as introduced - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to human services; making technical changes 1.3 in health care programs; amending Minnesota Statutes 1.4 2000, sections 13.05, subdivision 4; 245.4932, 1.5 subdivision 3; 245.50, subdivisions 1, 2, 5; 253B.045, 1.6 subdivision 2; 256.01, subdivision 11; 256.023; 1.7 256.9685, subdivision 1; 256.9866; 256B.041, 1.8 subdivision 5; 256B.0575; 256B.0629, subdivision 2; 1.9 256B.0915, subdivision 1c; 256B.0945, subdivision 4; 1.10 256B.19, subdivisions 1, 1d, 2b; 256B.692, subdivision 1.11 3; 256F.10, subdivision 9; 256F.13, subdivision 1; 1.12 256L.05, subdivision 3; 256L.07, subdivision 3; 1.13 Minnesota Statutes 2001 Supplement, sections 245.474, 1.14 subdivision 4; 256B.0623, subdivision 14; 256B.0625, 1.15 subdivision 20; 256B.0915, subdivision 3; 256B.0924, 1.16 subdivision 6; 256L.06, subdivision 3; Laws 2001, 1.17 First Special Session chapter 9, article 2, section 1.18 76; repealing Minnesota Statutes 2000, sections 1.19 256.025; 256B.0635, subdivision 3; 256B.19, 1.20 subdivision 1a; 256B.77, subdivision 24. 1.21 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.22 Section 1. Minnesota Statutes 2000, section 13.05, 1.23 subdivision 4, is amended to read: 1.24 Subd. 4. [LIMITATIONS ON COLLECTION AND USE OF DATA.] 1.25 Private or confidential data on an individual shall not be 1.26 collected, stored, used, or disseminated by political 1.27 subdivisions, statewide systems, or state agencies for any 1.28 purposes other than those stated to the individual at the time 1.29 of collection in accordance with section 13.04, except as 1.30 provided in this subdivision. 1.31 (a) Data collected prior to August 1, 1975, and which have 1.32 not been treated as public data, may be used, stored, and 1.33 disseminated for the purposes for which the data was originally 2.1 collected or for purposes which are specifically approved by the 2.2 commissioner as necessary to public health, safety, or welfare. 2.3 (b) Private or confidential data may be used and 2.4 disseminated to individuals or agencies specifically authorized 2.5 access to that data by state, local, or federal law enacted or 2.6 promulgated after the collection of the data. 2.7 (c) Private or confidential data may be used and 2.8 disseminated to individuals or agencies subsequent to the 2.9 collection of the data when the responsible authority 2.10 maintaining the data has requested approval for a new or 2.11 different use or dissemination of the data and that request has 2.12 been specifically approved by the commissioner as necessary to 2.13 carry out a function assigned by law. 2.14 (d) Private data may be used by and disseminated to any 2.15 person or agency if the individual subject or subjects of the 2.16 data have given their informed consent. Whether a data subject 2.17 has given informed consent shall be determined by rules of the 2.18 commissioner. The format for informed consent is as follows, 2.19 unless otherwise prescribed by the HIPAA, Standards for Privacy 2.20 of Individually Identifiable Health Information, 65 Fed. Reg. 2.21 82, 461 (2000) (to be codified as Code of Federal Regulations, 2.22 title 45, section 164): informed consent shall not be deemed to 2.23 have been given by an individual subject of the data by the 2.24 signing of any statement authorizing any person or agency to 2.25 disclose information about the individual to an insurer or its 2.26 authorized representative, unless the statement is: 2.27 (1) in plain language; 2.28 (2) dated; 2.29 (3) specific in designating the particular persons or 2.30 agencies the data subject is authorizing to disclose information 2.31 about the data subject; 2.32 (4) specific as to the nature of the information the 2.33 subject is authorizing to be disclosed; 2.34 (5) specific as to the persons or agencies to whom the 2.35 subject is authorizing information to be disclosed; 2.36 (6) specific as to the purpose or purposes for which the 3.1 information may be used by any of the parties named in clause 3.2 (5), both at the time of the disclosure and at any time in the 3.3 future; 3.4 (7) specific as to its expiration date which should be 3.5 within a reasonable period of time, not to exceed one year 3.6 except in the case of authorizations given in connection with 3.7 applications for life insurance or noncancelable or guaranteed 3.8 renewable health insurance and identified as such, two years 3.9 after the date of the policy. 3.10 The responsible authority may require a person requesting 3.11 copies of data under this paragraph to pay the actual costs of 3.12 making, certifying, and compiling the copies. 3.13 (e) Private or confidential data on an individual may be 3.14 discussed at a meeting open to the public to the extent provided 3.15 in section 13D.05. 3.16 Sec. 2. Minnesota Statutes 2001 Supplement, section 3.17 245.474, subdivision 4, is amended to read: 3.18 Subd. 4. [STAFF SAFETY TRAINING.] The commissioner 3.19 shall
by rulerequire all staff in mental health and support 3.20 units at regional treatment centers who have contact with 3.21 persons with mental illness or severe emotional disturbance to 3.22 be appropriately trained in violence reduction and violence 3.23 prevention and shall establish criteria for such training. 3.24 Training programs shall be developed with input from consumer 3.25 advocacy organizations and shall employ violence prevention 3.26 techniques as preferable to physical interaction. 3.27 Sec. 3. Minnesota Statutes 2000, section 245.4932, 3.28 subdivision 3, is amended to read: 3.29 Subd. 3. [PAYMENTS.] Notwithstanding section 256.025,3.30 subdivision 2,Payments under sections 245.493 to 245.496 to 3.31 providers for services for which the collaborative elects to pay 3.32 the nonfederal share of medical assistance shall only be made of 3.33 federal earnings from services provided under sections 245.493 3.34 to 245.496. 3.35 Sec. 4. Minnesota Statutes 2000, section 245.50, 3.36 subdivision 1, is amended to read: 4.1 Subdivision 1. [DEFINITIONS.] For purposes of this 4.2 section, the following terms have the meanings given them. 4.3 (a) "Bordering state" means Iowa, North Dakota, South 4.4 Dakota, or Wisconsin. 4.5 (b) "Receiving agency or facility" means a public or 4.6 private hospital, mental health center, or other person or 4.7 organization authorized by a state to providewhich provides 4.8 mental health services under this section to individuals from a 4.9 state other than the state in which the agency or facility is 4.10 located. 4.11 (c) "Receiving state" means the state in which a receiving 4.12 agency is located. 4.13 (d) "Sending agency" means a state or county agency which 4.14 sends an individual to a bordering state for treatment under 4.15 this section. 4.16 (e) "Sending state" means the state in which the sending 4.17 agency is located. 4.18 Sec. 5. Minnesota Statutes 2000, section 245.50, 4.19 subdivision 2, is amended to read: 4.20 Subd. 2. [PURPOSE AND AUTHORITY.] (a) The purpose of this 4.21 section is to enable appropriate treatment to be provided to 4.22 individuals, across state lines from the individual's state of 4.23 residence, in qualified facilities that are closer to the homes 4.24 of individuals than are facilities available in the individual's 4.25 home state. 4.26 (b) Unless prohibited by another law and subject to the 4.27 exceptions listed in subdivision 3, a county board or the 4.28 commissioner of human services may contract with an agency or 4.29 facility in a bordering state for mental health services for 4.30 residents of Minnesota, and a Minnesota mental health agency or 4.31 facility may contract to provide services to residents of 4.32 bordering states. Except as provided in subdivision 5, a person 4.33 who receives services in another state under this section is 4.34 subject to the laws of the state in which services are 4.35 provided. A person who will receive services in another state 4.36 under this section must be informed of the consequences of 5.1 receiving services in another state, including the implications 5.2 of the differences in state laws. 5.3 Sec. 6. Minnesota Statutes 2000, section 245.50, 5.4 subdivision 5, is amended to read: 5.5 Subd. 5. [SPECIAL CONTRACTS; WISCONSINBORDERING 5.6 STATES.] The commissioner of the Minnesota department of human5.7 services must enter into negotiations with appropriate personnel5.8 at the Wisconsin department of health and social services and5.9 must develop an agreement that conforms to the requirements of5.10 subdivision 4, to enable the placement in Minnesota of patients5.11 who are on emergency holds or who have been involuntarily5.12 committed as mentally ill or chemically dependent in Wisconsin5.13 and to enable the temporary placement in Wisconsin of patients5.14 who are on emergency holds in Minnesota under section 253B.05,5.15 provided that the Minnesota courts retain jurisdiction over5.16 Minnesota patients, and the state of Wisconsin affords to5.17 Minnesota patients the rights under Minnesota law. Persons5.18 committed by the Wisconsin courts and placed in Minnesota5.19 facilities shall continue to be in the legal custody of5.20 Wisconsin and Wisconsin's laws governing length of commitment,5.21 reexaminations, and extension of commitment shall continue to5.22 apply to these residents. In all other respects, Wisconsin5.23 residents placed in Minnesota facilities are subject to5.24 Minnesota laws. The agreement must specify that responsibility5.25 for payment for the cost of care of Wisconsin residents shall5.26 remain with the state of Wisconsin and the cost of care of5.27 Minnesota residents shall remain with the state of Minnesota.5.28 The commissioner shall be assisted by attorneys from the5.29 Minnesota attorney general's office in negotiating and5.30 finalizing this agreement. The agreement shall be completed so5.31 as to permit placement of Wisconsin residents in Minnesota5.32 facilities and Minnesota residents in Wisconsin facilities5.33 beginning July 1, 1994.(a) An individual who is detained, 5.34 committed, or placed on an involuntary basis under chapter 253B 5.35 may be confined or treated in a bordering state pursuant to a 5.36 contract under this section. An individual who is detained, 6.1 committed, or placed on an involuntary basis under the civil law 6.2 of a bordering state may be confined or treated in Minnesota 6.3 pursuant to a contract under this section. Court orders valid 6.4 under the law of the sending state are granted recognition and 6.5 reciprocity in the receiving state for individuals covered by a 6.6 contract under this section to the extent that the court orders 6.7 relate to confinement for treatment or care of mental illness. 6.8 These court orders are not subject to legal challenge in the 6.9 courts of the receiving state. Persons who are detained, 6.10 committed, or placed under the law of a sending state and who 6.11 are transferred to a receiving state under this section continue 6.12 to be in the legal custody of the authority responsible for them 6.13 under the law of the sending state. Except in emergencies, 6.14 those persons may not be transferred, removed, or furloughed 6.15 from a receiving agency or facility without the specific 6.16 approval of the authority responsible for them under the law of 6.17 the sending state. 6.18 (b) While in the receiving state pursuant to a contract 6.19 under this section, an individual shall be subject to the 6.20 sending state's laws and rules relating to length of 6.21 confinement, reexaminations, and extensions of confinement. No 6.22 person may be sent to another state pursuant to a contract under 6.23 this section until the receiving state has enacted a law 6.24 recognizing the validity and applicability of this section. 6.25 (c) If an individual receiving services pursuant to a 6.26 contract under this section escapes from the receiving agency 6.27 and the individual at the time of escape is subject to 6.28 involuntary confinement under the law of the sending state, the 6.29 receiving agency shall use all reasonable means to recapture the 6.30 individual. The receiving agency shall immediately report the 6.31 escape to the sending agency. The receiving state has the 6.32 primary responsibility for, and the authority to direct, the 6.33 pursuit, retaking, and prosecution of escaped persons within its 6.34 borders and is liable for the cost of the action to the extent 6.35 that it would be liable for costs if its own resident escaped. 6.36 (d) Responsibility for payment for the cost of care remains 7.1 with the sending agency. 7.2 (e) This subdivision also applies to county contracts under 7.3 subdivision 2 which include emergency care and treatment 7.4 provided to a county resident in a bordering state. 7.5 Sec. 7. Minnesota Statutes 2000, section 253B.045, 7.6 subdivision 2, is amended to read: 7.7 Subd. 2. [FACILITIES.] Each county or a group of counties 7.8 shall maintain or provide by contract a facility for confinement 7.9 of persons held temporarily for observation, evaluation, 7.10 diagnosis, treatment, and care. When the temporary confinement 7.11 is provided at a regional center, the commissioner shall charge 7.12 the county of financial responsibility for the costs of 7.13 confinement of persons hospitalized under section 253B.05, 7.14 subdivisions 1 and 2, and section 253B.07, subdivision 2b, 7.15 except that the commissioner shall bill the responsible prepaid 7.16 plan for medically necessary hospitalizations for individuals 7.17 enrolled in a prepaid plan under contract to provide medical 7.18 assistance, general assistance medical care, or MinnesotaCare 7.19 services, including all individuals covered by any health plan. 7.20 If the prepaid plan determines under the terms of the medical 7.21 assistance, general assistance medical care, or MinnesotaCare 7.22 contract that a hospitalization was not medically necessary, the 7.23 county is responsible. "County of financial responsibility" 7.24 means the county in which the person resides at the time of 7.25 confinement or, if the person has no residence in this state, 7.26 the county which initiated the confinement. The charge shall be 7.27 based on the commissioner's determination of the cost of care 7.28 pursuant to section 246.50, subdivision 5. When there is a 7.29 dispute as to which county is the county of financial 7.30 responsibility, the county charged for the costs of confinement 7.31 shall pay for them pending final determination of the dispute 7.32 over financial responsibility. Disputes about the county of 7.33 financial responsibility shall be submitted to the commissioner 7.34 to be settled in the manner prescribed in section 256G.09. 7.35 Sec. 8. Minnesota Statutes 2000, section 256.01, 7.36 subdivision 11, is amended to read: 8.1 Subd. 11. [CENTRALIZED DISBURSEMENT SYSTEM.] The state 8.2 agency may establish a system for the centralized disbursement 8.3 of food coupons, assistance payments, and related documents. 8.4 Benefits shall be issued by the state or county and funded under8.5 this section according to section 256.025, subdivision 3, and8.6 subject to section 256.017. 8.7 Sec. 9. Minnesota Statutes 2000, section 256.023, is 8.8 amended to read: 8.9 256.023 [ONE HUNDRED PERCENT COUNTY ASSISTANCE.] 8.10 The commissioner of human services may maintain client 8.11 records and issue public assistance benefits that are over state 8.12 and federal standards or that are not required by state or 8.13 federal law, providing the cost of benefits is paid by the 8.14 counties to the department of human services. Payment methods8.15 for this section shall be according to section 256.025,8.16 subdivision 3.8.17 Sec. 10. Minnesota Statutes 2000, section 256.9685, 8.18 subdivision 1, is amended to read: 8.19 Subdivision 1. [AUTHORITY.] (a) The commissioner shall 8.20 establish procedures for determining medical assistance and 8.21 general assistance medical care payment rates under a 8.22 prospective payment system for inpatient hospital services in 8.23 hospitals that qualify as vendors of medical assistance. The 8.24 commissioner shall establish, by rule, procedures for 8.25 implementing this section and sections 256.9686, 256.969, and 8.26 256.9695. Services must meet the requirements of section 8.27 256B.04, subdivision 15, or 256D.03, subdivision 7, paragraph 8.28 (b), to be eligible for payment. 8.29 (b) The commissioner may reduce the types of inpatient 8.30 hospital admissions that are required to be certified as 8.31 medically necessary after notice in the state register and a 8.32 30-day comment period. 8.33 Sec. 11. Minnesota Statutes 2000, section 256.9866, is 8.34 amended to read: 8.35 256.9866 [COMMUNITY SERVICE AS A COUNTY OBLIGATION.] 8.36 Community service shall be an acceptable sentencing option 9.1 but shall not reduce the state or federal share of any amount to 9.2 be repaid or any subsequent recovery. Any reduction or offset 9.3 of any such amount ordered by a court shall be treated as 9.4 follows: 9.5 (1) any reduction in an overpayment amount, to include the 9.6 amount ordered as restitution, shall not reduce the underlying 9.7 amount established as an overpayment by the state or county 9.8 agency; 9.9 (2) total overpayments shall continue as a debt owed and 9.10 may be recovered by any civil or administrative means otherwise 9.11 available to the state or county agency; and 9.12 (3) any amount ordered to be offset against any overpayment 9.13 shall be deducted from the county share only of any recovery and 9.14 shall be based on the prevailing state minimum wage. To the9.15 extent that any deduction is in fact made against any state or9.16 county share, it shall be reimbursed from the county share of9.17 payments to be made under section 256.025.9.18 Sec. 12. Minnesota Statutes 2000, section 256B.041, 9.19 subdivision 5, is amended to read: 9.20 Subd. 5. [PAYMENT BY COUNTY TO STATE TREASURER.] If 9.21 required by federal law or rules promulgated thereunder, or by 9.22 authorized rule of the state agency, each county shall pay to 9.23 the state treasurer the portion of medical assistance paid by 9.24 the state for which it is responsible. The county's share of9.25 cost shall be ten percent of that portion not met by federal9.26 funds.9.27 The county shall advance ten percent of that portion of9.28 medical assistance costs not met by federal funds, based upon 9.29 estimates submitted by the state agency to the county agency, 9.30 stating the estimated expenditures for the succeeding month. 9.31 Upon the direction of the county agency, payment shall be made 9.32 monthly by the county to the state for the estimated 9.33 expenditures for each month. Adjustment of any overestimate or 9.34 underestimate based on actual expenditures shall be made by the 9.35 state agency by adjusting the estimate for any succeeding month. 9.36 Beginning July 1, 1991, the state will reimburse counties10.1 according to the payment schedule in section 256.025 for the10.2 county share of local agency expenditures under this subdivision10.3 from January 1, 1991, on.Payment to counties under this 10.4 subdivision is subject to the provisions of section 256.017. 10.5 Sec. 13. Minnesota Statutes 2000, section 256B.0575, is 10.6 amended to read: 10.7 256B.0575 [AVAILABILITY OF INCOME FOR INSTITUTIONALIZED 10.8 PERSONS.] 10.9 When an institutionalized person is determined eligible for 10.10 medical assistance, the income that exceeds the deductions in 10.11 paragraphs (a) and (b) must be applied to the cost of 10.12 institutional care. 10.13 (a) The following amounts must be deducted from the 10.14 institutionalized person's income in the following order: 10.15 (1) the personal needs allowance under section 256B.35 or, 10.16 for a veteran who does not have a spouse or child, or a 10.17 surviving spouse of a veteran having no child, the amount of an 10.18 improved pension received from the veteran's administration not 10.19 exceeding $90 per month; 10.20 (2) the personal allowance for disabled individuals under 10.21 section 256B.36; 10.22 (3) if the institutionalized person has a legally appointed 10.23 guardian or conservator, five percent of the recipient's gross 10.24 monthly income up to $100 as reimbursement for guardianship or 10.25 conservatorship services; 10.26 (4) a monthly income allowance determined under section 10.27 256B.058, subdivision 2, but only to the extent income of the 10.28 institutionalized spouse is made available to the community 10.29 spouse; 10.30 (5) a monthly allowance for children under age 18 which, 10.31 together with the net income of the children, would provide 10.32 income equal to the medical assistance standard for families and 10.33 children according to section 256B.056, subdivision 4, for a 10.34 family size that includes only the minor children. This 10.35 deduction applies only if the children do not live with the 10.36 community spouse and only to the extent that the deduction is 11.1 not included in the personal needs allowance under section 11.2 256B.35, subdivision 1, as child support garnished under a court 11.3 order; 11.4 (6) a monthly family allowance for other family members, 11.5 equal to one-third of the difference between 122 percent of the 11.6 federal poverty guidelines and the monthly income for that 11.7 family member; 11.8 (7) reparations payments made by the Federal Republic of 11.9 Germany and reparations payments made by the Netherlands for 11.10 victims of Nazi persecution between 1940 and 1945; 11.11 (8) all other exclusions from income for institutionalized 11.12 persons as mandated by federal law; and 11.13 (9) amounts for reasonable expenses incurred for necessary 11.14 medical or remedial care for the institutionalized spouseperson 11.15 that are not medical assistance covered expenses and that are 11.16 not subject to payment by a third party. 11.17 For purposes of clause (6), "other family member" means a 11.18 person who resides with the community spouse and who is a minor 11.19 or dependent child, dependent parent, or dependent sibling of 11.20 either spouse. "Dependent" means a person who could be claimed 11.21 as a dependent for federal income tax purposes under the 11.22 Internal Revenue Code. 11.23 (b) Income shall be allocated to an institutionalized 11.24 person for a period of up to three calendar months, in an amount 11.25 equal to the medical assistance standard for a family size of 11.26 one if: 11.27 (1) a physician certifies that the person is expected to 11.28 reside in the long-term care facility for three calendar months 11.29 or less; 11.30 (2) if the person has expenses of maintaining a residence 11.31 in the community; and 11.32 (3) if one of the following circumstances apply: 11.33 (i) the person was not living together with a spouse or a 11.34 family member as defined in paragraph (a) when the person 11.35 entered a long-term care facility; or 11.36 (ii) the person and the person's spouse become 12.1 institutionalized on the same date, in which case the allocation 12.2 shall be applied to the income of one of the spouses. 12.3 For purposes of this paragraph, a person is determined to be 12.4 residing in a licensed nursing home, regional treatment center, 12.5 or medical institution if the person is expected to remain for a 12.6 period of one full calendar month or more. 12.7 Sec. 14. Minnesota Statutes 2001 Supplement, section 12.8 256B.0623, subdivision 14, is amended to read: 12.9 Subd. 14. [BILLING WHEN SERVICES ARE PROVIDED BY QUALIFIED 12.10 STATE STAFF.] When rehabilitative services are provided by 12.11 qualified state staff who are assigned to pilot projects under 12.12 section 245.4661, the county or other local entity to which the 12.13 qualified state staff are assigned may consider these staff part 12.14 of the local provider entity for which certification is sought 12.15 under this section and may bill the medical assistance program 12.16 for qualifying services provided by the qualified state 12.17 staff. Notwithstanding section 256.025, subdivision 2,Payments 12.18 for services provided by state staff who are assigned to adult 12.19 mental health initiatives shall only be made from federal funds. 12.20 Sec. 15. Minnesota Statutes 2001 Supplement, section 12.21 256B.0625, subdivision 20, is amended to read: 12.22 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 12.23 extent authorized by rule of the state agency, medical 12.24 assistance covers case management services to persons with 12.25 serious and persistent mental illness and children with severe 12.26 emotional disturbance. Services provided under this section 12.27 must meet the relevant standards in sections 245.461 to 12.28 245.4888, the Comprehensive Adult and Children's Mental Health 12.29 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 12.30 9505.0322, excluding subpart 10. 12.31 (b) Entities meeting program standards set out in rules 12.32 governing family community support services as defined in 12.33 section 245.4871, subdivision 17, are eligible for medical 12.34 assistance reimbursement for case management services for 12.35 children with severe emotional disturbance when these services 12.36 meet the program standards in Minnesota Rules, parts 9520.0900 13.1 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 13.2 (c) Medical assistance and MinnesotaCare payment for mental 13.3 health case management shall be made on a monthly basis. In 13.4 order to receive payment for an eligible child, the provider 13.5 must document at least a face-to-face contact with the child, 13.6 the child's parents, or the child's legal representative. To 13.7 receive payment for an eligible adult, the provider must 13.8 document: 13.9 (1) at least a face-to-face contact with the adult or the 13.10 adult's legal representative; or 13.11 (2) at least a telephone contact with the adult or the 13.12 adult's legal representative and document a face-to-face contact 13.13 with the adult or the adult's legal representative within the 13.14 preceding two months. 13.15 (d) Payment for mental health case management provided by 13.16 county or state staff shall be based on the monthly rate 13.17 methodology under section 256B.094, subdivision 6, paragraph 13.18 (b), with separate rates calculated for child welfare and mental 13.19 health, and within mental health, separate rates for children 13.20 and adults. 13.21 (e) Payment for mental health case management provided by 13.22 Indian health services or by agencies operated by Indian tribes 13.23 may be made according to this section or other relevant 13.24 federally approved rate setting methodology. 13.25 (f) Payment for mental health case management provided by 13.26 vendors who contract with a county or Indian tribe shall be 13.27 based on a monthly rate negotiated by the host county or tribe. 13.28 The negotiated rate must not exceed the rate charged by the 13.29 vendor for the same service to other payers. If the service is 13.30 provided by a team of contracted vendors, the county or tribe 13.31 may negotiate a team rate with a vendor who is a member of the 13.32 team. The team shall determine how to distribute the rate among 13.33 its members. No reimbursement received by contracted vendors 13.34 shall be returned to the county or tribe, except to reimburse 13.35 the county or tribe for advance funding provided by the county 13.36 or tribe to the vendor. 14.1 (g) If the service is provided by a team which includes 14.2 contracted vendors, tribal staff, and county or state staff, the 14.3 costs for county or state staff participation in the team shall 14.4 be included in the rate for county-provided services. In this 14.5 case, the contracted vendor, the tribal agency, and the county 14.6 may each receive separate payment for services provided by each 14.7 entity in the same month. In order to prevent duplication of 14.8 services, each entity must document, in the recipient's file, 14.9 the need for team case management and a description of the roles 14.10 of the team members. 14.11 (h) The commissioner shall calculate the nonfederal share 14.12 of actual medical assistance and general assistance medical care 14.13 payments for each county, based on the higher of calendar year 14.14 1995 or 1996, by service date, project that amount forward to 14.15 1999, and transfer one-half of the result from medical 14.16 assistance and general assistance medical care to each county's 14.17 mental health grants under sections 245.4886 and 256E.12 for 14.18 calendar year 1999. The annualized minimum amount added to each 14.19 county's mental health grant shall be $3,000 per year for 14.20 children and $5,000 per year for adults. The commissioner may 14.21 reduce the statewide growth factor in order to fund these 14.22 minimums. The annualized total amount transferred shall become 14.23 part of the base for future mental health grants for each county. 14.24 (i) Any net increase in revenue to the county or tribe as a 14.25 result of the change in this section must be used to provide 14.26 expanded mental health services as defined in sections 245.461 14.27 to 245.4888, the Comprehensive Adult and Children's Mental 14.28 Health Acts, excluding inpatient and residential treatment. For 14.29 adults, increased revenue may also be used for services and 14.30 consumer supports which are part of adult mental health projects 14.31 approved under Laws 1997, chapter 203, article 7, section 25. 14.32 For children, increased revenue may also be used for respite 14.33 care and nonresidential individualized rehabilitation services 14.34 as defined in section 245.492, subdivisions 17 and 23. 14.35 "Increased revenue" has the meaning given in Minnesota Rules, 14.36 part 9520.0903, subpart 3. 15.1 (j) Notwithstanding section 256B.19, subdivision 1, the 15.2 nonfederal share of costs for mental health case management 15.3 shall be provided by the recipient's county of responsibility, 15.4 as defined in sections 256G.01 to 256G.12, from sources other 15.5 than federal funds or funds used to match other federal funds. 15.6 If the service is provided by a tribal agency, the nonfederal 15.7 share, if any, shall be provided by the recipient's tribe. 15.8 (k) The commissioner may suspend, reduce, or terminate the 15.9 reimbursement to a provider that does not meet the reporting or 15.10 other requirements of this section. The county of 15.11 responsibility, as defined in sections 256G.01 to 256G.12, or, 15.12 if applicable, the tribal agency, is responsible for any federal 15.13 disallowances. The county or tribe may share this 15.14 responsibility with its contracted vendors. 15.15 (l) The commissioner shall set aside a portion of the 15.16 federal funds earned under this section to repay the special 15.17 revenue maximization account under section 256.01, subdivision 15.18 2, clause (15). The repayment is limited to: 15.19 (1) the costs of developing and implementing this section; 15.20 and 15.21 (2) programming the information systems. 15.22 (m) Notwithstanding section 256.025, subdivision 2,15.23 Payments to counties and tribal agencies for case management 15.24 expenditures under this section shall only be made from federal 15.25 earnings from services provided under this section. Payments to 15.26 county-contracted vendors shall include both the federal 15.27 earnings and the county share. 15.28 (n) Notwithstanding section 256B.041, county payments for 15.29 the cost of mental health case management services provided by 15.30 county or state staff shall not be made to the state treasurer. 15.31 For the purposes of mental health case management services 15.32 provided by county or state staff under this section, the 15.33 centralized disbursement of payments to counties under section 15.34 256B.041 consists only of federal earnings from services 15.35 provided under this section. 15.36 (o) Case management services under this subdivision do not 16.1 include therapy, treatment, legal, or outreach services. 16.2 (p) If the recipient is a resident of a nursing facility, 16.3 intermediate care facility, or hospital, and the recipient's 16.4 institutional care is paid by medical assistance, payment for 16.5 case management services under this subdivision is limited to 16.6 the last 180 days of the recipient's residency in that facility 16.7 and may not exceed more than six months in a calendar year. 16.8 (q) Payment for case management services under this 16.9 subdivision shall not duplicate payments made under other 16.10 program authorities for the same purpose. 16.11 (r) By July 1, 2000, the commissioner shall evaluate the 16.12 effectiveness of the changes required by this section, including 16.13 changes in number of persons receiving mental health case 16.14 management, changes in hours of service per person, and changes 16.15 in caseload size. 16.16 (s) For each calendar year beginning with the calendar year 16.17 2001, the annualized amount of state funds for each county 16.18 determined under paragraph (h) shall be adjusted by the county's 16.19 percentage change in the average number of clients per month who 16.20 received case management under this section during the fiscal 16.21 year that ended six months prior to the calendar year in 16.22 question, in comparison to the prior fiscal year. 16.23 (t) For counties receiving the minimum allocation of $3,000 16.24 or $5,000 described in paragraph (h), the adjustment in 16.25 paragraph (s) shall be determined so that the county receives 16.26 the higher of the following amounts: 16.27 (1) a continuation of the minimum allocation in paragraph 16.28 (h); or 16.29 (2) an amount based on that county's average number of 16.30 clients per month who received case management under this 16.31 section during the fiscal year that ended six months prior to 16.32 the calendar year in question, times the average statewide grant 16.33 per person per month for counties not receiving the minimum 16.34 allocation. 16.35 (u) The adjustments in paragraphs (s) and (t) shall be 16.36 calculated separately for children and adults. 17.1 Sec. 16. Minnesota Statutes 2000, section 256B.0629, 17.2 subdivision 2, is amended to read: 17.3 Subd. 2. [FUNCTION AND OBJECTIVES.] The advisory committee17.4 shall meet at least twice a year.The committee's activities 17.5 include, but are not limited to: 17.6 (1) collection of information on the efficacy and 17.7 experience of various forms of transplantation not approved by 17.8 Medicare; 17.9 (2) collection of information from Minnesota transplant 17.10 providers on available services, success rates, and the current 17.11 status of transplant activity in the state; 17.12 (3) development of guidelines for determining when and 17.13 under what conditions organ and tissue transplants not approved 17.14 by Medicare should be eligible for reimbursement by medical 17.15 assistance and general assistance medical care; 17.16 (4) providing recommendations , at least annually,to the 17.17 commissioner on: (i) organ and tissue transplant procedures, 17.18 beyond those approved by Medicare, that should also be eligible 17.19 for reimbursement under medical assistance and general 17.20 assistance medical care; and (ii) which transplant centers 17.21 should be eligible for reimbursement from medical assistance and 17.22 general assistance medical care. 17.23 Sec. 17. Minnesota Statutes 2000, section 256B.0915, 17.24 subdivision 1c, is amended to read: 17.25 Subd. 1c. [CASE MANAGEMENT ACTIVITIES UNDER THE STATE 17.26 PLAN.] The commissioner shall seek an amendment to the home and 17.27 community-based services waiver for the elderly to implement the 17.28 provisions of subdivisions 1a and 1b. If the commissioner is 17.29 unable to secure the approval of the secretary of health and 17.30 human services for the requested waiver amendment by December 17.31 31, 1993, the commissioner shall amend the medical assistance 17.32 state plan to provide that case management provided under the 17.33 home and community-based services waiver for the elderly is 17.34 performed by counties as an administrative function for the 17.35 proper and effective administration of the state medical 17.36 assistance plan. Notwithstanding section 256.025, subdivision18.1 3,The state shall reimburse counties for the nonfederal share 18.2 of costs for case management performed as an administrative 18.3 function under the home and community-based services waiver for 18.4 the elderly. 18.5 Sec. 18. Minnesota Statutes 2001 Supplement, section 18.6 256B.0915, subdivision 3, is amended to read: 18.7 Subd. 3. [LIMITS OF CASES, RATES, PAYMENTS, AND 18.8 FORECASTING.] (a) The number of medical assistance waiver 18.9 recipients that a county may serve must be allocated according 18.10 to the number of medical assistance waiver cases open on July 1 18.11 of each fiscal year. Additional recipients may be served with 18.12 the approval of the commissioner. 18.13 (b) The monthly limit for the cost of waivered services to 18.14 an individual elderly waiver client shall be the weighted 18.15 average monthly nursing facility rate of the case mix resident 18.16 class to which the elderly waiver client would be assigned under 18.17 Minnesota Rules, parts 9549.0050 to 9549.0059, less the 18.18 recipient's maintenance needs allowance as described in 18.19 subdivision 1d, paragraph (a), until the first day of the state 18.20 fiscal year in which the resident assessment system as described 18.21 in section 256B.437 for nursing home rate determination is 18.22 implemented. Effective on the first day of the state fiscal 18.23 year in which the resident assessment system as described in 18.24 section 256B.437 for nursing home rate determination is 18.25 implemented and the first day of each subsequent state fiscal 18.26 year, the monthly limit for the cost of waivered services to an 18.27 individual elderly waiver client shall be the rate of the case 18.28 mix resident class to which the waiver client would be assigned 18.29 under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect 18.30 on the last day of the previous state fiscal year, adjusted by 18.31 the greater of any legislatively adopted home and 18.32 community-based services cost-of-living percentage increase or 18.33 any legislatively adopted statewide percent rate increase for 18.34 nursing facilities. 18.35 (c) If extended medical supplies and equipment or 18.36 environmental modifications are or will be purchased for an 19.1 elderly waiver client, the costs may be prorated for up to 12 19.2 consecutive months beginning with the month of purchase. If the 19.3 monthly cost of a recipient's waivered services exceeds the 19.4 monthly limit established in paragraph (b), the annual cost of 19.5 all waivered services shall be determined. In this event, the 19.6 annual cost of all waivered services shall not exceed 12 times 19.7 the monthly limit of waivered services as described in paragraph 19.8 (b). 19.9 (d) For a person who is a nursing facility resident at the 19.10 time of requesting a determination of eligibility for elderly 19.11 waivered services, a monthly conversion limit for the cost of 19.12 elderly waivered services may be requested. The monthly 19.13 conversion limit for the cost of elderly waiver services shall 19.14 be the resident class assigned under Minnesota Rules, parts 19.15 9549.0050 to 9549.0059, for that resident in the nursing 19.16 facility where the resident currently resides until July 1 of 19.17 the state fiscal year in which the resident assessment system as 19.18 described in section 256B.437 for nursing home rate 19.19 determination is implemented. Effective on July 1 of the state 19.20 fiscal year in which the resident assessment system as described 19.21 in section 256B.437 for nursing home rate determination is 19.22 implemented, the monthly conversion limit for the cost of 19.23 elderly waiver services shall be the per diem nursing facility 19.24 rate as determined by the resident assessment system as 19.25 described in section 256B.437 for that resident in the nursing 19.26 facility where the resident currently resides multiplied by 365 19.27 and divided by 12, less the recipient's maintenance needs 19.28 allowance as described in subdivision 1d. The limit under this 19.29 clause only applies to persons discharged from a nursing 19.30 facility after a minimum 30-day stay and found eligible for 19.31 waivered services on or after July 1, 1997. The following costs 19.32 must be included in determining the total monthly costs for the 19.33 waiver client: 19.34 (1) cost of all waivered services, including extended 19.35 medical supplies and equipment and environmental modifications; 19.36 and 20.1 (2) cost of skilled nursing, home health aide, and personal 20.2 care services reimbursable by medical assistance. 20.3 (e) Medical assistance funding for skilled nursing 20.4 services, private duty nursing, home health aide, and personal 20.5 care services for waiver recipients must be approved by the case 20.6 manager and included in the individual care plan. 20.7 (f) A county is not required to contract with a provider of 20.8 supplies and equipment if the monthly cost of the supplies and 20.9 equipment is less than $250. 20.10 (g) The adult foster care rate shall be considered a 20.11 difficulty of care payment and shall not include room and 20.12 board. The adult foster care service rate shall be negotiated 20.13 between the county agency and the foster care provider. The 20.14 elderly waiver payment for the foster care service in 20.15 combination with the payment for all other elderly waiver 20.16 services, including case management, must not exceed the limit 20.17 specified in paragraph (b). 20.18 (h) Payment for assisted living service shall be a monthly 20.19 rate negotiated and authorized by the county agency based on an 20.20 individualized service plan for each resident and may not cover 20.21 direct rent or food costs. 20.22 (1) The individualized monthly negotiated payment for 20.23 assisted living services as described in section 256B.0913, 20.24 subdivision 5, paragraph (g) or (h), and residential care 20.25 services as described in section 256B.0913, subdivision 5, 20.26 paragraph (f), shall not exceed the nonfederal share, in effect 20.27 on July 1 of the state fiscal year for which the rate limit is 20.28 being calculated, of the greater of either the statewide or any 20.29 of the geographic groups' weighted average monthly nursing 20.30 facility rate of the case mix resident class to which the 20.31 elderly waiver eligible client would be assigned under Minnesota 20.32 Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 20.33 allowance as described in subdivision 1d, paragraph (a), until 20.34 the July 1 of the state fiscal year in which the resident 20.35 assessment system as described in section 256B.437 for nursing 20.36 home rate determination is implemented. Effective on July 1 of 21.1 the state fiscal year in which the resident assessment system as 21.2 described in section 256B.437 for nursing home rate 21.3 determination is implemented and July 1 of each subsequent state 21.4 fiscal year, the individualized monthly negotiated payment for 21.5 the services described in this clause shall not exceed the limit 21.6 described in this clause which was in effect on June 30 of the 21.7 previous state fiscal year and which has been adjusted by the 21.8 greater of any legislatively adopted home and community-based 21.9 services cost-of-living percentage increase or any legislatively 21.10 adopted statewide percent rate increase for nursing facilities. 21.11 (2) The individualized monthly negotiated payment for 21.12 assisted living services described in section 144A.4605 and 21.13 delivered by a provider licensed by the department of health as 21.14 a class A home care provider or an assisted living home care 21.15 provider and provided in a building that is registered as a 21.16 housing with services establishment under chapter 144D and that 21.17 provides 24-hour supervision in combination with the payment for 21.18 other elderly waiver services, including case management, must 21.19 not exceed the limit specified in paragraph (b). 21.20 (i) The county shall negotiate individual service rates 21.21 with vendors and may authorize payment for actual costs up to 21.22 the county's current approved rate. Persons or agencies must be 21.23 employed by or under a contract with the county agency or the 21.24 public health nursing agency of the local board of health in 21.25 order to receive funding under the elderly waiver program, 21.26 except as a provider of supplies and equipment when the monthly 21.27 cost of the supplies and equipment is less than $250. 21.28 (j) Reimbursement for the medical assistance recipients 21.29 under the approved waiver shall be made from the medical 21.30 assistance account through the invoice processing procedures of 21.31 the department's Medicaid Management Information System (MMIS), 21.32 only with the approval of the client's case manager. The budget 21.33 for the state share of the Medicaid expenditures shall be 21.34 forecasted with the medical assistance budget, and shall be 21.35 consistent with the approved waiver. 21.36 (k) To improve access to community services and eliminate 22.1 payment disparities between the alternative care program and the 22.2 elderly waiver, the commissioner shall establish statewide 22.3 maximum service rate limits and eliminate county-specific 22.4 service rate limits. 22.5 (1) Effective July 1, 2001, for service rate limits, except 22.6 those described or defined in paragraphs (g) and (h), the rate 22.7 limit for each service shall be the greater of the alternative 22.8 care statewide maximum rate or the elderly waiver statewide 22.9 maximum rate. 22.10 (2) Counties may negotiate individual service rates with 22.11 vendors for actual costs up to the statewide maximum service 22.12 rate limit. 22.13 (l) Beginning July 1, 1991, the state shall reimburse22.14 counties according to the payment schedule in section 256.02522.15 for the county share of costs incurred under this subdivision on22.16 or after January 1, 1991, for individuals who are receiving22.17 medical assistance.22.18 Sec. 19. Minnesota Statutes 2001 Supplement, section 22.19 256B.0924, subdivision 6, is amended to read: 22.20 Subd. 6. [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 22.21 Medical assistance and MinnesotaCare payment for targeted case 22.22 management shall be made on a monthly basis. In order to 22.23 receive payment for an eligible adult, the provider must 22.24 document at least one contact per month and not more than two 22.25 consecutive months without a face-to-face contact with the adult 22.26 or the adult's legal representative. 22.27 (b) Payment for targeted case management provided by county 22.28 staff under this subdivision shall be based on the monthly rate 22.29 methodology under section 256B.094, subdivision 6, paragraph 22.30 (b), calculated as one combined average rate together with adult 22.31 mental health case management under section 256B.0625, 22.32 subdivision 20, except for calendar year 2002. In calendar year 22.33 2002, the rate for case management under this section shall be 22.34 the same as the rate for adult mental health case management in 22.35 effect as of December 31, 2001. Billing and payment must 22.36 identify the recipient's primary population group to allow 23.1 tracking of revenues. 23.2 (c) Payment for targeted case management provided by 23.3 county-contracted vendors shall be based on a monthly rate 23.4 negotiated by the host county. The negotiated rate must not 23.5 exceed the rate charged by the vendor for the same service to 23.6 other payers. If the service is provided by a team of 23.7 contracted vendors, the county may negotiate a team rate with a 23.8 vendor who is a member of the team. The team shall determine 23.9 how to distribute the rate among its members. No reimbursement 23.10 received by contracted vendors shall be returned to the county, 23.11 except to reimburse the county for advance funding provided by 23.12 the county to the vendor. 23.13 (d) If the service is provided by a team that includes 23.14 contracted vendors and county staff, the costs for county staff 23.15 participation on the team shall be included in the rate for 23.16 county-provided services. In this case, the contracted vendor 23.17 and the county may each receive separate payment for services 23.18 provided by each entity in the same month. In order to prevent 23.19 duplication of services, the county must document, in the 23.20 recipient's file, the need for team targeted case management and 23.21 a description of the different roles of the team members. 23.22 (e) Notwithstanding section 256B.19, subdivision 1, the 23.23 nonfederal share of costs for targeted case management shall be 23.24 provided by the recipient's county of responsibility, as defined 23.25 in sections 256G.01 to 256G.12, from sources other than federal 23.26 funds or funds used to match other federal funds. 23.27 (f) The commissioner may suspend, reduce, or terminate 23.28 reimbursement to a provider that does not meet the reporting or 23.29 other requirements of this section. The county of 23.30 responsibility, as defined in sections 256G.01 to 256G.12, is 23.31 responsible for any federal disallowances. The county may share 23.32 this responsibility with its contracted vendors. 23.33 (g) The commissioner shall set aside five percent of the 23.34 federal funds received under this section for use in reimbursing 23.35 the state for costs of developing and implementing this section. 23.36 (h) Notwithstanding section 256.025, subdivision 2,24.1 Payments to counties for targeted case management expenditures 24.2 under this section shall only be made from federal earnings from 24.3 services provided under this section. Payments to contracted 24.4 vendors shall include both the federal earnings and the county 24.5 share. 24.6 (i) Notwithstanding section 256B.041, county payments for 24.7 the cost of case management services provided by county staff 24.8 shall not be made to the state treasurer. For the purposes of 24.9 targeted case management services provided by county staff under 24.10 this section, the centralized disbursement of payments to 24.11 counties under section 256B.041 consists only of federal 24.12 earnings from services provided under this section. 24.13 (j) If the recipient is a resident of a nursing facility, 24.14 intermediate care facility, or hospital, and the recipient's 24.15 institutional care is paid by medical assistance, payment for 24.16 targeted case management services under this subdivision is 24.17 limited to the last 180 days of the recipient's residency in 24.18 that facility and may not exceed more than six months in a 24.19 calendar year. 24.20 (k) Payment for targeted case management services under 24.21 this subdivision shall not duplicate payments made under other 24.22 program authorities for the same purpose. 24.23 (l) Any growth in targeted case management services and 24.24 cost increases under this section shall be the responsibility of 24.25 the counties. 24.26 Sec. 20. Minnesota Statutes 2000, section 256B.0945, 24.27 subdivision 4, is amended to read: 24.28 Subd. 4. [PAYMENT RATES.] (a) Notwithstanding sections 24.29 256.025, subdivision 2;256B.19 ;and 256B.041, payments to 24.30 counties for residential services provided by a residential 24.31 facility shall only be made of federal earnings for services 24.32 provided under this section, and the nonfederal share of costs 24.33 for services provided under this section shall be paid by the 24.34 county from sources other than federal funds or funds used to 24.35 match other federal funds. Payment to counties for services 24.36 provided according to subdivision 2, paragraph (a), shall be the 25.1 federal share of the contract rate. Payment to counties for 25.2 services provided according to subdivision 2, paragraph (b), 25.3 shall be a proportion of the per day contract rate that relates 25.4 to rehabilitative mental health services and shall not include 25.5 payment for costs or services that are billed to the IV-E 25.6 program as room and board. 25.7 (b) The commissioner shall set aside a portion not to 25.8 exceed five percent of the federal funds earned under this 25.9 section to cover the state costs of administering this section. 25.10 Any unexpended funds from the set-aside shall be distributed to 25.11 the counties in proportion to their earnings under this section. 25.12 Sec. 21. Minnesota Statutes 2000, section 256B.19, 25.13 subdivision 1, is amended to read: 25.14 Subdivision 1. [DIVISION OF COST.] The state and county 25.15 share of medical assistance costs not paid by federal funds 25.16 shall be as follows: 25.17 (1) ninety percent state funds and ten percent county25.18 funds, unless otherwise provided below;25.19 (2)beginning January 1, 1992, 50 percent state funds and 25.20 50 percent county funds for the cost of placement of severely 25.21 emotionally disturbed children in regional treatment centers. 25.22 For counties that participate in a Medicaid demonstration 25.23 project under sections 256B.69 and 256B.71, the division of the 25.24 nonfederal share of medical assistance expenses for payments 25.25 made to prepaid health plans or for payments made to health 25.26 maintenance organizations in the form of prepaid capitation 25.27 payments, this division of medical assistance expenses shall be 25.28 95 percent by the state and five percent by the county of 25.29 financial responsibility. 25.30 In counties where prepaid health plans are under contract 25.31 to the commissioner to provide services to medical assistance 25.32 recipients, the cost of court ordered treatment ordered without 25.33 consulting the prepaid health plan that does not include 25.34 diagnostic evaluation, recommendation, and referral for 25.35 treatment by the prepaid health plan is the responsibility of 25.36 the county of financial responsibility. 26.1 Sec. 22. Minnesota Statutes 2000, section 256B.19, 26.2 subdivision 1d, is amended to read: 26.3 Subd. 1d. [PORTION OF NONFEDERAL SHARE TO BE PAID BY 26.4 CERTAIN COUNTIES.] In addition to the percentage contribution 26.5 paid by a county under subdivision 1, the governmental units 26.6 designated in this subdivision shall be responsible for an 26.7 additional portion of the nonfederal share of medical assistance 26.8 cost. For purposes of this subdivision, "designated 26.9 governmental unit" means the counties of Becker, Beltrami, 26.10 Clearwater, Cook, Dodge, Hubbard, Itasca, Lake, Pennington, 26.11 Pipestone, Ramsey, St. Louis, Steele, Todd, Traverse, and Wadena. 26.12 Beginning in 1994, each of the governmental units 26.13 designated in this subdivision shall transfer before noon on May 26.14 31 to the state Medicaid agency an amount equal to the number of 26.15 licensed beds in any nursing home owned and operated by the 26.16 county, with the county named as licensee, multiplied by $5,723. 26.17 If two or more counties own and operate a nursing home, the 26.18 payment shall be prorated. These sums shall be part of the 26.19 designated governmental unit's portion of the nonfederal share 26.20 of medical assistance costs , but shall not be subject to payback26.21 provisions of section 256.025. 26.22 Sec. 23. Minnesota Statutes 2000, section 256B.19, 26.23 subdivision 2b, is amended to read: 26.24 Subd. 2b. [PILOT PROJECT REIMBURSEMENT.] In counties where 26.25 a pilot or demonstration project is operated under the medical 26.26 assistance program, the state may pay 100 percent of the 26.27 administrative costs for the pilot or demonstration project 26.28 after June 30, 1990. Reimbursement for these costs is subject26.29 to section 256.025.26.30 Sec. 24. Minnesota Statutes 2000, section 256B.692, 26.31 subdivision 3, is amended to read: 26.32 Subd. 3. [REQUIREMENTS OF THE COUNTY BOARD.] A county 26.33 board that intends to purchase or provide health care under this 26.34 section, which may include purchasing all or part of these 26.35 services from health plans or individual providers on a 26.36 fee-for-service basis, or providing these services directly, 27.1 must demonstrate the ability to follow and agree to the 27.2 following requirements: 27.3 (1) purchase all covered services for a fixed payment from 27.4 the state that does not exceed the estimated state and federal 27.5 cost that would have occurred under the prepaid medical 27.6 assistance and general assistance medical care programs; 27.7 (2) ensure that covered services are accessible to all 27.8 enrollees and that enrollees have a reasonable choice of 27.9 providers, health plans, or networks when possible. If the 27.10 county is also a provider of service, the county board shall 27.11 develop a process to ensure that providers employed by the 27.12 county are not the sole referral source and are not the sole 27.13 provider of health care services if other providers, which meet 27.14 the same quality and cost requirements are available; 27.15 (3) issue payments to participating vendors or networks in 27.16 a timely manner; 27.17 (4) establish a process to ensure and improve the quality 27.18 of care provided; 27.19 (5) provide appropriate quality and other required data in 27.20 a format required by the state; 27.21 (6) provide a system for advocacy, enrollee protection, and 27.22 complaints and appeals that is independent of care providers or 27.23 other risk bearers and complies with section 256B.69; 27.24 (7) for counties within the seven-county metropolitan area,27.25 ensure that the implementation and operation of the Minnesota 27.26 senior health options demonstration project and the Minnesota 27.27 Disability health options demonstration project, authorized 27.28 under section 256B.69, subdivision 23, will not be impeded; 27.29 (8) ensure that all recipients that are enrolled in the 27.30 prepaid medical assistance or general assistance medical care 27.31 program will be transferred to county-based purchasing without 27.32 utilizing the department's fee-for-service claims payment 27.33 system; 27.34 (9) ensure that all recipients who are required to 27.35 participate in county-based purchasing are given sufficient 27.36 information prior to enrollment in order to make informed 28.1 decisions; and 28.2 (10) ensure that the state and the medical assistance and 28.3 general assistance medical care recipients will be held harmless 28.4 for the payment of obligations incurred by the county if the 28.5 county, or a health plan providing services on behalf of the 28.6 county, or a provider participating in county-based purchasing 28.7 becomes insolvent, and the state has made the payments due to 28.8 the county under this section. 28.9 Sec. 25. Minnesota Statutes 2000, section 256F.10, 28.10 subdivision 9, is amended to read: 28.11 Subd. 9. [PAYMENTS.] Notwithstanding section 256.025,28.12 subdivision 2,Payments to certified providers for child welfare 28.13 targeted case management expenditures under section 256B.094 and 28.14 this section shall only be made of federal earnings from 28.15 services provided under section 256B.094 and this section. 28.16 Payments to contracted vendors shall include both the federal 28.17 earnings and the nonfederal share. 28.18 Sec. 26. Minnesota Statutes 2000, section 256F.13, 28.19 subdivision 1, is amended to read: 28.20 Subdivision 1. [FEDERAL REVENUE ENHANCEMENT.] (a) [DUTIES 28.21 OF THE COMMISSIONER OF HUMAN SERVICES.] The commissioner of 28.22 human services may enter into an agreement with one or more 28.23 family services collaboratives to enhance federal reimbursement 28.24 under Title IV-E of the Social Security Act and federal 28.25 administrative reimbursement under Title XIX of the Social 28.26 Security Act. The commissioner may contract with the department 28.27 of children, families, and learning for purposes of transferring 28.28 the federal reimbursement to the commissioner of children, 28.29 families, and learning to be distributed to the collaboratives 28.30 according to clause (2). The commissioner shall have the 28.31 following authority and responsibilities regarding family 28.32 services collaboratives: 28.33 (1) the commissioner shall submit amendments to state plans 28.34 and seek waivers as necessary to implement the provisions of 28.35 this section; 28.36 (2) the commissioner shall pay the federal reimbursement 29.1 earned under this subdivision to each collaborative based on 29.2 their earnings. Notwithstanding section 256.025, subdivision 2,29.3 Payments to collaboratives for expenditures under this 29.4 subdivision will only be made of federal earnings from services 29.5 provided by the collaborative; 29.6 (3) the commissioner shall review expenditures of family 29.7 services collaboratives using reports specified in the agreement 29.8 with the collaborative to ensure that the base level of 29.9 expenditures is continued and new federal reimbursement is used 29.10 to expand education, social, health, or health-related services 29.11 to young children and their families; 29.12 (4) the commissioner may reduce, suspend, or eliminate a 29.13 family services collaborative's obligations to continue the base 29.14 level of expenditures or expansion of services if the 29.15 commissioner determines that one or more of the following 29.16 conditions apply: 29.17 (i) imposition of levy limits that significantly reduce 29.18 available funds for social, health, or health-related services 29.19 to families and children; 29.20 (ii) reduction in the net tax capacity of the taxable 29.21 property eligible to be taxed by the lead county or 29.22 subcontractor that significantly reduces available funds for 29.23 education, social, health, or health-related services to 29.24 families and children; 29.25 (iii) reduction in the number of children under age 19 in 29.26 the county, collaborative service delivery area, subcontractor's 29.27 district, or catchment area when compared to the number in the 29.28 base year using the most recent data provided by the state 29.29 demographer's office; or 29.30 (iv) termination of the federal revenue earned under the 29.31 family services collaborative agreement; 29.32 (5) the commissioner shall not use the federal 29.33 reimbursement earned under this subdivision in determining the 29.34 allocation or distribution of other funds to counties or 29.35 collaboratives; 29.36 (6) the commissioner may suspend, reduce, or terminate the 30.1 federal reimbursement to a provider that does not meet the 30.2 reporting or other requirements of this subdivision; 30.3 (7) the commissioner shall recover from the family services 30.4 collaborative any federal fiscal disallowances or sanctions for 30.5 audit exceptions directly attributable to the family services 30.6 collaborative's actions in the integrated fund, or the 30.7 proportional share if federal fiscal disallowances or sanctions 30.8 are based on a statewide random sample; and 30.9 (8) the commissioner shall establish criteria for the 30.10 family services collaborative for the accounting and financial 30.11 management system that will support claims for federal 30.12 reimbursement. 30.13 (b) [FAMILY SERVICES COLLABORATIVE RESPONSIBILITIES.] The 30.14 family services collaborative shall have the following authority 30.15 and responsibilities regarding federal revenue enhancement: 30.16 (1) the family services collaborative shall be the party 30.17 with which the commissioner contracts. A lead county shall be 30.18 designated as the fiscal agency for reporting, claiming, and 30.19 receiving payments; 30.20 (2) the family services collaboratives may enter into 30.21 subcontracts with other counties, school districts, special 30.22 education cooperatives, municipalities, and other public and 30.23 nonprofit entities for purposes of identifying and claiming 30.24 eligible expenditures to enhance federal reimbursement, or to 30.25 expand education, social, health, or health-related services to 30.26 families and children; 30.27 (3) the family services collaborative must continue the 30.28 base level of expenditures for education, social, health, or 30.29 health-related services to families and children from any state, 30.30 county, federal, or other public or private funding source 30.31 which, in the absence of the new federal reimbursement earned 30.32 under this subdivision, would have been available for those 30.33 services, except as provided in subdivision 1, paragraph (a), 30.34 clause (4). The base year for purposes of this subdivision 30.35 shall be the four-quarter calendar year ending at least two 30.36 calendar quarters before the first calendar quarter in which the 31.1 new federal reimbursement is earned; 31.2 (4) the family services collaborative must use all new 31.3 federal reimbursement resulting from federal revenue enhancement 31.4 to expand expenditures for education, social, health, or 31.5 health-related services to families and children beyond the base 31.6 level, except as provided in subdivision 1, paragraph (a), 31.7 clause (4); 31.8 (5) the family services collaborative must ensure that 31.9 expenditures submitted for federal reimbursement are not made 31.10 from federal funds or funds used to match other federal funds. 31.11 Notwithstanding section 256B.19, subdivision 1, for the purposes 31.12 of family services collaborative expenditures under agreement 31.13 with the department, the nonfederal share of costs shall be 31.14 provided by the family services collaborative from sources other 31.15 than federal funds or funds used to match other federal funds; 31.16 (6) the family services collaborative must develop and 31.17 maintain an accounting and financial management system adequate 31.18 to support all claims for federal reimbursement, including a 31.19 clear audit trail and any provisions specified in the agreement; 31.20 and 31.21 (7) the family services collaborative shall submit an 31.22 annual report to the commissioner as specified in the agreement. 31.23 Sec. 27. Minnesota Statutes 2000, section 256L.05, 31.24 subdivision 3, is amended to read: 31.25 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] (a) The effective 31.26 date of coverage is the first day of the month following the 31.27 month in which eligibility is approved and the first premium 31.28 payment has been received. As provided in section 256B.057, 31.29 coverage for newborns is automatic from the date of birth and 31.30 must be coordinated with other health coverage. The effective 31.31 date of coverage for eligible newly adoptive children added to a 31.32 family receiving covered health services is the date of entry 31.33 into the family. The effective date of coverage for other new 31.34 recipients added to the family receiving covered health services 31.35 is the first day of the month following the month in which 31.36 eligibility is approved or at renewal, whichever the family 32.1 receiving covered health services prefers. All eligibility 32.2 criteria must be met by the family at the time the new family 32.3 member is added. The income of the new family member is 32.4 included with the family's gross income and the adjusted premium 32.5 begins in the month the new family member is added. 32.6 (b) The initial premium must be received eightby the last 32.7 working days prior to the endday of the month for coverage to 32.8 begin the first day of the following month. 32.9 (c) Benefits are not available until the day following 32.10 discharge if an enrollee is hospitalized on the first day of 32.11 coverage. 32.12 (d) Notwithstanding any other law to the contrary, benefits 32.13 under sections 256L.01 to 256L.18 are secondary to a plan of 32.14 insurance or benefit program under which an eligible person may 32.15 have coverage and the commissioner shall use cost avoidance 32.16 techniques to ensure coordination of any other health coverage 32.17 for eligible persons. The commissioner shall identify eligible 32.18 persons who may have coverage or benefits under other plans of 32.19 insurance or who become eligible for medical assistance. 32.20 Sec. 28. Minnesota Statutes 2001 Supplement, section 32.21 256L.06, subdivision 3, is amended to read: 32.22 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 32.23 Premiums are dedicated to the commissioner for MinnesotaCare. 32.24 (b) The commissioner shall develop and implement procedures 32.25 to: (1) require enrollees to report changes in income; (2) 32.26 adjust sliding scale premium payments, based upon changes in 32.27 enrollee income; and (3) disenroll enrollees from MinnesotaCare 32.28 for failure to pay required premiums. Failure to pay includes 32.29 payment with a dishonored check, a returned automatic bank 32.30 withdrawal, or a refused credit card or debit card payment. The 32.31 commissioner may demand a guaranteed form of payment, including 32.32 a cashier's check or a money order, as the only means to replace 32.33 a dishonored, returned, or refused payment. 32.34 (c) Premiums are calculated on a calendar month basis and 32.35 may be paid on a monthly, quarterly, or annual basis, with the 32.36 first payment due upon notice from the commissioner of the 33.1 premium amount required. The commissioner shall inform 33.2 applicants and enrollees of these premium payment options. 33.3 Premium payment is required before enrollment is complete and to 33.4 maintain eligibility in MinnesotaCare. Premium payments 33.5 received before noon are credited the same day. Premium 33.6 payments received after noon are credited on the next working 33.7 day. 33.8 (d) Nonpayment of the premium will result in disenrollment 33.9 from the plan effective for the calendar month for which the 33.10 premium was due. Persons disenrolled for nonpayment or who 33.11 voluntarily terminate coverage from the program may not reenroll 33.12 until four calendar months have elapsed. Persons disenrolled 33.13 for nonpayment who pay all past due premiums as well as current 33.14 premiums due, including premiums due for the period of 33.15 disenrollment, within 20 days of disenrollment, shall be 33.16 reenrolled retroactively to the first day of disenrollment. 33.17 Persons disenrolled for nonpayment or who voluntarily terminate 33.18 coverage from the program may not reenroll for four calendar 33.19 months unless the person demonstrates good cause for 33.20 nonpayment. Good cause does not exist if a person chooses to 33.21 pay other family expenses instead of the premium. The 33.22 commissioner shall define good cause in rule. 33.23 Sec. 29. Minnesota Statutes 2000, section 256L.07, 33.24 subdivision 3, is amended to read: 33.25 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 33.26 individuals enrolled in the MinnesotaCare program must have no 33.27 health coverage while enrolled or for at least four months prior 33.28 to application and renewal. Children enrolled in the original 33.29 children's health plan and children in families with income 33.30 equal to or less than 150 percent of the federal poverty 33.31 guidelines, who have other health insurance, are eligible if the 33.32 coverage: 33.33 (1) lacks two or more of the following: 33.34 (i) basic hospital insurance; 33.35 (ii) medical-surgical insurance; 33.36 (iii) prescription drug coverage; 34.1 (iv) dental coverage; or 34.2 (v) vision coverage; 34.3 (2) requires a deductible of $100 or more per person per 34.4 year; or 34.5 (3) lacks coverage because the child has exceeded the 34.6 maximum coverage for a particular diagnosis or the policy 34.7 excludes a particular diagnosis. 34.8 The commissioner may change this eligibility criterion for 34.9 sliding scale premiums in order to remain within the limits of 34.10 available appropriations. The requirement of no health coverage 34.11 does not apply to newborns. 34.12 (b) Medical assistance, general assistance medical care, 34.13 and the Civilian Health and Medical Program of the Uniformed 34.14 Service, CHAMPUS, or other coverage provided under United States 34.15 Code, title 10, subtitle A, part II, chapter 55, are not 34.16 considered insurance or health coverage for purposes of the 34.17 four-month requirement described in this subdivision. 34.18 (c) For purposes of this subdivision, Medicare Part A or B 34.19 coverage under title XVIII of the Social Security Act, United 34.20 States Code, title 42, sections 1395c to 1395w-4, is considered 34.21 health coverage. An applicant or enrollee may not refuse 34.22 Medicare coverage to establish eligibility for MinnesotaCare. 34.23 (d) Applicants who were recipients of medical assistance or 34.24 general assistance medical care within one month of application 34.25 must meet the provisions of this subdivision and subdivision 2. 34.26 Sec. 30. Laws 2001, First Special Session chapter 9, 34.27 article 2, section 76, is amended to read: 34.28 Sec. 76. [REPEALER.] 34.29 (a) Minnesota Statutes 2000, section 256B.0635, subdivision34.30 3, and256B.19, subdivision 1b, areis repealed effective July 34.31 1, 2001. 34.32 (b) Minnesota Statutes 2000, section 256L.02, subdivision 34.33 4, is repealed effective January 1, 2003. 34.34 Sec. 31. [REVISOR INSTRUCTION.] 34.35 In the next edition of Minnesota Statutes and Minnesota 34.36 Rules, the revisor shall replace the terms "Health Care 35.1 Financing Administration" and "federal Department of Health, 35.2 Education and Welfare" with "Centers for Medicare and Medicaid 35.3 Services" wherever it refers to the federal agency that provides 35.4 funding for the medical assistance program. 35.5 Sec. 32. [REPEALER.] 35.6 (a) Minnesota Statutes 2000, section 256B.0635, subdivision 35.7 3, is repealed effective July 1, 2002. 35.8 (b) Minnesota Statutes 2000, sections 256.025; 256B.19, 35.9 subdivision 1a; and 256B.77, subdivision 24, are repealed.