1.1                          A bill for an act 
  1.2             relating to human services; amending provisions 
  1.3             relating to special education; modifying consent 
  1.4             requirements for billing medical assistance and 
  1.5             MinnesotaCare for covered individual education plan 
  1.6             services; amending Minnesota Statutes 2000, sections 
  1.7             125A.03; 125A.21, subdivision 2; 125A.27, subdivision 
  1.8             10; 125A.43; 125A.76, subdivision 7; 256B.0625, 
  1.9             subdivision 26; Minnesota Statutes 2001 Supplement, 
  1.10            section 125A.09, subdivision 3; proposing coding for 
  1.11            new law in Minnesota Statutes, chapter 125A. 
  1.12  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.13     Section 1.  [125A.021] [DEPARTMENT DUTY.] 
  1.14     The department of children, families, and learning shall 
  1.15  enforce all federal and state laws, federal regulations, and 
  1.16  state rules for special education. 
  1.17     Sec. 2.  Minnesota Statutes 2000, section 125A.03, is 
  1.18  amended to read: 
  1.19     125A.03 [SPECIAL INSTRUCTION FOR CHILDREN WITH A 
  1.20  DISABILITY.] 
  1.21     (a) As defined in paragraph (b), every district or other 
  1.22  entity providing public education must provide special 
  1.23  instruction and a free appropriate public education through 
  1.24  specialized instruction and related services, either within the 
  1.25  district or in another district, for all children with a 
  1.26  disability who are residents of the district and who are 
  1.27  disabled as set forth in section 125A.02 in conformance with 
  1.28  sections 121A.40 to 121A.56. 
  2.1      (b) Notwithstanding any age limits in laws to the contrary, 
  2.2   special instruction and related services must be provided from 
  2.3   birth until July 1 after the child with a disability becomes 21 
  2.4   years old but shall not extend beyond secondary school or its 
  2.5   equivalent, except as provided in section 124D.68, subdivision 
  2.6   2.  Local health, education, and social service agencies must 
  2.7   refer children under age five who are known to need or suspected 
  2.8   of needing special instruction and services to the school 
  2.9   district.  Districts with less than the minimum number of 
  2.10  eligible children with a disability as determined by the 
  2.11  commissioner must cooperate with other districts to maintain a 
  2.12  full range of programs for education and services for children 
  2.13  with a disability.  This section does not alter the compulsory 
  2.14  attendance requirements of section 120A.22. 
  2.15     Sec. 3.  Minnesota Statutes 2001 Supplement, section 
  2.16  125A.09, subdivision 3, is amended to read: 
  2.17     Subd. 3.  [INITIAL ACTION; PARENT CONSENT.] (a) The 
  2.18  district must not proceed with the initial formal assessment of 
  2.19  a child, the initial placement of a child in a special education 
  2.20  program, or the initial provision of special education services 
  2.21  for a child without the prior written consent of the child's 
  2.22  parent or guardian.  The refusal of a parent or guardian to 
  2.23  consent to an initial evaluation or reevaluation may be 
  2.24  overridden by the decision in a hearing held pursuant to 
  2.25  subdivision 6 at the district's initiative. 
  2.26     (b) A parent, after consulting with health care, education, 
  2.27  or other professional providers, may agree or disagree to 
  2.28  provide the parent's child with sympathomimetic medications 
  2.29  unless section 144.344 applies. 
  2.30     Sec. 4.  Minnesota Statutes 2000, section 125A.21, 
  2.31  subdivision 2, is amended to read: 
  2.32     Subd. 2.  [THIRD PARTY REIMBURSEMENT.] (a) Beginning July 
  2.33  1, 2000, districts shall seek reimbursement from insurers and 
  2.34  similar third parties for the cost of services provided by the 
  2.35  district whenever the services provided by the district are 
  2.36  otherwise covered by the child's health coverage.  Districts 
  3.1   shall request, but may not require, the child's family to 
  3.2   provide information about the child's health coverage when a 
  3.3   child with a disability begins to receive services from the 
  3.4   district of a type that may be reimbursable, and shall request, 
  3.5   but may not require, updated information after that as needed.  
  3.6      (b) For children enrolled in medical assistance under 
  3.7   chapter 256B or MinnesotaCare under chapter 256L who have no 
  3.8   other health coverage, a district shall provide an initial 
  3.9   written notice to the enrolled child's parent or legal 
  3.10  representative of its intent to seek reimbursement from medical 
  3.11  assistance or MinnesotaCare for the individual education plan 
  3.12  health-related services provided by the district. 
  3.13     (c) The district shall give the parent or legal 
  3.14  representative annual written notice of: 
  3.15     (1) the district's intent to seek reimbursement from 
  3.16  medical assistance or MinnesotaCare for individual education 
  3.17  plan health-related services provided by the district; 
  3.18     (2) the right of the parent or legal representative to 
  3.19  request a copy of all records concerning individual education 
  3.20  plan health-related services disclosed by the district to any 
  3.21  third party; and 
  3.22     (3) the right of the parent or legal representative to 
  3.23  withdraw consent for disclosure of a child's records at any time 
  3.24  without consequence. 
  3.25  The written notice shall be provided as part of the written 
  3.26  notice required by Code of Federal Regulations, title 34, 
  3.27  section 300.503. 
  3.28     Districts shall request, but may not require, the child's 
  3.29  parent or legal representative to sign a consent form, 
  3.30  permitting the school district to apply for and receive 
  3.31  reimbursement directly from the insurer or other similar third 
  3.32  party, to the extent permitted by the insurer or other third 
  3.33  party and subject to their networking credentialing, prior 
  3.34  authorization, and determination of medical necessity criteria. 
  3.35     (d) When a district proposes to access the private health 
  3.36  care coverage of a child who is covered by private health care 
  4.1   coverage in whole or in part, the district must: 
  4.2      (1) obtain written informed consent from the parent or 
  4.3   legal representative, in compliance with subdivision 5; and 
  4.4      (2) inform the parent or legal representative that a 
  4.5   refusal to permit the district or state Medicaid agency to 
  4.6   access their private health care coverage does not relieve the 
  4.7   district of its responsibility to provide all services necessary 
  4.8   to provide free and appropriate public education at no cost to 
  4.9   the parent or legal representative. 
  4.10     (e) If the commissioner of human services obtains federal 
  4.11  approval to exempt covered individual education plan 
  4.12  health-related services from the requirement that private health 
  4.13  care coverage refuse payment before medical assistance may be 
  4.14  billed, paragraphs (b), (c), and (d) shall also apply to 
  4.15  students with a combination of private health care coverage and 
  4.16  health care coverage through medical assistance or MinnesotaCare.
  4.17     (f) In the event that Congress or any federal agency or the 
  4.18  Minnesota legislature or any state agency establishes lifetime 
  4.19  limits, limits for any health care services, cost-sharing 
  4.20  provisions, or otherwise provides that individual education plan 
  4.21  health-related services impact benefits for persons enrolled in 
  4.22  medical assistance or MinnesotaCare, the amendments to this 
  4.23  subdivision adopted in 2002 are repealed on the effective date 
  4.24  of any federal or state law or regulation that imposes the 
  4.25  limits.  In that event, districts must obtain informed consent 
  4.26  consistent with this subdivision as it existed prior to the 2002 
  4.27  amendments and subdivision 5, before seeking reimbursement for 
  4.28  children enrolled in medical assistance under Minnesota 
  4.29  Statutes, section 256B.055, or MinnesotaCare under Minnesota 
  4.30  Statutes, chapter 256L, who have no other health care coverage. 
  4.31     Sec. 5.  Minnesota Statutes 2000, section 125A.27, 
  4.32  subdivision 10, is amended to read: 
  4.33     Subd. 10.  [INDIVIDUALIZED FAMILY SERVICE PLAN.] 
  4.34  "Individualized family service plan" or "IFSP" means a written 
  4.35  plan for providing services to a child age birth to three years 
  4.36  and the child's family.  
  5.1      Sec. 6.  Minnesota Statutes 2000, section 125A.43, is 
  5.2   amended to read: 
  5.3      125A.43 [MEDIATION PROCEDURE.] 
  5.4      (a) The commissioner, or the commissioner's designee, of 
  5.5   the state lead agency must use federal funds to provide 
  5.6   mediation for the activities in paragraphs (b) and (c). 
  5.7      (b) A parent may resolve a dispute regarding issues in 
  5.8   section 125A.42, paragraph (b), clause (5), through mediation.  
  5.9   If the parent chooses mediation, all public agencies involved in 
  5.10  the dispute must participate in the mediation process mediation 
  5.11  must be voluntary on the part of all parties.  The parent and 
  5.12  the public agencies must complete the mediation process within 
  5.13  30 calendar days of the date the office of dispute resolution 
  5.14  receives a parent's written request for mediation.  The 
  5.15  mediation process may not be used to delay a parent's right to a 
  5.16  due process hearing.  The resolution of the mediation is not 
  5.17  binding on any party. 
  5.18     (c) Resolution of a dispute through mediation, or other 
  5.19  form of alternative dispute resolution, is not limited to formal 
  5.20  disputes arising from the objection of a parent or guardian and 
  5.21  is not limited to the period following a request for a due 
  5.22  process hearing. 
  5.23     (d) The commissioner shall provide training and resources 
  5.24  to school districts to facilitate early identification of 
  5.25  disputes and access to mediation. 
  5.26     (e) The local primary agency may request mediation on 
  5.27  behalf of involved agencies when there are disputes between 
  5.28  agencies regarding responsibilities to coordinate, provide, pay 
  5.29  for, or facilitate payment for early intervention services. 
  5.30     Sec. 7.  Minnesota Statutes 2000, section 125A.76, 
  5.31  subdivision 7, is amended to read: 
  5.32     Subd. 7.  [REVENUE ALLOCATION FROM COOPERATIVE CENTERS AND 
  5.33  INTERMEDIATES.] For the purposes of this section, a special 
  5.34  education cooperative, a service cooperative, an education 
  5.35  district, or an intermediate district must allocate its approved 
  5.36  expenditures for special education programs among participating 
  6.1   school districts. 
  6.2      Sec. 8.  Minnesota Statutes 2000, section 256B.0625, 
  6.3   subdivision 26, is amended to read: 
  6.4      Subd. 26.  [SPECIAL EDUCATION SERVICES.] (a) Medical 
  6.5   assistance covers medical services identified in a recipient's 
  6.6   individualized education plan and covered under the medical 
  6.7   assistance state plan.  Covered services include occupational 
  6.8   therapy, physical therapy, speech-language therapy, clinical 
  6.9   psychological services, nursing services, school psychological 
  6.10  services, school social work services, personal care assistants 
  6.11  serving as management aides, assistive technology devices, 
  6.12  transportation services, health assessments, and other services 
  6.13  covered under the medical assistance state plan.  Mental health 
  6.14  services eligible for medical assistance reimbursement must be 
  6.15  provided or coordinated through a children's mental health 
  6.16  collaborative where a collaborative exists if the child is 
  6.17  included in the collaborative operational target population.  
  6.18  The provision or coordination of services does not require that 
  6.19  the individual education plan be developed by the collaborative. 
  6.20     The services may be provided by a Minnesota school district 
  6.21  that is enrolled as a medical assistance provider or its 
  6.22  subcontractor, and only if the services meet all the 
  6.23  requirements otherwise applicable if the service had been 
  6.24  provided by a provider other than a school district, in the 
  6.25  following areas:  medical necessity, physician's orders, 
  6.26  documentation, personnel qualifications, and prior authorization 
  6.27  requirements.  The nonfederal share of costs for services 
  6.28  provided under this subdivision is the responsibility of the 
  6.29  local school district as provided in section 125A.74.  Services 
  6.30  listed in a child's individual education plan are eligible for 
  6.31  medical assistance reimbursement only if those services meet 
  6.32  criteria for federal financial participation under the Medicaid 
  6.33  program.  
  6.34     (b) Approval of health-related services for inclusion in 
  6.35  the individual education plan does not require prior 
  6.36  authorization for purposes of reimbursement under this chapter.  
  7.1   The commissioner may require physician review and approval of 
  7.2   the plan not more than once annually or upon any modification of 
  7.3   the individual education plan that reflects a change in 
  7.4   health-related services. 
  7.5      (c) Services of a speech-language pathologist provided 
  7.6   under this section are covered notwithstanding Minnesota Rules, 
  7.7   part 9505.0390, subpart 1, item L, if the person: 
  7.8      (1) holds a masters degree in speech-language pathology; 
  7.9      (2) is licensed by the Minnesota board of teaching as an 
  7.10  educational speech-language pathologist; and 
  7.11     (3) either has a certificate of clinical competence from 
  7.12  the American Speech and Hearing Association, has completed the 
  7.13  equivalent educational requirements and work experience 
  7.14  necessary for the certificate or has completed the academic 
  7.15  program and is acquiring supervised work experience to qualify 
  7.16  for the certificate. 
  7.17     (d) Medical assistance coverage for medically necessary 
  7.18  services provided under other subdivisions in this section may 
  7.19  not be denied solely on the basis that the same or similar 
  7.20  services are covered under this subdivision. 
  7.21     (e) The commissioner shall develop and implement package 
  7.22  rates, bundled rates, or per diem rates for special education 
  7.23  services under which separately covered services are grouped 
  7.24  together and billed as a unit in order to reduce administrative 
  7.25  complexity.  
  7.26     (f) The commissioner shall develop a cost-based payment 
  7.27  structure for payment of these services.  
  7.28     (g) Effective July 1, 2000, medical assistance services 
  7.29  provided under an individual education plan or an individual 
  7.30  family service plan by local school districts shall not count 
  7.31  against medical assistance authorization thresholds for that 
  7.32  child. 
  7.33     (h) Nursing services as defined in section 148.171, 
  7.34  subdivision 15, and provided as an individual education plan 
  7.35  health-related service, are eligible for medical assistance 
  7.36  payment if they are otherwise a covered service in the medical 
  8.1   assistant program. 
  8.2      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
  8.3   following final enactment. 
  8.4      Sec. 9.  [COMMISSIONER DUTIES.] 
  8.5      By January 15, 2003, the commissioner of human services 
  8.6   shall propose a fixed billing process for special education 
  8.7   transportation services on a per-trip or per-day rate based on 
  8.8   actual cost data for consideration for implementation beginning 
  8.9   in the 2003-2004 school year.