diagnosed by a licensed physician, 455.21 psychological practitioner, or other qualified professional, as 455.22 mentally retarded or mentally ill, and that condition prevents 455.23 the person from obtaining or retaining employment; 455.24 (2) a person who has been assessed by a vocational 455.25 specialist, job counselor, or the county agency to be 455.26 unemployable for purposes of this subdivision; a person is 455.27 considered employable if positions of employment in the local 455.28 labor market exist, regardless of the current availability of 455.29 openings for those positions, that the person is capable of 455.30 performing. The person's eligibility under this category must 455.31 be reassessed at least annually; or 455.32 (3) a person who is determined by the county agency, 455.33 according to Minnesota Rules, part 9500.1251, subpart 2, item I, 455.34 to be learning disabled, provided that if a rehabilitation plan 455.35 for the person is developed or approved by the county agency, 455.36 the person is following the plan. A rehabilitation plan does 456.1 not replace the requirement to develop and comply with an 456.2 employment plan under section 256J.52. 456.3 (b) An assistance unit receiving assistance under a 456.4 hardship extension under this subdivision may continue to 456.5 receive assistance under MFIP as long as the participant meets 456.6 the criteria in paragraph (a), clause (1), (2), or (3), and all 456.7 participants in the assistance unit remain in compliance with, 456.8 or are exempt from, the employment and training services 456.9 requirements in sections 256J.52 to 256J.55. 456.10 Subd. 4. [VICTIMS OF FAMILY VIOLENCE.] A participant who 456.11 received TANF assistance that counted towards the federal 456.12 60-month time limit while the participant complied with a safety 456.13 plan or, after October 1, 2001, an alternative employment plan 456.14 under the MFIP employment and training component is eligible for 456.15 assistance under a hardship extension for a period of time equal 456.16 to the number of months that were counted toward the federal 456.17 60-month time limit while the participant complied with a safety 456.18 plan or, after October 1, 2001, an alternative employment plan 456.19 under the MFIP employment and training component. 456.20 Subd. 5. [ACCRUAL OF CERTAIN EXEMPT MONTHS.] (a) A 456.21 participant who received TANF assistance that counted towards 456.22 the federal 60-month time limit while the participant was or 456.23 would have been exempt under section 256J.56, paragraph (a), 456.24 clause (7), from employment and training services requirements 456.25 and who is no longer eligible for assistance under a hardship 456.26 extension under subdivision 2, paragraph (a), clause (3), is 456.27 eligible for assistance under a hardship extension for a period 456.28 of time equal to the number of months that were counted toward 456.29 the federal 60-month time limit while the participant was or 456.30 would have been exempt under section 256J.56, paragraph (a), 456.31 clause (7), from the employment and training services 456.32 requirements. 456.33 (b) A participant who received TANF assistance that counted 456.34 towards the federal 60-month time limit while the participant 456.35 met the state time limit exemption criteria under section 456.36 256J.42, subdivision 5, is eligible for assistance under a 457.1 hardship extension for a period of time equal to the number of 457.2 months that were counted toward the federal 60-month time limit 457.3 while the participant met the state time limit exemption 457.4 criteria under section 256J.42, subdivision 5. 457.5 Sec. 15. Minnesota Statutes 2000, section 256J.45, 457.6 subdivision 1, is amended to read: 457.7 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 457.8 county agency must provide a face-to-face orientation to each 457.9 MFIP caregiverwho is not exempt under section 256J.56,457.10paragraph (a), clause (6) or (8), with a face-to-face457.11orientationunless the caregiver is: 457.12 (1) a single parent, or one parent in a two-parent family, 457.13 employed at least 35 hours per week; or 457.14 (2) a second parent in a two-parent family who is employed 457.15 for 20 or more hours per week provided the first parent is 457.16 employed at least 35 hours per week. 457.17 The county agency must inform caregivers who are not exempt 457.18 undersection 256J.56, paragraph (a), clause (6) or (8),clause 457.19 (1) or (2) that failure to attend the orientation is considered 457.20 an occurrence of noncompliance with program requirements, and 457.21 will result in the imposition of a sanction under section 457.22 256J.46. If the client complies with the orientation 457.23 requirement prior to the first day of the month in which the 457.24 grant reduction is proposed to occur, the orientation sanction 457.25 shall be lifted. 457.26 Sec. 16. Minnesota Statutes 2000, section 256J.46, 457.27 subdivision 1, is amended to read: 457.28 Subdivision 1. [SANCTIONS FORPARTICIPANTS NOT COMPLYING 457.29 WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 457.30 good cause to comply with the requirements of this chapter, and 457.31 who is not subject to a sanction under subdivision 2, shall be 457.32 subject to a sanction as provided in this subdivision. Prior to 457.33 the imposition of a sanction, a county agency shall provide a 457.34 notice of intent to sanction under section 256J.57, subdivision 457.35 2, and, when applicable, a notice of adverse action as provided 457.36 in section 256J.31. 458.1 (b) A participant who fails to comply with an alternative 458.2 employment plan must have the plan reviewed by a person trained 458.3 in domestic violence and a job counselor to determine if 458.4 components of the alternative employment plan are still 458.5 appropriate. If the activities are no longer appropriate, the 458.6 plan must be revised with a person trained in domestic violence 458.7 and approved by a job counselor. A participant who fails to 458.8 comply with a plan that is determined not to need revision will 458.9 lose their exemption and be required to comply with regular 458.10 employment services activities. 458.11 (c) A sanction under this subdivision becomes effective the 458.12 month following the month in which a required notice is given. 458.13 A sanction must not be imposed when a participant comes into 458.14 compliance with the requirements for orientation under section 458.15 256J.45 or third-party liability for medical services under 458.16 section 256J.30, subdivision 10, prior to the effective date of 458.17 the sanction. A sanction must not be imposed when a participant 458.18 comes into compliance with the requirements for employment and 458.19 training services under sections 256J.49 to256J.72256J.55 ten 458.20 days prior to the effective date of the sanction. For purposes 458.21 of this subdivision, each month that a participant fails to 458.22 comply with a requirement of this chapter shall be considered a 458.23 separate occurrence of noncompliance. A participant who has had 458.24 one or more sanctions imposed must remain in compliance with the 458.25 provisions of this chapter for six months in order for a 458.26 subsequent occurrence of noncompliance to be considered a first 458.27 occurrence. 458.28(b)(d) Sanctions for noncompliance shall be imposed as 458.29 follows: 458.30 (1) For the first occurrence of noncompliance by a 458.31 participant ina single-parent household or by one participant458.32in a two-parent householdan assistance unit, the assistance 458.33 unit's grant shall be reduced by ten percent of the MFIP 458.34 standard of need for an assistance unit of the same size with 458.35 the residual grant paid to the participant. The reduction in 458.36 the grant amount must be in effect for a minimum of one month 459.1 and shall be removed in the month following the month that the 459.2 participant returns to compliance. 459.3 (2) For a secondor subsequentand third occurrence of 459.4 noncompliance by a participant in an assistance unit, or 459.5 whenbotheach of the participants in a two-parenthousehold are459.6out of complianceassistance unit have a first occurrence of 459.7 noncompliance at the same time, the assistance unit's shelter 459.8 costs shall be vendor paid up to the amount of the cash portion 459.9 of the MFIP grant for which theparticipant'sassistance unit is 459.10 eligible. At county option, the assistance unit's utilities may 459.11 also be vendor paid up to the amount of the cash portion of the 459.12 MFIP grant remaining after vendor payment of the assistance 459.13 unit's shelter costs. The residual amount of the grant after 459.14 vendor payment, if any, must be reduced by an amount equal to 30 459.15 percent of the MFIP standard of need for an assistance unit of 459.16 the same size before the residual grant is paid to the 459.17 assistance unit. The reduction in the grant amount must be in 459.18 effect for a minimum of one month and shall be removed in the 459.19 month following the month thatathe participant in a one-parent 459.20householdassistance unit returns to compliance. In a 459.21 two-parenthouseholdassistance unit, the grant reduction must 459.22 be in effect for a minimum of one month and shall be removed in 459.23 the month following the month both participants return to 459.24 compliance. The vendor payment of shelter costs and, if 459.25 applicable, utilities shall be removed six months after the 459.26 month in which the participant or participants return to 459.27 compliance. If an assistance unit is sanctioned under this 459.28 clause, the participant's case file must be reviewed as required 459.29 under paragraph (e). 459.30 (3) For a fourth occurrence of noncompliance, the 459.31 assistance unit is disqualified from receiving MFIP assistance, 459.32 both the cash and food portions. This disqualification must be 459.33 in effect for a minimum of one full month. Disqualification 459.34 under this clause does not make a participant ineligible for 459.35 food stamps. Before an assistance unit is disqualified under 459.36 this clause, the county must ensure that: 460.1 (i) the case has been reviewed by the job counselor's 460.2 supervisor or the review team designated in the county's 460.3 approved local service unit plan to determine if the review 460.4 required under paragraph (e) has occurred; and 460.5 (ii) the job counselor attempted to meet with the 460.6 participant face-to-face. 460.7(c) No later than during the second month that(e) When a 460.8 sanction under paragraph(b)(d), clause (2), is in effectdue460.9to noncompliance with employment services, the participant's460.10case file must be reviewed to determine if, the county agency or 460.11 job counselor must review the participant's case to determine if 460.12 the employment plan is still appropriate and attempt to meet 460.13 with the participant face-to-face. If a face-to-face meeting is 460.14 not possible, the county agency must send the participant a 460.15 notice of adverse action as provided in section 256J.31, 460.16 subdivisions 4 and 5. 460.17 (1) During the face-to-face meeting, the job counselor must: 460.18 (i) determine whether the continued noncompliance can be 460.19 explained and mitigated by providing a needed preemployment 460.20 activity, as defined in section 256J.49, subdivision 13, clause 460.21 (16), or services under a local intervention grant for 460.22 self-sufficiency under section 256J.625; 460.23 (ii) determine whether the participant qualifies for a good 460.24 cause exception under section 256J.57;or460.25 (iii) determine whether the participant qualifies for an 460.26 exemption under section 256J.56; 460.27 (iv) determine whether the participant qualifies for an 460.28 exemption for victims of family violence under section 256J.52, 460.29 subdivision 6; 460.30 (v) inform the participant of the participant's sanction 460.31 status and explain the consequences of continuing noncompliance; 460.32 (vi) identify other resources that may be available to the 460.33 participant to meet the needs of the family if the participant 460.34 is sanctioned and disqualified from MFIP under paragraph (d), 460.35 clause (3); and 460.36 (vii) inform the participant of the right to appeal under 461.1 section 256J.40. 461.2 (2) If the lack of an identified activity can explain the 461.3 noncompliance, the county must work with the participant to 461.4 provide the identified activity, and the county must restore the 461.5 participant's grant amount to the full amount for which the 461.6 assistance unit is eligible. The grant must be restored 461.7 retroactively to the first day of the month in which the 461.8 participant was found to lack preemployment activities or to 461.9 qualify for an exemptionorunder section 256J.56, a good cause 461.10 exception under section 256J.57, or an exemption for victims of 461.11 family violence under section 256J.52, subdivision 6. 461.12 (3) If the participant is found to qualify for a good cause 461.13 exception or an exemption, the county must restore the 461.14 participant's grant to the full amount for which the assistance 461.15 unit is eligible. 461.16[EFFECTIVE DATE.] The family violence provisions in 461.17 paragraph (e) are effective October 1, 2001, if the alternative 461.18 employment plan and family violence provisions in section 461.19 256J.52, subdivision 6, are enacted during the 2001 session. 461.20 Sec. 17. Minnesota Statutes 2000, section 256J.46, 461.21 subdivision 2a, is amended to read: 461.22 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 461.23 provisions of subdivisions 1 and 2, for a participant subject to 461.24 a sanction for refusal to comply with child support requirements 461.25 under subdivision 2 and subject to a concurrent sanction for 461.26 refusal to cooperate with other program requirements under 461.27 subdivision 1, sanctions shall be imposed in the manner 461.28 prescribed in this subdivision. 461.29 A participant who has had one or more sanctions imposed 461.30 under this subdivision must remain in compliance with the 461.31 provisions of this chapter for six months in order for a 461.32 subsequent occurrence of noncompliance to be considered a first 461.33 occurrence. Any vendor payment of shelter costs or utilities 461.34 under this subdivision must remain in effect for six months 461.35 after the month in which the participant is no longer subject to 461.36 sanction under subdivision 1. 462.1 (b) If the participant was subject to sanctionfor:462.2(i) noncompliance under subdivision 1 before being subject462.3to sanction for noncooperation under subdivision 2; or462.4(ii) noncooperation under subdivision 2 before being462.5subject to sanction for noncompliance under subdivision 1;under 462.6 subdivision 1 or 2 before being subject to sanction under the 462.7 other of those subdivisions, the participant shall be sanctioned 462.8 as provided in subdivision 1, paragraph(b)(d),clause462.9 clauses (2) and (3), and the requirement that the county conduct 462.10 a review as specified in subdivision 1, paragraph(c)(e), 462.11 remains in effect. 462.12 (c) A participant who first becomes subject to sanction 462.13 under both subdivisions 1 and 2 in the same month is subject to 462.14 sanction as follows: 462.15 (i) in the first month of noncompliance and noncooperation, 462.16 the participant's grant must be reduced by 25 percent of the 462.17 applicable MFIP standard of need, with any residual amount paid 462.18 to the participant; 462.19 (ii) in the second and subsequent months of noncompliance 462.20 and noncooperation, the participant shall be sanctioned as 462.21 provided in subdivision 1, paragraph(b)(d),clauseclauses (2) 462.22 and (3). 462.23 The requirement that the county conduct a review as 462.24 specified in subdivision 1, paragraph(c)(e), remains in effect. 462.25 (d) A participant remains subject to sanction under 462.26 subdivision 2 if the participant: 462.27 (i) returns to compliance and is no longer subject to 462.28 sanction under subdivision 1; or 462.29 (ii) has the sanction under subdivision 1, 462.30 paragraph(b)(d), removed upon completion of the review under 462.31 subdivision 1, paragraph(c)(e). 462.32 A participant remains subject to sanction under subdivision 462.33 1, paragraph(b)(d), if the participant cooperates and is no 462.34 longer subject to sanction under subdivision 2. 462.35 Sec. 18. Minnesota Statutes 2000, section 256J.46, is 462.36 amended by adding a subdivision to read: 463.1 Subd. 3. [SANCTION STATUS AFTER DISQUALIFICATION.] An 463.2 applicant who is a member of an assistance unit that was 463.3 disqualified from receiving MFIP under subdivision 1, paragraph 463.4 (d), clause (3), who applies for MFIP assistance within six 463.5 months of the date of the disqualification, and who is 463.6 determined to be eligible for MFIP assistance, is considered to 463.7 have a first occurrence of noncompliance. An applicant who is a 463.8 member of an assistance unit that was disqualified from MFIP 463.9 under subdivision 1, paragraph (d), clause (3), a second or 463.10 subsequent time, who applies for assistance within six months of 463.11 the date of disqualification, and who is determined to be 463.12 eligible for MFIP assistance, is considered to have a third 463.13 occurrence of noncompliance. The applicant must remain in 463.14 compliance with the provisions of this chapter for six months in 463.15 order for a subsequent occurrence of noncompliance to be 463.16 considered a first occurrence. 463.17 Sec. 19. Minnesota Statutes 2000, section 256J.50, 463.18 subdivision 1, is amended to read: 463.19 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT 463.20 OF MFIP.] (a) By January 1, 1998, each county must develop and 463.21 implement an employment and training services component of MFIP 463.22 which is designed to put participants on the most direct path to 463.23 unsubsidized employment. Participation in these services is 463.24 mandatory for all MFIP caregivers, unless the caregiver is 463.25 exempt under section 256J.56. 463.26 (b) A county must provide employment and training services 463.27 under sections 256J.515 to 256J.74 within 30 days after the 463.28 caregiver's participation becomes mandatory under subdivision 463.29 5 or within 30 days of receipt of a request for services from a 463.30 caregiver who under section 256J.42 is no longer eligible to 463.31 receive MFIP but whose income is below 120 percent of the 463.32 federal poverty guidelines for a family of the same size. The 463.33 request must be made within 12 months of the date the 463.34 caregivers' MFIP case was closed. 463.35 Sec. 20. Minnesota Statutes 2000, section 256J.50, 463.36 subdivision 7, is amended to read: 464.1 Subd. 7. [LOCAL SERVICE UNIT PLAN.] (a) Each local or 464.2 county service unit shall prepare and submit a plan as specified 464.3 in section 268.88. 464.4 (b) The plan must include a description of how projects 464.5 funded under the local intervention grants for self-sufficiency 464.6 in section 256J.625, subdivisions 2 and 3, operate in the local 464.7 service unit, including: 464.8 (1) the target populations of hard-to-employ participants 464.9and, working participants in need of job retention and wage 464.10 advancement services, and caregivers who, within the last 12 464.11 months, have been determined under section 256J.42 to no longer 464.12 be eligible to receive MFIP and whose income is below 120 464.13 percent of the federal poverty guidelines for a family of the 464.14 same size, with a description of how individual participant 464.15 needs will be met; 464.16 (2) services that will be provided which may include paid 464.17 work experience, enhanced mental health services, outreach to 464.18 sanctioned families and to caregivers who, within the last 12 464.19 months, have been determined under section 256J.42 to no longer 464.20 be eligible to receive MFIP but whose income is below 120 464.21 percent of the federal poverty guidelines for a family of the 464.22 same size, child care for social services, child care transition 464.23 year set-aside, homeless and housing advocacy, and 464.24 transportation; 464.25 (3) projected expenditures by activity; 464.26 (4) anticipated program outcomes including the anticipated 464.27 impact the intervention efforts will have on performance 464.28 measures under section 256J.751 and on reducing the number of 464.29 MFIP participants expected to reach their 60-month time limit; 464.30 and 464.31 (5) a description of services that are provided or will be 464.32 provided to MFIP participants affected by chemical dependency, 464.33 mental health issues, learning disabilities, or family violence. 464.34 Each plan must demonstrate how the county or tribe is 464.35 working within its organization and with other organizations in 464.36 the community to serve hard-to-employ populations, including how 465.1 organizations in the community were engaged in planning for use 465.2 of these funds, services other entities will provide under the 465.3 plan, and whether multicounty or regional strategies are being 465.4 implemented as part of this plan. 465.5 (c) Activities and expenditures in the plan must enhance or 465.6 supplement MFIP activities without supplanting existing 465.7 activities and expenditures. However, this paragraph does not 465.8 require a county to maintain either: 465.9 (1) its current provision of child care assistance to MFIP 465.10 families through the expenditure of county resources under 465.11 chapter 256E for social services child care assistance if funds 465.12 are appropriated by another law for an MFIP social services 465.13 child care pool; 465.14 (2) its current provision of transition-year child care 465.15 assistance through the expenditure of county resources if funds 465.16 are appropriated by another law for this purpose; or 465.17 (3) its current provision of intensive ESL programs through 465.18 the expenditure of county resources if funds are appropriated by 465.19 another law for intensive ESL grants. 465.20 (d) The plan required under this subdivision must be 465.21 approved before the local or county service unit is eligible to 465.22 receive funds under section 256J.625, subdivisions 2 and 3. 465.23 Sec. 21. Minnesota Statutes 2000, section 256J.56, is 465.24 amended to read: 465.25 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 465.26 EXEMPTIONS.] 465.27 (a) An MFIPcaregiverparticipant is exempt from the 465.28 requirements of sections 256J.52 to 256J.55 if thecaregiver465.29 participant belongs to any of the following groups: 465.30 (1)individualsparticipants who are age 60 or older; 465.31 (2)individualsparticipants who are suffering from a 465.32 professionally certified permanent or temporary illness, injury, 465.33 or incapacity which is expected to continue for more than 30 465.34 days and which prevents the person from obtaining or retaining 465.35 employment. Persons in this category with a temporary illness, 465.36 injury, or incapacity must be reevaluated at least quarterly; 466.1 (3)caregiversparticipants whose presence in the home is 466.2 required because of the professionally certified illness or 466.3 incapacity of another member in the assistance unit, a relative 466.4 in the household, or a foster child in the household and the 466.5 illness or incapacity is expected to continue for more than 30 466.6 days; 466.7 (4) women who are pregnant, if the pregnancy has resulted 466.8 in a professionally certified incapacity that prevents the woman 466.9 from obtaining or retaining employment; 466.10 (5) caregivers of a child under the age of one year who 466.11 personally provide full-time care for the child. This exemption 466.12 may be used for only 12 months in a lifetime. In two-parent 466.13 households, only one parent or other relative may qualify for 466.14 this exemption; 466.15(6) individuals who are single parents, or one parent in a466.16two-parent family, employed at least 35 hours per week;466.17(7) individuals(6) participants experiencing a personal or 466.18 family crisis that makes them incapable of participating in the 466.19 program, as determined by the county agency. If the participant 466.20 does not agree with the county agency's determination, the 466.21 participant may seek professional certification, as defined in 466.22 section 256J.08, that the participant is incapable of 466.23 participating in the program. 466.24 Persons in this exemption category must be reevaluated 466.25 every 60 days; or 466.26(8) second parents in two-parent families employed for 20466.27or more hours per week, provided the first parent is employed at466.28least 35 hours per week; or466.29(9)(7) caregivers with a child or an adult in the 466.30 household who meets the disability or medical criteria for home 466.31 care services under section 256B.0627, subdivision 1, paragraph 466.32 (c), or a home and community-based waiver services program under 466.33 chapter 256B, or meets the criteria for severe emotional 466.34 disturbance under section 245.4871, subdivision 6, or for 466.35 serious and persistent mental illness under section 245.462, 466.36 subdivision 20, paragraph (c). Caregivers in this exemption 467.1 category are presumed to be prevented from obtaining or 467.2 retaining employment. 467.3 A caregiver who is exempt under clause (5) must enroll in 467.4 and attend an early childhood and family education class, a 467.5 parenting class, or some similar activity, if available, during 467.6 the period of time the caregiver is exempt under this section. 467.7 Notwithstanding section 256J.46, failure to attend the required 467.8 activity shall not result in the imposition of a sanction. 467.9 (b) The county agency must provide employment and training 467.10 services to MFIPcaregiversparticipants who are exempt under 467.11 this section, but who volunteer to participate. Exempt 467.12 volunteers may request approval for any work activity under 467.13 section 256J.49, subdivision 13. The hourly participation 467.14 requirements for nonexemptcaregiversparticipants under section 467.15 256J.50, subdivision 5, do not apply to exemptcaregivers467.16 participants who volunteer to participate. 467.17 Sec. 22. Minnesota Statutes 2000, section 256J.57, 467.18 subdivision 2, is amended to read: 467.19 Subd. 2. [NOTICE OF INTENT TO SANCTION.] (a) When a 467.20 participant fails without good cause to comply with the 467.21 requirements of sections 256J.52 to 256J.55, the job counselor 467.22 or the county agency must provide a notice of intent to sanction 467.23 to the participant specifying the program requirements that were 467.24 not complied with, informing the participant that the county 467.25 agency will impose the sanctions specified in section 256J.46, 467.26 and informing the participant of the opportunity to request a 467.27 conciliation conference as specified in paragraph (b). The 467.28 notice must also state that the participant's continuing 467.29 noncompliance with the specified requirements will result in 467.30 additional sanctions under section 256J.46, without the need for 467.31 additional notices or conciliation conferences under this 467.32 subdivision. The notice, written in English, must include the 467.33 department of human services language block, and must be sent to 467.34 every applicable participant. If the participant does not 467.35 request a conciliation conference within ten calendar days of 467.36 the mailing of the notice of intent to sanction, the job 468.1 counselor must notify the county agency that the assistance 468.2 payment should be reduced. The county must then send a notice 468.3 of adverse action to the participant informing the participant 468.4 of the sanction that will be imposed, the reasons for the 468.5 sanction, the effective date of the sanction, and the 468.6 participant's right to have a fair hearing under section 256J.40. 468.7 (b) The participant may request a conciliation conference 468.8 by sending a written request, by making a telephone request, or 468.9 by making an in-person request. The request must be received 468.10 within ten calendar days of the date the county agency mailed 468.11 the ten-day notice of intent to sanction. If a timely request 468.12 for a conciliation is received, the county agency's service 468.13 provider must conduct the conference within five days of the 468.14 request. The job counselor's supervisor, or a designee of the 468.15 supervisor, must review the outcome of the conciliation 468.16 conference. If the conciliation conference resolves the 468.17 noncompliance, the job counselor must promptly inform the county 468.18 agency and request withdrawal of the sanction notice. 468.19 (c) Upon receiving a sanction notice, the participant may 468.20 request a fair hearing under section 256J.40, without exercising 468.21 the option of a conciliation conference. In such cases, the 468.22 county agency shall not require the participant to engage in a 468.23 conciliation conference prior to the fair hearing. 468.24 (d) If the participant requests a fair hearing or a 468.25 conciliation conference, sanctions will not be imposed until 468.26 there is a determination of noncompliance. Sanctions must be 468.27 imposed as provided in section 256J.46. 468.28 Sec. 23. Minnesota Statutes 2000, section 256J.62, 468.29 subdivision 9, is amended to read: 468.30 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] At the 468.31 request of thecaregiverparticipant, the county may continue to 468.32 provide case management, counseling, or other support services 468.33 to a participantfollowing the participant's achievement of: 468.34 (a) who has achieved the employment goal,; or 468.35 (b) who under section 256J.42 is no longer eligible to 468.36 receive MFIP. 469.1 These services may be provided for up to 12 months 469.2 following termination of the participant's eligibility for MFIP. 469.3A county may expend funds for a specific employment and469.4training service for the duration of that service to a469.5participant if the funds are obligated or expended prior to the469.6participant losing MFIP eligibility.469.7 Sec. 24. Minnesota Statutes 2000, section 256J.625, 469.8 subdivision 1, is amended to read: 469.9 Subdivision 1. [ESTABLISHMENT; GUARANTEED MINIMUM 469.10 ALLOCATION.] (a) The commissioner shall make grants under this 469.11 subdivision to assist county and tribal TANF programs to more 469.12 effectively serve hard-to-employ MFIP participants and 469.13 participants who, within the last 12 months, have been 469.14 determined under section 256J.42 to no longer be eligible to 469.15 receive MFIP but whose income is below 120 percent of the 469.16 federal poverty guidelines for a family of the same size. Funds 469.17 appropriated for local intervention grants for self-sufficiency 469.18 must be allocated first in amounts equal to the guaranteed 469.19 minimum in paragraph (b), and second according to the provisions 469.20 of subdivision 2. Any remaining funds must be allocated 469.21 according to the formula in subdivision 3. Counties or tribes 469.22 must have an approved local service unit plan under section 469.23 256J.50, subdivision 7, paragraph (b), in order to receive and 469.24 expend funds under subdivisions 2 and 3. 469.25 (b) Each county or tribal program shall receive a 469.26 guaranteed minimum annual allocation of $25,000. 469.27 Sec. 25. Minnesota Statutes 2000, section 256J.625, 469.28 subdivision 2, is amended to read: 469.29 Subd. 2. [SET-ASIDE FUNDS.] (a) Of the funds appropriated 469.30 for grants under this section, after the allocation in 469.31 subdivision 1, paragraph (b), is made, 20 percent of the 469.32 remaining funds each year shall be retained by the commissioner 469.33 and awarded to counties or tribes whose approved plans 469.34 demonstrate additional need based on their identification of 469.35 hard-to-employ familiesand, working participants in need of job 469.36 retention and wage advancement services, and participants who 470.1 within the last 12 months, have been determined under section 470.2 256J.42 to no longer be eligible to receive MFIP but whose 470.3 income is below 120 percent of the federal poverty guidelines 470.4 for a family of same size, strong anticipated outcomes for 470.5 families and an effective plan for monitoring performance, or, 470.6 use of a multicounty, multi-entity or regional approach to serve 470.7 hard-to-employ familiesand, working participants in need of job 470.8 retention and wage advancement services, and participants who, 470.9 within the last 12 months, have been determined under section 470.10 256J.42 to no longer be eligible to receive MFIP but whose 470.11 income is below 120 percent of the federal poverty guidelines 470.12 for a family of the same size, who are identified as a target 470.13 population to be served in the plan submitted under section 470.14 256J.50, subdivision 7, paragraph (b). In distributing funds 470.15 under this paragraph, the commissioner must achieve a geographic 470.16 balance. The commissioner may award funds under this paragraph 470.17 to other public, private, or nonprofit entities to deliver 470.18 services in a county or region where the entity or entities 470.19 submit a plan that demonstrates a strong capability to fulfill 470.20 the terms of the plan and where the plan shows an innovative or 470.21 multi-entity approach. 470.22 (b) For fiscal year 2001 only, of the funds available under 470.23 this subdivision the commissioner must allocate funding in the 470.24 amounts specified in article 1, section 2, subdivision 7, for an 470.25 intensive intervention transitional employment training project 470.26 and for nontraditional career assistance and training programs. 470.27 These allocations must occur before any set-aside funds are 470.28 allocated under paragraph (a). 470.29 Sec. 26. Minnesota Statutes 2000, section 256J.625, 470.30 subdivision 4, is amended to read: 470.31 Subd. 4. [USE OF FUNDS.] (a) A county or tribal program 470.32 may use funds allocated under this subdivision to provide 470.33 services to MFIP participants who are hard-to-employ and their 470.34 families. Services provided must be intended to reduce the 470.35 number of MFIP participants who are expected to reach the 470.36 60-month time limit under section 256J.42. Counties, tribes, 471.1 and other entities receiving funds under subdivision 2 or 3 must 471.2 submit semiannual progress reports to the commissioner which 471.3 detail program outcomes. 471.4 (b) Funds allocated under this section may not be used to 471.5 provide benefits that are defined as "assistance" in Code of 471.6 Federal Regulations, title 45, section 260.31, to an assistance 471.7 unit that is only receiving the food portion of MFIP benefits or 471.8 under section 256J.42 is no longer eligible to receive MFIP. 471.9 (c) A county may use funds allocated under this section for 471.10 that part of the match for federal access to jobs transportation 471.11 funds that is TANF-eligible. A county may also use funds 471.12 allocated under this section to enhance transportation choices 471.13 for eligible recipients up to 150 percent of the federal poverty 471.14 guidelines. 471.15 Sec. 27. Minnesota Statutes 2000, section 256J.751, is 471.16 amended to read: 471.17 256J.751 [COUNTY PERFORMANCE MANAGEMENT.] 471.18(a)Subdivision 1. [QUARTERLY COUNTY CASELOAD REPORT.] The 471.19 commissioner shall report quarterly toall countieseach county 471.20 on the county's performance on the following measures: 471.21 (1)percent of MFIP caseload working in paid employment;471.22(2) percentnumber ofMFIP caseloadcases receiving only 471.23 the food portion of assistance; 471.24 (2) number of child-only cases; 471.25 (3) number of minor caregivers; 471.26 (4) number of cases that are exempt from the 60-month time 471.27 limit by the exemption category under section 256J.42; 471.28 (5) number of participants who are exempt from employment 471.29 and training services requirements by the exemption category 471.30 under section 256J.56; 471.31 (6) number of assistance units receiving assistance under a 471.32 hardship extension under section 256J.425; 471.33 (7) number of participants and number of months spent in 471.34 each level of sanction under section 256J.46, subdivision 1; 471.35(3)(8) number of MFIP cases that have left assistance; 471.36(4)(9) federal participation requirements as specified in 472.1 title 1 of Public Law Number 104-193;and472.2(5)(10) median placement wage rate.; and 472.3(b)(11) of each county's total MFIP caseload less the 472.4 number of cases in clauses (1) to (6): 472.5 (i) number of one-parent cases; 472.6 (ii) number of two-parent cases; 472.7 (iii) percent of one-parent cases that are working more 472.8 than 20 hours per week; 472.9 (iv) percent of two-parent cases that are working more than 472.10 20 hours per week; and 472.11 (v) percent of cases that have received more than 36 months 472.12 of assistance. 472.13 Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner 472.14 shall report quarterly to all counties on each county's 472.15 performance on the following measures: 472.16 (1) percent of MFIP caseload working in paid employment; 472.17 (2) percent of MFIP caseload receiving only the food 472.18 portion of assistance; 472.19 (3) number of MFIP cases that have left assistance; 472.20 (4) federal participation requirements as specified in 472.21 Title 1 of Public Law Number 104-193; 472.22 (5) median placement wage rate; and 472.23 (6) caseload by months of TANF assistance. 472.24 Subd. 3. [ANNUAL REPORT.] The commissioner must report to 472.25 all counties and to the legislature on each county's annual 472.26 performance on the measures required under subdivision 1 by 472.27 racial and ethnic group and, to the extent consistent with state 472.28 and federal law, must include each county's performance on: 472.29 (1) the number of out-of-wedlock births and births to teen 472.30 mothers; and 472.31 (2) number of cases by racial and ethnic group. 472.32 The report must be completed by January 1, 2002, and 472.33 January 1 of each year thereafter and must comply with sections 472.34 3.195 and 3.197. 472.35 Subd. 4. [DEVELOPMENT OF PERFORMANCE MEASURES.] By January 472.36 1, 2002, the commissioner shall, in consultation with counties, 473.1 develop measures for county performance in addition to those in 473.2paragraph (a)subdivision 1 and 2. In developing these 473.3 measures, the commissioner must consider: 473.4 (1) a measure for MFIP cases that leave assistance due to 473.5 employment; 473.6 (2) job retention after participants leave MFIP; and 473.7 (3) participant's earnings at a follow-up point after the 473.8 participant has left MFIP; and 473.9 (4) the appropriateness of services provided to minority 473.10 groups. 473.11(c)Subd. 5. [FAILURE TO MEET FEDERAL PERFORMANCE 473.12 STANDARDS.] (a) If sanctions occur for failure to meet the 473.13 performance standards specified in title 1 of Public Law Number 473.14 104-193 of the Personal Responsibility and Work Opportunity Act 473.15 of 1996, the state shall pay 88 percent of the sanction. The 473.16 remaining 12 percent of the sanction will be paid by the 473.17 counties. The county portion of the sanction will be 473.18 distributed across all counties in proportion to each county's 473.19 percentage of the MFIP average monthly caseload during the 473.20 period for which the sanction was applied. 473.21(d)(b) If a county fails to meet the performance standards 473.22 specified in title 1 of Public Law Number 104-193 of the 473.23 Personal Responsibility and Work Opportunity Act of 1996 for any 473.24 year, the commissioner shall work with counties to organize a 473.25 joint state-county technical assistance team to work with the 473.26 county. The commissioner shall coordinate any technical 473.27 assistance with other departments and agencies including the 473.28 departments of economic security and children, families, and 473.29 learning as necessary to achieve the purpose of this paragraph. 473.30 Sec. 28. Minnesota Statutes 2000, section 256K.25, 473.31 subdivision 1, is amended to read: 473.32 Subdivision 1. [ESTABLISHMENT AND PURPOSE.] (a) The 473.33 commissioner shall establish a supportive housing and managed 473.34 care pilot projectin two counties, one within the seven-county473.35metropolitan area and one outside of that area,to determine 473.36 whether the integrated delivery of employment services, 474.1 supportive services, housing, and health care into a single, 474.2 flexible program will: 474.3 (1) reduce public expenditures on homeless families with 474.4 minor children, homeless noncustodial parents, and other 474.5 homeless individuals; 474.6 (2) increase the employment rates of these persons; and 474.7 (3) provide a new alternative to providing services to this 474.8 hard-to-serve population. 474.9 (b) The commissioner shall create a program for counties 474.10 for the purpose of providing integrated intensive and 474.11 individualized case management services, employment services, 474.12 health care services, rent subsidies or other short- or 474.13 medium-term housing assistance, and other supportive services to 474.14 eligible families and individuals. Minimum project and 474.15 application requirements shall be developed by the commissioner 474.16 in cooperation with counties and their nonprofit partners with 474.17 the goal to provide the maximum flexibility in program design. 474.18 (c) Services available under this project must be 474.19 coordinated with available health care services for an eligible 474.20 project participant. 474.21 Sec. 29. Minnesota Statutes 2000, section 256K.25, 474.22 subdivision 3, is amended to read: 474.23 Subd. 3. [COUNTY ELIGIBILITY.] (a) A county may request 474.24 funding under this pilot project if the county: 474.25 (1) agrees to develop, in cooperation with nonprofit 474.26 partners, a supportive housing and managed care pilot project 474.27 that integrates the delivery of employment services, supportive 474.28 services, housing and health care for eligible families and 474.29 individuals, or agrees to contract with an existing integrated 474.30 program; 474.31 (2) for eligible participants who are also MFIP recipients, 474.32 agrees to develop, in cooperation with nonprofit partners, 474.33 procedures to ensure that the services provided under the pilot 474.34 project are closely coordinated with the services provided under 474.35 MFIP;and474.36 (3) develops a method for evaluating the quality of the 475.1 integrated services provided and the amount of any resulting 475.2 cost savings to the county and state.; and 475.3 (4) addresses in the pilot design the prevalence in the 475.4 homeless population served those individuals with mental 475.5 illness, a history of substance abuse, or HIV. 475.6 (b) Preference may be given to counties that cooperate with 475.7 other counties participating in the pilot project for purposes 475.8 of evaluation and counties that provide additional funding. 475.9 Sec. 30. Minnesota Statutes 2000, section 256K.25, 475.10 subdivision 4, is amended to read: 475.11 Subd. 4. [PARTICIPANT ELIGIBILITY.] (a) In order tobe475.12eligiblemeet initial eligibility criteria for the pilot 475.13 project, the county must determine that a participant is 475.14 homeless or is at risk of homelessness; has a mental illness, a475.15history of substance abuse, or HIV;and is a family that meets 475.16 the criteria in paragraph (b) or is an individual who meets the 475.17 criteria in paragraph (c). 475.18 (b) An eligible family must include a minor child or a 475.19 pregnant woman, and: 475.20 (1) be receiving or be eligible for MFIP assistance under 475.21 chapter 256J; or 475.22 (2) include an adult caregiver who is employed or is 475.23 receiving employment and training services, and have household 475.24 income below the MFIP exit level in section 256J.24, subdivision 475.25 10. 475.26 (c) An eligible individual must: 475.27 (1) meet the eligibility requirements of the group 475.28 residential housing program under section 256I.04, subdivision 475.29 1; or 475.30 (2) be a noncustodial parent who is employed or is 475.31 receiving employment and training services, and have household 475.32 income below the MFIP exit level in section 256J.24, subdivision 475.33 10. 475.34 (d) Counties participating in the pilot project may develop 475.35 and initiate disenrollment criteria, subject to approval by the 475.36 commissioner of human services. 476.1 Sec. 31. Minnesota Statutes 2000, section 256K.25, 476.2 subdivision 5, is amended to read: 476.3 Subd. 5. [FUNDING.] A county may request funding from the 476.4 commissioner for a specified number ofTANF-eligibleproject 476.5 participants. The commissioner shall review the request for 476.6 compliance with subdivisions 1 to 4 and may approve or 476.7 disapprove the request. If other funds are available, the 476.8 commissioner may allocate funding for project participants who 476.9 meet the eligibility requirements of subdivision 4, paragraph 476.10 (c). The commissioner may also redirect funds to the pilot 476.11 project. 476.12 Sec. 32. Minnesota Statutes 2000, section 256K.25, 476.13 subdivision 6, is amended to read: 476.14 Subd. 6. [REPORT.] Participating counties and the 476.15 commissioner shall collaborate to prepare and issue an annual 476.16 report, beginning December 1, 2001, to the chairs of the 476.17 appropriate legislative committees on the pilot project's use of 476.18 public resources, including other funds leveraged for this 476.19 initiative,and an assessment of the feasibility of financing 476.20 the pilot through other health and human services programs, the 476.21 employment and housing status of the families and individuals 476.22 served in the project, and the cost-effectiveness of the 476.23 project. The annual report must also evaluate the pilot project 476.24 with respect to the following project goals: that participants 476.25 will lead more productive, healthier, more stable and better 476.26 quality lives; that the teams created under the project to 476.27 deliver services for each project participant will be 476.28 accountable for ensuring that services are more appropriate, 476.29 cost-effective and well-coordinated; and that the system-wide 476.30 costs of serving this population, and the inappropriate use of 476.31 emergency, crisis-oriented or institutional services, will be 476.32 materially reduced. The commissioner shall provide data that 476.33 may be needed to evaluate the project to participating counties 476.34 that request the data. 476.35 Sec. 33. Minnesota Statutes 2000, section 261.062, is 476.36 amended to read: 477.1 261.062 [TAX FOR SUPPORT OF POOR.] 477.2 The county boardshallmay levy a tax annually sufficient 477.3 to defray the estimated expenses of supporting and relieving the 477.4 poor therein during the succeeding year, and to make up any 477.5 deficiency in the fund raised for that purpose during the 477.6 preceding year. 477.7 Sec. 34. Minnesota Statutes 2000, section 268.0122, 477.8 subdivision 2, is amended to read: 477.9 Subd. 2. [SPECIFIC POWERS.] The commissioner of economic 477.10 security shall: 477.11 (1) administer and supervise all forms of unemployment 477.12 benefits provided for under federal and state laws that are 477.13 vested in the commissioner, including make investigations and 477.14 audits, secure and transmit information, and make available 477.15 services and facilities as the commissioner considers necessary 477.16 or appropriate to facilitate the administration of any other 477.17 states, or the federal Economic Security Law, and accept and use 477.18 information, services, and facilities made available by other 477.19 states or the federal government; 477.20 (2) administer and supervise all employment and training 477.21 services assigned to the department under federal or state law; 477.22 (3) review and comment on local service unit plans and 477.23 community investment program plans and approve or disapprove the 477.24 plans; 477.25 (4) establish and maintain administrative units necessary 477.26 to perform administrative functions common to all divisions of 477.27 the department; 477.28 (5) supervise the county boards of commissioners, local 477.29 service units, and any other units of government designated in 477.30 federal or state law as responsible for employment and training 477.31 programs; 477.32 (6) establish administrative standards and payment 477.33 conditions for providers of employment and training services; 477.34 (7) act as the agent of, and cooperate with, the federal 477.35 government in matters of mutual concern, including the 477.36 administration of any federal funds granted to the state to aid 478.1 in the performance of functions of the commissioner; 478.2 (8) obtain reports from local service units and service 478.3 providers for the purpose of evaluating the performance of 478.4 employment and training services;and478.5 (9) review and comment on plans for Indian tribe employment 478.6 and training services and approve or disapprove the plans; and 478.7 (10) require all general employment and training programs 478.8 that receive state funds to make available information about 478.9 opportunities for women in nontraditional careers in the trades 478.10 and technical occupations. 478.11 Sec. 35. Laws 1997, chapter 203, article 9, section 21, as 478.12 amended by Laws 1998, chapter 407, article 6, section 111, and 478.13 Laws 2000, chapter 488, article 10, section 28, is amended to 478.14 read: 478.15 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 478.16 (a) Effective on the date specified, the following persons 478.17 will be ineligible for general assistance and general assistance 478.18 medical care under Minnesota Statutes, chapter 256D, group 478.19 residential housing under Minnesota Statutes, chapter 256I, and 478.20 MFIP assistance under Minnesota Statutes, chapter 256J, funded 478.21 with state money: 478.22 (1) Beginning July 1, 2002, persons who are terminated from 478.23 or denied Supplemental Security Income due to the 1996 changes 478.24 in the federal law making persons whose alcohol or drug 478.25 addiction is a material factor contributing to the person's 478.26 disability ineligible for Supplemental Security Income, and are 478.27 eligible for general assistance under Minnesota Statutes, 478.28 section 256D.05, subdivision 1, paragraph (a), clause (15), 478.29 general assistance medical care under Minnesota Statutes, 478.30 chapter 256D, or group residential housing under Minnesota 478.31 Statutes, chapter 256I; 478.32 (2) Beginning July 1, 2002, legal noncitizens who are 478.33 ineligible for Supplemental Security Income due to the 1996 478.34 changes in federal law making certain noncitizens ineligible for 478.35 these programs due to their noncitizen status; and 478.36 (3) Beginning July 1,20012002, legal noncitizens who are 479.1 eligible for MFIP assistance, either the cash assistance portion 479.2 or the food assistance portion, funded entirely with state money. 479.3 (b) State money that remains unspent due to changes in 479.4 federal law enacted after May 12, 1997, that reduce state 479.5 spending for legal noncitizens or for persons whose alcohol or 479.6 drug addiction is a material factor contributing to the person's 479.7 disability, or enacted after February 1, 1998, that reduce state 479.8 spending for food benefits for legal noncitizens shall not 479.9 cancel and shall be deposited in the TANF reserve account. 479.10 Sec. 36. [REPORT ON ASSESSMENT OF COUNTY PERFORMANCE.] 479.11 By January 15, 2003, the commissioner, in consultation with 479.12 counties, must report to the chairs of the house and senate 479.13 committees having jurisdiction over human services, on a 479.14 proposal for assessing county performance using a methodology 479.15 that controls for demographic, economic, and other variables 479.16 that may impact county achievement of MFIP performance 479.17 outcomes. The proposal must recommend how state and federal 479.18 funds may be allocated to counties to encourage and reward high 479.19 performance. 479.20 Sec. 37. [REPEALER.] 479.21 Minnesota Statutes 2000, sections 256J.42, subdivision 4; 479.22 256J.44; and 256J.46, subdivision 1a, are repealed. 479.23 ARTICLE 11 479.24 DHS LICENSING 479.25 Section 1. Minnesota Statutes 2000, section 13.46, 479.26 subdivision 4, is amended to read: 479.27 Subd. 4. [LICENSING DATA.] (a) As used in this subdivision: 479.28 (1) "licensing data" means all data collected, maintained, 479.29 used, or disseminated by the welfare system pertaining to 479.30 persons licensed or registered or who apply for licensure or 479.31 registration or who formerly were licensed or registered under 479.32 the authority of the commissioner of human services; 479.33 (2) "client" means a person who is receiving services from 479.34 a licensee or from an applicant for licensure; and 479.35 (3) "personal and personal financial data" means social 479.36 security numbers, identity of and letters of reference, 480.1 insurance information, reports from the bureau of criminal 480.2 apprehension, health examination reports, and social/home 480.3 studies. 480.4 (b)(1) Except as provided in paragraph (c), the following 480.5 data on current and former licensees are public: name, address, 480.6 telephone number of licensees, licensed capacity, type of client 480.7 preferred, variances granted, type of dwelling, name and 480.8 relationship of other family members, previous license history, 480.9 class of license, and the existence and status of complaints. 480.10 When disciplinary action has been taken against a licensee or 480.11 the complaint is resolved, the following data are public: the 480.12 substance of the complaint, the findings of the investigation of 480.13 the complaint, the record of informal resolution of a licensing 480.14 violation, orders of hearing, findings of fact, conclusions of 480.15 law, and specifications of the final disciplinary action 480.16 contained in the record of disciplinary action. 480.17 (2) The following data on persons subject to 480.18 disqualification under section 245A.04 in connection with a 480.19 license to provide family day care for children, child care 480.20 center services, foster care for children in the provider's 480.21 home, or foster care or day care services for adults in the 480.22 provider's home, are public: the nature of any disqualification 480.23 set aside under section 245A.04, subdivision 3b, and the reasons 480.24 for setting aside the disqualification; and the reasons for 480.25 granting any variance under section 245A.04, subdivision 9. 480.26 (3) When maltreatment is substantiated under section 480.27 626.556 or 626.557 and the victim and the substantiated 480.28 perpetrator are affiliated with a program licensed under chapter 480.29 245A, the commissioner of human services, local social services 480.30 agency, or county welfare agency may inform the license holder 480.31 where the maltreatment occurred of the identity of the 480.32 substantiated perpetrator and the victim. 480.33 (c) The following are private data on individuals under 480.34 section 13.02, subdivision 12, or nonpublic data under section 480.35 13.02, subdivision 9: personal and personal financial data on 480.36 family day care program and family foster care program 481.1 applicants and licensees and their family members who provide 481.2 services under the license. 481.3 (d) The following are private data on individuals: the 481.4 identity of persons who have made reports concerning licensees 481.5 or applicants that appear in inactive investigative data, and 481.6 the records of clients or employees of the licensee or applicant 481.7 for licensure whose records are received by the licensing agency 481.8 for purposes of review or in anticipation of a contested 481.9 matter. The names of reporters under sections 626.556 and 481.10 626.557 may be disclosed only as provided in section 626.556, 481.11 subdivision 11, or 626.557, subdivision 12b. 481.12 (e) Data classified as private, confidential, nonpublic, or 481.13 protected nonpublic under this subdivision become public data if 481.14 submitted to a court or administrative law judge as part of a 481.15 disciplinary proceeding in which there is a public hearing 481.16 concerning the disciplinary action. 481.17 (f) Data generated in the course of licensing 481.18 investigations that relate to an alleged violation of law are 481.19 investigative data under subdivision 3. 481.20 (g) Data that are not public data collected, maintained, 481.21 used, or disseminated under this subdivision that relate to or 481.22 are derived from a report as defined in section 626.556, 481.23 subdivision 2, are subject to the destruction provisions of 481.24 section 626.556, subdivision 11. 481.25 (h) Upon request, not public data collected, maintained, 481.26 used, or disseminated under this subdivision that relate to or 481.27 are derived from a report of substantiated maltreatment as 481.28 defined in section 626.556 or 626.557 may be exchanged with the 481.29 department of health for purposes of completing background 481.30 studies pursuant to section 144.057. 481.31 (i) Data on individuals collected according to licensing 481.32 activities under chapter 245A, and data on individuals collected 481.33 by the commissioner of human services according to maltreatment 481.34 investigations under sections 626.556 and 626.557, may be shared 481.35 with the department of human rights, the department of health, 481.36 the department of corrections, the ombudsman for mental health 482.1 and retardation, and the individual's professional regulatory 482.2 board when there is reason to believe that laws or standards 482.3 under the jurisdiction of those agencies may have been violated. 482.4 (j) In addition to the notice of determinations required 482.5 under section 626.556, subdivision 10f, if the commissioner or 482.6 the local social services agency has determined that an 482.7 individual is a substantiated perpetrator of maltreatment of a 482.8 child based on sexual abuse, as defined in section 626.556, 482.9 subdivision 2, and the commissioner or local social services 482.10 agency knows that the individual is a person responsible for a 482.11 child's care in another facility, the commissioner or local 482.12 social services agency shall notify the head of that facility of 482.13 this determination. The notification must include an 482.14 explanation of the individual's available appeal rights and the 482.15 status of any appeal. If a notice is given under this 482.16 paragraph, the government entity making the notification shall 482.17 provide a copy of the notice to the individual who is the 482.18 subject of the notice. 482.19[EFFECTIVE DATE.] This section is effective July 1, 2001. 482.20 Sec. 2. Minnesota Statutes 2000, section 13.461, 482.21 subdivision 17, is amended to read: 482.22 Subd. 17. [VULNERABLE ADULTMALTREATMENT REVIEWPANEL482.23 PANELS.] Data of the vulnerable adult maltreatment review 482.24 panel or the child maltreatment review panel are classified 482.25 under section 256.021 or section 256.022. 482.26[EFFECTIVE DATE.] This section is effective July 1, 2001. 482.27 Sec. 3. Minnesota Statutes 2000, section 144.057, is 482.28 amended to read: 482.29 144.057 [BACKGROUND STUDIES ON LICENSEES AND SUPPLEMENTAL 482.30 NURSING SERVICES AGENCY PERSONNEL.] 482.31 Subdivision 1. [BACKGROUND STUDIES REQUIRED.] The 482.32 commissioner of health shall contract with the commissioner of 482.33 human services to conduct background studies of: 482.34 (1) individuals providing services which have direct 482.35 contact, as defined under section 245A.04, subdivision 3, with 482.36 patients and residents in hospitals, boarding care homes, 483.1 outpatient surgical centers licensed under sections 144.50 to 483.2 144.58; nursing homes and home care agencies licensed under 483.3 chapter 144A; residential care homes licensed under chapter 483.4 144B, and board and lodging establishments that are registered 483.5 to provide supportive or health supervision services under 483.6 section 157.17;and483.7 (2) beginning July 1, 1999, all other employees in nursing 483.8 homes licensed under chapter 144A, and boarding care homes 483.9 licensed under sections 144.50 to 144.58. A disqualification of 483.10 an individual in this section shall disqualify the individual 483.11 from positions allowing direct contact or access to patients or 483.12 residents receiving services; 483.13 (3) individuals employed by a supplemental nursing services 483.14 agency, as defined under section 144A.70, who are providing 483.15 services in health care facilities; and 483.16 (4) controlling persons of a supplemental nursing services 483.17 agency, as defined under section 144A.70. 483.18 If a facility or program is licensed by the department of 483.19 human services and subject to the background study provisions of 483.20 chapter 245A and is also licensed by the department of health, 483.21 the department of human services is solely responsible for the 483.22 background studies of individuals in the jointly licensed 483.23 programs. 483.24 Subd. 2. [RESPONSIBILITIES OF DEPARTMENT OF HUMAN 483.25 SERVICES.] The department of human services shall conduct the 483.26 background studies required by subdivision 1 in compliance with 483.27 the provisions of chapter 245A and Minnesota Rules, parts 483.28 9543.3000 to 9543.3090. For the purpose of this section, the 483.29 term "residential program" shall include all facilities 483.30 described in subdivision 1. The department of human services 483.31 shall provide necessary forms and instructions, shall conduct 483.32 the necessary background studies of individuals, and shall 483.33 provide notification of the results of the studies to the 483.34 facilities, supplemental nursing services agencies, individuals, 483.35 and the commissioner of health. Individuals shall be 483.36 disqualified under the provisions of chapter 245A and Minnesota 484.1 Rules, parts 9543.3000 to 9543.3090. If an individual is 484.2 disqualified, the department of human services shall notify the 484.3 facility, the supplemental nursing services agency, and the 484.4 individual and shall inform the individual of the right to 484.5 request a reconsideration of the disqualification by submitting 484.6 the request to the department of health. 484.7 Subd. 3. [RECONSIDERATIONS.] The commissioner of health 484.8 shall review and decide reconsideration requests, including the 484.9 granting of variances, in accordance with the procedures and 484.10 criteria contained in chapter 245A and Minnesota Rules, parts 484.11 9543.3000 to 9543.3090. The commissioner's decision shall be 484.12 provided to the individual and to the department of human 484.13 services. The commissioner's decision to grant or deny a 484.14 reconsideration of disqualification is the final administrative 484.15 agency action, except for the provisions under section 245A.04, 484.16 subdivisions 3b, paragraphs (e) and (f); and 3c, paragraph (a). 484.17[EFFECTIVE DATE.] This subdivision is effective January 1, 484.18 2002. 484.19 Subd. 4. [RESPONSIBILITIES OF FACILITIES AND AGENCIES.] 484.20 Facilities and agencies described in subdivision 1 shall be 484.21 responsible for cooperating with the departments in implementing 484.22 the provisions of this section. The responsibilities imposed on 484.23 applicants and licensees under chapter 245A and Minnesota Rules, 484.24 parts 9543.3000 to 9543.3090, shall apply to these 484.25 facilities and supplemental nursing services agencies. The 484.26 provision of section 245A.04, subdivision 3, paragraph (e), 484.27 shall apply to applicants, licensees, registrants, or an 484.28 individual's refusal to cooperate with the completion of the 484.29 background studies. Supplemental nursing services agencies 484.30 subject to the registration requirements in section 144A.71 must 484.31 maintain records verifying compliance with the background study 484.32 requirements under this section. 484.33 Sec. 4. Minnesota Statutes 2000, section 214.104, is 484.34 amended to read: 484.35 214.104 [HEALTH-RELATED LICENSING BOARDS; DETERMINATIONS 484.36 REGARDINGDISQUALIFICATIONS FORMALTREATMENT.] 485.1 (a) A health-related licensing board shall make 485.2 determinations as to whetherlicenseesregulated persons who are 485.3 under the board's jurisdiction should bedisqualified under485.4section 245A.04, subdivision 3d, from positions allowing direct485.5contact with persons receiving servicesthe subject of 485.6 disciplinary or corrective action because of substantiated 485.7 maltreatment under section 626.556 or 626.557.A determination485.8under this section may be done as part of an investigation under485.9section 214.103.The board shall make a determinationwithin 90485.10days ofupon receipt, and after the review, of an investigation 485.11 memorandum or other notice of substantiated maltreatment under 485.12 section 626.556 or 626.557, or of a notice from the commissioner 485.13 of human services that a background study of alicensee485.14 regulated person shows substantiated maltreatment.The board485.15shall also make a determination under this section upon485.16consideration of the licensure of an individual who was subject485.17to disqualification before licensure because of substantiated485.18maltreatment.485.19(b) In making a determination under this section, the board485.20shall consider the nature and extent of any injury or harm485.21resulting from the conduct that would constitute grounds for485.22disqualification, the seriousness of the misconduct, the extent485.23that disqualification is necessary to protect persons receiving485.24services or the public, and other factors specified in section485.25245A.04, subdivision 3b, paragraph (b).485.26(c) The board shall determine the duration and extent of485.27the disqualification or may establish conditions under which the485.28licensee may hold a position allowing direct contact with485.29persons receiving services or in a licensed facility.485.30 (b) Upon completion of its review of a report of 485.31 substantiated maltreatment, the board shall notify the 485.32 commissioner of human servicesand the lead agency that485.33conducted an investigation under section 626.556 or 626.557, as485.34applicable,of its determination. The board shall notify the 485.35 commissioner of human services if, following a review of the 485.36 report of substantiated maltreatment, the board determines that 486.1 it does not have jurisdiction in the matter and the commissioner 486.2 shall make the appropriate disqualification decision regarding 486.3 the regulated person as otherwise provided in chapter 245A. The 486.4 board shall also notify the commissioner of health or the 486.5 commissioner of human services immediately upon receipt of 486.6 knowledge of a facility or program allowing a regulated person 486.7 to provide direct contact services at the facility or program 486.8 while not complying with requirements placed on the regulated 486.9 person. 486.10 (c) In addition to any other remedy provided by law, the 486.11 board may, through its designated board member, temporarily 486.12 suspend the license of a licensee; deny a credential to an 486.13 applicant; or require the regulated person to be continuously 486.14 supervised, if the board finds there is probable cause to 486.15 believe the regulated person referred to the board according to 486.16 paragraph (a) poses an immediate risk of harm to vulnerable 486.17 persons. The board shall consider all relevant information 486.18 available, which may include but is not limited to: 486.19 (1) the extent the action is needed to protect persons 486.20 receiving services or the public; 486.21 (2) the recency of the maltreatment; 486.22 (3) the number of incidents of maltreatment; 486.23 (4) the intrusiveness or violence of the maltreatment; and 486.24 (5) the vulnerability of the victim of maltreatment. 486.25 The action shall take effect upon written notice to the 486.26 regulated person, served by certified mail, specifying the 486.27 statute violated. The board shall notify the commissioner of 486.28 health or the commissioner of human services of the suspension 486.29 or denial of a credential. The action shall remain in effect 486.30 until the board issues a temporary stay or a final order in the 486.31 matter after a hearing or upon agreement between the board and 486.32 the regulated person. At the time the board issues the notice, 486.33 the regulated person shall inform the board of all settings in 486.34 which the regulated person is employed or practices and the 486.35 board shall inform all known employment and practice settings of 486.36 the board action and schedule a disciplinary hearing to be held 487.1 under chapter 14. The board shall provide the regulated person 487.2 with at least 30 days' notice of the hearing, unless the parties 487.3 agree to a hearing date that provides less than 30 days notice, 487.4 and shall schedule the hearing to begin no later than 90 days 487.5 after issuance of the notice of hearing. 487.6[EFFECTIVE DATE.] This section is effective July 1, 2001. 487.7 Sec. 5. Minnesota Statutes 2000, section 245A.03, 487.8 subdivision 2b, is amended to read: 487.9 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 487.10 clause (2), does not apply to: 487.11 (1) a child care provider who as an applicant for licensure 487.12 or as a license holder has received a license denial under 487.13 section 245A.05, afineconditional license under section 487.14 245A.06, or a sanction under section 245A.07 from the 487.15 commissioner that has not been reversed on appeal; or 487.16 (2) a child care provider, or a child care provider who has 487.17 a household member who, as a result of a licensing process, has 487.18 a disqualification under this chapter that has not been set 487.19 aside by the commissioner. 487.20[EFFECTIVE DATE.] This section is effective January 1, 2002. 487.21 Sec. 6. Minnesota Statutes 2000, section 245A.04, 487.22 subdivision 3a, is amended to read: 487.23 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 487.24 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 487.25 commissioner shall notify the applicantor, license holder, or 487.26 registrant and the individual who is the subject of the study, 487.27 in writing or by electronic transmission, of the results of the 487.28 study. When the study is completed, a notice that the study was 487.29 undertaken and completed shall be maintained in the personnel 487.30 files of the program. For studies on individuals pertaining to 487.31 a license to provide family day care or group family day care, 487.32 foster care for children in the provider's own home, or foster 487.33 care or day care services for adults in the provider's own home, 487.34 the commissioner is not required to provide a separate notice of 487.35 the background study results to the individual who is the 487.36 subject of the study unless the study results in a 488.1 disqualification of the individual. 488.2 The commissioner shall notify the individual studied if the 488.3 information in the study indicates the individual is 488.4 disqualified from direct contact with persons served by the 488.5 program. The commissioner shall disclose the information 488.6 causing disqualification and instructions on how to request a 488.7 reconsideration of the disqualification to the individual 488.8 studied. An applicant or license holder who is not the subject 488.9 of the study shall be informed that the commissioner has found 488.10 information that disqualifies the subject from direct contact 488.11 with persons served by the program. However, only the 488.12 individual studied must be informed of the information contained 488.13 in the subject's background study unless theonlybasis for the 488.14 disqualification is failure to cooperate, substantiated 488.15 maltreatment under section 626.556 or 626.557, the Data 488.16 Practices Act provides for release of the information, or the 488.17 individual studied authorizes the release of the 488.18 information. When a disqualification is based on the subject's 488.19 failure to cooperate with the background study or substantiated 488.20 maltreatment under section 626.556 or 626.557, the agency that 488.21 initiated the study shall be informed by the commissioner of the 488.22 reason for the disqualification. 488.23 (b) Except as provided in subdivision 3d, paragraph (b), if 488.24 the commissioner determines that the individual studied has a 488.25 disqualifying characteristic, the commissioner shall review the 488.26 information immediately available and make a determination as to 488.27 the subject's immediate risk of harm to persons served by the 488.28 program where the individual studied will have direct contact. 488.29 The commissioner shall consider all relevant information 488.30 available, including the following factors in determining the 488.31 immediate risk of harm: the recency of the disqualifying 488.32 characteristic; the recency of discharge from probation for the 488.33 crimes; the number of disqualifying characteristics; the 488.34 intrusiveness or violence of the disqualifying characteristic; 488.35 the vulnerability of the victim involved in the disqualifying 488.36 characteristic; and the similarity of the victim to the persons 489.1 served by the program where the individual studied will have 489.2 direct contact. The commissioner may determine that the 489.3 evaluation of the information immediately available gives the 489.4 commissioner reason to believe one of the following: 489.5 (1) The individual poses an imminent risk of harm to 489.6 persons served by the program where the individual studied will 489.7 have direct contact. If the commissioner determines that an 489.8 individual studied poses an imminent risk of harm to persons 489.9 served by the program where the individual studied will have 489.10 direct contact, the individual and the license holder must be 489.11 sent a notice of disqualification. The commissioner shall order 489.12 the license holder to immediately remove the individual studied 489.13 from direct contact. The notice to the individual studied must 489.14 include an explanation of the basis of this determination. 489.15 (2) The individual poses a risk of harm requiring 489.16 continuous supervision while providing direct contact services 489.17 during the period in which the subject may request a 489.18 reconsideration. If the commissioner determines that an 489.19 individual studied poses a risk of harm that requires continuous 489.20 supervision, the individual and the license holder must be sent 489.21 a notice of disqualification. The commissioner shall order the 489.22 license holder to immediately remove the individual studied from 489.23 direct contact services or assure that the individual studied is 489.24 within sight or hearing of another staff person when providing 489.25 direct contact services during the period in which the 489.26 individual may request a reconsideration of the 489.27 disqualification. If the individual studied does not submit a 489.28 timely request for reconsideration, or the individual submits a 489.29 timely request for reconsideration, but the disqualification is 489.30 not set aside for that license holder, the license holder will 489.31 be notified of the disqualification and ordered to immediately 489.32 remove the individual from any position allowing direct contact 489.33 with persons receiving services from the license holder. 489.34 (3) The individual does not pose an imminent risk of harm 489.35 or a risk of harm requiring continuous supervision while 489.36 providing direct contact services during the period in which the 490.1 subject may request a reconsideration. If the commissioner 490.2 determines that an individual studied does not pose a risk of 490.3 harm that requires continuous supervision, only the individual 490.4 must be sent a notice of disqualification. The license holder 490.5 must be sent a notice that more time is needed to complete the 490.6 individual's background study. If the individual studied 490.7 submits a timely request for reconsideration, and if the 490.8 disqualification is set aside for that license holder, the 490.9 license holder will receive the same notification received by 490.10 license holders in cases where the individual studied has no 490.11 disqualifying characteristic. If the individual studied does 490.12 not submit a timely request for reconsideration, or the 490.13 individual submits a timely request for reconsideration, but the 490.14 disqualification is not set aside for that license holder, the 490.15 license holder will be notified of the disqualification and 490.16 ordered to immediately remove the individual from any position 490.17 allowing direct contact with persons receiving services from the 490.18 license holder. 490.19 (c) County licensing agencies performing duties under this 490.20 subdivision may develop an alternative system for determining 490.21 the subject's immediate risk of harm to persons served by the 490.22 program, providing the notices under paragraph (b), and 490.23 documenting the action taken by the county licensing agency. 490.24 Each county licensing agency's implementation of the alternative 490.25 system is subject to approval by the commissioner. 490.26 Notwithstanding this alternative system, county licensing 490.27 agencies shall complete the requirements of paragraph (a). 490.28[EFFECTIVE DATE.] This section is effective July 1, 2001. 490.29 Sec. 7. Minnesota Statutes 2000, section 245A.04, 490.30 subdivision 3b, is amended to read: 490.31 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 490.32 individual who is the subject of the disqualification may 490.33 request a reconsideration of the disqualification. 490.34 The individual must submit the request for reconsideration 490.35 to the commissioner in writing. A request for reconsideration 490.36 for an individual who has been sent a notice of disqualification 491.1 under subdivision 3a, paragraph (b), clause (1) or (2), must be 491.2 submitted within 30 calendar days of the disqualified 491.3 individual's receipt of the notice of disqualification. A 491.4 request for reconsideration for an individual who has been sent 491.5 a notice of disqualification under subdivision 3a, paragraph 491.6 (b), clause (3), must be submitted within 15 calendar days of 491.7 the disqualified individual's receipt of the notice of 491.8 disqualification. An individual who was determined to have 491.9 maltreated a child under section 626.556 or a vulnerable adult 491.10 under section 626.557, and who was disqualified under this 491.11 section on the basis of serious or recurring maltreatment, may 491.12 request reconsideration of both the maltreatment and the 491.13 disqualification determinations. The request for 491.14 reconsideration of the maltreatment determination and the 491.15 disqualification must be submitted within 30 calendar days of 491.16 the individual's receipt of the notice of disqualification. 491.17 Removal of a disqualified individual from direct contact shall 491.18 be ordered if the individual does not request reconsideration 491.19 within the prescribed time, and for an individual who submits a 491.20 timely request for reconsideration, if the disqualification is 491.21 not set aside. The individual must present information showing 491.22 that: 491.23 (1) the information the commissioner relied upon is 491.24 incorrect or inaccurate. If the basis of a reconsideration 491.25 request is that a maltreatment determination or disposition 491.26 under section 626.556 or 626.557 is incorrect, and the 491.27 commissioner has issued a final order in an appeal of that 491.28 determination or disposition under section 256.045 or 245A.08, 491.29 subdivision 5, the commissioner's order is conclusive on the 491.30 issue of maltreatment. If the individual did not request 491.31 reconsideration of the maltreatment determination, the 491.32 maltreatment determination is deemed conclusive; or 491.33 (2) the subject of the study does not pose a risk of harm 491.34 to any person served by the applicantor, license holder, or 491.35 registrant. 491.36 (b) The commissioner shall rescind the disqualification if 492.1 the commissioner finds that the information relied on to 492.2 disqualify the subject is incorrect. The commissioner may set 492.3 aside the disqualification under this section if the 492.4 commissioner finds that theinformation the commissioner relied492.5upon is incorrect or theindividual does not pose a risk of harm 492.6 to any person served by the applicantor, license holder, or 492.7 registrant. In determining that an individual does not pose a 492.8 risk of harm, the commissioner shall consider the consequences 492.9 of the event or events that lead to disqualification, whether 492.10 there is more than one disqualifying event, the vulnerability of 492.11 the victim at the time of the event, the time elapsed without a 492.12 repeat of the same or similar event, documentation of successful 492.13 completion by the individual studied of training or 492.14 rehabilitation pertinent to the event, and any other information 492.15 relevant to reconsideration. In reviewing a disqualification 492.16 under this section, the commissioner shall give preeminent 492.17 weight to the safety of each person to be served by the license 492.18 holderor, applicant, or registrant over the interests of the 492.19 license holderor, applicant, or registrant. 492.20 (c) Unless the information the commissioner relied on in 492.21 disqualifying an individual is incorrect, the commissioner may 492.22 not set aside the disqualification of an individual in 492.23 connection with a license to provide family day care for 492.24 children, foster care for children in the provider's own home, 492.25 or foster care or day care services for adults in the provider's 492.26 own home if: 492.27 (1) less than ten years have passed since the discharge of 492.28 the sentence imposed for the offense; and the individual has 492.29 been convicted of a violation of any offense listed in sections 492.30 609.20 (manslaughter in the first degree), 609.205 (manslaughter 492.31 in the second degree), criminal vehicular homicide under 609.21 492.32 (criminal vehicular homicide and injury), 609.215 (aiding 492.33 suicide or aiding attempted suicide), felony violations under 492.34 609.221 to 609.2231 (assault in the first, second, third, or 492.35 fourth degree), 609.713 (terroristic threats), 609.235 (use of 492.36 drugs to injure or to facilitate crime), 609.24 (simple 493.1 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 493.2 609.255 (false imprisonment), 609.561 or 609.562 (arson in the 493.3 first or second degree), 609.71 (riot), burglary in the first or 493.4 second degree under 609.582 (burglary), 609.66 (dangerous 493.5 weapon), 609.665 (spring guns), 609.67 (machine guns and 493.6 short-barreled shotguns), 609.749 (harassment; stalking), 493.7 152.021 or 152.022 (controlled substance crime in the first or 493.8 second degree), 152.023, subdivision 1, clause (3) or (4), or 493.9 subdivision 2, clause (4) (controlled substance crime in the 493.10 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 493.11 (controlled substance crime in the fourth degree), 609.224, 493.12 subdivision 2, paragraph (c) (fifth-degree assault by a 493.13 caregiver against a vulnerable adult), 609.228 (great bodily 493.14 harm caused by distribution of drugs), 609.23 (mistreatment of 493.15 persons confined), 609.231 (mistreatment of residents or 493.16 patients), 609.2325 (criminal abuse of a vulnerable adult), 493.17 609.233 (criminal neglect of a vulnerable adult), 609.2335 493.18 (financial exploitation of a vulnerable adult), 609.234 (failure 493.19 to report), 609.265 (abduction), 609.2664 to 609.2665 493.20 (manslaughter of an unborn child in the first or second degree), 493.21 609.267 to 609.2672 (assault of an unborn child in the first, 493.22 second, or third degree), 609.268 (injury or death of an unborn 493.23 child in the commission of a crime), 617.293 (disseminating or 493.24 displaying harmful material to minors), a gross misdemeanor 493.25 offense under 609.324, subdivision 1 (other prohibited acts), a 493.26 gross misdemeanor offense under 609.378 (neglect or endangerment 493.27 of a child), a gross misdemeanor offense under 609.377 493.28 (malicious punishment of a child), 609.72, subdivision 3 493.29 (disorderly conduct against a vulnerable adult); or an attempt 493.30 or conspiracy to commit any of these offenses, as each of these 493.31 offenses is defined in Minnesota Statutes; or an offense in any 493.32 other state, the elements of which are substantially similar to 493.33 the elements of any of the foregoing offenses; 493.34 (2) regardless of how much time has passed since the 493.35 discharge of the sentence imposed for the offense, the 493.36 individual was convicted of a violation of any offense listed in 494.1 sections 609.185 to 609.195 (murder in the first, second, or 494.2 third degree), 609.2661 to 609.2663 (murder of an unborn child 494.3 in the first, second, or third degree), a felony offense under 494.4 609.377 (malicious punishment of a child), a felony offense 494.5 under 609.324, subdivision 1 (other prohibited acts), a felony 494.6 offense under 609.378 (neglect or endangerment of a child), 494.7 609.322 (solicitation, inducement, and promotion of 494.8 prostitution), 609.342 to 609.345 (criminal sexual conduct in 494.9 the first, second, third, or fourth degree), 609.352 494.10 (solicitation of children to engage in sexual conduct), 617.246 494.11 (use of minors in a sexual performance), 617.247 (possession of 494.12 pictorial representations of a minor), 609.365 (incest), a 494.13 felony offense under sections 609.2242 and 609.2243 (domestic 494.14 assault), a felony offense of spousal abuse, a felony offense of 494.15 child abuse or neglect, a felony offense of a crime against 494.16 children, or an attempt or conspiracy to commit any of these 494.17 offenses as defined in Minnesota Statutes, or an offense in any 494.18 other state, the elements of which are substantially similar to 494.19 any of the foregoing offenses; 494.20 (3) within the seven years preceding the study, the 494.21 individual committed an act that constitutes maltreatment of a 494.22 child under section 626.556, subdivision 10e, and that resulted 494.23 in substantial bodily harm as defined in section 609.02, 494.24 subdivision 7a, or substantial mental or emotional harm as 494.25 supported by competent psychological or psychiatric evidence; or 494.26 (4) within the seven years preceding the study, the 494.27 individual was determined under section 626.557 to be the 494.28 perpetrator of a substantiated incident of maltreatment of a 494.29 vulnerable adult that resulted in substantial bodily harm as 494.30 defined in section 609.02, subdivision 7a, or substantial mental 494.31 or emotional harm as supported by competent psychological or 494.32 psychiatric evidence. 494.33 In the case of any ground for disqualification under 494.34 clauses (1) to (4), if the act was committed by an individual 494.35 other than the applicantor, license holder, or registrant 494.36 residing in the applicant'sor, license holder's, or 495.1 registrant's home, the applicantor, license holder, or 495.2 registrant may seek reconsideration when the individual who 495.3 committed the act no longer resides in the home. 495.4 The disqualification periods provided under clauses (1), 495.5 (3), and (4) are the minimum applicable disqualification 495.6 periods. The commissioner may determine that an individual 495.7 should continue to be disqualified from licensure or 495.8 registration because the license holderor, applicant, or 495.9 registrant poses a risk of harm to a person served by that 495.10 individual after the minimum disqualification period has passed. 495.11 (d) The commissioner shall respond in writing or by 495.12 electronic transmission to all reconsideration requests for 495.13 which the basis for the request is that the information relied 495.14 upon by the commissioner to disqualify is incorrect or 495.15 inaccurate within 30 working days of receipt of a request and 495.16 all relevant information. If the basis for the request is that 495.17 the individual does not pose a risk of harm, the commissioner 495.18 shall respond to the request within 15 working days after 495.19 receiving the request for reconsideration and all relevant 495.20 information. If the request is based on both the correctness or 495.21 accuracy of the information relied on to disqualify the 495.22 individual and the risk of harm, the commissioner shall respond 495.23 to the request within 45 working days after receiving the 495.24 request for reconsideration and all relevant information. If 495.25 the disqualification is set aside, the commissioner shall notify 495.26 the applicant or license holder in writing or by electronic 495.27 transmission of the decision. 495.28 (e) Except as provided in subdivision 3c,the495.29commissioner's decision to disqualify an individual, including495.30the decision to grant or deny a rescission or set aside a495.31disqualification under this section, is the final administrative495.32agency action and shall not be subject to further review in a495.33contested case under chapter 14 involving a negative licensing495.34appeal taken in response to the disqualification or involving an495.35accuracy and completeness appeal under section 13.04.if a 495.36 disqualification is not set aside or is not rescinded, an 496.1 individual who was disqualified on the basis of a preponderance 496.2 of evidence that the individual committed an act or acts that 496.3 meet the definition of any of the crimes lists in subdivision 496.4 3d, paragraph (a), clauses (1) to (4); or for failure to make 496.5 required reports under section 626.556, subdivision 3, or 496.6 626.557, subdivision 3, pursuant to subdivision 3d, paragraph 496.7 (a), clause (4), may request a fair hearing under section 496.8 256.045. Except as provided under subdivision 3c, the 496.9 commissioner's final order for an individual under this 496.10 paragraph is conclusive on the issue of disqualification, 496.11 including for purposes of subsequent studies conducted under 496.12 section 245A.04, subdivision 3, and is the only administrative 496.13 appeal of the final agency determination, specifically, 496.14 including a challenge to the accuracy and completeness of data 496.15 under section 13.04. 496.16 (f) Except as provided under subdivision 3c, if an 496.17 individual was disqualified on the basis of a determination of 496.18 maltreatment under section 626.556 or 626.557, which was serious 496.19 or recurring, and the individual has requested reconsideration 496.20 of the maltreatment determination under section 626.556, 496.21 subdivision 10i, or 626.557, subdivision 9d, and also requested 496.22 reconsideration of the disqualification under this subdivision, 496.23 reconsideration of the maltreatment determination and 496.24 reconsideration of the disqualification shall be consolidated 496.25 into a single reconsideration. For maltreatment and 496.26 disqualification determinations made by county agencies, the 496.27 consolidated reconsideration shall be conducted by the county 496.28 agency. Except as provided under subdivision 3c, if an 496.29 individual who was disqualified on the basis of serious or 496.30 recurring maltreatment requests a fair hearing on the 496.31 maltreatment determination under section 626.556, subdivision 496.32 10i, or 626.557, subdivision 9d, the scope of the fair hearing 496.33 under section 256.045 shall include the maltreatment 496.34 determination and the disqualification. Except as provided 496.35 under subdivision 3c, the commissioner's final order for an 496.36 individual under this paragraph is conclusive on the issue of 497.1 maltreatment and disqualification, including for purposes of 497.2 subsequent studies conducted under subdivision 3, and is the 497.3 only administrative appeal of the final agency determination, 497.4 specifically, including a challenge to the accuracy and 497.5 completeness of data under section 13.04. 497.6[EFFECTIVE DATE.] This section is effective January 1, 2002. 497.7 Sec. 8. Minnesota Statutes 2000, section 245A.04, 497.8 subdivision 3c, is amended to read: 497.9 Subd. 3c. [CONTESTED CASE.] (a) Notwithstanding 497.10 subdivision 3b, paragraphs (e) and (f), if a disqualification is 497.11 not set aside, a person who is an employee of an employer, as 497.12 defined in section 179A.03, subdivision 15, may request a 497.13 contested case hearing under chapter 14. If the 497.14 disqualification which was not set aside or was not rescinded 497.15 was based on a maltreatment determination, the scope of the 497.16 contested case hearing shall include the maltreatment 497.17 determination and the disqualification. In such cases, a fair 497.18 hearing shall not be conducted under section 256.045. Rules 497.19 adopted under this chapter may not preclude an employee in a 497.20 contested case hearing for disqualification from submitting 497.21 evidence concerning information gathered under subdivision 3, 497.22 paragraph (e). 497.23 (b) If a disqualification for which reconsideration was 497.24 requested and which was not set aside or was not rescinded under 497.25 subdivision 3b is the basis for a denial of a license under 497.26 section 245A.05 or a licensing sanction under section 245A.07, 497.27 the license holder has the right to a contested case hearing 497.28 under chapter 14 and Minnesota Rules, parts 1400.8510 to 497.29 1400.8612 and successor rules. The appeal must be submitted in 497.30 accordance with section 245A.05 or 245A.07, subdivision 3. As 497.31 provided for under section 245A.08, subdivision 2a, the scope of 497.32 the consolidated contested case hearing shall include the 497.33 disqualification and the licensing sanction or denial of a 497.34 license. If the disqualification was based on a determination 497.35 of substantiated serious or recurring maltreatment under section 497.36 626.556 or 626.557, the appeal must be submitted in accordance 498.1 with sections 245A.07, subdivision 3, and 626.556, subdivision 498.2 10i, or 626.557, subdivision 9d. As provided for under section 498.3 245A.08, subdivision 2a, the scope of the contested case hearing 498.4 shall include the maltreatment determination, the 498.5 disqualification, and the licensing sanction or denial of a 498.6 license. In such cases, a fair hearing shall not be conducted 498.7 under section 256.045. 498.8 (c) If a maltreatment determination or disqualification, 498.9 which was not set aside or was not rescinded under subdivision 498.10 3b, is the basis for a denial of a license under section 245A.05 498.11 or a licensing sanction under section 245A.07, and the 498.12 disqualified subject is an individual other than the license 498.13 holder and upon whom a background study must be conducted under 498.14 subdivision 3, the hearing of all parties may be consolidated 498.15 into a single contested case hearing upon consent of all parties 498.16 and the administrative law judge. 498.17 (d) The commissioner's final order under section 245A.08, 498.18 subdivision 5, is conclusive on the issue of maltreatment and 498.19 disqualification, including for purposes of subsequent 498.20 background studies. The contested case hearing under this 498.21 subdivision is the only administrative appeal of the final 498.22 agency determination, specifically, including a challenge to the 498.23 accuracy and completeness of data under section 13.04. 498.24[EFFECTIVE DATE.] This section is effective January 1, 2002. 498.25 Sec. 9. Minnesota Statutes 2000, section 245A.04, 498.26 subdivision 3d, is amended to read: 498.27 Subd. 3d. [DISQUALIFICATION.] (a) Except as provided in 498.28 paragraph (b), when a background study completed under 498.29 subdivision 3 shows any of the following: a conviction of one 498.30 or more crimes listed in clauses (1) to (4); the individual has 498.31 admitted to or a preponderance of the evidence indicates the 498.32 individual has committed an act or acts that meet the definition 498.33 of any of the crimes listed in clauses (1) to (4); or an 498.34 investigation results in an administrative determination listed 498.35 under clause (4), the individual shall be disqualified from any 498.36 position allowing direct contact with persons receiving services 499.1 from the license holder, registrant and for individuals studied 499.2 under section 245A.04, subdivision 3, paragraph (c), clauses 499.3 (2), (6), and (7), in H.F. 1381, if enacted, the individual 499.4 shall also be disqualified from access to persons receiving 499.5 services from the license holder: 499.6 (1) regardless of how much time has passed since the 499.7 discharge of the sentence imposed for the offense, and unless 499.8 otherwise specified, regardless of the level of the conviction, 499.9 the individual was convicted of any of the following offenses: 499.10 sections 609.185 (murder in the first degree); 609.19 (murder in 499.11 the second degree); 609.195 (murder in the third degree); 499.12 609.2661 (murder of an unborn child in the first degree); 499.13 609.2662 (murder of an unborn child in the second degree); 499.14 609.2663 (murder of an unborn child in the third degree); 499.15 609.322 (solicitation, inducement, and promotion of 499.16 prostitution); 609.342 (criminal sexual conduct in the first 499.17 degree); 609.343 (criminal sexual conduct in the second degree); 499.18 609.344 (criminal sexual conduct in the third degree); 609.345 499.19 (criminal sexual conduct in the fourth degree); 609.352 499.20 (solicitation of children to engage in sexual conduct); 609.365 499.21 (incest); felony offense under 609.377 (malicious punishment of 499.22 a child); a felony offense under 609.378 (neglect or 499.23 endangerment of a child); a felony offense under 609.324, 499.24 subdivision 1 (other prohibited acts); 617.246 (use of minors in 499.25 sexual performance prohibited); 617.247 (possession of pictorial 499.26 representations of minors); a felony offense under sections 499.27 609.2242 and 609.2243 (domestic assault), a felony offense of 499.28 spousal abuse, a felony offense of child abuse or neglect, a 499.29 felony offense of a crime against children; or attempt or 499.30 conspiracy to commit any of these offenses as defined in 499.31 Minnesota Statutes, or an offense in any other state or country, 499.32 where the elements are substantially similar to any of the 499.33 offenses listed in this clause; 499.34 (2) if less than 15 years have passed since the discharge 499.35 of the sentence imposed for the offense; and the individual has 499.36 received a felony conviction for a violation of any of these 500.1 offenses: sections 609.20 (manslaughter in the first degree); 500.2 609.205 (manslaughter in the second degree); 609.21 (criminal 500.3 vehicular homicide and injury); 609.215 (suicide); 609.221 to 500.4 609.2231 (assault in the first, second, third, or fourth 500.5 degree); repeat offenses under 609.224 (assault in the fifth 500.6 degree); repeat offenses under 609.3451 (criminal sexual conduct 500.7 in the fifth degree); 609.713 (terroristic threats); 609.235 500.8 (use of drugs to injure or facilitate crime); 609.24 (simple 500.9 robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 500.10 609.255 (false imprisonment); 609.561 (arson in the first 500.11 degree); 609.562 (arson in the second degree); 609.563 (arson in 500.12 the third degree); repeat offenses under 617.23 (indecent 500.13 exposure; penalties); repeat offenses under 617.241 (obscene 500.14 materials and performances; distribution and exhibition 500.15 prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 500.16 609.67 (machine guns and short-barreled shotguns); 609.749 500.17 (harassment; stalking; penalties); 609.228 (great bodily harm 500.18 caused by distribution of drugs); 609.2325 (criminal abuse of a 500.19 vulnerable adult); 609.2664 (manslaughter of an unborn child in 500.20 the first degree); 609.2665 (manslaughter of an unborn child in 500.21 the second degree); 609.267 (assault of an unborn child in the 500.22 first degree); 609.2671 (assault of an unborn child in the 500.23 second degree); 609.268 (injury or death of an unborn child in 500.24 the commission of a crime); 609.52 (theft); 609.2335 (financial 500.25 exploitation of a vulnerable adult); 609.521 (possession of 500.26 shoplifting gear); 609.582 (burglary); 609.625 (aggravated 500.27 forgery); 609.63 (forgery); 609.631 (check forgery; offering a 500.28 forged check); 609.635 (obtaining signature by false pretense); 500.29 609.27 (coercion); 609.275 (attempt to coerce); 609.687 500.30 (adulteration); 260C.301 (grounds for termination of parental 500.31 rights); and chapter 152 (drugs; controlled substance). An 500.32 attempt or conspiracy to commit any of these offenses, as each 500.33 of these offenses is defined in Minnesota Statutes; or an 500.34 offense in any other state or country, the elements of which are 500.35 substantially similar to the elements of the offenses in this 500.36 clause. If the individual studied is convicted of one of the 501.1 felonies listed in this clause, but the sentence is a gross 501.2 misdemeanor or misdemeanor disposition, the lookback period for 501.3 the conviction is the period applicable to the disposition, that 501.4 is the period for gross misdemeanors or misdemeanors; 501.5 (3) if less than ten years have passed since the discharge 501.6 of the sentence imposed for the offense; and the individual has 501.7 received a gross misdemeanor conviction for a violation of any 501.8 of the following offenses: sections 609.224 (assault in the 501.9 fifth degree); 609.2242 and 609.2243 (domestic assault); 501.10 violation of an order for protection under 518B.01, subdivision 501.11 14; 609.3451 (criminal sexual conduct in the fifth degree); 501.12 repeat offenses under 609.746 (interference with privacy); 501.13 repeat offenses under 617.23 (indecent exposure); 617.241 501.14 (obscene materials and performances); 617.243 (indecent 501.15 literature, distribution); 617.293 (harmful materials; 501.16 dissemination and display to minors prohibited); 609.71 (riot); 501.17 609.66 (dangerous weapons); 609.749 (harassment; stalking; 501.18 penalties); 609.224, subdivision 2, paragraph (c) (assault in 501.19 the fifth degree by a caregiver against a vulnerable adult); 501.20 609.23 (mistreatment of persons confined); 609.231 (mistreatment 501.21 of residents or patients); 609.2325 (criminal abuse of a 501.22 vulnerable adult); 609.233 (criminal neglect of a vulnerable 501.23 adult); 609.2335 (financial exploitation of a vulnerable adult); 501.24 609.234 (failure to report maltreatment of a vulnerable adult); 501.25 609.72, subdivision 3 (disorderly conduct against a vulnerable 501.26 adult); 609.265 (abduction); 609.378 (neglect or endangerment of 501.27 a child); 609.377 (malicious punishment of a child); 609.324, 501.28 subdivision 1a (other prohibited acts; minor engaged in 501.29 prostitution); 609.33 (disorderly house); 609.52 (theft); 501.30 609.582 (burglary); 609.631 (check forgery; offering a forged 501.31 check); 609.275 (attempt to coerce); or an attempt or conspiracy 501.32 to commit any of these offenses, as each of these offenses is 501.33 defined in Minnesota Statutes; or an offense in any other state 501.34 or country, the elements of which are substantially similar to 501.35 the elements of any of the offenses listed in this clause. If 501.36 the defendant is convicted of one of the gross misdemeanors 502.1 listed in this clause, but the sentence is a misdemeanor 502.2 disposition, the lookback period for the conviction is the 502.3 period applicable to misdemeanors; or 502.4 (4) if less than seven years have passed since the 502.5 discharge of the sentence imposed for the offense; and the 502.6 individual has received a misdemeanor conviction for a violation 502.7 of any of the following offenses: sections 609.224 (assault in 502.8 the fifth degree); 609.2242 (domestic assault); violation of an 502.9 order for protection under 518B.01 (Domestic Abuse Act); 502.10 violation of an order for protection under 609.3232 (protective 502.11 order authorized; procedures; penalties); 609.746 (interference 502.12 with privacy); 609.79 (obscene or harassing phone calls); 502.13 609.795 (letter, telegram, or package; opening; harassment); 502.14 617.23 (indecent exposure; penalties); 609.2672 (assault of an 502.15 unborn child in the third degree); 617.293 (harmful materials; 502.16 dissemination and display to minors prohibited); 609.66 502.17 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 502.18 exploitation of a vulnerable adult); 609.234 (failure to report 502.19 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 502.20 (coercion); or an attempt or conspiracy to commit any of these 502.21 offenses, as each of these offenses is defined in Minnesota 502.22 Statutes; or an offense in any other state or country, the 502.23 elements of which are substantially similar to the elements of 502.24 any of the offenses listed in this clause; failure to make 502.25 required reports under section 626.556, subdivision 3, or 502.26 626.557, subdivision 3, for incidents in which: (i) the final 502.27 disposition under section 626.556 or 626.557 was substantiated 502.28 maltreatment, and (ii) the maltreatment was recurring or 502.29 serious; or substantiated serious or recurring maltreatment of a 502.30 minor under section 626.556 or of a vulnerable adult under 502.31 section 626.557 for which there is a preponderance of evidence 502.32 that the maltreatment occurred, and that the subject was 502.33 responsible for the maltreatment. 502.34 For the purposes of this section, "serious maltreatment" 502.35 means sexual abuse; maltreatment resulting in death; or 502.36 maltreatment resulting in serious injury which reasonably 503.1 requires the care of a physician whether or not the care of a 503.2 physician was sought; or abuse resulting in serious injury. For 503.3 purposes of this section, "abuse resulting in serious injury" 503.4 means: bruises, bites, skin laceration or tissue damage; 503.5 fractures; dislocations; evidence of internal injuries; head 503.6 injuries with loss of consciousness; extensive second-degree or 503.7 third-degree burns and other burns for which complications are 503.8 present; extensive second-degree or third-degree frostbite, and 503.9 others for which complications are present; irreversible 503.10 mobility or avulsion of teeth; injuries to the eyeball; 503.11 ingestion of foreign substances and objects that are harmful; 503.12 near drowning; and heat exhaustion or sunstroke. For purposes 503.13 of this section, "care of a physician" is treatment received or 503.14 ordered by a physician, but does not include diagnostic testing, 503.15 assessment, or observation. For the purposes of this section, 503.16 "recurring maltreatment" means more than one incident of 503.17 maltreatment for which there is a preponderance of evidence that 503.18 the maltreatment occurred, and that the subject was responsible 503.19 for the maltreatment. For purposes of this section, "access" 503.20 means physical access to an individual receiving services or the 503.21 individual's personal property without continuous, direct 503.22 supervision as defined in section 245A.04, subdivision 3. 503.23 (b)IfExcept for background studies related to child 503.24 foster care, adult foster care, or family child care licensure, 503.25 when the subject of a background study islicensedregulated by 503.26 a health-related licensing board as defined in chapter 214, and 503.27 the regulated person has been determined to have been 503.28 responsible for substantiated maltreatment under section 626.556 503.29 or 626.557, instead of the commissioner making a decision 503.30 regarding disqualification, the board shall makethea 503.31 determinationregarding a disqualification under this503.32subdivision based on a finding of substantiated maltreatment503.33under section 626.556 or 626.557. The commissioner shall notify503.34the health-related licensing board if a background study shows503.35that a licensee would be disqualified because of substantiated503.36maltreatment and the board shall make a determination under504.1section 214.104.whether to impose disciplinary or corrective 504.2 action under chapter 214. 504.3 (1) The commissioner shall notify the health-related 504.4 licensing board: 504.5 (i) upon completion of a background study that produces a 504.6 record showing that the individual was determined to have been 504.7 responsible for substantiated maltreatment; 504.8 (ii) upon the commissioner's completion of an investigation 504.9 that determined the individual was responsible for substantiated 504.10 maltreatment; or 504.11 (iii) upon receipt from another agency of a finding of 504.12 substantiated maltreatment for which the individual was 504.13 responsible. 504.14 (2) The commissioner's notice shall indicate whether the 504.15 individual would have been disqualified by the commissioner for 504.16 the substantiated maltreatment if the individual were not 504.17 regulated by the board. The commissioner shall concurrently 504.18 send a copy of this notice to the individual. 504.19 (3) Notwithstanding the exclusion from this subdivision for 504.20 individuals who provide child foster care, adult foster care, or 504.21 family child care, when the commissioner or a local agency has 504.22 reason to believe that the direct contact services provided by 504.23 the individual may fall within the jurisdiction of a 504.24 health-related licensing board, a referral shall be made to the 504.25 board as provided in this section. 504.26 (4) If, upon review of the information provided by the 504.27 commissioner, a health-related licensing board informs the 504.28 commissioner that the board does not have jurisdiction to take 504.29 disciplinary or corrective action, the commissioner shall make 504.30 the appropriate disqualification decision regarding the 504.31 individual as otherwise provided in this chapter. 504.32 (5) The commissioner has the authority to monitor the 504.33 facility's compliance with any requirements that the 504.34 health-related licensing board places on regulated persons 504.35 practicing in a facility either during the period pending a 504.36 final decision on a disciplinary or corrective action or as a 505.1 result of a disciplinary or corrective action. The commissioner 505.2 has the authority to order the immediate removal of a regulated 505.3 person from direct contact or access when a board issues an 505.4 order of temporary suspension based on a determination that the 505.5 regulated person poses an immediate risk of harm to persons 505.6 receiving services in a licensed facility. 505.7 (6) A facility that allows a regulated person to provide 505.8 direct contact services while not complying with the 505.9 requirements imposed by the health-related licensing board is 505.10 subject to action by the commissioner as specified under 505.11 sections 245A.06 and 245A.07. 505.12 (7) The commissioner shall notify a health-related 505.13 licensing board immediately upon receipt of knowledge of 505.14 noncompliance with requirements placed on a facility or upon a 505.15 person regulated by the board. 505.16[EFFECTIVE DATE.] This section is effective July 1, 2001. 505.17 Sec. 10. Minnesota Statutes 2000, section 245A.05, is 505.18 amended to read: 505.19 245A.05 [DENIAL OF APPLICATION.] 505.20 The commissioner may deny a license if an applicant fails 505.21 to comply with applicable laws or rules, or knowingly withholds 505.22 relevant information from or gives false or misleading 505.23 information to the commissioner in connection with an 505.24 application for a license or during an investigation. An 505.25 applicant whose application has been denied by the commissioner 505.26 must be given notice of the denial. Notice must be given by 505.27 certified mail. The notice must state the reasons the 505.28 application was denied and must inform the applicant of the 505.29 right to a contested case hearing under chapter 14 and Minnesota 505.30 Rules, parts 1400.8510 to 1400.8612 and successor rules. The 505.31 applicant may appeal the denial by notifying the commissioner in 505.32 writing by certified mail within 20 calendar days after 505.33 receiving notice that the application was denied. Section 505.34 245A.08 applies to hearings held to appeal the commissioner's 505.35 denial of an application. 505.36[EFFECTIVE DATE.] This section is effective January 1, 2002. 506.1 Sec. 11. Minnesota Statutes 2000, section 245A.06, is 506.2 amended to read: 506.3 245A.06 [CORRECTION ORDER ANDFINESCONDITIONAL LICENSE.] 506.4 Subdivision 1. [CONTENTS OF CORRECTION ORDERSOR FINESAND 506.5 CONDITIONAL LICENSES.] (a) If the commissioner finds that the 506.6 applicant or license holder has failed to comply with an 506.7 applicable law or rule and this failure does not imminently 506.8 endanger the health, safety, or rights of the persons served by 506.9 the program, the commissioner may issue a correction order and 506.10 an order of conditional license toor impose a fine onthe 506.11 applicant or license holder. When issuing a conditional 506.12 license, the commissioner shall consider the nature, chronicity, 506.13 or severity of the violation of law or rule and the effect of 506.14 the violation on the health, safety, or rights of persons served 506.15 by the program. The correction order orfineconditional 506.16 license must state: 506.17 (1) the conditions that constitute a violation of the law 506.18 or rule; 506.19 (2) the specific law or rule violated; 506.20 (3) the time allowed to correct each violation; and 506.21 (4) if afine is imposed, the amount of the finelicense is 506.22 made conditional, the length and terms of the conditional 506.23 license. 506.24 (b) Nothing in this section prohibits the commissioner from 506.25 proposing a sanction as specified in section 245A.07, prior to 506.26 issuing a correction order orfineconditional license. 506.27 Subd. 2. [RECONSIDERATION OF CORRECTION ORDERS.] If the 506.28 applicant or license holder believes that the contents of the 506.29 commissioner's correction order are in error, the applicant or 506.30 license holder may ask the department of human services to 506.31 reconsider the parts of the correction order that are alleged to 506.32 be in error. The request for reconsideration must be in writing 506.33 and received by the commissioner within 20 calendar days after 506.34 receipt of the correction order by the applicant or license 506.35 holder, and: 506.36 (1) specify the parts of the correction order that are 507.1 alleged to be in error; 507.2 (2) explain why they are in error; and 507.3 (3) include documentation to support the allegation of 507.4 error. 507.5 A request for reconsideration does not stay any provisions 507.6 or requirements of the correction order. The commissioner's 507.7 disposition of a request for reconsideration is final and not 507.8 subject to appeal under chapter 14. 507.9 Subd. 3. [FAILURE TO COMPLY.] If the commissioner finds 507.10 that the applicant or license holder has not corrected the 507.11 violations specified in the correction order or conditional 507.12 license, the commissioner may impose a fine and order other 507.13 licensing sanctions pursuant to section 245A.07.If a fine was507.14imposed and the violation was not corrected, the commissioner507.15may impose an additional fine. This section does not prohibit507.16the commissioner from seeking a court order, denying an507.17application, or suspending, revoking, or making conditional the507.18license in addition to imposing a fine.507.19 Subd. 4. [NOTICE OFFINECONDITIONAL LICENSE; 507.20 RECONSIDERATION OFFINECONDITIONAL LICENSE.]A license holder507.21who is ordered to pay a fineIf a license is made conditional, 507.22 the license holder must be notified of the order by certified 507.23 mail. The notice must be mailed to the address shown on the 507.24 application or the last known address of the license holder. 507.25 The notice must state the reasons thefineconditional license 507.26 was ordered and must inform the license holder of the 507.27responsibility for payment of fines in subdivision 7 and the507.28 right to request reconsideration of thefineconditional license 507.29 by the commissioner. The license holder may request 507.30 reconsideration of the orderto forfeit a fineof conditional 507.31 license by notifying the commissioner by certified mailwithin507.3220 calendar days after receiving the order. The request must be 507.33 in writing and must be received by the commissioner within ten 507.34 calendar days after the license holder received the order. The 507.35 license holder may submit with the request for reconsideration 507.36 written argument or evidence in support of the request for 508.1 reconsideration. A timely request for reconsideration shall 508.2 stayforfeiture of the fineimposition of the terms of the 508.3 conditional license until the commissioner issues a decision on 508.4 the request for reconsideration.The request for508.5reconsideration must be in writing and:508.6(1) specify the parts of the violation that are alleged to508.7be in error;508.8(2) explain why they are in error;508.9(3) include documentation to support the allegation of508.10error; and508.11(4) any other information relevant to the fine or the508.12amount of the fine.508.13 The commissioner's disposition of a request for 508.14 reconsideration is final and not subject to appeal under chapter 508.15 14. 508.16Subd. 5. [FORFEITURE OF FINES.] The license holder shall508.17pay the fines assessed on or before the payment date specified508.18in the commissioner's order. If the license holder fails to508.19fully comply with the order, the commissioner shall issue a508.20second fine or suspend the license until the license holder508.21complies. If the license holder receives state funds, the508.22state, county, or municipal agencies or departments responsible508.23for administering the funds shall withhold payments and recover508.24any payments made while the license is suspended for failure to508.25pay a fine.508.26Subd. 5a. [ACCRUAL OF FINES.] A license holder shall508.27promptly notify the commissioner of human services, in writing,508.28when a violation specified in an order to forfeit is corrected.508.29If upon reinspection the commissioner determines that a508.30violation has not been corrected as indicated by the order to508.31forfeit, the commissioner may issue a second fine. The508.32commissioner shall notify the license holder by certified mail508.33that a second fine has been assessed. The license holder may508.34request reconsideration of the second fine under the provisions508.35of subdivision 4.508.36Subd. 6. [AMOUNT OF FINES.] Fines shall be assessed as509.1follows:509.2(1) the license holder shall forfeit $1,000 for each509.3occurrence of violation of law or rule prohibiting the509.4maltreatment of children or the maltreatment of vulnerable509.5adults, including but not limited to corporal punishment,509.6illegal or unauthorized use of physical, mechanical, or chemical509.7restraints, and illegal or unauthorized use of aversive or509.8deprivation procedures;509.9(2) the license holder shall forfeit $200 for each509.10occurrence of a violation of law or rule governing matters of509.11health, safety, or supervision, including but not limited to the509.12provision of adequate staff to child or adult ratios; and509.13(3) the license holder shall forfeit $100 for each509.14occurrence of a violation of law or rule other than those509.15included in clauses (1) and (2).509.16For the purposes of this section, "occurrence" means each509.17violation identified in the commissioner's forfeiture order.509.18Subd. 7. [RESPONSIBILITY FOR PAYMENT OF FINES.] When a509.19fine has been assessed, the license holder may not avoid payment509.20by closing, selling, or otherwise transferring the licensed509.21program to a third party. In such an event, the license holder509.22will be personally liable for payment. In the case of a509.23corporation, each controlling individual is personally and509.24jointly liable for payment.509.25Fines for child care centers must be assessed according to509.26this section.509.27[EFFECTIVE DATE.] This section is effective January 1, 2002. 509.28 Sec. 12. Minnesota Statutes 2000, section 245A.07, is 509.29 amended to read: 509.30 245A.07 [SANCTIONS.] 509.31 Subdivision 1. [SANCTIONS AVAILABLE.] In addition to 509.32ordering forfeiture of finesmaking a license conditional under 509.33 section 245A.06, the commissioner may propose to suspend,or 509.34 revoke, or make conditionalthe license, impose a fine, or 509.35 secure an injunction against the continuing operation of the 509.36 program of a license holder who does not comply with applicable 510.1 law or rule. When applying sanctions authorized under this 510.2 section, the commissioner shall consider the nature, chronicity, 510.3 or severity of the violation of law or rule and the effect of 510.4 the violation on the health, safety, or rights of persons served 510.5 by the program. 510.6 Subd. 2. [IMMEDIATE SUSPENSION IN CASES OF IMMINENT DANGER510.7TO HEALTH, SAFETY, OR RIGHTSTEMPORARY IMMEDIATE SUSPENSION.] (a) 510.8 If the license holder's actions or failure to comply with 510.9 applicable law or rulehas placedposes an imminent risk of harm 510.10 to the health, safety, or rights of persons served by the 510.11 programin imminent danger, the commissioner shall act 510.12 immediately to temporarily suspend the license. No state funds 510.13 shall be made available or be expended by any agency or 510.14 department of state, county, or municipal government for use by 510.15 a license holder regulated under this chapter while a license is 510.16 under immediate suspension. A notice stating the reasons for 510.17 the immediate suspension and informing the license holder of the 510.18 right toa contested casean expedited hearing under chapter 510.19 14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and 510.20 successor rules, must be delivered by personal service to the 510.21 address shown on the application or the last known address of 510.22 the license holder. The license holder may appeal an order 510.23 immediately suspending a license. The appeal of an order 510.24 immediately suspending a license must be made in writing by 510.25 certified mail and must be received by the commissioner within 510.26 five calendar days after the license holder receives notice that 510.27 the license has been immediately suspended. A license holder 510.28 and any controlling individual shall discontinue operation of 510.29 the program upon receipt of the commissioner's order to 510.30 immediately suspend the license. 510.31 (b) The commissioner is liable to the license holder for 510.32 actual damages for days of lost service in an amount not more 510.33 than $50,000 when: 510.34 (1) the commissioner immediately suspends a license under 510.35 paragraph (a); and 510.36 (2) the administrative law judge recommends, after a review 511.1 of the facts in an expedited hearing under chapter 14 and 511.2 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 511.3 rules, that reasonable cause did not exist at the time the 511.4 commissioner issued the immediate suspension. 511.5 (c) If the commissioner immediately suspends a license 511.6 under paragraph (a) and the administrative law judge recommends 511.7 that reasonable cause exists for the immediate suspension, the 511.8 commissioner is not liable to the license holder. 511.9 Subd. 2a. [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 511.10 Within five working days of receipt of the license holder's 511.11 timely appeal, the commissioner shall request assignment of an 511.12 administrative law judge. The request must include a proposed 511.13 date, time, and place of a hearing. A hearing must be conducted 511.14 by an administrative law judge within 30 calendar days of the 511.15 request for assignment, unless an extension is requested by 511.16 either party and granted by the administrative law judge for 511.17 good cause. The commissioner shall issue a notice of hearing by 511.18 certified mail at least ten working days before the hearing. 511.19 The scope of the hearing shall be limited solely to the issue of 511.20 whether the temporary immediate suspension should remain in 511.21 effect pending the commissioner's final order under section 511.22 245A.08, regarding a licensing sanction issued under subdivision 511.23 3 following the immediate suspension. The burden of proof in 511.24 expedited hearings under this subdivision shall be limited to 511.25 the commissioner's demonstration that reasonable cause exists to 511.26 believe that the license holder's actions or failure to comply 511.27 with applicable law or rule poses an imminent risk of harm to 511.28 the health, safety, or rights of persons served by the program. 511.29 (b) The administrative law judge shall issue findings of 511.30 fact, conclusions, and a recommendation within ten working days 511.31 from the date of hearing. The commissioner's final order shall 511.32 be issued within ten working days from receipt of the 511.33 recommendation of the administrative law judge. Within 90 511.34 calendar days after a final order affirming an immediate 511.35 suspension, the commissioner shall make a determination 511.36 regarding whether a final licensing sanction shall be issued 512.1 under subdivision 3. The license holder shall continue to be 512.2 prohibited from operation of the program during this 90-day 512.3 period. 512.4 Subd. 3. [LICENSE SUSPENSION, REVOCATION,DENIALOR 512.5CONDITIONAL LICENSEFINE.] The commissioner may suspend,or 512.6 revoke, make conditional, or denya license, or impose a fine if 512.7an applicant ora license holder fails to comply fully with 512.8 applicable laws or rules, or knowingly withholds relevant 512.9 information from or gives false or misleading information to the 512.10 commissioner in connection with an application for a license or 512.11 during an investigation. A license holder who has had a license 512.12 suspended, revoked, ormade conditionalhas been ordered to pay 512.13 a fine must be given notice of the action by certified mail. 512.14 The notice must be mailed to the address shown on the 512.15 application or the last known address of the license holder. 512.16 The notice must state the reasons the license was suspended, 512.17 revoked, ormade conditionala fine was ordered. 512.18 (a) If the license was suspended or revoked, the notice 512.19 must inform the license holder of the right to a contested case 512.20 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 512.21 1400.8612 and successor rules. The license holder may appeal an 512.22 order suspending or revoking a license. The appeal of an order 512.23 suspending or revoking a license must be made in writing by 512.24 certified mail and must be received by the commissioner within 512.25 ten calendar days after the license holder receives notice that 512.26 the license has been suspended or revoked. 512.27 (b)If the license was made conditional, the notice must512.28inform the license holder of the right to request a512.29reconsideration by the commissioner. The request for512.30reconsideration must be made in writing by certified mail and512.31must be received by the commissioner within ten calendar days512.32after the license holder receives notice that the license has512.33been made conditional. The license holder may submit with the512.34request for reconsideration written argument or evidence in512.35support of the request for reconsideration. The commissioner's512.36disposition of a request for reconsideration is final and is not513.1subject to appeal under chapter 14.(1) If the license holder 513.2 was ordered to pay a fine, the notice must inform the license 513.3 holder of the responsibility for payment of fines and the right 513.4 to a contested case hearing under chapter 14 and Minnesota 513.5 Rules, parts 1400.8510 to 1400.8612 and successor rules. The 513.6 appeal of an order to pay a fine must be made in writing by 513.7 certified mail and must be received by the commissioner within 513.8 ten calendar days after the license holder receives notice that 513.9 the fine has been ordered. 513.10 (2) The license holder shall pay the fines assessed on or 513.11 before the payment date specified. If the license holder fails 513.12 to fully comply with the order, the commissioner may issue a 513.13 second fine or suspend the license until the license holder 513.14 complies. If the license holder receives state funds, the 513.15 state, county, or municipal agencies or departments responsible 513.16 for administering the funds shall withhold payments and recover 513.17 any payments made while the license is suspended for failure to 513.18 pay a fine. A timely appeal shall stay payment of the fine 513.19 until the commissioner issues a final order. 513.20 (3) A license holder shall promptly notify the commissioner 513.21 of human services, in writing, when a violation specified in the 513.22 order to forfeit a fine is corrected. If upon reinspection the 513.23 commissioner determines that a violation has not been corrected 513.24 as indicated by the order to forfeit a fine, the commissioner 513.25 may issue a second fine. The commissioner shall notify the 513.26 license holder by certified mail that a second fine has been 513.27 assessed. The license holder may appeal the second fine as 513.28 provided under this subdivision. 513.29 (4) Fines shall be assessed as follows: the license holder 513.30 shall forfeit $1,000 for each determination of maltreatment of a 513.31 child under section 626.556 or the maltreatment of a vulnerable 513.32 adult under section 626.557; the license holder shall forfeit 513.33 $200 for each occurrence of a violation of law or rule governing 513.34 matters of health, safety, or supervision, including but not 513.35 limited to the provision of adequate staff to child or adult 513.36 ratios, and failure to submit a background study; and the 514.1 license holder shall forfeit $100 for each occurrence of a 514.2 violation of law or rule other than those subject to a $1,000 or 514.3 $200 fine above. For purposes of this section, "occurrence" 514.4 means each violation identified in the commissioner's fine order. 514.5 (5) When a fine has been assessed, the license holder may 514.6 not avoid payment by closing, selling, or otherwise transferring 514.7 the licensed program to a third party. In such an event, the 514.8 license holder will be personally liable for payment. In the 514.9 case of a corporation, each controlling individual is personally 514.10 and jointly liable for payment. 514.11 Subd. 4. [ADOPTION AGENCY VIOLATIONS.] If a license holder 514.12 licensed to place children for adoption fails to provide 514.13 services as described in the disclosure form required by section 514.14 259.37, subdivision 2, the sanctions under this section may be 514.15 imposed. 514.16[EFFECTIVE DATE.] This section is effective January 1, 2002. 514.17 Sec. 13. Minnesota Statutes 2000, section 245A.08, is 514.18 amended to read: 514.19 245A.08 [HEARINGS.] 514.20 Subdivision 1. [RECEIPT OF APPEAL; CONDUCT OF HEARING.] 514.21 Upon receiving a timely appeal or petition pursuant to 514.22 section 245A.04, subdivision 3c, 245A.05, or 245A.07, 514.23 subdivision 3, the commissioner shall issue a notice of and 514.24 order for hearing to the appellant under chapter 14 and 514.25 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 514.26 rules. 514.27 Subd. 2. [CONDUCT OF HEARINGS.] At any hearing provided 514.28 for by section 245A.04, subdivision 3c, 245A.05, or 245A.07, 514.29 subdivision 3, the appellant may be represented by counsel and 514.30 has the right to call, examine, and cross-examine witnesses. 514.31 The administrative law judge may require the presence of 514.32 witnesses and evidence by subpoena on behalf of any party. 514.33 Subd. 2a. [CONSOLIDATED CONTESTED CASE HEARINGS FOR 514.34 SANCTIONS BASED ON MALTREATMENT DETERMINATIONS AND 514.35 DISQUALIFICATIONS.] (a) When a denial of a license under section 514.36 245A.05 or a licensing sanction under section 245A.07, 515.1 subdivision 3, is based on a disqualification for which 515.2 reconsideration was requested and which was not set aside or was 515.3 not rescinded under section 245A.04, subdivision 3b, the scope 515.4 of the contested case hearing shall include the disqualification 515.5 and the licensing sanction or denial of a license. When the 515.6 licensing sanction or denial of a license is based on a 515.7 determination of maltreatment under section 626.556 or 626.557, 515.8 or a disqualification for serious or recurring maltreatment 515.9 which was not set aside or was not rescinded, the scope of the 515.10 contested case hearing shall include the maltreatment 515.11 determination, disqualification, and the licensing sanction or 515.12 denial of a license. In such cases, a fair hearing under 515.13 section 256.045 shall not be conducted as provided for in 515.14 sections 626.556, subdivision 10i, and 626.557, subdivision 9d. 515.15 (b) In consolidated contested case hearings regarding 515.16 sanctions issued in family child care, child foster care, and 515.17 adult foster care, the county attorney shall defend the 515.18 commissioner's orders in accordance with section 245A.16, 515.19 subdivision 4. 515.20 (c) The commissioner's final order under subdivision 5 is 515.21 the final agency action on the issue of maltreatment and 515.22 disqualification, including for purposes of subsequent 515.23 background studies under section 245A.04, subdivision 3, and is 515.24 the only administrative appeal of the final agency 515.25 determination, specifically, including a challenge to the 515.26 accuracy and completeness of data under section 13.04. 515.27 (d) When consolidated hearings under this subdivision 515.28 involve a licensing sanction based on a previous maltreatment 515.29 determination for which the commissioner has issued a final 515.30 order in an appeal of that determination under section 256.045, 515.31 or the individual failed to exercise the right to appeal the 515.32 previous maltreatment determination under section 626.556, 515.33 subdivision 10i, or 626.557, subdivision 9d, the commissioner's 515.34 order is conclusive on the issue of maltreatment. In such 515.35 cases, the scope of the administrative law judge's review shall 515.36 be limited to the disqualification and the licensing sanction or 516.1 denial of a license. In the case of a denial of a license or a 516.2 licensing sanction issued to a facility based on a maltreatment 516.3 determination regarding an individual who is not the license 516.4 holder or a household member, the scope of the administrative 516.5 law judge's review includes the maltreatment determination. 516.6 (e) If a maltreatment determination or disqualification, 516.7 which was not set aside or was not rescinded under section 516.8 245A.04, subdivision 3b, is the basis for a denial of a license 516.9 under section 245A.05 or a licensing sanction under section 516.10 245A.07, and the disqualified subject is an individual other 516.11 than the license holder and upon whom a background study must be 516.12 conducted under section 245A.04, subdivision 3, the hearings of 516.13 all parties may be consolidated into a single contested case 516.14 hearing upon consent of all parties and the administrative law 516.15 judge. 516.16 Subd. 3. [BURDEN OF PROOF.] (a) At a hearing regarding 516.17suspension, immediate suspension, or revocation of a license for516.18family day care or foster carea licensing sanction under 516.19 section 245A.07, including consolidated hearings under 516.20 subdivision 2a, the commissioner may demonstrate reasonable 516.21 cause for action taken by submitting statements, reports, or 516.22 affidavits to substantiate the allegations that the license 516.23 holder failed to comply fully with applicable law or rule. If 516.24 the commissioner demonstrates that reasonable cause existed, the 516.25 burden of proofin hearings involving suspension, immediate516.26suspension, or revocation of a family day care or foster care516.27licenseshifts to the license holder to demonstrate by a 516.28 preponderance of the evidence that the license holder was in 516.29 full compliance with those laws or rules that the commissioner 516.30 alleges the license holder violated, at the time that the 516.31 commissioner alleges the violations of law or rules occurred. 516.32 (b) At a hearing on denial of an application, the applicant 516.33 bears the burden of proof to demonstrate by a preponderance of 516.34 the evidence that the appellant has complied fully withsections516.35245A.01 to 245A.15this chapter and other applicable law or rule 516.36 and that the application should be approved and a license 517.1 granted. 517.2(c) At all other hearings under this section, the517.3commissioner bears the burden of proof to demonstrate, by a517.4preponderance of the evidence, that the violations of law or517.5rule alleged by the commissioner occurred.517.6 Subd. 4. [RECOMMENDATION OF ADMINISTRATIVE LAW JUDGE.] The 517.7 administrative law judge shall recommend whether or not the 517.8 commissioner's order should be affirmed. The recommendations 517.9 must be consistent with this chapter and the rules of the 517.10 commissioner. The recommendations must be in writing and 517.11 accompanied by findings of fact and conclusions and must be 517.12 mailed to the parties by certified mail to their last known 517.13 addresses as shown on the license or application. 517.14 Subd. 5. [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 517.15 considering the findings of fact, conclusions, and 517.16 recommendations of the administrative law judge, the 517.17 commissioner shall issue a final order. The commissioner shall 517.18 consider, but shall not be bound by, the recommendations of the 517.19 administrative law judge. The appellant must be notified of the 517.20 commissioner's final order as required by chapter 14 and 517.21 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 517.22 rules. The notice must also contain information about the 517.23 appellant's rights under chapter 14 and Minnesota Rules, parts 517.24 1400.8510 to 1400.8612 and successor rules. The institution of 517.25 proceedings for judicial review of the commissioner's final 517.26 order shall not stay the enforcement of the final order except 517.27 as provided in section 14.65. A license holder and each 517.28 controlling individual of a license holder whose license has 517.29 been revoked because of noncompliance with applicable law or 517.30 rule must not be granted a license for five years following the 517.31 revocation. An applicant whose application was denied must not 517.32 be granted a license for two years following a denial, unless 517.33 the applicant's subsequent application contains new information 517.34 which constitutes a substantial change in the conditions that 517.35 caused the previous denial. 517.36[EFFECTIVE DATE.] This section is effective January 1, 2002. 518.1 Sec. 14. Minnesota Statutes 2000, section 245A.16, 518.2 subdivision 1, is amended to read: 518.3 Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 518.4 County agencies and private agencies that have been designated 518.5 or licensed by the commissioner to perform licensing functions 518.6 and activities under section 245A.04, to recommend denial of 518.7 applicants under section 245A.05, to issue correction orders, to 518.8 issue variances, and recommendfinesa conditional license under 518.9 section 245A.06, or to recommend suspending,or revoking, and518.10making licenses probationarya license or issuing a fine under 518.11 section 245A.07, shall comply with rules and directives of the 518.12 commissioner governing those functions and with this section. 518.13 (b) For family day care programs, the commissioner may 518.14 authorize licensing reviews every two years after a licensee has 518.15 had at least one annual review. 518.16[EFFECTIVE DATE.] This section is effective January 1, 2002. 518.17 Sec. 15. Minnesota Statutes 2000, section 245B.08, 518.18 subdivision 3, is amended to read: 518.19 Subd. 3. [SANCTIONS AVAILABLE.] Nothing in this 518.20 subdivision shall be construed to limit the commissioner's 518.21 authority to suspend,or revoke a license, ormake conditional518.22 issue a fine at any timea licenseunder section 245A.07; make 518.23 correction orders andrequire finesmake a license conditional 518.24 for failure to comply with applicable laws or rules under 518.25 section 245A.06; or deny an application for license under 518.26 section 245A.05. 518.27[EFFECTIVE DATE.] This section is effective January 1, 2002. 518.28 Sec. 16. [256.022] [CHILD MALTREATMENT REVIEW PANEL.] 518.29 Subdivision 1. [CREATION.] The commissioner of human 518.30 services shall establish a review panel for purposes of 518.31 reviewing investigating agency determinations regarding 518.32 maltreatment of a child in a facility in response to requests 518.33 received under section 626.556, subdivision 10i, paragraph (b). 518.34 The review panel consists of the commissioners of health; human 518.35 services; children, families, and learning; and corrections; the 518.36 ombudsman for crime victims; and the ombudsman for mental health 519.1 and mental retardation; or their designees. 519.2 Subd. 2. [REVIEW PROCEDURE.] (a) The panel shall hold 519.3 quarterly meetings for purposes of conducting reviews under this 519.4 section. If an interested person acting on behalf of a child 519.5 requests a review under this section, the panel shall review the 519.6 request at its next quarterly meeting. If the next quarterly 519.7 meeting is within ten days of the panel's receipt of the request 519.8 for review, the review may be delayed until the next subsequent 519.9 meeting. The panel shall review the request and the final 519.10 determination regarding maltreatment made by the investigating 519.11 agency and may review any other data on the investigation 519.12 maintained by the agency that are pertinent and necessary to its 519.13 review of the determination. If more than one person requests a 519.14 review under this section with respect to the same 519.15 determination, the review panel shall combine the requests into 519.16 one review. Upon receipt of a request for a review, the panel 519.17 shall notify the alleged perpetrator of maltreatment that a 519.18 review has been requested and provide an approximate timeline 519.19 for conducting the review. 519.20 (b) Within 30 days of the review under this section, the 519.21 panel shall notify the investigating agency and the interested 519.22 person who requested the review as to whether the panel agrees 519.23 with the determination or whether the investigating agency must 519.24 reconsider the determination. If the panel determines that the 519.25 agency must reconsider the determination, the panel must make 519.26 specific investigative recommendations to the agency. Within 30 519.27 days the investigating agency shall conduct a review and report 519.28 back to the panel with its reconsidered determination and the 519.29 specific rationale for its determination. 519.30 Subd. 3. [REPORT.] By January 15 of each year, the panel 519.31 shall submit a report to the committees of the legislature with 519.32 jurisdiction over section 626.556 regarding the number of 519.33 requests for review it receives under this section, the number 519.34 of cases where the panel requires the investigating agency to 519.35 reconsider its final determination, the number of cases where 519.36 the final determination is changed, and any recommendations to 520.1 improve the review or investigative process. 520.2 Subd. 4. [DATA.] Data of the review panel created as part 520.3 of a review under this section are private data on individuals 520.4 as defined in section 13.02. 520.5[EFFECTIVE DATE.] This section is effective July 1, 2001. 520.6 Sec. 17. Minnesota Statutes 2000, section 256.045, 520.7 subdivision 3, is amended to read: 520.8 Subd. 3. [STATE AGENCY HEARINGS.] (a) State agency 520.9 hearings are available for the following: (1) any person 520.10 applying for, receiving or having received public assistance, 520.11 medical care, or a program of social services granted by the 520.12 state agency or a county agency or the federal Food Stamp Act 520.13 whose application for assistance is denied, not acted upon with 520.14 reasonable promptness, or whose assistance is suspended, 520.15 reduced, terminated, or claimed to have been incorrectly paid; 520.16 (2) any patient or relative aggrieved by an order of the 520.17 commissioner under section 252.27; (3) a party aggrieved by a 520.18 ruling of a prepaid health plan; (4) except as provided under 520.19 chapter 245A, any individual or facility determined by a lead 520.20 agency to have maltreated a vulnerable adult under section 520.21 626.557 after they have exercised their right to administrative 520.22 reconsideration under section 626.557; (5) any person whose 520.23 claim for foster care payment according to a placement of the 520.24 child resulting from a child protection assessment under section 520.25 626.556 is denied or not acted upon with reasonable promptness, 520.26 regardless of funding source; (6) any person to whom a right of 520.27 appeal according to this section is given by other provision of 520.28 law; (7) an applicant aggrieved by an adverse decision to an 520.29 application for a hardship waiver under section 520.30 256B.15;or(8) except as provided under chapter 245A, an 520.31 individual or facility determined to have maltreated a minor 520.32 under section 626.556, after the individual or facility has 520.33 exercised the right to administrative reconsideration under 520.34 section 626.556; or (9) except as provided under chapter 245A, 520.35 an individual disqualified under section 245A.04, subdivision 520.36 3d, on the basis of serious or recurring maltreatment; a 521.1 preponderance of the evidence that the individual has committed 521.2 an act or acts that meet the definition of any of the crimes 521.3 listed in section 245A.04, subdivision 3d, paragraph (a), 521.4 clauses (1) to (4); or for failing to make reports required 521.5 under section 626.556, subdivision 3, or 626.557, subdivision 521.6 3. Hearings regarding a maltreatment determination under clause 521.7 (4) or (8) and a disqualification under this clause in which the 521.8 basis for a disqualification is serious or recurring 521.9 maltreatment, which has not been set aside or rescinded under 521.10 section 245A.04, subdivision 3b, shall be consolidated into a 521.11 single fair hearing. In such cases, the scope of review by the 521.12 human services referee shall include both the maltreatment 521.13 determination and the disqualification. The failure to exercise 521.14 the right to an administrative reconsideration shall not be a 521.15 bar to a hearing under this section if federal law provides an 521.16 individual the right to a hearing to dispute a finding of 521.17 maltreatment. Individuals and organizations specified in this 521.18 section may contest the specified action, decision, or final 521.19 disposition before the state agency by submitting a written 521.20 request for a hearing to the state agency within 30 days after 521.21 receiving written notice of the action, decision, or final 521.22 disposition, or within 90 days of such written notice if the 521.23 applicant, recipient, patient, or relative shows good cause why 521.24 the request was not submitted within the 30-day time limit. 521.25 The hearing for an individual or facility under clause 521.26 (4)or, (8), or (9) is the only administrative appeal to the 521.27 final agency determination specifically, including a challenge 521.28 to the accuracy and completeness of data under section 13.04. 521.29 Hearings requested under clause (4) apply only to incidents of 521.30 maltreatment that occur on or after October 1, 1995. Hearings 521.31 requested by nursing assistants in nursing homes alleged to have 521.32 maltreated a resident prior to October 1, 1995, shall be held as 521.33 a contested case proceeding under the provisions of chapter 14. 521.34 Hearings requested under clause (8) apply only to incidents of 521.35 maltreatment that occur on or after July 1, 1997. A hearing for 521.36 an individual or facility under clause (8) is only available 522.1 when there is no juvenile court or adult criminal action 522.2 pending. If such action is filed in either court while an 522.3 administrative review is pending, the administrative review must 522.4 be suspended until the judicial actions are completed. If the 522.5 juvenile court action or criminal charge is dismissed or the 522.6 criminal action overturned, the matter may be considered in an 522.7 administrative hearing. 522.8 For purposes of this section, bargaining unit grievance 522.9 procedures are not an administrative appeal. 522.10 The scope of hearings involving claims to foster care 522.11 payments under clause (5) shall be limited to the issue of 522.12 whether the county is legally responsible for a child's 522.13 placement under court order or voluntary placement agreement 522.14 and, if so, the correct amount of foster care payment to be made 522.15 on the child's behalf and shall not include review of the 522.16 propriety of the county's child protection determination or 522.17 child placement decision. 522.18 (b) A vendor of medical care as defined in section 256B.02, 522.19 subdivision 7, or a vendor under contract with a county agency 522.20 to provide social services under section 256E.08, subdivision 4, 522.21 is not a party and may not request a hearing under this section, 522.22 except if assisting a recipient as provided in subdivision 4. 522.23 (c) An applicant or recipient is not entitled to receive 522.24 social services beyond the services included in the amended 522.25 community social services plan developed under section 256E.081, 522.26 subdivision 3, if the county agency has met the requirements in 522.27 section 256E.081. 522.28 (d) The commissioner may summarily affirm the county or 522.29 state agency's proposed action without a hearing when the sole 522.30 issue is an automatic change due to a change in state or federal 522.31 law. 522.32[EFFECTIVE DATE.] This section is effective January 1, 2002. 522.33 Sec. 18. Minnesota Statutes 2000, section 256.045, 522.34 subdivision 3b, is amended to read: 522.35 Subd. 3b. [STANDARD OF EVIDENCE FOR MALTREATMENT AND 522.36 DISQUALIFICATION HEARINGS.] The state human services referee 523.1 shall determine that maltreatment has occurred if a 523.2 preponderance of evidence exists to support the final 523.3 disposition under sections 626.556 and 626.557. For purposes of 523.4 hearings regarding disqualification, the state human services 523.5 referee shall affirm the proposed disqualification in an appeal 523.6 under subdivision 3, paragraph (a), clause (9), if a 523.7 preponderance of the evidence shows the individual has: 523.8 (1) committed maltreatment under section 626.556 or 523.9 626.557, which is serious or recurring; 523.10 (2) committed an act or acts meeting the definition of any 523.11 of the crimes listed in section 245A.04, subdivision 3d, 523.12 paragraph (a), clauses (1) to (4); or 523.13 (3) failed to make required reports under section 626.556 523.14 or 626.557 for incidents in which: 523.15 (i) the final disposition under section 626.556 or 626.557 523.16 was substantiated maltreatment; and 523.17 (ii) the maltreatment was recurring or serious; or 523.18 substantiated serious or recurring maltreatment of a minor under 523.19 section 626.556 or of a vulnerable adult under section 626.557 523.20 for which there is a preponderance of evidence that the 523.21 maltreatment occurred, and that the subject was responsible for 523.22 the maltreatment. If the disqualification is affirmed, the 523.23 state human services referee shall determine whether the 523.24 individual poses a risk of harm in accordance with the 523.25 requirements of section 245A.04, subdivision 3b. 523.26 The state human services referee shall recommend an order 523.27 to the commissioner of health or human services, as applicable, 523.28 who shall issue a final order. The commissioner shall affirm, 523.29 reverse, or modify the final disposition. Any order of the 523.30 commissioner issued in accordance with this subdivision is 523.31 conclusive upon the parties unless appeal is taken in the manner 523.32 provided in subdivision 7. Except as provided under section 523.33 245A.04, subdivisions 3b, paragraphs (e) and (f); and 3c, in any 523.34 licensing appeal under chapter 245A and sections 144.50 to 523.35 144.58 and 144A.02 to 144A.46, the commissioner's determination 523.36 as to maltreatment is conclusive. 524.1[EFFECTIVE DATE.] This section is effective January 1, 2002. 524.2 Sec. 19. Minnesota Statutes 2000, section 256.045, 524.3 subdivision 4, is amended to read: 524.4 Subd. 4. [CONDUCT OF HEARINGS.] (a) All hearings held 524.5 pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 524.6 according to the provisions of the federal Social Security Act 524.7 and the regulations implemented in accordance with that act to 524.8 enable this state to qualify for federal grants-in-aid, and 524.9 according to the rules and written policies of the commissioner 524.10 of human services. County agencies shall install equipment 524.11 necessary to conduct telephone hearings. A state human services 524.12 referee may schedule a telephone conference hearing when the 524.13 distance or time required to travel to the county agency offices 524.14 will cause a delay in the issuance of an order, or to promote 524.15 efficiency, or at the mutual request of the parties. Hearings 524.16 may be conducted by telephone conferences unless the applicant, 524.17 recipient, former recipient, person, or facility contesting 524.18 maltreatment objects. The hearing shall not be held earlier 524.19 than five days after filing of the required notice with the 524.20 county or state agency. The state human services referee shall 524.21 notify all interested persons of the time, date, and location of 524.22 the hearing at least five days before the date of the hearing. 524.23 Interested persons may be represented by legal counsel or other 524.24 representative of their choice, including a provider of therapy 524.25 services, at the hearing and may appear personally, testify and 524.26 offer evidence, and examine and cross-examine witnesses. The 524.27 applicant, recipient, former recipient, person, or facility 524.28 contesting maltreatment shall have the opportunity to examine 524.29 the contents of the case file and all documents and records to 524.30 be used by the county or state agency at the hearing at a 524.31 reasonable time before the date of the hearing and during the 524.32 hearing. In hearings under subdivision 3, paragraph (a), 524.33 clauses (4)and, (8), and (9), either party may subpoena the 524.34 private data relating to the investigation prepared by the 524.35 agency under section 626.556 or 626.557 that is not otherwise 524.36 accessible under section 13.04, provided the identity of the 525.1 reporter may not be disclosed. 525.2 (b) The private data obtained by subpoena in a hearing 525.3 under subdivision 3, paragraph (a), clause (4)or, (8), or (9), 525.4 must be subject to a protective order which prohibits its 525.5 disclosure for any other purpose outside the hearing provided 525.6 for in this section without prior order of the district court. 525.7 Disclosure without court order is punishable by a sentence of 525.8 not more than 90 days imprisonment or a fine of not more than 525.9 $700, or both. These restrictions on the use of private data do 525.10 not prohibit access to the data under section 13.03, subdivision 525.11 6. Except for appeals under subdivision 3, paragraph (a), 525.12 clauses (4), (5),and(8), and (9), upon request, the county 525.13 agency shall provide reimbursement for transportation, child 525.14 care, photocopying, medical assessment, witness fee, and other 525.15 necessary and reasonable costs incurred by the applicant, 525.16 recipient, or former recipient in connection with the appeal. 525.17 All evidence, except that privileged by law, commonly accepted 525.18 by reasonable people in the conduct of their affairs as having 525.19 probative value with respect to the issues shall be submitted at 525.20 the hearing and such hearing shall not be "a contested case" 525.21 within the meaning of section 14.02, subdivision 3. The agency 525.22 must present its evidence prior to or at the hearing, and may 525.23 not submit evidence after the hearing except by agreement of the 525.24 parties at the hearing, provided the petitioner has the 525.25 opportunity to respond. 525.26[EFFECTIVE DATE.] This section is effective January 1, 2002. 525.27 Sec. 20. Minnesota Statutes 2000, section 626.556, is 525.28 amended by adding a subdivision to read: 525.29 Subd. 2a. [DEFINITION; THREATENED INJURY.] As used in this 525.30 section, "threatened injury," as defined in subdivision 2, 525.31 paragraph (l) includes, but is not limited to, exposing a child 525.32 to a person responsible for the child's care, as defined in 525.33 paragraph (b), clause (1), who has: 525.34 (1) subjected a child to, or failed to protect a child 525.35 from, an overt act or condition that constitutes egregious harm, 525.36 as defined in section 260C.007, subdivision 26, or a similar law 526.1 of another jurisdiction; 526.2 (2) been found to be palpably unfit under section 260C.301, 526.3 paragraph (b), clause (4), or a similar law of another 526.4 jurisdiction; 526.5 (3) committed an act that has resulted in an involuntary 526.6 termination of parental rights under section 260C.301, or a 526.7 similar law of another jurisdiction; or 526.8 (4) committed an act that has resulted in the involuntary 526.9 transfer of permanent legal and physical custody of a child to a 526.10 relative under section 260C.201, subdivision 11, paragraph (e), 526.11 clause (1), or a similar law of another jurisdiction. 526.12 Sec. 21. Minnesota Statutes 2000, section 626.556, 526.13 subdivision 3, is amended to read: 526.14 Subd. 3. [PERSONS MANDATED TO REPORT.] (a) A person who 526.15 knows or has reason to believe a child is being neglected or 526.16 physically or sexually abused, as defined in subdivision 2, or 526.17 has been neglected or physically or sexually abused within the 526.18 preceding three years, shall immediately report the information 526.19 to the local welfare agency, agency responsible for assessing or 526.20 investigating the report, police department, or the county 526.21 sheriff if the person is: 526.22 (1) a professional or professional's delegate who is 526.23 engaged in the practice of the healing arts, social services, 526.24 hospital administration, psychological or psychiatric treatment, 526.25 child care, education, or law enforcement; or 526.26 (2) employed as a member of the clergy and received the 526.27 information while engaged in ministerial duties, provided that a 526.28 member of the clergy is not required by this subdivision to 526.29 report information that is otherwise privileged under section 526.30 595.02, subdivision 1, paragraph (c). 526.31 The police department or the county sheriff, upon receiving 526.32 a report, shall immediately notify the local welfare agency or 526.33 agency responsible for assessing or investigating the report, 526.34 orally and in writing. The local welfare agency, or agency 526.35 responsible for assessing or investigating the report, upon 526.36 receiving a report, shall immediately notify the local police 527.1 department or the county sheriff orally and in writing. The 527.2 county sheriff and the head of every local welfare agency, 527.3 agency responsible for assessing or investigating reports, and 527.4 police department shall each designate a person within their 527.5 agency, department, or office who is responsible for ensuring 527.6 that the notification duties of this paragraph and paragraph (b) 527.7 are carried out. Nothing in this subdivision shall be construed 527.8 to require more than one report from any institution, facility, 527.9 school, or agency. 527.10 (b) Any person may voluntarily report to the local welfare 527.11 agency, agency responsible for assessing or investigating the 527.12 report, police department, or the county sheriff if the person 527.13 knows, has reason to believe, or suspects a child is being or 527.14 has been neglected or subjected to physical or sexual abuse. 527.15 The police department or the county sheriff, upon receiving a 527.16 report, shall immediately notify the local welfare agency or 527.17 agency responsible for assessing or investigating the report, 527.18 orally and in writing. The local welfare agency or agency 527.19 responsible for assessing or investigating the report, upon 527.20 receiving a report, shall immediately notify the local police 527.21 department or the county sheriff orally and in writing. 527.22 (c) A person mandated to report physical or sexual child 527.23 abuse or neglect occurring within a licensed facility shall 527.24 report the information to the agency specified under 527.25 subdivisions 3b and 3c as responsible forlicensing527.26theassessing or investigating a facility licensed under 527.27 sections 144.50 to 144.58; a facility licensed under section 527.28 241.021;245A.01 to 245A.16; or 245B, ora facility licensed 527.29 under chapter 245A; a school as defined insectionssection 527.30 120A.05, subdivisions 9, 11, and 13; and, or section 124D.10; or 527.31 a nonlicensed personal care provider organization as defined 527.32 insectionssection 256B.04, subdivision 16; and, or section 527.33 256B.0625, subdivision 19.A health or correctionsAn agency 527.34 receiving a report may request the local welfare agency to 527.35 provide assistance pursuant to subdivisions 10, 10a, and 10b. 527.36 (d) Any person mandated to report shall receive a summary 528.1 of the disposition of any report made by that reporter, 528.2 including whether the case has been opened for child protection 528.3 or other services, or if a referral has been made to a community 528.4 organization, unless release would be detrimental to the best 528.5 interests of the child. Any person who is not mandated to 528.6 report shall, upon request to the local welfare agency, receive 528.7 a concise summary of the disposition of any report made by that 528.8 reporter, unless release would be detrimental to the best 528.9 interests of the child. 528.10 (e) For purposes of this subdivision, "immediately" means 528.11 as soon as possible but in no event longer than 24 hours. 528.12[EFFECTIVE DATE.] This section is effective July 1, 2001. 528.13 Sec. 22. Minnesota Statutes 2000, section 626.556, 528.14 subdivision 3c, is amended to read: 528.15 Subd. 3c. [AGENCY RESPONSIBLE FOR ASSESSING OR 528.16 INVESTIGATING REPORTS OF MALTREATMENT.] The following agencies 528.17 are the administrative agencies responsible for assessing or 528.18 investigating reports of alleged child maltreatment in 528.19 facilities made under this section: 528.20 (1) the county local welfare agency is the agency 528.21 responsible for assessing or investigating allegations of 528.22 maltreatment in child foster care, family child care, and 528.23 legally unlicensed child careand; 528.24 (2) the department of human services is the agency 528.25 responsible for assessing or investigating allegations of 528.26 maltreatment in juvenile correctional facilities licensed under 528.27 section 241.021located in the local welfare agency's county; 528.28(2)(3) the department of human services is the agency 528.29 responsible for assessing or investigating allegations of 528.30 maltreatment in facilities licensed under chapters 245A and 528.31 245B, except for child foster care and family child care; and 528.32(3)(4) the department of health is the agency responsible 528.33 for assessing or investigating allegations of child maltreatment 528.34 in facilities licensed under sections 144.50 to 144.58, and in 528.35 unlicensed home health care. 528.36[EFFECTIVE DATE.] This section is effective July 1, 2001. 529.1 Sec. 23. Minnesota Statutes, section 626.556, is amended 529.2 by adding a subdivision to read: 529.3 Subd. 3d. [COMMISSIONER OF HEALTH; 529.4 DUTIES.] Notwithstanding the designation of certain data as 529.5 confidential under section 144.225, subdivision 2 or private 529.6 under section 144.225, subdivision 2a, the commissioner shall 529.7 give the commissioner of human services access to birth record 529.8 data and data contained in recognitions of parentage prepared 529.9 according to section 257.75 necessary to enable the commissioner 529.10 of human services to identify a child who is subject to 529.11 threatened injury, as defined in subdivision 2, paragraph (l), 529.12 by a person responsible for the child's care, as defined in 529.13 subdivision 2, paragraph (b), clause (1). The commissioner 529.14 shall be given access to all data included on official birth 529.15 certificates. 529.16 Sec. 24. Minnesota Statutes 2000, section 626.556, 529.17 subdivision 10, is amended to read: 529.18 Subd. 10. [DUTIES OF LOCAL WELFARE AGENCY AND LOCAL LAW 529.19 ENFORCEMENT AGENCY UPON RECEIPT OF A REPORT.] (a) If the report 529.20 alleges neglect, physical abuse, or sexual abuse by a parent, 529.21 guardian, or individual functioning within the family unit as a 529.22 person responsible for the child's care, the local welfare 529.23 agency shall immediately conduct an assessment including 529.24 gathering information on the existence of substance abuse and 529.25 offer protective social services for purposes of preventing 529.26 further abuses, safeguarding and enhancing the welfare of the 529.27 abused or neglected minor, and preserving family life whenever 529.28 possible. If the report alleges a violation of a criminal 529.29 statute involving sexual abuse, physical abuse, or neglect or 529.30 endangerment, under section 609.378, the local law enforcement 529.31 agency and local welfare agency shall coordinate the planning 529.32 and execution of their respective investigation and assessment 529.33 efforts to avoid a duplication of fact-finding efforts and 529.34 multiple interviews. Each agency shall prepare a separate 529.35 report of the results of its investigation. In cases of alleged 529.36 child maltreatment resulting in death, the local agency may rely 530.1 on the fact-finding efforts of a law enforcement investigation 530.2 to make a determination of whether or not maltreatment 530.3 occurred. When necessary the local welfare agency shall seek 530.4 authority to remove the child from the custody of a parent, 530.5 guardian, or adult with whom the child is living. In performing 530.6 any of these duties, the local welfare agency shall maintain 530.7 appropriate records. 530.8 If the assessment indicates there is a potential for abuse 530.9 of alcohol or other drugs by the parent, guardian, or person 530.10 responsible for the child's care, the local welfare agency shall 530.11 conduct a chemical use assessment pursuant to Minnesota Rules, 530.12 part 9530.6615. The local welfare agency shall report the 530.13 determination of the chemical use assessment, and the 530.14 recommendations and referrals for alcohol and other drug 530.15 treatment services to the state authority on alcohol and drug 530.16 abuse. 530.17 (b) When a local agency receives a report or otherwise has 530.18 information indicating that a child who is a client, as defined 530.19 in section 245.91, has been the subject of physical abuse, 530.20 sexual abuse, or neglect at an agency, facility, or program as 530.21 defined in section 245.91, it shall, in addition to its other 530.22 duties under this section, immediately inform the ombudsman 530.23 established under sections 245.91 to 245.97. 530.24 (c) Authority of the local welfare agency responsible for 530.25 assessing the child abuse or neglect report and of the local law 530.26 enforcement agency for investigating the alleged abuse or 530.27 neglect includes, but is not limited to, authority to interview, 530.28 without parental consent, the alleged victim and any other 530.29 minors who currently reside with or who have resided with the 530.30 alleged offender. The interview may take place at school or at 530.31 any facility or other place where the alleged victim or other 530.32 minors might be found or the child may be transported to, and 530.33 the interview conducted at, a place appropriate for the 530.34 interview of a child designated by the local welfare agency or 530.35 law enforcement agency. The interview may take place outside 530.36 the presence of the alleged offender or parent, legal custodian, 531.1 guardian, or school official. Except as provided in this 531.2 paragraph, the parent, legal custodian, or guardian shall be 531.3 notified by the responsible local welfare or law enforcement 531.4 agency no later than the conclusion of the investigation or 531.5 assessment that this interview has occurred. Notwithstanding 531.6 rule 49.02 of the Minnesota rules of procedure for juvenile 531.7 courts, the juvenile court may, after hearing on an ex parte 531.8 motion by the local welfare agency, order that, where reasonable 531.9 cause exists, the agency withhold notification of this interview 531.10 from the parent, legal custodian, or guardian. If the interview 531.11 took place or is to take place on school property, the order 531.12 shall specify that school officials may not disclose to the 531.13 parent, legal custodian, or guardian the contents of the 531.14 notification of intent to interview the child on school 531.15 property, as provided under this paragraph, and any other 531.16 related information regarding the interview that may be a part 531.17 of the child's school record. A copy of the order shall be sent 531.18 by the local welfare or law enforcement agency to the 531.19 appropriate school official. 531.20 (d) When the local welfare or local law enforcement agency 531.21 determines that an interview should take place on school 531.22 property, written notification of intent to interview the child 531.23 on school property must be received by school officials prior to 531.24 the interview. The notification shall include the name of the 531.25 child to be interviewed, the purpose of the interview, and a 531.26 reference to the statutory authority to conduct an interview on 531.27 school property. For interviews conducted by the local welfare 531.28 agency, the notification shall be signed by the chair of the 531.29 local social services agency or the chair's designee. The 531.30 notification shall be private data on individuals subject to the 531.31 provisions of this paragraph. School officials may not disclose 531.32 to the parent, legal custodian, or guardian the contents of the 531.33 notification or any other related information regarding the 531.34 interview until notified in writing by the local welfare or law 531.35 enforcement agency that the investigation or assessment has been 531.36 concluded. Until that time, the local welfare or law 532.1 enforcement agency shall be solely responsible for any 532.2 disclosures regarding the nature of the assessment or 532.3 investigation. 532.4 Except where the alleged offender is believed to be a 532.5 school official or employee, the time and place, and manner of 532.6 the interview on school premises shall be within the discretion 532.7 of school officials, but the local welfare or law enforcement 532.8 agency shall have the exclusive authority to determine who may 532.9 attend the interview. The conditions as to time, place, and 532.10 manner of the interview set by the school officials shall be 532.11 reasonable and the interview shall be conducted not more than 24 532.12 hours after the receipt of the notification unless another time 532.13 is considered necessary by agreement between the school 532.14 officials and the local welfare or law enforcement agency. 532.15 Where the school fails to comply with the provisions of this 532.16 paragraph, the juvenile court may order the school to comply. 532.17 Every effort must be made to reduce the disruption of the 532.18 educational program of the child, other students, or school 532.19 staff when an interview is conducted on school premises. 532.20 (e) Where the alleged offender or a person responsible for 532.21 the care of the alleged victim or other minor prevents access to 532.22 the victim or other minor by the local welfare agency, the 532.23 juvenile court may order the parents, legal custodian, or 532.24 guardian to produce the alleged victim or other minor for 532.25 questioning by the local welfare agency or the local law 532.26 enforcement agency outside the presence of the alleged offender 532.27 or any person responsible for the child's care at reasonable 532.28 places and times as specified by court order. 532.29 (f) Before making an order under paragraph (e), the court 532.30 shall issue an order to show cause, either upon its own motion 532.31 or upon a verified petition, specifying the basis for the 532.32 requested interviews and fixing the time and place of the 532.33 hearing. The order to show cause shall be served personally and 532.34 shall be heard in the same manner as provided in other cases in 532.35 the juvenile court. The court shall consider the need for 532.36 appointment of a guardian ad litem to protect the best interests 533.1 of the child. If appointed, the guardian ad litem shall be 533.2 present at the hearing on the order to show cause. 533.3 (g) The commissioner, the ombudsman for mental health and 533.4 mental retardation, the local welfare agencies responsible for 533.5 investigating reports, and the local law enforcement agencies 533.6 have the right to enter facilities as defined in subdivision 2 533.7 and to inspect and copy the facility's records, including 533.8 medical records, as part of the investigation. Notwithstanding 533.9 the provisions of chapter 13, they also have the right to inform 533.10 the facility under investigation that they are conducting an 533.11 investigation, to disclose to the facility the names of the 533.12 individuals under investigation for abusing or neglecting a 533.13 child, and to provide the facility with a copy of the report and 533.14 the investigative findings. 533.15 (h) The local welfare agency shall collect available and 533.16 relevant information to ascertain whether maltreatment occurred 533.17 and whether protective services are needed. Information 533.18 collected includes, when relevant, information with regard to 533.19 the person reporting the alleged maltreatment, including the 533.20 nature of the reporter's relationship to the child and to the 533.21 alleged offender, and the basis of the reporter's knowledge for 533.22 the report; the child allegedly being maltreated; the alleged 533.23 offender; the child's caretaker; and other collateral sources 533.24 having relevant information related to the alleged 533.25 maltreatment. The local welfare agency may make a determination 533.26 of no maltreatment early in an assessment, and close the case 533.27 and retain immunity, if the collected information shows no basis 533.28 for a full assessment or investigation. 533.29 Information relevant to the assessment or investigation 533.30 must be asked for, and may include: 533.31 (1) the child's sex and age, prior reports of maltreatment, 533.32 information relating to developmental functioning, credibility 533.33 of the child's statement, and whether the information provided 533.34 under this clause is consistent with other information collected 533.35 during the course of the assessment or investigation; 533.36 (2) the alleged offender's age, a record check for prior 534.1 reports of maltreatment, and criminal charges and convictions. 534.2 The local welfare agency must provide the alleged offender with 534.3 an opportunity to make a statement. The alleged offender may 534.4 submit supporting documentation relevant to the assessment or 534.5 investigation; 534.6 (3) collateral source information regarding the alleged 534.7 maltreatment and care of the child. Collateral information 534.8 includes, when relevant: (i) a medical examination of the 534.9 child; (ii) prior medical records relating to the alleged 534.10 maltreatment or the care of the child maintained by any 534.11 facility, clinic, or health care professional and an interview 534.12 with the treating professionals; and (iii) interviews with the 534.13 child's caretakers, including the child's parent, guardian, 534.14 foster parent, child care provider, teachers, counselors, family 534.15 members, relatives, and other persons who may have knowledge 534.16 regarding the alleged maltreatment and the care of the child; 534.17 and 534.18 (4) information on the existence of domestic abuse and 534.19 violence in the home of the child, and substance abuse. 534.20 Nothing in this paragraph precludes the local welfare 534.21 agency from collecting other relevant information necessary to 534.22 conduct the assessment or investigation. Notwithstanding 534.23 section 13.384 or 144.335, the local welfare agency has access 534.24 to medical data and records for purposes of clause (3). 534.25 Notwithstanding the data's classification in the possession of 534.26 any other agency, data acquired by the local welfare agency 534.27 during the course of the assessment or investigation are private 534.28 data on individuals and must be maintained in accordance with 534.29 subdivision 11. 534.30 (i) In the initial stages of an assessment or 534.31 investigation, the local welfare agency shall conduct a 534.32 face-to-face observation of the child reported to be maltreated 534.33 and a face-to-face interview of the alleged offender. The 534.34 interview with the alleged offender may be postponed if it would 534.35 jeopardize an active law enforcement investigation. 534.36 (j) The local welfare agency shall use a question and 535.1 answer interviewing format with questioning as nondirective as 535.2 possible to elicit spontaneous responses. The following 535.3 interviewing methods and procedures must be used whenever 535.4 possible when collecting information: 535.5 (1) audio recordings of all interviews with witnesses and 535.6 collateral sources; and 535.7 (2) in cases of alleged sexual abuse, audio-video 535.8 recordings of each interview with the alleged victim and child 535.9 witnesses. 535.10[EFFECTIVE DATE.] This section is effective July 1, 2001. 535.11 Sec. 25. Minnesota Statutes 2000, section 626.556, 535.12 subdivision 10b, is amended to read: 535.13 Subd. 10b. [DUTIES OF COMMISSIONER; NEGLECT OR ABUSE IN 535.14 FACILITY.] (a) This section applies to the commissioners of 535.15 human services, health, and children, families, and learning. 535.16 The commissioner of the agency responsible for assessing or 535.17 investigating the report shall immediately investigate if the 535.18 report alleges that: 535.19 (1) a child who is in the care of a facility as defined in 535.20 subdivision 2 is neglected, physically abused,orsexually 535.21 abused, or is the victim of maltreatment in a facility by an 535.22 individual in that facility, or has been so neglected or abused, 535.23 or been the victim of maltreatment in a facility by an 535.24 individual in that facility within the three years preceding the 535.25 report; or 535.26 (2) a child was neglected, physically abused,orsexually 535.27 abused, or is the victim of maltreatment in a facility by an 535.28 individual in a facility defined in subdivision 2, while in the 535.29 care of that facility within the three years preceding the 535.30 report. 535.31 The commissioner of the agency responsible for assessing or 535.32 investigating the report shall arrange for the transmittal to 535.33 the commissioner of reports received by local agencies and may 535.34 delegate to a local welfare agency the duty to investigate 535.35 reports. In conducting an investigation under this section, the 535.36 commissioner has the powers and duties specified for local 536.1 welfare agencies under this section. The commissioner of the 536.2 agency responsible for assessing or investigating the report or 536.3 local welfare agency may interview any children who are or have 536.4 been in the care of a facility under investigation and their 536.5 parents, guardians, or legal custodians. 536.6 (b) Prior to any interview, the commissioner of the agency 536.7 responsible for assessing or investigating the report or local 536.8 welfare agency shall notify the parent, guardian, or legal 536.9 custodian of a child who will be interviewed in the manner 536.10 provided for in subdivision 10d, paragraph (a). If reasonable 536.11 efforts to reach the parent, guardian, or legal custodian of a 536.12 child in an out-of-home placement have failed, the child may be 536.13 interviewed if there is reason to believe the interview is 536.14 necessary to protect the child or other children in the 536.15 facility. The commissioner of the agency responsible for 536.16 assessing or investigating the report or local agency must 536.17 provide the information required in this subdivision to the 536.18 parent, guardian, or legal custodian of a child interviewed 536.19 without parental notification as soon as possible after the 536.20 interview. When the investigation is completed, any parent, 536.21 guardian, or legal custodian notified under this subdivision 536.22 shall receive the written memorandum provided for in subdivision 536.23 10d, paragraph (c). 536.24 (c) In conducting investigations under this subdivision the 536.25commissioner or local welfareagency responsible for assessing 536.26 or investigating the report shallobtainbe given access to 536.27 information consistent with subdivision 10, paragraphs (g), (h), 536.28 (i), and (j), and shall be granted the same access to the 536.29 facility as the facility's licensing agency under the 536.30 corresponding facility licensing statute. A facility that 536.31 denies the investigating agency access to this information shall 536.32 be subject to a negative licensing action by the appropriate 536.33 licensing agency. When the agency responsible for assessing or 536.34 investigating a report under this section and the licensing 536.35 agency for the facility involved are not the same agency, the 536.36 investigating agency and the licensing agency may share not 537.1 public data as necessary to complete the investigation or to 537.2 determine appropriate licensing action. 537.3 (d) Except for foster care and family child care, the 537.4 commissioner has the primary responsibility for the 537.5 investigations and notifications required under subdivisions 10d 537.6 and 10f for reports that allege maltreatment related to the care 537.7 provided by or in facilities licensed by the commissioner. The 537.8 commissioner may request assistance from the local social 537.9 services agency. 537.10[EFFECTIVE DATE.] This section is effective July 1, 2001. 537.11 Sec. 26. Minnesota Statutes 2000, section 626.556, 537.12 subdivision 10d, is amended to read: 537.13 Subd. 10d. [NOTIFICATION OF NEGLECT OR ABUSE IN FACILITY.] 537.14 (a) When a report is received that alleges neglect, physical 537.15 abuse,orsexual abuse, or maltreatment of a child while in the 537.16 care of a licensed or unlicensed day care facility, residential 537.17 facility, agency, hospital, sanitarium, or other facility or 537.18 institution required to be licensed according to sections 144.50 537.19 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B, or a 537.20 school as defined in sections 120A.05, subdivisions 9, 11, and 537.21 13; and 124D.10; or a nonlicensed personal care provider 537.22 organization as defined in section 256B.04, subdivision 16, and 537.23 256B.0625, subdivision 19a, the commissioner of the agency 537.24 responsible for assessing or investigating the report or local 537.25 welfare agency investigating the report shall provide the 537.26 following information to the parent, guardian, or legal 537.27 custodian of a child alleged to have been neglected, physically 537.28 abused,orsexually abused, or the victim of maltreatment of a 537.29 child in the facility: the name of the facility; the fact that 537.30 a report alleging neglect, physical abuse,orsexual abuse, or 537.31 maltreatment of a child in the facility has been received; the 537.32 nature of the alleged neglect, physical abuse,orsexual abuse, 537.33 or maltreatment of a child in the facility; that the agency is 537.34 conducting an investigation; any protective or corrective 537.35 measures being taken pending the outcome of the investigation; 537.36 and that a written memorandum will be provided when the 538.1 investigation is completed. 538.2 (b) The commissioner of the agency responsible for 538.3 assessing or investigating the report or local welfare agency 538.4 may also provide the information in paragraph (a) to the parent, 538.5 guardian, or legal custodian of any other child in the facility 538.6 if the investigative agency knows or has reason to believe the 538.7 alleged neglect, physical abuse,orsexual abuse, or 538.8 maltreatment of a child in the facility has occurred. In 538.9 determining whether to exercise this authority, the commissioner 538.10 of the agency responsible for assessing or investigating the 538.11 report or local welfare agency shall consider the seriousness of 538.12 the alleged neglect, physical abuse,orsexual abuse, or 538.13 maltreatment of a child in the facility; the number of children 538.14 allegedly neglected, physically abused,orsexually abused, or 538.15 victims of maltreatment of a child in the facility; the number 538.16 of alleged perpetrators; and the length of the investigation. 538.17 The facility shall be notified whenever this discretion is 538.18 exercised. 538.19 (c) When the commissioner of the agency responsible for 538.20 assessing or investigating the report or local welfare agency 538.21 has completed its investigation, every parent, guardian, or 538.22 legal custodian notified of the investigation by the 538.23 commissioner or local welfare agency shall be provided with the 538.24 following information in a written memorandum: the name of the 538.25 facility investigated; the nature of the alleged neglect, 538.26 physical abuse,orsexual abuse, or maltreatment of a child in 538.27 the facility; the investigator's name; a summary of the 538.28 investigation findings; a statement whether maltreatment was 538.29 found; and the protective or corrective measures that are being 538.30 or will be taken. The memorandum shall be written in a manner 538.31 that protects the identity of the reporter and the child and 538.32 shall not contain the name, or to the extent possible, reveal 538.33 the identity of the alleged perpetrator or of those interviewed 538.34 during the investigation. If maltreatment is determined to 538.35 exist, the commissioner or local welfare agency shall also 538.36 provide the written memorandum to the parent, guardian, or legal 539.1 custodian of each child in the facilityif maltreatment is539.2determined to existwho had contact with the individual 539.3 responsible for the maltreatment. When the facility is the 539.4 responsible party for maltreatment, the commissioner or local 539.5 welfare agency shall also provide the written memorandum to the 539.6 parent, guardian, or legal custodian of each child who received 539.7 services in the population of the facility where the 539.8 maltreatment occurred. This notification must be provided to 539.9 the parent, guardian, or legal custodian of each child receiving 539.10 services from the time the maltreatment occurred until either 539.11 the individual responsible for maltreatment is no longer in 539.12 contact with a child or children in the facility or the 539.13 conclusion of the investigation. 539.14[EFFECTIVE DATE.] This section is effective July 1, 2001. 539.15 Sec. 27. Minnesota Statutes 2000, section 626.556, 539.16 subdivision 10e, is amended to read: 539.17 Subd. 10e. [DETERMINATIONS.] Upon the conclusion of every 539.18 assessment or investigation it conducts, the local welfare 539.19 agency shall make two determinations: first, whether 539.20 maltreatment has occurred; and second, whether child protective 539.21 services are needed. When maltreatment is determined in an 539.22 investigation involving a facility, the investigating agency 539.23 shall also determine whether the facility or individual was 539.24 responsible for the maltreatment using the mitigating factors in 539.25 paragraph (d). Determinations under this subdivision must be 539.26 made based on a preponderance of the evidence. 539.27 (a) For the purposes of this subdivision, "maltreatment" 539.28 means any of the following acts or omissionscommitted by a539.29person responsible for the child's care: 539.30 (1) physical abuse as defined in subdivision 2, paragraph 539.31 (d); 539.32 (2) neglect as defined in subdivision 2, paragraph (c); 539.33 (3) sexual abuse as defined in subdivision 2, paragraph 539.34 (a);or539.35 (4) mental injury as defined in subdivision 2, paragraph 539.36 (k); or 540.1 (5) maltreatment of a child in a facility as defined in 540.2 subdivision 2, paragraph (f). 540.3 (b) For the purposes of this subdivision, a determination 540.4 that child protective services are needed means that the local 540.5 welfare agency has documented conditions during the assessment 540.6 or investigation sufficient to cause a child protection worker, 540.7 as defined in section 626.559, subdivision 1, to conclude that a 540.8 child is at significant risk of maltreatment if protective 540.9 intervention is not provided and that the individuals 540.10 responsible for the child's care have not taken or are not 540.11 likely to take actions to protect the child from maltreatment or 540.12 risk of maltreatment. 540.13 (c) This subdivision does not mean that maltreatment has 540.14 occurred solely because the child's parent, guardian, or other 540.15 person responsible for the child's care in good faith selects 540.16 and depends upon spiritual means or prayer for treatment or care 540.17 of disease or remedial care of the child, in lieu of medical 540.18 care. However, if lack of medical care may result in serious 540.19 danger to the child's health, the local welfare agency may 540.20 ensure that necessary medical services are provided to the child. 540.21 (d) When determining whether the facility or individual is 540.22 the responsible party for determined maltreatment in a facility, 540.23 the investigating agency shall consider at least the following 540.24 mitigating factors: 540.25 (1) whether the actions of the facility or the individual 540.26 caregivers were according to, and followed the terms of, an 540.27 erroneous physician order, prescription, individual care plan, 540.28 or directive; however, this is not a mitigating factor when the 540.29 facility or caregiver was responsible for the issuance of the 540.30 erroneous order, prescription, individual care plan, or 540.31 directive or knew or should have known of the errors and took no 540.32 reasonable measures to correct the defect before administering 540.33 care; 540.34 (2) comparative responsibility between the facility, other 540.35 caregivers, and requirements placed upon an employee, including 540.36 the facility's compliance with related regulatory standards and 541.1 the adequacy of facility policies and procedures, facility 541.2 training, an individual's participation in the training, the 541.3 caregiver's supervision, and facility staffing levels and the 541.4 scope of the individual employee's authority and discretion; and 541.5 (3) whether the facility or individual followed 541.6 professional standards in exercising professional judgment. 541.7 Individual counties may implement more detailed definitions 541.8 or criteria that indicate which allegations to investigate, as 541.9 long as a county's policies are consistent with the definitions 541.10 in the statutes and rules and are approved by the county board. 541.11 Each local welfare agency shall periodically inform mandated 541.12 reporters under subdivision 3 who work in the county of the 541.13 definitions of maltreatment in the statutes and rules and any 541.14 additional definitions or criteria that have been approved by 541.15 the county board. 541.16[EFFECTIVE DATE.] This section is effective July 1, 2001. 541.17 Sec. 28. Minnesota Statutes 2000, section 626.556, 541.18 subdivision 10f, is amended to read: 541.19 Subd. 10f. [NOTICE OF DETERMINATIONS.] Within ten working 541.20 days of the conclusion of an assessment, the local welfare 541.21 agency or agency responsible for assessing or investigating the 541.22 report shall notify the parent or guardian of the child, the 541.23 person determined to be maltreating the child, and if 541.24 applicable, the director of the facility, of the determination 541.25 and a summary of the specific reasons for the determination. 541.26 The notice must also include a certification that the 541.27 information collection procedures under subdivision 10, 541.28 paragraphs (h), (i), and (j), were followed and a notice of the 541.29 right of a data subject to obtain access to other private data 541.30 on the subject collected, created, or maintained under this 541.31 section. In addition, the notice shall include the length of 541.32 time that the records will be kept under subdivision 11c. The 541.33 investigating agency shall notify the parent or guardian of the 541.34 child who is the subject of the report, and any person or 541.35 facility determined to have maltreated a child, of their 541.36 appeal or review rights under this section or section 256.022. 542.1[EFFECTIVE DATE.] This section is effective July 1, 2001. 542.2 Sec. 29. Minnesota Statutes 2000, section 626.556, 542.3 subdivision 10i, is amended to read: 542.4 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL 542.5 DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 542.6 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 542.7 provided under paragraph (e), an individual or facility that the 542.8 commissioner or a local social service agency determines has 542.9 maltreated a child, orthe child's designeean interested person 542.10 acting on behalf of the child, regardless of the determination, 542.11 who contests the investigating agency's final determination 542.12 regarding maltreatment, may request the investigating agency to 542.13 reconsider its final determination regarding maltreatment. The 542.14 request for reconsideration must be submitted in writing to the 542.15 investigating agency within 15 calendar days after receipt of 542.16 notice of the final determination regarding maltreatment or, if 542.17 the request is made by an interested person who is not entitled 542.18 to notice, within 15 days after receipt of the notice by the 542.19 parent or guardian of the child. Effective January 1, 2002, an 542.20 individual who was determined to have maltreated a child under 542.21 this section and who was disqualified on the basis of serious or 542.22 recurring maltreatment under section 245A.04, subdivision 3d, 542.23 may request reconsideration of the maltreatment determination 542.24 and the disqualification. The request for reconsideration of 542.25 the maltreatment determination and the disqualification must be 542.26 submitted within 30 calendar days of the individual's receipt of 542.27 the notice of disqualification under section 245A.04, 542.28 subdivision 3a. 542.29 (b) Except as provided under paragraphs (e) and (f), if the 542.30 investigating agency denies the request or fails to act upon the 542.31 request within 15 calendar days after receiving the request for 542.32 reconsideration, the person or facility entitled to a fair 542.33 hearing under section 256.045 may submit to the commissioner of 542.34 human services a written request for a hearing under that 542.35 section. For reports involving maltreatment of a child in a 542.36 facility, an interested person acting on behalf of the child may 543.1 request a review by the child maltreatment review panel under 543.2 section 256.022 if the investigating agency denies the request 543.3 or fails to act upon the request or if the interested person 543.4 contests a reconsidered determination. The investigating agency 543.5 shall notify persons who request reconsideration of their rights 543.6 under this paragraph. The request must be submitted in writing 543.7 to the review panel and a copy sent to the investigating agency 543.8 within 30 calendar days of receipt of notice of a denial of a 543.9 request for reconsideration or of a reconsidered determination. 543.10 The request must specifically identify the aspects of the agency 543.11 determination with which the person is dissatisfied. 543.12 (c) If, as a result ofthea reconsideration or review, the 543.13 investigating agency changes the final determination of 543.14 maltreatment, that agency shall notify the parties specified in 543.15 subdivisions 10b, 10d, and 10f. 543.16 (d) Except as provided under paragraph (f), if an 543.17 individual or facility contests the investigating agency's final 543.18 determination regarding maltreatment by requesting a fair 543.19 hearing under section 256.045, the commissioner of human 543.20 services shall assure that the hearing is conducted and a 543.21 decision is reached within 90 days of receipt of the request for 543.22 a hearing. The time for action on the decision may be extended 543.23 for as many days as the hearing is postponed or the record is 543.24 held open for the benefit of either party. 543.25 (e) Effective January 1, 2002, if an individual was 543.26 disqualified under section 245A.04, subdivision 3d, on the basis 543.27 of a determination of maltreatment, which was serious or 543.28 recurring, and the individual has requested reconsideration of 543.29 the maltreatment determination under paragraph (a) and requested 543.30 reconsideration of the disqualification under section 245A.04, 543.31 subdivision 3b, reconsideration of the maltreatment 543.32 determination and reconsideration of the disqualification shall 543.33 be consolidated into a single reconsideration. If an individual 543.34 disqualified on the basis of a determination of maltreatment, 543.35 which was serious or recurring requests a fair hearing under 543.36 paragraph (b), the scope of the fair hearing shall include the 544.1 maltreatment determination and the disqualification. 544.2 (f) Effective January 1, 2002, if a maltreatment 544.3 determination or a disqualification based on serious or 544.4 recurring maltreatment is the basis for a denial of a license 544.5 under section 245A.05 or a licensing sanction under section 544.6 245A.07, the license holder has the right to a contested case 544.7 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 544.8 1400.8612 and successor rules. As provided for under section 544.9 245A.08, subdivision 2a, the scope of the contested case hearing 544.10 shall include the maltreatment determination, disqualification, 544.11 and licensing sanction or denial of a license. In such cases, a 544.12 fair hearing regarding the maltreatment determination shall not 544.13 be conducted under paragraph (b). If the disqualified subject 544.14 is an individual other than the license holder and upon whom a 544.15 background study must be conducted under section 245A.04, 544.16 subdivision 3, the hearings of all parties may be consolidated 544.17 into a single contested case hearing upon consent of all parties 544.18 and the administrative law judge. 544.19 (g) For purposes of this subdivision, "interested person 544.20 acting on behalf of the child" means a parent or legal guardian; 544.21 stepparent; grandparent; guardian ad litem; adult stepbrother, 544.22 stepsister, or sibling; or adult aunt or uncle; unless the 544.23 person has been determined to be the perpetrator of the 544.24 maltreatment. 544.25 Sec. 30. Minnesota Statutes 2000, section 626.556, 544.26 subdivision 11, is amended to read: 544.27 Subd. 11. [RECORDS.] (a) Except as provided in paragraph 544.28 (b) or (c) and subdivisions 10b, 10d, 10g, and 11b, all records 544.29 concerning individuals maintained by a local welfare agency or 544.30 agency responsible for assessing or investigating the report 544.31 under this section, including any written reports filed under 544.32 subdivision 7, shall be private data on individuals, except 544.33 insofar as copies of reports are required by subdivision 7 to be 544.34 sent to the local police department or the county sheriff. 544.35 Reports maintained by any police department or the county 544.36 sheriff shall be private data on individuals except the reports 545.1 shall be made available to the investigating, petitioning, or 545.2 prosecuting authority, including county medical examiners or 545.3 county coroners. Section 13.82, subdivisions 7, 5a, and 5b, 545.4 apply to law enforcement data other than the reports. The local 545.5 social services agency or agency responsible for assessing or 545.6 investigating the report shall make available to the 545.7 investigating, petitioning, or prosecuting authority, including 545.8 county medical examiners or county coroners or their 545.9 professional delegates, any records which contain information 545.10 relating to a specific incident of neglect or abuse which is 545.11 under investigation, petition, or prosecution and information 545.12 relating to any prior incidents of neglect or abuse involving 545.13 any of the same persons. The records shall be collected and 545.14 maintained in accordance with the provisions of chapter 13. In 545.15 conducting investigations and assessments pursuant to this 545.16 section, the notice required by section 13.04, subdivision 2, 545.17 need not be provided to a minor under the age of ten who is the 545.18 alleged victim of abuse or neglect. An individual subject of a 545.19 record shall have access to the record in accordance with those 545.20 sections, except that the name of the reporter shall be 545.21 confidential while the report is under assessment or 545.22 investigation except as otherwise permitted by this 545.23 subdivision. Any person conducting an investigation or 545.24 assessment under this section who intentionally discloses the 545.25 identity of a reporter prior to the completion of the 545.26 investigation or assessment is guilty of a misdemeanor. After 545.27 the assessment or investigation is completed, the name of the 545.28 reporter shall be confidential. The subject of the report may 545.29 compel disclosure of the name of the reporter only with the 545.30 consent of the reporter or upon a written finding by the court 545.31 that the report was false and that there is evidence that the 545.32 report was made in bad faith. This subdivision does not alter 545.33 disclosure responsibilities or obligations under the rules of 545.34 criminal procedure. 545.35 (b) Upon request of the legislative auditor, data on 545.36 individuals maintained under this section must be released to 546.1 the legislative auditor in order for the auditor to fulfill the 546.2 auditor's duties under section 3.971. The auditor shall 546.3 maintain the data in accordance with chapter 13. 546.4 (c) The investigating agency shall exchange not public data 546.5 with the child maltreatment review panel under section 256.022 546.6 if the data are pertinent and necessary for a review requested 546.7 under section 256.022. Upon completion of the review, the not 546.8 public data received by the review panel must be returned to the 546.9 investigating agency. 546.10[EFFECTIVE DATE.] This section is effective July 1, 2001. 546.11 Sec. 31. Minnesota Statutes 2000, section 626.556, 546.12 subdivision 12, is amended to read: 546.13 Subd. 12. [DUTIES OF FACILITY OPERATORS.] Any operator, 546.14 employee, or volunteer worker at any facility who intentionally 546.15 neglects, physically abuses, or sexually abuses any child in the 546.16 care of that facility may be charged with a violation of section 546.17 609.255, 609.377, or 609.378. Any operator of a facility who 546.18 knowingly permits conditions to exist which result in neglect, 546.19 physical abuse,orsexual abuse, or maltreatment of a child in a 546.20 facility while in the care of that facility may be charged with 546.21 a violation of section 609.378. The facility operator shall 546.22 inform all mandated reporters employed by or otherwise 546.23 associated with the facility of the duties required of mandated 546.24 reporters and shall inform all mandatory reporters of the 546.25 prohibition against retaliation for reports made in good faith 546.26 under this section. 546.27[EFFECTIVE DATE.] This section is effective July 1, 2001. 546.28 Sec. 32. Minnesota Statutes 2000, section 626.557, 546.29 subdivision 3, is amended to read: 546.30 Subd. 3. [TIMING OF REPORT.] (a) A mandated reporter who 546.31 has reason to believe that a vulnerable adult is being or has 546.32 been maltreated, or who has knowledge that a vulnerable adult 546.33 has sustained a physical injury which is not reasonably 546.34 explained shall immediately report the information to the common 546.35 entry point. If an individual is a vulnerable adult solely 546.36 because the individual is admitted to a facility, a mandated 547.1 reporter is not required to report suspected maltreatment of the 547.2 individual that occurred prior to admission, unless: 547.3 (1) the individual was admitted to the facility from 547.4 another facility and the reporter has reason to believe the 547.5 vulnerable adult was maltreated in the previous facility; or 547.6 (2) the reporter knows or has reason to believe that the 547.7 individual is a vulnerable adult as defined in section 626.5572, 547.8 subdivision 21, clause (4). 547.9 (b) A person not required to report under the provisions of 547.10 this section may voluntarily report as described above. 547.11 (c) Nothing in this section requires a report of known or 547.12 suspected maltreatment, if the reporter knows or has reason to 547.13 know that a report has been made to the common entry point. 547.14 (d) Nothing in this section shall preclude a reporter from 547.15 also reporting to a law enforcement agency. 547.16 (e) A mandated reporter who knows or has reason to believe 547.17 that an error under section 626.5572, subdivision 17, paragraph 547.18 (c), clause (5), occurred must make a report under this 547.19 subdivision. If the reporter or a facility, at any time 547.20 believes that an investigation by a lead agency will determine 547.21 or should determine that the reported error was not neglect 547.22 according to the criteria under section 626.5572, subdivision 547.23 17, paragraph (c), clause (5), the reporter or facility may 547.24 provide to the common entry point or directly to the lead agency 547.25 information explaining how the event meets the criteria under 547.26 section 626.5572, subdivision 17, paragraph (c), clause (5). 547.27 The lead agency shall consider this information when making an 547.28 initial disposition of the report under subdivision 9c. 547.29[EFFECTIVE DATE.] This section is effective August 1, 2001. 547.30 Sec. 33. Minnesota Statutes 2000, section 626.557, 547.31 subdivision 9d, is amended to read: 547.32 Subd. 9d. [ADMINISTRATIVE RECONSIDERATION OF FINAL 547.33 DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 547.34 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 547.35 provided under paragraph (e), any individual or facility which a 547.36 lead agency determines has maltreated a vulnerable adult, or the 548.1 vulnerable adult or an interested person acting on behalf of the 548.2 vulnerable adult, regardless of the lead agency's determination, 548.3 who contests the lead agency's final disposition of an 548.4 allegation of maltreatment, may request the lead agency to 548.5 reconsider its final disposition. The request for 548.6 reconsideration must be submitted in writing to the lead agency 548.7 within 15 calendar days after receipt of notice of final 548.8 disposition or, if the request is made by an interested person 548.9 who is not entitled to notice, within 15 days after receipt of 548.10 the notice by the vulnerable adult or the vulnerable adult's 548.11 legal guardian. An individual who was determined to have 548.12 maltreated a vulnerable adult under this section and who was 548.13 disqualified on the basis of serious or recurring maltreatment 548.14 under section 245A.04, subdivision 3d, may request 548.15 reconsideration of the maltreatment determination and the 548.16 disqualification. The request for reconsideration of the 548.17 maltreatment determination and the disqualification must be 548.18 submitted within 30 calendar days of the individual's receipt of 548.19 the notice of disqualification under section 245A.04, 548.20 subdivision 3a. 548.21 (b) Except as provided under paragraphs (e) and (f), if the 548.22 lead agency denies the request or fails to act upon the request 548.23 within 15 calendar days after receiving the request for 548.24 reconsideration, the person or facility entitled to a fair 548.25 hearing under section 256.045, may submit to the commissioner of 548.26 human services a written request for a hearing under that 548.27 statute. The vulnerable adult, or an interested person acting 548.28 on behalf of the vulnerable adult, may request a review by the 548.29 vulnerable adult maltreatment review panel under section 256.021 548.30 if the lead agency denies the request or fails to act upon the 548.31 request, or if the vulnerable adult or interested person 548.32 contests a reconsidered disposition. The lead agency shall 548.33 notify persons who request reconsideration of their rights under 548.34 this paragraph. The request must be submitted in writing to the 548.35 review panel and a copy sent to the lead agency within 30 548.36 calendar days of receipt of notice of a denial of a request for 549.1 reconsideration or of a reconsidered disposition. The request 549.2 must specifically identify the aspects of the agency 549.3 determination with which the person is dissatisfied. 549.4 (c) If, as a result of a reconsideration or review, the 549.5 lead agency changes the final disposition, it shall notify the 549.6 parties specified in subdivision 9c, paragraph (d). 549.7 (d) For purposes of this subdivision, "interested person 549.8 acting on behalf of the vulnerable adult" means a person 549.9 designated in writing by the vulnerable adult to act on behalf 549.10 of the vulnerable adult, or a legal guardian or conservator or 549.11 other legal representative, a proxy or health care agent 549.12 appointed under chapter 145B or 145C, or an individual who is 549.13 related to the vulnerable adult, as defined in section 245A.02, 549.14 subdivision 13. 549.15 (e) If an individual was disqualified under section 549.16 245A.04, subdivision 3d, on the basis of a determination of 549.17 maltreatment, which was serious or recurring, and the individual 549.18 has requested reconsideration of the maltreatment determination 549.19 under paragraph (a) and reconsideration of the disqualification 549.20 under section 245A.04, subdivision 3b, reconsideration of the 549.21 maltreatment determination and requested reconsideration of the 549.22 disqualification shall be consolidated into a single 549.23 reconsideration. If an individual who was disqualified on the 549.24 basis of serious or recurring maltreatment requests a fair 549.25 hearing under paragraph (b), the scope of the fair hearing shall 549.26 include the maltreatment determination and the disqualification. 549.27 (f) If a maltreatment determination or a disqualification 549.28 based on serious or recurring maltreatment is the basis for a 549.29 denial of a license under section 245A.05 or a licensing 549.30 sanction under section 245A.07, the license holder has the right 549.31 to a contested case hearing under chapter 14 and Minnesota 549.32 Rules, parts 1400.8510 to 1400.8612 and successor rules. As 549.33 provided for under section 245A.08, the scope of the contested 549.34 case hearing shall include the maltreatment determination, 549.35 disqualification, and licensing sanction or denial of a 549.36 license. In such cases, a fair hearing shall not be conducted 550.1 under paragraph (b). If the disqualified subject is an 550.2 individual other than the license holder and upon whom a 550.3 background study must be conducted under section 245A.04, 550.4 subdivision 3, the hearings of all parties may be consolidated 550.5 into a single contested case hearing upon consent of all parties 550.6 and the administrative law judge. 550.7 (g) Until August 1, 2002, an individual or facility that 550.8 was determined by the commissioner of human services or the 550.9 commissioner of health to be responsible for neglect under 550.10 section 626.5572, subdivision 17, after October 1, 1995, and 550.11 before August 1, 2001, that believes that the finding of neglect 550.12 does not meet an amended definition of neglect may request a 550.13 reconsideration of the determination of neglect. The 550.14 commissioner of human services or the commissioner of health 550.15 shall mail a notice to the last known address of individuals who 550.16 are eligible to seek this reconsideration. The request for 550.17 reconsideration must state how the established findings no 550.18 longer meet the elements of the definition of neglect. The 550.19 commissioner shall review the request for reconsideration and 550.20 make a determination within 15 calendar days. The 550.21 commissioner's decision on this reconsideration is the final 550.22 agency action. 550.23 (1) For purposes of compliance with the data destruction 550.24 schedule under subdivision 12b, paragraph (d), when a finding of 550.25 substantiated maltreatment has been changed as a result of a 550.26 reconsideration under this paragraph, the date of the original 550.27 finding of a substantiated maltreatment must be used to 550.28 calculate the destruction date. 550.29 (2) For purposes of any background studies under section 550.30 245A.04, when a determination of substantiated maltreatment has 550.31 been changed as a result of a reconsideration under this 550.32 paragraph, any prior disqualification of the individual under 550.33 section 245A.04 that was based on this determination of 550.34 maltreatment shall be rescinded, and for future background 550.35 studies under section 245A.04 the commissioner must not use the 550.36 previous determination of substantiated maltreatment as a basis 551.1 for disqualification or as a basis for referring the 551.2 individual's maltreatment history to a health-related licensing 551.3 board under section 245A.04, subdivision 3d, paragraph (b). 551.4[EFFECTIVE DATE.] Paragraph (g) of this section is 551.5 effective the day following final enactment. Paragraphs (a), 551.6 (b), (e), and (f) are effective January 1, 2002. 551.7 Sec. 34. Minnesota Statutes 2000, section 626.5572, 551.8 subdivision 17, is amended to read: 551.9 Subd. 17. [NEGLECT.] "Neglect" means: 551.10 (a) The failure or omission by a caregiver to supply a 551.11 vulnerable adult with care or services, including but not 551.12 limited to, food, clothing, shelter, health care, or supervision 551.13 which is: 551.14 (1) reasonable and necessary to obtain or maintain the 551.15 vulnerable adult's physical or mental health or safety, 551.16 considering the physical and mental capacity or dysfunction of 551.17 the vulnerable adult; and 551.18 (2) which is not the result of an accident or therapeutic 551.19 conduct. 551.20 (b) The absence or likelihood of absence of care or 551.21 services, including but not limited to, food, clothing, shelter, 551.22 health care, or supervision necessary to maintain the physical 551.23 and mental health of the vulnerable adult which a reasonable 551.24 person would deem essential to obtain or maintain the vulnerable 551.25 adult's health, safety, or comfort considering the physical or 551.26 mental capacity or dysfunction of the vulnerable adult. 551.27 (c) For purposes of this section, a vulnerable adult is not 551.28 neglected for the sole reason that: 551.29 (1) the vulnerable adult or a person with authority to make 551.30 health care decisions for the vulnerable adult under sections 551.31 144.651, 144A.44, chapter 145B, 145C, or 252A, or section 551.32 253B.03, or 525.539 to 525.6199, refuses consent or withdraws 551.33 consent, consistent with that authority and within the boundary 551.34 of reasonable medical practice, to any therapeutic conduct, 551.35 including any care, service, or procedure to diagnose, maintain, 551.36 or treat the physical or mental condition of the vulnerable 552.1 adult, or, where permitted under law, to provide nutrition and 552.2 hydration parenterally or through intubation; this paragraph 552.3 does not enlarge or diminish rights otherwise held under law by: 552.4 (i) a vulnerable adult or a person acting on behalf of a 552.5 vulnerable adult, including an involved family member, to 552.6 consent to or refuse consent for therapeutic conduct; or 552.7 (ii) a caregiver to offer or provide or refuse to offer or 552.8 provide therapeutic conduct; or 552.9 (2) the vulnerable adult, a person with authority to make 552.10 health care decisions for the vulnerable adult, or a caregiver 552.11 in good faith selects and depends upon spiritual means or prayer 552.12 for treatment or care of disease or remedial care of the 552.13 vulnerable adult in lieu of medical care, provided that this is 552.14 consistent with the prior practice or belief of the vulnerable 552.15 adult or with the expressed intentions of the vulnerable adult; 552.16 (3) the vulnerable adult, who is not impaired in judgment 552.17 or capacity by mental or emotional dysfunction or undue 552.18 influence, engages in sexual contact with: 552.19 (i) a person including a facility staff person when a 552.20 consensual sexual personal relationship existed prior to the 552.21 caregiving relationship; or 552.22 (ii) a personal care attendant, regardless of whether the 552.23 consensual sexual personal relationship existed prior to the 552.24 caregiving relationship; or 552.25 (4) an individual makes an error in the provision of 552.26 therapeutic conduct to a vulnerable adult which: (i)does not 552.27 result in injury or harm which reasonably requires medical or 552.28 mental health care; or, if it reasonably requires care,552.29 (5) an individual makes an error in the provision of 552.30 therapeutic conduct to a vulnerable adult that results in injury 552.31 or harm which reasonably requires the care of a physician; and: 552.32 (i) the necessary care issought andprovided in a timely 552.33 fashion as dictated by the condition of the vulnerable adult; 552.34and(ii) the injury or harm that required care does not result 552.35 insubstantial acute, orchronic injury or illness, or permanent 552.36 disability above and beyond the vulnerable adult's preexisting 553.1 condition; 553.2(ii) is(iii) the error is not part of a pattern of errors 553.3 by the individual; 553.4 (iv) if in a facility, the error is immediately reported as 553.5 required under section 626.557, and recorded internallyby the553.6employee or person providing servicesin the facilityin order553.7to evaluate and identify corrective action; 553.8 (v) if in a facility, the facility identifies and takes 553.9 corrective action and implements measures designed to reduce the 553.10 risk of further occurrence of this error and similar errors; and 553.11(iii) is(vi) if in a facility, the actions required under 553.12 items (iv) and (v) are sufficiently documented for review and 553.13 evaluation by the facility and any applicable licensing, 553.14 certification, and ombudsman agency; and. 553.15(iv) is not part of a pattern of errors by the individual.553.16 (d) Nothing in this definition requires a caregiver, if 553.17 regulated, to provide services in excess of those required by 553.18 the caregiver's license, certification, registration, or other 553.19 regulation. 553.20 (e) If the findings of an investigation by a lead agency 553.21 result in a determination of substantiated maltreatment for the 553.22 sole reason that the actions required of a facility under 553.23 paragraph (c), clause (5), item (iv), (v), or (vi), were not 553.24 taken, then the facility is subject to a correction order. This 553.25 must not alter the lead agency's determination of mitigating 553.26 factors under section 626.557, subdivision 9c, paragraph (c). 553.27[EFFECTIVE DATE.] This section is effective the day 553.28 following final enactment. 553.29 Sec. 35. Minnesota Statutes 2000, section 626.559, 553.30 subdivision 2, is amended to read: 553.31 Subd. 2. [JOINT TRAINING.] The commissioners of human 553.32 services and public safety shall cooperate in the development of 553.33 a joint program for training child abuse services professionals 553.34 in the appropriate techniques for child abuse assessment and 553.35 investigation. The program shall include but need not be 553.36 limited to the following areas: 554.1 (1) the public policy goals of the state as set forth in 554.2 section 260C.001 and the role of the assessment or investigation 554.3 in meeting these goals; 554.4 (2) the special duties of child protection workers and law 554.5 enforcement officers under section 626.556; 554.6 (3) the appropriate methods for directing and managing 554.7 affiliated professionals who may be utilized in providing 554.8 protective services and strengthening family ties; 554.9 (4) the appropriate methods for interviewing alleged 554.10 victims of child abuse and other minors in the course of 554.11 performing an assessment or an investigation; 554.12 (5) the dynamics of child abuse and neglect within family 554.13 systems and the appropriate methods for interviewing parents in 554.14 the course of the assessment or investigation, including 554.15 training in recognizing cases in which one of the parents is a 554.16 victim of domestic abuse and in need of special legal or medical 554.17 services; 554.18 (6) the legal, evidentiary considerations that may be 554.19 relevant to the conduct of an assessment or an investigation; 554.20 (7) the circumstances under which it is appropriate to 554.21 remove the alleged abuser or the alleged victim from the home; 554.22 (8) the protective social services that are available to 554.23 protect alleged victims from further abuse, to prevent child 554.24 abuse and domestic abuse, and to preserve the family unit, and 554.25 training in the preparation of case plans to coordinate services 554.26 for the alleged child abuse victim with services for any parents 554.27 who are victims of domestic abuse;and554.28 (9) the methods by which child protection workers and law 554.29 enforcement workers cooperate in conducting assessments and 554.30 investigations in order to avoid duplication of efforts; and 554.31 (10) appropriate methods for interviewing alleged victims 554.32 of child abuse and conducting investigations in cases where the 554.33 alleged victim is developmentally, physically, or mentally 554.34 disabled. 554.35[EFFECTIVE DATE.] This section is effective July 1, 2001. 554.36 Sec. 36. [FEDERAL LAW CHANGE REQUEST OR WAIVER.] 555.1 The commissioner of health or human services, whichever is 555.2 appropriate, shall pursue changes to federal law necessary to 555.3 allow greater discretion on disciplinary activities of 555.4 unlicensed health care workers and apply for necessary federal 555.5 waivers or approval that would allow for a set-aside process 555.6 related to disqualifications for nurse aides in nursing homes by 555.7 July 1, 2002. 555.8[EFFECTIVE DATE.] This section is effective July 1, 2001. 555.9 Sec. 37. [WAIVER FROM FEDERAL RULES AND REGULATIONS.] 555.10 By January 2002, the commissioner of health shall work with 555.11 providers to examine federal rules and regulations prohibiting 555.12 neglect, abuse, and financial exploitation of residents in 555.13 licensed nursing facilities and shall apply for federal waivers 555.14 to: 555.15 (1) allow the use of Minnesota Statutes, section 626.5572, 555.16 to control the identification and prevention of maltreatment of 555.17 residents in licensed nursing facilities, rather than the 555.18 definitions under federal rules and regulations; and 555.19 (2) allow the use of Minnesota Statutes, sections 214.104, 555.20 245A.04, and 626.557 to control the disqualification or 555.21 discipline of any persons providing services to residents in 555.22 licensed nursing facilities, rather than the nurse aide registry 555.23 or other exclusionary provisions of federal rules and 555.24 regulations. 555.25[EFFECTIVE DATE.] This section is effective July 1, 2001. 555.26 ARTICLE 12 555.27 MISCELLANEOUS 555.28 Section 1. Minnesota Statutes 2000, section 144.1222, is 555.29 amended by adding a subdivision to read: 555.30 Subd. 2a. [POOLS AT FAMILY DAY CARE OR GROUP FAMILY DAY 555.31 CARE HOMES.] Notwithstanding Minnesota Rules, part 4717.0250, 555.32 subpart 8, a pool that is located at a family day care or group 555.33 family day care home licensed under Minnesota Rules, chapter 555.34 9502, shall not be considered a public pool, and is exempt from 555.35 the requirements for public pools in Minnesota Rules, parts 555.36 4717.0150 to 4717.3975. If the provider chooses to allow 556.1 children cared for at the family day care or group family day 556.2 care home to use the pool located at the home, the provider must 556.3 satisfy the requirements in section 245A.14, subdivision 10. 556.4 Sec. 2. Minnesota Statutes 2000, section 148B.21, 556.5 subdivision 6a, is amended to read: 556.6 Subd. 6a. [BACKGROUND CHECKS.] The board shall request a 556.7 criminal history background check from the superintendent of the 556.8 bureau of criminal apprehension on all applicants for initial 556.9 licensure. An application for a license under this section must 556.10 be accompanied by an executed criminal history consent form and 556.11 the fee for conducting the criminal history background 556.12 check. The board shall deposit all fees paid by applicants for 556.13 criminal history background checks under this subdivision into 556.14 the miscellaneous special revenue fund and shall reimburse the 556.15 bureau of criminal apprehension for the cost of the background 556.16 checks upon their completion. 556.17 Sec. 3. Minnesota Statutes 2000, section 148B.22, 556.18 subdivision 3, is amended to read: 556.19 Subd. 3. [BACKGROUND CHECKS.] The board shall request a 556.20 criminal history background check from the superintendent of the 556.21 bureau of criminal apprehension on all licensees under its 556.22 jurisdiction who did not complete a criminal history background 556.23 check as part of an application for initial licensure. This 556.24 background check is a one-time requirement. An application for 556.25 a license under this section must be accompanied by an executed 556.26 criminal history consent form and the fee for conducting the 556.27 criminal history background check. The board shall deposit all 556.28 fees paid by licensees for criminal history background checks 556.29 under this subdivision into the miscellaneous special revenue 556.30 fund and shall reimburse the bureau of criminal apprehension for 556.31 the cost of the background checks upon their completion. 556.32 Sec. 4. Minnesota Statutes 2000, section 245A.14, is 556.33 amended by adding a subdivision to read: 556.34 Subd. 10. [SWIMMING POOLS; FAMILY DAY CARE AND GROUP 556.35 FAMILY DAY CARE PROVIDERS.] (a) This subdivision governs pools 556.36 located at family day care or group family day care homes 557.1 licensed under Minnesota Rules, chapter 9502. This subdivision 557.2 does not apply to portable wading pools or whirlpools located at 557.3 family day care or group family day care homes licensed under 557.4 Minnesota Rules, chapter 9502. For a provider to be eligible to 557.5 allow a child cared for at the family day care or group family 557.6 day care home to use the pool located at the home, the provider 557.7 must not have had a licensing sanction under section 245A.07 or 557.8 a correction order or fine under section 245A.06 relating to the 557.9 supervision or health and safety of children substantiated by 557.10 the county agency during the prior 24 months, and must satisfy 557.11 the following requirements: 557.12 (1) obtain written consent from a child's parent or legal 557.13 guardian allowing the child to use the pool, and renew the 557.14 parent's or legal guardian's written consent at least annually. 557.15 The written consent must include a statement that the parent or 557.16 legal guardian has received and read materials provided by the 557.17 department of health to the department of human services for 557.18 distribution to all family day care or group family day care 557.19 homes related to the risk of disease transmission as well as 557.20 other health risks associated with swimming pools. The written 557.21 consent must also include a statement that the department of 557.22 health and county agency will not monitor or inspect the 557.23 provider's swimming pool to ensure compliance with the 557.24 requirements in this subdivision; 557.25 (2) enter into a written contract with a child's parent or 557.26 legal guardian, and renew the written contract annually. The 557.27 terms of the written contract must specify that the provider 557.28 agrees to perform all of the requirements in this subdivision; 557.29 (3) attend and successfully complete a pool operator 557.30 training course once every five years. Acceptable training 557.31 courses are: 557.32 (i) the National Swimming Pool Foundation Certified Pool 557.33 Operator course; 557.34 (ii) the National Spa and Pool Institute Tech I and Tech II 557.35 courses (both required); or 557.36 (iii) the National Recreation and Park Association Aquatic 558.1 Facility Operator course; 558.2 (4) require a caregiver trained in first aid and adult and 558.3 child cardiopulmonary resuscitation to supervise and be present 558.4 at the pool with any children in the pool; 558.5 (5) toilet all potty-trained children before they enter the 558.6 pool; 558.7 (6) require all children who are not potty-trained to wear 558.8 swim diapers while in the pool; 558.9 (7) if fecal material enters the pool water, add three 558.10 times the normal shock treatment to the pool water to raise the 558.11 chlorine level to at least 20 parts per million, and close the 558.12 pool to swimming for the 24 hours following the entrance of 558.13 fecal material into the water or until the water pH and 558.14 disinfectant concentration levels have returned to the standards 558.15 specified in clause (9), whichever is later; 558.16 (8) prevent any child from entering the pool who has an 558.17 open wound or any child who has or is suspected of having a 558.18 communicable disease; 558.19 (9) maintain the pool water at a pH of not less than 7.2 558.20 and not more than 8.0, maintain the disinfectant concentration 558.21 between two and five parts per million for chlorine or between 558.22 2.3 and 4.5 parts per million for bromine, and maintain a daily 558.23 record of the pool's operation with pH and disinfectant 558.24 concentration readings on days when children cared for at the 558.25 family day care or group family day care home are present; 558.26 (10) have a disinfectant feeder or feeders; 558.27 (11) have a recirculation system that will clarify and 558.28 disinfect the pool volume of water in ten hours or less; 558.29 (12) maintain the pool's water clarity so that an object on 558.30 the pool floor at the pool's deepest point is easily visible; 558.31 (13) have two or more suction lines in the pool; 558.32 (14) have in place and enforce written safety rules and 558.33 pool policies; 558.34 (15) prohibit diving; 558.35 (16) prohibit pushing or rough play in the pool area; 558.36 (17) have in place at all times a safety rope that divides 559.1 the shallow and deep portions of the pool; 559.2 (18) satisfy any existing local ordinances regarding pool 559.3 installation, decks, and fencing; 559.4 (19) maintain a water temperature of not more than 104 559.5 degrees Fahrenheit and not less than 70 degrees Fahrenheit; and 559.6 (20) for lifesaving equipment, have a United States Coast 559.7 Guard-approved life ring attached to a rope, an exit ladder, and 559.8 a shepherd's hook available at all times to the caregiver 559.9 supervising the pool. 559.10 (b) A violation of this subdivision is grounds for a 559.11 sanction under section 245A.07, or a correction order or fine 559.12 under section 245A.06. If a provider under this subdivision 559.13 receives a licensing sanction or a correction order or fine 559.14 relating to the supervision or health and safety of children, 559.15 the provider is prohibited from allowing a child cared for at 559.16 the family day care or group family day care home to continue to 559.17 use the pool located at the home. 559.18 Sec. 5. Minnesota Statutes 2000, section 246.57, is 559.19 amended by adding a subdivision to read: 559.20 Subd. 7. [SHARED SERVICES ACCOUNT.] Notwithstanding 559.21 subdivision 1, beginning July 1, 2001, $6,000,000 each biennium 559.22 is transferred from the shared services account into which 559.23 receipts for shared services under subdivision 1 are deposited 559.24 to the general fund. This subdivision expires June 30, 2005. 559.25 Sec. 6. Minnesota Statutes 2000, section 252A.02, is 559.26 amended by adding a subdivision to read: 559.27 Subd. 3a. [GUARDIANSHIP SERVICE PROVIDERS.] "Guardianship 559.28 service providers" are individuals or agencies that meet the 559.29 ethical conduct and best practice standards of the National 559.30 Guardianship Association, meet the criminal background check 559.31 requirements of section 245A.04, and do not provide any other 559.32 services to the individuals for whom guardianship services are 559.33 provided. 559.34 Sec. 7. Minnesota Statutes 2000, section 252A.02, 559.35 subdivision 12, is amended to read: 559.36 Subd. 12. [COMPREHENSIVE EVALUATION.] "Comprehensive 560.1 evaluation" shall consist of: 560.2 (1) a medical report on the health status and physical 560.3 condition of the proposed ward, prepared under the direction of 560.4 a licensed physician; 560.5 (2) a report on the proposed ward's intellectual capacity 560.6 and functional abilities, specifying the tests and other data 560.7 used in reaching its conclusions, prepared by a psychologist who 560.8 is qualified in the diagnosis of mental retardation; and 560.9 (3) a report from the case manager that includes: 560.10 (i) the most current assessment of individual service needs 560.11 as described in rules of the commissioner; 560.12 (ii) the most current individual service planas described560.13in rules of the commissionerunder section 256B.092, subdivision 560.14 1b; and 560.15 (iii) a description of contacts with and responses of near 560.16 relatives of the proposed ward notifying them that a nomination 560.17 for public guardianship has been made and advising them that 560.18 they may seek private guardianship. 560.19 Each report shall contain recommendations as to the amount 560.20 of assistance and supervision required by the proposed ward to 560.21 function as independently as possible in society. To be 560.22 considered part of the comprehensive evaluation, reports must be 560.23 completed no more than one year before filing the petition under 560.24 section 252A.05. 560.25 Sec. 8. Minnesota Statutes 2000, section 252A.02, 560.26 subdivision 13, is amended to read: 560.27 Subd. 13. [CASE MANAGER.] "Case manager" means the person 560.28 designatedby the county board under rules of the commissioner560.29to provide case management servicesunder section 256B.092. 560.30 Sec. 9. Minnesota Statutes 2000, section 252A.111, 560.31 subdivision 6, is amended to read: 560.32 Subd. 6. [SPECIAL DUTIES.] In exercising powers and duties 560.33 under this chapter, the commissioner shall: 560.34 (1) maintain close contact with the ward, visiting at least 560.35 twice a year; 560.36 (2)prohibit filming a ward in any way that would reveal561.1the identity of the ward unless the commissioner determines the561.2filming to be in the best interests of the ward. The561.3commissioner may give written consent for filming of the ward561.4after permitting and encouraging input by the nearest relative561.5 protect and exercise the legal rights of the ward; 561.6 (3) take actions and make decisions on behalf of the ward 561.7 that encourage and allow the maximum level of independent 561.8 functioning in a manner least restrictive of the ward's personal 561.9 freedom consistent with the need for supervision and protection; 561.10 and 561.11 (4) permit and encourage maximum self-reliance on the part 561.12 of the ward and permit and encourage input by the nearest 561.13 relative of the ward in planning and decision making on behalf 561.14 of the ward. 561.15 Sec. 10. Minnesota Statutes 2000, section 252A.16, 561.16 subdivision 1, is amended to read: 561.17 Subdivision 1. [REVIEW REQUIRED.] The commissioner 561.18 shallproviderequire an annual review of the physical, mental, 561.19 and social adjustment and progress of every ward and 561.20 conservatee. A copy of this review shall be kept on file at the 561.21 department of human services and may be inspected by the ward or 561.22 conservatee, the ward's or conservatee's parents, spouse, or 561.23 relatives and other persons who receive the permission of the 561.24 commissioner. The review shall contain information required 561.25 underrules of the commissionerMinnesota Rules, part 9525.3065, 561.26 subpart 1. 561.27 Sec. 11. Minnesota Statutes 2000, section 252A.19, 561.28 subdivision 2, is amended to read: 561.29 Subd. 2. [PETITION.] The commissioner, ward, or any 561.30 interested person may petition the appointing court or the court 561.31 to which venue has been transferred for an order to remove the 561.32 guardianship or to limit or expand the powers of the 561.33 conservatorship or to appoint a guardian or conservator under 561.34 sections 525.539 to 525.705 or to restore the ward or 561.35 conservatee to full legal capacity or to review de novo any 561.36 decision made by the public guardian or public conservator for 562.1 or on behalf of a ward or conservatee or for any other order as 562.2 the court may deem just and equitable. Section 525.61, 562.3 subdivision 3, does not apply to a petition to remove a public 562.4 guardian. 562.5 Sec. 12. Minnesota Statutes 2000, section 252A.20, 562.6 subdivision 1, is amended to read: 562.7 Subdivision 1. [WITNESS AND ATTORNEY FEES.] In each 562.8 proceeding under sections 252A.01 to 252A.21, the court shall 562.9 allow and order paid to each witness subpoenaed the fees and 562.10 mileage prescribed by law; to each physician, psychologist, or 562.11 social worker who assists in the preparation of the 562.12 comprehensive evaluation and who is not in the employ of the 562.13 local agency,or the state department of human services,or area562.14mental health-mental retardation board,a reasonable sum for 562.15 services and for travel; and to the ward's counsel, when 562.16 appointed by the court, a reasonable sum for travel and for each 562.17 day or portion of a day actually employed in court or actually 562.18 consumed in preparing for the hearing. Upon order the county 562.19 auditor shall issue a warrant on the county treasurer for 562.20 payment of the amount allowed. 562.21 Sec. 13. Minnesota Statutes 2000, section 256.482, 562.22 subdivision 8, is amended to read: 562.23 Subd. 8. [SUNSET.] Notwithstanding section 15.059, 562.24 subdivision 5, the council on disability shall not sunset until 562.25 June 30,20012005. 562.26 Sec. 14. [260.0121] [PRIOR INVOLUNTARY TERMINATION OF 562.27 PARENTAL RIGHTS.] 562.28 In addition to the circumstances listed in section 260.012, 562.29 paragraph (a), clause (1) under which reasonable efforts for 562.30 rehabilitation and reunification are not required, reasonable 562.31 efforts for rehabilitation and reunification are also not 562.32 required upon a determination by the court that a termination of 562.33 parental rights petition has been filed stating a prima facie 562.34 case that the parent's custodial rights to another child have 562.35 been involuntarily transferred to a relative under section 562.36 260C.201, subdivision 11, paragraph (e), clause (1), or a 563.1 similar law of another jurisdiction. 563.2 Sec. 15. Minnesota Statutes 2000, section 260C.307, 563.3 subdivision 3, is amended to read: 563.4 Subd. 3. [NOTICE.] The court shall have notice of the 563.5 time, place, and purpose of the hearing served on the parents, 563.6 as defined in sections 257.51 to 257.74 or 259.49, subdivision 563.7 1, clause (2), and upon the child's grandparentif the child has563.8lived with the grandparent within the two years immediately563.9preceding the filing of the petition. Notice must be served in 563.10 the manner provided in sections 260C.151 and 260C.152, except 563.11 that personal service shall be made at least ten days before the 563.12 day of the hearing. Published notice shall be made for three 563.13 weeks, the last publication to be at least ten days before the 563.14 day of the hearing; and notice sent by certified mail shall be 563.15 mailed at least 20 days before the day of the hearing. A parent 563.16 who consents to the termination of parental rights under the 563.17 provisions of section 260C.301, subdivision 2, clause (a), may 563.18 waive in writing the notice required by this subdivision; 563.19 however, if the parent is a minor or incompetent the waiver 563.20 shall be effective only if the parent's guardian ad litem 563.21 concurs in writing. 563.22 Sec. 16. Minnesota Statutes 2000, section 260C.301, is 563.23 amended by adding a subdivision to read: 563.24 Subd. 3a. ADDITIONAL GROUND FOR REQUIRED TERMINATION OF 563.25 PARENTAL RIGHTS.] In addition to the grounds listed in 563.26 subdivision 3, paragraph (a), the county attorney shall file a 563.27 termination of parental rights petition within 30 days of the 563.28 responsible social services agency determining that the parent 563.29 has lost parental rights to another child through an order 563.30 involuntarily terminating the parent's rights, or another child 563.31 of the parent is the subject of an order transferring permanent 563.32 legal and physical custody of the child to a relative under 563.33 section 260C.201, subdivision 11, paragraph (e), clause (1), or 563.34 a similar law of another jurisdiction. 563.35 Sec. 17. Minnesota Statutes 2000, section 260C.301, is 563.36 amended by adding a subdivision to read: 564.1 Subd. 1a. [ADDITIONAL FACTOR UPON WHICH PARENTAL RIGHTS 564.2 MAY BE TERMINATED.] In addition to the presumptions upon which 564.3 parental rights may be terminated that are listed in subdivision 564.4 1, paragraph (b), clause (4), it is presumed that a parent is 564.5 palpably unfit to be a party to the parent and child 564.6 relationship upon a showing that the parent's custodial rights 564.7 to another child have been involuntarily transferred to a 564.8 relative under section 260C.201, subdivision 11, paragraph (e), 564.9 clause (1), or a similar law of another jurisdiction. 564.10 Sec. 18. Minnesota Statutes 2000, section 260C.317, is 564.11 amended by adding a subdivision to read: 564.12 Subd. 5. [GRANDPARENT VISITATION.] In all proceedings for 564.13 termination of parental rights, after notification of a 564.14 grandparent under section 260C.307, subdivision 3, or at any 564.15 time after completion of the proceeding and continuing during 564.16 the minority of the child, a grandparent may seek an order of 564.17 the court granting visitation rights to the grandparent under 564.18 section 257.022, subdivision 2. 564.19[EFFECTIVE DATE.] This section applies to proceedings 564.20 commenced or completed before the effective date of this section. 564.21 Sec. 19. [PUBLIC GUARDIANSHIP ALTERNATIVES.] 564.22 The commissioner of human services shall provide county 564.23 agencies with funds up to the amount appropriated for public 564.24 guardianship alternatives based on proposals by the counties to 564.25 establish private alternatives. 564.26 Sec. 20. [AUTOMATIC DEFIBRILLATOR STUDY.] 564.27 The emergency medical services regulatory board, in 564.28 consultation with the department of public safety, shall study 564.29 and report to the legislature by December 15, 2002, regarding 564.30 the availability of automatic defibrillators outside the 564.31 seven-county metropolitan area. The report shall include 564.32 recommendations to make these devices accessible within a 564.33 reasonable distance throughout the nonmetropolitan area, 564.34 including recommendations for funding their acquisition and 564.35 distribution. 564.36 Sec. 21. [AH-GWAH-CHING CENTER.] 565.1 The commissioner of human services and the Cass county 565.2 board of commissioners, in consultation with the commissioner of 565.3 administration, shall evaluate the feasibility of allowing Cass 565.4 county to buy or lease unused portions of Ah-Gwah-Ching center. 565.5 The commissioner shall present the results of this evaluation 565.6 and recommendations to the chairs of the house and senate 565.7 committees with jurisdiction over health and human services 565.8 policy and finance. 565.9 Sec. 22. [STUDY OF OUTCOMES FOR CHILDREN IN THE CHILD 565.10 PROTECTION SYSTEM.] 565.11 (a) The commissioner of human services, in consultation 565.12 with local social services agencies, councils of color, 565.13 representatives of communities of color, and other interested 565.14 parties, shall study why African American children in Minnesota 565.15 are disproportionately represented in out-of-home placements. 565.16 The commissioner also shall study each stage of the proceedings 565.17 concerning children in need of protection or services, including 565.18 the point at which children enter the child welfare system, each 565.19 decision-making point in the child welfare system, and the 565.20 outcomes for children in the child welfare system, to determine 565.21 why outcomes for children differ by race. The commissioner 565.22 shall use child welfare performance and outcome indicators and 565.23 data and other available data as part of this study. The 565.24 commissioner also shall study and determine if there are 565.25 decision-making points in the child welfare system that lead to 565.26 different outcomes for children and how those decision-making 565.27 points affect outcomes for children. The commissioner shall 565.28 report and make legislative recommendations on the following: 565.29 (1) amending the child welfare statutes to reduce any 565.30 identified disparities in the child welfare system relating to 565.31 outcomes for children of color, as compared to white children; 565.32 (2) reducing any identified bias in the child welfare 565.33 system; 565.34 (3) reducing the number and duration of out-of-home 565.35 placements for African American children; and 565.36 (4) improving the long-term outcomes for African American 566.1 children in out-of-home placements. 566.2 (b) The commissioner of human services shall submit the 566.3 report and recommended legislation to the chairs and ranking 566.4 minority members of the committees in the house of 566.5 representatives and senate with jurisdiction over child 566.6 protection and out-of-home placement issues by January 15, 2002. 566.7 Sec. 23. [BOARD OF NURSING FEES.] 566.8 Fee modifications proposed by the governor for the board of 566.9 nursing in the 2002-2003 health and human services biennial 566.10 budget document are approved. 566.11 Sec. 24. [BOARD OF MARRIAGE AND FAMILY THERAPY FEES.] 566.12 Fee increases and new fees proposed by the governor for the 566.13 board of marriage and family therapy in the 2002-2003 health and 566.14 human services biennial budget document are approved. 566.15 Sec. 25. [REPEALER.] 566.16 Minnesota Statutes 2000, section 252A.111, subdivision 3, 566.17 is repealed. 566.18 ARTICLE 13 566.19 APPROPRIATIONS 566.20 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 566.21 The sums shown in the columns marked "APPROPRIATIONS" are 566.22 appropriated from the general fund, or any other named fund, to 566.23 the agencies and for the purposes specified in the following 566.24 sections of this article, to be available for the fiscal years 566.25 indicated for each purpose. The figures "2002" and "2003" where 566.26 used in this article, mean that the appropriation or 566.27 appropriations listed under them are available for the fiscal 566.28 year ending June 30, 2002, or June 30, 2003, respectively. 566.29 Where a dollar amount appears in parentheses, it means a 566.30 reduction of an appropriation. 566.31 SUMMARY BY FUND 566.32 APPROPRIATIONS BIENNIAL 566.33 2002 2003 TOTAL 566.34 General $3,083,463,000 $3,390,947,000 $6,474,410,000 566.35 State Government 566.36 Special Revenue 35,451,000 37,127,000 72,578,000 566.37 Health Care 567.1 Access 214,712,000 269,923,000 484,635,000 567.2 Federal TANF 318,103,000 277,420,000 595,523,000 567.3 Lottery Cash Flow 1,300,000 1,300,000 2,600,000 567.4 TOTAL $3,653,029,000 $3,976,717,000 $7,629,746,000 567.5 APPROPRIATIONS 567.6 Available for the Year 567.7 Ending June 30 567.8 2002 2003 567.9 Sec. 2. COMMISSIONER OF 567.10 HUMAN SERVICES 567.11 Subdivision 1. Total 567.12 Appropriation $3,475,621,000 $3,799,990,000 567.13 Summary by Fund 567.14 General 2,962,827,000 3,272,668,000 567.15 State Government 567.16 Special Revenue 507,000 507,000 567.17 Health Care 567.18 Access 207,884,000 263,095,000 567.19 Federal TANF 303,103,000 262,420,000 567.20 Lottery Cash Flow 1,300,000 1,300,000 567.21 [APPROPRIATION FOR COURT-ORDERED MENTAL 567.22 HEALTH TREATMENT.] Of the general fund 567.23 appropriation, $2,289,000 in fiscal 567.24 year 2002 and $2,289,000 in fiscal year 567.25 2003 are for the cost of implementing 567.26 H.F. 560, if enacted. This 567.27 appropriation is available only if H.F. 567.28 560 is enacted. 567.29 [APPROPRIATIONS FOR CIVIL COMMITMENT.] 567.30 (a) Of the general fund appropriation, 567.31 $3,386,000 in fiscal year 2003 is for 567.32 the cost of implementing H.F. 281, if 567.33 enacted. This appropriation is 567.34 available only if H.F. 281 is enacted. 567.35 (b) Of the general fund appropriation, 567.36 $155,000 in fiscal year 2003 is 567.37 appropriated to the commissioner to be 567.38 transferred to the Minnesota supreme 567.39 court for costs associated with 567.40 petitions filed for judicial 567.41 commitment. This appropriation is 567.42 available only if H.F. 281 is enacted. 567.43 [APPROPRIATIONS FOR CHILD SUPPORT.] (1) 567.44 Of the general fund appropriation, 567.45 $32,000 in fiscal year 2002 and $32,000 567.46 in fiscal year 2003 are for the cost of 567.47 implementing H.F. 1807, if enacted. 567.48 This appropriation is available only if 567.49 H.F. 1807 is enacted. 567.50 (2) Of the general fund appropriation, 567.51 $435,000 in fiscal year 2002 is for the 567.52 cost of implementing H.F. 1446, if 567.53 enacted. This appropriation is 567.54 available only if H.F. 1446 is enacted. 568.1 [APPROPRIATION FOR PATIENT 568.2 PROTECTIONS.] (a) Of the general fund 568.3 appropriation, $248,000 in fiscal year 568.4 2002 and $591,000 in fiscal year 2003 568.5 are for the cost of implementing the 568.6 patient protection provisions in H.F. 568.7 560, if enacted. This appropriation is 568.8 available only if H.F. 560 is enacted. 568.9 (b) Of the health care access fund 568.10 appropriation, $106,000 in fiscal year 568.11 2002 and $255,000 in fiscal year 2003 568.12 are for the cost of implementing H.F. 568.13 560, if enacted. This appropriation is 568.14 available only if H.F. 560 is enacted. 568.15 [RECEIPTS FOR SYSTEMS PROJECTS.] 568.16 Appropriations and federal receipts for 568.17 information system projects for MAXIS, 568.18 PRISM, MMIS, and SSIS must be deposited 568.19 in the state system account authorized 568.20 in Minnesota Statutes, section 568.21 256.014. Money appropriated for 568.22 computer projects approved by the 568.23 Minnesota office of technology, funded 568.24 by the legislature, and approved by the 568.25 commissioner of finance may be 568.26 transferred from one project to another 568.27 and from development to operations as 568.28 the commissioner of human services 568.29 considers necessary. Any unexpended 568.30 balance in the appropriation for these 568.31 projects does not cancel but is 568.32 available for ongoing development and 568.33 operations. 568.34 [GIFTS.] Notwithstanding Minnesota 568.35 Statutes, chapter 7, the commissioner 568.36 may accept on behalf of the state 568.37 additional funding from sources other 568.38 than state funds for the purpose of 568.39 financing the cost of assistance 568.40 program grants or nongrant 568.41 administration. All additional funding 568.42 is appropriated to the commissioner for 568.43 use as designated by the grantor of 568.44 funding. 568.45 [SYSTEMS CONTINUITY.] In the event of 568.46 disruption of technical systems or 568.47 computer operations, the commissioner 568.48 may use available grant appropriations 568.49 to ensure continuity of payments for 568.50 maintaining the health, safety, and 568.51 well-being of clients served by 568.52 programs administered by the department 568.53 of human services. Grant funds must be 568.54 used in a manner consistent with the 568.55 original intent of the appropriation. 568.56 [SPECIAL REVENUE FUND INFORMATION.] On 568.57 December 1, 2001, and December 1, 2002, 568.58 the commissioner shall provide the 568.59 chairs of the house health and human 568.60 services finance committee and the 568.61 senate health, human services, and 568.62 corrections budget division with 568.63 detailed fund balance information for 568.64 each special revenue fund account. 568.65 [FEDERAL ADMINISTRATIVE REIMBURSEMENT.] 569.1 Federal administrative reimbursement 569.2 resulting from MinnesotaCare outreach 569.3 grants and the Minnesota senior health 569.4 options project are appropriated to the 569.5 commissioner for these activities. Any 569.6 balance from this appropriation 569.7 remaining at the end of the biennium 569.8 shall be transferred to the general 569.9 fund. 569.10 [NONFEDERAL SHARE TRANSFERS.] The 569.11 nonfederal share of activities for 569.12 which federal administrative 569.13 reimbursement is appropriated to the 569.14 commissioner may be transferred to the 569.15 special revenue fund. Any balance from 569.16 this appropriation remaining at the end 569.17 of the biennium shall be transferred to 569.18 the general fund. 569.19 [MAJOR SYSTEMS TRANSFER.] (1) 569.20 $21,550,000 of funds available in the 569.21 state systems account authorized in 569.22 Minnesota Statutes, section 256.014, is 569.23 transferred to the general fund for the 569.24 biennium ending June 30, 2003. 569.25 (2) $2,450,000 of funds available in 569.26 the state systems account authorized in 569.27 Minnesota Statutes, section 256.014, is 569.28 transferred to the general fund for the 569.29 biennium ending June 30, 2005. 569.30 Notwithstanding section 13 of this 569.31 article, this rider does not expire on 569.32 June 30, 2003. 569.33 [TANF FUNDS APPROPRIATED TO OTHER 569.34 ENTITIES.] Any expenditures from the 569.35 TANF block grant shall be expended in 569.36 accordance with the requirements and 569.37 limitations of part A of title IV of 569.38 the Social Security Act, as amended, 569.39 and any other applicable federal 569.40 requirement or limitation. Prior to 569.41 any expenditure of these funds, the 569.42 commissioner shall assure that funds 569.43 are expended in compliance with the 569.44 requirements and limitations of federal 569.45 law and that any reporting requirements 569.46 of federal law are met. It shall be 569.47 the responsibility of any entity to 569.48 which these funds are appropriated to 569.49 implement a memorandum of understanding 569.50 with the commissioner that provides the 569.51 necessary assurance of compliance prior 569.52 to any expenditure of funds. The 569.53 commissioner shall receipt TANF funds 569.54 appropriated to other state agencies 569.55 and coordinate all related interagency 569.56 accounting transactions necessary to 569.57 implement these appropriations. 569.58 Unexpended TANF funds appropriated to 569.59 any state, local, or nonprofit entity 569.60 cancel at the end of the state fiscal 569.61 year unless appropriating language 569.62 permits otherwise. 569.63 [TANF FUNDS TRANSFERRED TO OTHER 569.64 FEDERAL GRANTS.] The commissioner must 569.65 authorize transfers from TANF to other 569.66 federal block grants so that funds are 570.1 available to meet the annual 570.2 expenditure needs as appropriated. 570.3 Transfers may be authorized prior to 570.4 the expenditure year with the agreement 570.5 of the receiving entity. Transferred 570.6 funds must be expended in the year for 570.7 which the funds were appropriated 570.8 unless appropriation language permits 570.9 otherwise. In accelerating transfer 570.10 authorizations, the commissioner must 570.11 aim to preserve the future potential 570.12 transfer capacity from TANF to other 570.13 block grants. 570.14 [TANF MAINTENANCE OF EFFORT.] (a) In 570.15 order to meet the basic maintenance of 570.16 effort (MOE) requirements of the TANF 570.17 block grant specified under Code of 570.18 Federal Regulations, title 45, section 570.19 263.1, the commissioner may only report 570.20 nonfederal money expended for allowable 570.21 activities listed in the following 570.22 clauses as TANF MOE expenditures: 570.23 (1) MFIP cash and food assistance 570.24 benefits under Minnesota Statutes, 570.25 chapter 256J; 570.26 (2) the child care assistance programs 570.27 under Minnesota Statutes, sections 570.28 119B.03 and 119B.05, and county child 570.29 care administrative costs under 570.30 Minnesota Statutes, section 119B.15; 570.31 (3) state and county MFIP 570.32 administrative costs under Minnesota 570.33 Statutes, chapters 256J and 256K; 570.34 (4) state, county, and tribal MFIP 570.35 employment services under Minnesota 570.36 Statutes, chapters 256J and 256K; and 570.37 (5) expenditures made on behalf of 570.38 noncitizen MFIP recipients who qualify 570.39 for the medical assistance without 570.40 federal financial participation program 570.41 under Minnesota Statutes, section 570.42 256B.06, subdivision 4, paragraphs (d), 570.43 (e), and (j). 570.44 (b) The commissioner shall ensure that 570.45 sufficient qualified nonfederal 570.46 expenditures are made each year to meet 570.47 the state's TANF MOE requirements. For 570.48 the activities listed in paragraph (a), 570.49 clauses (2) to (5), the commissioner 570.50 may only report expenditures that are 570.51 excluded from the definition of 570.52 assistance under Code of Federal 570.53 Regulations, title 45, section 260.31. 570.54 (c) If nonfederal expenditures for the 570.55 programs and purposes listed in 570.56 paragraph (a) are insufficient to meet 570.57 the state's TANF MOE requirements, the 570.58 commissioner shall recommend additional 570.59 allowable sources of nonfederal 570.60 expenditures to the legislature, if the 570.61 legislature is or will be in session to 570.62 take action to specify additional 570.63 sources of nonfederal expenditures for 571.1 TANF MOE before a federal penalty is 571.2 imposed. The commissioner shall 571.3 otherwise provide notice to the 571.4 legislative commission on planning and 571.5 fiscal policy under paragraph (e). 571.6 (d) If the commissioner uses authority 571.7 granted under Laws 1999, chapter 245, 571.8 article 1, section 10, or similar 571.9 authority granted by a subsequent 571.10 legislature, to meet the state's TANF 571.11 MOE requirements in a reporting period, 571.12 the commissioner shall inform the 571.13 chairs of the appropriate legislative 571.14 committees about all transfers made 571.15 under that authority for this purpose. 571.16 (e) If the commissioner determines that 571.17 nonfederal expenditures under paragraph 571.18 (a) are insufficient to meet TANF MOE 571.19 expenditure requirements, and if the 571.20 legislature is not or will not be in 571.21 session to take timely action to avoid 571.22 a federal penalty, the commissioner may 571.23 report nonfederal expenditures from 571.24 other allowable sources as TANF MOE 571.25 expenditures after the requirements of 571.26 this paragraph are met. The 571.27 commissioner may report nonfederal 571.28 expenditures in addition to those 571.29 specified under paragraph (a) as 571.30 nonfederal TANF MOE expenditures, but 571.31 only ten days after the commissioner of 571.32 finance has first submitted the 571.33 commissioner's recommendations for 571.34 additional allowable sources of 571.35 nonfederal TANF MOE expenditures to the 571.36 members of the legislative commission 571.37 on planning and fiscal policy for their 571.38 review. 571.39 (f) The commissioner of finance shall 571.40 not incorporate any changes in federal 571.41 TANF expenditures or nonfederal 571.42 expenditures for TANF MOE that may 571.43 result from reporting additional 571.44 allowable sources of nonfederal TANF 571.45 MOE expenditures under the interim 571.46 procedures in paragraph (e) into the 571.47 February or November forecasts required 571.48 under Minnesota Statutes, section 571.49 16A.103, unless the commissioner of 571.50 finance has approved the additional 571.51 sources of expenditures under paragraph 571.52 (e). 571.53 (g) The provisions of Minnesota 571.54 Statutes, section 256.011, subdivision 571.55 3, which require that federal grants or 571.56 aids secured or obtained under that 571.57 subdivision be used to reduce any 571.58 direct appropriations provided by law, 571.59 do not apply if the grants or aids are 571.60 federal TANF funds. 571.61 (h) Notwithstanding section 14 of this 571.62 article, paragraphs (a) to (h) expire 571.63 June 30, 2005. 571.64 Subd. 2. Agency Management 572.1 General 34,546,000 33,003,000 572.2 State Government 572.3 Special Revenue 392,000 392,000 572.4 Health Care 572.5 Access 3,591,000 3,602,000 572.6 Federal TANF 546,000 454,000 572.7 The amounts that may be spent from the 572.8 appropriation for each purpose are as 572.9 follows: 572.10 (a) Financial Operations 572.11 General 6,708,000 6,708,000 572.12 Health Care 572.13 Access 803,000 803,000 572.14 Federal TANF 546,000 454,000 572.15 (b) Legal and Regulation Operations 572.16 General 8,728,000 8,337,000 572.17 State Government 572.18 Special Revenue 392,000 392,000 572.19 Health Care 572.20 Access 233,000 244,000 572.21 [CORE LICENSING ACTIVITIES.] Of the 572.22 general fund appropriation, $1,138,000 572.23 in fiscal year 2002 and $923,000 in 572.24 fiscal year 2003 is to support 14 new 572.25 licensor positions. Of this amount, 572.26 $72,000 in fiscal year 2002 and 572.27 $107,000 in fiscal year 2003 is to 572.28 cover maintenance and operational costs 572.29 for a new computer system, which will 572.30 provide public access to licensing 572.31 information. In order to receive 572.32 continued appropriations for these 572.33 purposes, by January 1, 2003, the 572.34 commissioner shall: 572.35 (1) reduce the average length of time 572.36 to complete investigations of licensing 572.37 complaints within 75 days; 572.38 (2) complete all licensing reviews 572.39 within the one-year and two-year 572.40 intervals set forth in statutes; and 572.41 (3) complete negative licensing action 572.42 decisions within 45 days of county 572.43 recommendations. 572.44 [EXPEDITED MALTREATMENT 572.45 INVESTIGATIONS.] Of the general fund 572.46 appropriation, $359,000 in fiscal year 572.47 2002 and $277,000 in fiscal year 2003 572.48 are for one senior investigator 572.49 position, three investigator positions, 572.50 and one-half of a clerical position to 572.51 achieve the goals for expedited 572.52 maltreatment investigations. In order 572.53 to receive continued appropriations for 572.54 this purpose, by January 1, 2003, the 573.1 commissioner shall reduce the average 573.2 length of time to complete maltreatment 573.3 investigations to 60 days. 573.4 [PUBLIC GUARDIANSHIP INCENTIVES.] Of 573.5 the general fund appropriation, 573.6 $250,000 in fiscal year 2002 and 573.7 $250,000 in fiscal year 2003 is to be 573.8 used for the purposes of providing 573.9 fiscal incentives to encourage counties 573.10 to establish private alternatives. 573.11 [CHILD MALTREATMENT REVIEW PANEL.] Of 573.12 the general fund appropriation, $46,000 573.13 in fiscal year 2002 and $32,000 in 573.14 fiscal year 2003 is to establish a 573.15 review panel for purposes of reviewing 573.16 investigating agency determinations 573.17 regarding maltreatment of a child in a 573.18 facility in response to requests 573.19 received under Minnesota Statutes, 573.20 section 626.556, subdivision 10i, 573.21 paragraph (b). 573.22 (c) Management Operations 573.23 General 19,110,000 17,958,000 573.24 Health Care 573.25 Access 2,555,000 2,555,000 573.26 Subd. 3. Administrative Reimbursement/ 573.27 Pass Through 573.28 Federal TANF 60,565 51,992 573.29 Subd. 4. Children's Services Grants 573.30 General 59,320,000 59,833,000 573.31 Federal TANF 6,290,000 6,290,000 573.32 [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 573.33 Federal funds available during fiscal 573.34 year 2002 and fiscal year 2003, for 573.35 adoption incentive grants are 573.36 appropriated to the commissioner for 573.37 these purposes. 573.38 [TANF TRANSFER TO SOCIAL SERVICES.] 573.39 $4,650,000 is appropriated to the 573.40 commissioner in fiscal year 2002 and in 573.41 fiscal year 2003 for purposes of 573.42 increasing services for families with 573.43 children whose incomes are at or below 573.44 200 percent of the federal poverty 573.45 guidelines. The commissioner shall 573.46 authorize a sufficient transfer of 573.47 funds from the state's federal TANF 573.48 block grant to the state's federal 573.49 social services block grant to meet 573.50 this appropriation. 573.51 [SOCIAL SERVICES BLOCK GRANT FUNDS FOR 573.52 CONCURRENT PERMANENCY PLANNING.] 573.53 Notwithstanding Minnesota Statutes, 573.54 section 256E.07, $4,650,000 in fiscal 573.55 year 2002 and $4,650,000 in fiscal year 573.56 2003 in social services block grant 573.57 funds allocated to the commissioner 573.58 under title XX of the Social Security 574.1 Act are available for distribution to 574.2 counties under the formula in Minnesota 574.3 Statutes, section 260C.213, for the 574.4 purposes of concurrent permanency 574.5 planning. 574.6 Subd. 5. Children's Services Management 574.7 General 4,880,000 4,252,000 574.8 Subd. 6. Basic Health Care Grants 574.9 Summary by Fund 574.10 General 1,114,020,000 1,317,641,000 574.11 Health Care 574.12 Access 189,392,000 244,592,000 574.13 The amounts that may be spent from this 574.14 appropriation for each purpose are as 574.15 follows: 574.16 (a) MinnesotaCare Grants 574.17 Health Care 574.18 Access 188,642,000 243,842,000 574.19 [MINNESOTACARE FEDERAL RECEIPTS.] 574.20 Receipts received as a result of 574.21 federal participation pertaining to 574.22 administrative costs of the Minnesota 574.23 health care reform waiver shall be 574.24 deposited as nondedicated revenue in 574.25 the health care access fund. Receipts 574.26 received as a result of federal 574.27 participation pertaining to grants 574.28 shall be deposited in the federal fund 574.29 and shall offset health care access 574.30 funds for payments to providers. 574.31 [MINNESOTACARE FUNDING.] The 574.32 commissioner may expend money 574.33 appropriated from the health care 574.34 access fund for MinnesotaCare in either 574.35 fiscal year of the biennium. 574.36 (b) MA Basic Health Care Grants - 574.37 Families and Children 574.38 General 433,298,000 517,563,000 574.39 (c) MA Basic Health Care Grants - 574.40 Elderly and Disabled 574.41 General 511,946,000 604,451,000 574.42 [MEDICALLY NEEDY STANDARD AND FEDERAL 574.43 AUTHORIZATION.] If federal 574.44 authorization to use the medical 574.45 assistance income standard in Minnesota 574.46 Statutes, section 256B.056, subdivision 574.47 4, as the medically needy standard is 574.48 not obtained, the commissioner shall 574.49 use all resulting savings to provide 574.50 services under the home and 574.51 community-based waiver for persons with 574.52 mental retardation and related 574.53 conditions. 574.54 (d) General Assistance Medical Care 575.1 General 155,744,000 176,748,000 575.2 (e) Health Care Grants - Other Assistance 575.3 General 13,032,000 18,879,000 575.4 Health Care 575.5 Access 750,000 750,000 575.6 [PURCHASING ALLIANCE STOP-LOSS 575.7 FUNDING.] Of the general fund 575.8 appropriation, $150,000 in fiscal year 575.9 2002 and $500,000 in fiscal year 2003 575.10 are appropriated to the commissioner 575.11 for the cost of establishing the 575.12 Purchasing Alliance Stop-loss fund 575.13 under Minnesota Statutes, section 575.14 256.956. 575.15 Subd. 7. Basic Health Care Management 575.16 General 20,730,000 20,715,000 575.17 Health Care 575.18 Access 13,583,000 13,583,000 575.19 The amounts that may be spent from this 575.20 appropriation for each purpose are as 575.21 follows: 575.22 (a) Health Care Policy Administration 575.23 General 2,822,000 2,862,000 575.24 Health Care 575.25 Access 562,000 562,000 575.26 (b) Health Care Operations 575.27 General 17,908,000 17,853,000 575.28 Health Care 575.29 Access 13,021,000 13,021,000 575.30 [PREPAID MEDICAL PROGRAMS.] The 575.31 nonfederal share of the prepaid medical 575.32 assistance program fund, which has been 575.33 appropriated to fund county managed 575.34 care advocacy and enrollment operating 575.35 costs, shall be disbursed as grants 575.36 using either a reimbursement or block 575.37 grant mechanism. 575.38 Subd. 8. State-Operated Services 575.39 General 205,868,000 199,287,000 575.40 The amounts that may be spent from this 575.41 appropriation for each purpose are as 575.42 follows: 575.43 [MITIGATION RELATED TO STATE-OPERATED 575.44 SERVICES RESTRUCTURING.] Money 575.45 appropriated to finance mitigation 575.46 expenses related to restructuring 575.47 state-operated services programs and 575.48 administrative services may be 575.49 transferred between fiscal years within 575.50 the biennium. 575.51 [STATE-OPERATED SERVICES CHEMICAL 576.1 DEPENDENCY PROGRAMS.] When the 576.2 operations of the state-operated 576.3 services chemical dependency fund 576.4 created in Minnesota Statutes, section 576.5 246.18, subdivision 2, are impeded by 576.6 projected cash deficiencies resulting 576.7 from delays in the receipt of grants, 576.8 dedicated income, or other similar 576.9 receivables, and when the deficiencies 576.10 would be corrected within the budget 576.11 period involved, the commissioner of 576.12 finance may transfer general fund cash 576.13 reserves into this account as necessary 576.14 to meet cash demands. The cash flow 576.15 transfers must be returned to the 576.16 general fund in the fiscal year that 576.17 the transfer was made. Any interest 576.18 earned on general fund cash flow 576.19 transfers accrues to the general fund 576.20 and not the state-operated services 576.21 chemical dependency fund. 576.22 [STATE-OPERATED SERVICES 576.23 RESTRUCTURING.] For purposes of 576.24 restructuring state-operated services, 576.25 any state-operated services employee 576.26 whose position is to be eliminated 576.27 shall be afforded the options provided 576.28 in applicable collective bargaining 576.29 agreements. All salary and mitigation 576.30 allocations from fiscal year 2002 shall 576.31 be carried forward into fiscal year 576.32 2003. Provided there is no conflict 576.33 with any collective bargaining 576.34 agreement, any state-operated services 576.35 position reduction must only be 576.36 accomplished through mitigation, 576.37 attrition, transfer, and other measures 576.38 as provided in state or applicable 576.39 collective bargaining agreements and in 576.40 Minnesota Statutes, section 252.50, 576.41 subdivision 11, and not through layoff. 576.42 [REPAIRS AND BETTERMENTS.] The 576.43 commissioner may transfer unencumbered 576.44 appropriation balances between fiscal 576.45 years within the biennium for the state 576.46 residential facilities repairs and 576.47 betterments account and special 576.48 equipment. 576.49 Subd. 9. Continuing Care Grants 576.50 General 1,370,056,000 1,486,468,000 576.51 Lottery Cash Flow 1,158,000 1,158,000 576.52 The amounts that may be spent from this 576.53 appropriation for each purpose are as 576.54 follows: 576.55 (a) Community Social Services 576.56 Block Grants 576.57 48,718,000 49,695,000 576.58 [CSSA TRADITIONAL APPROPRIATION.] 576.59 Notwithstanding Minnesota Statutes, 576.60 section 256E.06, subdivisions 1 and 2, 576.61 the appropriations available under that 576.62 section in fiscal years 2002 and 2003 577.1 must be distributed to each county 577.2 proportionately to the aid received by 577.3 the county in calendar year 2000. 577.4 (b) Aging Adult Service Grants 577.5 13,500,000 13,732,000 577.6 [COUNTY PLANNING AND SERVICE 577.7 DEVELOPMENT.] Of this appropriation, 577.8 $1,200,000 in fiscal year 2002 and 577.9 $1,600,000 in fiscal year 2003 are for 577.10 distribution to county boards for 577.11 planning and development of community 577.12 services for the elderly as required 577.13 under Minnesota Statutes, section 577.14 256B.437, subdivision 2. For Phase I 577.15 funding to develop the initial biennial 577.16 plan addendum, the commissioner shall 577.17 distribute a minimum of $10,000 to each 577.18 county on July 1, 2001. In a county 577.19 with more than 10,000 persons over 65 577.20 years, the funding allocation shall be 577.21 $15,000; with more than 30,000 persons 577.22 over 65 years - $20,000; with more than 577.23 50,000 persons over 65 years - $25,000; 577.24 and with more than 100,000 persons over 577.25 65 years - $30,000. Upon submission of 577.26 the completed biennial plan addendum, 577.27 the commissioner shall distribute Phase 577.28 II funding to each county for 577.29 development of community-based services 577.30 no later than January 1, 2002. For 577.31 counties with less than 4,500 persons 577.32 under 65 years, the Phase II allocation 577.33 shall be $10,000. For counties with 577.34 more than 4,500 persons over 65 years, 577.35 the Phase II allocation shall be $2.23 577.36 per person over 65 years. Any 577.37 remaining funds shall be available as 577.38 targeted funds distributed to counties 577.39 with designated critical access sites. 577.40 Phase I funding may be carried over by 577.41 the county into 2002 and 2003 for the 577.42 development of services. 577.43 [GRANTS FOR SENIOR NUTRITION.] Of the 577.44 general fund appropriation, $40,881 in 577.45 fiscal year 2002 is appropriated to the 577.46 commissioner for senior nutrition 577.47 programs under Minnesota Statutes, 577.48 section 256.9752 and shall be 577.49 distributed as follows: 577.50 (1) $12,023 is for development region 577.51 6E; 577.52 (2) $18,692 is for development region 577.53 6W; and 577.54 (3) $10,166 is for development region 8. 577.55 [MINNESOTA SENIOR SERVICE CORPS.] Of 577.56 the general fund appropriation, 577.57 $3,200,000 for fiscal year 2002 and 577.58 fiscal year 2003 is for the following 577.59 purposes: 577.60 (a) $1,000,000 each year in fiscal year 577.61 2002 and fiscal year 2003 is for the 577.62 volunteer programs for retired senior 578.1 citizens under Minnesota Statutes, 578.2 section 256.9753, to expand the seniors 578.3 in schools initiative, provide travel 578.4 reimbursement to volunteers, and to 578.5 continue community outreach and the 578.6 expansion of the program. 578.7 (b) $200,000 each year in fiscal year 578.8 2002 and fiscal year 2003 is for the 578.9 foster grandparents program under 578.10 Minnesota Statutes, section 256.976, to 578.11 assist with necessary extensive 578.12 training expenses and travel 578.13 reimbursement for volunteers. 578.14 (c) $400,000 each year in fiscal year 578.15 2002 and fiscal year 2003 is for the 578.16 senior companion program under 578.17 Minnesota Statutes, section 256.977, to 578.18 expand the program, assist with travel 578.19 reimbursement for volunteers, and 578.20 continue the experience corps for 578.21 independent living. 578.22 (c) Deaf and Hard-of-Hearing 578.23 Services Grants 578.24 1,923,000 1,825,000 578.25 [SERVICES TO DEAF PERSONS WITH MENTAL 578.26 ILLNESS.] Of this appropriation, 578.27 $100,000 in fiscal year 2002 and 578.28 $100,000 in fiscal year 2003 is for a 578.29 grant to a nonprofit agency that 578.30 currently serves deaf and 578.31 hard-of-hearing adults with mental 578.32 illness through residential programs 578.33 and supportive housing outreach 578.34 activities. The grant must be used to 578.35 continue and maintain community support 578.36 services for deaf and hard-of-hearing 578.37 adults with mental illness who use or 578.38 wish to use sign language as their 578.39 primary means of communication. 578.40 (d) Mental Health Grants 578.41 General 50,014,000 51,525,000 578.42 Lottery Cash Flow 1,158,000 1,158,000 578.43 (e) Community Support Grants 578.44 12,698,000 12,920,000 578.45 (f) Medical Assistance Long-Term 578.46 Care Waivers and Home Care 578.47 452,689,000 533,489,000 578.48 [PROVIDER RATE INCREASES.] (1) The 578.49 commissioner shall increase 578.50 reimbursement rates by 3.0 percent the 578.51 first year of the biennium and by 3.0 578.52 percent the second year for the 578.53 providers listed in paragraph (2). The 578.54 increases shall be effective for 578.55 services rendered on or after July 1 of 578.56 each year. 578.57 (2) The rate increases described in 579.1 this section shall be provided to home 579.2 and community-based waivered services 579.3 for persons with mental retardation or 579.4 related conditions under Minnesota 579.5 Statutes, section 256B.501; home and 579.6 community-based waivered services for 579.7 the elderly under Minnesota Statutes, 579.8 section 256B.0915; waivered services 579.9 under community alternatives for 579.10 disabled individuals under Minnesota 579.11 Statutes, section 256B.49; community 579.12 alternative care waivered services 579.13 under Minnesota Statutes, section 579.14 256B.49; traumatic brain injury 579.15 waivered services under Minnesota 579.16 Statutes, section 256B.49; nursing 579.17 services and home health services under 579.18 Minnesota Statutes, section 256B.0625, 579.19 subdivision 6a; personal care services 579.20 and nursing supervision of personal 579.21 care services under Minnesota Statutes, 579.22 section 256B.0625, subdivision 19a; 579.23 private-duty nursing services under 579.24 Minnesota Statutes, section 256B.0625, 579.25 subdivision 7; day training and 579.26 habilitation services for adults with 579.27 mental retardation or related 579.28 conditions under Minnesota Statutes, 579.29 sections 252.40 to 252.46; alternative 579.30 care services under Minnesota Statutes, 579.31 section 256B.0913; adult residential 579.32 program grants under Minnesota Rules, 579.33 parts 9535.2000 to 9535.3000; adult and 579.34 family community support grants under 579.35 Minnesota Rules, parts 9535.1700 to 579.36 9535.1760; semi-independent living 579.37 services under Minnesota Statutes, 579.38 section 252.275, including SILS funding 579.39 under county social services grants 579.40 formerly funded under Minnesota 579.41 Statutes, chapter 256I; community 579.42 support services for deaf and 579.43 hard-of-hearing adults with mental 579.44 illness who use or wish to use sign 579.45 language as their primary means of 579.46 communication; and living skills 579.47 training programs for persons with 579.48 intractable epilepsy who need 579.49 assistance in the transition to 579.50 independent living; and group 579.51 residential housing supplementary 579.52 service rate under Minnesota Statutes, 579.53 section 256I.05, subdivision 1a. 579.54 (g) Medical Assistance Long-Term 579.55 Care Facilities 579.56 590,638,000 599,866,000 579.57 [MORATORIUM EXCEPTIONS.] During each 579.58 year of the biennium beginning July 1, 579.59 2001, the commissioner of health may 579.60 approve moratorium exception projects 579.61 under Minnesota Statutes, section 579.62 144A.073, for which the full annualized 579.63 state share of medical assistance costs 579.64 does not exceed $2,000,000. 579.65 [NURSING FACILITY OPERATED BY THE RED 579.66 LAKE BAND OF CHIPPEWA INDIANS.] (1) The 579.67 medical assistance payment rates for 580.1 the 47-bed nursing facility operated by 580.2 the Red Lake Band of Chippewa Indians 580.3 must be calculated according to 580.4 allowable reimbursement costs under the 580.5 medical assistance program, as 580.6 specified in Minnesota Statutes, 580.7 section 246.50, and are subject to the 580.8 facility-specific Medicare upper limits. 580.9 (2) In addition, the commissioner shall 580.10 make available rate adjustments for the 580.11 biennium beginning July 1, 2001, on the 580.12 same basis as the adjustments provided 580.13 to nursing facilities under Minnesota 580.14 Statutes, section 256B.431. The 580.15 commissioner must use the facility's 580.16 final 2000 and 2001 Medicare cost 580.17 reports to calculate the adjustments. 580.18 This rate increase shall become part of 580.19 the facility's base rate for future 580.20 rate years. 580.21 [ICF/MR DISALLOWANCES.] Of this 580.22 appropriation, $65,000 in each fiscal 580.23 year is to reimburse a four-bed ICF/MR 580.24 in Ramsey county for disallowance 580.25 resulting from field audit findings. 580.26 The commissioner shall exempt these 580.27 facilities from the provisions of 580.28 Minnesota Statutes, section 256B.501, 580.29 subdivision 5b, paragraph (d), clause 580.30 (6), for the rate years beginning 580.31 October 1, 1996, and October 1, 1997. 580.32 [COMMUNITY SERVICES DEVELOPMENT GRANTS 580.33 PROGRAM.] Of this appropriation, 580.34 $18,000,000 for the biennium ending 580.35 June 30, 2003, is to the commissioner 580.36 for grants under Minnesota Statutes, 580.37 section 256.9754. Unexpended 580.38 appropriations in fiscal year 2002 do 580.39 not cancel but are available to the 580.40 commissioner for these purposes in 580.41 fiscal year 2003. This is a one-time 580.42 appropriation and shall not become part 580.43 of the base-level funding for the 580.44 2004-2005 biennium. 580.45 [LONG-TERM CARE CONSULTATION SERVICES.] 580.46 Long-term care consultation services 580.47 payments to all counties shall continue 580.48 at the payment amount in effect for 580.49 preadmission screening in fiscal year 580.50 2001. 580.51 (h) Alternative Care Grants 580.52 General 75,764,000 89,646,000 580.53 [ALTERNATIVE CARE TRANSFER.] Any money 580.54 allocated to the alternative care 580.55 program that is not spent for the 580.56 purposes indicated does not cancel but 580.57 shall be transferred to the medical 580.58 assistance account. 580.59 [ALTERNATIVE CARE APPROPRIATION.] The 580.60 commissioner may expend the money 580.61 appropriated for the alternative care 580.62 program for that purpose in either year 580.63 of the biennium. 581.1 (i) Group Residential Housing 581.2 General 78,712,000 86,807,000 581.3 (j) Chemical Dependency 581.4 Entitlement Grants 581.5 General 39,459,000 41,045,000 581.6 (k) Chemical Dependency 581.7 Nonentitlement Grants 581.8 General 5,941,000 5,918,000 581.9 [CONSOLIDATED CHEMICAL DEPENDENCY 581.10 TREATMENT FUND ONE-TIME TRANSFER.] 581.11 $9,367,000 of funds available in the 581.12 consolidated chemical dependency 581.13 treatment fund general reserve account 581.14 is transferred in fiscal year 2002 to 581.15 the general fund. 581.16 Subd. 10. Continuing Care Management 581.17 General 24,546,000 23,928,000 581.18 State Government 581.19 Special Revenue 115,000 115,000 581.20 Lottery Cash Flow 142,000 142,000 581.21 [COUNTY INVOLVEMENT COSTS.] Of this 581.22 appropriation, up to $481,000 in fiscal 581.23 year 2002 and up to $642,000 in fiscal 581.24 year 2003 are for the commissioner to 581.25 allocate to counties for resident 581.26 relocation costs resulting from planned 581.27 closures under Minnesota Statutes, 581.28 section 256B.437, and resident 581.29 relocations under Minnesota Statutes, 581.30 section 144A.161. Unexpended funds for 581.31 fiscal year 2002 do not cancel but are 581.32 available to the commissioner for this 581.33 purpose in fiscal year 2003. 581.34 [REGION 10 QUALITY ASSURANCE 581.35 COMMISSION.] (1) Of the appropriation 581.36 from the general fund for the biennium 581.37 ending June 30, 2003, $548,000 is to 581.38 the commissioner of human services to 581.39 be allocated to the region 10 quality 581.40 assurance commission for operating 581.41 costs of the alternative quality 581.42 assurance licensing project and for 581.43 grants to counties participating in 581.44 that project. 581.45 (2) $50,000 is appropriated from the 581.46 general fund to the commissioner of 581.47 human services for the biennium ending 581.48 June 30, 2003, for the region 10 581.49 quality assurance commission to conduct 581.50 the evaluation required under Minnesota 581.51 Statutes, section 256B.0951, 581.52 subdivision 9. 581.53 (3) $150,000 is appropriated from the 581.54 general fund to the commissioner of 581.55 human services for the biennium ending 581.56 June 30, 2003, for the commissioner to 581.57 conduct the project evaluation required 582.1 for the federal 1115 waiver of ICF/MR 582.2 regulations. 582.3 Subd. 11. Economic Support Grants 582.4 General 91,086,000 90,136,000 582.5 Federal TANF 233,209,000 202,741,000 582.6 The amounts that may be spent from this 582.7 appropriation for each purpose are as 582.8 follows: 582.9 (a) Assistance to Families Grants 582.10 General 25,237,000 21,821,000 582.11 Federal TANF 164,745,000 133,553,000 582.12 (b) Work Grants 582.13 General 9,844,000 9,844,000 582.14 Federal TANF 67,203,000 66,403,000 582.15 [NONTRADITIONAL CAREER ASSISTANCE.] Of 582.16 the federal TANF appropriation, 582.17 $500,000 for fiscal year 2002 and 582.18 $500,000 for fiscal year 2003 is for 582.19 grants for nontraditional career 582.20 assistance training programs under 582.21 Minnesota Statutes, section 256K.30. 582.22 This is a one-time appropriation and 582.23 shall not be added to the base-level 582.24 funding in the 2004-2005 biennium. 582.25 [SUPPORTIVE HOUSING AND MANAGED CARE 582.26 PILOT PROJECT.] Of the general fund 582.27 appropriation, $2,000,000 in fiscal 582.28 year 2002 and $5,000,000 in fiscal year 582.29 2003 is for the supportive housing and 582.30 managed care pilot project under 582.31 Minnesota Statutes, section 256K.25. 582.32 This appropriation may be transferred 582.33 between fiscal years within the 582.34 biennium. 582.35 [INTENSIVE INTERVENTION TRANSITIONAL 582.36 EMPLOYMENT TRAINING PROJECT.] Of the 582.37 federal TANF appropriation, $800,000 582.38 for the biennium ending June 30, 2003, 582.39 is for the Southeast Asian 582.40 collaborative in Hennepin county for an 582.41 intensive intervention transitional 582.42 employment training project, which 582.43 serves TANF-eligible recipients, and 582.44 which moves refugee and immigrant 582.45 welfare recipients into unsubsidized 582.46 employment leading to 582.47 self-sufficiency. The commissioner 582.48 must select one of the five partners in 582.49 the collaborative as the fiscal agent 582.50 for the project. The primary effort of 582.51 the project must be on intensive 582.52 employment skills training, including 582.53 workplace English and overcoming 582.54 cultural barriers, and on specialized 582.55 training in fields of work which 582.56 involve a credit-based curriculum. For 582.57 recipients without a high school 582.58 diploma or a GED, extra effort shall be 583.1 made to help the recipient meet the 583.2 "ability to benefit test" so the 583.3 recipient can receive financial aid for 583.4 further training. During the 583.5 specialized training, efforts should be 583.6 made to involve the recipients with an 583.7 internship program and retention 583.8 specialist. A minor amount of the 583.9 grant may be used for other efforts to 583.10 make the recipient families more 583.11 self-sufficient as provided within TANF 583.12 rules. This is a one-time 583.13 appropriation and shall not be added to 583.14 the base-level funding for the 583.15 2004-2005 biennium. 583.16 [LOCAL INTERVENTION GRANTS FOR 583.17 SELF-SUFFICIENCY CARRYFORWARD.] 583.18 Unexpended funds appropriated for local 583.19 intervention grants under Minnesota 583.20 Statutes, section 256J.625, for fiscal 583.21 year 2002 do not cancel but are 583.22 available to the commissioner for these 583.23 purposes in fiscal year 2003. 583.24 [WELFARE-TO-WORK GRANTS.] Of the 583.25 federal TANF appropriation, $5,000,000 583.26 each year in fiscal year 2002 and 583.27 fiscal year 2003 is for welfare-to-work 583.28 programs administered by the 583.29 commissioner of economic security that 583.30 have utilized all of the federal 583.31 welfare-to-work funding received. The 583.32 commissioner of economic security shall 583.33 establish guidelines for distributing 583.34 the funds to local workforce service 583.35 areas based on current expenditures and 583.36 documented need and, by January 15, 583.37 2003, shall report to the chairs of the 583.38 house health and human services finance 583.39 committee and the senate health, human 583.40 services and corrections budget 583.41 division on the use of state and 583.42 federal funds appropriated for 583.43 welfare-to-work programs and the 583.44 effectiveness of such programs. 583.45 (c) Economic Support Grants - 583.46 Other Assistance 583.47 General 4,682,000 6,931,000 583.48 Federal TANF 1,001,000 2,525,000 583.49 [TANF TRANSFER TO CHILD CARE AND 583.50 DEVELOPMENT BLOCK GRANT.] $1,526,000 583.51 for fiscal year 2003 is appropriated to 583.52 the commissioner of children, families, 583.53 and learning for the purposes of 583.54 Minnesota Statutes, section 119B.05. 583.55 The commissioner of human services 583.56 shall authorize a sufficient transfer 583.57 of funds from the state's federal TANF 583.58 block grant to the state's child care 583.59 and development fund block grant to 583.60 meet this appropriation. 583.61 [WORKING FAMILY TAX CREDITS.] (1) On a 583.62 regular basis, the commissioner of 583.63 revenue, with the assistance of the 583.64 commissioner of human services, shall 584.1 calculate the value of the refundable 584.2 portion of the Minnesota working family 584.3 credits provided under Minnesota 584.4 Statutes, section 290.0671, that 584.5 qualifies for federal reimbursement 584.6 from the temporary assistance for needy 584.7 families block grant. The commissioner 584.8 of revenue shall provide the 584.9 commissioner of human services with 584.10 such expenditure records and 584.11 information as are necessary to support 584.12 draws of federal funds. 584.13 (2) Federal TANF funds, as specified in 584.14 this paragraph, are appropriated to the 584.15 commissioner of human services based on 584.16 calculations under paragraph (a) of 584.17 working family tax credit expenditures 584.18 that qualify for reimbursement from the 584.19 TANF block grant for income tax refunds 584.20 payable in federal fiscal years 584.21 beginning October 1, 2001. The draws 584.22 of federal TANF funds shall be made on 584.23 a regular basis based on calculations 584.24 of credit expenditures by the 584.25 commissioner of revenue. Up to the 584.26 following amounts of federal TANF draws 584.27 are appropriated to the commissioner of 584.28 human services to deposit in the 584.29 general fund: in fiscal year 2002, 584.30 $25,000,000; and in fiscal year 2003, 584.31 $16,000,000. 584.32 (d) Child Support Enforcement 584.33 General 4,239,000 4,239,000 584.34 Federal TANF 260,000 260,000 584.35 [CHILD SUPPORT PAYMENT CENTER.] 584.36 Payments to the commissioner from other 584.37 governmental units, private 584.38 enterprises, and individuals for 584.39 services performed by the child support 584.40 payment center must be deposited in the 584.41 state systems account authorized under 584.42 Minnesota Statutes, section 256.014. 584.43 These payments are appropriated to the 584.44 commissioner for the operation of the 584.45 child support payment center or system, 584.46 according to Minnesota Statutes, 584.47 section 256.014. 584.48 (e) General Assistance 584.49 General 17,156,000 15,700,000 584.50 [GENERAL ASSISTANCE STANDARD.] The 584.51 commissioner shall set the monthly 584.52 standard of assistance for general 584.53 assistance units consisting of an adult 584.54 recipient who is childless and 584.55 unmarried or living apart from his or 584.56 her parents or a legal guardian at 584.57 $203. The commissioner may reduce this 584.58 amount in accordance with Laws 1997, 584.59 chapter 85, article 3, section 54. 584.60 (f) Minnesota Supplemental Aid 584.61 General 29,678,000 31,351,000 585.1 (g) Refugee Services 585.2 General 250,000 250,000 585.3 Subd. 12. Economic Support 585.4 Management 585.5 General 37,775,000 37,405,000 585.6 Health Care 585.7 Access 1,318,000 1,318,000 585.8 Federal TANF 2,493,000 943,000 585.9 The amounts that may be spent from this 585.10 appropriation for each purpose are as 585.11 follows: 585.12 (a) Economic Support Policy 585.13 Administration 585.14 General 6,528,000 6,191,000 585.15 Federal TANF 2,493,000 943,000 585.16 [FOOD STAMP ADMINISTRATIVE 585.17 REIMBURSEMENT.] The commissioner shall 585.18 reduce quarterly food stamp 585.19 administrative reimbursement to 585.20 counties in fiscal years 2002 and 2003 585.21 by the amount that the United States 585.22 Department of Health and Human Services 585.23 determines to be the county random 585.24 moment study share of the food stamp 585.25 adjustment under Public Law Number 585.26 105-185. The reductions shall be 585.27 allocated to each county in proportion 585.28 to each county's contribution, if any, 585.29 to the amount of the adjustment. Any 585.30 adjustment to medical assistance 585.31 administrative reimbursement that is 585.32 based on the United States Department 585.33 of Health and Human Services' 585.34 determinations under Public Law Number 585.35 105-185 shall be distributed to 585.36 counties in the same manner. 585.37 [EMPLOYMENT SERVICES TRACKING SYSTEM.] 585.38 Of the federal TANF appropriation, 585.39 $1,750,000 in fiscal year 2002 and 585.40 $200,000 in fiscal year 2003 are for 585.41 development of an employment tracking 585.42 system in collaboration with the 585.43 department of economic security. 585.44 Unexpended funds in fiscal year 2002 do 585.45 not cancel but are available to the 585.46 commissioner for these purposes in 585.47 fiscal year 2003. This is a one-time 585.48 appropriation and shall not be added to 585.49 the base-level funding for the 585.50 2004-2005 biennium. 585.51 (b) Economic Support Operations 585.52 General 31,247,000 31,214,000 585.53 Health Care 585.54 Access 1,318,000 1,318,000 585.55 Federal TANF ...,-0-,... ...,-0-,... 586.1 [SPENDING AUTHORITY FOR FOOD STAMP 586.2 ENHANCED FUNDING.] In the event that 586.3 Minnesota qualifies for United States 586.4 Department of Agriculture Food and 586.5 Nutrition Services Food Stamp Program 586.6 enhanced funding beginning in federal 586.7 fiscal year 1998, the money is 586.8 appropriated to the commissioner for 586.9 the purposes of the program. The 586.10 commissioner shall retain 25 percent of 586.11 the enhanced funding for the Minnesota 586.12 food assistance program, with the 586.13 remaining 75 percent divided among the 586.14 counties according to a formula that 586.15 takes into account each county's impact 586.16 on the statewide food stamp error rate. 586.17 [FINANCIAL INSTITUTION DATA MATCH AND 586.18 PAYMENT OF FEES.] The commissioner is 586.19 authorized to allocate up to $310,000 586.20 each year in fiscal year 2002 and 586.21 fiscal year 2003 from the PRISM special 586.22 revenue account to make payments to 586.23 financial institutions in exchange for 586.24 performing data matches between account 586.25 information held by financial 586.26 institutions and the public authority's 586.27 database of child support obligors as 586.28 authorized by Minnesota Statutes, 586.29 section 13B.06, subdivision 7. 586.30 Sec. 3. COMMISSIONER OF HEALTH 586.31 Subdivision 1. Total 586.32 Appropriation 130,391,000 130,516,000 586.33 Summary by Fund 586.34 General 84,419,000 82,960,000 586.35 State Government 586.36 Special Revenue 24,144,000 25,728,000 586.37 Health Care 586.38 Access 6,828,000 6,828,000 586.39 Federal TANF 15,000,000 15,000,000 586.40 Subd. 2. Family and 586.41 Community Health 64,335,000 64,647,000 586.42 Summary by Fund 586.43 General 44,743,000 44,056,000 586.44 State Government 586.45 Special Revenue 936,000 1,935,000 586.46 Health Care 586.47 Access 3,656,000 3,656,000 586.48 Federal TANF 15,000,000 15,000,000 586.49 [ELIMINATING HEALTH DISPARITIES.] Of 586.50 the general fund appropriation, 586.51 $6,000,000 each year is for reducing 586.52 health disparities. Of the amounts 586.53 available: 586.54 (1) $1,500,000 each year is for 586.55 competitive grants under Minnesota 587.1 Statutes, section 145.928, subdivision 587.2 7, to eligible applicants to reduce 587.3 health disparities in infant mortality 587.4 rates and adult and child immunization 587.5 rates. 587.6 (2) $2,000,000 each year is for 587.7 competitive grants under Minnesota 587.8 Statutes, section 145.928, subdivision 587.9 8, to eligible applicants to reduce 587.10 health disparities in breast and 587.11 cervical cancer screening rates, 587.12 HIV/AIDS and sexually transmitted 587.13 infection rates, cardiovascular disease 587.14 rates, diabetes rates, and rates of 587.15 accidental injuries and violence. 587.16 (3) $500,000 each year is for grants 587.17 under Minnesota Statutes, section 587.18 145.928, subdivision 9, to community 587.19 health boards as defined in Minnesota 587.20 Statutes, section 145A.02, to improve 587.21 access to health screening and 587.22 follow-up services for refugee 587.23 populations. 587.24 (4) $2,000,000 each year is for grants 587.25 to community health boards as defined 587.26 in Minnesota Statutes, section 145A.02, 587.27 according to the formula in Minnesota 587.28 Statutes, section 145.882, subdivision 587.29 4a, to provide services targeted at 587.30 reducing maternal and child health 587.31 disparities. 587.32 [TEEN PREGNANCY PREVENTION.] 587.33 $10,000,000 from the TANF fund for the 587.34 2002-2003 biennium is appropriated to 587.35 the commissioner of health for a teen 587.36 pregnancy prevention program. Of the 587.37 amounts available: 587.38 (1) $1,750,000 in fiscal year 2002 and 587.39 $2,500,000 in fiscal year 2003 are for 587.40 teen pregnancy prevention disparity 587.41 grants under Minnesota Statutes, 587.42 section 145.9257, subdivision 6. 587.43 (2) $1,500,000 in fiscal year 2002 and 587.44 $1,500,000 in fiscal year 2003 are for 587.45 high-risk community teen pregnancy 587.46 prevention grants under Minnesota 587.47 Statutes, section 145.9257, subdivision 587.48 7. 587.49 (3) $1,000,000 in fiscal year 2002 and 587.50 $1,000,000 in fiscal year 2003 are for 587.51 transfer to the commissioner of 587.52 children, families, and learning to 587.53 increase the number of adolescent 587.54 parenting grants. 587.55 (4) $750,000 in fiscal year 2002 is for 587.56 one-time grants to public school 587.57 districts to implement an abstinence 587.58 until marriage curriculum and to train 587.59 staff to implement the curriculum. The 587.60 curriculum shall educate adolescents 587.61 that abstinence from sexual activity 587.62 outside of marriage is the expected 587.63 standard and that sexual activity 588.1 outside the context of marriage is 588.2 likely to have harmful emotional, 588.3 physical, and social effects; and shall 588.4 provide an explanation of the value of 588.5 the institution of marriage and a 588.6 discussion of the historical purpose 588.7 and significance of marriage. The 588.8 commissioner of health, in consultation 588.9 with the commissioner of children, 588.10 families, and learning, shall make 588.11 school districts aware of the 588.12 availability of funds for this 588.13 purpose. This appropriation shall not 588.14 become part of the base-level funding 588.15 for this activity. 588.16 [POISON INFORMATION SYSTEM.] Of the 588.17 general fund appropriation, $1,360,000 588.18 each fiscal year is for poison control 588.19 system grants under Minnesota Statutes, 588.20 section 145.93. This is a one-time 588.21 appropriation that shall not become 588.22 part of base-level funding in 2004-2005. 588.23 [SUICIDE PREVENTION.] Of the general 588.24 fund appropriation, $1,100,000 each 588.25 fiscal year is for suicide prevention 588.26 activities under Minnesota Statutes, 588.27 section 145.56. Of the amounts 588.28 available: 588.29 (1) $275,000 each fiscal year is for 588.30 refining, coordinating, and 588.31 implementing the suicide prevention 588.32 plan according to Minnesota Statutes, 588.33 section 145.56, subdivisions 1, 3, 4, 588.34 and 5. 588.35 (2) $825,000 each fiscal year is to 588.36 fund community-based programs under 588.37 Minnesota Statutes, section 145.56, 588.38 subdivision 2. 588.39 [TANF HOME VISITING PROGRAM.] Of the 588.40 federal TANF appropriation, $10,000,000 588.41 in fiscal year 2002 and $10,000,000 in 588.42 fiscal year 2003 are for family home 588.43 visiting programs under Minnesota 588.44 Statutes, section 145A.17. These 588.45 amounts include $7,000,000 in fiscal 588.46 year 2002 and $7,000,000 in fiscal year 588.47 2003 of appropriations to the 588.48 commissioner of human services for 588.49 transfer to the commissioner of health 588.50 authorized in Laws 2000, chapter 488, 588.51 article 13, section 15, subdivision 6, 588.52 clause (3), as amended by Laws 2000, 588.53 chapter 499, sections 22 and 39. 588.54 [TANF HOME VISITING CARRYFORWARD.] Any 588.55 unexpended balance of the TANF funds 588.56 appropriated for family home visiting 588.57 in the first year of the biennium does 588.58 not cancel but is available for the 588.59 second year. 588.60 [TEEN PREGNANCY PREVENTION 588.61 CARRYFORWARD.] Any unexpended balance 588.62 of the TANF funds appropriated for teen 588.63 pregnancy prevention in the first 588.64 fiscal year of the biennium does not 589.1 cancel but is available for the second 589.2 year. 589.3 [WIC TRANSFERS.] The general fund 589.4 appropriation for the women, infants, 589.5 and children (WIC) food supplement 589.6 program is available for either year of 589.7 the biennium. Transfers of these funds 589.8 between fiscal years must be either to 589.9 maximize federal funds or to minimize 589.10 fluctuations in the number of program 589.11 participants. 589.12 [MINNESOTA CHILDREN WITH SPECIAL HEALTH 589.13 NEEDS CARRYFORWARD.] General fund 589.14 appropriations for treatment services 589.15 in the services for Minnesota children 589.16 with special health needs program are 589.17 available for either year of the 589.18 biennium. 589.19 [ONE-TIME REDUCTION FOR FAMILY PLANNING 589.20 SPECIAL PROJECT GRANTS.] For fiscal 589.21 year 2003, base-level funding for the 589.22 Family Planning Special Project Grants 589.23 under Minnesota Statutes, section 589.24 145.925, shall be reduced by $690,000. 589.25 Subd. 3. Access and Quality 589.26 Improvement 31,284,000 30,268,000 589.27 Summary by Fund 589.28 General 21,160,000 20,194,000 589.29 State Government 589.30 Special Revenue 6,952,000 6,902,000 589.31 Health Care 589.32 Access 3,172,000 3,172,000 589.33 [HEALTH CARE SAFETY NET.] (1) Of the 589.34 general fund appropriation, $5,000,000 589.35 each year is for a grant program to aid 589.36 safety net community clinics. 589.37 (2) $5,000,000 each year is for a grant 589.38 program to provide rural hospital 589.39 capital improvement grants described in 589.40 Minnesota Statutes, section 144.148. 589.41 [LICENSE FEES.] Notwithstanding the 589.42 provisions of Minnesota Statutes, 589.43 sections 144.122, 144.53, and 144A.07, 589.44 a health care facility licensed under 589.45 the provisions of Minnesota Statutes, 589.46 chapter 144 or 144A, may submit the 589.47 required fee for licensure renewal in 589.48 quarterly installments. Any health 589.49 care facility requesting to pay the 589.50 renewal fees in quarterly payments 589.51 shall make the request at the time of 589.52 license renewal. Facilities licensed 589.53 under the provisions of Minnesota 589.54 Statutes, chapter 144, shall submit 589.55 quarterly payments by January 1, April 589.56 1, July 1, and October 1 of each year. 589.57 Nursing homes licensed under Minnesota 589.58 Statutes, chapter 144A, shall submit 589.59 the first quarterly payment with the 589.60 application for renewal, and the 590.1 remaining payments shall be submitted 590.2 at three-month intervals from the 590.3 license expiration date. The 590.4 commissioner of health can require full 590.5 payment of any outstanding balance if a 590.6 quarterly payment is late. Full 590.7 payment of the annual renewal fee will 590.8 be required in the event that the 590.9 facility is sold or ceases operation 590.10 during the licensure year. Failure to 590.11 pay the licensure fee is grounds for 590.12 the nonrenewal of the license. 590.13 Subd. 4. Health Protection 29,808,000 30,639,000 590.14 Summary by Fund 590.15 General 13,699,000 13,895,000 590.16 State Government 590.17 Special Revenue 16,109,000 16,744,000 590.18 [EMERGING HEALTH THREATS.] (a) Of the 590.19 general fund appropriation, $2,200,000 590.20 in the first year and $2,400,000 in the 590.21 second year are to increase the state 590.22 capacity to identify and respond to 590.23 emerging health threats. 590.24 (b) Of these amounts, $1,900,000 in the 590.25 first year and $2,100,000 in the second 590.26 year are to expand state laboratory 590.27 capacity to identify infectious disease 590.28 organisms, evaluate environmental 590.29 contaminants, develop new analytical 590.30 techniques, provide emergency response, 590.31 and support local government by 590.32 training health care system workers to 590.33 deal with biological and chemical 590.34 health threats. 590.35 (c) $300,000 each year is to train, 590.36 consult, and otherwise assist local 590.37 officials responding to clandestine 590.38 drug laboratories and minimizing health 590.39 risks to responders and the public. 590.40 Subd. 5. Management and 590.41 Support Services 4,964,000 4,962,000 590.42 Summary by Fund 590.43 General 4,817,000 4,815,000 590.44 State Government 590.45 Special Revenue 147,000 147,000 590.46 Sec. 4. VETERANS NURSING 590.47 HOMES BOARD 30,943,000 30,019,000 590.48 [VETERANS HOME RATE INCREASE.] Of the 590.49 general fund appropriation, $607,000 in 590.50 fiscal year 2002 and $1,235,000 in 590.51 fiscal year 2003 is for a base 590.52 adjustment for salary and benefits for 590.53 employees of the veterans nursing homes 590.54 board. 590.55 [VETERANS HOMES SPECIAL REVENUE 590.56 ACCOUNT.] The general fund 590.57 appropriations made to the board may be 591.1 transferred to a veterans homes special 591.2 revenue account in the special revenue 591.3 fund in the same manner as other 591.4 receipts are deposited according to 591.5 Minnesota Statutes, section 198.34, and 591.6 are appropriated to the board for the 591.7 operation of board facilities and 591.8 programs. 591.9 [SETTING COST OF CARE.] The cost of 591.10 care for the domiciliary residents at 591.11 the Minneapolis veterans home for 591.12 fiscal year 2002 and fiscal year 2003 591.13 shall be calculated based on 100 591.14 percent occupancy at each facility. 591.15 [DEFICIENCY FUNDING.] Of the general 591.16 fund appropriation in fiscal year 2002, 591.17 $2,000,000 is available with the 591.18 approval of the commissioner of 591.19 finance. Approval of the commissioner 591.20 of finance is contingent upon review of 591.21 the board's submittal of a report 591.22 outlining the following: 591.23 (1) a long-term revenue outlook for the 591.24 homes; 591.25 (2) a review and recommendation of 591.26 alternative funding sources for the 591.27 homes' operations; and 591.28 (3) administrative and service options 591.29 to bring cost growth in line with 591.30 revenues. 591.31 Sec. 5. HEALTH-RELATED BOARDS 591.32 Subdivision 1. Total 591.33 Appropriation 10,800,000 10,892,000 591.34 [STATE GOVERNMENT SPECIAL REVENUE 591.35 FUND.] The appropriations in this 591.36 section are from the state government 591.37 special revenue fund. 591.38 [NO SPENDING IN EXCESS OF REVENUES.] 591.39 The commissioner of finance shall not 591.40 permit the allotment, encumbrance, or 591.41 expenditure of money appropriated in 591.42 this section in excess of the 591.43 anticipated biennial revenues or 591.44 accumulated surplus revenues from fees 591.45 collected by the boards. Neither this 591.46 provision nor Minnesota Statutes, 591.47 section 214.06, applies to transfers 591.48 from the general contingent account. 591.49 Subd. 2. Board of Chiropractic 591.50 Examiners 361,000 361,000 591.51 Subd. 3. Board of Dentistry 806,000 806,000 591.52 Subd. 4. Board of Dietetic 591.53 and Nutrition Practice 95,000 95,000 591.54 Subd. 5. Board of Marriage and 591.55 Family Therapy 111,000 111,000 591.56 Subd. 6. Board of Medical 591.57 Practice 3,270,000 3,270,000 592.1 Subd. 7. Board of Nursing 2,704,000 2,772,000 592.2 [HEALTH PROFESSIONAL SERVICES 592.3 ACTIVITY.] Of these appropriations, 592.4 $534,000 in fiscal year 2002 and 592.5 $566,000 in fiscal year 2003 are for 592.6 the Health Professional Services 592.7 Activity. 592.8 Subd. 8. Board of Nursing 592.9 Home Administrators 194,000 186,000 592.10 Subd. 9. Board of Optometry 90,000 90,000 592.11 Subd. 10. Board of Pharmacy 1,301,000 1,316,000 592.12 [ADMINISTRATIVE SERVICES UNIT.] Of this 592.13 appropriation, $433,000 the first year 592.14 and $441,000 the second year are for 592.15 the health boards administrative 592.16 services unit. The administrative 592.17 services unit may receive and expend 592.18 reimbursements for services performed 592.19 for other agencies. 592.20 Subd. 11. Board of Physical Therapy 185,000 185,000 592.21 Subd. 12. Board of Podiatry 52,000 42,000 592.22 Subd. 13. Board of Psychology 653,000 647,000 592.23 Subd. 14. Board of Social Work 825,000 832,000 592.24 Subd. 15. Board of Veterinary 592.25 Medicine 153,000 179,000 592.26 Sec. 6. EMERGENCY MEDICAL 592.27 SERVICES BOARD 3,033,000 3,037,000 592.28 Summary by Fund 592.29 General 3,033,000 3,037,000 592.30 [COMPREHENSIVE ADVANCED LIFE SUPPORT 592.31 (CALS).] $500,000 in fiscal year 2002 592.32 and $500,000 in fiscal year 2003 are 592.33 for the comprehensive advanced life 592.34 support educational program under 592.35 Minnesota Statutes, section 144E.37. 592.36 Sec. 7. COUNCIL ON DISABILITY 692,000 714,000 592.37 Sec. 8. OMBUDSMAN FOR MENTAL 592.38 HEALTH AND MENTAL RETARDATION 1,378,000 1,378,000 592.39 Sec. 9. OMBUDSMAN 592.40 FOR FAMILIES 171,000 171,000 592.41 Sec. 10. TRANSFERS 592.42 Subdivision 1. Grants 592.43 The commissioner of human services, 592.44 with the approval of the commissioner 592.45 of finance, and after notification of 592.46 the chair of the senate health and 592.47 family security budget division and the 592.48 chair of the house health and human 592.49 services finance committee, may 592.50 transfer unencumbered appropriation 593.1 balances for the biennium ending June 593.2 30, 2003, within fiscal years among the 593.3 MFIP, general assistance, general 593.4 assistance medical care, medical 593.5 assistance, Minnesota supplemental aid, 593.6 and group residential housing programs, 593.7 and the entitlement portion of the 593.8 chemical dependency consolidated 593.9 treatment fund, and between fiscal 593.10 years of the biennium. 593.11 Subd. 2. Administration 593.12 Positions, salary money, and nonsalary 593.13 administrative money may be transferred 593.14 within the departments of human 593.15 services and health and within the 593.16 programs operated by the veterans 593.17 nursing homes board as the 593.18 commissioners and the board consider 593.19 necessary, with the advance approval of 593.20 the commissioner of finance. The 593.21 commissioner or the board shall inform 593.22 the chairs of the house health and 593.23 human services finance committee and 593.24 the senate health and family security 593.25 budget division quarterly about 593.26 transfers made under this provision. 593.27 Sec. 11. INDIRECT COSTS NOT TO 593.28 FUND PROGRAMS. 593.29 The commissioners of health and of 593.30 human services shall not use indirect 593.31 cost allocations to pay for the 593.32 operational costs of any program for 593.33 which they are responsible. 593.34 Sec. 12. CARRYOVER LIMITATION 593.35 None of the appropriations in this 593.36 article which are allowed to be carried 593.37 forward from fiscal year 2002 to fiscal 593.38 year 2003 shall become part of the base 593.39 level funding for the 2004-2005 593.40 biennial budget, unless specifically 593.41 directed by the legislature. 593.42 Sec. 13. SUNSET OF UNCODIFIED LANGUAGE 593.43 All uncodified language contained in 593.44 this article expires on June 30, 2003, 593.45 unless a different expiration date is 593.46 explicit. 593.47 Sec. 14. FINANCIAL ADJUSTMENTS AND DIRECT CARE 593.48 STAFF OR SERVICES 593.49 The commissioners of health and of 593.50 human services, in making agency 593.51 financial adjustments related to 593.52 funding levels for salary supplements 593.53 and rent increases, shall not layoff 593.54 employees providing direct health care 593.55 or mental health services to patients, 593.56 or reduce the level of funding for the 593.57 provision of direct health care and 593.58 mental health services. 593.59 Sec. 15. Minnesota Statutes 2000, section 13B.06, 594.1 subdivision 4, is amended to read: 594.2 Subd. 4. [METHOD TO PROVIDE DATA.] To comply with the 594.3 requirements of this section, a financial institutionmay either:594.4(1) provide to the public authority a list containing only594.5the names and other necessary personal identifying information594.6of all account holders for the public authority to compare594.7against its list of child support obligors for the purpose of594.8identifying which obligors maintain an account at the financial594.9institution; the names of the obligors who maintain an account594.10at the institution shall then be transmitted to the financial594.11institution which shall provide the public authority with594.12account information on those obligors; or594.13(2)must obtain a list of child support obligors from the 594.14 public authority and compare that data to the data maintained at 594.15 the financial institution to identify which of the identified 594.16 obligors maintains an account at the financial institution. 594.17A financial institution shall elect either method in594.18writing upon written request of the public authority, and the594.19election remains in effect unless the public authority agrees in594.20writing to a change.594.21The commissioner shall keep track of the number of594.22financial institutions that elect to report under clauses (1)594.23and (2) respectively and shall report this information to the594.24legislature by December 1, 1999.594.25 Sec. 16. [246.141] [PROJECT LABOR.] 594.26 Wages for project labor may be paid by the commissioner out 594.27 of repairs and betterments money if the individual is to be 594.28 engaged in a construction project or a repair project of 594.29 short-term and nonrecurring nature. Compensation for project 594.30 labor shall be based on the prevailing wage rates, as defined in 594.31 section 177.42, subdivision 6. Project laborers are excluded 594.32 from the provisions of sections 43A.22 to 43A.30, and shall not 594.33 be eligible for state-paid insurance and benefits. 594.34 Sec. 17. [EXCHANGE OF RECORDS BETWEEN DEPARTMENT OF HEALTH 594.35 AND DEPARTMENT OF HUMAN SERVICES.] 594.36 The commissioners of health and human services shall 595.1 exchange birth record data and data contained in recognitions of 595.2 parentage for the purpose of identifying a child who is subject 595.3 to threatened injury by a person responsible for a child's care 595.4 to the extent possible using existing resources and information 595.5 systems.