3rd 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 for 1.3 certain government data; modifying the Human Services 1.4 Licensing Act; modifying certain hearing provisions; 1.5 modifying provisions for reporting maltreatment of 1.6 minors and vulnerable adults; modifying continuing 1.7 care provisions; modifying moratorium provisions on 1.8 certification of nursing home beds; modifying 1.9 eligibility for transition planning grants; providing 1.10 for optional registration as housing with services 1.11 establishment; modifying case manager continuing 1.12 education requirements; modifying provisions for 1.13 interstate contracts for mental health services; 1.14 modifying commissioner's authority to administer a 1.15 supplemental drug rebate program; designating state 1.16 agent to carry out responsibilities under the Ryan 1.17 White Comprehensive AIDS Resources Emergency Act; 1.18 allowing certain nursing homes to elect to participate 1.19 in the medical assistance program; modifying medical 1.20 assistance provisions; modifying group residential 1.21 housing provisions; modifying MinnesotaCare 1.22 provisions; modifying prior appropriations; providing 1.23 for the use of certain grants to develop certain 1.24 housing options; providing for deaf-blind services; 1.25 modifying provisions for funding medical education; 1.26 providing for special education; providing for 1.27 identification of certain deceased individuals; 1.28 modifying provisions for rural hospital capital 1.29 improvement grants; modifying provisions for costs 1.30 associated with patient records; requiring legislative 1.31 approval of Clean Indoor Air Act rules; modifying 1.32 acupuncture provisions; modifying provisions for 1.33 county relief of the poor; requiring studies, reports, 1.34 and recommendations; appropriating money; amending 1.35 Minnesota Statutes 2000, sections 13.41, subdivision 1.36 1; 13.46, subdivision 3; 62J.692, subdivision 4, as 1.37 amended; 125A.76, subdivision 5; 144.05, by adding a 1.38 subdivision; 144.335, subdivision 5; 144.417, 1.39 subdivision 1; 144D.01, subdivision 4; 147B.02, 1.40 subdivision 9; 245.462, subdivision 4; 245.4871, 1.41 subdivision 4; 245.50, subdivisions 1, 2, 5; 245A.02, 1.42 by adding subdivisions; 245A.035, subdivision 3; 1.43 245A.04, by adding a subdivision; 256.01, by adding a 1.44 subdivision; 256.9657, subdivision 1, as amended; 1.45 256B.0625, subdivisions 26, as amended, 35, by adding 1.46 a subdivision; 256B.0915, subdivisions 4, 6, by adding 2.1 a subdivision; 256B.19, subdivision 1, as amended; 2.2 256B.431, subdivisions 14, 30; 256B.5012, subdivision 2.3 2; 256B.69, subdivision 5a, as amended; 256I.04, 2.4 subdivision 2a; 256L.12, subdivision 9, as amended; 2.5 261.063; 626.557, subdivision 3a; Minnesota Statutes 2.6 2001 Supplement, sections 13.46, subdivisions 1, 4; 2.7 125A.515; 144.148, subdivision 2; 144A.071, 2.8 subdivision 1a; 144A.36, subdivision 1; 149A.90, 2.9 subdivision 1; 245A.03, subdivision 2; 245A.04, 2.10 subdivisions 3, 3a, 3b; 245A.07, subdivisions 2a, 3; 2.11 245A.144; 245A.16, subdivision 1; 256.01, subdivision 2.12 2, as amended; 256.045, subdivisions 3b, 4; 256B.0625, 2.13 subdivision 13, as amended; 256B.0627, subdivision 10; 2.14 256B.0911, subdivisions 4b, 4d; 256B.0913, 2.15 subdivisions 4, 5, 8, 10, 12, 14; 256B.0915, 2.16 subdivisions 3, 5; 256B.0924, subdivision 6; 2.17 256B.0951, subdivisions 7, 8; 256B.431, subdivisions 2.18 2e, 33; 256B.437, subdivisions 3, 6; 256B.438, 2.19 subdivision 1; 256B.76; 626.556, subdivision 10i; 2.20 626.557, subdivision 9d; Laws 2002, chapter 220, 2.21 article 17, section 2, subdivision 6; proposing coding 2.22 for new law in Minnesota Statutes, chapters 144D; 2.23 245A; repealing Minnesota Statutes 2000, section 2.24 147B.01, subdivisions 8, 15; Minnesota Statutes 2001 2.25 Supplement, section 256B.0621, subdivision 1. 2.26 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 2.27 ARTICLE 1 2.28 LICENSING 2.29 Section 1. Minnesota Statutes 2000, section 13.41, 2.30 subdivision 1, is amended to read: 2.31 Subdivision 1. [DEFINITION.] As used in this section 2.32 "licensing agency" means any board, department or agency of this 2.33 state which is given the statutory authority to issue 2.34 professional or other types of licenses, except the various 2.35 agencies primarily administered by the commissioner of human 2.36 services. Data pertaining to persons or agencies licensed or 2.37 registered under authority of the commissioner of human services 2.38 shall be administered pursuant to section 13.46
, subdivision 4. 2.39 Sec. 2. Minnesota Statutes 2001 Supplement, section 13.46, 2.40 subdivision 1, is amended to read: 2.41 Subdivision 1. [DEFINITIONS.] As used in this section: 2.42 (a) "Individual" means an individual according to section 2.43 13.02, subdivision 8, but does not include a vendor of services. 2.44 (b) "Program" includes all programs for which authority is 2.45 vested in a component of the welfare system according to statute 2.46 or federal law, including, but not limited to, the aid to 2.47 families with dependent children program formerly codified in 2.48 sections 256.72 to 256.87, Minnesota Family Investment Program, 3.1 medical assistance, general assistance, general assistance 3.2 medical care, and child support collections. 3.3 (c) "Welfare system" includes the department of human 3.4 services, local social services agencies, county welfare 3.5 agencies, private licensing agencies, the public authority 3.6 responsible for child support enforcement, human services 3.7 boards, community mental health center boards, state hospitals, 3.8 state nursing homes, the ombudsman for mental health and mental 3.9 retardation, and persons, agencies, institutions, organizations, 3.10 and other entities under contract to any of the above agencies 3.11 to the extent specified in the contract. 3.12 (d) "Mental health data" means data on individual clients 3.13 and patients of community mental health centers, established 3.14 under section 245.62, mental health divisions of counties and 3.15 other providers under contract to deliver mental health 3.16 services, or the ombudsman for mental health and mental 3.17 retardation. 3.18 (e) "Fugitive felon" means a person who has been convicted 3.19 of a felony and who has escaped from confinement or violated the 3.20 terms of probation or parole for that offense. 3.21 (f) "Private licensing agency" means an agency licensed by 3.22 the commissioner of human services under chapter 245A to perform 3.23 the duties under section 245A.16. 3.24 Sec. 3. Minnesota Statutes 2000, section 13.46, 3.25 subdivision 3, is amended to read: 3.26 Subd. 3. [INVESTIGATIVE DATA.] (a) Data on persons, 3.27 including data on vendors of services and data on licensees, 3.28 that is collected, maintained, used, or disseminated by the 3.29 welfare system in an investigation, authorized by statute and 3.30 relating to the enforcement of rules or law, is confidential 3.31 data on individuals pursuant to section 13.02, subdivision 3, or 3.32 protected nonpublic data not on individuals pursuant to section 3.33 13.02, subdivision 13, and shall not be disclosed except: 3.34 (a)(1) pursuant to section 13.05; 3.35 (b)(2) pursuant to statute or valid court order; 3.36 (c)(3) to a party named in a civil or criminal proceeding, 4.1 administrative or judicial, for preparation of defense; or 4.2 (d)(4) to provide notices required or permitted by statute. 4.3 The data referred to in this subdivision shall be 4.4 classified as public data upon its submission to an 4.5 administrative law judge or court in an administrative or 4.6 judicial proceeding. Inactive welfare investigative data shall 4.7 be treated as provided in section 13.39, subdivision 3. 4.8 (b) Notwithstanding any other provision in law, the 4.9 commissioner of human services shall provide all active and 4.10 inactive investigative data, including the name of the reporter 4.11 of alleged maltreatment under section 626.556 or 626.557, to the 4.12 ombudsman for mental health and retardation upon the request of 4.13 the ombudsman. 4.14 Sec. 4. Minnesota Statutes 2001 Supplement, section 13.46, 4.15 subdivision 4, is amended to read: 4.16 Subd. 4. [LICENSING DATA.] (a) As used in this subdivision: 4.17 (1) "licensing data" means all data collected, maintained, 4.18 used, or disseminated by the welfare system pertaining to 4.19 persons licensed or registered or who apply for licensure or 4.20 registration or who formerly were licensed or registered under 4.21 the authority of the commissioner of human services; 4.22 (2) "client" means a person who is receiving services from 4.23 a licensee or from an applicant for licensure; and 4.24 (3) "personal and personal financial data" means social 4.25 security numbers, identity of and letters of reference, 4.26 insurance information, reports from the bureau of criminal 4.27 apprehension, health examination reports, and social/home 4.28 studies. 4.29 (b)(1) Except as provided in paragraph (c), the following 4.30 data on current and former licensees are public: name, address, 4.31 telephone number of licensees, date of receipt of a completed 4.32 application, dates of licensure, licensed capacity, type of 4.33 client preferred, variances granted, type of dwelling, name and 4.34 relationship of other family members, previous license history, 4.35 class of license, and the existence and status of complaints. 4.36 When a correction order or fine has been issued, a license is 5.1 suspended, immediately suspended, revoked, denied, or made 5.2 conditional, or a complaint is resolved, the following data on 5.3 current and former licensees are public: the substance and 5.4 investigative findings of the complaint, licensing violation, or 5.5 substantiated maltreatment; the record of informal resolution of 5.6 a licensing violation; orders of hearing; findings of fact; 5.7 conclusions of law; specifications of the final correction 5.8 order, fine, suspension, immediate suspension, revocation, 5.9 denial, or conditional license contained in the record of 5.10 licensing action; and the status of any appeal of these 5.11 actions. When an individual licensee is a substantiated 5.12 perpetrator of maltreatment, and the substantiated maltreatment 5.13 is a reason for the licensing action, the identity of the 5.14 licensee as a perpetrator is public data. For purposes of this 5.15 clause, a person is a substantiated perpetrator if the 5.16 maltreatment determination has been upheld under section 5.17 626.556, subdivision 10i, 626.557, subdivision 9d, or 256.045, 5.18 or an individual or facility has not timely exercised appeal 5.19 rights under these sections. 5.20 (2) For applicants who withdraw their application prior to 5.21 licensure or denial of a license, the following data are 5.22 public: the name of the applicant, the city and county in which 5.23 the applicant was seeking licensure, the dates of the 5.24 commissioner's receipt of the initial application and completed 5.25 application, the type of license sought, and the date of 5.26 withdrawal of the application. 5.27 (3) For applicants who are denied a license, the following 5.28 data are public: the name of the applicant, the city and county 5.29 in which the applicant was seeking licensure, the dates of the 5.30 commissioner's receipt of the initial application and completed 5.31 application, the type of license sought, the date of denial of 5.32 the application, the nature of the basis for the denial, and the 5.33 status of any appeal of the denial. 5.34 (4) The following data on persons subject to 5.35 disqualification under section 245A.04 in connection with a 5.36 license to provide family day care for children, child care 6.1 center services, foster care for children in the provider's 6.2 home, or foster care or day care services for adults in the 6.3 provider's home, are public: the nature of any disqualification 6.4 set aside under section 245A.04, subdivision 3b, and the reasons 6.5 for setting aside the disqualification; and the reasons for 6.6 granting any variance under section 245A.04, subdivision 9. 6.7 (5) When maltreatment is substantiated under section 6.8 626.556 or 626.557 and the victim and the substantiated 6.9 perpetrator are affiliated with a program licensed under chapter 6.10 245A, the commissioner of human services, local social services 6.11 agency, or county welfare agency may inform the license holder 6.12 where the maltreatment occurred of the identity of the 6.13 substantiated perpetrator and the victim. 6.14 (c) The following are private data on individuals under 6.15 section 13.02, subdivision 12, or nonpublic data under section 6.16 13.02, subdivision 9: personal and personal financial data on 6.17 family day care program and family foster care program 6.18 applicants and licensees and their family members who provide 6.19 services under the license. 6.20 (d) The following are private data on individuals: the 6.21 identity of persons who have made reports concerning licensees 6.22 or applicants that appear in inactive investigative data, and 6.23 the records of clients or employees of the licensee or applicant 6.24 for licensure whose records are received by the licensing agency 6.25 for purposes of review or in anticipation of a contested 6.26 matter. The names of reporters under sections 626.556 and 6.27 626.557 may be disclosed only as provided in section 626.556, 6.28 subdivision 11, or 626.557, subdivision 12b. 6.29 (e) Data classified as private, confidential, nonpublic, or 6.30 protected nonpublic under this subdivision become public data if 6.31 submitted to a court or administrative law judge as part of a 6.32 disciplinary proceeding in which there is a public hearing 6.33 concerning a license which has been suspended, immediately 6.34 suspended, revoked, or denied. 6.35 (f) Data generated in the course of licensing 6.36 investigations that relate to an alleged violation of law are 7.1 investigative data under subdivision 3. 7.2 (g) Data that are not public data collected, maintained, 7.3 used, or disseminated under this subdivision that relate to or 7.4 are derived from a report as defined in section 626.556, 7.5 subdivision 2, or 626.5572, subdivision 18, are subject to the 7.6 destruction provisions of sections 626.556, subdivision 11c, and 7.7 626.557, subdivision 12b. 7.8 (h) Upon request, not public data collected, maintained, 7.9 used, or disseminated under this subdivision that relate to or 7.10 are derived from a report of substantiated maltreatment as 7.11 defined in section 626.556 or 626.557 may be exchanged with the 7.12 department of health for purposes of completing background 7.13 studies pursuant to section 144.057 and with the department of 7.14 corrections for purposes of completing background studies 7.15 pursuant to section 241.021. 7.16 (i) Data on individuals collected according to licensing 7.17 activities under chapter 245A, and data on individuals collected 7.18 by the commissioner of human services according to maltreatment 7.19 investigations under sections 626.556 and 626.557, may be shared 7.20 with the department of human rights, the department of health, 7.21 the department of corrections, the ombudsman for mental health 7.22 and retardation, and the individual's professional regulatory 7.23 board when there is reason to believe that laws or standards 7.24 under the jurisdiction of those agencies may have been violated. 7.25 (j) In addition to the notice of determinations required 7.26 under section 626.556, subdivision 10f, if the commissioner or 7.27 the local social services agency has determined that an 7.28 individual is a substantiated perpetrator of maltreatment of a 7.29 child based on sexual abuse, as defined in section 626.556, 7.30 subdivision 2, and the commissioner or local social services 7.31 agency knows that the individual is a person responsible for a 7.32 child's care in another facility, the commissioner or local 7.33 social services agency shall notify the head of that facility of 7.34 this determination. The notification must include an 7.35 explanation of the individual's available appeal rights and the 7.36 status of any appeal. If a notice is given under this 8.1 paragraph, the government entity making the notification shall 8.2 provide a copy of the notice to the individual who is the 8.3 subject of the notice. 8.4 Sec. 5. Minnesota Statutes 2000, section 245A.02, is 8.5 amended by adding a subdivision to read: 8.6 Subd. 2a. [ADULT DAY CARE.] "Adult day care" means a 8.7 program operating less than 24 hours per day that provides 8.8 functionally impaired adults with an individualized and 8.9 coordinated set of services including health services, social 8.10 services, and nutritional services that are directed at 8.11 maintaining or improving the participants' capabilities for 8.12 self-care. Adult day care does not include programs where 8.13 adults gather or congregate primarily for purposes of 8.14 socialization, education, supervision, caregiver respite, 8.15 religious expression, exercise, or nutritious meals. 8.16 Sec. 6. Minnesota Statutes 2000, section 245A.02, is 8.17 amended by adding a subdivision to read: 8.18 Subd. 2b. [ANNUAL OR ANNUALLY.] "Annual" or "annually" 8.19 means prior to or within the same month of the subsequent 8.20 calendar year. 8.21 Sec. 7. Minnesota Statutes 2001 Supplement, section 8.22 245A.03, subdivision 2, is amended to read: 8.23 Subd. 2. [EXCLUSION FROM LICENSURE.] (a) This chapter does 8.24 not apply to: 8.25 (1) residential or nonresidential programs that are 8.26 provided to a person by an individual who is related unless the 8.27 residential program is a child foster care placement made by a 8.28 local social services agency or a licensed child-placing agency, 8.29 except as provided in subdivision 2a; 8.30 (2) nonresidential programs that are provided by an 8.31 unrelated individual to persons from a single related family; 8.32 (3) residential or nonresidential programs that are 8.33 provided to adults who do not abuse chemicals or who do not have 8.34 a chemical dependency, a mental illness, mental retardation or a 8.35 related condition, a functional impairment, or a physical 8.36 handicap; 9.1 (4) sheltered workshops or work activity programs that are 9.2 certified by the commissioner of economic security; 9.3 (5) programs for children enrolled in kindergarten to the 9.4 12th grade and prekindergarten special education in a school as 9.5 defined in section 120A.22, subdivision 4, and programs serving 9.6 children in combined special education and regular 9.7 prekindergarten programs that are operated or assisted by the 9.8 commissioner of children, families, and learning; 9.9 (6) nonresidential programs primarily for children that 9.10 provide care or supervision, without charge for ten or fewer 9.11 days a year, and for periods of less than three hours a day 9.12 while the child's parent or legal guardian is in the same 9.13 building as the nonresidential program or present within another 9.14 building that is directly contiguous to the building in which 9.15 the nonresidential program is located; 9.16 (7) nursing homes or hospitals licensed by the commissioner 9.17 of health except as specified under section 245A.02; 9.18 (8) board and lodge facilities licensed by the commissioner 9.19 of health that provide services for five or more persons whose 9.20 primary diagnosis is mental illness who have refused an 9.21 appropriate residential program offered by a county agency .9.22 This exclusion expires on July 1, 1990; 9.23 (9) homes providing programs for persons placed there by a 9.24 licensed agency for legal adoption, unless the adoption is not 9.25 completed within two years; 9.26 (10) programs licensed by the commissioner of corrections; 9.27 (11) recreation programs for children or adults that 9.28 operate for fewer than 40 calendar days in a calendar year or 9.29 programs operated by a park and recreation board of a city of 9.30 the first class whose primary purpose is to provide social and 9.31 recreational activities to school age children, provided the 9.32 program is approved by the park and recreation board; 9.33 (12) programs operated by a school as defined in section 9.34 120A.22, subdivision 4, whose primary purpose is to provide 9.35 child care to school-age children, provided the program is 9.36 approved by the district's school board; 10.1 (13) Head Start nonresidential programs which operate for 10.2 less than 31 days in each calendar year; 10.3 (14) noncertified boarding care homes unless they provide 10.4 services for five or more persons whose primary diagnosis is 10.5 mental illness or mental retardation; 10.6 (15) nonresidential programs for nonhandicapped children 10.7 provided for a cumulative total of less than 30 days in any 10.8 12-month period; 10.9 (16) residential programs for persons with mental illness, 10.10 that are located in hospitals, until the commissioner adopts 10.11 appropriate rules; 10.12 (17) the religious instruction of school-age children; 10.13 Sabbath or Sunday schools; or the congregate care of children by 10.14 a church, congregation, or religious society during the period 10.15 used by the church, congregation, or religious society for its 10.16 regular worship; 10.17 (18) camps licensed by the commissioner of health under 10.18 Minnesota Rules, chapter 4630; 10.19 (19) mental health outpatient services for adults with 10.20 mental illness or children with emotional disturbance; 10.21 (20) residential programs serving school-age children whose 10.22 sole purpose is cultural or educational exchange, until the 10.23 commissioner adopts appropriate rules; 10.24 (21) unrelated individuals who provide out-of-home respite 10.25 care services to persons with mental retardation or related 10.26 conditions from a single related family for no more than 90 days 10.27 in a 12-month period and the respite care services are for the 10.28 temporary relief of the person's family or legal representative; 10.29 (22) respite care services provided as a home and 10.30 community-based service to a person with mental retardation or a 10.31 related condition, in the person's primary residence; 10.32 (23) community support services programs as defined in 10.33 section 245.462, subdivision 6, and family community support 10.34 services as defined in section 245.4871, subdivision 17; 10.35 (24) the placement of a child by a birth parent or legal 10.36 guardian in a preadoptive home for purposes of adoption as 11.1 authorized by section 259.47; 11.2 (25) settings registered under chapter 144D which provide 11.3 home care services licensed by the commissioner of health to 11.4 fewer than seven adults; or 11.5 (26) consumer-directed community support service funded 11.6 under the Medicaid waiver for persons with mental retardation 11.7 and related conditions when the individual who provided the 11.8 service is: 11.9 (i) the same individual who is the direct payee of these 11.10 specific waiver funds or paid by a fiscal agent, fiscal 11.11 intermediary, or employer of record; and 11.12 (ii) not otherwise under the control of a residential or 11.13 nonresidential program that is required to be licensed under 11.14 this chapter when providing the service. 11.15 (b) For purposes of paragraph (a), clause (6), a building 11.16 is directly contiguous to a building in which a nonresidential 11.17 program is located if it shares a common wall with the building 11.18 in which the nonresidential program is located or is attached to 11.19 that building by skyway, tunnel, atrium, or common roof. 11.20 (c) Nothing in this chapter shall be construed to require 11.21 licensure for any services provided and funded according to an 11.22 approved federal waiver plan where licensure is specifically 11.23 identified as not being a condition for the services and funding. 11.24 Sec. 8. Minnesota Statutes 2000, section 245A.035, 11.25 subdivision 3, is amended to read: 11.26 Subd. 3. [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an 11.27 emergency license may be issued, the following requirements must 11.28 be met: 11.29 (1) the county agency must conduct an initial inspection of 11.30 the premises where the foster care is to be provided to ensure 11.31 the health and safety of any child placed in the home. The 11.32 county agency shall conduct the inspection using a form 11.33 developed by the commissioner; 11.34 (2) at the time of the inspection or placement, whichever 11.35 is earlier, the relative being considered for an emergency 11.36 license shall receive an application form for a child foster 12.1 care license; and12.2 (3) whenever possible, prior to placing the child in the 12.3 relative's home, the relative being considered for an emergency 12.4 license shall provide the information required by section 12.5 245A.04, subdivision 3, paragraph (b); and 12.6 (4) if the county determines, prior to the issuance of an 12.7 emergency license, that anyone requiring a background study may 12.8 be disqualified under section 245A.04, and the disqualification 12.9 is one which the commissioner cannot set aside, an emergency 12.10 license shall not be issued. 12.11 Sec. 9. Minnesota Statutes 2001 Supplement, section 12.12 245A.04, subdivision 3, is amended to read: 12.13 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 12.14 (a) Individuals and organizations that are required in statute 12.15 to initiate background studies under this section shall comply 12.16 with the following requirements: 12.17 (1) Applicants for licensure, license holders, and other 12.18 entities as provided in this section must submit completed 12.19 background study forms to the commissioner before individuals 12.20 specified in paragraph (c), clauses (1) to (4), (6), and (7), 12.21 begin positions allowing direct contact in any licensed program. 12.22 (2) Applicants and license holders under the jurisdiction 12.23 of other state agencies who are required in other statutory 12.24 sections to initiate background studies under this section must 12.25 submit completed background study forms to the commissioner 12.26 prior to the background study subject beginning in a position 12.27 allowing direct contact in the licensed program, or where 12.28 applicable, prior to being employed. 12.29 (3) Organizations required to initiate background studies 12.30 under section 256B.0627 for individuals described in paragraph 12.31 (c), clause (5), must submit a completed background study form 12.32 to the commissioner before those individuals begin a position 12.33 allowing direct contact with persons served by the 12.34 organization. The commissioner shall recover the cost of these 12.35 background studies through a fee of no more than $12 per study 12.36 charged to the organization responsible for submitting the 13.1 background study form. The fees collected under this paragraph 13.2 are appropriated to the commissioner for the purpose of 13.3 conducting background studies. 13.4 Upon receipt of the background study forms from the 13.5 entities in clauses (1) to (3), the commissioner shall complete 13.6 the background study as specified under this section and provide 13.7 notices required in subdivision 3a. Unless otherwise specified, 13.8 the subject of a background study may have direct contact with 13.9 persons served by a program after the background study form is 13.10 mailed or submitted to the commissioner pending notification of 13.11 the study results under subdivision 3a. A county agency may 13.12 accept a background study completed by the commissioner under 13.13 this section in place of the background study required under 13.14 section 245A.16, subdivision 3, in programs with joint licensure 13.15 as home and community-based services and adult foster care for 13.16 people with developmental disabilities when the license holder 13.17 does not reside in the foster care residence and the subject of 13.18 the study has been continuously affiliated with the license 13.19 holder since the date of the commissioner's study. 13.20 (b) The definitions in this paragraph apply only to 13.21 subdivisions 3 to 3e. 13.22 (1) "Background study" means the review of records 13.23 conducted by the commissioner to determine whether a subject is 13.24 disqualified from direct contact with persons served by a 13.25 program, and where specifically provided in statutes, whether a 13.26 subject is disqualified from having access to persons served by 13.27 a program. 13.28 (2) "Continuous, direct supervision" means an individual is 13.29 within sight or hearing of the supervising person to the extent 13.30 that supervising person is capable at all times of intervening 13.31 to protect the health and safety of the persons served by the 13.32 program. 13.33 (3) "Contractor" means any person, regardless of employer, 13.34 who is providing program services for hire under the control of 13.35 the provider. 13.36 (4) "Direct contact" means providing face-to-face care, 14.1 training, supervision, counseling, consultation, or medication 14.2 assistance to persons served by the program. 14.3 (5) "Reasonable cause" means information or circumstances 14.4 exist which provide the commissioner with articulable suspicion 14.5 that further pertinent information may exist concerning a 14.6 subject. The commissioner has reasonable cause when, but not 14.7 limited to, the commissioner has received a report from the 14.8 subject, the license holder, or a third party indicating that 14.9 the subject has a history that would disqualify the person or 14.10 that may pose a risk to the health or safety of persons 14.11 receiving services. 14.12 (6) "Subject of a background study" means an individual on 14.13 whom a background study is required or completed. 14.14 (c) The applicant, license holder, registrant under section 14.15 144A.71, subdivision 1, bureau of criminal apprehension, 14.16 commissioner of health, and county agencies, after written 14.17 notice to the individual who is the subject of the study, shall 14.18 help with the study by giving the commissioner criminal 14.19 conviction data and reports about the maltreatment of adults 14.20 substantiated under section 626.557 and the maltreatment of 14.21 minors in licensed programs substantiated under section 14.22 626.556. If a background study is initiated by an applicant or 14.23 license holder and the applicant or license holder receives 14.24 information about the possible criminal or maltreatment history 14.25 of an individual who is the subject of the background study, the 14.26 applicant or license holder must immediately provide the 14.27 information to the commissioner. The individuals to be studied 14.28 shall include: 14.29 (1) the applicant; 14.30 (2) persons age 13 and over living in the household where 14.31 the licensed program will be provided; 14.32 (3) current employees or contractors of the applicant who 14.33 will have direct contact with persons served by the facility, 14.34 agency, or program; 14.35 (4) volunteers or student volunteers who have direct 14.36 contact with persons served by the program to provide program 15.1 services, if the contact is not directly supervised by the15.2 individualsunder the continuous, direct supervision by an 15.3 individual listed in clause (1) or (3); 15.4 (5) any person required under section 256B.0627 to have a 15.5 background study completed under this section; 15.6 (6) persons ages 10 to 12 living in the household where the 15.7 licensed services will be provided when the commissioner has 15.8 reasonable cause; and 15.9 (7) persons who, without providing direct contact services 15.10 at a licensed program, may have unsupervised access to children 15.11 or vulnerable adults receiving services from the program 15.12 licensed to provide family child care for children, foster care 15.13 for children in the provider's own home, or foster care or day 15.14 care services for adults in the provider's own home when the 15.15 commissioner has reasonable cause. 15.16 (d) According to paragraph (c), clauses (2) and (6), the 15.17 commissioner shall review records from the juvenile courts. For 15.18 persons under paragraph (c), clauses (1), (3), (4), (5), and 15.19 (7), who are ages 13 to 17, the commissioner shall review 15.20 records from the juvenile courts when the commissioner has 15.21 reasonable cause. The juvenile courts shall help with the study 15.22 by giving the commissioner existing juvenile court records on 15.23 individuals described in paragraph (c), clauses (2), (6), and 15.24 (7), relating to delinquency proceedings held within either the 15.25 five years immediately preceding the background study or the 15.26 five years immediately preceding the individual's 18th birthday, 15.27 whichever time period is longer. The commissioner shall destroy 15.28 juvenile records obtained pursuant to this subdivision when the 15.29 subject of the records reaches age 23. 15.30 (e) Beginning August 1, 2001, the commissioner shall 15.31 conduct all background studies required under this chapter and 15.32 initiated by supplemental nursing services agencies registered 15.33 under section 144A.71, subdivision 1. Studies for the agencies 15.34 must be initiated annually by each agency. The commissioner 15.35 shall conduct the background studies according to this chapter. 15.36 The commissioner shall recover the cost of the background 16.1 studies through a fee of no more than $8 per study, charged to 16.2 the supplemental nursing services agency. The fees collected 16.3 under this paragraph are appropriated to the commissioner for 16.4 the purpose of conducting background studies. 16.5 (f) For purposes of this section, a finding that a 16.6 delinquency petition is proven in juvenile court shall be 16.7 considered a conviction in state district court. 16.8 (g) A study of an individual in paragraph (c), clauses (1) 16.9 to (7), shall be conducted at least upon application for initial 16.10 license for all license types or registration under section 16.11 144A.71, subdivision 1, and at reapplication for a license or16.12 registrationfor family child care, child foster care, and adult 16.13 foster care. The commissioner is not required to conduct a 16.14 study of an individual at the time of reapplication for a 16.15 license or if the individual has been continuously affiliated 16.16 with a foster care provider licensed by the commissioner of 16.17 human services and registered under chapter 144D, other than a 16.18 family day care or foster care license, if: (i) a study of the 16.19 individual was conducted either at the time of initial licensure 16.20 or when the individual became affiliated with the license 16.21 holder; (ii) the individual has been continuously affiliated 16.22 with the license holder since the last study was conducted; and 16.23 (iii) the procedure described in paragraph (j) has been 16.24 implemented and was in effect continuously since the last study 16.25 was conducted. For the purposes of this section, a physician 16.26 licensed under chapter 147 is considered to be continuously 16.27 affiliated upon the license holder's receipt from the 16.28 commissioner of health or human services of the physician's 16.29 background study results. For individuals who are required to 16.30 have background studies under paragraph (c) and who have been 16.31 continuously affiliated with a foster care provider that is 16.32 licensed in more than one county, criminal conviction data may 16.33 be shared among those counties in which the foster care programs 16.34 are licensed. A county agency's receipt of criminal conviction 16.35 data from another county agency shall meet the criminal data 16.36 background study requirements of this section. 17.1 (h) The commissioner may also conduct studies on 17.2 individuals specified in paragraph (c), clauses (3) and (4), 17.3 when the studies are initiated by: 17.4 (i) personnel pool agencies; 17.5 (ii) temporary personnel agencies; 17.6 (iii) educational programs that train persons by providing 17.7 direct contact services in licensed programs; and 17.8 (iv) professional services agencies that are not licensed 17.9 and which contract with licensed programs to provide direct 17.10 contact services or individuals who provide direct contact 17.11 services. 17.12 (i) Studies on individuals in paragraph (h), items (i) to 17.13 (iv), must be initiated annually by these agencies, programs, 17.14 and individuals. Except as provided in paragraph (a), clause 17.15 (3), no applicant, license holder, or individual who is the 17.16 subject of the study shall pay any fees required to conduct the 17.17 study. 17.18 (1) At the option of the licensed facility, rather than 17.19 initiating another background study on an individual required to 17.20 be studied who has indicated to the licensed facility that a 17.21 background study by the commissioner was previously completed, 17.22 the facility may make a request to the commissioner for 17.23 documentation of the individual's background study status, 17.24 provided that: 17.25 (i) the facility makes this request using a form provided 17.26 by the commissioner; 17.27 (ii) in making the request the facility informs the 17.28 commissioner that either: 17.29 (A) the individual has been continuously affiliated with a 17.30 licensed facility since the individual's previous background 17.31 study was completed, or since October 1, 1995, whichever is 17.32 shorter; or 17.33 (B) the individual is affiliated only with a personnel pool 17.34 agency, a temporary personnel agency, an educational program 17.35 that trains persons by providing direct contact services in 17.36 licensed programs, or a professional services agency that is not 18.1 licensed and which contracts with licensed programs to provide 18.2 direct contact services or individuals who provide direct 18.3 contact services; and 18.4 (iii) the facility provides notices to the individual as 18.5 required in paragraphs (a) to (j), and that the facility is 18.6 requesting written notification of the individual's background 18.7 study status from the commissioner. 18.8 (2) The commissioner shall respond to each request under 18.9 paragraph (1) with a written or electronic notice to the 18.10 facility and the study subject. If the commissioner determines 18.11 that a background study is necessary, the study shall be 18.12 completed without further request from a licensed agency or 18.13 notifications to the study subject. 18.14 (3) When a background study is being initiated by a 18.15 licensed facility or a foster care provider that is also 18.16 registered under chapter 144D, a study subject affiliated with 18.17 multiple licensed facilities may attach to the background study 18.18 form a cover letter indicating the additional facilities' names, 18.19 addresses, and background study identification numbers. When 18.20 the commissioner receives such notices, each facility identified 18.21 by the background study subject shall be notified of the study 18.22 results. The background study notice sent to the subsequent 18.23 agencies shall satisfy those facilities' responsibilities for 18.24 initiating a background study on that individual. 18.25 (j) If an individual who is affiliated with a program or 18.26 facility regulated by the department of human services or 18.27 department of health or who is affiliated with any type of home 18.28 care agency or provider of personal care assistance services, is 18.29 convicted of a crime constituting a disqualification under 18.30 subdivision 3d, the probation officer or corrections agent shall 18.31 notify the commissioner of the conviction. For the purpose of 18.32 this paragraph, "conviction" has the meaning given it in section 18.33 609.02, subdivision 5. The commissioner, in consultation with 18.34 the commissioner of corrections, shall develop forms and 18.35 information necessary to implement this paragraph and shall 18.36 provide the forms and information to the commissioner of 19.1 corrections for distribution to local probation officers and 19.2 corrections agents. The commissioner shall inform individuals 19.3 subject to a background study that criminal convictions for 19.4 disqualifying crimes will be reported to the commissioner by the 19.5 corrections system. A probation officer, corrections agent, or 19.6 corrections agency is not civilly or criminally liable for 19.7 disclosing or failing to disclose the information required by 19.8 this paragraph. Upon receipt of disqualifying information, the 19.9 commissioner shall provide the notifications required in 19.10 subdivision 3a, as appropriate to agencies on record as having 19.11 initiated a background study or making a request for 19.12 documentation of the background study status of the individual. 19.13 This paragraph does not apply to family day care and child 19.14 foster care programs. 19.15 (k) The individual who is the subject of the study must 19.16 provide the applicant or license holder with sufficient 19.17 information to ensure an accurate study including the 19.18 individual's first, middle, and last name and all other names by 19.19 which the individual has been known; home address, city, county, 19.20 and state of residence for the past five years; zip code; sex; 19.21 date of birth; and driver's license number or state 19.22 identification number. The applicant or license holder shall 19.23 provide this information about an individual in paragraph (c), 19.24 clauses (1) to (7), on forms prescribed by the commissioner. By 19.25 January 1, 2000, for background studies conducted by the 19.26 department of human services, the commissioner shall implement a 19.27 system for the electronic transmission of: (1) background study 19.28 information to the commissioner; and (2) background study 19.29 results to the license holder. The commissioner may request 19.30 additional information of the individual, which shall be 19.31 optional for the individual to provide, such as the individual's 19.32 social security number or race. 19.33 (l) For programs directly licensed by the commissioner, a 19.34 study must include information related to names of substantiated 19.35 perpetrators of maltreatment of vulnerable adults that has been 19.36 received by the commissioner as required under section 626.557, 20.1 subdivision 9c, paragraph (i), and the commissioner's records 20.2 relating to the maltreatment of minors in licensed programs, 20.3 information from juvenile courts as required in paragraph (c) 20.4 for persons listed in paragraph (c), clauses (2), (6), and (7), 20.5 and information from the bureau of criminal apprehension. For 20.6 child foster care, adult foster care, and family day care homes, 20.7 the study must include information from the county agency's 20.8 record of substantiated maltreatment of adults, and the 20.9 maltreatment of minors, information from juvenile courts as 20.10 required in paragraph (c) for persons listed in paragraph (c), 20.11 clauses (2), (6), and (7), and information from the bureau of 20.12 criminal apprehension. The commissioner may also review arrest 20.13 and investigative information from the bureau of criminal 20.14 apprehension, the commissioner of health, a county attorney, 20.15 county sheriff, county agency, local chief of police, other 20.16 states, the courts, or the Federal Bureau of Investigation if 20.17 the commissioner has reasonable cause to believe the information 20.18 is pertinent to the disqualification of an individual listed in 20.19 paragraph (c), clauses (1) to (7). The commissioner is not 20.20 required to conduct more than one review of a subject's records 20.21 from the Federal Bureau of Investigation if a review of the 20.22 subject's criminal history with the Federal Bureau of 20.23 Investigation has already been completed by the commissioner and 20.24 there has been no break in the subject's affiliation with the 20.25 license holder who initiated the background study. 20.26 (m) When the commissioner has reasonable cause to believe 20.27 that further pertinent information may exist on the subject, the 20.28 subject shall provide a set of classifiable fingerprints 20.29 obtained from an authorized law enforcement agency. For 20.30 purposes of requiring fingerprints, the commissioner shall be 20.31 considered to have reasonable cause under, but not limited to, 20.32 the following circumstances: 20.33 (1) information from the bureau of criminal apprehension 20.34 indicates that the subject is a multistate offender; 20.35 (2) information from the bureau of criminal apprehension 20.36 indicates that multistate offender status is undetermined; or 21.1 (3) the commissioner has received a report from the subject 21.2 or a third party indicating that the subject has a criminal 21.3 history in a jurisdiction other than Minnesota. 21.4 (n) The failure or refusal of an applicant, license holder, 21.5 or registrant under section 144A.71, subdivision 1, to cooperate 21.6 with the commissioner is reasonable cause to disqualify a 21.7 subject, deny a license application or immediately suspend, 21.8 suspend, or revoke a license or registration. Failure or 21.9 refusal of an individual to cooperate with the study is just 21.10 cause for denying or terminating employment of the individual if 21.11 the individual's failure or refusal to cooperate could cause the 21.12 applicant's application to be denied or the license holder's 21.13 license to be immediately suspended, suspended, or revoked. 21.14 (o) The commissioner shall not consider an application to 21.15 be complete until all of the information required to be provided 21.16 under this subdivision has been received. 21.17 (p) No person in paragraph (c), clauses (1) to (7), who is 21.18 disqualified as a result of this section may be retained by the 21.19 agency in a position involving direct contact with persons 21.20 served by the program or in a position allowingand no person in 21.21 paragraph (c), clauses (2), (6), and (7), or as provided 21.22 elsewhere in statute who is disqualified as a result of this 21.23 section may be allowed access to persons served by the 21.24 program as provided for in statutes, unless the commissioner has 21.25 provided written notice to the agency stating that: 21.26 (1) the individual may remain in direct contact during the 21.27 period in which the individual may request reconsideration as 21.28 provided in subdivision 3a, paragraph (b), clause (2) or (3); 21.29 (2) the individual's disqualification has been set aside 21.30 for that agency as provided in subdivision 3b, paragraph (b); or 21.31 (3) the license holder has been granted a variance for the 21.32 disqualified individual under subdivision 3e. 21.33 (q) Termination of affiliation with persons in paragraph 21.34 (c), clauses (1) to (7), made in good faith reliance on a notice 21.35 of disqualification provided by the commissioner shall not 21.36 subject the applicant or license holder to civil liability. 22.1 (r) The commissioner may establish records to fulfill the 22.2 requirements of this section. 22.3 (s) The commissioner may not disqualify an individual 22.4 subject to a study under this section because that person has, 22.5 or has had, a mental illness as defined in section 245.462, 22.6 subdivision 20. 22.7 (t) An individual subject to disqualification under this 22.8 subdivision has the applicable rights in subdivision 3a, 3b, or 22.9 3c. 22.10 (u) For the purposes of background studies completed by 22.11 tribal organizations performing licensing activities otherwise 22.12 required of the commissioner under this chapter, after obtaining 22.13 consent from the background study subject, tribal licensing 22.14 agencies shall have access to criminal history data in the same 22.15 manner as county licensing agencies and private licensing 22.16 agencies under this chapter. 22.17 (v) County agencies shall have access to the criminal 22.18 history data in the same manner as county licensing agencies 22.19 under this chapter for purposes of background studies completed 22.20 by county agencies on legal nonlicensed child care providers to 22.21 determine eligibility for child care funds under chapter 119B. 22.22 Sec. 10. Minnesota Statutes 2001 Supplement, section 22.23 245A.04, subdivision 3a, is amended to read: 22.24 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 22.25 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) Within 15 22.26 working days, the commissioner shall notify the applicant, 22.27 license holder, or registrant under section 144A.71, subdivision 22.28 1, and the individual who is the subject of the study, in 22.29 writing or by electronic transmission, of the results of the 22.30 study or that more time is needed to complete the study. When 22.31 the study is completed, a notice that the study was undertaken 22.32 and completed shall be maintained in the personnel files of the 22.33 program. For studies on individuals pertaining to a license to 22.34 provide family day care or group family day care, foster care 22.35 for children in the provider's own home, or foster care or day 22.36 care services for adults in the provider's own home, the 23.1 commissioner is not required to provide a separate notice of the 23.2 background study results to the individual who is the subject of 23.3 the study unless the study results in a disqualification of the 23.4 individual. 23.5 The commissioner shall notify the individual studied if the 23.6 information in the study indicates the individual is 23.7 disqualified from direct contact with persons served by the 23.8 program. The commissioner shall disclose the information 23.9 causing disqualification and instructions on how to request a 23.10 reconsideration of the disqualification to the individual 23.11 studied. An applicant or license holder who is not the subject 23.12 of the study shall be informed that the commissioner has found 23.13 information that disqualifies the subject from direct contact 23.14 with persons served by the program. However, only the 23.15 individual studied must be informed of the information contained 23.16 in the subject's background study unless the basis for the 23.17 disqualification is failure to cooperate, substantiated 23.18 maltreatment under section 626.556 or 626.557, the Data 23.19 Practices Act provides for release of the information, or the 23.20 individual studied authorizes the release of the information. 23.21 When a disqualification is based on the subject's failure to 23.22 cooperate with the background study or substantiated 23.23 maltreatment under section 626.556 or 626.557, the agency that 23.24 initiated the study shall be informed by the commissioner of the 23.25 reason for the disqualification. 23.26 (b) Except as provided in subdivision 3d, paragraph (b), if 23.27 the commissioner determines that the individual studied has a 23.28 disqualifying characteristic, the commissioner shall review the 23.29 information immediately available and make a determination as to 23.30 the subject's immediate risk of harm to persons served by the 23.31 program where the individual studied will have direct contact. 23.32 The commissioner shall consider all relevant information 23.33 available, including the following factors in determining the 23.34 immediate risk of harm: the recency of the disqualifying 23.35 characteristic; the recency of discharge from probation for the 23.36 crimes; the number of disqualifying characteristics; the 24.1 intrusiveness or violence of the disqualifying characteristic; 24.2 the vulnerability of the victim involved in the disqualifying 24.3 characteristic; and the similarity of the victim to the persons 24.4 served by the program where the individual studied will have 24.5 direct contact. The commissioner may determine that the 24.6 evaluation of the information immediately available gives the 24.7 commissioner reason to believe one of the following: 24.8 (1) The individual poses an imminent risk of harm to 24.9 persons served by the program where the individual studied will 24.10 have direct contact. If the commissioner determines that an 24.11 individual studied poses an imminent risk of harm to persons 24.12 served by the program where the individual studied will have 24.13 direct contact, the individual and the license holder must be 24.14 sent a notice of disqualification. The commissioner shall order 24.15 the license holder to immediately remove the individual studied 24.16 from direct contact. The notice to the individual studied must 24.17 include an explanation of the basis of this determination. 24.18 (2) The individual poses a risk of harm requiring 24.19 continuous, direct supervision while providing direct contact 24.20 services during the period in which the subject may request a 24.21 reconsideration. If the commissioner determines that an 24.22 individual studied poses a risk of harm that requires 24.23 continuous, direct supervision, the individual and the license 24.24 holder must be sent a notice of disqualification. The 24.25 commissioner shall order the license holder to immediately 24.26 remove the individual studied from direct contact services or 24.27 assure that the individual studied is within sight or hearing24.28 under the continuous, direct supervision of another staff person 24.29 when providing direct contact services during the period in 24.30 which the individual may request a reconsideration of the 24.31 disqualification. If the individual studied does not submit a 24.32 timely request for reconsideration, or the individual submits a 24.33 timely request for reconsideration, but the disqualification is 24.34 not set aside for that license holder, the license holder will 24.35 be notified of the disqualification and ordered to immediately 24.36 remove the individual from any position allowing direct contact 25.1 with persons receiving services from the license holder. 25.2 (3) The individual does not pose an imminent risk of harm 25.3 or a risk of harm requiring continuous, direct supervision while 25.4 providing direct contact services during the period in which the 25.5 subject may request a reconsideration. If the commissioner 25.6 determines that an individual studied does not pose a risk of 25.7 harm that requires continuous, direct supervision, only the 25.8 individual must be sent a notice of disqualification. The 25.9 license holder must be sent a notice that more time is needed to 25.10 complete the individual's background study. If the individual 25.11 studied submits a timely request for reconsideration, and if the 25.12 disqualification is set aside for that license holder, the 25.13 license holder will receive the same notification received by 25.14 license holders in cases where the individual studied has no 25.15 disqualifying characteristic. If the individual studied does 25.16 not submit a timely request for reconsideration, or the 25.17 individual submits a timely request for reconsideration, but the 25.18 disqualification is not set aside for that license holder, the 25.19 license holder will be notified of the disqualification and 25.20 ordered to immediately remove the individual from any position 25.21 allowing direct contact with persons receiving services from the 25.22 license holder. 25.23 (c) County licensing agencies performing duties under this 25.24 subdivision may develop an alternative system for determining 25.25 the subject's immediate risk of harm to persons served by the 25.26 program, providing the notices under paragraph (b), and 25.27 documenting the action taken by the county licensing agency. 25.28 Each county licensing agency's implementation of the alternative 25.29 system is subject to approval by the commissioner. 25.30 Notwithstanding this alternative system, county licensing 25.31 agencies shall complete the requirements of paragraph (a). 25.32 Sec. 11. Minnesota Statutes 2001 Supplement, section 25.33 245A.04, subdivision 3b, is amended to read: 25.34 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 25.35 individual who is the subject of the disqualification may 25.36 request a reconsideration of the disqualification. 26.1 The individual must submit the request for reconsideration 26.2 to the commissioner in writing. A request for reconsideration 26.3 for an individual who has been sent a notice of disqualification 26.4 under subdivision 3a, paragraph (b), clause (1) or (2), must be 26.5 submitted within 30 calendar days of the disqualified 26.6 individual's receipt of the notice of disqualification. Upon 26.7 showing that the information in clause (1) or (2) cannot be 26.8 obtained within 30 days, the disqualified individual may request 26.9 additional time, not to exceed 30 days, to obtain that 26.10 information. A request for reconsideration for an individual 26.11 who has been sent a notice of disqualification under subdivision 26.12 3a, paragraph (b), clause (3), must be submitted within 15 26.13 calendar days of the disqualified individual's receipt of the 26.14 notice of disqualification. An individual who was determined to 26.15 have maltreated a child under section 626.556 or a vulnerable 26.16 adult under section 626.557, and who was disqualified under this 26.17 section on the basis of serious or recurring maltreatment, may 26.18 request reconsideration of both the maltreatment and the 26.19 disqualification determinations. The request for 26.20 reconsideration of the maltreatment determination and the 26.21 disqualification must be submitted within 30 calendar days of 26.22 the individual's receipt of the notice of disqualification. 26.23 Removal of a disqualified individual from direct contact shall 26.24 be ordered if the individual does not request reconsideration 26.25 within the prescribed time, and for an individual who submits a 26.26 timely request for reconsideration, if the disqualification is 26.27 not set aside. The individual must present information showing 26.28 that: 26.29 (1) the information the commissioner relied upon in 26.30 determining that the underlying conduct giving rise to the 26.31 disqualification occurred, and for maltreatment, that the 26.32 maltreatment was serious or recurring, is incorrect or26.33 inaccurate. If the basis of a reconsideration request is that a26.34 maltreatment determination or disposition under section 626.55626.35 or 626.557 is incorrect, and the commissioner has issued a final26.36 order in an appeal of that determination or disposition under27.1 section 256.045 or 245A.08, subdivision 5, the commissioner's27.2 order is conclusive on the issue of maltreatment. If the27.3 individual did not request reconsideration of the maltreatment27.4 determination, the maltreatment determination is deemed27.5 conclusive; or 27.6 (2) the subject of the study does not pose a risk of harm 27.7 to any person served by the applicant, license holder, or 27.8 registrant under section 144A.71, subdivision 1. 27.9 (b) The commissioner shall rescind the disqualification if 27.10 the commissioner finds that the information relied on to 27.11 disqualify the subject is incorrect. The commissioner may set 27.12 aside the disqualification under this section if the 27.13 commissioner finds that the individual does not pose a risk of 27.14 harm to any person served by the applicant, license holder, or 27.15 registrant under section 144A.71, subdivision 1. In determining 27.16 that an individual does not pose a risk of harm, the 27.17 commissioner shall consider the nature, severity, and 27.18 consequences of the event or events that lead to 27.19 disqualification, whether there is more than one disqualifying 27.20 event, the age and vulnerability of the victim at the time of 27.21 the event, the harm suffered by the victim, the similarity 27.22 between the victim and persons served by the program, the time 27.23 elapsed without a repeat of the same or similar event, 27.24 documentation of successful completion by the individual studied 27.25 of training or rehabilitation pertinent to the event, and any 27.26 other information relevant to reconsideration. In reviewing a 27.27 disqualification under this section, the commissioner shall give 27.28 preeminent weight to the safety of each person to be served by 27.29 the license holder, applicant, or registrant under section 27.30 144A.71, subdivision 1, over the interests of the license 27.31 holder, applicant, or registrant under section 144A.71, 27.32 subdivision 1. 27.33 (c) Unless the information the commissioner relied on in 27.34 disqualifying an individual is incorrect, the commissioner may 27.35 not set aside the disqualification of an individual in 27.36 connection with a license to provide family day care for 28.1 children, foster care for children in the provider's own home, 28.2 or foster care or day care services for adults in the provider's 28.3 own home if: 28.4 (1) less than ten years have passed since the discharge of 28.5 the sentence imposed for the offense; and the individual has 28.6 been convicted of a violation of any offense listed in sections 28.7 609.20 (manslaughter in the first degree), 609.205 (manslaughter 28.8 in the second degree), criminal vehicular homicide under 609.21 28.9 (criminal vehicular homicide and injury), 609.215 (aiding 28.10 suicide or aiding attempted suicide), felony violations under 28.11 609.221 to 609.2231 (assault in the first, second, third, or 28.12 fourth degree), 609.713 (terroristic threats), 609.235 (use of 28.13 drugs to injure or to facilitate crime), 609.24 (simple 28.14 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 28.15 609.255 (false imprisonment), 609.561 or 609.562 (arson in the 28.16 first or second degree), 609.71 (riot), burglary in the first or 28.17 second degree under 609.582 (burglary), 609.66 (dangerous 28.18 weapon), 609.665 (spring guns), 609.67 (machine guns and 28.19 short-barreled shotguns), 609.749 (harassment; stalking), 28.20 152.021 or 152.022 (controlled substance crime in the first or 28.21 second degree), 152.023, subdivision 1, clause (3) or (4), or 28.22 subdivision 2, clause (4) (controlled substance crime in the 28.23 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 28.24 (controlled substance crime in the fourth degree), 609.224, 28.25 subdivision 2, paragraph (c) (fifth-degree assault by a 28.26 caregiver against a vulnerable adult), 609.228 (great bodily 28.27 harm caused by distribution of drugs), 609.23 (mistreatment of 28.28 persons confined), 609.231 (mistreatment of residents or 28.29 patients), 609.2325 (criminal abuse of a vulnerable adult), 28.30 609.233 (criminal neglect of a vulnerable adult), 609.2335 28.31 (financial exploitation of a vulnerable adult), 609.234 (failure 28.32 to report), 609.265 (abduction), 609.2664 to 609.2665 28.33 (manslaughter of an unborn child in the first or second degree), 28.34 609.267 to 609.2672 (assault of an unborn child in the first, 28.35 second, or third degree), 609.268 (injury or death of an unborn 28.36 child in the commission of a crime), 617.293 (disseminating or 29.1 displaying harmful material to minors), a felony level 29.2 conviction involving alcohol or drug use, a gross misdemeanor 29.3 offense under 609.324, subdivision 1 (other prohibited acts), a 29.4 gross misdemeanor offense under 609.378 (neglect or endangerment 29.5 of a child), a gross misdemeanor offense under 609.377 29.6 (malicious punishment of a child), 609.72, subdivision 3 29.7 (disorderly conduct against a vulnerable adult); or an attempt 29.8 or conspiracy to commit any of these offenses, as each of these 29.9 offenses is defined in Minnesota Statutes; or an offense in any 29.10 other state, the elements of which are substantially similar to 29.11 the elements of any of the foregoing offenses; 29.12 (2) regardless of how much time has passed since the 29.13 involuntary termination of parental rights under section 29.14 260C.301 or the discharge of the sentence imposed for the 29.15 offense, the individual was convicted of a violation of any 29.16 offense listed in sections 609.185 to 609.195 (murder in the 29.17 first, second, or third degree), 609.2661 to 609.2663 (murder of 29.18 an unborn child in the first, second, or third degree), a felony 29.19 offense under 609.377 (malicious punishment of a child), a 29.20 felony offense under 609.324, subdivision 1 (other prohibited 29.21 acts), a felony offense under 609.378 (neglect or endangerment 29.22 of a child), 609.322 (solicitation, inducement, and promotion of 29.23 prostitution), 609.342 to 609.345 (criminal sexual conduct in 29.24 the first, second, third, or fourth degree), 609.352 29.25 (solicitation of children to engage in sexual conduct), 617.246 29.26 (use of minors in a sexual performance), 617.247 (possession of 29.27 pictorial representations of a minor), 609.365 (incest), a 29.28 felony offense under sections 609.2242 and 609.2243 (domestic 29.29 assault), a felony offense of spousal abuse, a felony offense of 29.30 child abuse or neglect, a felony offense of a crime against 29.31 children, or an attempt or conspiracy to commit any of these 29.32 offenses as defined in Minnesota Statutes, or an offense in any 29.33 other state, the elements of which are substantially similar to 29.34 any of the foregoing offenses; 29.35 (3) within the seven years preceding the study, the 29.36 individual committed an act that constitutes maltreatment of a 30.1 child under section 626.556, subdivision 10e, and that resulted 30.2 in substantial bodily harm as defined in section 609.02, 30.3 subdivision 7a, or substantial mental or emotional harm as 30.4 supported by competent psychological or psychiatric evidence; or 30.5 (4) within the seven years preceding the study, the 30.6 individual was determined under section 626.557 to be the 30.7 perpetrator of a substantiated incident of maltreatment of a 30.8 vulnerable adult that resulted in substantial bodily harm as 30.9 defined in section 609.02, subdivision 7a, or substantial mental 30.10 or emotional harm as supported by competent psychological or 30.11 psychiatric evidence. 30.12 In the case of any ground for disqualification under 30.13 clauses (1) to (4), if the act was committed by an individual 30.14 other than the applicant, license holder, or registrant under 30.15 section 144A.71, subdivision 1, residing in the applicant's or 30.16 license holder's home, or the home of a registrant under section 30.17 144A.71, subdivision 1, the applicant, license holder, or 30.18 registrant under section 144A.71, subdivision 1, may seek 30.19 reconsideration when the individual who committed the act no 30.20 longer resides in the home. 30.21 The disqualification periods provided under clauses (1), 30.22 (3), and (4) are the minimum applicable disqualification 30.23 periods. The commissioner may determine that an individual 30.24 should continue to be disqualified from licensure or 30.25 registration under section 144A.71, subdivision 1, because the 30.26 license holder, applicant, or registrant under section 144A.71, 30.27 subdivision 1, poses a risk of harm to a person served by that 30.28 individual after the minimum disqualification period has passed. 30.29 (d) The commissioner shall respond in writing or by 30.30 electronic transmission to all reconsideration requests for 30.31 which the basis for the request is that the information relied 30.32 upon by the commissioner to disqualify is incorrect or 30.33 inaccurate within 30 working days of receipt of a request and 30.34 all relevant information. If the basis for the request is that 30.35 the individual does not pose a risk of harm, the commissioner 30.36 shall respond to the request within 15 working days after 31.1 receiving the request for reconsideration and all relevant 31.2 information. If the request is based on both the correctness or 31.3 accuracy of the information relied on to disqualify the 31.4 individual and the risk of harm, the commissioner shall respond 31.5 to the request within 45 working days after receiving the 31.6 request for reconsideration and all relevant information. If 31.7 the disqualification is set aside, the commissioner shall notify 31.8 the applicant or license holder in writing or by electronic 31.9 transmission of the decision. 31.10 (e) Except as provided in subdivision 3c, if a 31.11 disqualification for which reconsideration was requested is not 31.12 set aside or is not rescinded, an individual who was 31.13 disqualified on the basis of a preponderance of evidence that 31.14 the individual committed an act or acts that meet the definition 31.15 of any of the crimes listslisted in subdivision 3d, paragraph 31.16 (a), clauses (1) to (4); or for failure to make required reports 31.17 under section 626.556, subdivision 3, or 626.557, subdivision 3, 31.18 pursuant to subdivision 3d, paragraph (a), clause (4), may 31.19 request a fair hearing under section 256.045. Except as 31.20 provided under subdivision 3c, the commissioner's final order31.21 for an individual under this paragraph is conclusive on the31.22 issue of maltreatment and disqualification, including for31.23 purposes of subsequent studies conducted under subdivision 3,31.24 andfair hearing is the only administrative appeal of the final 31.25 agency determination, specifically, including a challenge to the 31.26 accuracy and completeness of data under section 13.04. 31.27 (f) Except as provided under subdivision 3c, if an 31.28 individual was disqualified on the basis of a determination of 31.29 maltreatment under section 626.556 or 626.557, which was serious 31.30 or recurring, and the individual has requested reconsideration 31.31 of the maltreatment determination under section 626.556, 31.32 subdivision 10i, or 626.557, subdivision 9d, and also requested 31.33 reconsideration of the disqualification under this subdivision, 31.34 reconsideration of the maltreatment determination and 31.35 reconsideration of the disqualification shall be consolidated 31.36 into a single reconsideration. For maltreatment and 32.1 disqualification determinations made by county agencies, the 32.2 consolidated reconsideration shall be conducted by the county 32.3 agency. If the county agency has disqualified an individual on 32.4 multiple bases, one of which is a county maltreatment 32.5 determination for which the individual has a right to request 32.6 reconsideration, the county shall conduct the reconsideration of 32.7 all disqualifications. Except as provided under subdivision 3c, 32.8 if an individual who was disqualified on the basis of serious or 32.9 recurring maltreatment requests a fair hearing on the 32.10 maltreatment determination under section 626.556, subdivision 32.11 10i, or 626.557, subdivision 9d, and requests a fair hearing on 32.12 the disqualification, which has not been set aside or rescinded 32.13 under this subdivision, the scope of the fair hearing under 32.14 section 256.045 shall include the maltreatment determination and 32.15 the disqualification. Except as provided under subdivision 32.16 3c, the commissioner's final order for an individual under this32.17 paragraph is conclusive on the issue of maltreatment and32.18 disqualification, including for purposes of subsequent studies32.19 conducted under subdivision 3, anda fair hearing is the only 32.20 administrative appeal of the final agency determination, 32.21 specifically, including a challenge to the accuracy and 32.22 completeness of data under section 13.04. 32.23 Sec. 12. Minnesota Statutes 2000, section 245A.04, is 32.24 amended by adding a subdivision to read: 32.25 Subd. 3f. [CONCLUSIVE DETERMINATIONS OR DISPOSITIONS.] 32.26 Unless otherwise specified in statute, the following 32.27 determinations or dispositions are deemed conclusive: 32.28 (1) a maltreatment determination or disposition under 32.29 section 626.556 or 626.557, if: 32.30 (i) the commissioner has issued a final order in an appeal 32.31 of that determination or disposition under section 245A.08, 32.32 subdivision 5, or 256.045; 32.33 (ii) the individual did not request reconsideration of the 32.34 maltreatment determination or disposition under section 626.556 32.35 or 626.557; or 32.36 (iii) the individual did not request a hearing of the 33.1 maltreatment determination or disposition under section 256.045; 33.2 and 33.3 (2) a determination that the information relied upon to 33.4 disqualify an individual under subdivision 3d, was correct based 33.5 on serious or recurring maltreatment; or 33.6 (3) a preponderance of evidence shows that the individual 33.7 committed an act or acts that meet the definition of any of the 33.8 crimes listed in subdivision 3d, paragraph (a), clauses (1) to 33.9 (4); or the individual's failure to make required reports under 33.10 section 626.556, subdivision 3, or 626.557, subdivision 3, if: 33.11 (i) the commissioner has issued a final order in an appeal 33.12 of that determination under section 245A.08, subdivision 5, or 33.13 256.045, or a court has issued a final decision; 33.14 (ii) the individual did not request reconsideration of the 33.15 disqualification under this section; or 33.16 (iii) the individual did not request a hearing on the 33.17 disqualification under section 256.045. 33.18 Sec. 13. Minnesota Statutes 2001 Supplement, section 33.19 245A.07, subdivision 2a, is amended to read: 33.20 Subd. 2a. [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 33.21 Within five working days of receipt of the license holder's 33.22 timely appeal, the commissioner shall request assignment of an 33.23 administrative law judge. The request must include a proposed 33.24 date, time, and place of a hearing. A hearing must be conducted 33.25 by an administrative law judge within 30 calendar days of the 33.26 request for assignment, unless an extension is requested by 33.27 either party and granted by the administrative law judge for 33.28 good cause. The commissioner shall issue a notice of hearing by 33.29 certified mail at least ten working days before the hearing. 33.30 The scope of the hearing shall be limited solely to the issue of 33.31 whether the temporary immediate suspension should remain in 33.32 effect pending the commissioner's final order under section 33.33 245A.08, regarding a licensing sanction issued under subdivision 33.34 3 following the immediate suspension. The burden of proof in 33.35 expedited hearings under this subdivision shall be limited to 33.36 the commissioner's demonstration that reasonable cause exists to 34.1 believe that the license holder's actions or failure to comply 34.2 with applicable law or rule poses an imminent risk of harm to 34.3 the health, safety, or rights of persons served by the program. 34.4 (b) The administrative law judge shall issue findings of 34.5 fact, conclusions, and a recommendation within ten working days 34.6 from the date of hearing. The commissioner's final order shall 34.7 be issued within ten working days from receipt of the 34.8 recommendation of the administrative law judge. Within 90 34.9 calendar days after a final order affirming an immediate 34.10 suspension, the commissioner shall make a determination 34.11 regarding whether a final licensing sanction shall be issued 34.12 under subdivision 3. The license holder shall continue to be 34.13 prohibited from operation of the program during this 90-day 34.14 period. 34.15 (c) When the final order under paragraph (b) affirms an 34.16 immediate suspension, and a final licensing sanction is issued 34.17 under subdivision 3, and the license holder appeals that 34.18 sanction, the license holder continues to be prohibited from 34.19 operation of the program pending a final commissioner's order 34.20 under section 245A.08, subdivision 5, regarding the final 34.21 licensing sanction. 34.22 Sec. 14. Minnesota Statutes 2001 Supplement, section 34.23 245A.07, subdivision 3, is amended to read: 34.24 Subd. 3. [LICENSE SUSPENSION, REVOCATION, OR FINE.] The 34.25 commissioner may suspend or revoke a license, or impose a fine 34.26 if a license holder fails to comply fully with applicable laws 34.27 or rules, or knowingly withholds relevant information from or 34.28 gives false or misleading information to the commissioner in 34.29 connection with an application for a license, in connection with 34.30 the background study status of an individual, or during an 34.31 investigation. A license holder who has had a license 34.32 suspended, revoked, or has been ordered to pay a fine must be 34.33 given notice of the action by certified mail. The notice must 34.34 be mailed to the address shown on the application or the last 34.35 known address of the license holder. The notice must state the 34.36 reasons the license was suspended, revoked, or a fine was 35.1 ordered. 35.2 (a) If the license was suspended or revoked, the notice 35.3 must inform the license holder of the right to a contested case 35.4 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 35.5 1400.8612 and successor rules. The license holder may appeal an 35.6 order suspending or revoking a license. The appeal of an order 35.7 suspending or revoking a license must be made in writing by 35.8 certified mail and must be received by the commissioner within 35.9 ten calendar days after the license holder receives notice that 35.10 the license has been suspended or revoked. Except as provided 35.11 in subdivision 2a, paragraph (c), a timely appeal of an order 35.12 suspending or revoking a license shall stay the suspension or 35.13 revocation until the commissioner issues a final order. 35.14 (b)(1) If the license holder was ordered to pay a fine, the 35.15 notice must inform the license holder of the responsibility for 35.16 payment of fines and the right to a contested case hearing under 35.17 chapter 14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and 35.18 successor rules. The appeal of an order to pay a fine must be 35.19 made in writing by certified mail and must be received by the 35.20 commissioner within ten calendar days after the license holder 35.21 receives notice that the fine has been ordered. 35.22 (2) The license holder shall pay the fines assessed on or 35.23 before the payment date specified. If the license holder fails 35.24 to fully comply with the order, the commissioner may issue a 35.25 second fine or suspend the license until the license holder 35.26 complies. If the license holder receives state funds, the 35.27 state, county, or municipal agencies or departments responsible 35.28 for administering the funds shall withhold payments and recover 35.29 any payments made while the license is suspended for failure to 35.30 pay a fine. A timely appeal shall stay payment of the fine 35.31 until the commissioner issues a final order. 35.32 (3) A license holder shall promptly notify the commissioner 35.33 of human services, in writing, when a violation specified in the 35.34 order to forfeit a fine is corrected. If upon reinspection the 35.35 commissioner determines that a violation has not been corrected 35.36 as indicated by the order to forfeit a fine, the commissioner 36.1 may issue a second fine. The commissioner shall notify the 36.2 license holder by certified mail that a second fine has been 36.3 assessed. The license holder may appeal the second fine as 36.4 provided under this subdivision. 36.5 (4) Fines shall be assessed as follows: the license holder 36.6 shall forfeit $1,000 for each determination of maltreatment of a 36.7 child under section 626.556 or the maltreatment of a vulnerable 36.8 adult under section 626.557; the license holder shall forfeit 36.9 $200 for each occurrence of a violation of law or rule governing 36.10 matters of health, safety, or supervision, including but not 36.11 limited to the provision of adequate staff-to-child or adult 36.12 ratios, and failure to submit a background study; and the 36.13 license holder shall forfeit $100 for each occurrence of a 36.14 violation of law or rule other than those subject to a $1,000 or 36.15 $200 fine above. For purposes of this section, "occurrence" 36.16 means each violation identified in the commissioner's fine order. 36.17 (5) When a fine has been assessed, the license holder may 36.18 not avoid payment by closing, selling, or otherwise transferring 36.19 the licensed program to a third party. In such an event, the 36.20 license holder will be personally liable for payment. In the 36.21 case of a corporation, each controlling individual is personally 36.22 and jointly liable for payment. 36.23 Sec. 15. [245A.085] [CONSOLIDATION OF HEARINGS; 36.24 RECONSIDERATION.] 36.25 Hearings authorized under this chapter and sections 36.26 256.045, 626.556, and 626.557, shall be consolidated if feasible 36.27 and in accordance with other applicable statutes and rules. 36.28 Reconsideration under sections 245A.04, subdivision 3c; 626.556, 36.29 subdivision 10i; and 626.557, subdivision 9d, shall also be 36.30 consolidated if feasible. 36.31 Sec. 16. Minnesota Statutes 2001 Supplement, section 36.32 245A.144, is amended to read: 36.33 245A.144 [REDUCTION OF RISK OF SUDDEN INFANT DEATH SYNDROME 36.34 IN CHILD CARE PROGRAMS.] 36.35 License holders must ensure that before staff persons, 36.36 caregivers, and helpers assist in the care of infants, they 37.1 receive training on reducing the risk of sudden infant death 37.2 syndrome. The training on reducing the risk of sudden infant 37.3 death syndrome may be provided as orientation training under 37.4 Minnesota Rules, part 9503.0035, subpart 1, as initial training 37.5 under Minnesota Rules, part 9502.0385, subpart 2, as in-service 37.6 training under Minnesota Rules, part 9503.0035, subpart 4, or as 37.7 ongoing training under Minnesota Rules, part 9502.0385, subpart 37.8 3. Training required under this section must be at least one 37.9 hour in length and must be completed at least once every five 37.10 years. At a minimum, the training must address the risk factors 37.11 related to sudden infant death syndrome, means of reducing the 37.12 risk of sudden infant death syndrome in child care, and license 37.13 holder communication with parents regarding reducing the risk of 37.14 sudden infant death syndrome. Training for family and group 37.15 family child care providers must be approved by the county 37.16 licensing agency according to Minnesota Rules, part 9502.0385. 37.17 Sec. 17. [245A.151] [FIRE MARSHAL INSPECTION.] 37.18 When licensure under this chapter requires an inspection by 37.19 a fire marshal to determine compliance with the Minnesota 37.20 Uniform Fire Code under section 299F.011, a local fire code 37.21 inspector approved by the state fire marshal may conduct the 37.22 inspection. If a community does not have a local fire code 37.23 inspector or if the local fire code inspector does not perform 37.24 the inspection, the state fire marshal must conduct the 37.25 inspection. A local fire code inspector or the state fire 37.26 marshal may recover the cost of these inspections through a fee 37.27 of no more than $50 per inspection charged to the applicant or 37.28 license holder. The fees collected by the state fire marshal 37.29 under this section are appropriated to the commissioner of 37.30 public safety for the purpose of conducting the inspections. 37.31 Sec. 18. Minnesota Statutes 2001 Supplement, section 37.32 245A.16, subdivision 1, is amended to read: 37.33 Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 37.34 County agencies and private agencies that have been designated 37.35 or licensed by the commissioner to perform licensing functions 37.36 and activities under section 245A.04, to recommend denial of 38.1 applicants under section 245A.05, to issue correction orders, to 38.2 issue variances, and recommend a conditional license under 38.3 section 245A.06, or to recommend suspending or revoking a 38.4 license or issuing a fine under section 245A.07, shall comply 38.5 with rules and directives of the commissioner governing those 38.6 functions and with this section. The following variances are 38.7 excluded from the delegation of variance authority and may be 38.8 issued only by the commissioner: 38.9 (1) dual licensure of family child care and child foster 38.10 care, dual licensure of child and adult foster care, and adult 38.11 foster care and family child care; 38.12 (2) adult foster care maximum capacity; 38.13 (3) adult foster care minimum age requirement; 38.14 (4) child foster care maximum age requirement; 38.15 (5) variances regarding disqualified individuals except 38.16 that county agencies may issue variances under section 245A.04, 38.17 subdivision 3e, regarding disqualified individuals when the 38.18 county is responsible for conducting a consolidated 38.19 reconsideration according to section 245A.04, subdivision 3b, 38.20 paragraph (f), of a county maltreatment determination and a 38.21 disqualification based on serious or recurring maltreatment; and 38.22 (6) the required presence of a caregiver in the adult 38.23 foster care residence during normal sleeping hours. 38.24 (b) County agencies must report information about 38.25 disqualification reconsiderations under section 245A.04, 38.26 subdivision 3b, paragraph (f), and variances granted under 38.27 paragraph (a), clause (5), to the commissioner at least monthly 38.28 in a format prescribed by the commissioner. 38.29 (c) For family day care programs, the commissioner may 38.30 authorize licensing reviews every two years after a licensee has 38.31 had at least one annual review. 38.32 Sec. 19. Minnesota Statutes 2001 Supplement, section 38.33 256.045, subdivision 3b, is amended to read: 38.34 Subd. 3b. [STANDARD OF EVIDENCE FOR MALTREATMENT AND 38.35 DISQUALIFICATION HEARINGS.] (a) The state human services referee 38.36 shall determine that maltreatment has occurred if a 39.1 preponderance of evidence exists to support the final 39.2 disposition under sections 626.556 and 626.557. For purposes of 39.3 hearings regarding disqualification, the state human services 39.4 referee shall affirm the proposed disqualification in an appeal 39.5 under subdivision 3, paragraph (a), clause (9), if a 39.6 preponderance of the evidence shows the individual has: 39.7 (1) committed maltreatment under section 626.556 or 39.8 626.557, which is serious or recurring; 39.9 (2) committed an act or acts meeting the definition of any 39.10 of the crimes listed in section 245A.04, subdivision 3d, 39.11 paragraph (a), clauses (1) to (4); or 39.12 (3) failed to make required reports under section 626.556 39.13 or 626.557, for incidents in which :39.14 (i)the final disposition under section 626.556 or 626.557 39.15 was substantiated maltreatment ; and39.16 (ii) the maltreatment was recurring or serious; or39.17 substantiated serious or recurring maltreatment of a minor under39.18 section 626.556 or of a vulnerable adult under section 626.55739.19 for which there is a preponderance of evidence that the39.20 maltreatment occurred, and that the subject was responsible for39.21 the maltreatmentthat was serious or recurring. 39.22 (b) If the disqualification is affirmed, the state human 39.23 services referee shall determine whether the individual poses a 39.24 risk of harm in accordance with the requirements of section 39.25 245A.04, subdivision 3b. 39.26 (c) The state human services referee shall recommend an 39.27 order to the commissioner of health, children, families, and 39.28 learning, or human services, as applicable, who shall issue a 39.29 final order. The commissioner shall affirm, reverse, or modify 39.30 the final disposition. Any order of the commissioner issued in 39.31 accordance with this subdivision is conclusive upon the parties 39.32 unless appeal is taken in the manner provided in subdivision 7. 39.33 Except as provided under section 245A.04, subdivisions 3b,39.34 paragraphs (e) and (f), and 3c,In any licensing appeal under 39.35 chapter 245A and sections 144.50 to 144.58 and 144A.02 to 39.36 144A.46, the commissioner's determination as to maltreatment is 40.1 conclusive, as provided under section 245A.04, subdivision 3f. 40.2 Sec. 20. Minnesota Statutes 2001 Supplement, section 40.3 256.045, subdivision 4, is amended to read: 40.4 Subd. 4. [CONDUCT OF HEARINGS.] (a) All hearings held 40.5 pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 40.6 according to the provisions of the federal Social Security Act 40.7 and the regulations implemented in accordance with that act to 40.8 enable this state to qualify for federal grants-in-aid, and 40.9 according to the rules and written policies of the commissioner 40.10 of human services. County agencies shall install equipment 40.11 necessary to conduct telephone hearings. A state human services 40.12 referee may schedule a telephone conference hearing when the 40.13 distance or time required to travel to the county agency offices 40.14 will cause a delay in the issuance of an order, or to promote 40.15 efficiency, or at the mutual request of the parties. Hearings 40.16 may be conducted by telephone conferences unless the applicant, 40.17 recipient, former recipient, person, or facility contesting 40.18 maltreatment objects. The hearing shall not be held earlier 40.19 than five days after filing of the required notice with the 40.20 county or state agency. The state human services referee shall 40.21 notify all interested persons of the time, date, and location of 40.22 the hearing at least five days before the date of the hearing. 40.23 Interested persons may be represented by legal counsel or other 40.24 representative of their choice, including a provider of therapy 40.25 services, at the hearing and may appear personally, testify and 40.26 offer evidence, and examine and cross-examine witnesses. The 40.27 applicant, recipient, former recipient, person, or facility 40.28 contesting maltreatment shall have the opportunity to examine 40.29 the contents of the case file and all documents and records to 40.30 be used by the county or state agency at the hearing at a 40.31 reasonable time before the date of the hearing and during the 40.32 hearing. In hearings under subdivision 3, paragraph (a), 40.33 clauses (4), (8), and (9), either party may subpoena the private 40.34 data relating to the investigation prepared by the agency under 40.35 section 626.556 or 626.557 that is not otherwise accessible 40.36 under section 13.04, provided the identity of the reporter may 41.1 not be disclosed. 41.2 (b) The private data obtained by subpoena in a hearing 41.3 under subdivision 3, paragraph (a), clause (4), (8), or (9), 41.4 must be subject to a protective order which prohibits its 41.5 disclosure for any other purpose outside the hearing provided 41.6 for in this section without prior order of the district court. 41.7 Disclosure without court order is punishable by a sentence of 41.8 not more than 90 days imprisonment or a fine of not more than 41.9 $700, or both. These restrictions on the use of private data do 41.10 not prohibit access to the data under section 13.03, subdivision 41.11 6. Except for appeals under subdivision 3, paragraph (a), 41.12 clauses (4), (5), (8), and (9), upon request, the county agency 41.13 shall provide reimbursement for transportation, child care, 41.14 photocopying, medical assessment, witness fee, and other 41.15 necessary and reasonable costs incurred by the applicant, 41.16 recipient, or former recipient in connection with the appeal. 41.17 All evidence, except that privileged by law, commonly accepted 41.18 by reasonable people in the conduct of their affairs as having 41.19 probative value with respect to the issues shall be submitted at 41.20 the hearing and such hearing shall not be "a contested case" 41.21 within the meaning of section 14.02, subdivision 3. The agency 41.22 must present its evidence prior to or at the hearing, and may 41.23 not submit evidence after the hearing except by agreement of the 41.24 parties at the hearing, provided the petitioner has the 41.25 opportunity to respond. 41.26 (c) In hearings under subdivision 3, paragraph (a), clauses 41.27 (4), (8), and (9), involving determinations of maltreatment or 41.28 disqualification made by more than one county agency, by a 41.29 county agency and a state agency, or by more than one state 41.30 agency, the hearings may be consolidated into a single fair 41.31 hearing upon the consent of all parties and the state human 41.32 services referee. 41.33 Sec. 21. Minnesota Statutes 2001 Supplement, section 41.34 626.556, subdivision 10i, is amended to read: 41.35 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL 41.36 DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 42.1 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 42.2 provided under paragraph (e), an individual or facility that the 42.3 commissioner of human services, a local social service agency, 42.4 or the commissioner of children, families, and learning 42.5 determines has maltreated a child, an interested person acting 42.6 on behalf of the child, regardless of the determination, who 42.7 contests the investigating agency's final determination 42.8 regarding maltreatment, may request the investigating agency to 42.9 reconsider its final determination regarding maltreatment. The 42.10 request for reconsideration must be submitted in writing to the 42.11 investigating agency within 15 calendar days after receipt of 42.12 notice of the final determination regarding maltreatment or, if 42.13 the request is made by an interested person who is not entitled 42.14 to notice, within 15 days after receipt of the notice by the 42.15 parent or guardian of the child. Effective January 1, 2002, an 42.16 individual who was determined to have maltreated a child under 42.17 this section and who was disqualified on the basis of serious or 42.18 recurring maltreatment under section 245A.04, subdivision 3d, 42.19 may request reconsideration of the maltreatment determination 42.20 and the disqualification. The request for reconsideration of 42.21 the maltreatment determination and the disqualification must be 42.22 submitted within 30 calendar days of the individual's receipt of 42.23 the notice of disqualification under section 245A.04, 42.24 subdivision 3a. 42.25 (b) Except as provided under paragraphs (e) and (f), if the 42.26 investigating agency denies the request or fails to act upon the 42.27 request within 15 calendar days after receiving the request for 42.28 reconsideration, the person or facility entitled to a fair 42.29 hearing under section 256.045 may submit to the commissioner of 42.30 human services or the commissioner of children, families, and 42.31 learning a written request for a hearing under that section. 42.32 Section 256.045 also governs hearings requested to contest a 42.33 final determination of the commissioner of children, families, 42.34 and learning. For reports involving maltreatment of a child in 42.35 a facility, an interested person acting on behalf of the child 42.36 may request a review by the child maltreatment review panel 43.1 under section 256.022 if the investigating agency denies the 43.2 request or fails to act upon the request or if the interested 43.3 person contests a reconsidered determination. The investigating 43.4 agency shall notify persons who request reconsideration of their 43.5 rights under this paragraph. The request must be submitted in 43.6 writing to the review panel and a copy sent to the investigating 43.7 agency within 30 calendar days of receipt of notice of a denial 43.8 of a request for reconsideration or of a reconsidered 43.9 determination. The request must specifically identify the 43.10 aspects of the agency determination with which the person is 43.11 dissatisfied. 43.12 (c) If, as a result of a reconsideration or review, the 43.13 investigating agency changes the final determination of 43.14 maltreatment, that agency shall notify the parties specified in 43.15 subdivisions 10b, 10d, and 10f. 43.16 (d) Except as provided under paragraph (f), if an 43.17 individual or facility contests the investigating agency's final 43.18 determination regarding maltreatment by requesting a fair 43.19 hearing under section 256.045, the commissioner of human 43.20 services shall assure that the hearing is conducted and a 43.21 decision is reached within 90 days of receipt of the request for 43.22 a hearing. The time for action on the decision may be extended 43.23 for as many days as the hearing is postponed or the record is 43.24 held open for the benefit of either party. 43.25 (e) Effective January 1, 2002, if an individual was 43.26 disqualified under section 245A.04, subdivision 3d, on the basis 43.27 of a determination of maltreatment, which was serious or 43.28 recurring, and the individual has requested reconsideration of 43.29 the maltreatment determination under paragraph (a) and requested 43.30 reconsideration of the disqualification under section 245A.04, 43.31 subdivision 3b, reconsideration of the maltreatment 43.32 determination and reconsideration of the disqualification shall 43.33 be consolidated into a single reconsideration. If 43.34 reconsideration of the maltreatment determination is denied or 43.35 the disqualification is not set aside or rescinded under section 43.36 245A.04, subdivision 3b, the individual may request a fair 44.1 hearing under section 256.045. If an individual disqualified on44.2 the basis of a determination of maltreatment, which was serious44.3 or recurringrequests a fair hearing under paragraph (b)on the 44.4 maltreatment determination and the disqualification, the scope 44.5 of the fair hearing shall include both the maltreatment 44.6 determination and the disqualification. 44.7 (f) Effective January 1, 2002, if a maltreatment 44.8 determination or a disqualification based on serious or 44.9 recurring maltreatment is the basis for a denial of a license 44.10 under section 245A.05 or a licensing sanction under section 44.11 245A.07, the license holder has the right to a contested case 44.12 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 44.13 1400.8612 and successor rules. As provided for under section 44.14 245A.08, subdivision 2a, the scope of the contested case hearing 44.15 shall include the maltreatment determination, disqualification, 44.16 and licensing sanction or denial of a license. In such cases, a 44.17 fair hearing regarding the maltreatment determination shall not 44.18 be conducted under paragraph (b). If the disqualified subject 44.19 is an individual other than the license holder and upon whom a 44.20 background study must be conducted under section 245A.04, 44.21 subdivision 3, the hearings of all parties may be consolidated 44.22 into a single contested case hearing upon consent of all parties 44.23 and the administrative law judge. 44.24 (g) For purposes of this subdivision, "interested person 44.25 acting on behalf of the child" means a parent or legal guardian; 44.26 stepparent; grandparent; guardian ad litem; adult stepbrother, 44.27 stepsister, or sibling; or adult aunt or uncle; unless the 44.28 person has been determined to be the perpetrator of the 44.29 maltreatment. 44.30 Sec. 22. Minnesota Statutes 2000, section 626.557, 44.31 subdivision 3a, is amended to read: 44.32 Subd. 3a. [REPORT NOT REQUIRED.] The following events are 44.33 not required to be reported under this section: 44.34 (a) A circumstance where federal law specifically prohibits 44.35 a person from disclosing patient identifying information in 44.36 connection with a report of suspected maltreatment, unless the 45.1 vulnerable adult, or the vulnerable adult's guardian, 45.2 conservator, or legal representative, has consented to 45.3 disclosure in a manner which conforms to federal requirements. 45.4 Facilities whose patients or residents are covered by such a 45.5 federal law shall seek consent to the disclosure of suspected 45.6 maltreatment from each patient or resident, or a guardian, 45.7 conservator, or legal representative, upon the patient's or 45.8 resident's admission to the facility. Persons who are 45.9 prohibited by federal law from reporting an incident of 45.10 suspected maltreatment shall immediately seek consent to make a 45.11 report. 45.12 (b) Verbal or physical aggression occurring between 45.13 patients, residents, or clients of a facility, or self-abusive 45.14 behavior by these persons does not constitute abuse unless the 45.15 behavior causes serious harm. The operator of the facility or a 45.16 designee shall record incidents of aggression and self-abusive 45.17 behavior to facilitate review by licensing agencies and county 45.18 and local welfare agencies. 45.19 (c) Accidents as defined in section 626.5572, subdivision 3. 45.20 (d) Events occurring in a facility that result from an 45.21 individual's single mistakeerror in the provision of 45.22 therapeutic conduct to a vulnerable adult, as definedprovided 45.23 in section 626.5572, subdivision 17, paragraph (c), clause (4). 45.24 (e) Nothing in this section shall be construed to require a 45.25 report of financial exploitation, as defined in section 45.26 626.5572, subdivision 9, solely on the basis of the transfer of 45.27 money or property by gift or as compensation for services 45.28 rendered. 45.29 Sec. 23. Minnesota Statutes 2001 Supplement, section 45.30 626.557, subdivision 9d, is amended to read: 45.31 Subd. 9d. [ADMINISTRATIVE RECONSIDERATION OF FINAL 45.32 DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 45.33 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 45.34 provided under paragraph (e), any individual or facility which a 45.35 lead agency determines has maltreated a vulnerable adult, or the 45.36 vulnerable adult or an interested person acting on behalf of the 46.1 vulnerable adult, regardless of the lead agency's determination, 46.2 who contests the lead agency's final disposition of an 46.3 allegation of maltreatment, may request the lead agency to 46.4 reconsider its final disposition. The request for 46.5 reconsideration must be submitted in writing to the lead agency 46.6 within 15 calendar days after receipt of notice of final 46.7 disposition or, if the request is made by an interested person 46.8 who is not entitled to notice, within 15 days after receipt of 46.9 the notice by the vulnerable adult or the vulnerable adult's 46.10 legal guardian. An individual who was determined to have 46.11 maltreated a vulnerable adult under this section and who was 46.12 disqualified on the basis of serious or recurring maltreatment 46.13 under section 245A.04, subdivision 3d, may request 46.14 reconsideration of the maltreatment determination and the 46.15 disqualification. The request for reconsideration of the 46.16 maltreatment determination and the disqualification must be 46.17 submitted within 30 calendar days of the individual's receipt of 46.18 the notice of disqualification under section 245A.04, 46.19 subdivision 3a. 46.20 (b) Except as provided under paragraphs (e) and (f), if the 46.21 lead agency denies the request or fails to act upon the request 46.22 within 15 calendar days after receiving the request for 46.23 reconsideration, the person or facility entitled to a fair 46.24 hearing under section 256.045, may submit to the commissioner of 46.25 human services a written request for a hearing under that 46.26 statute. The vulnerable adult, or an interested person acting 46.27 on behalf of the vulnerable adult, may request a review by the 46.28 vulnerable adult maltreatment review panel under section 256.021 46.29 if the lead agency denies the request or fails to act upon the 46.30 request, or if the vulnerable adult or interested person 46.31 contests a reconsidered disposition. The lead agency shall 46.32 notify persons who request reconsideration of their rights under 46.33 this paragraph. The request must be submitted in writing to the 46.34 review panel and a copy sent to the lead agency within 30 46.35 calendar days of receipt of notice of a denial of a request for 46.36 reconsideration or of a reconsidered disposition. The request 47.1 must specifically identify the aspects of the agency 47.2 determination with which the person is dissatisfied. 47.3 (c) If, as a result of a reconsideration or review, the 47.4 lead agency changes the final disposition, it shall notify the 47.5 parties specified in subdivision 9c, paragraph (d). 47.6 (d) For purposes of this subdivision, "interested person 47.7 acting on behalf of the vulnerable adult" means a person 47.8 designated in writing by the vulnerable adult to act on behalf 47.9 of the vulnerable adult, or a legal guardian or conservator or 47.10 other legal representative, a proxy or health care agent 47.11 appointed under chapter 145B or 145C, or an individual who is 47.12 related to the vulnerable adult, as defined in section 245A.02, 47.13 subdivision 13. 47.14 (e) If an individual was disqualified under section 47.15 245A.04, subdivision 3d, on the basis of a determination of 47.16 maltreatment, which was serious or recurring, and the individual 47.17 has requested reconsideration of the maltreatment determination 47.18 under paragraph (a) and reconsideration of the disqualification 47.19 under section 245A.04, subdivision 3b, reconsideration of the 47.20 maltreatment determination and requested reconsideration of the 47.21 disqualification shall be consolidated into a single 47.22 reconsideration. If reconsideration of the maltreatment 47.23 determination is denied or if the disqualification is not set 47.24 aside or rescinded under section 245A.04, subdivision 3b, the 47.25 individual may request a fair hearing under section 256.045. If 47.26 an individual who was disqualified on the basis of serious or47.27 recurring maltreatmentrequests a fair hearing under paragraph47.28 (b)on the maltreatment determination and the disqualification, 47.29 the scope of the fair hearing shall include both the 47.30 maltreatment determination and the disqualification. 47.31 (f) If a maltreatment determination or a disqualification 47.32 based on serious or recurring maltreatment is the basis for a 47.33 denial of a license under section 245A.05 or a licensing 47.34 sanction under section 245A.07, the license holder has the right 47.35 to a contested case hearing under chapter 14 and Minnesota 47.36 Rules, parts 1400.8510 to 1400.8612 and successor rules. As 48.1 provided for under section 245A.08, the scope of the contested 48.2 case hearing shall include the maltreatment determination, 48.3 disqualification, and licensing sanction or denial of a 48.4 license. In such cases, a fair hearing shall not be conducted 48.5 under paragraph (b). If the disqualified subject is an 48.6 individual other than the license holder and upon whom a 48.7 background study must be conducted under section 245A.04, 48.8 subdivision 3, the hearings of all parties may be consolidated 48.9 into a single contested case hearing upon consent of all parties 48.10 and the administrative law judge. 48.11 (g) Until August 1, 2002, an individual or facility that 48.12 was determined by the commissioner of human services or the 48.13 commissioner of health to be responsible for neglect under 48.14 section 626.5572, subdivision 17, after October 1, 1995, and 48.15 before August 1, 2001, that believes that the finding of neglect 48.16 does not meet an amended definition of neglect may request a 48.17 reconsideration of the determination of neglect. The 48.18 commissioner of human services or the commissioner of health 48.19 shall mail a notice to the last known address of individuals who 48.20 are eligible to seek this reconsideration. The request for 48.21 reconsideration must state how the established findings no 48.22 longer meet the elements of the definition of neglect. The 48.23 commissioner shall review the request for reconsideration and 48.24 make a determination within 15 calendar days. The 48.25 commissioner's decision on this reconsideration is the final 48.26 agency action. 48.27 (1) For purposes of compliance with the data destruction 48.28 schedule under subdivision 12b, paragraph (d), when a finding of 48.29 substantiated maltreatment has been changed as a result of a 48.30 reconsideration under this paragraph, the date of the original 48.31 finding of a substantiated maltreatment must be used to 48.32 calculate the destruction date. 48.33 (2) For purposes of any background studies under section 48.34 245A.04, when a determination of substantiated maltreatment has 48.35 been changed as a result of a reconsideration under this 48.36 paragraph, any prior disqualification of the individual under 49.1 section 245A.04 that was based on this determination of 49.2 maltreatment shall be rescinded, and for future background 49.3 studies under section 245A.04 the commissioner must not use the 49.4 previous determination of substantiated maltreatment as a basis 49.5 for disqualification or as a basis for referring the 49.6 individual's maltreatment history to a health-related licensing 49.7 board under section 245A.04, subdivision 3d, paragraph (b). 49.8 ARTICLE 2 49.9 CONTINUING CARE AND HEALTH CARE 49.10 Section 1. Minnesota Statutes 2001 Supplement, section 49.11 144A.071, subdivision 1a, is amended to read: 49.12 Subd. 1a. [DEFINITIONS.] For purposes of sections 144A.071 49.13 to 144A.073, the following terms have the meanings given them: 49.14 (a) "Attached fixtures" has the meaning given in Minnesota 49.15 Rules, part 9549.0020, subpart 6. 49.16 (b) "Buildings" has the meaning given in Minnesota Rules, 49.17 part 9549.0020, subpart 7. 49.18 (c) "Capital assets" has the meaning given in section 49.19 256B.421, subdivision 16. 49.20 (d) "Commenced construction" means that all of the 49.21 following conditions were met: the final working drawings and 49.22 specifications were approved by the commissioner of health; the 49.23 construction contracts were let; a timely construction schedule 49.24 was developed, stipulating dates for beginning, achieving 49.25 various stages, and completing construction; and all zoning and 49.26 building permits were applied for. 49.27 (e) "Completion date" means the date on which a certificate 49.28 of occupancy is issued for a construction project, or if a 49.29 certificate of occupancy is not required, the date on which the 49.30 construction project is available for facility use. 49.31 (f) "Construction" means any erection, building, 49.32 alteration, reconstruction, modernization, or improvement 49.33 necessary to comply with the nursing home licensure rules. 49.34 (g) "Construction project" means: 49.35 (1) a capital asset addition to, or replacement of a 49.36 nursing home or certified boarding care home that results in new 50.1 space or the remodeling of or renovations to existing facility 50.2 space; 50.3 (2) the remodeling or renovation of existing facility space 50.4 the use of which is modified as a result of the project 50.5 described in clause (1). This existing space and the project 50.6 described in clause (1) must be used for the functions as 50.7 designated on the construction plans on completion of the 50.8 project described in clause (1) for a period of not less than 24 50.9 months; or 50.10 (3) capital asset additions or replacements that are 50.11 completed within 12 months before or after the completion date 50.12 of the project described in clause (1). 50.13 (h) "New licensed" or "new certified beds" means: 50.14 (1) newly constructed beds in a facility or the 50.15 construction of a new facility that would increase the total 50.16 number of licensed nursing home beds or certified boarding care 50.17 or nursing home beds in the state; or 50.18 (2) newly licensed nursing home beds or newly certified 50.19 boarding care or nursing home beds that result from remodeling 50.20 of the facility that involves relocation of beds but does not 50.21 result in an increase in the total number of beds, except when 50.22 the project involves the upgrade of boarding care beds to 50.23 nursing home beds, as defined in section 144A.073, subdivision 50.24 1. "Remodeling" includes any of the type of conversion, 50.25 renovation, replacement, or upgrading projects as defined in 50.26 section 144A.073, subdivision 1. 50.27 (i) "Project construction costs" means the cost of the 50.28 facility capital asset additions, replacements, renovations, or 50.29 remodeling projects, construction site preparation costs, and 50.30 related soft costs. Project construction costs include the cost 50.31 of any remodeling or renovation of existing facility space which 50.32 is modified as a result of the construction project. Project 50.33 construction costs also includes the cost of new technology 50.34 implemented as part of the construction project. Project 50.35 construction costs also include the cost of new technology 50.36 implemented as part of the construction project and depreciable 51.1 equipment directly identified to the project. Any new 51.2 technology and depreciable equipment included in the project 51.3 construction costs shall, at the written election of the 51.4 facility, be included in the facility's appraised value for 51.5 purposes of Minnesota Rules, part 9549.0020, subpart 5, and debt 51.6 incurred for its purchase shall be included as allowable debt 51.7 for purposes of Minnesota Rules, part 9549.0060, subpart 5, 51.8 items A and C. Any new technology and depreciable equipment 51.9 included in the project construction costs that the facility 51.10 elects not to include in its appraised value and allowable debt 51.11 shall be treated as provided in section 256B.431, subdivision 51.12 17, paragraph (b). Written election under this paragraph must 51.13 be included in the facility's request for the rate change 51.14 related to the project, and this election may not be changed. 51.15 (j) "Technology" means information systems or devices that 51.16 make documentation, charting, and staff time more efficient or 51.17 encourage and allow for care through alternative settings 51.18 including, but not limited to, touch screens, monitors, 51.19 hand-helds, swipe cards, motion detectors, pagers, telemedicine, 51.20 medication dispensers, and equipment to monitor vital signs and 51.21 self-injections, and to observe skin and other conditions. 51.22 Sec. 2. Minnesota Statutes 2001 Supplement, section 51.23 144A.36, subdivision 1, is amended to read: 51.24 Subdivision 1. [DEFINITIONS.] "Eligible nursing home" 51.25 means any nursing home licensed under sections 144A.01 to 51.26 144A.155 andor any boarding care facility, certified by the 51.27 appropriate authority under United States Code, title 42, 51.28 sections 1396-1396p, to participate as a vendor in the medical 51.29 assistance program established under chapter 256B. 51.30 Sec. 3. Minnesota Statutes 2000, section 144D.01, 51.31 subdivision 4, is amended to read: 51.32 Subd. 4. [HOUSING WITH SERVICES ESTABLISHMENT OR 51.33 ESTABLISHMENT.] (a) "Housing with services establishment" or 51.34 "establishment" means: 51.35 (1) an establishment providing sleeping accommodations to 51.36 one or more adult residents, at least 80 percent of which are 55 52.1 years of age or older, and offering or providing, for a fee, one 52.2 or more regularly scheduled health-related services or two or 52.3 more regularly scheduled supportive services, whether offered or 52.4 provided directly by the establishment or by another entity 52.5 arranged for by the establishment; or 52.6 (2) an establishment that registers under section 144D.025. 52.7 (b) Housing with services establishment does not include: 52.8 (1) a nursing home licensed under chapter 144A; 52.9 (2) a hospital, certified boarding care home, or supervised 52.10 living facility licensed under sections 144.50 to 144.56; 52.11 (3) a board and lodging establishment licensed under 52.12 chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, 52.13 9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to 52.14 9530.4450, or under chapter 245B; 52.15 (4) a board and lodging establishment which serves as a 52.16 shelter for battered women or other similar purpose; 52.17 (5) a family adult foster care home licensed by the 52.18 department of human services; 52.19 (6) private homes in which the residents are related by 52.20 kinship, law, or affinity with the providers of services; 52.21 (7) residential settings for persons with mental 52.22 retardation or related conditions in which the services are 52.23 licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or 52.24 applicable successor rules or laws; 52.25 (8) a home-sharing arrangement such as when an elderly or 52.26 disabled person or single-parent family makes lodging in a 52.27 private residence available to another person in exchange for 52.28 services or rent, or both; 52.29 (9) a duly organized condominium, cooperative, common 52.30 interest community, or owners' association of the foregoing 52.31 where at least 80 percent of the units that comprise the 52.32 condominium, cooperative, or common interest community are 52.33 occupied by individuals who are the owners, members, or 52.34 shareholders of the units; or 52.35 (10) services for persons with developmental disabilities 52.36 that are provided under a license according to Minnesota Rules, 53.1 parts 9525.2000 to 9525.2140 in effect until January 1, 1998, or 53.2 under chapter 245B. 53.3 Sec. 4. [144D.025] [OPTIONAL REGISTRATION.] 53.4 An establishment that meets all the requirements of this 53.5 chapter except that fewer than 80 percent of the adult residents 53.6 are age 55 or older may, at its option, register as a housing 53.7 with services establishment. 53.8 Sec. 5. Minnesota Statutes 2000, section 245.462, 53.9 subdivision 4, is amended to read: 53.10 Subd. 4. [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 53.11 management service provider" means a case manager or case 53.12 manager associate employed by the county or other entity 53.13 authorized by the county board to provide case management 53.14 services specified in section 245.4711. 53.15 (b) A case manager must: 53.16 (1) be skilled in the process of identifying and assessing 53.17 a wide range of client needs; 53.18 (2) be knowledgeable about local community resources and 53.19 how to use those resources for the benefit of the client; 53.20 (3) have a bachelor's degree in one of the behavioral 53.21 sciences or related fields including, but not limited to, social 53.22 work, psychology, or nursing from an accredited college or 53.23 university or meet the requirements of paragraph (c); and 53.24 (4) meet the supervision and continuing education 53.25 requirements described in paragraphs (d), (e), and (f), as 53.26 applicable. 53.27 (c) Case managers without a bachelor's degree must meet one 53.28 of the requirements in clauses (1) to (3): 53.29 (1) have three or four years of experience as a case 53.30 manager associate as defined in this section; 53.31 (2) be a registered nurse without a bachelor's degree and 53.32 have a combination of specialized training in psychiatry and 53.33 work experience consisting of community interaction and 53.34 involvement or community discharge planning in a mental health 53.35 setting totaling three years; or 53.36 (3) be a person who qualified as a case manager under the 54.1 1998 department of human service waiver provision and meet the 54.2 continuing education and mentoring requirements in this section. 54.3 (d) A case manager with at least 2,000 hours of supervised 54.4 experience in the delivery of services to adults with mental 54.5 illness must receive regular ongoing supervision and clinical 54.6 supervision totaling 38 hours per year of which at least one 54.7 hour per month must be clinical supervision regarding individual 54.8 service delivery with a case management supervisor. The 54.9 remaining 26 hours of supervision may be provided by a case 54.10 manager with two years of experience. Group supervision may not 54.11 constitute more than one-half of the required supervision 54.12 hours. Clinical supervision must be documented in the client 54.13 record. 54.14 (e) A case manager without 2,000 hours of supervised 54.15 experience in the delivery of services to adults with mental 54.16 illness must: 54.17 (1) receive clinical supervision regarding individual 54.18 service delivery from a mental health professional at least one 54.19 hour per week until the requirement of 2,000 hours of experience 54.20 is met; and 54.21 (2) complete 40 hours of training approved by the 54.22 commissioner in case management skills and the characteristics 54.23 and needs of adults with serious and persistent mental illness. 54.24 (f) A case manager who is not licensed, registered, or 54.25 certified by a health-related licensing board must receive 30 54.26 hours of continuing education and training in mental illness and 54.27 mental health services annuallyevery two years. 54.28 (g) A case manager associate (CMA) must: 54.29 (1) work under the direction of a case manager or case 54.30 management supervisor; 54.31 (2) be at least 21 years of age; 54.32 (3) have at least a high school diploma or its equivalent; 54.33 and 54.34 (4) meet one of the following criteria: 54.35 (i) have an associate of arts degree in one of the 54.36 behavioral sciences or human services; 55.1 (ii) be a registered nurse without a bachelor's degree; 55.2 (iii) within the previous ten years, have three years of 55.3 life experience with serious and persistent mental illness as 55.4 defined in section 245.462, subdivision 20; or as a child had 55.5 severe emotional disturbance as defined in section 245.4871, 55.6 subdivision 6; or have three years life experience as a primary 55.7 caregiver to an adult with serious and persistent mental illness 55.8 within the previous ten years; 55.9 (iv) have 6,000 hours work experience as a nondegreed state 55.10 hospital technician; or 55.11 (v) be a mental health practitioner as defined in section 55.12 245.462, subdivision 17, clause (2). 55.13 Individuals meeting one of the criteria in items (i) to 55.14 (iv), may qualify as a case manager after four years of 55.15 supervised work experience as a case manager associate. 55.16 Individuals meeting the criteria in item (v), may qualify as a 55.17 case manager after three years of supervised experience as a 55.18 case manager associate. 55.19 (h) A case management associate must meet the following 55.20 supervision, mentoring, and continuing education requirements: 55.21 (1) have 40 hours of preservice training described under 55.22 paragraph (e), clause (2); 55.23 (2) receive at least 40 hours of continuing education in 55.24 mental illness and mental health services annually; and 55.25 (3) receive at least five hours of mentoring per week from 55.26 a case management mentor. 55.27 A "case management mentor" means a qualified, practicing case 55.28 manager or case management supervisor who teaches or advises and 55.29 provides intensive training and clinical supervision to one or 55.30 more case manager associates. Mentoring may occur while 55.31 providing direct services to consumers in the office or in the 55.32 field and may be provided to individuals or groups of case 55.33 manager associates. At least two mentoring hours per week must 55.34 be individual and face-to-face. 55.35 (i) A case management supervisor must meet the criteria for 55.36 mental health professionals, as specified in section 245.462, 56.1 subdivision 18. 56.2 (j) An immigrant who does not have the qualifications 56.3 specified in this subdivision may provide case management 56.4 services to adult immigrants with serious and persistent mental 56.5 illness who are members of the same ethnic group as the case 56.6 manager if the person: 56.7 (1) is currently enrolled in and is actively pursuing 56.8 credits toward the completion of a bachelor's degree in one of 56.9 the behavioral sciences or a related field including, but not 56.10 limited to, social work, psychology, or nursing from an 56.11 accredited college or university; 56.12 (2) completes 40 hours of training as specified in this 56.13 subdivision; and 56.14 (3) receives clinical supervision at least once a week 56.15 until the requirements of this subdivision are met. 56.16 Sec. 6. Minnesota Statutes 2000, section 245.4871, 56.17 subdivision 4, is amended to read: 56.18 Subd. 4. [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 56.19 management service provider" means a case manager or case 56.20 manager associate employed by the county or other entity 56.21 authorized by the county board to provide case management 56.22 services specified in subdivision 3 for the child with severe 56.23 emotional disturbance and the child's family. 56.24 (b) A case manager must: 56.25 (1) have experience and training in working with children; 56.26 (2) have at least a bachelor's degree in one of the 56.27 behavioral sciences or a related field including, but not 56.28 limited to, social work, psychology, or nursing from an 56.29 accredited college or university or meet the requirements of 56.30 paragraph (d); 56.31 (3) have experience and training in identifying and 56.32 assessing a wide range of children's needs; 56.33 (4) be knowledgeable about local community resources and 56.34 how to use those resources for the benefit of children and their 56.35 families; and 56.36 (5) meet the supervision and continuing education 57.1 requirements of paragraphs (e), (f), and (g), as applicable. 57.2 (c) A case manager may be a member of any professional 57.3 discipline that is part of the local system of care for children 57.4 established by the county board. 57.5 (d) A case manager without a bachelor's degree must meet 57.6 one of the requirements in clauses (1) to (3): 57.7 (1) have three or four years of experience as a case 57.8 manager associate; 57.9 (2) be a registered nurse without a bachelor's degree who 57.10 has a combination of specialized training in psychiatry and work 57.11 experience consisting of community interaction and involvement 57.12 or community discharge planning in a mental health setting 57.13 totaling three years; or 57.14 (3) be a person who qualified as a case manager under the 57.15 1998 department of human services waiver provision and meets the 57.16 continuing education, supervision, and mentoring requirements in 57.17 this section. 57.18 (e) A case manager with at least 2,000 hours of supervised 57.19 experience in the delivery of mental health services to children 57.20 must receive regular ongoing supervision and clinical 57.21 supervision totaling 38 hours per year, of which at least one 57.22 hour per month must be clinical supervision regarding individual 57.23 service delivery with a case management supervisor. The other 57.24 26 hours of supervision may be provided by a case manager with 57.25 two years of experience. Group supervision may not constitute 57.26 more than one-half of the required supervision hours. 57.27 (f) A case manager without 2,000 hours of supervised 57.28 experience in the delivery of mental health services to children 57.29 with emotional disturbance must: 57.30 (1) begin 40 hours of training approved by the commissioner 57.31 of human services in case management skills and in the 57.32 characteristics and needs of children with severe emotional 57.33 disturbance before beginning to provide case management 57.34 services; and 57.35 (2) receive clinical supervision regarding individual 57.36 service delivery from a mental health professional at least one 58.1 hour each week until the requirement of 2,000 hours of 58.2 experience is met. 58.3 (g) A case manager who is not licensed, registered, or 58.4 certified by a health-related licensing board must receive 30 58.5 hours of continuing education and training in severe emotional 58.6 disturbance and mental health services annuallyevery two years. 58.7 (h) Clinical supervision must be documented in the child's 58.8 record. When the case manager is not a mental health 58.9 professional, the county board must provide or contract for 58.10 needed clinical supervision. 58.11 (i) The county board must ensure that the case manager has 58.12 the freedom to access and coordinate the services within the 58.13 local system of care that are needed by the child. 58.14 (j) A case manager associate (CMA) must: 58.15 (1) work under the direction of a case manager or case 58.16 management supervisor; 58.17 (2) be at least 21 years of age; 58.18 (3) have at least a high school diploma or its equivalent; 58.19 and 58.20 (4) meet one of the following criteria: 58.21 (i) have an associate of arts degree in one of the 58.22 behavioral sciences or human services; 58.23 (ii) be a registered nurse without a bachelor's degree; 58.24 (iii) have three years of life experience as a primary 58.25 caregiver to a child with serious emotional disturbance as 58.26 defined in section 245.4871, subdivision 6, within the previous 58.27 ten years; 58.28 (iv) have 6,000 hours work experience as a nondegreed state 58.29 hospital technician; or 58.30 (v) be a mental health practitioner as defined in 58.31 subdivision 26, clause (2). 58.32 Individuals meeting one of the criteria in items (i) to 58.33 (iv) may qualify as a case manager after four years of 58.34 supervised work experience as a case manager associate. 58.35 Individuals meeting the criteria in item (v) may qualify as a 58.36 case manager after three years of supervised experience as a 59.1 case manager associate. 59.2 (k) Case manager associates must meet the following 59.3 supervision, mentoring, and continuing education requirements; 59.4 (1) have 40 hours of preservice training described under 59.5 paragraph (f), clause (1); 59.6 (2) receive at least 40 hours of continuing education in 59.7 severe emotional disturbance and mental health service annually; 59.8 and 59.9 (3) receive at least five hours of mentoring per week from 59.10 a case management mentor. A "case management mentor" means a 59.11 qualified, practicing case manager or case management supervisor 59.12 who teaches or advises and provides intensive training and 59.13 clinical supervision to one or more case manager associates. 59.14 Mentoring may occur while providing direct services to consumers 59.15 in the office or in the field and may be provided to individuals 59.16 or groups of case manager associates. At least two mentoring 59.17 hours per week must be individual and face-to-face. 59.18 (l) A case management supervisor must meet the criteria for 59.19 a mental health professional as specified in section 245.4871, 59.20 subdivision 27. 59.21 (m) An immigrant who does not have the qualifications 59.22 specified in this subdivision may provide case management 59.23 services to child immigrants with severe emotional disturbance 59.24 of the same ethnic group as the immigrant if the person: 59.25 (1) is currently enrolled in and is actively pursuing 59.26 credits toward the completion of a bachelor's degree in one of 59.27 the behavioral sciences or related fields at an accredited 59.28 college or university; 59.29 (2) completes 40 hours of training as specified in this 59.30 subdivision; and 59.31 (3) receives clinical supervision at least once a week 59.32 until the requirements of obtaining a bachelor's degree and 59.33 2,000 hours of supervised experience are met. 59.34 Sec. 7. Minnesota Statutes 2000, section 245.50, 59.35 subdivision 1, is amended to read: 59.36 Subdivision 1. [DEFINITIONS.] For purposes of this 60.1 section, the following terms have the meanings given them. 60.2 (a) "Bordering state" means Iowa, North Dakota, South 60.3 Dakota, or Wisconsin. 60.4 (b) "Receiving agency or facility" means a public or 60.5 private hospital, mental health center, or other person or 60.6 organization authorized by a state to providewhich provides 60.7 mental health services under this section to individuals from a 60.8 state other than the state in which the agency is located. 60.9 (c) "Receiving state" means the state in which a receiving 60.10 agency is located. 60.11 (d) "Sending agency" means a state or county agency which 60.12 sends an individual to a bordering state for treatment under 60.13 this section. 60.14 (e) "Sending state" means the state in which the sending 60.15 agency is located. 60.16 Sec. 8. Minnesota Statutes 2000, section 245.50, 60.17 subdivision 2, is amended to read: 60.18 Subd. 2. [PURPOSE AND AUTHORITY.] (a) The purpose of this 60.19 section is to enable appropriate treatment to be provided to 60.20 individuals, across state lines from the individual's state of 60.21 residence, in qualified facilities that are closer to the homes 60.22 of individuals than are facilities available in the individual's 60.23 home state. 60.24 (b) Unless prohibited by another law and subject to the 60.25 exceptions listed in subdivision 3, a county board or the 60.26 commissioner of human services may contract with an agency or 60.27 facility in a bordering state for mental health services for 60.28 residents of Minnesota, and a Minnesota mental health agency or 60.29 facility may contract to provide services to residents of 60.30 bordering states. Except as provided in subdivision 5, a person 60.31 who receives services in another state under this section is 60.32 subject to the laws of the state in which services are 60.33 provided. A person who will receive services in another state 60.34 under this section must be informed of the consequences of 60.35 receiving services in another state, including the implications 60.36 of the differences in state laws, to the extent the individual 61.1 will be subject to the laws of the receiving state. 61.2 Sec. 9. Minnesota Statutes 2000, section 245.50, 61.3 subdivision 5, is amended to read: 61.4 Subd. 5. [SPECIAL CONTRACTS; WISCONSINBORDERING 61.5 STATES.] The commissioner of the Minnesota department of human61.6 services must enter into negotiations with appropriate personnel61.7 at the Wisconsin department of health and social services and61.8 must develop an agreement that conforms to the requirements of61.9 subdivision 4, to enable the placement in Minnesota of patients61.10 who are on emergency holds or who have been involuntarily61.11 committed as mentally ill or chemically dependent in Wisconsin61.12 and to enable the temporary placement in Wisconsin of patients61.13 who are on emergency holds in Minnesota under section 253B.05,61.14 provided that the Minnesota courts retain jurisdiction over61.15 Minnesota patients, and the state of Wisconsin affords to61.16 Minnesota patients the rights under Minnesota law. Persons61.17 committed by the Wisconsin courts and placed in Minnesota61.18 facilities shall continue to be in the legal custody of61.19 Wisconsin and Wisconsin's laws governing length of commitment,61.20 reexaminations, and extension of commitment shall continue to61.21 apply to these residents. In all other respects, Wisconsin61.22 residents placed in Minnesota facilities are subject to61.23 Minnesota laws. The agreement must specify that responsibility61.24 for payment for the cost of care of Wisconsin residents shall61.25 remain with the state of Wisconsin and the cost of care of61.26 Minnesota residents shall remain with the state of Minnesota.61.27 The commissioner shall be assisted by attorneys from the61.28 Minnesota attorney general's office in negotiating and61.29 finalizing this agreement. The agreement shall be completed so61.30 as to permit placement of Wisconsin residents in Minnesota61.31 facilities and Minnesota residents in Wisconsin facilities61.32 beginning July 1, 1994.(a) An individual who is detained, 61.33 committed, or placed on an involuntary basis under chapter 253B 61.34 may be confined or treated in a bordering state pursuant to a 61.35 contract under this section. An individual who is detained, 61.36 committed, or placed on an involuntary basis under the civil law 62.1 of a bordering state may be confined or treated in Minnesota 62.2 pursuant to a contract under this section. A peace or health 62.3 officer who is acting under the authority of the sending state 62.4 may transport an individual to a receiving agency that provides 62.5 services pursuant to a contract under this section and may 62.6 transport the individual back to the sending state under the 62.7 laws of the sending state. Court orders valid under the law of 62.8 the sending state are granted recognition and reciprocity in the 62.9 receiving state for individuals covered by a contract under this 62.10 section to the extent that the court orders relate to 62.11 confinement for treatment or care of mental illness. Such 62.12 treatment or care may address other conditions that may be 62.13 co-occurring with the mental illness. These court orders are 62.14 not subject to legal challenge in the courts of the receiving 62.15 state. Individuals who are detained, committed, or placed under 62.16 the law of a sending state and who are transferred to a 62.17 receiving state under this section continue to be in the legal 62.18 custody of the authority responsible for them under the law of 62.19 the sending state. Except in emergencies, those individuals may 62.20 not be transferred, removed, or furloughed from a receiving 62.21 agency without the specific approval of the authority 62.22 responsible for them under the law of the sending state. 62.23 (b) While in the receiving state pursuant to a contract 62.24 under this section, an individual shall be subject to the 62.25 sending state's laws and rules relating to length of 62.26 confinement, reexaminations, and extensions of confinement. No 62.27 individual may be sent to another state pursuant to a contract 62.28 under this section until the receiving state has enacted a law 62.29 recognizing the validity and applicability of this section. 62.30 (c) If an individual receiving services pursuant to a 62.31 contract under this section leaves the receiving agency without 62.32 permission and the individual is subject to involuntary 62.33 confinement under the law of the sending state, the receiving 62.34 agency shall use all reasonable means to return the individual 62.35 to the receiving agency. The receiving agency shall immediately 62.36 report the absence to the sending agency. The receiving state 63.1 has the primary responsibility for, and the authority to direct, 63.2 the return of these individuals within its borders and is liable 63.3 for the cost of the action to the extent that it would be liable 63.4 for costs of its own resident. 63.5 (d) Responsibility for payment for the cost of care remains 63.6 with the sending agency. 63.7 (e) This subdivision also applies to county contracts under 63.8 subdivision 2 which include emergency care and treatment 63.9 provided to a county resident in a bordering state. 63.10 Sec. 10. Minnesota Statutes 2001 Supplement, section 63.11 256.01, subdivision 2, as amended by Laws 2002, chapter 220, 63.12 article 15, section 4, is amended to read: 63.13 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 63.14 section 241.021, subdivision 2, the commissioner of human 63.15 services shall: 63.16 (1) Administer and supervise all forms of public assistance 63.17 provided for by state law and other welfare activities or 63.18 services as are vested in the commissioner. Administration and 63.19 supervision of human services activities or services includes, 63.20 but is not limited to, assuring timely and accurate distribution 63.21 of benefits, completeness of service, and quality program 63.22 management. In addition to administering and supervising human 63.23 services activities vested by law in the department, the 63.24 commissioner shall have the authority to: 63.25 (a) require county agency participation in training and 63.26 technical assistance programs to promote compliance with 63.27 statutes, rules, federal laws, regulations, and policies 63.28 governing human services; 63.29 (b) monitor, on an ongoing basis, the performance of county 63.30 agencies in the operation and administration of human services, 63.31 enforce compliance with statutes, rules, federal laws, 63.32 regulations, and policies governing welfare services and promote 63.33 excellence of administration and program operation; 63.34 (c) develop a quality control program or other monitoring 63.35 program to review county performance and accuracy of benefit 63.36 determinations; 64.1 (d) require county agencies to make an adjustment to the 64.2 public assistance benefits issued to any individual consistent 64.3 with federal law and regulation and state law and rule and to 64.4 issue or recover benefits as appropriate; 64.5 (e) delay or deny payment of all or part of the state and 64.6 federal share of benefits and administrative reimbursement 64.7 according to the procedures set forth in section 256.017; 64.8 (f) make contracts with and grants to public and private 64.9 agencies and organizations, both profit and nonprofit, and 64.10 individuals, using appropriated funds; and 64.11 (g) enter into contractual agreements with federally 64.12 recognized Indian tribes with a reservation in Minnesota to the 64.13 extent necessary for the tribe to operate a federally approved 64.14 family assistance program or any other program under the 64.15 supervision of the commissioner. The commissioner shall consult 64.16 with the affected county or counties in the contractual 64.17 agreement negotiations, if the county or counties wish to be 64.18 included, in order to avoid the duplication of county and tribal 64.19 assistance program services. The commissioner may establish 64.20 necessary accounts for the purposes of receiving and disbursing 64.21 funds as necessary for the operation of the programs. 64.22 (2) Inform county agencies, on a timely basis, of changes 64.23 in statute, rule, federal law, regulation, and policy necessary 64.24 to county agency administration of the programs. 64.25 (3) Administer and supervise all child welfare activities; 64.26 promote the enforcement of laws protecting handicapped, 64.27 dependent, neglected and delinquent children, and children born 64.28 to mothers who were not married to the children's fathers at the 64.29 times of the conception nor at the births of the children; 64.30 license and supervise child-caring and child-placing agencies 64.31 and institutions; supervise the care of children in boarding and 64.32 foster homes or in private institutions; and generally perform 64.33 all functions relating to the field of child welfare now vested 64.34 in the state board of control. 64.35 (4) Administer and supervise all noninstitutional service 64.36 to handicapped persons, including those who are visually 65.1 impaired, hearing impaired, or physically impaired or otherwise 65.2 handicapped. The commissioner may provide and contract for the 65.3 care and treatment of qualified indigent children in facilities 65.4 other than those located and available at state hospitals when 65.5 it is not feasible to provide the service in state hospitals. 65.6 (5) Assist and actively cooperate with other departments, 65.7 agencies and institutions, local, state, and federal, by 65.8 performing services in conformity with the purposes of Laws 65.9 1939, chapter 431. 65.10 (6) Act as the agent of and cooperate with the federal 65.11 government in matters of mutual concern relative to and in 65.12 conformity with the provisions of Laws 1939, chapter 431, 65.13 including the administration of any federal funds granted to the 65.14 state to aid in the performance of any functions of the 65.15 commissioner as specified in Laws 1939, chapter 431, and 65.16 including the promulgation of rules making uniformly available 65.17 medical care benefits to all recipients of public assistance, at 65.18 such times as the federal government increases its participation 65.19 in assistance expenditures for medical care to recipients of 65.20 public assistance, the cost thereof to be borne in the same 65.21 proportion as are grants of aid to said recipients. 65.22 (7) Establish and maintain any administrative units 65.23 reasonably necessary for the performance of administrative 65.24 functions common to all divisions of the department. 65.25 (8) Act as designated guardian of both the estate and the 65.26 person of all the wards of the state of Minnesota, whether by 65.27 operation of law or by an order of court, without any further 65.28 act or proceeding whatever, except as to persons committed as 65.29 mentally retarded. For children under the guardianship of the 65.30 commissioner whose interests would be best served by adoptive 65.31 placement, the commissioner may contract with a licensed 65.32 child-placing agency or a Minnesota tribal social services 65.33 agency to provide adoption services. A contract with a licensed 65.34 child-placing agency must be designed to supplement existing 65.35 county efforts and may not replace existing county programs, 65.36 unless the replacement is agreed to by the county board and the 66.1 appropriate exclusive bargaining representative or the 66.2 commissioner has evidence that child placements of the county 66.3 continue to be substantially below that of other counties. 66.4 Funds encumbered and obligated under an agreement for a specific 66.5 child shall remain available until the terms of the agreement 66.6 are fulfilled or the agreement is terminated. 66.7 (9) Act as coordinating referral and informational center 66.8 on requests for service for newly arrived immigrants coming to 66.9 Minnesota. 66.10 (10) The specific enumeration of powers and duties as 66.11 hereinabove set forth shall in no way be construed to be a 66.12 limitation upon the general transfer of powers herein contained. 66.13 (11) Establish county, regional, or statewide schedules of 66.14 maximum fees and charges which may be paid by county agencies 66.15 for medical, dental, surgical, hospital, nursing and nursing 66.16 home care and medicine and medical supplies under all programs 66.17 of medical care provided by the state and for congregate living 66.18 care under the income maintenance programs. 66.19 (12) Have the authority to conduct and administer 66.20 experimental projects to test methods and procedures of 66.21 administering assistance and services to recipients or potential 66.22 recipients of public welfare. To carry out such experimental 66.23 projects, it is further provided that the commissioner of human 66.24 services is authorized to waive the enforcement of existing 66.25 specific statutory program requirements, rules, and standards in 66.26 one or more counties. The order establishing the waiver shall 66.27 provide alternative methods and procedures of administration, 66.28 shall not be in conflict with the basic purposes, coverage, or 66.29 benefits provided by law, and in no event shall the duration of 66.30 a project exceed four years. It is further provided that no 66.31 order establishing an experimental project as authorized by the 66.32 provisions of this section shall become effective until the 66.33 following conditions have been met: 66.34 (a) The secretary of health and human services of the 66.35 United States has agreed, for the same project, to waive state 66.36 plan requirements relative to statewide uniformity. 67.1 (b) A comprehensive plan, including estimated project 67.2 costs, shall be approved by the legislative advisory commission 67.3 and filed with the commissioner of administration. 67.4 (13) According to federal requirements, establish 67.5 procedures to be followed by local welfare boards in creating 67.6 citizen advisory committees, including procedures for selection 67.7 of committee members. 67.8 (14) Allocate federal fiscal disallowances or sanctions 67.9 which are based on quality control error rates for the aid to 67.10 families with dependent children program formerly codified in 67.11 sections 256.72 to 256.87, medical assistance, or food stamp 67.12 program in the following manner: 67.13 (a) One-half of the total amount of the disallowance shall 67.14 be borne by the county boards responsible for administering the 67.15 programs. For the medical assistance and the AFDC program 67.16 formerly codified in sections 256.72 to 256.87, disallowances 67.17 shall be shared by each county board in the same proportion as 67.18 that county's expenditures for the sanctioned program are to the 67.19 total of all counties' expenditures for the AFDC program 67.20 formerly codified in sections 256.72 to 256.87, and medical 67.21 assistance programs. For the food stamp program, sanctions 67.22 shall be shared by each county board, with 50 percent of the 67.23 sanction being distributed to each county in the same proportion 67.24 as that county's administrative costs for food stamps are to the 67.25 total of all food stamp administrative costs for all counties, 67.26 and 50 percent of the sanctions being distributed to each county 67.27 in the same proportion as that county's value of food stamp 67.28 benefits issued are to the total of all benefits issued for all 67.29 counties. Each county shall pay its share of the disallowance 67.30 to the state of Minnesota. When a county fails to pay the 67.31 amount due hereunder, the commissioner may deduct the amount 67.32 from reimbursement otherwise due the county, or the attorney 67.33 general, upon the request of the commissioner, may institute 67.34 civil action to recover the amount due. 67.35 (b) Notwithstanding the provisions of paragraph (a), if the 67.36 disallowance results from knowing noncompliance by one or more 68.1 counties with a specific program instruction, and that knowing 68.2 noncompliance is a matter of official county board record, the 68.3 commissioner may require payment or recover from the county or 68.4 counties, in the manner prescribed in paragraph (a), an amount 68.5 equal to the portion of the total disallowance which resulted 68.6 from the noncompliance, and may distribute the balance of the 68.7 disallowance according to paragraph (a). 68.8 (15) Develop and implement special projects that maximize 68.9 reimbursements and result in the recovery of money to the 68.10 state. For the purpose of recovering state money, the 68.11 commissioner may enter into contracts with third parties. Any 68.12 recoveries that result from projects or contracts entered into 68.13 under this paragraph shall be deposited in the state treasury 68.14 and credited to a special account until the balance in the 68.15 account reaches $1,000,000. When the balance in the account 68.16 exceeds $1,000,000, the excess shall be transferred and credited 68.17 to the general fund. All money in the account is appropriated 68.18 to the commissioner for the purposes of this paragraph. 68.19 (16) Have the authority to make direct payments to 68.20 facilities providing shelter to women and their children 68.21 according to section 256D.05, subdivision 3. Upon the written 68.22 request of a shelter facility that has been denied payments 68.23 under section 256D.05, subdivision 3, the commissioner shall 68.24 review all relevant evidence and make a determination within 30 68.25 days of the request for review regarding issuance of direct 68.26 payments to the shelter facility. Failure to act within 30 days 68.27 shall be considered a determination not to issue direct payments. 68.28 (17) Have the authority to establish and enforce the 68.29 following county reporting requirements: 68.30 (a) The commissioner shall establish fiscal and statistical 68.31 reporting requirements necessary to account for the expenditure 68.32 of funds allocated to counties for human services programs. 68.33 When establishing financial and statistical reporting 68.34 requirements, the commissioner shall evaluate all reports, in 68.35 consultation with the counties, to determine if the reports can 68.36 be simplified or the number of reports can be reduced. 69.1 (b) The county board shall submit monthly or quarterly 69.2 reports to the department as required by the commissioner. 69.3 Monthly reports are due no later than 15 working days after the 69.4 end of the month. Quarterly reports are due no later than 30 69.5 calendar days after the end of the quarter, unless the 69.6 commissioner determines that the deadline must be shortened to 69.7 20 calendar days to avoid jeopardizing compliance with federal 69.8 deadlines or risking a loss of federal funding. Only reports 69.9 that are complete, legible, and in the required format shall be 69.10 accepted by the commissioner. 69.11 (c) If the required reports are not received by the 69.12 deadlines established in clause (b), the commissioner may delay 69.13 payments and withhold funds from the county board until the next 69.14 reporting period. When the report is needed to account for the 69.15 use of federal funds and the late report results in a reduction 69.16 in federal funding, the commissioner shall withhold from the 69.17 county boards with late reports an amount equal to the reduction 69.18 in federal funding until full federal funding is received. 69.19 (d) A county board that submits reports that are late, 69.20 illegible, incomplete, or not in the required format for two out 69.21 of three consecutive reporting periods is considered 69.22 noncompliant. When a county board is found to be noncompliant, 69.23 the commissioner shall notify the county board of the reason the 69.24 county board is considered noncompliant and request that the 69.25 county board develop a corrective action plan stating how the 69.26 county board plans to correct the problem. The corrective 69.27 action plan must be submitted to the commissioner within 45 days 69.28 after the date the county board received notice of noncompliance. 69.29 (e) The final deadline for fiscal reports or amendments to 69.30 fiscal reports is one year after the date the report was 69.31 originally due. If the commissioner does not receive a report 69.32 by the final deadline, the county board forfeits the funding 69.33 associated with the report for that reporting period and the 69.34 county board must repay any funds associated with the report 69.35 received for that reporting period. 69.36 (f) The commissioner may not delay payments, withhold 70.1 funds, or require repayment under paragraph (c) or (e) if the 70.2 county demonstrates that the commissioner failed to provide 70.3 appropriate forms, guidelines, and technical assistance to 70.4 enable the county to comply with the requirements. If the 70.5 county board disagrees with an action taken by the commissioner 70.6 under paragraph (c) or (e), the county board may appeal the 70.7 action according to sections 14.57 to 14.69. 70.8 (g) Counties subject to withholding of funds under 70.9 paragraph (c) or forfeiture or repayment of funds under 70.10 paragraph (e) shall not reduce or withhold benefits or services 70.11 to clients to cover costs incurred due to actions taken by the 70.12 commissioner under paragraph (c) or (e). 70.13 (18) Allocate federal fiscal disallowances or sanctions for 70.14 audit exceptions when federal fiscal disallowances or sanctions 70.15 are based on a statewide random sample for the foster care 70.16 program under title IV-E of the Social Security Act, United 70.17 States Code, title 42, in direct proportion to each county's 70.18 title IV-E foster care maintenance claim for that period. 70.19 (19) Be responsible for ensuring the detection, prevention, 70.20 investigation, and resolution of fraudulent activities or 70.21 behavior by applicants, recipients, and other participants in 70.22 the human services programs administered by the department. 70.23 (20) Require county agencies to identify overpayments, 70.24 establish claims, and utilize all available and cost-beneficial 70.25 methodologies to collect and recover these overpayments in the 70.26 human services programs administered by the department. 70.27 (21) Have the authority to administer a drug rebate program 70.28 for drugs purchased pursuant to the prescription drug program 70.29 established under section 256.955 after the beneficiary's 70.30 satisfaction of any deductible established in the program. The 70.31 commissioner shall require a rebate agreement from all 70.32 manufacturers of covered drugs as defined in section 256B.0625, 70.33 subdivision 13. Rebate agreements for prescription drugs 70.34 delivered on or after July 1, 2002, must include rebates for 70.35 individuals covered under the prescription drug program who are 70.36 under 65 years of age. For each drug, the amount of the rebate 71.1 shall be equal to the basic rebate as defined for purposes of 71.2 the federal rebate program in United States Code, title 42, 71.3 section 1396r-8(c)(1). This basic rebate shall be applied to 71.4 single-source and multiple-source drugs. The manufacturers must 71.5 provide full payment within 30 days of receipt of the state 71.6 invoice for the rebate within the terms and conditions used for 71.7 the federal rebate program established pursuant to section 1927 71.8 of title XIX of the Social Security Act. The manufacturers must 71.9 provide the commissioner with any information necessary to 71.10 verify the rebate determined per drug. The rebate program shall 71.11 utilize the terms and conditions used for the federal rebate 71.12 program established pursuant to section 1927 of title XIX of the 71.13 Social Security Act. 71.14 (22) Have the authority to administer the federal drug 71.15 rebate program for drugs purchased under the medical assistance 71.16 program as allowed by section 1927 of title XIX of the Social 71.17 Security Act and according to the terms and conditions of 71.18 section 1927. Rebates shall be collected for all drugs that 71.19 have been dispensed or administered in an outpatient setting and 71.20 that are from manufacturers who have signed a rebate agreement 71.21 with the United States Department of Health and Human Services. 71.22 (23) Have the authority to administer a supplemental drug 71.23 rebate program for drugs purchased under the medical assistance 71.24 program and under the prescription drug program established in71.25 section 256.955. The commissioner may enter into supplemental 71.26 rebate contracts with pharmaceutical manufacturers and may 71.27 require prior authorization for drugs that are from 71.28 manufacturers that have not signed a supplemental rebate 71.29 contract. Prior authorization of drugs shall be subject to the 71.30 provisions of section 256B.0625, subdivision 13 , paragraph (b). 71.31 (24) Operate the department's communication systems account 71.32 established in Laws 1993, First Special Session chapter 1, 71.33 article 1, section 2, subdivision 2, to manage shared 71.34 communication costs necessary for the operation of the programs 71.35 the commissioner supervises. A communications account may also 71.36 be established for each regional treatment center which operates 72.1 communications systems. Each account must be used to manage 72.2 shared communication costs necessary for the operations of the 72.3 programs the commissioner supervises. The commissioner may 72.4 distribute the costs of operating and maintaining communication 72.5 systems to participants in a manner that reflects actual usage. 72.6 Costs may include acquisition, licensing, insurance, 72.7 maintenance, repair, staff time and other costs as determined by 72.8 the commissioner. Nonprofit organizations and state, county, 72.9 and local government agencies involved in the operation of 72.10 programs the commissioner supervises may participate in the use 72.11 of the department's communications technology and share in the 72.12 cost of operation. The commissioner may accept on behalf of the 72.13 state any gift, bequest, devise or personal property of any 72.14 kind, or money tendered to the state for any lawful purpose 72.15 pertaining to the communication activities of the department. 72.16 Any money received for this purpose must be deposited in the 72.17 department's communication systems accounts. Money collected by 72.18 the commissioner for the use of communication systems must be 72.19 deposited in the state communication systems account and is 72.20 appropriated to the commissioner for purposes of this section. 72.21 (25) Receive any federal matching money that is made 72.22 available through the medical assistance program for the 72.23 consumer satisfaction survey. Any federal money received for 72.24 the survey is appropriated to the commissioner for this 72.25 purpose. The commissioner may expend the federal money received 72.26 for the consumer satisfaction survey in either year of the 72.27 biennium. 72.28 (26) Incorporate cost reimbursement claims from First Call 72.29 Minnesota and Greater Twin Cities United Way into the federal 72.30 cost reimbursement claiming processes of the department 72.31 according to federal law, rule, and regulations. Any 72.32 reimbursement received is appropriated to the commissioner and 72.33 shall be disbursed to First Call Minnesota and Greater Twin 72.34 Cities United Way according to normal department payment 72.35 schedules. 72.36 (27) Develop recommended standards for foster care homes 73.1 that address the components of specialized therapeutic services 73.2 to be provided by foster care homes with those services. 73.3 Sec. 11. Minnesota Statutes 2000, section 256.01, is 73.4 amended by adding a subdivision to read: 73.5 Subd. 20. [RYAN WHITE COMPREHENSIVE AIDS RESOURCES 73.6 EMERGENCY ACT.] The commissioner shall act as the designated 73.7 state agent for carrying out responsibilities required under 73.8 Title II of the federal Ryan White Comprehensive AIDS Resources 73.9 Emergency (CARE) Act. These responsibilities include: 73.10 (1) coordinating statewide HIV/AIDS needs assessment 73.11 activities; 73.12 (2) developing the state's plan to meet identified health 73.13 and support service needs of people living with HIV/AIDS; 73.14 (3) administering federal funds designed to provide 73.15 comprehensive health and support services to persons living with 73.16 HIV/AIDS; 73.17 (4) administering federal funds designated for the AIDS 73.18 drug assistance program (ADAP); 73.19 (5) collecting rebates from pharmaceutical manufacturers on 73.20 drugs purchased with federal ADAP funds; and 73.21 (6) utilizing ADAP rebate funds in accordance with 73.22 guidelines of the federal Health Resources and Services 73.23 Administration. 73.24 Rebates collected under this subdivision shall be deposited into 73.25 the ADAP account in the special revenue fund and are 73.26 appropriated to the commissioner for purposes of this 73.27 subdivision. 73.28 Sec. 12. Minnesota Statutes 2000, section 256.9657, 73.29 subdivision 1, as amended by Laws 2002, chapter 220, article 14, 73.30 section 5, is amended to read: 73.31 Subdivision 1. [NURSING HOME LICENSE SURCHARGE.] (a) 73.32 Effective July 1, 1993, each non-state-operated nursing home 73.33 licensed under chapter 144A shall pay to the commissioner an 73.34 annual surcharge according to the schedule in subdivision 4. 73.35 The surcharge shall be calculated as $620 per licensed bed. If 73.36 the number of licensed beds is reduced, the surcharge shall be 74.1 based on the number of remaining licensed beds the second month 74.2 following the receipt of timely notice by the commissioner of 74.3 human services that beds have been delicensed. The nursing home 74.4 must notify the commissioner of health in writing when beds are 74.5 delicensed. The commissioner of health must notify the 74.6 commissioner of human services within ten working days after 74.7 receiving written notification. If the notification is received 74.8 by the commissioner of human services by the 15th of the month, 74.9 the invoice for the second following month must be reduced to 74.10 recognize the delicensing of beds. Beds on layaway status 74.11 continue to be subject to the surcharge. The commissioner of 74.12 human services must acknowledge a medical care surcharge appeal 74.13 within 30 days of receipt of the written appeal from the 74.14 provider. 74.15 (b) Effective July 1, 1994, the surcharge in paragraph (a) 74.16 shall be increased to $625. 74.17 (c) Effective August 15, 2003, the surcharge under 74.18 paragraph (b) shall be increased by an amount necessary to 74.19 ensure a net gain to the general fund of $9,620,000 during 74.20 fiscal year 2004 as a result of: 74.21 (1) the total transfers anticipated during the fiscal year 74.22 ending June 30, 2004, under section 256B.19, subdivision 1d, 74.23 paragraph (c); 74.24 (2) the county nursing home payment adjustments under 74.25 section 256B.431, subdivision 23, paragraph (c); 74.26 (3) the surcharges under this paragraph; and 74.27 (4) the nursing facility rate increases under section 74.28 256B.431, subdivision 37. 74.29 The increase under this paragraph shall not exceed $365 per bed. 74.30 (d) Effective August 15, 2004, the surcharge under 74.31 paragraph (c) shall be equal to an amount necessary to ensure a 74.32 net gain to the general fund each fiscal year of $10,228,000 as 74.33 a result of: 74.34 (1) the total transfers anticipated during the fiscal year 74.35 under section 256B.19, subdivision 1d, paragraph (c); 74.36 (2) the county nursing home payment adjustments under 75.1 section 256B.431, subdivision 23, paragraph (c); 75.2 (3) the surcharges under this paragraph; and 75.3 (4) the nursing facility rate increases under section 75.4 256B.431, subdivision 37. 75.5 The surcharge under this paragraph shall not exceed $365 per bed. 75.6 (e) Between April 1, 2002, and August 15, 2003, a facility 75.7 governed by this subdivision may elect to assume full 75.8 participation in the medical assistance program by agreeing to 75.9 comply with all of the requirements of the medical assistance 75.10 program, including the rate equalization law in section 256B.48, 75.11 subdivision 1, paragraph (a), and all other requirements 75.12 established in law or rule, and to begin intake of new medical 75.13 assistance recipients. Rates will be determined under Minnesota 75.14 Rules, parts 9549.0010 to 9549.0080. Notwithstanding section 75.15 256B.431, subdivision 27, paragraph (i), rate calculations will 75.16 be subject to limits as prescribed in rule and law. Other than 75.17 the adjustments in sections 256B.431, subdivisions 30 and 32; 75.18 256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 75.19 9549.0057, and any other applicable legislation enacted prior to 75.20 the finalization of rates, facilities assuming full 75.21 participation in medical assistance under this paragraph are not 75.22 eligible for any rate adjustments until the July 1 following 75.23 their settle-up period. 75.24 [EFFECTIVE DATE.] This section is effective April 1, 2002. 75.25 Sec. 13. Minnesota Statutes 2001 Supplement, section 75.26 256B.0625, subdivision 13, as amended by Laws 2002, chapter 220, 75.27 article 15, section 13, is amended to read: 75.28 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 75.29 except for fertility drugs when specifically used to enhance 75.30 fertility, if prescribed by a licensed practitioner and 75.31 dispensed by a licensed pharmacist, by a physician enrolled in 75.32 the medical assistance program as a dispensing physician, or by 75.33 a physician or a nurse practitioner employed by or under 75.34 contract with a community health board as defined in section 75.35 145A.02, subdivision 5, for the purposes of communicable disease 75.36 control. The commissioner, after receiving recommendations from 76.1 professional medical associations and professional pharmacist 76.2 associations, shall designate a formulary committee to advise 76.3 the commissioner on the names of drugs for which payment is 76.4 made, recommend a system for reimbursing providers on a set fee 76.5 or charge basis rather than the present system, and develop 76.6 methods encouraging use of generic drugs when they are less 76.7 expensive and equally effective as trademark drugs. The 76.8 formulary committee shall consist of nine members, four of whom 76.9 shall be physicians who are not employed by the department of 76.10 human services, and a majority of whose practice is for persons 76.11 paying privately or through health insurance, three of whom 76.12 shall be pharmacists who are not employed by the department of 76.13 human services, and a majority of whose practice is for persons 76.14 paying privately or through health insurance, a consumer 76.15 representative, and a nursing home representative. Committee 76.16 members shall serve three-year terms and shall serve without 76.17 compensation. Members may be reappointed once. 76.18 (b) The commissioner shall establish a drug formulary. Its 76.19 establishment and publication shall not be subject to the 76.20 requirements of the Administrative Procedure Act, but the 76.21 formulary committee shall review and comment on the formulary 76.22 contents. 76.23 The formulary shall not include: 76.24 (i) drugs or products for which there is no federal 76.25 funding; 76.26 (ii) over-the-counter drugs, except for antacids, 76.27 acetaminophen, family planning products, aspirin, insulin, 76.28 products for the treatment of lice, vitamins for adults with 76.29 documented vitamin deficiencies, vitamins for children under the 76.30 age of seven and pregnant or nursing women, and any other 76.31 over-the-counter drug identified by the commissioner, in 76.32 consultation with the drug formulary committee, as necessary, 76.33 appropriate, and cost-effective for the treatment of certain 76.34 specified chronic diseases, conditions or disorders, and this 76.35 determination shall not be subject to the requirements of 76.36 chapter 14; 77.1 (iii) anorectics, except that medically necessary 77.2 anorectics shall be covered for a recipient previously diagnosed 77.3 as having pickwickian syndrome and currently diagnosed as having 77.4 diabetes and being morbidly obese; 77.5 (iv) drugs for which medical value has not been 77.6 established; and 77.7 (v) drugs from manufacturers who have not signed a rebate 77.8 agreement with the Department of Health and Human Services 77.9 pursuant to section 1927 of title XIX of the Social Security Act. 77.10 The commissioner shall publish conditions for prohibiting 77.11 payment for specific drugs after considering the formulary 77.12 committee's recommendations. An honorarium of $100 per meeting 77.13 and reimbursement for mileage shall be paid to each committee 77.14 member in attendance. 77.15 (c) The basis for determining the amount of payment shall 77.16 be the lower of the actual acquisition costs of the drugs plus a 77.17 fixed dispensing fee; the maximum allowable cost set by the 77.18 federal government or by the commissioner plus the fixed 77.19 dispensing fee; or the usual and customary price charged to the 77.20 public. The pharmacy dispensing fee shall be $3.65, except that 77.21 the dispensing fee for intravenous solutions which must be 77.22 compounded by the pharmacist shall be $8 per bag, $14 per bag 77.23 for cancer chemotherapy products, and $30 per bag for total 77.24 parenteral nutritional products dispensed in one liter 77.25 quantities, or $44 per bag for total parenteral nutritional 77.26 products dispensed in quantities greater than one liter. Actual 77.27 acquisition cost includes quantity and other special discounts 77.28 except time and cash discounts. The actual acquisition cost of 77.29 a drug shall be estimated by the commissioner, at average 77.30 wholesale price minus nine percent, except that where a drug has 77.31 had its wholesale price reduced as a result of the actions of 77.32 the National Association of Medicaid Fraud Control Units, the 77.33 estimated actual acquisition cost shall be the reduced average 77.34 wholesale price, without the nine percent deduction. The 77.35 maximum allowable cost of a multisource drug may be set by the 77.36 commissioner and it shall be comparable to, but no higher than, 78.1 the maximum amount paid by other third-party payors in this 78.2 state who have maximum allowable cost programs. The 78.3 commissioner shall set maximum allowable costs for multisource 78.4 drugs that are not on the federal upper limit list as described 78.5 in United States Code, title 42, chapter 7, section 1396r-8(e), 78.6 the Social Security Act, and Code of Federal Regulations, title 78.7 42, part 447, section 447.332. Establishment of the amount of 78.8 payment for drugs shall not be subject to the requirements of 78.9 the Administrative Procedure Act. An additional dispensing fee 78.10 of $.30 may be added to the dispensing fee paid to pharmacists 78.11 for legend drug prescriptions dispensed to residents of 78.12 long-term care facilities when a unit dose blister card system, 78.13 approved by the department, is used. Under this type of 78.14 dispensing system, the pharmacist must dispense a 30-day supply 78.15 of drug. The National Drug Code (NDC) from the drug container 78.16 used to fill the blister card must be identified on the claim to 78.17 the department. The unit dose blister card containing the drug 78.18 must meet the packaging standards set forth in Minnesota Rules, 78.19 part 6800.2700, that govern the return of unused drugs to the 78.20 pharmacy for reuse. The pharmacy provider will be required to 78.21 credit the department for the actual acquisition cost of all 78.22 unused drugs that are eligible for reuse. Over-the-counter 78.23 medications must be dispensed in the manufacturer's unopened 78.24 package. The commissioner may permit the drug clozapine to be 78.25 dispensed in a quantity that is less than a 30-day supply. 78.26 Whenever a generically equivalent product is available, payment 78.27 shall be on the basis of the actual acquisition cost of the 78.28 generic drug, unless the prescriber specifically indicates 78.29 "dispense as written - brand necessary" on the prescription as 78.30 required by section 151.21, subdivision 2. 78.31 (d) For purposes of this subdivision, "multisource drugs" 78.32 means covered outpatient drugs, excluding innovator multisource 78.33 drugs for which there are two or more drug products, which: 78.34 (1) are related as therapeutically equivalent under the 78.35 Food and Drug Administration's most recent publication of 78.36 "Approved Drug Products with Therapeutic Equivalence 79.1 Evaluations"; 79.2 (2) are pharmaceutically equivalent and bioequivalent as 79.3 determined by the Food and Drug Administration; and 79.4 (3) are sold or marketed in Minnesota. 79.5 "Innovator multisource drug" means a multisource drug that was 79.6 originally marketed under an original new drug application 79.7 approved by the Food and Drug Administration. 79.8 (e) The formulary committee shall review and recommend 79.9 drugs which require prior authorization. The formulary 79.10 committee may recommend drugs for prior authorization directly 79.11 to the commissioner, as long as opportunity for public input is 79.12 provided. Prior authorization may be requested by the 79.13 commissioner based on medical and clinical criteria and on cost 79.14 before certain drugs are eligible for payment. Before a drug 79.15 may be considered for prior authorization at the request of the 79.16 commissioner: 79.17 (1) the drug formulary committee must develop criteria to 79.18 be used for identifying drugs; the development of these criteria 79.19 is not subject to the requirements of chapter 14, but the 79.20 formulary committee shall provide opportunity for public input 79.21 in developing criteria; 79.22 (2) the drug formulary committee must hold a public forum 79.23 and receive public comment for an additional 15 days; and79.24 (3) the drug formulary committee must consider data from 79.25 the state Medicaid program if such data is available; and 79.26 (4) the commissioner must provide information to the 79.27 formulary committee on the impact that placing the drug on prior 79.28 authorization will have on the quality of patient care and on 79.29 program costs, and information regarding whether the drug is 79.30 subject to clinical abuse or misuse. 79.31 Prior authorization may be required by the commissioner 79.32 before certain formulary drugs are eligible for payment. If 79.33 prior authorization of a drug is required by the commissioner, 79.34 the commissioner must provide a 30-day notice period before 79.35 implementing the prior authorization. If a prior authorization 79.36 request is denied by the department, the recipient may appeal 80.1 the denial in accordance with section 256.045. If an appeal is 80.2 filed, the drug must be provided without prior authorization 80.3 until a decision is made on the appeal. 80.4 (f) The basis for determining the amount of payment for 80.5 drugs administered in an outpatient setting shall be the lower 80.6 of the usual and customary cost submitted by the provider; the 80.7 average wholesale price minus five percent; or the maximum 80.8 allowable cost set by the federal government under United States 80.9 Code, title 42, chapter 7, section 1396r-8(e), and Code of 80.10 Federal Regulations, title 42, section 447.332, or by the 80.11 commissioner under paragraph (c). 80.12 (g) Prior authorization shall not be required or utilized 80.13 for any antipsychotic drug prescribed for the treatment of 80.14 mental illness where there is no generically equivalent drug 80.15 available unless the commissioner determines that prior 80.16 authorization is necessary for patient safety. This paragraph 80.17 applies to any supplemental drug rebate program established or 80.18 administered by the commissioner. 80.19 (h) Prior authorization shall not be required or utilized 80.20 for any antihemophilic factor drug prescribed for the treatment 80.21 of hemophilia and blood disorders where there is no generically 80.22 equivalent drug available unless the commissioner determines 80.23 that prior authorization is necessary for patient safety. This 80.24 paragraph applies to any supplemental drug rebate program 80.25 established or administered by the commissioner. This paragraph 80.26 expires July 1, 2003. 80.27 Sec. 14. Minnesota Statutes 2000, section 256B.0625, 80.28 subdivision 26, as amended by Laws 2002, chapter 294, section 6, 80.29 is amended to read: 80.30 Subd. 26. [SPECIAL EDUCATION SERVICES.] (a) Medical 80.31 assistance covers medical services identified in a recipient's 80.32 individualized education plan and covered under the medical 80.33 assistance state plan. Covered services include occupational 80.34 therapy, physical therapy, speech-language therapy, clinical 80.35 psychological services, nursing services, school psychological 80.36 services, school social work services, personal care assistants 81.1 serving as management aides, assistive technology devices, 81.2 transportation services, health assessments, and other services 81.3 covered under the medical assistance state plan. Mental health 81.4 services eligible for medical assistance reimbursement must be 81.5 provided or coordinated through a children's mental health 81.6 collaborative where a collaborative exists if the child is 81.7 included in the collaborative operational target population. 81.8 The provision or coordination of services does not require that 81.9 the individual education plan be developed by the collaborative. 81.10 The services may be provided by a Minnesota school district 81.11 that is enrolled as a medical assistance provider or its 81.12 subcontractor, and only if the services meet all the 81.13 requirements otherwise applicable if the service had been 81.14 provided by a provider other than a school district, in the 81.15 following areas: medical necessity, physician's orders, 81.16 documentation, personnel qualifications, and prior authorization 81.17 requirements. The nonfederal share of costs for services 81.18 provided under this subdivision is the responsibility of the 81.19 local school district as provided in section 125A.74. Services 81.20 listed in a child's individual education plan are eligible for 81.21 medical assistance reimbursement only if those services meet 81.22 criteria for federal financial participation under the Medicaid 81.23 program. 81.24 (b) Approval of health-related services for inclusion in 81.25 the individual education plan does not require prior 81.26 authorization for purposes of reimbursement under this chapter. 81.27 The commissioner may require physician review and approval of 81.28 the plan not more than once annually or upon any modification of 81.29 the individual education plan that reflects a change in 81.30 health-related services. 81.31 (c) Services of a speech-language pathologist provided 81.32 under this section are covered notwithstanding Minnesota Rules, 81.33 part 9505.0390, subpart 1, item L, if the person: 81.34 (1) holds a masters degree in speech-language pathology; 81.35 (2) is licensed by the Minnesota board of teaching as an 81.36 educational speech-language pathologist; and 82.1 (3) either has a certificate of clinical competence from 82.2 the American Speech and Hearing Association, has completed the 82.3 equivalent educational requirements and work experience 82.4 necessary for the certificate or has completed the academic 82.5 program and is acquiring supervised work experience to qualify 82.6 for the certificate. 82.7 (d) Medical assistance coverage for medically necessary 82.8 services provided under other subdivisions in this section may 82.9 not be denied solely on the basis that the same or similar 82.10 services are covered under this subdivision. 82.11 (e) The commissioner shall develop and implement package 82.12 rates, bundled rates, or per diem rates for special education 82.13 services under which separately covered services are grouped 82.14 together and billed as a unit in order to reduce administrative 82.15 complexity. 82.16 (f) The commissioner shall develop a cost-based payment 82.17 structure for payment of these services. 82.18 (g) Effective July 1, 2000, medical assistance services 82.19 provided under an individual education plan or an individual 82.20 family service plan by local school districts shall not count 82.21 against medical assistance authorization thresholds for that 82.22 child. 82.23 (h) Nursing services as defined in section 148.171, 82.24 subdivision 15, and provided as an individual education plan 82.25 health-related service, are eligible for medical assistance 82.26 payment if they are otherwise a covered service inunder the 82.27 medical assistantassistance program. Medical assistance covers 82.28 the administration of prescription medications by a licensed 82.29 nurse who is employed by or under contract with a school 82.30 district when the administration of medications is identified in 82.31 the child's individualized education plan. The simple 82.32 administration of medications alone is not covered under medical 82.33 assistance when administered by a provider other than a school 82.34 district or when it is not identified in the child's 82.35 individualized education plan. 82.36 [EFFECTIVE DATE.] This section is effective for services 83.1 provided on or after April 1, 2002, upon federal approval, if 83.2 federal approval is required. 83.3 Sec. 15. Minnesota Statutes 2000, section 256B.0625, 83.4 subdivision 35, is amended to read: 83.5 Subd. 35. [FAMILY COMMUNITY SUPPORT SERVICES.] (a) Medical 83.6 assistance covers family community support services as defined 83.7 in section 245.4871, subdivision 17. In addition to the 83.8 provisions of section 245.4871, and to the extent authorized by 83.9 rules promulgated by the state agency, medical assistance covers 83.10 the following services as family community support services: 83.11 (1) services identified in an individual treatment plan 83.12 when provided by a trained mental health behavioral aide under 83.13 the direction of a mental health practitioner or mental health 83.14 professional; 83.15 (2) mental health crisis intervention and crisis 83.16 stabilization services provided outside of hospital inpatient 83.17 settings; and 83.18 (3) the therapeutic components of preschool and therapeutic 83.19 camp programs. 83.20 (b) Notwithstanding the provisions of Minnesota Rules, 83.21 parts 9505.0324, subpart 2, 9505.0326, subpart 2, and 9505.0327, 83.22 subpart 2, a provider of family community support services, 83.23 home-based mental health services, or therapeutic support of 83.24 foster care services under contract with a county may continue 83.25 to provide existing services, and may provide new services, to a 83.26 child if that child is placed in foster care, or the child and 83.27 family relocate, outside the original county of residence. 83.28 Sec. 16. Minnesota Statutes 2000, section 256B.0625, is 83.29 amended by adding a subdivision to read: 83.30 Subd. 44. [TARGETED CASE MANAGEMENT SERVICES.] Medical 83.31 assistance covers case management services for vulnerable adults 83.32 and adults with developmental disabilities, as provided under 83.33 section 256B.0924. 83.34 Sec. 17. Minnesota Statutes 2001 Supplement, section 83.35 256B.0627, subdivision 10, is amended to read: 83.36 Subd. 10. [FISCAL INTERMEDIARY OPTION AVAILABLE FOR 84.1 PERSONAL CARE ASSISTANT SERVICES.] (a) The commissioner may 84.2 allow a recipient of personal care assistant services to use a 84.3 fiscal intermediary to assist the recipient in paying and 84.4 accounting for medically necessary covered personal care 84.5 assistant services authorized in subdivision 4 and within the 84.6 payment parameters of subdivision 5. Unless otherwise provided 84.7 in this subdivision, all other statutory and regulatory 84.8 provisions relating to personal care assistant services apply to 84.9 a recipient using the fiscal intermediary option. 84.10 (b) The recipient or responsible party shall: 84.11 (1) recruit, hire, and terminate a qualified professional, 84.12 if a qualified professional is requested by the recipient or 84.13 responsible party; 84.14 (2) verify and document the credentials of the qualified 84.15 professional, if a qualified professional is requested by the 84.16 recipient or responsible party; 84.17 (3) develop a service plan based on physician orders and 84.18 public health nurse assessment with the assistance of a 84.19 qualified professional, if a qualified professional is requested 84.20 by the recipient or responsible party, that addresses the health 84.21 and safety of the recipient; 84.22 (4) recruit, hire, and terminate the personal care 84.23 assistant; 84.24 (5) orient and train the personal care assistant with 84.25 assistance as needed from the qualified professional; 84.26 (6) supervise and evaluate the personal care assistant with 84.27 assistance as needed from the recipient's physician or the 84.28 qualified professional; 84.29 (7) monitor and verify in writing and report to the fiscal 84.30 intermediary the number of hours worked by the personal care 84.31 assistant and the qualified professional; and 84.32 (8) enter into a written agreement, as specified in 84.33 paragraph (f). 84.34 (c) The duties of the fiscal intermediary shall be to: 84.35 (1) bill the medical assistance program for personal care 84.36 assistant and qualified professional services; 85.1 (2) request and secure background checks on personal care 85.2 assistants and qualified professionals according to section 85.3 245A.04; 85.4 (3) pay the personal care assistant and qualified 85.5 professional based on actual hours of services provided; 85.6 (4) withhold and pay all applicable federal and state 85.7 taxes; 85.8 (5) verify and keep records of hours worked by the personal 85.9 care assistant and qualified professional; 85.10 (6) make the arrangements and pay unemployment insurance, 85.11 taxes, workers' compensation, liability insurance, and other 85.12 benefits, if any; 85.13 (7) enroll in the medical assistance program as a fiscal 85.14 intermediary; and 85.15 (8) enter into a written agreement as specified in 85.16 paragraph (f) before services are provided. 85.17 (d) The fiscal intermediary: 85.18 (1) may not be related to the recipient, qualified 85.19 professional, or the personal care assistant; 85.20 (2) must ensure arm's length transactions with the 85.21 recipient and personal care assistant; and 85.22 (3) shall be considered a joint employer of the personal 85.23 care assistant and qualified professional to the extent 85.24 specified in this section. 85.25 The fiscal intermediary or owners of the entity that 85.26 provides fiscal intermediary services under this subdivision 85.27 must pass a criminal background check as required in section 85.28 256B.0627, subdivision 1, paragraph (e). 85.29 (e) If the recipient or responsible party requests a 85.30 qualified professional, the qualified professional providing 85.31 assistance to the recipient shall meet the qualifications 85.32 specified in section 256B.0625, subdivision 19c. The qualified 85.33 professional shall assist the recipient in developing and 85.34 revising a plan to meet the recipient's needs, as assessed by 85.35 the public health nurse. In performing this function, the 85.36 qualified professional must visit the recipient in the 86.1 recipient's home at least once annually. The qualified 86.2 professional must report any suspected abuse, neglect, or 86.3 financial exploitation of the recipient to the appropriate 86.4 authorities. 86.5 (f) The fiscal intermediary, recipient or responsible 86.6 party, personal care assistant, and qualified professional shall 86.7 enter into a written agreement before services are started. The 86.8 agreement shall include: 86.9 (1) the duties of the recipient, qualified professional, 86.10 personal care assistant, and fiscal agent based on paragraphs 86.11 (a) to (e); 86.12 (2) the salary and benefits for the personal care assistant 86.13 and the qualified professional; 86.14 (3) the administrative fee of the fiscal intermediary and 86.15 services paid for with that fee, including background check 86.16 fees; 86.17 (4) procedures to respond to billing or payment complaints; 86.18 and 86.19 (5) procedures for hiring and terminating the personal care 86.20 assistant and the qualified professional. 86.21 (g) The rates paid for personal care assistant 86.22 services, shared care services, qualified professional services, 86.23 and fiscal intermediary services under this subdivision shall be 86.24 the same rates paid for personal care assistant services and 86.25 qualified professional services under subdivision 2 86.26 respectively. Except for the administrative fee of the fiscal 86.27 intermediary specified in paragraph (f), the remainder of the 86.28 rates paid to the fiscal intermediary must be used to pay for 86.29 the salary and benefits for the personal care assistant or the 86.30 qualified professional. 86.31 (h) As part of the assessment defined in subdivision 1, the 86.32 following conditions must be met to use or continue use of a 86.33 fiscal intermediary: 86.34 (1) the recipient must be able to direct the recipient's 86.35 own care, or the responsible party for the recipient must be 86.36 readily available to direct the care of the personal care 87.1 assistant; 87.2 (2) the recipient or responsible party must be 87.3 knowledgeable of the health care needs of the recipient and be 87.4 able to effectively communicate those needs; 87.5 (3) a face-to-face assessment must be conducted by the 87.6 local county public health nurse at least annually, or when 87.7 there is a significant change in the recipient's condition or 87.8 change in the need for personal care assistant services; 87.9 (4) the recipient cannot select the shared services option87.10 as specified in subdivision 8recipients who choose to use the 87.11 shared care option as specified in subdivision 8 must utilize 87.12 the same fiscal intermediary; and 87.13 (5) parties must be in compliance with the written 87.14 agreement specified in paragraph (f). 87.15 (i) The commissioner shall deny, revoke, or suspend the 87.16 authorization to use the fiscal intermediary option if: 87.17 (1) it has been determined by the qualified professional or 87.18 local county public health nurse that the use of this option 87.19 jeopardizes the recipient's health and safety; 87.20 (2) the parties have failed to comply with the written 87.21 agreement specified in paragraph (f); or 87.22 (3) the use of the option has led to abusive or fraudulent 87.23 billing for personal care assistant services. 87.24 The recipient or responsible party may appeal the 87.25 commissioner's action according to section 256.045. The denial, 87.26 revocation, or suspension to use the fiscal intermediary option 87.27 shall not affect the recipient's authorized level of personal 87.28 care assistant services as determined in subdivision 5. 87.29 Sec. 18. Minnesota Statutes 2001 Supplement, section 87.30 256B.0911, subdivision 4b, is amended to read: 87.31 Subd. 4b. [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 87.32 Exemptions from the federal screening requirements outlined in 87.33 subdivision 4a, paragraphs (b) and (c), are limited to: 87.34 (1) a person who, having entered an acute care facility 87.35 from a certified nursing facility, is returning to a certified 87.36 nursing facility; and88.1 (2) a person transferring from one certified nursing 88.2 facility in Minnesota to another certified nursing facility in 88.3 Minnesota; and 88.4 (3) a person, 21 years of age or older, who satisfies the 88.5 following criteria, as specified in Code of Federal Regulations, 88.6 title 42, section 483.106(b)(2): 88.7 (i) the person is admitted to a nursing facility directly 88.8 from a hospital after receiving acute inpatient care at the 88.9 hospital; 88.10 (ii) the person requires nursing facility services for the 88.11 same condition for which care was provided in the hospital; and 88.12 (iii) the attending physician has certified before the 88.13 nursing facility admission that the person is likely to receive 88.14 less than 30 days of nursing facility services. 88.15 (b) Persons who are exempt from preadmission screening for 88.16 purposes of level of care determination include: 88.17 (1) persons described in paragraph (a); 88.18 (2) an individual who has a contractual right to have 88.19 nursing facility care paid for indefinitely by the veterans' 88.20 administration; 88.21 (3) an individual enrolled in a demonstration project under 88.22 section 256B.69, subdivision 8, at the time of application to a 88.23 nursing facility; 88.24 (4) an individual currently being served under the 88.25 alternative care program or under a home and community-based 88.26 services waiver authorized under section 1915(c) of the federal 88.27 Social Security Act; and 88.28 (5) individuals admitted to a certified nursing facility 88.29 for a short-term stay, which is expected to be 14 days or less 88.30 in duration based upon a physician's certification, and who have 88.31 been assessed and approved for nursing facility admission within 88.32 the previous six months. This exemption applies only if the 88.33 consultation team member determines at the time of the initial 88.34 assessment of the six-month period that it is appropriate to use 88.35 the nursing facility for short-term stays and that there is an 88.36 adequate plan of care for return to the home or community-based 89.1 setting. If a stay exceeds 14 days, the individual must be 89.2 referred no later than the first county working day following 89.3 the 14th resident day for a screening, which must be completed 89.4 within five working days of the referral. The payment 89.5 limitations in subdivision 7 apply to an individual found at 89.6 screening to not meet the level of care criteria for admission 89.7 to a certified nursing facility. 89.8 (c) Persons admitted to a Medicaid-certified nursing 89.9 facility from the community on an emergency basis as described 89.10 in paragraph (d) or from an acute care facility on a nonworking 89.11 day must be screened the first working day after admission. 89.12 (d) Emergency admission to a nursing facility prior to 89.13 screening is permitted when all of the following conditions are 89.14 met: 89.15 (1) a person is admitted from the community to a certified 89.16 nursing or certified boarding care facility during county 89.17 nonworking hours; 89.18 (2) a physician has determined that delaying admission 89.19 until preadmission screening is completed would adversely affect 89.20 the person's health and safety; 89.21 (3) there is a recent precipitating event that precludes 89.22 the client from living safely in the community, such as 89.23 sustaining an injury, sudden onset of acute illness, or a 89.24 caregiver's inability to continue to provide care; 89.25 (4) the attending physician has authorized the emergency 89.26 placement and has documented the reason that the emergency 89.27 placement is recommended; and 89.28 (5) the county is contacted on the first working day 89.29 following the emergency admission. 89.30 Transfer of a patient from an acute care hospital to a nursing 89.31 facility is not considered an emergency except for a person who 89.32 has received hospital services in the following situations: 89.33 hospital admission for observation, care in an emergency room 89.34 without hospital admission, or following hospital 24-hour bed 89.35 care. 89.36 (e) A nursing facility must provide a written notice to 90.1 persons who satisfy the criteria in paragraph (a), clause (3), 90.2 regarding the person's right to request and receive long-term 90.3 care consultation services as defined in subdivision 1a. The 90.4 notice must be provided prior to the person's discharge from the 90.5 facility and in a format specified by the commissioner. 90.6 [EFFECTIVE DATE.] This section is effective the day 90.7 following final enactment. 90.8 Sec. 19. Minnesota Statutes 2001 Supplement, section 90.9 256B.0911, subdivision 4d, is amended to read: 90.10 Subd. 4d. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 90.11 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 90.12 ensure that individuals with disabilities or chronic illness are 90.13 served in the most integrated setting appropriate to their needs 90.14 and have the necessary information to make informed choices 90.15 about home and community-based service options. 90.16 (b) Individuals under 65 years of age who are admitted to a 90.17 nursing facility from a hospital must be screened prior to 90.18 admission as outlined in subdivisions 4a through 4c. 90.19 (c) Individuals under 65 years of age who are admitted to 90.20 nursing facilities with only a telephone screening must receive 90.21 a face-to-face assessment from the long-term care consultation 90.22 team member of the county in which the facility is located or 90.23 from the recipient's county case manager within 20 working days 90.24 of admission. 90.25 (d) Individuals under 65 years of age who are admitted to a 90.26 nursing facility without preadmission screening according to the 90.27 exemption described in subdivision 4b, paragraph (a), clause 90.28 (3), and who remain in the facility longer than 30 days must 90.29 receive a face-to-face assessment within 40 days of admission. 90.30 (e) At the face-to-face assessment, the long-term care 90.31 consultation team member or county case manager must perform the 90.32 activities required under subdivision 3b. 90.33 (e)(f) For individuals under 21 years of age, a screening 90.34 interview which recommends nursing facility admission must be 90.35 face-to-face and approved by the commissioner before the 90.36 individual is admitted to the nursing facility. 91.1 (f)(g) In the event that an individual under 65 years of 91.2 age is admitted to a nursing facility on an emergency basis, the 91.3 county must be notified of the admission on the next working 91.4 day, and a face-to-face assessment as described in paragraph (c) 91.5 must be conducted within 20 working days of admission. 91.6 (g)(h) At the face-to-face assessment, the long-term care 91.7 consultation team member or the case manager must present 91.8 information about home and community-based options so the 91.9 individual can make informed choices. If the individual chooses 91.10 home and community-based services, the long-term care 91.11 consultation team member or case manager must complete a written 91.12 relocation plan within 20 working days of the visit. The plan 91.13 shall describe the services needed to move out of the facility 91.14 and a time line for the move which is designed to ensure a 91.15 smooth transition to the individual's home and community. 91.16 (h)(i) An individual under 65 years of age residing in a 91.17 nursing facility shall receive a face-to-face assessment at 91.18 least every 12 months to review the person's service choices and 91.19 available alternatives unless the individual indicates, in 91.20 writing, that annual visits are not desired. In this case, the 91.21 individual must receive a face-to-face assessment at least once 91.22 every 36 months for the same purposes. 91.23 (i)(j) Notwithstanding the provisions of subdivision 6, 91.24 the commissioner may pay county agencies directly for 91.25 face-to-face assessments for individuals under 65 years of age 91.26 who are being considered for placement or residing in a nursing 91.27 facility. 91.28 [EFFECTIVE DATE.] This section is effective the day 91.29 following final enactment. 91.30 Sec. 20. Minnesota Statutes 2001 Supplement, section 91.31 256B.0913, subdivision 4, is amended to read: 91.32 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 91.33 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 91.34 under the alternative care program is available to persons who 91.35 meet the following criteria: 91.36 (1) the person has been determined by a community 92.1 assessment under section 256B.0911 to be a person who would 92.2 require the level of care provided in a nursing facility, but 92.3 for the provision of services under the alternative care 92.4 program; 92.5 (2) the person is age 65 or older; 92.6 (3) the person would be eligible for medical assistance 92.7 within 180 days of admission to a nursing facility; 92.8 (4) the person is not ineligible for the medical assistance 92.9 program due to an asset transfer penalty; 92.10 (5) the person needs services that are not funded through 92.11 other state or federal funding; and 92.12 (6) the monthly cost of the alternative care services 92.13 funded by the program for this person does not exceed 75 percent 92.14 of the statewide weighted average monthly nursing facility rate 92.15 of the case mix resident class to which the individual 92.16 alternative care client would be assigned under Minnesota Rules, 92.17 parts 9549.0050 to 9549.0059, less the recipient's maintenance 92.18 needs allowance as described in section 256B.0915, subdivision 92.19 1d, paragraph (a), until the first day of the state fiscal year 92.20 in which the resident assessment system, under section 256B.437, 92.21 for nursing home rate determination is implemented. Effective 92.22 on the first day of the state fiscal year in which a resident 92.23 assessment system, under section 256B.437, for nursing home rate 92.24 determination is implemented and the first day of each 92.25 subsequent state fiscal year, the monthly cost of alternative 92.26 care services for this person shall not exceed the alternative 92.27 care monthly cap for the case mix resident class to which the 92.28 alternative care client would be assigned under Minnesota Rules, 92.29 parts 9549.0050 to 9549.0059, which was in effect on the last 92.30 day of the previous state fiscal year, and adjusted by the 92.31 greater of any legislatively adopted home and community-based 92.32 services cost-of-living percentage increase or any legislatively 92.33 adopted statewide percent rate increase for nursing facilities. 92.34 This monthly limit does not prohibit the alternative care client 92.35 from payment for additional services, but in no case may the 92.36 cost of additional services purchased under this section exceed 93.1 the difference between the client's monthly service limit 93.2 defined under section 256B.0915, subdivision 3, and the 93.3 alternative care program monthly service limit defined in this 93.4 paragraph. If medical supplies and equipment or environmental 93.5 modifications are or will be purchased for an alternative care 93.6 services recipient, the costs may be prorated on a monthly basis 93.7 for up to 12 consecutive months beginning with the month of 93.8 purchase. If the monthly cost of a recipient's other 93.9 alternative care services exceeds the monthly limit established 93.10 in this paragraph, the annual cost of the alternative care 93.11 services shall be determined. In this event, the annual cost of 93.12 alternative care services shall not exceed 12 times the monthly 93.13 limit described in this paragraph. 93.14 (b) Alternative care funding under this subdivision is not 93.15 available for a person who is a medical assistance recipient or 93.16 who would be eligible for medical assistance without a spenddown 93.17 or waiver obligation. A person whose initial application for 93.18 medical assistance is being processed may be served under the 93.19 alternative care program for a period up to 60 days. If the 93.20 individual is found to be eligible for medical assistance, 93.21 medical assistance must be billed for services payable under the 93.22 federally approved elderly waiver plan and delivered from the 93.23 date the individual was found eligible for the federally 93.24 approved elderly waiver plan. Notwithstanding this provision, 93.25 upon federal approval, alternative care funds may not be used to 93.26 pay for any service the cost of which is payable by medical 93.27 assistance or which is used by a recipient to meet a medical 93.28 assistance income spenddown or waiver obligation. 93.29 (c) Alternative care funding is not available for a person 93.30 who resides in a licensed nursing home, certified boarding care 93.31 home, hospital, or intermediate care facility, except for case 93.32 management services which are provided in support of the 93.33 discharge planning process to a nursing home resident or 93.34 certified boarding care home resident who is ineligible for case93.35 management funded by medical assistance. 93.36 Sec. 21. Minnesota Statutes 2001 Supplement, section 94.1 256B.0913, subdivision 5, is amended to read: 94.2 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 94.3 Alternative care funding may be used for payment of costs of: 94.4 (1) adult foster care; 94.5 (2) adult day care; 94.6 (3) home health aide; 94.7 (4) homemaker services; 94.8 (5) personal care; 94.9 (6) case management; 94.10 (7) respite care; 94.11 (8) assisted living; 94.12 (9) residential care services; 94.13 (10) care-related supplies and equipment; 94.14 (11) meals delivered to the home; 94.15 (12) transportation; 94.16 (13) skillednursing services; 94.17 (14) chore services; 94.18 (15) companion services; 94.19 (16) nutrition services; 94.20 (17) training for direct informal caregivers; 94.21 (18) telemedicinetelehome care devices to monitor 94.22 recipients in their own homes as an alternative to hospital 94.23 care, nursing home care, or home visits; 94.24 (19) other services which includes discretionary funds and 94.25 direct cash payments to clients, following approval by the 94.26 commissioner, subject to the provisions of paragraph (j). Total 94.27 annual payments for "other services" for all clients within a 94.28 county may not exceed either ten25 percent of that county's 94.29 annual alternative care program base allocation or $5,000,94.30 whichever is greater. In no case shall this amount exceed the94.31 county's total annual alternative care program base allocation; 94.32 and 94.33 (20) environmental modifications. 94.34 (b) The county agency must ensure that the funds are not 94.35 used to supplant services available through other public 94.36 assistance or services programs. 95.1 (c) Unless specified in statute, the services, service 95.2 definitions, and standards for alternative care services shall 95.3 be the same as the services, service definitions, and standards 95.4 specified in the federally approved elderly waiver plan. Except 95.5 for the county agencies' approval of direct cash payments to 95.6 clients as described in paragraph (j) or for a provider of 95.7 supplies and equipment when the monthly cost of the supplies and 95.8 equipment is less than $250, persons or agencies must be 95.9 employed by or under a contract with the county agency or the 95.10 public health nursing agency of the local board of health in 95.11 order to receive funding under the alternative care program. 95.12 Supplies and equipment may be purchased from a vendor not 95.13 certified to participate in the Medicaid program if the cost for 95.14 the item is less than that of a Medicaid vendor. 95.15 (d) The adult foster care rate shall be considered a 95.16 difficulty of care payment and shall not include room and 95.17 board. The adult foster care rate shall be negotiated between 95.18 the county agency and the foster care provider. The alternative 95.19 care payment for the foster care service in combination with the 95.20 payment for other alternative care services, including case 95.21 management, must not exceed the limit specified in subdivision 95.22 4, paragraph (a), clause (6). 95.23 (e) Personal care services must meet the service standards 95.24 defined in the federally approved elderly waiver plan, except 95.25 that a county agency may contract with a client's relative who 95.26 meets the relative hardship waiver requirement as defined in 95.27 section 256B.0627, subdivision 4, paragraph (b), clause (10), to 95.28 provide personal care services if the county agency ensures 95.29 supervision of this service by a registered nurse or mental95.30 health practitionerqualified professional as defined in section 95.31 256B.0625, subdivision 19c. 95.32 (f) For purposes of this section, residential care services 95.33 are services which are provided to individuals living in 95.34 residential care homes. Residential care homes are currently 95.35 licensed as board and lodging establishments and are registered 95.36 with the department of health as providing special services 96.1 under section 157.17 and are not subject to registration under 96.2 chapter 144D. Residential care services are defined as 96.3 "supportive services" and "health-related services." 96.4 "Supportive services" means the provision of up to 24-hour 96.5 supervision and oversight. Supportive services includes: (1) 96.6 transportation, when provided by the residential care home only; 96.7 (2) socialization, when socialization is part of the plan of 96.8 care, has specific goals and outcomes established, and is not 96.9 diversional or recreational in nature; (3) assisting clients in 96.10 setting up meetings and appointments; (4) assisting clients in 96.11 setting up medical and social services; (5) providing assistance 96.12 with personal laundry, such as carrying the client's laundry to 96.13 the laundry room. Assistance with personal laundry does not 96.14 include any laundry, such as bed linen, that is included in the 96.15 room and board rate. "Health-related services" are limited to 96.16 minimal assistance with dressing, grooming, and bathing and 96.17 providing reminders to residents to take medications that are 96.18 self-administered or providing storage for medications, if 96.19 requested. Individuals receiving residential care services 96.20 cannot receive homemaking services funded under this section. 96.21 (g) For the purposes of this section, "assisted living" 96.22 refers to supportive services provided by a single vendor to 96.23 clients who reside in the same apartment building of three or 96.24 more units which are not subject to registration under chapter 96.25 144D and are licensed by the department of health as a class A 96.26 home care provider or a class E home care provider. Assisted 96.27 living services are defined as up to 24-hour supervision, and 96.28 oversight, supportive services as defined in clause (1), 96.29 individualized home care aide tasks as defined in clause (2), 96.30 and individualized home management tasks as defined in clause 96.31 (3) provided to residents of a residential center living in 96.32 their units or apartments with a full kitchen and bathroom. A 96.33 full kitchen includes a stove, oven, refrigerator, food 96.34 preparation counter space, and a kitchen utensil storage 96.35 compartment. Assisted living services must be provided by the 96.36 management of the residential center or by providers under 97.1 contract with the management or with the county. 97.2 (1) Supportive services include: 97.3 (i) socialization, when socialization is part of the plan 97.4 of care, has specific goals and outcomes established, and is not 97.5 diversional or recreational in nature; 97.6 (ii) assisting clients in setting up meetings and 97.7 appointments; and 97.8 (iii) providing transportation, when provided by the 97.9 residential center only. 97.10 (2) Home care aide tasks means: 97.11 (i) preparing modified diets, such as diabetic or low 97.12 sodium diets; 97.13 (ii) reminding residents to take regularly scheduled 97.14 medications or to perform exercises; 97.15 (iii) household chores in the presence of technically 97.16 sophisticated medical equipment or episodes of acute illness or 97.17 infectious disease; 97.18 (iv) household chores when the resident's care requires the 97.19 prevention of exposure to infectious disease or containment of 97.20 infectious disease; and 97.21 (v) assisting with dressing, oral hygiene, hair care, 97.22 grooming, and bathing, if the resident is ambulatory, and if the 97.23 resident has no serious acute illness or infectious disease. 97.24 Oral hygiene means care of teeth, gums, and oral prosthetic 97.25 devices. 97.26 (3) Home management tasks means: 97.27 (i) housekeeping; 97.28 (ii) laundry; 97.29 (iii) preparation of regular snacks and meals; and 97.30 (iv) shopping. 97.31 Individuals receiving assisted living services shall not 97.32 receive both assisted living services and homemaking services. 97.33 Individualized means services are chosen and designed 97.34 specifically for each resident's needs, rather than provided or 97.35 offered to all residents regardless of their illnesses, 97.36 disabilities, or physical conditions. Assisted living services 98.1 as defined in this section shall not be authorized in boarding 98.2 and lodging establishments licensed according to sections 98.3 157.011 and 157.15 to 157.22. 98.4 (h) For establishments registered under chapter 144D, 98.5 assisted living services under this section means either the 98.6 services described in paragraph (g) and delivered by a class E 98.7 home care provider licensed by the department of health or the 98.8 services described under section 144A.4605 and delivered by an 98.9 assisted living home care provider or a class A home care 98.10 provider licensed by the commissioner of health. 98.11 (i) Payment for assisted living services and residential 98.12 care services shall be a monthly rate negotiated and authorized 98.13 by the county agency based on an individualized service plan for 98.14 each resident and may not cover direct rent or food costs. 98.15 (1) The individualized monthly negotiated payment for 98.16 assisted living services as described in paragraph (g) or (h), 98.17 and residential care services as described in paragraph (f), 98.18 shall not exceed the nonfederal share in effect on July 1 of the 98.19 state fiscal year for which the rate limit is being calculated 98.20 of the greater of either the statewide or any of the geographic 98.21 groups' weighted average monthly nursing facility payment rate 98.22 of the case mix resident class to which the alternative care 98.23 eligible client would be assigned under Minnesota Rules, parts 98.24 9549.0050 to 9549.0059, less the maintenance needs allowance as 98.25 described in section 256B.0915, subdivision 1d, paragraph (a), 98.26 until the first day of the state fiscal year in which a resident 98.27 assessment system, under section 256B.437, of nursing home rate 98.28 determination is implemented. Effective on the first day of the 98.29 state fiscal year in which a resident assessment system, under 98.30 section 256B.437, of nursing home rate determination is 98.31 implemented and the first day of each subsequent state fiscal 98.32 year, the individualized monthly negotiated payment for the 98.33 services described in this clause shall not exceed the limit 98.34 described in this clause which was in effect on the last day of 98.35 the previous state fiscal year and which has been adjusted by 98.36 the greater of any legislatively adopted home and 99.1 community-based services cost-of-living percentage increase or 99.2 any legislatively adopted statewide percent rate increase for 99.3 nursing facilities. 99.4 (2) The individualized monthly negotiated payment for 99.5 assisted living services described under section 144A.4605 and 99.6 delivered by a provider licensed by the department of health as 99.7 a class A home care provider or an assisted living home care 99.8 provider and provided in a building that is registered as a 99.9 housing with services establishment under chapter 144D and that 99.10 provides 24-hour supervision in combination with the payment for 99.11 other alternative care services, including case management, must 99.12 not exceed the limit specified in subdivision 4, paragraph (a), 99.13 clause (6). 99.14 (j) A county agency may make payment from their alternative 99.15 care program allocation for "other services" which include use 99.16 of "discretionary funds" for services that are not otherwise 99.17 defined in this section and direct cash payments to the client 99.18 for the purpose of purchasing the services. The following 99.19 provisions apply to payments under this paragraph: 99.20 (1) a cash payment to a client under this provision cannot 99.21 exceed 80 percent ofthe monthly payment limit for that client 99.22 as specified in subdivision 4, paragraph (a), clause (6); 99.23 (2) a county may not approve any cash payment for a client 99.24 who meets either of the following: 99.25 (i) has been assessed as having a dependency in 99.26 orientation, unless the client has an authorized 99.27 representative. An "authorized representative" means an 99.28 individual who is at least 18 years of age and is designated by 99.29 the person or the person's legal representative to act on the 99.30 person's behalf. This individual may be a family member, 99.31 guardian, representative payee, or other individual designated 99.32 by the person or the person's legal representative, if any, to 99.33 assist in purchasing and arranging for supports; or 99.34 (ii) is concurrently receiving adult foster care, 99.35 residential care, or assisted living services; 99.36 (3) cash payments to a person or a person's family will be 100.1 provided through a monthly payment and be in the form of cash, 100.2 voucher, or direct county payment to a vendor. Fees or premiums 100.3 assessed to the person for eligibility for health and human 100.4 services are not reimbursable through this service option. 100.5 Services and goods purchased through cash payments must be 100.6 identified in the person's individualized care plan and must 100.7 meet all of the following criteria: 100.8 (i) they must be over and above the normal cost of caring 100.9 for the person if the person did not have functional 100.10 limitations; 100.11 (ii) they must be directly attributable to the person's 100.12 functional limitations; 100.13 (iii) they must have the potential to be effective at 100.14 meeting the goals of the program; 100.15 (iv) they must be consistent with the needs identified in 100.16 the individualized service plan. The service plan shall specify 100.17 the needs of the person and family, the form and amount of 100.18 payment, the items and services to be reimbursed, and the 100.19 arrangements for management of the individual grant; and 100.20 (v) the person, the person's family, or the legal 100.21 representative shall be provided sufficient information to 100.22 ensure an informed choice of alternatives. The local agency 100.23 shall document this information in the person's care plan, 100.24 including the type and level of expenditures to be reimbursed; 100.25 (4) the state of Minnesota, county, lead agency under 100.26 contract, or tribal government under contract to administer the 100.27 alternative care program shall not be liable for damages, 100.28 injuries, or liabilities sustained through the purchase of 100.29 direct supports or goods by the person, the person's family, or 100.30 the authorized representative with funds received through the 100.31 cash payments under this section. Liabilities include, but are 100.32 not limited to, workers' compensation, the Federal Insurance 100.33 Contributions Act (FICA), or the Federal Unemployment Tax Act 100.34 (FUTA); 100.35 (5) persons receiving grants under this section shall have 100.36 the following responsibilities: 101.1 (i) spend the grant money in a manner consistent with their 101.2 individualized service plan with the local agency; 101.3 (ii) notify the local agency of any necessary changes in 101.4 the grant expenditures; 101.5 (iii) arrange and pay for supports; and 101.6 (iv) inform the local agency of areas where they have 101.7 experienced difficulty securing or maintaining supports; and 101.8 (6) the county shall report client outcomes, services, and 101.9 costs under this paragraph in a manner prescribed by the 101.10 commissioner. 101.11 (k) Upon implementation of direct cash payments to clients101.12 under this section, any person determined eligible for the101.13 alternative care program who chooses a cash payment approved by101.14 the county agency shall receive the cash payment under this101.15 section and not under section 256.476 unless the person was101.16 receiving a consumer support grant under section 256.476 before101.17 implementation of direct cash payments under this section.101.18 Sec. 22. Minnesota Statutes 2001 Supplement, section 101.19 256B.0913, subdivision 8, is amended to read: 101.20 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 101.21 case manager shall implement the plan of care for each 101.22 alternative care client and ensure that a client's service needs 101.23 and eligibility are reassessed at least every 12 months. The 101.24 plan shall include any services prescribed by the individual's 101.25 attending physician as necessary to allow the individual to 101.26 remain in a community setting. In developing the individual's 101.27 care plan, the case manager should include the use of volunteers 101.28 from families and neighbors, religious organizations, social 101.29 clubs, and civic and service organizations to support the formal 101.30 home care services. The county shall be held harmless for 101.31 damages or injuries sustained through the use of volunteers 101.32 under this subdivision including workers' compensation 101.33 liability. The lead agency shall provide documentation in each 101.34 individual's plan of care and, if requested, to the commissioner 101.35 that the most cost-effective alternatives available have been 101.36 offered to the individual and that the individual was free to 102.1 choose among available qualified providers, both public and 102.2 private. The case manager must give the individual a ten-day 102.3 written notice of any decrease in ordenial, termination, or 102.4 reduction of alternative care services. 102.5 (b) If the county administering alternative care services 102.6 is different than the county of financial responsibility, the 102.7 care plan may be implemented without the approval of the county 102.8 of financial responsibility. 102.9 Sec. 23. Minnesota Statutes 2001 Supplement, section 102.10 256B.0913, subdivision 10, is amended to read: 102.11 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 102.12 appropriation for fiscal years 1992 and beyond shall cover only 102.13 alternative care eligible clients. Prior toBy July 1 of each 102.14 year, the commissioner shall allocate to county agencies the 102.15 state funds available for alternative care for persons eligible 102.16 under subdivision 2. 102.17 (b) The adjusted base for each county is the county's 102.18 current fiscal year base allocation plus any targeted funds 102.19 approved during the current fiscal year. Calculations for 102.20 paragraphs (c) and (d) are to be made as follows: for each 102.21 county, the determination of alternative care program 102.22 expenditures shall be based on payments for services rendered 102.23 from April 1 through March 31 in the base year, to the extent 102.24 that claims have been submitted and paid by June 1 of that year. 102.25 (c) If the alternative care program expenditures as defined 102.26 in paragraph (b) are 95 percent or more of the county's adjusted 102.27 base allocation, the allocation for the next fiscal year is 100 102.28 percent of the adjusted base, plus inflation to the extent that 102.29 inflation is included in the state budget. 102.30 (d) If the alternative care program expenditures as defined 102.31 in paragraph (b) are less than 95 percent of the county's 102.32 adjusted base allocation, the allocation for the next fiscal 102.33 year is the adjusted base allocation less the amount of unspent 102.34 funds below the 95 percent level. 102.35 (e) If the annual legislative appropriation for the 102.36 alternative care program is inadequate to fund the combined 103.1 county allocations for a biennium, the commissioner shall 103.2 distribute to each county the entire annual appropriation as 103.3 that county's percentage of the computed base as calculated in 103.4 paragraphs (c) and (d). 103.5 Sec. 24. Minnesota Statutes 2001 Supplement, section 103.6 256B.0913, subdivision 12, is amended to read: 103.7 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 103.8 all alternative care eligible clients to help pay for the cost 103.9 of participating in the program. The amount of the premium for 103.10 the alternative care client shall be determined as follows: 103.11 (1) when the alternative care client's income less 103.12 recurring and predictable medical expenses is greater than the 103.13 recipient's maintenance needs allowance as defined in section 103.14 256B.0915, subdivision 1d, paragraph (a), but less than 150 103.15 percent of the federal poverty guideline effective on July 1 of 103.16 the state fiscal year in which the premium is being computed, 103.17 and total assets are less than $10,000, the fee is zero; 103.18 (2) when the alternative care client's income less 103.19 recurring and predictable medical expenses is greater than 150 103.20 percent of the federal poverty guideline effective on July 1 of 103.21 the state fiscal year in which the premium is being computed, 103.22 and total assets are less than $10,000, the fee is 25 percent of 103.23 the cost of alternative care services or the difference between 103.24 150 percent of the federal poverty guideline effective on July 1 103.25 of the state fiscal year in which the premium is being computed 103.26 and the client's income less recurring and predictable medical 103.27 expenses, whichever is less; and 103.28 (3) when the alternative care client's total assets are 103.29 greater than $10,000, the fee is 25 percent of the cost of 103.30 alternative care services. 103.31 For married persons, total assets are defined as the total 103.32 marital assets less the estimated community spouse asset 103.33 allowance, under section 256B.059, if applicable. For married 103.34 persons, total income is defined as the client's income less the 103.35 monthly spousal allotment, under section 256B.058. 103.36 All alternative care services except case management shall 104.1 be included in the estimated costs for the purpose of 104.2 determining 25 percent of the costs. 104.3 The monthly premium shall be calculated based on the cost104.4 of the first full month of alternative care services and shall104.5 continue unaltered until the next reassessment is completed or104.6 at the end of 12 months, whichever comes first.Premiums are 104.7 due and payable each month alternative care services are 104.8 received unless the actual cost of the services is less than the 104.9 premium. 104.10 (b) The fee shall be waived by the commissioner when: 104.11 (1) a person who is residing in a nursing facility is 104.12 receiving case management only; 104.13 (2) a person is applying for medical assistance; 104.14 (3) a married couple is requesting an asset assessment 104.15 under the spousal impoverishment provisions; 104.16 (4) a person is found eligible for alternative care, but is 104.17 not yet receiving alternative care services; or 104.18 (5) a person's fee under paragraph (a) is less than $25. 104.19 (c) The county agency must record in the state's receivable 104.20 system the client's assessed premium amount or the reason the 104.21 premium has been waived. The commissioner will bill and collect 104.22 the premium from the client. Money collected must be deposited 104.23 in the general fund and is appropriated to the commissioner for 104.24 the alternative care program. The client must supply the county 104.25 with the client's social security number at the time of 104.26 application. The county shall supply the commissioner with the 104.27 client's social security number and other information the 104.28 commissioner requires to collect the premium from the client. 104.29 The commissioner shall collect unpaid premiums using the Revenue 104.30 Recapture Act in chapter 270A and other methods available to the 104.31 commissioner. The commissioner may require counties to inform 104.32 clients of the collection procedures that may be used by the 104.33 state if a premium is not paid. This paragraph does not apply 104.34 to alternative care pilot projects authorized in Laws 1993, 104.35 First Special Session chapter 1, article 5, section 133, if a 104.36 county operating under the pilot project reports the following 105.1 dollar amounts to the commissioner quarterly: 105.2 (1) total premiums billed to clients; 105.3 (2) total collections of premiums billed; and 105.4 (3) balance of premiums owed by clients. 105.5 If a county does not adhere to these reporting requirements, the 105.6 commissioner may terminate the billing, collecting, and 105.7 remitting portions of the pilot project and require the county 105.8 involved to operate under the procedures set forth in this 105.9 paragraph. 105.10 (d) The commissioner shall begin to adopt emergency or105.11 permanent rules governing client premiums within 30 days after105.12 July 1, 1991, including criteria for determining when services105.13 to a client must be terminated due to failure to pay a premium.105.14 Sec. 25. Minnesota Statutes 2001 Supplement, section 105.15 256B.0913, subdivision 14, is amended to read: 105.16 Subd. 14. [PROVIDER REQUIREMENTS, PAYMENT, AND RATE 105.17 ADJUSTMENTS.] (a) Unless otherwise specified in statute, 105.18 providers must be enrolled as Minnesota health care program 105.19 providers and abide by the requirements for provider 105.20 participation according to Minnesota Rules, part 9505.0195. 105.21 (b) Payment for provided alternative care services as 105.22 approved by the client's case manager shall beoccur through the 105.23 invoice processing procedures of the department's Medicaid 105.24 Management Information System (MMIS). To receive payment, the 105.25 county or vendor must submit invoices within 12 months following 105.26 the date of service. The county agency and its vendors under 105.27 contract shall not be reimbursed for services which exceed the 105.28 county allocation. 105.29 (b)(c) The county shall negotiate individual rates with 105.30 vendors and may authorize service payment for actual costs up to 105.31 the county's current approved rate. Notwithstanding any other 105.32 rule or statutory provision to the contrary, the commissioner 105.33 shall not be authorized to increase rates by an annual inflation 105.34 factor, unless so authorized by the legislature. To improve 105.35 access to community services and eliminate payment disparities 105.36 between the alternative care program and the elderly waiver 106.1 program, the commissioner shall establish statewide maximum 106.2 service rate limits and eliminate county-specific service rate 106.3 limits. 106.4 (1) Effective July 1, 2001, for service rate limits, except 106.5 those in subdivision 5, paragraphs (d) and (i), the rate limit 106.6 for each service shall be the greater of the alternative care 106.7 statewide maximum rate or the elderly waiver statewide maximum 106.8 rate. 106.9 (2) Counties may negotiate individual service rates with 106.10 vendors for actual costs up to the statewide maximum service 106.11 rate limit. 106.12 Sec. 26. Minnesota Statutes 2001 Supplement, section 106.13 256B.0915, subdivision 3, is amended to read: 106.14 Subd. 3. [LIMITS OF CASES, RATES, PAYMENTS, AND 106.15 FORECASTING.] (a) The number of medical assistance waiver 106.16 recipients that a county may serve must be allocated according 106.17 to the number of medical assistance waiver cases open on July 1 106.18 of each fiscal year. Additional recipients may be served with 106.19 the approval of the commissioner. 106.20 (b) The monthly limit for the cost of waivered services to 106.21 an individual elderly waiver client shall be the weighted 106.22 average monthly nursing facility rate of the case mix resident 106.23 class to which the elderly waiver client would be assigned under 106.24 Minnesota Rules, parts 9549.0050 to 9549.0059, less the 106.25 recipient's maintenance needs allowance as described in 106.26 subdivision 1d, paragraph (a), until the first day of the state 106.27 fiscal year in which the resident assessment system as described 106.28 in section 256B.437 for nursing home rate determination is 106.29 implemented. Effective on the first day of the state fiscal 106.30 year in which the resident assessment system as described in 106.31 section 256B.437 for nursing home rate determination is 106.32 implemented and the first day of each subsequent state fiscal 106.33 year, the monthly limit for the cost of waivered services to an 106.34 individual elderly waiver client shall be the rate of the case 106.35 mix resident class to which the waiver client would be assigned 106.36 under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect 107.1 on the last day of the previous state fiscal year, adjusted by 107.2 the greater of any legislatively adopted home and 107.3 community-based services cost-of-living percentage increase or 107.4 any legislatively adopted statewide percent rate increase for 107.5 nursing facilities. 107.6 (c) If extended medical supplies and equipment or 107.7 environmental modifications are or will be purchased for an 107.8 elderly waiver client, the costs may be prorated for up to 12 107.9 consecutive months beginning with the month of purchase. If the 107.10 monthly cost of a recipient's waivered services exceeds the 107.11 monthly limit established in paragraph (b), the annual cost of 107.12 all waivered services shall be determined. In this event, the 107.13 annual cost of all waivered services shall not exceed 12 times 107.14 the monthly limit of waivered services as described in paragraph 107.15 (b). 107.16 (d) For a person who is a nursing facility resident at the 107.17 time of requesting a determination of eligibility for elderly 107.18 waivered services, a monthly conversion limit for the cost of 107.19 elderly waivered services may be requested. The monthly 107.20 conversion limit for the cost of elderly waiver services shall 107.21 be the resident class assigned under Minnesota Rules, parts 107.22 9549.0050 to 9549.0059, for that resident in the nursing 107.23 facility where the resident currently resides until July 1 of 107.24 the state fiscal year in which the resident assessment system as 107.25 described in section 256B.437 for nursing home rate 107.26 determination is implemented. Effective on July 1 of the state 107.27 fiscal year in which the resident assessment system as described 107.28 in section 256B.437 for nursing home rate determination is 107.29 implemented, the monthly conversion limit for the cost of 107.30 elderly waiver services shall be the per diem nursing facility 107.31 rate as determined by the resident assessment system as 107.32 described in section 256B.437 for that resident in the nursing 107.33 facility where the resident currently resides multiplied by 365 107.34 and divided by 12, less the recipient's maintenance needs 107.35 allowance as described in subdivision 1d. The initially 107.36 approved conversion rate may be adjusted by the greater of any 108.1 subsequent legislatively adopted home and community-based 108.2 services cost-of-living percentage increase or any subsequent 108.3 legislatively adopted statewide percentage rate increase for 108.4 nursing facilities. The limit under this clause only applies to 108.5 persons discharged from a nursing facility after a minimum 108.6 30-day stay and found eligible for waivered services on or after 108.7 July 1, 1997. The following costs must be included in 108.8 determining the total monthly costs for the waiver client: 108.9 (1) cost of all waivered services, including extended 108.10 medical supplies and equipment and environmental modifications; 108.11 and 108.12 (2) cost of skilled nursing, home health aide, and personal 108.13 care services reimbursable by medical assistance. 108.14 (e) Medical assistance funding for skilled nursing 108.15 services, private duty nursing, home health aide, and personal 108.16 care services for waiver recipients must be approved by the case 108.17 manager and included in the individual care plan. 108.18 (f) A county is not required to contract with a provider of 108.19 supplies and equipment if the monthly cost of the supplies and 108.20 equipment is less than $250. 108.21 (g) The adult foster care rate shall be considered a 108.22 difficulty of care payment and shall not include room and 108.23 board. The adult foster care service rate shall be negotiated 108.24 between the county agency and the foster care provider. The 108.25 elderly waiver payment for the foster care service in 108.26 combination with the payment for all other elderly waiver 108.27 services, including case management, must not exceed the limit 108.28 specified in paragraph (b). 108.29 (h) Payment for assisted living service shall be a monthly 108.30 rate negotiated and authorized by the county agency based on an 108.31 individualized service plan for each resident and may not cover 108.32 direct rent or food costs. 108.33 (1) The individualized monthly negotiated payment for 108.34 assisted living services as described in section 256B.0913, 108.35 subdivision 5, paragraph (g) or (h), and residential care 108.36 services as described in section 256B.0913, subdivision 5, 109.1 paragraph (f), shall not exceed the nonfederal share, in effect 109.2 on July 1 of the state fiscal year for which the rate limit is 109.3 being calculated, of the greater of either the statewide or any 109.4 of the geographic groups' weighted average monthly nursing 109.5 facility rate of the case mix resident class to which the 109.6 elderly waiver eligible client would be assigned under Minnesota 109.7 Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 109.8 allowance as described in subdivision 1d, paragraph (a), until 109.9 the July 1 of the state fiscal year in which the resident 109.10 assessment system as described in section 256B.437 for nursing 109.11 home rate determination is implemented. Effective on July 1 of 109.12 the state fiscal year in which the resident assessment system as 109.13 described in section 256B.437 for nursing home rate 109.14 determination is implemented and July 1 of each subsequent state 109.15 fiscal year, the individualized monthly negotiated payment for 109.16 the services described in this clause shall not exceed the limit 109.17 described in this clause which was in effect on June 30 of the 109.18 previous state fiscal year and which has been adjusted by the 109.19 greater of any legislatively adopted home and community-based 109.20 services cost-of-living percentage increase or any legislatively 109.21 adopted statewide percent rate increase for nursing facilities. 109.22 (2) The individualized monthly negotiated payment for 109.23 assisted living services described in section 144A.4605 and 109.24 delivered by a provider licensed by the department of health as 109.25 a class A home care provider or an assisted living home care 109.26 provider and provided in a building that is registered as a 109.27 housing with services establishment under chapter 144D and that 109.28 provides 24-hour supervision in combination with the payment for 109.29 other elderly waiver services, including case management, must 109.30 not exceed the limit specified in paragraph (b). 109.31 (i) The county shall negotiate individual service rates 109.32 with vendors and may authorize payment for actual costs up to 109.33 the county's current approved rate. Persons or agencies must be 109.34 employed by or under a contract with the county agency or the 109.35 public health nursing agency of the local board of health in 109.36 order to receive funding under the elderly waiver program, 110.1 except as a provider of supplies and equipment when the monthly 110.2 cost of the supplies and equipment is less than $250. 110.3 (j) Reimbursement for the medical assistance recipients 110.4 under the approved waiver shall be made from the medical 110.5 assistance account through the invoice processing procedures of 110.6 the department's Medicaid Management Information System (MMIS), 110.7 only with the approval of the client's case manager. The budget 110.8 for the state share of the Medicaid expenditures shall be 110.9 forecasted with the medical assistance budget, and shall be 110.10 consistent with the approved waiver. 110.11 (k) To improve access to community services and eliminate 110.12 payment disparities between the alternative care program and the 110.13 elderly waiver, the commissioner shall establish statewide 110.14 maximum service rate limits and eliminate county-specific 110.15 service rate limits. 110.16 (1) Effective July 1, 2001, for service rate limits, except 110.17 those described or defined in paragraphs (g) and (h), the rate 110.18 limit for each service shall be the greater of the alternative 110.19 care statewide maximum rate or the elderly waiver statewide 110.20 maximum rate. 110.21 (2) Counties may negotiate individual service rates with 110.22 vendors for actual costs up to the statewide maximum service 110.23 rate limit. 110.24 (l) Beginning July 1, 1991, the state shall reimburse 110.25 counties according to the payment schedule in section 256.025 110.26 for the county share of costs incurred under this subdivision on 110.27 or after January 1, 1991, for individuals who are receiving 110.28 medical assistance. 110.29 Sec. 27. Minnesota Statutes 2000, section 256B.0915, 110.30 subdivision 4, is amended to read: 110.31 Subd. 4. [TERMINATION NOTICE.] The case manager must give 110.32 the individual a ten-day written notice of any decrease in110.33 denial, reduction, or termination of waivered services. 110.34 Sec. 28. Minnesota Statutes 2001 Supplement, section 110.35 256B.0915, subdivision 5, is amended to read: 110.36 Subd. 5. [ASSESSMENTS AND REASSESSMENTS FOR WAIVER 111.1 CLIENTS.] Each client shall receive an initial assessment of 111.2 strengths, informal supports, and need for services in 111.3 accordance with section 256B.0911, subdivisions 3, 3a, and 3b. 111.4 A reassessment of a client served under the elderly waiver must 111.5 be conducted at least every 12 months and at other times when 111.6 the case manager determines that there has been significant 111.7 change in the client's functioning. This may include instances 111.8 where the client is discharged from the hospital. 111.9 Sec. 29. Minnesota Statutes 2000, section 256B.0915, 111.10 subdivision 6, is amended to read: 111.11 Subd. 6. [IMPLEMENTATION OF CARE PLAN.] Each elderly 111.12 waiver client shall be provided a copy of a written care plan 111.13 that meets the requirements outlined in section 256B.0913, 111.14 subdivision 8. If the county administering waivered services is 111.15 different than the county of financial responsibility, the care 111.16 plan may be implemented without the approval of the county of 111.17 financial responsibility. 111.18 Sec. 30. Minnesota Statutes 2000, section 256B.0915, is 111.19 amended by adding a subdivision to read: 111.20 Subd. 8. [SERVICES AND SUPPORTS.] (a) Services and 111.21 supports shall meet the requirements set out in United States 111.22 Code, title 42, section 1396n. 111.23 (b) Services and supports shall promote consumer choice and 111.24 be arranged and provided consistent with individualized, written 111.25 care plans. 111.26 (c) The state of Minnesota, county, or tribal government 111.27 under contract to administer the elderly waiver shall not be 111.28 liable for damages, injuries, or liabilities sustained through 111.29 the purchase of direct supports or goods by the person, the 111.30 person's family, or the authorized representatives with funds 111.31 received through consumer-directed community support services 111.32 under the federally approved waiver plan. Liabilities include, 111.33 but are not limited to, workers' compensation liability, the 111.34 Federal Insurance Contributions Act (FICA), or the Federal 111.35 Unemployment Tax Act (FUTA). 111.36 Sec. 31. Minnesota Statutes 2001 Supplement, section 112.1 256B.0924, subdivision 6, is amended to read: 112.2 Subd. 6. [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 112.3 Medical assistance and MinnesotaCare payment for targeted case 112.4 management shall be made on a monthly basis. In order to 112.5 receive payment for an eligible adult, the provider must 112.6 document at least one contact per month and not more than two 112.7 consecutive months without a face-to-face contact with the adult 112.8 or the adult's legal representative, family, primary caregiver, 112.9 or other relevant persons identified as necessary to the 112.10 development or implementation of the goals of the personal 112.11 service plan. 112.12 (b) Payment for targeted case management provided by county 112.13 staff under this subdivision shall be based on the monthly rate 112.14 methodology under section 256B.094, subdivision 6, paragraph 112.15 (b), calculated as one combined average rate together with adult 112.16 mental health case management under section 256B.0625, 112.17 subdivision 20, except for calendar year 2002. In calendar year 112.18 2002, the rate for case management under this section shall be 112.19 the same as the rate for adult mental health case management in 112.20 effect as of December 31, 2001. Billing and payment must 112.21 identify the recipient's primary population group to allow 112.22 tracking of revenues. 112.23 (c) Payment for targeted case management provided by 112.24 county-contracted vendors shall be based on a monthly rate 112.25 negotiated by the host county. The negotiated rate must not 112.26 exceed the rate charged by the vendor for the same service to 112.27 other payers. If the service is provided by a team of 112.28 contracted vendors, the county may negotiate a team rate with a 112.29 vendor who is a member of the team. The team shall determine 112.30 how to distribute the rate among its members. No reimbursement 112.31 received by contracted vendors shall be returned to the county, 112.32 except to reimburse the county for advance funding provided by 112.33 the county to the vendor. 112.34 (d) If the service is provided by a team that includes 112.35 contracted vendors and county staff, the costs for county staff 112.36 participation on the team shall be included in the rate for 113.1 county-provided services. In this case, the contracted vendor 113.2 and the county may each receive separate payment for services 113.3 provided by each entity in the same month. In order to prevent 113.4 duplication of services, the county must document, in the 113.5 recipient's file, the need for team targeted case management and 113.6 a description of the different roles of the team members. 113.7 (e) Notwithstanding section 256B.19, subdivision 1, the 113.8 nonfederal share of costs for targeted case management shall be 113.9 provided by the recipient's county of responsibility, as defined 113.10 in sections 256G.01 to 256G.12, from sources other than federal 113.11 funds or funds used to match other federal funds. 113.12 (f) The commissioner may suspend, reduce, or terminate 113.13 reimbursement to a provider that does not meet the reporting or 113.14 other requirements of this section. The county of 113.15 responsibility, as defined in sections 256G.01 to 256G.12, is 113.16 responsible for any federal disallowances. The county may share 113.17 this responsibility with its contracted vendors. 113.18 (g) The commissioner shall set aside five percent of the 113.19 federal funds received under this section for use in reimbursing 113.20 the state for costs of developing and implementing this section. 113.21 (h) Notwithstanding section 256.025, subdivision 2, 113.22 payments to counties for targeted case management expenditures 113.23 under this section shall only be made from federal earnings from 113.24 services provided under this section. Payments to contracted 113.25 vendors shall include both the federal earnings and the county 113.26 share. 113.27 (i) Notwithstanding section 256B.041, county payments for 113.28 the cost of case management services provided by county staff 113.29 shall not be made to the state treasurer. For the purposes of 113.30 targeted case management services provided by county staff under 113.31 this section, the centralized disbursement of payments to 113.32 counties under section 256B.041 consists only of federal 113.33 earnings from services provided under this section. 113.34 (j) If the recipient is a resident of a nursing facility, 113.35 intermediate care facility, or hospital, and the recipient's 113.36 institutional care is paid by medical assistance, payment for 114.1 targeted case management services under this subdivision is 114.2 limited to the last 180 days of the recipient's residency in 114.3 that facility and may not exceed more than six months in a 114.4 calendar year. 114.5 (k) Payment for targeted case management services under 114.6 this subdivision shall not duplicate payments made under other 114.7 program authorities for the same purpose. 114.8 (l) Any growth in targeted case management services and 114.9 cost increases under this section shall be the responsibility of 114.10 the counties. 114.11 Sec. 32. Minnesota Statutes 2001 Supplement, section 114.12 256B.0951, subdivision 7, is amended to read: 114.13 Subd. 7. [WAIVER OF RULES.] If a federal waiver is 114.14 approved under subdivision 8, the commissioner of health may 114.15 exempt residents of intermediate care facilities for persons 114.16 with mental retardation (ICFs/MR) who participate in the 114.17 three-yearalternative quality assurance pilotproject 114.18 established in section 256B.095 from the requirements of 114.19 Minnesota Rules, chapter 4665 , upon approval by the federal114.20 government of a waiver of federal certification requirements for114.21 ICFs/MR. 114.22 Sec. 33. Minnesota Statutes 2001 Supplement, section 114.23 256B.0951, subdivision 8, is amended to read: 114.24 Subd. 8. [FEDERAL WAIVER.] The commissioner of human 114.25 services shall seek federal authority to waive provisions of114.26 intermediate care facilities for persons with mental retardation114.27 (ICFs/MR) regulations to enable the demonstration and evaluation114.28 of the alternative quality assurance system for ICFs/MR under114.29 the project. The commissioner of human services shall apply for114.30 any necessary waivers as soon as practicable.a federal waiver 114.31 to allow intermediate care facilities for persons with mental 114.32 retardation (ICFs/MR) in region 10 of Minnesota to participate 114.33 in the alternative licensing system. If it is necessary for 114.34 purposes of participation in this alternative licensing system 114.35 for a facility to be decertified as an ICF/MR facility according 114.36 to the terms of the federal waiver, when the facility seeks 115.1 recertification under the provisions of ICF/MR regulations at 115.2 the end of the demonstration project, it will not be considered 115.3 a new ICF/MR as defined under section 252.291 provided the 115.4 licensed capacity of the facility did not increase during its 115.5 participation in the alternative licensing system. The 115.6 provisions of sections 252.82, 252.292, and 256B.5011 to 115.7 256B.5015 will remain applicable for counties in region 10 of 115.8 Minnesota and the ICFs/MR located within those counties 115.9 notwithstanding a county's participation in the alternative 115.10 licensing system. 115.11 Sec. 34. Minnesota Statutes 2000, section 256B.19, 115.12 subdivision 1, as amended by Laws 2002, chapter 220, article 14, 115.13 section 7, is amended to read: 115.14 Subdivision 1. [DIVISION OF COST.] The state and county 115.15 share of medical assistance costs not paid by federal funds 115.16 shall be as follows: 115.17 (1) ninety90 percent state funds and ten percent county 115.18 funds, unless otherwise provided below; 115.19 (2) beginning January 1, 1992, 50 percent state funds and 115.20 50 percent county funds for the cost of placement of severely 115.21 emotionally disturbed children in regional treatment centers; 115.22 and 115.23 (3) beginning January 1, 2003, 80 percent state funds and 115.24 20 percent county funds for the costs of nursing facility 115.25 placements of persons with disabilities under the age of 65 that 115.26 have exceeded 90 days. This clause shall be subject to chapter 115.27 256G and shall not apply to placements in facilities not 115.28 certified to participate in medical assistance. 115.29 For counties that participate in a Medicaid demonstration 115.30 project under sections 256B.69 and 256B.71, the division of the 115.31 nonfederal share of medical assistance expenses for payments 115.32 made to prepaid health plans or for payments made to health 115.33 maintenance organizations in the form of prepaid capitation 115.34 payments, this division of medical assistance expenses shall be 115.35 95 percent by the state and five percent by the county of 115.36 financial responsibility. 116.1 In counties where prepaid health plans are under contract 116.2 to the commissioner to provide services to medical assistance 116.3 recipients, the cost of court ordered treatment ordered without 116.4 consulting the prepaid health plan that does not include 116.5 diagnostic evaluation, recommendation, and referral for 116.6 treatment by the prepaid health plan is the responsibility of 116.7 the county of financial responsibility. 116.8 Sec. 35. Minnesota Statutes 2001 Supplement, section 116.9 256B.431, subdivision 2e, is amended to read: 116.10 Subd. 2e. [CONTRACTS FOR SERVICES FOR VENTILATOR-DEPENDENT 116.11 PERSONS.] The commissioner may contractnegotiate with a nursing 116.12 facility eligible to receive medical assistance payments to 116.13 provide services to a ventilator-dependent person identified by 116.14 the commissioner according to criteria developed by the 116.15 commissioner, including: 116.16 (1) nursing facility care has been recommended for the 116.17 person by a preadmission screening team; 116.18 (2) the person has been hospitalized and no longer requires 116.19 inpatient acute care hospital services; and 116.20 (3) the commissioner has determined that necessary services 116.21 for the person cannot be provided under existing nursing 116.22 facility rates. 116.23 The commissioner may issue a request for proposals to116.24 provide services to a ventilator-dependent person to nursing116.25 facilities eligible to receive medical assistance payments and116.26 shall select nursing facilities from among respondents according116.27 to criteria developed by the commissioner, including:116.28 (1) the cost-effectiveness and appropriateness of services;116.29 (2) the nursing facility's compliance with federal and116.30 state licensing and certification standards; and116.31 (3) the proximity of the nursing facility to a116.32 ventilator-dependent person identified by the commissioner who116.33 requires nursing facility placement.116.34 The commissioner may negotiate an adjustment to the 116.35 operating cost payment rate for a nursing facility selected by116.36 the commissioner from among respondents to the request for117.1 proposalswith a resident who is ventilator-dependent, for that 117.2 resident. The negotiated adjustment must reflect only the 117.3 actual additional cost of meeting the specialized care needs of 117.4 a ventilator-dependent person identified by the commissioner for 117.5 whom necessary services cannot be provided under existing 117.6 nursing facility rates and which are not otherwise covered under 117.7 Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to 117.8 9505.0475. For persons who are initially admitted to a nursing 117.9 facility before July 1, 2001, and have their payment rate under 117.10 this subdivision negotiated after July 1, 2001, the negotiated 117.11 payment rate must not exceed 200 percent of the highest multiple 117.12 bedroom payment rate for the facility, as initially established 117.13 by the commissioner for the rate year for case mix 117.14 classification K; or, upon implementation of the RUGs-based case 117.15 mix system, 200 percent of the highest RUGs rate. For persons 117.16 initially admitted to a nursing facility on or after July 1, 117.17 2001, the negotiated payment rate must not exceed 300 percent of 117.18 the facility's multiple bedroom payment rate for case mix 117.19 classification K; or, upon implementation of the RUGs-based case 117.20 mix system, 300 percent of the highest RUGs rate. The 117.21 negotiated adjustment shall not affect the payment rate charged 117.22 to private paying residents under the provisions of section 117.23 256B.48, subdivision 1. 117.24 Sec. 36. Minnesota Statutes 2000, section 256B.431, 117.25 subdivision 14, is amended to read: 117.26 Subd. 14. [LIMITATIONS ON SALES OF NURSING FACILITIES.] 117.27 (a) For rate periods beginning on October 1, 1992, and for rate 117.28 years beginning after June 30, 1993, a nursing facility's 117.29 property-related payment rate as established under subdivision 117.30 13 shall be adjusted by either paragraph (b) or (c) for the sale 117.31 of the nursing facility, including sales occurring after June 117.32 30, 1992, as provided in this subdivision. 117.33 (b) If the nursing facility's property-related payment rate 117.34 under subdivision 13 prior to sale is greater than the nursing 117.35 facility's rental rate under Minnesota Rules, parts 9549.0010 to 117.36 9549.0080, and this section prior to sale, the nursing 118.1 facility's property-related payment rate after sale shall be the 118.2 greater of its property-related payment rate under subdivision 118.3 13 prior to sale or its rental rate under Minnesota Rules, parts 118.4 9549.0010 to 9549.0080, and this section calculated after sale. 118.5 (c) If the nursing facility's property-related payment rate 118.6 under subdivision 13 prior to sale is equal to or less than the 118.7 nursing facility's rental rate under Minnesota Rules, parts 118.8 9549.0010 to 9549.0080, and this section prior to sale, the 118.9 nursing facility's property-related payment rate after sale 118.10 shall be the nursing facility's property-related payment rate 118.11 under subdivision 13 plus the difference between its rental rate 118.12 calculated under Minnesota Rules, parts 9549.0010 to 9549.0080, 118.13 and this section prior to sale and its rental rate calculated 118.14 under Minnesota Rules, parts 9549.0010 to 9549.0080, and this 118.15 section calculated after sale. 118.16 (d) For purposes of this subdivision, "sale" means the 118.17 purchase of a nursing facility's capital assets with cash or 118.18 debt. The term sale does not include a stock purchase of a 118.19 nursing facility or any of the following transactions: 118.20 (1) a sale and leaseback to the same licensee that does not 118.21 constitute a change in facility license; 118.22 (2) a transfer of an interest to a trust; 118.23 (3) gifts or other transfers for no consideration; 118.24 (4) a merger of two or more related organizations; 118.25 (5) a change in the legal form of doing business, other 118.26 than a publicly held organization that becomes privately held or 118.27 vice versa; 118.28 (6) the addition of a new partner, owner, or shareholder 118.29 who owns less than 20 percent of the nursing facility or the 118.30 issuance of stock; and 118.31 (7) a sale, merger, reorganization, or any other transfer 118.32 of interest between related organizations other than those 118.33 permitted in this section. 118.34 (e) For purposes of this subdivision, "sale" includes the 118.35 sale or transfer of a nursing facility to a close relative as 118.36 defined in Minnesota Rules, part 9549.0020, subpart 38, item C, 119.1 upon the death of an owner, due to serious illness or 119.2 disability, as defined under the Social Security Act, under 119.3 United States Code, title 42, section 423(d)(1)(A), or upon 119.4 retirement of an owner from the business of owning or operating 119.5 a nursing home at 62 years of age or older. For sales to a 119.6 close relative allowed under this paragraph, otherwise 119.7 nonallowable debt resulting from seller financing of all or a 119.8 portion of the debt resulting from the sale shall be allowed and 119.9 shall not be subject to Minnesota Rules, part 9549.0060, subpart 119.10 5, item E, provided that in addition to existing requirements 119.11 for allowance of debt and interest, the debt is subject to 119.12 repayment through annual principal payments and the interest 119.13 rate on the related organization debt does not exceed three 119.14 percentage points above the posted yield for standard 119.15 conventional fixed rate mortgages of the Federal Home Loan 119.16 Mortgage Corporation for delivery in 60 days in effect on the 119.17 day of sale. If at any time, the seller forgives the related 119.18 organization debt allowed under this paragraph for other than 119.19 equal amount of payment on that debt, then the buyer shall pay 119.20 to the state the total revenue received by the nursing facility 119.21 after the sale attributable to the amount of allowable debt 119.22 which has been forgiven. Any assignment, sale, or transfer of 119.23 the debt instrument entered into by the close relatives, either 119.24 directly or indirectly, which grants to the close relative buyer 119.25 the right to receive all or a portion of the payments under the 119.26 debt instrument shall, effective on the date of the transfer, 119.27 result in the prospective reduction in the corresponding portion 119.28 of the allowable debt and interest expense. Upon the death of 119.29 the close relative seller, any remaining balance of the close 119.30 relative debt must be refinanced and such refinancing shall be 119.31 subject to the provisions of Minnesota Rules, part 9549.0060, 119.32 subpart 7, item G. This paragraph shall not apply to sales 119.33 occurring on or after June 30, 1997. 119.34 (f) For purposes of this subdivision, "effective date of 119.35 sale" means the later of either the date on which legal title to 119.36 the capital assets is transferred or the date on which closing 120.1 for the sale occurred. 120.2 (g) The effective day for the property-related payment rate 120.3 determined under this subdivision shall be the first day of the 120.4 month following the month in which the effective date of sale 120.5 occurs or October 1, 1992, whichever is later, provided that the 120.6 notice requirements under section 256B.47, subdivision 2, have 120.7 been met. 120.8 (h) Notwithstanding Minnesota Rules, part 9549.0060, 120.9 subparts 5, item A, subitems (3) and (4), and 7, items E and F, 120.10 the commissioner shall limit the total allowable debt and 120.11 related interest for sales occurring after June 30, 1992, to the 120.12 sum of clauses (1) to (3): 120.13 (1) the historical cost of capital assets, as of the 120.14 nursing facility's most recent previous effective date of sale 120.15 or, if there has been no previous sale, the nursing facility's 120.16 initial historical cost of constructing capital assets; 120.17 (2) the average annual capital asset additions after 120.18 deduction for capital asset deletions, not including 120.19 depreciations; and 120.20 (3) one-half of the allowed inflation on the nursing 120.21 facility's capital assets. The commissioner shall compute the 120.22 allowed inflation as described in paragraph (h)(i). 120.23 (i) For purposes of computing the amount of allowed 120.24 inflation, the commissioner must apply the following principles: 120.25 (1) the lesser of the Consumer Price Index for all urban 120.26 consumers or the Dodge Construction Systems Costs for Nursing 120.27 Homes for any time periods during which both are available must 120.28 be used. If the Dodge Construction Systems Costs for Nursing 120.29 Homes becomes unavailable, the commissioner shall substitute the 120.30 index in subdivision 3f, or such other index as the secretary of 120.31 the health care financing administration may designate; 120.32 (2) the amount of allowed inflation to be applied to the 120.33 capital assets in paragraph (g), clauses (1) and (2), must be 120.34 computed separately; 120.35 (3) the amount of allowed inflation must be determined on 120.36 an annual basis, prorated on a monthly basis for partial years 121.1 and if the initial month of use is not determinable for a 121.2 capital asset, then one-half of that calendar year shall be used 121.3 for purposes of prorating; 121.4 (4) the amount of allowed inflation to be applied to the 121.5 capital assets in paragraph (g), clauses (1) and (2), must not 121.6 exceed 300 percent of the total capital assets in any one of 121.7 those clauses; and 121.8 (5) the allowed inflation must be computed starting with 121.9 the month following the nursing facility's most recent previous 121.10 effective date of sale or, if there has been no previous sale, 121.11 the month following the date of the nursing facility's initial 121.12 occupancy, and ending with the month preceding the effective 121.13 date of sale. 121.14 (j) If the historical cost of a capital asset is not 121.15 readily available for the date of the nursing facility's most 121.16 recent previous sale or if there has been no previous sale for 121.17 the date of the nursing facility's initial occupancy, then the 121.18 commissioner shall limit the total allowable debt and related 121.19 interest after sale to the extent recognized by the Medicare 121.20 intermediary after the sale. For a nursing facility that has no 121.21 historical capital asset cost data available and does not have 121.22 allowable debt and interest calculated by the Medicare 121.23 intermediary, the commissioner shall use the historical cost of 121.24 capital asset data from the point in time for which capital 121.25 asset data is recorded in the nursing facility's audited 121.26 financial statements. 121.27 (k) The limitations in this subdivision apply only to debt 121.28 resulting from a sale of a nursing facility occurring after June 121.29 30, 1992, including debt assumed by the purchaser of the nursing 121.30 facility. 121.31 Sec. 37. Minnesota Statutes 2000, section 256B.431, 121.32 subdivision 30, is amended to read: 121.33 Subd. 30. [BED LAYAWAY AND DELICENSURE.] (a) For rate 121.34 years beginning on or after July 1, 2000, a nursing facility 121.35 reimbursed under this section which has placed beds on layaway 121.36 shall, for purposes of application of the downsizing incentive 122.1 in subdivision 3a, paragraph (d)(c), and calculation of the 122.2 rental per diem, have those beds given the same effect as if the 122.3 beds had been delicensed so long as the beds remain on layaway. 122.4 At the time of a layaway, a facility may change its single bed 122.5 election for use in calculating capacity days under Minnesota 122.6 Rules, part 9549.0060, subpart 11. The property payment rate 122.7 increase shall be effective the first day of the month following 122.8 the month in which the layaway of the beds becomes effective 122.9 under section 144A.071, subdivision 4b. 122.10 (b) For rate years beginning on or after July 1, 2000, 122.11 notwithstanding any provision to the contrary under section 122.12 256B.434, a nursing facility reimbursed under that section which 122.13 has placed beds on layaway shall, for so long as the beds remain 122.14 on layaway, be allowed to: 122.15 (1) aggregate the applicable investment per bed limits 122.16 based on the number of beds licensed immediately prior to 122.17 entering the alternative payment system; 122.18 (2) retain or change the facility's single bed election for 122.19 use in calculating capacity days under Minnesota Rules, part 122.20 9549.0060, subpart 11; and 122.21 (3) establish capacity days based on the number of beds 122.22 immediately prior to the layaway and the number of beds after 122.23 the layaway. 122.24 The commissioner shall increase the facility's property payment 122.25 rate by the incremental increase in the rental per diem 122.26 resulting from the recalculation of the facility's rental per 122.27 diem applying only the changes resulting from the layaway of 122.28 beds and clauses (1), (2), and (3). If a facility reimbursed 122.29 under section 256B.434 completes a moratorium exception project 122.30 after its base year, the base year property rate shall be the 122.31 moratorium project property rate. The base year rate shall be 122.32 inflated by the factors in section 256B.434, subdivision 4, 122.33 paragraph (c). The property payment rate increase shall be 122.34 effective the first day of the month following the month in 122.35 which the layaway of the beds becomes effective. 122.36 (c) If a nursing facility removes a bed from layaway status 123.1 in accordance with section 144A.071, subdivision 4b, the 123.2 commissioner shall establish capacity days based on the number 123.3 of licensed and certified beds in the facility not on layaway 123.4 and shall reduce the nursing facility's property payment rate in 123.5 accordance with paragraph (b). 123.6 (d) For the rate years beginning on or after July 1, 2000, 123.7 notwithstanding any provision to the contrary under section 123.8 256B.434, a nursing facility reimbursed under that section, 123.9 which has delicensed beds after July 1, 2000, by giving notice 123.10 of the delicensure to the commissioner of health according to 123.11 the notice requirements in section 144A.071, subdivision 4b, 123.12 shall be allowed to: 123.13 (1) aggregate the applicable investment per bed limits 123.14 based on the number of beds licensed immediately prior to 123.15 entering the alternative payment system; 123.16 (2) retain or change the facility's single bed election for 123.17 use in calculating capacity days under Minnesota Rules, part 123.18 9549.0060, subpart 11; and 123.19 (3) establish capacity days based on the number of beds 123.20 immediately prior to the delicensure and the number of beds 123.21 after the delicensure. 123.22 The commissioner shall increase the facility's property payment 123.23 rate by the incremental increase in the rental per diem 123.24 resulting from the recalculation of the facility's rental per 123.25 diem applying only the changes resulting from the delicensure of 123.26 beds and clauses (1), (2), and (3). If a facility reimbursed 123.27 under section 256B.434 completes a moratorium exception project 123.28 after its base year, the base year property rate shall be the 123.29 moratorium project property rate. The base year rate shall be 123.30 inflated by the factors in section 256B.434, subdivision 4, 123.31 paragraph (c). The property payment rate increase shall be 123.32 effective the first day of the month following the month in 123.33 which the delicensure of the beds becomes effective. 123.34 (e) For nursing facilities reimbursed under this section or 123.35 section 256B.434, any beds placed on layaway shall not be 123.36 included in calculating facility occupancy as it pertains to 124.1 leave days defined in Minnesota Rules, part 9505.0415. 124.2 (f) For nursing facilities reimbursed under this section or 124.3 section 256B.434, the rental rate calculated after placing beds 124.4 on layaway may not be less than the rental rate prior to placing 124.5 beds on layaway. 124.6 (g) A nursing facility receiving a rate adjustment as a 124.7 result of this section shall comply with section 256B.47, 124.8 subdivision 2. 124.9 (h) A facility that does not utilize the space made 124.10 available as a result of bed layaway or delicensure under this 124.11 subdivision to reduce the number of beds per room or provide 124.12 more common space for nursing facility uses or perform other 124.13 activities related to the operation of the nursing facility 124.14 shall have its property rate increase calculated under this 124.15 subdivision reduced by the ratio of the square footage made 124.16 available that is not used for these purposes to the total 124.17 square footage made available as a result of bed layaway or 124.18 delicensure. 124.19 Sec. 38. Minnesota Statutes 2001 Supplement, section 124.20 256B.431, subdivision 33, is amended to read: 124.21 Subd. 33. [STAGED REDUCTION IN RATE DISPARITIES.] (a) For 124.22 the rate years beginning July 1, 2001, and July 1, 2002, the 124.23 commissioner shall adjust the operating payment rates for 124.24 low-rate nursing facilities reimbursed under this section or 124.25 section 256B.434. 124.26 (b) For the rate year beginning July 1, 2001, for each case 124.27 mix level, if the amount computed under subdivision 3231 is 124.28 less than the amount in clause (1), the commissioner shall make 124.29 available the lesser of the amount in clause (1) or an increase 124.30 of ten percent over the rate in effect on June 30, 2001, as an 124.31 adjustment to the operating payment rate. For the rate year 124.32 beginning July 1, 2002, for each case mix level, if the amount 124.33 computed under subdivision 3231 is less than the amount in 124.34 clause (2), the commissioner shall make available the lesser of 124.35 the amount in clause (2) or an increase of ten percent over the 124.36 rate in effect on June 30, 2002, as an adjustment to the 125.1 operating payment rate. For purposes of this subdivision, 125.2 nursing facilities shall be considered to be metro if they are 125.3 located in Anoka, Carver, Dakota, Hennepin, Olmsted, Ramsey, 125.4 Scott, or Washington counties; or in the cities of Moorhead or 125.5 Breckenridge; or in St. Louis county, north of Toivola and south 125.6 of Cook; or in Itasca county, east of a north south line two 125.7 miles west of Grand Rapids: 125.8 (1) Operating Payment Rate Target Level for July 1, 2001: 125.9 Case Mix Classification Metro Nonmetro 125.10 A $ 76.00 $ 68.13 125.11 B $ 83.40 $ 74.46 125.12 C $ 91.67 $ 81.63 125.13 D $ 99.51 $ 88.04 125.14 E $107.46 $ 94.87 125.15 F $107.96 $ 95.29 125.16 G $114.67 $100.98 125.17 H $126.99 $111.31 125.18 I $131.42 $115.06 125.19 J $138.34 $120.85 125.20 K $152.26 $133.10 125.21 (2) Operating Payment Rate Target Level for July 1, 2002: 125.22 Case Mix Classification Metro Nonmetro 125.23 A $ 78.28 $ 70.51 125.24 B $ 85.91 $ 77.16 125.25 C $ 94.42 $ 84.62 125.26 D $102.50 $ 91.42 125.27 E $110.68 $ 98.40 125.28 F $111.20 $ 98.84 125.29 G $118.11 $104.77 125.30 H $130.80 $115.64 125.31 I $135.38 $119.50 125.32 J $142.49 $125.38 125.33 K $156.85 $137.77 125.34 Sec. 39. Minnesota Statutes 2001 Supplement, section 125.35 256B.437, subdivision 3, is amended to read: 125.36 Subd. 3. [APPLICATIONS FOR PLANNED CLOSURE OF NURSING 126.1 FACILITIES.] (a) By August 15, 2001, the commissioner of human 126.2 services shall implement and announce a program for closure or 126.3 partial closure of nursing facilities. Names and identifying 126.4 information provided in response to the announcement shall 126.5 remain private unless approved, according to the timelines 126.6 established in the plan. The announcement must specify: 126.7 (1) the criteria in subdivision 4 that will be used by the 126.8 commissioner to approve or reject applications; 126.9 (2) a requirement for the submission of a letter of intent126.10 before the submission of an application;126.11 (3)the information that must accompany an application; and 126.12 (4)(3) that applications may combine planned closure rate 126.13 adjustments with moratorium exception funding, in which case a 126.14 single application may serve both purposes. 126.15 Between August 1, 2001, and June 30, 2003, the commissioner may 126.16 approve planned closures of up to 5,140 nursing facility beds, 126.17 less the number of licensedbeds delicensed in facilities that126.18 closeduring the same time period without approved closure plans 126.19 or that have notified the commissioner of health of their intent 126.20 to close without an approved closure plan. 126.21 (b) A facility or facilities reimbursed under section 126.22 256B.431 or 256B.434 with a closure plan approved by the 126.23 commissioner under subdivision 5 may assign a planned closure 126.24 rate adjustment to another facility or facilities that are not 126.25 closing or in the case of a partial closure, to the facility 126.26 undertaking the partial closure. A facility may also elect to 126.27 have a planned closure rate adjustment shared equally by the 126.28 five nursing facilities with the lowest total operating payment 126.29 rates in the state development region designated under section 126.30 462.385, in which the facility that is closing is located. The 126.31 planned closure rate adjustment must be calculated under 126.32 subdivision 6. Facilities that closedelicense beds without a 126.33 closure plan, or whose closure plan is not approved by the 126.34 commissioner, are not eligible to assign a planned closure rate 126.35 adjustment under subdivision 6 ., unless they are delicensing 126.36 five or fewer beds, or less than six percent of their total 127.1 licensed bed capacity, whichever is greater, are located in a 127.2 county in the top three quartiles of beds per 1,000 persons aged 127.3 65 or older, and have not delicensed beds in the prior three 127.4 months. Facilities meeting these criteria are eligible to 127.5 assign the amount calculated under subdivision 6 to themselves. 127.6 If a facility is delicensing the greater of six or more beds, or 127.7 six percent or more of its total licensed bed capacity, and does 127.8 not have an approved closure plan or is not eligible for the 127.9 adjustment under subdivision 6, the commissioner shall calculate 127.10 the amount the facility would have been eligible to assign under 127.11 subdivision 6, and shall use this amount to provide equal rate 127.12 adjustments to the five nursing facilities with the lowest total 127.13 operating payment rates in the state development region 127.14 designated under section 462.385, in which the facility 127.15 that closeddelicensed beds is located. 127.16 (c) To be considered for approval, an application must 127.17 include: 127.18 (1) a description of the proposed closure plan, which must 127.19 include identification of the facility or facilities to receive 127.20 a planned closure rate adjustment and the amount and timing of a127.21 planned closure rate adjustment proposed for each facility; 127.22 (2) the proposed timetable for any proposed closure, 127.23 including the proposed dates for announcement to residents, 127.24 commencement of closure, and completion of closure; 127.25 (3) if available, the proposed relocation plan for current 127.26 residents of any facility designated for closure. The proposed127.27 If a relocation plan is not available, the application must 127.28 include a statement agreeing to develop a relocation plan must127.29 bedesigned to comply with all applicable state and federal127.30 statutes and regulations, including, but not limited to,section 127.31 144A.161; 127.32 (4) a description of the relationship between the nursing 127.33 facility that is proposed for closure and the nursing facility 127.34 or facilities proposed to receive the planned closure rate 127.35 adjustment. If these facilities are not under common ownership, 127.36 copies of any contracts, purchase agreements, or other documents 128.1 establishing a relationship or proposed relationship must be 128.2 provided; 128.3 (5) documentation, in a format approved by the 128.4 commissioner, that all the nursing facilities receiving a 128.5 planned closure rate adjustment under the plan have accepted 128.6 joint and several liability for recovery of overpayments under 128.7 section 256B.0641, subdivision 2, for the facilities designated 128.8 for closure under the plan; and 128.9 (6) an explanation of how the application coordinates with 128.10 planning efforts under subdivision 2. If the planning group 128.11 does not support a level of nursing facility closures that the 128.12 commissioner considers to be reasonable, the commissioner may 128.13 approve a planned closure proposal without its support. 128.14 (d) The application must address the criteria listed in 128.15 subdivision 4. 128.16 Sec. 40. Minnesota Statutes 2001 Supplement, section 128.17 256B.437, subdivision 6, is amended to read: 128.18 Subd. 6. [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 128.19 commissioner of human services shall calculate the amount of the 128.20 planned closure rate adjustment available under subdivision 3, 128.21 paragraph (b), for up to 5,140 beds according to clauses (1) to 128.22 (4): 128.23 (1) the amount available is the net reduction of nursing 128.24 facility beds multiplied by $2,080; 128.25 (2) the total number of beds in the nursing facility or 128.26 facilities receiving the planned closure rate adjustment must be 128.27 identified; 128.28 (3) capacity days are determined by multiplying the number 128.29 determined under clause (2) by 365; and 128.30 (4) the planned closure rate adjustment is the amount 128.31 available in clause (1), divided by capacity days determined 128.32 under clause (3). 128.33 (b) A planned closure rate adjustment under this section is 128.34 effective on the first day of the month following completion of 128.35 closure of the facility designated for closure in the 128.36 application and becomes part of the nursing facility's total 129.1 operating payment rate. 129.2 (c) Applicants may use the planned closure rate adjustment 129.3 to allow for a property payment for a new nursing facility or an 129.4 addition to an existing nursing facility or as an operating 129.5 payment rate adjustment. Applications approved under this 129.6 subdivision are exempt from other requirements for moratorium 129.7 exceptions under section 144A.073, subdivisions 2 and 3. 129.8 (d) Upon the request of a closing facility, the 129.9 commissioner must allow the facility a closure rate adjustment 129.10 as provided under section 144A.161, subdivision 10. 129.11 (e) A facility that has received a planned closure rate 129.12 adjustment may reassign it to another facility that is under the 129.13 same ownership at any time within three years of its effective 129.14 date. The amount of the adjustment shall be computed according 129.15 to paragraph (a). 129.16 (f) If the per bed dollar amount specified in paragraph 129.17 (a), clause (1), is increased, the commissioner shall 129.18 recalculate planned closure rate adjustments for facilities that 129.19 delicense beds under this section on or after July 1, 2001, to 129.20 reflect the increase in the per bed dollar amount. The 129.21 recalculated planned closure rate adjustment shall be effective 129.22 from the date the per bed dollar amount is increased. 129.23 Sec. 41. Minnesota Statutes 2001 Supplement, section 129.24 256B.438, subdivision 1, is amended to read: 129.25 Subdivision 1. [SCOPE.] This section establishes the 129.26 method and criteria used to determine resident reimbursement 129.27 classifications based upon the assessments of residents of 129.28 nursing homes and boarding care homes whose payment rates are 129.29 established under section 256B.431, 256B.434, or 256B.435. 129.30 Resident reimbursement classifications shall be established 129.31 according to the 34 group, resource utilization groups, version 129.32 III or RUG-III model as described in section 144.0724. 129.33 Reimbursement classifications established under this section 129.34 shall be implemented after June 30, 2002, but no later than 129.35 January 1, 2003. Reimbursement classifications established 129.36 under this section shall be implemented no earlier than six 130.1 weeks after the commissioner mails notices of payment rates to 130.2 the facilities. 130.3 Sec. 42. Minnesota Statutes 2000, section 256B.5012, 130.4 subdivision 2, is amended to read: 130.5 Subd. 2. [OPERATING PAYMENT RATE.] (a) The operating 130.6 payment rate equals the facility's total payment rate in effect 130.7 on September 30, 2000, minus the property rate. The operating 130.8 payment rate includes the special operating rate and the 130.9 efficiency incentive in effect as of September 30, 2000. Within 130.10 the limits of appropriations specifically for this purpose, the 130.11 operating payment shall be increased for each rate year by the 130.12 annual percentage change in the Employment Cost Index for 130.13 Private Industry Workers - Total Compensation, as forecasted by 130.14 the commissioner of finance's economic consultant, in the second 130.15 quarter of the calendar year preceding the start of each rate 130.16 year. In the case of the initial rate year beginning October 1, 130.17 2000, and continuing through December 31, 2001, the percentage 130.18 change shall be based on the percentage change in the Employment 130.19 Cost Index for Private Industry Workers - Total Compensation for 130.20 the 15-month period beginning October 1, 2000, as forecast by 130.21 Data Resources, Inc., in the first quarter of 2000. 130.22 (b) Effective October 1, 2000, the operating payment rate 130.23 shall be adjusted to reflect an occupancy rate equal to 100 130.24 percent of the facility's capacity days as of September 30, 2000. 130.25 (c) Effective July 1, 2001, the operating payment rate 130.26 shall be adjusted for the increases in the department of health 130.27 licensing fees that were authorized in Laws 2001, First Special 130.28 Session chapter 9, article 1, section 30. 130.29 Sec. 43. Minnesota Statutes 2000, section 256B.69, 130.30 subdivision 5a, as amended by Laws 2002, chapter 220, article 130.31 15, section 15, is amended to read: 130.32 Subd. 5a. [MANAGED CARE CONTRACTS.] (a) Managed care 130.33 contracts under this section and sections 256L.12 and 256D.03, 130.34 shall be entered into or renewed on a calendar year basis 130.35 beginning January 1, 1996. Managed care contracts which were in 130.36 effect on June 30, 1995, and set to renew on July 1, 1995, shall 131.1 be renewed for the period July 1, 1995 through December 31, 1995 131.2 at the same terms that were in effect on June 30, 1995. 131.3 (b) A prepaid health plan providing covered health services 131.4 for eligible persons pursuant to chapters 256B, 256D, and 256L, 131.5 is responsible for complying with the terms of its contract with 131.6 the commissioner. Requirements applicable to managed care 131.7 programs under chapters 256B, 256D, and 256L, established after 131.8 the effective date of a contract with the commissioner take 131.9 effect when the contract is next issued or renewed. 131.10 (c) Effective for services rendered on or after January 1, 131.11 2003, the commissioner shall withhold five percent of managed 131.12 care plan payments under this section for the prepaid medical 131.13 assistance and general assistance medical care programs pending 131.14 completion of performance targets. The withheld funds willmust 131.15 be returned no sooner than July of the following year if 131.16 performance targets in the contract are achieved. The 131.17 commissioner may exclude special demonstration projects under 131.18 subdivision 23. A managed care plan may include as admitted 131.19 assets under section 62D.044 any amount withheld under this 131.20 paragraph that is reasonably expected to be returned. 131.21 Sec. 44. Minnesota Statutes 2001 Supplement, section 131.22 256B.76, is amended to read: 131.23 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 131.24 (a) Effective for services rendered on or after October 1, 131.25 1992, the commissioner shall make payments for physician 131.26 services as follows: 131.27 (1) payment for level one Health Care Finance 131.28 Administration's common procedural coding system (HCPCS) codes 131.29 titled "office and other outpatient services," "preventive 131.30 medicine new and established patient," "delivery, antepartum, 131.31 and postpartum care," "critical care," cesarean delivery and 131.32 pharmacologic management provided to psychiatric patients, and 131.33 HCPCS level three codes for enhanced services for prenatal high 131.34 risk, shall be paid at the lower of (i) submitted charges, or 131.35 (ii) 25 percent above the rate in effect on June 30, 1992. If 131.36 the rate on any procedure code within these categories is 132.1 different than the rate that would have been paid under the 132.2 methodology in section 256B.74, subdivision 2, then the larger 132.3 rate shall be paid; 132.4 (2) payments for all other services shall be paid at the 132.5 lower of (i) submitted charges, or (ii) 15.4 percent above the 132.6 rate in effect on June 30, 1992; 132.7 (3) all physician rates shall be converted from the 50th 132.8 percentile of 1982 to the 50th percentile of 1989, less the 132.9 percent in aggregate necessary to equal the above increases 132.10 except that payment rates for home health agency services shall 132.11 be the rates in effect on September 30, 1992; 132.12 (4) effective for services rendered on or after January 1, 132.13 2000, payment rates for physician and professional services 132.14 shall be increased by three percent over the rates in effect on 132.15 December 31, 1999, except for home health agency and family 132.16 planning agency services; and 132.17 (5) the increases in clause (4) shall be implemented 132.18 January 1, 2000, for managed care. 132.19 (b) Effective for services rendered on or after October 1, 132.20 1992, the commissioner shall make payments for dental services 132.21 as follows: 132.22 (1) dental services shall be paid at the lower of (i) 132.23 submitted charges, or (ii) 25 percent above the rate in effect 132.24 on June 30, 1992; 132.25 (2) dental rates shall be converted from the 50th 132.26 percentile of 1982 to the 50th percentile of 1989, less the 132.27 percent in aggregate necessary to equal the above increases; 132.28 (3) effective for services rendered on or after January 1, 132.29 2000, payment rates for dental services shall be increased by 132.30 three percent over the rates in effect on December 31, 1999; 132.31 (4) the commissioner shall award grants to community 132.32 clinics or other nonprofit community organizations, political 132.33 subdivisions, professional associations, or other organizations 132.34 that demonstrate the ability to provide dental services 132.35 effectively to public program recipients. Grants may be used to 132.36 fund the costs related to coordinating access for recipients, 133.1 developing and implementing patient care criteria, upgrading or 133.2 establishing new facilities, acquiring furnishings or equipment, 133.3 recruiting new providers, or other development costs that will 133.4 improve access to dental care in a region. In awarding grants, 133.5 the commissioner shall give priority to applicants that plan to 133.6 serve areas of the state in which the number of dental providers 133.7 is not currently sufficient to meet the needs of recipients of 133.8 public programs or uninsured individuals. The commissioner 133.9 shall consider the following in awarding the grants: 133.10 (i) potential to successfully increase access to an 133.11 underserved population; 133.12 (ii) the ability to raise matching funds; 133.13 (iii) the long-term viability of the project to improve 133.14 access beyond the period of initial funding; 133.15 (iv) the efficiency in the use of the funding; and 133.16 (v) the experience of the proposers in providing services 133.17 to the target population. 133.18 The commissioner shall monitor the grants and may terminate 133.19 a grant if the grantee does not increase dental access for 133.20 public program recipients. The commissioner shall consider 133.21 grants for the following: 133.22 (i) implementation of new programs or continued expansion 133.23 of current access programs that have demonstrated success in 133.24 providing dental services in underserved areas; 133.25 (ii) a pilot program for utilizing hygienists outside of a 133.26 traditional dental office to provide dental hygiene services; 133.27 and 133.28 (iii) a program that organizes a network of volunteer 133.29 dentists, establishes a system to refer eligible individuals to 133.30 volunteer dentists, and through that network provides donated 133.31 dental care services to public program recipients or uninsured 133.32 individuals; 133.33 (5) beginning October 1, 1999, the payment for tooth 133.34 sealants and fluoride treatments shall be the lower of (i) 133.35 submitted charge, or (ii) 80 percent of median 1997 charges; 133.36 (6) the increases listed in clauses (3) and (5) shall be 134.1 implemented January 1, 2000, for managed care; and 134.2 (7) effective for services provided on or after January 1, 134.3 2002, payment for diagnostic examinations and dental x-rays 134.4 provided to children under age 21 shall be the lower of (i) the 134.5 submitted charge, or (ii) 85 percent of median 1999 charges. 134.6 (c) Effective for dental services rendered on or after 134.7 January 1, 2002, the commissioner may, within the limits of 134.8 available appropriation, increase reimbursements to dentists and 134.9 dental clinics deemed by the commissioner to be critical access 134.10 dental providers. Reimbursement to a critical access dental 134.11 provider may be increased by not more than 50 percent above the 134.12 reimbursement rate that would otherwise be paid to the 134.13 provider. Payments to health plan companies shall be adjusted 134.14 to reflect increased reimbursements to critical access dental 134.15 providers as approved by the commissioner. In determining which 134.16 dentists and dental clinics shall be deemed critical access 134.17 dental providers, the commissioner shall review: 134.18 (1) the utilization rate in the service area in which the 134.19 dentist or dental clinic operates for dental services to 134.20 patients covered by medical assistance, general assistance 134.21 medical care, or MinnesotaCare as their primary source of 134.22 coverage; 134.23 (2) the level of services provided by the dentist or dental 134.24 clinic to patients covered by medical assistance, general 134.25 assistance medical care, or MinnesotaCare as their primary 134.26 source of coverage; and 134.27 (3) whether the level of services provided by the dentist 134.28 or dental clinic is critical to maintaining adequate levels of 134.29 patient access within the service area. 134.30 In the absence of a critical access dental provider in a service 134.31 area, the commissioner may designate a dentist or dental clinic 134.32 as a critical access dental provider if the dentist or dental 134.33 clinic is willing to provide care to patients covered by medical 134.34 assistance, general assistance medical care, or MinnesotaCare at 134.35 a level which significantly increases access to dental care in 134.36 the service area. 135.1 (d) Effective July 1, 2001, the medical assistance rates 135.2 for outpatient mental health services provided by an entity that 135.3 operates: 135.4 (1) a Medicare-certified comprehensive outpatient 135.5 rehabilitation facility; and 135.6 (2) a facility that was certified prior to January 1, 1993, 135.7 with at least 33 percent of the clients receiving rehabilitation 135.8 services in the most recent calendar year who are medical 135.9 assistance recipients, will be increased by 38 percent, when 135.10 those services are provided within the comprehensive outpatient 135.11 rehabilitation facility and provided to residents of nursing 135.12 facilities owned by the entity. 135.13 (e) An entity that operates both a Medicare certified 135.14 comprehensive outpatient rehabilitation facility and a facility 135.15 which was certified prior to January 1, 1993, that is licensed 135.16 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 135.17 whom at least 33 percent of the clients receiving rehabilitation 135.18 services in the most recent calendar year are medical assistance 135.19 recipients, shall be reimbursed by the commissioner for 135.20 rehabilitation services at rates that are 38 percent greater 135.21 than the maximum reimbursement rate allowed under paragraph (a), 135.22 clause (2), when those services are (1) provided within the 135.23 comprehensive outpatient rehabilitation facility and (2) 135.24 provided to residents of nursing facilities owned by the entity. 135.25 Sec. 45. Minnesota Statutes 2000, section 256I.04, 135.26 subdivision 2a, is amended to read: 135.27 Subd. 2a. [LICENSE REQUIRED.] A county agency may not 135.28 enter into an agreement with an establishment to provide group 135.29 residential housing unless: 135.30 (1) the establishment is licensed by the department of 135.31 health as a hotel and restaurant; a board and lodging 135.32 establishment; a residential care home; a boarding care home 135.33 before March 1, 1985; or a supervised living facility, and the 135.34 service provider for residents of the facility is licensed under 135.35 chapter 245A. However, an establishment licensed by the 135.36 department of health to provide lodging need not also be 136.1 licensed to provide board if meals are being supplied to 136.2 residents under a contract with a food vendor who is licensed by 136.3 the department of health; 136.4 (2) the residence is licensed by the commissioner of human 136.5 services under Minnesota Rules, parts 9555.5050 to 9555.6265, or 136.6 certified by a county human services agency prior to July 1, 136.7 1992, using the standards under Minnesota Rules, parts 9555.5050 136.8 to 9555.6265; or 136.9 (3) the establishment is registered under chapter 144D and 136.10 provides three meals a day, except that an establishment 136.11 registered under section 144D.025 is not eligible for an 136.12 agreement to provide group residential housing. 136.13 The requirements under clauses (1), (2), and (3) do not 136.14 apply to establishments exempt from state licensure because they 136.15 are located on Indian reservations and subject to tribal health 136.16 and safety requirements. 136.17 Sec. 46. Minnesota Statutes 2000, section 256L.12, 136.18 subdivision 9, as amended by Laws 2002, chapter 220, article 15, 136.19 section 23, is amended to read: 136.20 Subd. 9. [RATE SETTING.] (a) Rates will be prospective, 136.21 per capita, where possible. The commissioner may allow health 136.22 plans to arrange for inpatient hospital services on a risk or 136.23 nonrisk basis. The commissioner shall consult with an 136.24 independent actuary to determine appropriate rates. 136.25 (b) For services rendered on or after January 1, 2003, the 136.26 commissioner shall withhold .5 percent of managed care plan 136.27 payments under this section pending completion of performance 136.28 targets. The withheld funds willmust be returned no sooner 136.29 than July 1 and no later than July 31 of the following year if 136.30 performance targets in the contract are achieved. A managed 136.31 care plan may include as admitted assets under section 62D.044 136.32 any amount withheld under this paragraph that is reasonably 136.33 expected to be returned. 136.34 Sec. 47. Laws 2002, chapter 220, article 17, section 2, 136.35 subdivision 6, is amended to read: 136.36 Subd. 6. Continuing Care 137.1 Grants 137.2 General (8,907,000) (26,227,000) 137.3 The amounts that may be spent from this 137.4 appropriation for each purpose are as 137.5 follows: 137.6 (a) Aging Adult Service 137.7 Grants 137.8 General -0- (2,638,000) 137.9 [PLANNING AND SERVICE DEVELOPMENT.] The 137.10 planning and service development grant 137.11 from Laws 2001, First Special Session 137.12 chapter 9, article 17, section 2, 137.13 subdivision 9, is eliminated for fiscal 137.14 year 2003. Base funding for the 137.15 2004-2005 biennium shall be $550,000 137.16 each year. Notwithstanding Laws 2001, 137.17 First Special Session chapter 9, 137.18 article 17, section 2, subdivision 9, 137.19 beginning in fiscal year 2004, the 137.20 commissioner shall annually distribute 137.21 $5,000 to each county. Counties with 137.22 more than 10,000 persons over age 65 137.23 shall receive a distribution of an 137.24 additional 25 cents for each person 137.25 over age 65. The amount distributed to 137.26 each area agency on aging shall be 137.27 $2,500. 137.28 [COMMUNITY SERVICES DEVELOPMENT 137.29 GRANTS.] For fiscal year 2003, base 137.30 level funding for community services 137.31 development grants under Minnesota 137.32 Statutes, section 256.9754, is reduced 137.33 by $1,478,000. For fiscal year 2004, 137.34 base level funding for these grants is 137.35 reduced by $768,000. For fiscal year 137.36 2005, base level funding shall be 137.37 $3,000,000, and this amount shall be 137.38 the base funding level for these grants 137.39 for the biennium beginning July 1, 137.40 2005. Notwithstanding section 5, this 137.41 provision shall not expire. 137.42 (b) Medical Assistance 137.43 Long-Term Care Waivers and 137.44 Home Care Grants 137.45 General 18,471,000 12,833,000 137.46 (c) Medical Assistance 137.47 Long-Term Care Facilities 137.48 Grants 137.49 General (27,382,000) (31,922,000) 137.50 (d) Group Residential 137.51 Housing Grants 137.52 General 4,000 574,000 137.53 [FEDERAL FUNDING FOR GROUP RESIDENTIAL137.54 HOUSING COSTS.] The commissioner shall137.55 seek federal funding to offset costs137.56 for group residential housing services137.57 under Minnesota Statutes, chapter 256I.137.58 Any federal funding received shall be138.1 distributed to counties on a pro rata138.2 basis according to county spending138.3 under Minnesota Statutes, section138.4 256B.19, subdivision 1, clause (3), for138.5 the costs of nursing facility138.6 placements of persons with disabilities138.7 under the age of 65 that have exceeded138.8 90 days. The commissioner shall report138.9 to the legislature by January 15, 2003,138.10 on the status of additional federal138.11 funding for group residential housing138.12 costs.138.13 (e) Chemical Dependency 138.14 Entitlement Grants 138.15 General -0- (84,000) 138.16 [CONSOLIDATED CHEMICAL DEPENDENCY 138.17 TREATMENT FUND RESERVE TRANSFER.] In 138.18 fiscal year 2003, $8,544,000 of funds 138.19 available in the consolidated chemical 138.20 dependency treatment fund general 138.21 reserve account is transferred to the 138.22 general fund. 138.23 (f) Community Social Services 138.24 Block Grants 138.25 General -0- (4,990,000) 138.26 [CSSA TRADITIONAL APPROPRIATION 138.27 REDUCTION.] For fiscal year 2003, base 138.28 level funding for community social 138.29 service aids under Minnesota Statutes, 138.30 section 256E.06, subdivisions 1 and 2, 138.31 is reduced by $4,700,000. This 138.32 reduction shall become part of base 138.33 level funding for the biennium 138.34 beginning July 1, 2003. 138.35 Notwithstanding section 5, this 138.36 provision shall not expire. 138.37 [CSSA GRANTS FOR FORMER GRH 138.38 RECIPIENTS.] For fiscal year 2003, base 138.39 level funding for community social 138.40 service aids under Minnesota Statutes, 138.41 section 256E.06, subdivision 2b, is 138.42 reduced by $290,000. This reduction 138.43 shall become part of base level funding 138.44 for the biennium beginning July 1, 138.45 2003. These reductions shall be made 138.46 on a pro rata basis to each affected 138.47 county. Notwithstanding section 5, 138.48 this provision shall not expire. 138.49 Sec. 48. [CASE MANAGEMENT STUDY.] 138.50 The commissioner of human services shall study case 138.51 management services for persons with disabilities, in 138.52 consultation with consumers, providers, consumer advocates, and 138.53 local social service and public health agencies. The 138.54 commissioner shall report to the chairs and ranking minority 138.55 members of the house and senate committees having jurisdiction 138.56 over health and human services policy and funding, by January 139.1 15, 2003, on strategies that: 139.2 (1) streamline administration; 139.3 (2) improve case management service availability across the 139.4 state; 139.5 (3) enhance consumer access to needed services and 139.6 supports; 139.7 (4) improve accountability and the use of performance 139.8 measures; 139.9 (5) provide for consumer choice of vendor; and 139.10 (6) improve the financing of case management services. 139.11 [EFFECTIVE DATE.] This section is effective the day 139.12 following final enactment. 139.13 Sec. 49. [MENTAL HEALTH SERVICES RATE INCREASE 139.14 PASS-THROUGH.] 139.15 Prepaid health plans must pass through to service providers 139.16 the rate increases provided under Minnesota Statutes, section 139.17 256B.761. 139.18 Sec. 50. [COMMUNITY SERVICES DEVELOPMENT GRANTS USAGE.] 139.19 For fiscal year 2003, the commissioner of human services 139.20 may make grants under the community services development grants 139.21 program in Minnesota Statutes, section 256.9754, for the 139.22 development of housing options for persons under age 65 residing 139.23 in nursing facilities. 139.24 Sec. 51. [ACCESS TO AFFORDABLE HOUSING.] 139.25 The commissioners of human services and the Minnesota 139.26 housing finance agency shall make recommendations to the 139.27 long-term care task force by January 15, 2003, on ways to 139.28 increase the ability of persons with disabilities to access 139.29 affordable housing. The recommendations shall include: 139.30 (1) income supplement or housing subsidy options that 139.31 support efforts to relocate persons under the age of 65 from 139.32 nursing facilities or to divert them from a nursing facility 139.33 placement; 139.34 (2) an analysis of the impacts of the state using a fixed 139.35 amount attributable to room and board costs for home and 139.36 community-based waiver recipients in group residential settings; 140.1 (3) options to maximize federal funding that result in no 140.2 additional costs to the state. These options may include the 140.3 transfer of state funds between income maintenance programs and 140.4 the Medicaid program. These options may be implemented prior to 140.5 the report to the task force. Any additional funds made 140.6 available through implementation of these options and not 140.7 utilized to support persons relocating from nursing facilities 140.8 shall be used to reduce the county share enacted in Laws 2002, 140.9 chapter 220, article 14, section 8; and 140.10 (4) alternatives that provide additional incentives to 140.11 county agencies that successfully discharge persons with 140.12 disabilities under the age of 65 from nursing facilities. 140.13 Sec. 52. [PRIOR AUTHORIZATION REPORT.] 140.14 The commissioner of human services shall review prior 140.15 authorization of prescription drugs in the fee-for-service 140.16 medical assistance program in terms of the cost effectiveness 140.17 achieved through prior authorization on prescription drug costs 140.18 and on other medical assistance costs and evaluate the effect 140.19 that placing a drug on prior authorization has had on the 140.20 quality of patient care. The commissioner shall submit the 140.21 results to the chairs and ranking minority members of the senate 140.22 and house of representatives committees having jurisdiction over 140.23 human services funding by January 15, 2004. 140.24 Sec. 53. [PILOT PROGRAM FOR DEAF-BLIND SERVICES.] 140.25 (a) The commissioners of human services; children, 140.26 families, and learning; and state services for the blind shall 140.27 meet with deaf-blind citizens, parents of deaf-blind children, 140.28 and the Minnesota commission serving deaf and hard-of-hearing 140.29 individuals to determine which agency can most efficiently and 140.30 effectively develop and administer a pilot program for 140.31 consumer-directed services to provide needed services to 140.32 deaf-blind adults, children, and families. 140.33 (b) The planning for this pilot program must proceed using 140.34 current appropriations. The agency that develops the pilot 140.35 program described in paragraph (a) shall provide a report to the 140.36 senate and house of representatives policy and fiscal committees 141.1 having jurisdiction over human services issues by January 1, 141.2 2003, that addresses future funding for the program. The report 141.3 shall include the program proposal, recommendations, and a 141.4 fiscal note. 141.5 Sec. 54. [SERVICES FOR DEAF-BLIND PERSONS.] 141.6 (a) Effective for fiscal years beginning on or after July 141.7 1, 2003, the commissioner of human services shall combine the 141.8 existing $1,000,000 biennial base level funding for deaf-blind 141.9 services into a single grant program. Within the limits of the 141.10 appropriation for this purpose, each biennium at least $350,000 141.11 shall be awarded for services to deaf-blind children and their 141.12 families and at least $250,000 shall be awarded for services to 141.13 deaf-blind adults. 141.14 (b) The commissioner may make grants: 141.15 (1) for services provided by organizations; and 141.16 (2) to develop and administer consumer-directed services. 141.17 (c) Any entity that is able to satisfy the grant criteria 141.18 is eligible to receive a grant under paragraph (a). 141.19 (d) Deaf-blind service providers are not required to, but 141.20 may, provide intervenor services as part of the service package 141.21 provided with grant funds under this section. 141.22 Sec. 55. [FEASIBILITY ASSESSMENT OF MEDICAL ASSISTANCE 141.23 EXPANSION TO COVER DEAF-BLIND SERVICES.] 141.24 (a) The commissioner of human services shall study and 141.25 report to the legislature by January 15, 2003, with a 141.26 feasibility assessment of the costs and policy implications, 141.27 including the necessity of federal waivers, to expand benefits 141.28 covered under medical assistance and under medical assistance 141.29 waiver programs to include the following services for deaf-blind 141.30 persons: 141.31 (1) sign language interpreters; 141.32 (2) intervenors; 141.33 (3) support service persons; 141.34 (4) orientation and mobility services; and 141.35 (5) rehabilitation teaching services. 141.36 (b) Notwithstanding Laws 2001, First Special Session 142.1 chapter 9, article 17, section 10, subdivision 3, the 142.2 commissioner may transfer $20,000 of deaf and hard-of-hearing 142.3 grants to operations for purposes of paragraph (a). The study 142.4 and report under paragraph (a) is exempt from the consulting 142.5 contract moratorium in Laws 2002, chapter 220, article 10, 142.6 section 37. 142.7 Sec. 56. [REPEALER; TARGETED CASE MANAGEMENT.] 142.8 Minnesota Statutes 2001 Supplement, section 256B.0621, 142.9 subdivision 1, is repealed. 142.10 ARTICLE 3 142.11 MISCELLANEOUS 142.12 Section 1. Minnesota Statutes 2000, section 62J.692, 142.13 subdivision 4, as amended by Laws 2002, chapter 220, article 15, 142.14 section 1, is amended to read: 142.15 Subd. 4. [DISTRIBUTION OF FUNDS.] (a) The commissioner 142.16 shall annually distribute medical education funds to all 142.17 qualifying applicants based on the following criteria: 142.18 (1) total medical education funds available for 142.19 distribution; 142.20 (2) total number of eligible trainee FTEs in each clinical 142.21 medical education program; and 142.22 (3) the statewide average cost per trainee as determined by 142.23 the application information provided in the first year of the 142.24 biennium, by type of trainee, in each clinical medical education 142.25 program. 142.26 (b) Funds distributed shall not be used to displace current 142.27 funding appropriations from federal or state sources. 142.28 (c) Funds shall be distributed to the sponsoring 142.29 institutions indicating the amount to be distributed to each of 142.30 the sponsor's clinical medical education programs based on the 142.31 criteria in this subdivision and in accordance with the 142.32 commissioner's approval letter. Each clinical medical education 142.33 program must distribute funds to the training sites as specified 142.34 in the commissioner's approval letter. Sponsoring institutions, 142.35 which are accredited through an organization recognized by the 142.36 department of education or the health care financing 143.1 administration, may contract directly with training sites to 143.2 provide clinical training. To ensure the quality of clinical 143.3 training, those accredited sponsoring institutions must: 143.4 (1) develop contracts specifying the terms, expectations, 143.5 and outcomes of the clinical training conducted at sites; and 143.6 (2) take necessary action if the contract requirements are 143.7 not met. Action may include the withholding of payments under 143.8 this section or the removal of students from the site. 143.9 (d) Any funds not distributed in accordance with the 143.10 commissioner's approval letter must be returned to the medical 143.11 education and research fund within 30 days of receiving notice 143.12 from the commissioner. The commissioner shall distribute 143.13 returned funds to the appropriate training sites in accordance 143.14 with the commissioner's approval letter. 143.15 (e) The commissioner shall distribute no later thanby June 143.16 30 of each year an amount equal to the funds transferred under 143.17 section 62J.694, subdivision 2a, paragraph (b), plus five 143.18 percent interest at a rate equal to the average earnings paid143.19 under section 62J.694, subdivision 2a,to the University of 143.20 Minnesota board of regents for the costs of the academic health 143.21 center as specified under section 62J.694, subdivision 2a, 143.22 paragraph (a). 143.23 Sec. 2. Minnesota Statutes 2001 Supplement, section 143.24 125A.515, is amended to read: 143.25 125A.515 [PLACEMENT OF CHILDREN WITHOUT DISABILITIES143.26 STUDENTS; APPROVAL OF EDUCATION PROGRAM.] 143.27 Subdivision 1. [APPROVAL OF EDUCATION PROGRAMS.] The 143.28 commissioner shall approve education programs in care and143.29 treatment facilitiesfor placement of children without143.30 disabilitiesand youth in care and treatment facilities 143.31 including detention centers, before being licensed by the 143.32 department of human services under Minnesota Rules, parts 143.33 9545.0905 to 9545.1125 and 9545.1400 to 9545.1480, or the 143.34 department of corrections under Minnesota Rules, chapters 2925, 143.35 2930, 2935, and 2950. For the purposes of this section, care143.36 and treatment facilities includes adult facilities that admit144.1 children and provide an education program specifically designed144.2 for children who are residents of the facility including144.3 chemical dependency and other substance abuse programs, shelter144.4 care facilities, hospitals, correctional facilities, mental144.5 health programs, and detention facilities.Education programs 144.6 in these facilities shall conform to state and federal education 144.7 laws including the Individuals with Disabilities Education Act 144.8 (IDEA). 144.9 Subd. 2. [DEFINITION OF CARE AND TREATMENT 144.10 PLACEMENT.] Students placed in the following public or private 144.11 facilities are considered to be placed for care and treatment: 144.12 (1) group foster home, department of corrections; 144.13 (2) secure juvenile detention facilities, department of 144.14 corrections; 144.15 (3) juvenile residential facilities, department of 144.16 corrections; 144.17 (4) temporary holdover - eight day, department of 144.18 corrections; 144.19 (5) group homes, department of human services; 144.20 (6) residential academies, department of human services; 144.21 (7) transitional programs, department of human services; 144.22 (8) shelter care, department of human services and 144.23 department of corrections; 144.24 (9) shelter for homeless, department of human services; 144.25 (10) adult facilities that admit persons under the age of 144.26 22; and 144.27 (11) residential treatment programs. 144.28 Subd. 3. [RESPONSIBILITIES FOR PROVIDING EDUCATION.] (a) 144.29 The district in which the facility is located must provide 144.30 education services, including special education if eligible, to 144.31 all students placed in a facility for care and treatment. 144.32 (b) For education programs operated by the department of 144.33 corrections, the providing district shall be the department of 144.34 corrections. For students remanded to the commissioner of 144.35 corrections, the providing and resident district shall be the 144.36 department of corrections. 145.1 (c) Placement for care and treatment does not automatically 145.2 make a student eligible for special education. A student placed 145.3 in a care and treatment facility is eligible for special 145.4 education under state and federal law including the Individuals 145.5 with Disabilities Education Act under United States Code, title 145.6 20, chapter 33. 145.7 Subd. 4. [EDUCATION SERVICES REQUIRED.] (a) Education 145.8 services must be provided to a student beginning within three 145.9 business days after the student enters the care and treatment 145.10 facility. The first four days of the student's placement may be 145.11 used to screen the student for educational and safety issues. 145.12 (b) If the student does not meet the eligibility criteria 145.13 for special education, regular education services must be 145.14 provided to that student. 145.15 Subd. 5. [EDUCATION PROGRAMS FOR STUDENTS PLACED IN 145.16 FACILITIES FOR CARE AND TREATMENT.] (a) When a student is placed 145.17 in a care and treatment facility that has an on-site education 145.18 program, the providing district, upon notice from the care and 145.19 treatment facility, must contact the resident district within 145.20 one business day to determine if a student has been identified 145.21 as having a disability, and to request at least the student's 145.22 transcript, and for students with disabilities, the most recent 145.23 individualized education plan (IEP) and evaluation report, and 145.24 to determine if the student has been identified as a student 145.25 with a disability. The resident district must send a facsimile 145.26 copy to the providing district within two business days of 145.27 receiving the request. 145.28 (b) If a student placed for care and treatment has been 145.29 identified as having a disability and has an individual 145.30 education plan in the resident district: 145.31 (1) the providing agency must conduct an individualized 145.32 education plan meeting to reach an agreement about continuing or 145.33 modifying special education services in accordance with the 145.34 current individualized education plan goals and objectives and 145.35 to determine if additional evaluations are necessary; and 145.36 (2) at least the following people shall receive written 146.1 notice or documented phone call to be followed with written 146.2 notice to attend the individualized education plan meeting: 146.3 (i) the person or agency placing the student; 146.4 (ii) the resident district; 146.5 (iii) the appropriate teachers and related services staff 146.6 from the providing district; 146.7 (iv) appropriate staff from the care and treatment 146.8 facility; 146.9 (v) the parents or legal guardians of the student; and 146.10 (vi) when appropriate, the student. 146.11 (c) For a student who has not been identified as a student 146.12 with a disability, a screening must be conducted by the 146.13 providing districts as soon as possible to determine the 146.14 student's educational and behavioral needs and must include a 146.15 review of the student's educational records. 146.16 Subd. 6. [EXIT REPORT SUMMARIZING EDUCATIONAL 146.17 PROGRESS.] If a student has been placed in a care and treatment 146.18 facility for 15 or more business days, the providing district 146.19 must prepare an exit report summarizing the regular education, 146.20 special education, evaluation, educational progress, and service 146.21 information and must send the report to the resident district 146.22 and the next providing district if different, the parent or 146.23 legal guardian, and any appropriate social service agency. For 146.24 students with disabilities, this report must include the 146.25 student's IEP. 146.26 Subd. 7. [MINIMUM EDUCATIONAL SERVICES REQUIRED.] At a 146.27 minimum, the providing district is responsible for: 146.28 (1) the education necessary, including summer school 146.29 services, for a student who is not performing at grade level as 146.30 indicated in the education record or IEP; and 146.31 (2) a school day, of the same length as the school day of 146.32 the providing district, unless the unique needs of the student, 146.33 as documented through the IEP or education record in 146.34 consultation with treatment providers, requires an alteration in 146.35 the length of the school day. 146.36 Subd. 8. [PLACEMENT, SERVICES, AND DUE PROCESS.] When a 147.1 student's treatment and educational needs allow, education shall 147.2 be provided in a regular educational setting. The determination 147.3 of the amount and site of integrated services must be a joint 147.4 decision between the student's parents or legal guardians and 147.5 the treatment and education staff. When applicable, educational 147.6 placement decisions must be made by the IEP team of the 147.7 providing district. Educational services shall be provided in 147.8 conformance with the least restrictive environment principle of 147.9 the Individuals with Disabilities Education Act. The providing 147.10 district and care and treatment facility shall cooperatively 147.11 develop discipline and behavior management procedures to be used 147.12 in emergency situations that comply with the Minnesota Pupil 147.13 Fair Dismissal Act and other relevant state and federal laws and 147.14 regulations. 147.15 Subd. 9. [REIMBURSEMENT FOR EDUCATION SERVICES.] (a) 147.16 Education services provided to students who have been placed for 147.17 care and treatment are reimbursable in accordance with special 147.18 education and general education statutes. 147.19 (b) Indirect or consultative services provided in 147.20 conjunction with regular education prereferral interventions and 147.21 assessment provided to regular education students suspected of 147.22 being disabled and who have demonstrated learning or behavioral 147.23 problems in a screening are reimbursable with special education 147.24 categorical aids. 147.25 (c) Regular education, including screening, provided to 147.26 students with or without disabilities is not reimbursable with 147.27 special education categorical aids. 147.28 Subd. 10. [STUDENTS UNABLE TO ATTEND SCHOOL BUT NOT PLACED 147.29 IN CARE AND TREATMENT FACILITIES.] Students who are absent from, 147.30 or predicted to be absent from, school for 15 consecutive or 147.31 intermittent days, at home or in facilities not licensed by the 147.32 departments of corrections or human services are not students 147.33 placed for care and treatment. These students include students 147.34 with and without disabilities who are home due to accident or 147.35 illness, in a hospital or other medical facility, or in a day 147.36 treatment center. These students are entitled to education 148.1 services through their district of residence. 148.2 Sec. 3. Minnesota Statutes 2000, section 125A.76, 148.3 subdivision 5, is amended to read: 148.4 Subd. 5. [SCHOOL DISTRICT SPECIAL EDUCATION AID.] (a) A 148.5 school district's special education aid for fiscal year 2000 and 148.6 later equals the state total special education aid, minus the 148.7 amount determined under paragraphs (b) and (c), times the ratio 148.8 of the district's adjusted special education base revenue to the 148.9 state total adjusted special education base revenue. If the 148.10 commissioner of children, families, and learning modifies its 148.11 rules for special education in a manner that increases a 148.12 district's special education obligations or service 148.13 requirements, the commissioner shall annually increase each 148.14 district's special education aid by the amount necessary to 148.15 compensate for the increased service requirements. The 148.16 additional aid equals the cost in the current year attributable 148.17 to rule changes not reflected in the computation of special 148.18 education base revenue, multiplied by the appropriate 148.19 percentages from subdivision 2. 148.20 (b) Notwithstanding paragraph (a), if the special education 148.21 base revenue for a district equals zero, the special education 148.22 aid equals the amount computed according to subdivision 2 using 148.23 current year data. 148.24 (c) Notwithstanding paragraphs (a) and (b), if the special 148.25 education base revenue for a district is greater than zero, and 148.26 the base year amount for the district under subdivision 2, 148.27 paragraph (a), clause (7), equals zero, the special education 148.28 aid equals the sum of the amount computed according to paragraph 148.29 (a), plus the amount computed according to subdivision 2, 148.30 paragraph (a), clause (7), using current year data. 148.31 (d) A charter school under section 124D.10 shall generate 148.32 state special education aid based on current year expenditures 148.33 for its first four years of operation and only in its fifth and 148.34 later years shall paragraphs (a), (b), and (c) apply. 148.35 [EFFECTIVE DATE.] This section is effective July 1, 2002. 148.36 Sec. 4. Minnesota Statutes 2000, section 144.05, is 149.1 amended by adding a subdivision to read: 149.2 Subd. 4. [IDENTIFICATION OF DECEASED INDIVIDUALS.] Upon 149.3 receiving notice under section 149A.90, subdivision 1, of the 149.4 death of an individual who cannot be identified, the 149.5 commissioner must post on the department's Web site information 149.6 regarding the individual for purposes of obtaining information 149.7 that may aid in identifying the individual and for purposes of 149.8 notifying relatives who may be seeking the individual. The 149.9 information must remain on the Web site continuously until the 149.10 person's identity is determined. 149.11 Sec. 5. Minnesota Statutes 2001 Supplement, section 149.12 144.148, subdivision 2, is amended to read: 149.13 Subd. 2. [PROGRAM.] (a) The commissioner of health shall 149.14 award rural hospital capital improvement grants to eligible 149.15 rural hospitals. Except as provided in paragraph (b), a grant 149.16 shall not exceed $500,000 per hospital. Prior to the receipt of 149.17 any grant, the hospital must certify to the commissioner that at 149.18 least one-quarter of the grant amount, which may include in-kind 149.19 services, is available for the same purposes from nonstate 149.20 resources. Notwithstanding any law to the contrary, funds 149.21 awarded to grantees in a grant agreement do not lapse until 149.22 expended by the grantee. 149.23 (b) A grant shall not exceed $1,500,000 per eligible rural 149.24 hospital that also satisfies the following criteria: 149.25 (1) is the only hospital in a county; 149.26 (2) has 25 or fewer licensed hospital beds with a net 149.27 hospital operating margin not greater than an average of two 149.28 percent over the three fiscal years prior to application; 149.29 (3) is located in a medically underserved community (MUC) 149.30 or a health professional shortage area (HPSA); 149.31 (4) is located near a migrant worker employment site and 149.32 regularly treats significant numbers of migrant workers and 149.33 their families; and 149.34 (5) has not previously received a grant under this section 149.35 prior to July 1, 1999. 149.36 Sec. 6. Minnesota Statutes 2000, section 144.335, 150.1 subdivision 5, is amended to read: 150.2 Subd. 5. [COSTS.] (a) When a patient requests a copy of 150.3 the patient's record for purposes of reviewing current medical 150.4 care, the provider must not charge a fee. 150.5 (b) When a provider or its representative makes copies of 150.6 patient records upon a patient's request under this section, the 150.7 provider or its representative may charge the patient or the 150.8 patient's representative no more than 75 cents per page, plus 150.9 $10 for time spent retrieving and copying the records, unless 150.10 other law or a rule or contract provide for a lower maximum 150.11 charge. This limitation does not apply to x-rays. The provider 150.12 may charge a patient no more than the actual cost of reproducing 150.13 X-rays, plus no more than $10 for the time spent retrieving and 150.14 copying the x-rays. 150.15 (c) The respective maximum charges of 75 cents per page and 150.16 $10 for time provided in this subdivision are in effect for 150.17 calendar year 1992 and may be adjusted annually each calendar 150.18 year as provided in this subdivision. The permissible maximum 150.19 charges shall change each year by an amount that reflects the 150.20 change, as compared to the previous year, in the consumer price 150.21 index for all urban consumers, Minneapolis-St. Paul (CPI-U), 150.22 published by the department of labor. 150.23 (d) A provider or its representative must not charge a fee 150.24 to provide copies of records requested by a patient or the 150.25 patient's authorized representative if the request for copies of 150.26 records is for purposes of appealing a denial of social security 150.27 disability income or social security disability benefits under 150.28 title II or title XVI of the Social Security Act. For the 150.29 purpose of further appeals, a patient may receive no more than 150.30 two medical record updates without charge, but only for medical 150.31 record information previously not provided. For purposes of 150.32 this paragraph, a patient's authorized representative does not 150.33 include units of state government engaged in the adjudication of 150.34 social security disability claims. 150.35 Sec. 7. Minnesota Statutes 2000, section 144.417, 150.36 subdivision 1, is amended to read: 151.1 Subdivision 1. [RULES.] (a) The state commissioner of 151.2 health shall adopt rules necessary and reasonable to implement 151.3 the provisions of sections 144.411 to 144.417, except as 151.4 provided for in section 144.414. 151.5 (b) Rules implementing sections 144.411 to 144.417 adopted 151.6 after January 1, 2002, may not take effect until approved by a 151.7 law enacted after January 1, 2002. This paragraph does not 151.8 apply to a rule or severable portion of a rule governing smoking 151.9 in office buildings, factories, warehouses, or similar places of 151.10 work, or in health care facilities. This paragraph does not 151.11 apply to a rule changing the definition of "restaurant" to make 151.12 it the same as the definition in section 157.15, subdivision 12. 151.13 [EFFECTIVE DATE.] This section is effective the day 151.14 following final enactment. 151.15 Sec. 8. Minnesota Statutes 2000, section 147B.02, 151.16 subdivision 9, is amended to read: 151.17 Subd. 9. [RENEWAL.] (a) To renew a license an applicant 151.18 must: 151.19 (1) annually, or as determined by the board, complete a 151.20 renewal application on a form provided by the board; 151.21 (2) submit the renewal fee; 151.22 (3) provide evidence annually of one hour of continuing151.23 education in the subject of infection control, including blood151.24 borne pathogen diseases;151.25 (4)provide documentation of current and active NCCAOM 151.26 certification; or 151.27 (5)(4) if licensed under subdivision 5 or 6, meet the same 151.28 NCCAOM professional development activity requirements as those 151.29 licensed under subdivision 7. 151.30 (b) An applicant shall submit any additional information 151.31 requested by the board to clarify information presented in the 151.32 renewal application. The information must be submitted within 151.33 30 days after the board's request, or the renewal request is 151.34 nullified. 151.35 Sec. 9. Minnesota Statutes 2001 Supplement, section 151.36 149A.90, subdivision 1, is amended to read: 152.1 Subdivision 1. [DEATH RECORD.] (a) Except as provided in 152.2 this section, a death record must be completed and filed for 152.3 every known death by the mortician, funeral director, or other 152.4 person lawfully in charge of the disposition of the body. 152.5 (b) If the body is that of an individual whose identity is 152.6 unknown, the person in charge of the disposition of the body 152.7 must notify the commissioner for purposes of compliance with 152.8 section 144.05, subdivision 4. 152.9 Sec. 10. Minnesota Statutes 2000, section 261.063, is 152.10 amended to read: 152.11 261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 152.12 PENALTY.] 152.13 (a) The board of county commissioners of each county shall 152.14 annually levy taxes and fix a rate sufficient to produce the 152.15 full amount required for poor relief, general assistance, 152.16 Minnesota family investment program, county share of county and 152.17 state supplemental aid to supplemental security income 152.18 applicants or recipients, and any other social security measures 152.19 wherein there is now or may hereafter be county participation, 152.20 sufficient to produce the full amount necessary for each such 152.21 item, including administrative expenses, for the ensuing year, 152.22 within the time fixed by law in addition to all other tax levies 152.23 and tax rates, however fixed or determined, and any commissioner 152.24 who shall fail to comply herewith shall be guilty of a gross 152.25 misdemeanor and shall be immediately removed from office by the 152.26 governor. For the purposes of this paragraph, "poor relief" 152.27 means county services provided under sections 261.035, 261.04, 152.28 and 261.21 to 261.231. 152.29 (b) Nothing within the provisions of this section shall be 152.30 construed as requiring a county agency to provide income support 152.31 or cash assistance to needy persons when they are no longer 152.32 eligible for assistance under general assistance, the Minnesota 152.33 family investment program, or Minnesota supplemental aid. 152.34 Sec. 11. [REPEALER.] 152.35 Minnesota Statutes 2000, section 147B.01, subdivisions 8 152.36 and 15, are repealed.