Minnesota Legislature
SF 3346
as introduced - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
1.1 A bill for an act 1.2 relating to human services; appropriating money; 1.3 changing provisions for long-term care, health care 1.4 programs and provisions, including MA and GAMC, 1.5 MinnesotaCare, welfare reform, and regional treatment 1.6 centers; imposing penalties; amending Minnesota 1.7 Statutes 1996, sections 16A.124, subdivision 4a; 1.8 119B.24; 144.701, subdivisions 1, 2, and 4; 144.702, 1.9 subdivisions 1, 2, and 8; 144A.09, subdivision 1; 1.10 144A.44, subdivision 2; 214.03; 245.462, subdivisions 1.11 4 and 8; 245.4871, subdivision 4; 245A.03, by adding a 1.12 subdivision; 245A.14, subdivision 4; 256.014, 1.13 subdivision 1; 256.969, subdivisions 16 and 17; 1.14 256B.03, subdivision 3; 256B.04, by adding a 1.15 subdivision; 256B.055, subdivision 7, and by adding a 1.16 subdivision; 256B.057, subdivision 3a, and by adding 1.17 subdivisions; 256B.0625, subdivisions 17, 20, 34, and 1.18 by adding a subdivision; 256B.0627, subdivision 4; 1.19 256B.0911, subdivision 4; 256B.0916; 256B.41, 1.20 subdivision 1; 256B.431, subdivisions 2b, 4, 11, 22, 1.21 and by adding a subdivision; 256B.501, subdivision 2; 1.22 256B.69, by adding subdivisions; 256D.03, subdivision 1.23 4, and by adding subdivisions; 256D.051, by adding a 1.24 subdivision; 256D.46, subdivision 2; 256I.04, 1.25 subdivisions 1, 3, and by adding a subdivision; and 1.26 256I.05, subdivision 2; Minnesota Statutes 1997 1.27 Supplement, sections 62J.69, subdivisions 1, 2, and by 1.28 adding a subdivision; 62J.75; 103I.208, subdivision 2; 1.29 144.1494, subdivision 1; 144A.071, subdivision 4a; 1.30 171.29, subdivision 2; 214.32, subdivision 1; 245B.06, 1.31 subdivision 2; 256.01, subdivision 2; 256.031, 1.32 subdivision 6; 256.9657, subdivision 3; 256.9685, 1.33 subdivision 1; 256.9864; 256B.04, subdivision 18; 1.34 256B.056, subdivisions 1a and 4; 256B.06, subdivision 1.35 4; 256B.062; 256B.0625, subdivision 31a; 256B.0627, 1.36 subdivision 5; 256B.0645; 256B.0911, subdivisions 2 1.37 and 7; 256B.0913, subdivision 14; 256B.0915, 1.38 subdivisions 1d and 3; 256B.0951, by adding a 1.39 subdivision; 256B.431, subdivisions 3f and 26; 1.40 256B.433, subdivision 3a; 256B.434, subdivision 10; 1.41 256B.69, subdivisions 2 and 3a; 256B.692, subdivisions 1.42 2 and 5; 256B.77, subdivisions 3, 7a, 10, and 12; 1.43 256D.03, subdivision 3; 256D.05, subdivision 8; 1.44 256J.02, subdivision 4; 256J.03; 256J.08, subdivisions 1.45 11, 26, 28, 40, 60, 68, 73, 83, and by adding 1.46 subdivisions; 256J.09, subdivisions 6 and 9; 256J.11, 2.1 subdivision 2, as amended; 256J.12; 256J.14; 256J.15, 2.2 subdivision 2; 256J.20, subdivisions 2 and 3; 256J.21; 2.3 256J.24, subdivisions 1, 2, 3, 4, and by adding a 2.4 subdivision; 256J.26, subdivisions 1, 2, 3, and 4; 2.5 256J.28, subdivisions 1, 2, and by adding a 2.6 subdivision; 256J.30, subdivisions 10 and 11; 256J.31, 2.7 subdivisions 5 and 10; 256J.32, subdivisions 4, 6, and 2.8 by adding a subdivision; 256J.33, subdivisions 1 and 2.9 4; 256J.35; 256J.36; 256J.37, subdivisions 1, 2, 9, 2.10 and by adding subdivisions; 256J.38, subdivision 1; 2.11 256J.39, subdivision 2; 256J.395; 256J.42; 256J.43; 2.12 256J.45, subdivisions 1, 2, and by adding a 2.13 subdivision; 256J.46, subdivisions 1 and 2; 256J.47, 2.14 subdivision 4; 256J.48, subdivisions 2, 3, and by 2.15 adding a subdivision; 256J.49, subdivision 4; 256J.50, 2.16 subdivision 5, and by adding a subdivision; 256J.52, 2.17 subdivision 4; 256J.54, subdivisions 2, 3, 4, and 5; 2.18 256J.55, subdivision 5; 256J.56; 256J.57, subdivision 2.19 1; 256J.74, subdivision 2; 256J.75, by adding a 2.20 subdivision; 256K.03, subdivision 5; 256L.01; 256L.02, 2.21 subdivisions 2 and 3; 256L.03, subdivisions 1, 3, 4, 2.22 5, and by adding subdivisions; 256L.04, subdivisions 2.23 1, 2, 7, 8, 9, 10, and by adding subdivisions; 2.24 256L.05, subdivisions 2, 3, 4, and by adding 2.25 subdivisions; 256L.06, subdivision 3; 256L.07; 2.26 256L.09, subdivisions 2, 4, and 6; 256L.11, 2.27 subdivision 6; 256L.12, subdivision 5; 256L.15; 2.28 256L.17, by adding a subdivision; and 270A.03, 2.29 subdivision 5; Laws 1995, chapter 234, article 6, 2.30 section 45; Laws 1997, chapter 203, article 4, section 2.31 64; and article 9, section 21; chapter 225, article 2, 2.32 section 64; and chapter 248, section 46, as amended; 2.33 proposing coding for new law in Minnesota Statutes, 2.34 chapters 62J; 144; 256; 256B; 256D; and 256J; 2.35 repealing Minnesota Statutes 1996, sections 144.0721, 2.36 subdivision 3a; 256.031, subdivisions 1, 2, 3, and 4; 2.37 256.032; 256.033, subdivisions 2, 3, 4, 5, and 6; 2.38 256.034; 256.035; 256.036; 256.0361; 256.047; 2.39 256.0475; 256.048; 256.049; and 256B.501, subdivision 2.40 3g; Minnesota Statutes 1997 Supplement, sections 2.41 62J.685; 144.0721, subdivision 3; 256.031, 2.42 subdivisions 5 and 6; 256.033, subdivisions 1 and 1a; 2.43 256B.057, subdivision 1a; 256B.062; 256B.0913, 2.44 subdivision 15; 256J.25; 256J.28, subdivision 4; 2.45 256J.32, subdivision 5; 256J.34, subdivision 5; 2.46 256J.76; 256L.04, subdivisions 3, 4, 5, and 6; 2.47 256L.06, subdivisions 1 and 2; 256L.08; 256L.09, 2.48 subdivision 3; 256L.13; 256L.14; and 256L.15, 2.49 subdivision 3; Laws 1997, chapter 85, article 1, 2.50 sections 61 and 71; and article 3, section 55; 2.51 Minnesota Rules (Exempt), parts 9500.9100; 9500.9110; 2.52 9500.9120; 9500.9130; 9500.9140; 9500.9150; 9500.9160; 2.53 9500.9170; 9500.9180; 9500.9190; 9500.9200; 9500.9210; 2.54 and 9500.9220. 2.55 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 2.56 ARTICLE 1 2.57 APPROPRIATIONS 2.58 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 2.59 The sums shown in the columns marked "APPROPRIATIONS" are 2.60 appropriated from the general fund, or any other fund named, to 2.61 the agencies and for the purposes specified in the following 2.62 sections of this article, to be available for the fiscal years 3.1 indicated for each purpose. The figures "1998" and "1999" where 3.2 used in this article, mean that the appropriation or 3.3 appropriations listed under them are available for the fiscal 3.4 year ending June 30, 1998, or June 30, 1999, respectively. 3.5 Where a dollar amount appears in parentheses, it means a 3.6 reduction of an appropriation. 3.7 SUMMARY BY FUND 3.8 APPROPRIATIONS BIENNIAL 3.9 1998 1999 TOTAL 3.10 General $ (119,518,000)$ (120,237,000)$ (239,755,000) 3.11 State Government 3.12 Special Revenue 113,000 224,000 337,000 3.13 Health Care Access 3.14 Fund 6,616,000 (255,000) 6,361,000 3.15 TOTAL $ (112,789,000)$ (120,268,000)$ (233,057,000) 3.16 APPROPRIATIONS 3.17 Available for the Year 3.18 Ending June 30 3.19 1998 1999 3.20 Sec. 2. COMMISSIONER OF 3.21 HUMAN SERVICES 3.22 Subdivision 1. Total 3.23 Appropriation $ (112,902,000)$ (127,343,000) 3.24 Summary by Fund 3.25 General (119,518,000) (126,579,000) 3.26 Health Care Access 6,616,000 (764,000) 3.27 This appropriation is taken from the 3.28 appropriation in Laws 1997, chapter 3.29 203, article 1, section 2. 3.30 The amounts that are added to or 3.31 reduced from the appropriation for each 3.32 program are specified in the following 3.33 subdivisions. 3.34 Subd. 2. Agency Management 3.35 -0- 80,000 3.36 Subd. 3. Children's Grants 3.37 (600,000) 2,771,000 3.38 [CRISIS NURSERY PROGRAMS.] Of this 3.39 appropriation, $200,000 in fiscal year 3.40 1999 is from the general fund to the 3.41 commissioner to contract for technical 3.42 assistance with counties that are 3.43 interested in developing a crisis 3.44 nursery program. The technical 3.45 assistance must be designed to assist 3.46 interested counties in building 3.47 capacity to develop and maintain a 4.1 crisis nursery program in the county. 4.2 The grant amounts to counties must 4.3 range from $10,000 to $20,000. To be 4.4 eligible to receive a grant under this 4.5 program, the county must not have an 4.6 existing crisis nursery program and 4.7 must not be a metropolitan county, as 4.8 that term is defined in Minnesota 4.9 Statutes, section 473.121. This 4.10 appropriation shall not become part of 4.11 base level funding for the 2000-2001 4.12 biennium. 4.13 [CHILDREN'S MENTAL HEALTH SERVICES.] 4.14 (1) Of this appropriation, $500,000 in 4.15 fiscal year 1999 from the general fund 4.16 is to the commissioner for the purpose 4.17 of awarding grants to counties for 4.18 children's mental health services. 4.19 (2) Funds shall be used to provide 4.20 services according to an individual 4.21 family community support plan as 4.22 described in Minnesota Statutes, 4.23 section 245.4881, subdivision 4. The 4.24 plan must be developed using a process 4.25 that enhances consumer empowerment. 4.26 (3) In awarding grants to counties, the 4.27 commissioner shall follow the process 4.28 established in Minnesota Statutes, 4.29 section 245.4886, subdivision 2. The 4.30 commissioner shall ensure that grant 4.31 funds are not used to replace existing 4.32 funds. 4.33 [INDIAN FAMILY PRESERVATION ACT.] Of 4.34 this appropriation, $100,000 from the 4.35 general fund for fiscal year 1999 is to 4.36 provide a grant under Minnesota 4.37 Statutes, section 257.3571, subdivision 4.38 1, to an Indian organization licensed 4.39 as an adoption agency. The grant must 4.40 be used to provide primary support for 4.41 implementation of the Minnesota Indian 4.42 Family Preservation Act and compliance 4.43 with the Indian Child Welfare Act. 4.44 [FAMILY PRESERVATION PROGRAM TANF 4.45 FUNDING.] $10,000,000 of federal funds 4.46 shall be transferred from TANF to the 4.47 family preservation program in the 4.48 fiscal year beginning July 1, 1998. 4.49 Notwithstanding Minnesota Statutes, 4.50 section 256E.07, the commissioner shall 4.51 distribute this money according to the 4.52 family preservation formula in 4.53 Minnesota Statutes, section 256F.05, 4.54 subdivision 3. Funds allocated to the 4.55 counties must be used in accordance 4.56 with federal TANF requirements and 4.57 Minnesota Statutes, chapter 256F. 4.58 Subd. 4. Children's Services Management 4.59 [SOCIAL SERVICES INFORMATION SYSTEM.] 4.60 Notwithstanding Laws 1997, chapter 203, 4.61 article 1, section 2, subdivision 4, 4.62 the appropriation in that subdivision 4.63 for the social services information 4.64 system shall become part of the base 5.1 for the biennium beginning July 1, 1999. 5.2 Subd. 5. Basic Health Care Grants 5.3 (67,836,000) (88,240,000) 5.4 Summary by Fund 5.5 General (74,644,000) (84,818,000) 5.6 Health Care Access 6,808,000 (3,422,000) 5.7 The amounts that may be spent from this 5.8 appropriation for each purpose are as 5.9 follows: 5.10 (a) Minnesota Care Grants 5.11 Health Care Access Fund 5.12 6,808,000 (3,422,000) 5.13 [SUBSIDIZED FAMILY HEALTH COVERAGE.] 5.14 (1) Of this appropriation, $500,000 5.15 from the health care access fund in 5.16 fiscal year 1999 is to implement the 5.17 program described in paragraph (b). 5.18 (2) The commissioner shall submit to 5.19 the health care financing 5.20 administration a plan to obtain federal 5.21 funding, according to section 5.22 2105(c)(3) of the Balanced Budget Act 5.23 of 1997, Public Law Number 105-33, to 5.24 subsidize health insurance coverage for 5.25 families who are ineligible for 5.26 MinnesotaCare under Minnesota Statutes, 5.27 section 256L.07, subdivision 2, 5.28 paragraph (b), due to the availability 5.29 of employer subsidized insurance for 5.30 which the employer pays 50 percent or 5.31 more of the cost of the coverage. Upon 5.32 federal approval of the plan, the 5.33 commissioner shall implement a program 5.34 to pay the difference of the 5.35 MinnesotaCare sliding premium scale as 5.36 specified in Minnesota Statutes, 5.37 section 256L.08, up to a maximum of 5.38 five percent of a qualifying family's 5.39 income and the employee share of the 5.40 cost of health insurance coverage. To 5.41 qualify, a family must meet all 5.42 MinnesotaCare eligibility criteria 5.43 according to Minnesota Statutes, 5.44 sections 256L.01 to 256L.18, except the 5.45 requirements of Minnesota Statutes, 5.46 section 256L.07, subdivision 2, 5.47 paragraph (b). Implementation of the 5.48 program shall be limited to the funds 5.49 appropriated from the health care 5.50 access fund for the fiscal year ending 5.51 June 30, 1999. 5.52 (b) MA Basic Health Care Grants- 5.53 Families and Children 5.54 General (23,231,000) (38,768,000) 5.55 [RESERVE ACCOUNT.] The commissioner 5.56 shall establish a reserve account for 5.57 the deposit of savings in prepaid 5.58 medical assistance and prepaid general 6.1 assistance medical care programs in 6.2 fiscal year 1999 as a result of the 6.3 delayed implementation of those 6.4 programs in certain counties. The 6.5 savings, in the amount of $7,943,000 in 6.6 medical assistance and $2,964,000 in 6.7 general assistance medical care, shall 6.8 be used in fiscal year 2000 for costs 6.9 in the prepaid programs. 6.10 Notwithstanding section 7, this 6.11 paragraph shall not expire. 6.12 (c) MA Basic Health Care Grants- 6.13 Elderly and Disabled 6.14 General (23,784,000) (37,807,000) 6.15 [MEDICAL EDUCATION RESEARCH TRUST FUND 6.16 BASE.] The appropriation in Laws 1997, 6.17 chapter 203, article 1. section 2, 6.18 subdivision 5, to the medical 6.19 assistance account for distribution to 6.20 medical assistance providers using the 6.21 methodology in Minnesota Statutes, 6.22 section 62J.69, shall become part of 6.23 the base for the biennium beginning 6.24 July 1, 1999, at the level of 6.25 $2,500,000 per year. Notwithstanding 6.26 section 7, this paragraph shall not 6.27 expire. 6.28 (d) General Assistance Medical Care 6.29 General (27,629,000) (8,243,000) 6.30 [HEALTH CARE ACCESS FUND TRANSFERS TO 6.31 THE GENERAL FUND.] Notwithstanding Laws 6.32 1997, chapter 203, article 1, section 6.33 2, subdivision 5, the commissioner 6.34 shall transfer funds from the health 6.35 care access fund to the general fund to 6.36 offset the projected savings to general 6.37 assistance medical care (GAMC) that 6.38 would result from the transition of 6.39 GAMC parents and adults without 6.40 children to MinnesotaCare. For fiscal 6.41 year 1998, the amount transferred from 6.42 the health care access fund to the 6.43 general fund shall be $13,700,000. The 6.44 amount of transfer for fiscal year 1999 6.45 shall be $2,659,000. 6.46 Subd. 6. Basic Health Care Management 6.47 (192,000) 2,448,000 6.48 Summary by Fund 6.49 General -0- 874,000 6.50 Health Care Access (192,000) 1,574,000 6.51 The amounts that may be spent from this 6.52 appropriation for each purpose are as 6.53 follows: 6.54 (a) Health Care Policy Administration 6.55 General -0- 786,000 6.56 Health Care Access (192,000) 37,000 7.1 [DELAY IN TRANSFERRING GAMC CLIENTS.] 7.2 Due to the delay in transferring GAMC 7.3 clients to MinnesotaCare until January 7.4 1, 2000, $192,000 in fiscal year 1998 7.5 health care access fund administrative 7.6 funds, appropriated in Laws 1997, 7.7 chapter 225, article 7, section 2, 7.8 subdivision 1, are canceled. 7.9 [HEALTH CARE MANUAL PRODUCTION COSTS.] 7.10 For the biennium ending June 30, 1999, 7.11 the difference between the cost of 7.12 producing and distributing the 7.13 department of human services health 7.14 care manual and the subsidized price 7.15 charged to individuals and private 7.16 entities on January 1, 1998, is 7.17 appropriated to the commissioner to 7.18 defray manual production and 7.19 distribution costs. 7.20 (b) Health Care Operations 7.21 General -0- 88,000 7.22 Health Care Access -0- 1,537,000 7.23 [MINNESOTACARE OUTREACH.] Unexpended 7.24 money in fiscal year 1998 for 7.25 MinnesotaCare outreach activities 7.26 appropriated in Laws 1997, chapter 225, 7.27 article 7, section 2, subdivision 1, 7.28 does not cancel, but is available for 7.29 those purposes in fiscal year 1999. 7.30 Subd. 7. State-Operated Services 7.31 -0- 508,000 7.32 The amounts that may be spent from this 7.33 appropriation for each purpose are as 7.34 follows: 7.35 (a) RTC Facilities 7.36 -0- 825,000 7.37 [LEAVE LIABILITIES.] The accrued leave 7.38 liabilities of state employees 7.39 transferred to state-operated services 7.40 programs may be paid from the 7.41 appropriation for state-operated 7.42 services in Laws 1997, chapter 203, 7.43 article 1, section 2, subdivision 7a. 7.44 Funds set aside for this purpose shall 7.45 not exceed the amount of the actual 7.46 leave liability calculated as of June 7.47 30, 1999, and shall be available until 7.48 expended. This paragraph is effective 7.49 the day following final enactment. 7.50 [GRAVE MARKERS.] Of the $195,000 7.51 retained by the commissioner out of the 7.52 $200,000 appropriation in Laws 1997, 7.53 chapter 203, article 1, section 2, 7.54 subdivision 7, paragraph (a), for grave 7.55 markers at regional treatment centers, 7.56 $29,250 is for community organizing, 7.57 coordination, fundraising, and 7.58 administration. 8.1 [RTC BUILDING AND SPACE ANALYSIS.] Of 8.2 this appropriation, $175,000 from the 8.3 general fund in fiscal year 1999 is for 8.4 the commissioner to conduct an analysis 8.5 of surplus land and buildings on the 8.6 regional treatment center campuses and 8.7 to develop recommendations for future 8.8 utilization of this property. The 8.9 commissioner shall report to the 8.10 legislature by January 15, 1999, with 8.11 recommendations for an orderly process 8.12 to sell, lease, demolish, transfer, or 8.13 otherwise dispose of unneeded buildings 8.14 and land. 8.15 (b) State-Operated Community 8.16 Services - DD 8.17 -0- (317,000) 8.18 Subd. 8. Continuing Care and 8.19 Community Support Grants 8.20 (35,100,000) (22,107,000) 8.21 The amounts that may be spent from this 8.22 appropriation for each purpose are as 8.23 follows: 8.24 (a) Community Services Block Grants 8.25 130,000 280,000 8.26 [WILKIN COUNTY FLOOD COSTS.] Of this 8.27 appropriation, $130,000 for fiscal year 8.28 1998 is to reimburse Wilkin county for 8.29 flood-related human service and public 8.30 health costs which cannot be reimbursed 8.31 through any other source. 8.32 (b) Aging Adult Service Grants 8.33 -0- 350,000 8.34 [METROPOLITAN AREA AGENCY ON AGING.] Of 8.35 this appropriation, $100,000 in fiscal 8.36 year 1999 from the general fund is for 8.37 the commissioner for the metropolitan 8.38 area agency on aging to provide 8.39 technical support and planning services 8.40 to enable older adults to remain living 8.41 in the community. This appropriation 8.42 shall not cancel but is available until 8.43 expended. 8.44 [HOME SHARING.] Of this appropriation, 8.45 $250,000 in fiscal year 1999 is from 8.46 the general fund to the commissioner 8.47 for the home-sharing program under 8.48 Minnesota Statutes, section 256.973, 8.49 which links elderly, disabled, and 8.50 families together to share a home. 8.51 (c) Deaf and Hard-of-Hearing 8.52 Services Grants 8.53 -0- 200,000 8.54 This appropriation is in addition to 8.55 the appropriation in Laws 1997, chapter 8.56 203, article 1, section 2, subdivision 9.1 8, paragraph (d), for a grant to a 9.2 nonprofit agency that currently 9.3 provides these services. 9.4 [SERVICES FOR DEAF-BLIND PERSONS.] Of 9.5 this appropriation, $200,000 in fiscal 9.6 year 1999 is for the following: 9.7 (1) $125,000 for a grant to Deaf Blind 9.8 Services Minnesota, Inc., in order to 9.9 provide services to deaf-blind children 9.10 and their families. The services 9.11 include providing intervenors to assist 9.12 deaf-blind children in participating in 9.13 their community and providing family 9.14 education specialists to teach siblings 9.15 and parents skills to support the 9.16 deaf-blind child in the family. 9.17 (2) $75,000 is for a grant to Deaf 9.18 Blind Services Minnesota, Inc., and 9.19 Duluth Lighthouse for the Blind, Inc., 9.20 in order to provide assistance to 9.21 deaf-blind persons who are working 9.22 toward establishing and maintaining 9.23 independence. 9.24 (d) Mental Health Grants 9.25 300,000 2,226,000 9.26 [FLOOD COSTS.] Of this appropriation, 9.27 $300,000 for fiscal year 1998 and 9.28 $1,000,000 for fiscal year 1999 is to 9.29 pay for flood-related mental health 9.30 services and to reimburse mental health 9.31 centers for the cost of disruptions in 9.32 the mental health centers' other 9.33 services that were caused by diversion 9.34 of staff to flood efforts. Funding is 9.35 limited to costs for services which 9.36 cannot be reimbursed through any other 9.37 source in counties officially declared 9.38 as disaster areas. 9.39 [COMPULSIVE GAMBLING CARRYFORWARD.] 9.40 Unexpended funds appropriated to the 9.41 commissioner for compulsive gambling 9.42 programs for fiscal year 1998 do not 9.43 cancel but are available for these 9.44 purposes for fiscal year 1999. 9.45 (e) Developmental Disabilities 9.46 Support Grants 9.47 -0- 54,000 9.48 (f) Medical Assistance Long-Term 9.49 Care Waivers and Home Care 9.50 (8,463,000) (12,308,000) 9.51 [JANUARY 1, 1999, PROVIDER RATE 9.52 INCREASE.] (1) Effective for services 9.53 rendered on or after January 1, 1999, 9.54 the commissioner shall increase 9.55 reimbursement or allocation rates by 9.56 two percent, and county boards shall 9.57 adjust provider contracts as needed, 9.58 for home and community-based waiver 9.59 services for persons with mental 10.1 retardation or related conditions under 10.2 Minnesota Statutes, section 256B.501; 10.3 home and community-based waiver 10.4 services for the elderly under 10.5 Minnesota Statutes, section 256B.0915; 10.6 waivered services under community 10.7 alternatives for disabled individuals 10.8 under Minnesota Statutes, section 10.9 256B.49; community alternative care 10.10 waivered services under Minnesota 10.11 Statutes, section 256B.49; traumatic 10.12 brain injury waivered services under 10.13 Minnesota Statutes, section 256B.49; 10.14 nursing services and home health 10.15 services under Minnesota Statutes, 10.16 section 256B.0625, subdivision 6a; 10.17 personal care services and nursing 10.18 supervision of personal care services 10.19 under Minnesota Statutes, section 10.20 256B.0625, subdivision 19a; private 10.21 duty nursing services under Minnesota 10.22 Statutes, section 256B.0625, 10.23 subdivision 7; day training and 10.24 habilitation services for adults with 10.25 mental retardation or related 10.26 conditions under Minnesota Statutes, 10.27 sections 252.40 to 252.46; physical 10.28 therapy services under Minnesota 10.29 Statutes, sections 256B.0625, 10.30 subdivision 8, and 256D.03, subdivision 10.31 4; occupational therapy services under 10.32 Minnesota Statutes, sections 256B.0625, 10.33 subdivision 8a, and 256D.03, 10.34 subdivision 4; speech-language therapy 10.35 services under Minnesota Statutes, 10.36 section 256D.03, subdivision 4, and 10.37 Minnesota Rules, part 9505.0390; 10.38 respiratory therapy services under 10.39 Minnesota Statutes, section 256D.03, 10.40 subdivision 4, and Minnesota Rules, 10.41 part 9505.0295; dental services under 10.42 Minnesota Statutes, sections 256B.0625, 10.43 subdivision 9, and 256D.03, subdivision 10.44 4; alternative care services under 10.45 Minnesota Statutes, section 256B.0913; 10.46 adult residential program grants under 10.47 Minnesota Rules, parts 9535.2000 to 10.48 9535.3000; adult and family community 10.49 support grants under Minnesota Rules, 10.50 parts 9535.1700 to 9535.1760; and 10.51 semi-independent living services under 10.52 Minnesota Statutes, section 252.275, 10.53 including SILS funding under county 10.54 social services grants formerly funded 10.55 under Minnesota Statutes, chapter 256I. 10.56 (2) The commissioner shall increase 10.57 prepaid medical assistance program 10.58 capitation rates as appropriate to 10.59 reflect the rate increases in paragraph 10.60 (l). 10.61 (g) Medical Assistance Long-Term 10.62 Care Facilities 10.63 (18,272,000) (18,426,000) 10.64 [ICFs/MR AND NURSING FACILITY 10.65 FLOOD-RELATED REPORTING.] For the 10.66 reporting year ending December 31, 10.67 1997, for ICFs/MR that temporarily 11.1 admitted victims of the flood of 1997, 11.2 the resident days related to the 11.3 temporary placement of persons not 11.4 formally admitted who continued to be 11.5 billed under the evacuated facility's 11.6 provider number will not be counted in 11.7 the cost report submitted to calculate 11.8 October 1, 1998, rates, and the 11.9 additional expenditures will be 11.10 considered nonallowable. 11.11 For the reporting year ending September 11.12 30, 1997, for nursing facilities that 11.13 temporarily admitted victims of the 11.14 flood of 1997, the resident days 11.15 related to the temporary placement of 11.16 persons not formally admitted who 11.17 continued to be billed under the 11.18 evacuated facility's provider number 11.19 will not be counted in the cost report 11.20 submitted to calculate July 1, 1998, 11.21 rates, and the additional expenditures 11.22 will be considered nonallowable. 11.23 [NURSING HOME MORATORIUM EXCEPTIONS.] 11.24 Base level funding for medical 11.25 assistance long-term care facilities is 11.26 increased by $255,000 in fiscal year 11.27 2000 and by $278,000 in fiscal year 11.28 2001 for the additional medical 11.29 assistance costs of the nursing home 11.30 moratorium exceptions under Minnesota 11.31 Statutes, section 144A.071, subdivision 11.32 4a, paragraphs (w) and (x). 11.33 Notwithstanding the provisions of 11.34 section 7, this paragraph shall not 11.35 expire. 11.36 (h) Alternative Care Grants 11.37 -0- 21,986,000 11.38 (i) Group Residential Housing 11.39 (8,795,000) (8,971,000) 11.40 [SERVICES TO DEAF PERSONS WITH MENTAL 11.41 ILLNESS.] Of this appropriation, 11.42 $70,000 in fiscal year 1999 is for a 11.43 grant to a nonprofit agency that 11.44 currently serves deaf and 11.45 hard-of-hearing adults with mental 11.46 illness through residential programs 11.47 and supported housing outreach 11.48 activities to increase by five percent, 11.49 retroactive to July 1, 1997, the 11.50 compensation packages of staff at the 11.51 nonprofit agency that currently 11.52 provides these services. 11.53 (j) Chemical Dependency 11.54 Entitlement Grants 11.55 -0- (7,498,000) 11.56 Subd. 9. Continuing Care and 11.57 Community Support Management 11.58 -0- 75,000 11.59 [REGION 10 COMMISSION CARRYOVER 12.1 AUTHORITY.] Any unspent portion of the 12.2 appropriation to the commissioner in 12.3 Laws 1997, chapter 203, article 1, 12.4 section 2, subdivision 9, for the 12.5 region 10 quality assurance commission 12.6 for fiscal year 1998 shall not cancel 12.7 but shall be available for the 12.8 commission for fiscal year 1999. 12.9 [STUDY OF DAY TRAINING CAPITAL NEEDS.] 12.10 (a) Of this appropriation, $25,000 in 12.11 fiscal year 1999 is from the general 12.12 fund to the commissioner to conduct a 12.13 study to: 12.14 (1) determine the extent to which day 12.15 training and habilitation programs have 12.16 unmet capital improvement needs; 12.17 (2) ascertain the degree to which these 12.18 unmet capital needs impact consumers of 12.19 day training and habilitation programs; 12.20 (3) determine the state's role and 12.21 responsibility in meeting the capital 12.22 improvement needs of day training and 12.23 habilitation programs; and 12.24 (4) examine the relationship among the 12.25 state, counties, and community 12.26 resources in meeting the capital 12.27 improvement needs of day training and 12.28 habilitation programs. 12.29 (b) The commissioner shall report to 12.30 the legislature by January 15, 1999, 12.31 the results of the study along with 12.32 recommendations for involving the 12.33 state, counties, and community 12.34 resources in collaborative initiatives 12.35 to assist in meeting the capital 12.36 improvement needs of day training and 12.37 habilitation programs. 12.38 (c) This appropriation shall not become 12.39 part of base level funding for the 12.40 2000-2001 biennium. 12.41 Subd. 10. Economic Support Grants 12.42 (9,174,000) (23,997,000) 12.43 The amounts that may be spent from this 12.44 appropriation for each purpose are as 12.45 follows: 12.46 (a) Assistance to Families Grants 12.47 -0- (20,343,000) 12.48 [FEDERAL TANF FUNDS.] Notwithstanding 12.49 any contrary provisions of Laws 1997, 12.50 chapter 203, article 1, section 2, 12.51 subdivision 12, federal TANF block 12.52 grant funds are appropriated to the 12.53 commissioner in amounts up to 12.54 $241,027,000 in fiscal year 1998 and 12.55 $294,860,000 in fiscal year 1999. 12.56 Additional federal TANF funds may be 12.57 expended but only to the extent that an 12.58 equal amount of state funds have been 13.1 transferred to the TANF reserve under 13.2 Minnesota Statutes, section 256J.03. 13.3 The commissioner may use TANF reserve 13.4 funds to meet TANF maintenance of 13.5 effort requirements and to offset 13.6 federal TANF block grants funds. The 13.7 commissioner shall transfer $3,500,000 13.8 from the state TANF reserve to the 13.9 general fund for the food stamp costs 13.10 for legal noncitizens who do not 13.11 receive TANF benefits. This paragraph 13.12 is effective the day following final 13.13 enactment. 13.14 (b) General Assistance 13.15 (6,933,000) (905,000) 13.16 (c) Minnesota Supplemental Aid 13.17 (2,241,000) (2,749,000) 13.18 Subd. 11. Economic Support 13.19 Management 13.20 -0- 1,119,000 13.21 Summary by Fund 13.22 General -0- 35,000 13.23 Health Care Access -0- 1,084,000 13.24 [EBT TRANSACTION COSTS.] Retailers 13.25 electing to integrate electronic 13.26 benefit transfer (EBT) with other 13.27 commercial systems, such as credit or 13.28 debit, on the retailer's own equipment, 13.29 shall be paid two cents by the 13.30 commissioner for each food stamp 13.31 withdrawal transaction. 13.32 Sec. 3. COMMISSIONER OF HEALTH 13.33 Subdivision 1. Total 13.34 Appropriation -0- 6,874,000 13.35 Summary by Fund 13.36 General -0- 6,264,000 13.37 State Government 13.38 Special Revenue -0- 101,000 13.39 Health Care Access -0- 509,000 13.40 This appropriation is added to the 13.41 appropriation in Laws 1997, chapter 13.42 203, article 1, section 3. 13.43 The amounts that may be spent from this 13.44 appropriation for each program are 13.45 specified in the following subdivisions. 13.46 Subd. 2. Health Systems 13.47 and Special Populations -0- 3,584,000 13.48 Summary by Fund 13.49 General -0- 3,075,000 14.1 Health Care Access -0- 509,000 14.2 [FETAL ALCOHOL SYNDROME.] (a) of the 14.3 general fund appropriation, $3,000,000 14.4 is for the following: 14.5 (1) $750,000 to administer community 14.6 grants for fetal alcohol syndrome 14.7 prevention and intervention as defined 14.8 in Minnesota Statutes, section 14.9 145.9266, subdivision 4; 14.10 (2) $750,000 to expand maternal and 14.11 child service programs under Minnesota 14.12 Statutes, section 254A.17, subdivision 14.13 1; 14.14 (3) $750,000 to expand treatment 14.15 services and halfway houses for 14.16 pregnant women and women with children; 14.17 and 14.18 (4) $750,000 to develop and implement a 14.19 public awareness campaign. 14.20 (b) The commissioner shall transfer 14.21 money appropriated in paragraph (a) to 14.22 the appropriate agencies involved in 14.23 implementing fetal alcohol syndrome 14.24 initiatives. 14.25 [GRANTS TO MEDICAL CLINICS.] Of the 14.26 appropriation for fiscal year 1999 from 14.27 the health care access fund to the 14.28 commissioner, $250,000 is for grants to 14.29 medical clinics receiving federal funds 14.30 under Public Law Number 91-572, title X 14.31 of the Public Health Service Act. 14.32 [FEASIBILITY STUDY OF PRESCRIPTION DRUG 14.33 PROGRAM.] The commissioner shall 14.34 evaluate the feasibility of the 14.35 prescription drug program described in 14.36 Minnesota Statutes, sections 16B.94, 14.37 16B.95, and 16B.96, and recommend to 14.38 the legislature by December 15, 1998, 14.39 whether the program: 14.40 (1) should be funded by the 1999 14.41 legislature; 14.42 (2) is not feasible in its current form 14.43 and should be amended or repealed; or 14.44 (3) should be studied further. 14.45 The report shall contain an analysis of 14.46 prescription drug programs, including, 14.47 but not limited to: 14.48 (i) benefits that may be available for 14.49 qualified Medicare beneficiaries under 14.50 a federal waiver; 14.51 (ii) the senior citizen drug program 14.52 described in Minnesota Statutes, 14.53 section 256.955; and 14.54 (iii) coverage options that may be 14.55 available following enactment of the 14.56 1997 Federal Balanced Budget Act. 15.1 The commissioner shall consult with the 15.2 commissioners of human services and 15.3 administration in the preparation of 15.4 the report. 15.5 Subd. 3. Health Protection -0- 3,290,000 15.6 Summary by Fund 15.7 General -0- 3,189,000 15.8 State Government 15.9 Special Revenue -0- 101,000 15.10 [RESPIRATORY DISEASE STUDY.] Of the 15.11 general fund appropriation, $250,000 is 15.12 to collect and analyze information 15.13 regarding the increased incidence of 15.14 respiratory diseases, including 15.15 mesothelioma and asbestosis, in 15.16 northeastern and central Minnesota to 15.17 determine the cause of these diseases. 15.18 The commissioner shall also make 15.19 recommendations for the implementation 15.20 of a statewide occupational respiratory 15.21 disease information system. The 15.22 commissioner shall submit a report on 15.23 the findings and recommendations to the 15.24 legislature by January 15, 1999. 15.25 [LEAD-SAFE HOUSING.] Of this 15.26 appropriation, $50,000 in fiscal year 15.27 1999 from the general fund is to the 15.28 commissioner to create a lead-safe 15.29 housing certification program within 15.30 the private sector. This appropriation 15.31 shall be used to recruit and train 15.32 individuals certified as independent 15.33 home inspectors and truth-in-sale-of 15.34 housing evaluators to be lead risk 15.35 assessors, and to subsidize the cost of 15.36 assessing and doing follow-up research 15.37 on 300 single family and rental units 15.38 that are demonstration cases for the 15.39 lead-safe property certification 15.40 program. 15.41 [CANCER SCREENING.] Of the general fund 15.42 appropriation, $910,000 is for 15.43 increased cancer screening and 15.44 diagnostic services for women, 15.45 particularly underserved women, and to 15.46 improve cancer screening rates for the 15.47 general population. Of this amount, at 15.48 least $700,000 is for grants and up to 15.49 $210,000 is for technical assistance, 15.50 consultation, and outreach. The grants 15.51 support local boards of health in 15.52 providing outreach and coordination and 15.53 reimburse health care providers for 15.54 screening and diagnostic tests. 15.55 [SEXUALLY TRANSMITTED DISEASE.](a) of 15.56 this appropriation, $350,000 in fiscal 15.57 year 1999 is from the general fund to 15.58 the commissioner to do the following, 15.59 in consultation with the HIV/STD 15.60 prevention task force and the 15.61 commissioner of children, families, and 15.62 learning: 16.1 (1) $150,000 to conduct a statewide 16.2 assessment of need and capacity to 16.3 prevent and treat sexually transmitted 16.4 diseases and prepare a comprehensive 16.5 plan for how to prevent and treat 16.6 sexually transmitted diseases, 16.7 including strategies for reducing 16.8 infection and for increasing access to 16.9 treatment; and 16.10 (2) $200,000 to conduct research on the 16.11 prevalence of sexually transmitted 16.12 diseases among populations at highest 16.13 risk for infection. The research may 16.14 be done in collaboration with the 16.15 University of Minnesota and nonprofit 16.16 community health clinics. 16.17 (b) This appropriation shall not become 16.18 part of the base for the 2000-2001 16.19 biennium. 16.20 [DIABETES PREVENTION.] Of this 16.21 appropriation, $75,000 in fiscal year 16.22 1999 from the general fund is to the 16.23 commissioner for statewide activities 16.24 related to general diabetes prevention, 16.25 the development and dissemination of 16.26 prevention materials to health care 16.27 providers, and for other statewide 16.28 activities related to diabetes 16.29 prevention and control for targeted 16.30 populations who are at high risk for 16.31 developing diabetes or health 16.32 complications from diabetes. 16.33 Sec. 4. HEALTH-RELATED BOARDS 16.34 Subdivision 1. Total 16.35 Appropriation 113,000 123,000 16.36 This appropriation is added to the 16.37 appropriation in Laws 1997, chapter 16.38 203, article 1, section 5. 16.39 [STATE GOVERNMENT SPECIAL REVENUE 16.40 FUND.] The appropriations in this 16.41 section are from the state government 16.42 special revenue fund. 16.43 [NO SPENDING IN EXCESS OF REVENUES.] 16.44 The commissioner of finance shall not 16.45 permit the allotment, encumbrance, or 16.46 expenditure of money appropriated in 16.47 this section in excess of the 16.48 anticipated biennial revenues or 16.49 accumulated surplus revenues from fees 16.50 collected by the boards. Neither this 16.51 provision nor Minnesota Statutes, 16.52 section 214.06, applies to transfers 16.53 from the general contingent account. 16.54 Subd. 2. Board of Medical 16.55 Practice 80,000 90,000 16.56 Subd. 3. Board of Veterinary 16.57 Medicine 33,000 33,000 16.58 Sec. 5. EMERGENCY MEDICAL 16.59 SERVICES BOARD -0- 78,000 17.1 This appropriation is added to the 17.2 appropriation in Laws 1997, chapter 17.3 203, article 1, section 6. 17.4 [EMERGENCY MEDICAL SERVICES 17.5 COMMUNICATIONS NEEDS ASSESSMENT.] (a) 17.6 Of this appropriation, $78,000 in 17.7 fiscal year 1999 is from the general 17.8 fund to the board to conduct an 17.9 emergency medical services needs 17.10 assessment for areas outside the 17.11 seven-county metropolitan area. The 17.12 assessment shall determine the current 17.13 status of and need for emergency 17.14 medical services communications 17.15 equipment. All regional emergency 17.16 medical services programs designated by 17.17 the board under Minnesota Statutes, 17.18 section 144.8093, shall cooperate in 17.19 the preparation of the assessment. 17.20 (b) The appropriation for this project 17.21 shall be distributed through the 17.22 emergency medical services system fund 17.23 under Minnesota Statutes, section 17.24 144E.50, through a request-for-proposal 17.25 process. The commissioner must select 17.26 a regional EMS program that receives at 17.27 least 20 percent of its funding from 17.28 nonstate sources to conduct the 17.29 assessment. The request for proposals 17.30 must be issued by August 1, 1998. 17.31 (c) A final report with recommendations 17.32 shall be presented to the board and the 17.33 legislature by July 1, 1999. 17.34 (d) This appropriation shall not become 17.35 part of base level funding for the 17.36 2000-2001 biennium. 17.37 Sec. 6. [CARRYOVER LIMITATION.] None 17.38 of the appropriations in this act which 17.39 are allowed to be carried forward from 17.40 fiscal year 1998 to fiscal year 1999 17.41 shall become part of the base level 17.42 funding for the 2000-2001 biennial 17.43 budget, unless specifically directed by 17.44 the legislature. 17.45 Sec. 7. [SUNSET OF UNCODIFIED 17.46 LANGUAGE.] All uncodified language 17.47 contained in this article expires on 17.48 June 30, 1999, unless a different 17.49 expiration date is explicit. 17.50 ARTICLE 2 17.51 HEALTH DEPARTMENT AND MISCELLANEOUS HEALTH PROVISIONS 17.52 Section 1. [62J.381] [PRESCRIPTION DRUG PRICE AND REBATE 17.53 DISCLOSURE.] 17.54 By April 1 of each year, group purchasers and hospitals 17.55 licensed under chapter 144 must submit to the commissioner of 17.56 health the total amount of aggregate purchases of prescription 17.57 drugs and discount or rebate received during the previous 18.1 calendar year. 18.2 Sec. 2. Minnesota Statutes 1997 Supplement, section 18.3 62J.69, subdivision 1, is amended to read: 18.4 Subdivision 1. [DEFINITIONS.] For purposes of this 18.5 section, the following definitions apply: 18.6 (a) "Medical education" means the accredited clinical 18.7 training of physicians (medical students and residents), doctor 18.8 of pharmacy practitioners, dentists, advanced practice nurses 18.9 (clinical nurse specialist, certified registered nurse 18.10 anesthetists, nurse practitioners, and certified nurse 18.11 midwives), and physician assistants. 18.12 (b) "Clinical training" means accredited training for the 18.13 health care practitioners listed in paragraph (a) that is funded 18.14and was historically fundedin part byinpatientpatient care 18.15 revenues and that occurs inbotheither an inpatientandor 18.16 ambulatory patient caresettingstraining site. 18.17 (c) "Trainee" means students involved in an accredited 18.18 clinical training program for medical education as defined in 18.19 paragraph (a). 18.20 (d) "Eligible trainee" means a student involved in an 18.21 accredited training program for medical education as defined in 18.22 paragraph (a), which meets the definition of clinical training 18.23 in paragraph (b), who is in a training site that is located in 18.24 Minnesota. 18.25 (e) "Health care research" means approved clinical, 18.26 outcomes, and health services investigations that are funded by 18.27 patient out-of-pocket expenses or a third-party payer. 18.28(e)(f) "Commissioner" means the commissioner of health. 18.29(f)(g) "Teaching institutions" means any hospital, medical 18.30 center, clinic, or other organization that currently sponsors or 18.31 conducts accredited medical education programs or clinical 18.32 research in Minnesota. 18.33 (h) "Accredited training" means training provided by a 18.34 program that is accredited through an organization recognized by 18.35 the department of education as the official accrediting body for 18.36 that program. 19.1 (i) "Sponsoring institution" means a hospital, school, or 19.2 consortium that sponsors and maintains primary organizational 19.3 and financial responsibility for an accredited medical education 19.4 program in Minnesota. 19.5 Sec. 3. Minnesota Statutes 1997 Supplement, section 19.6 62J.69, subdivision 2, is amended to read: 19.7 Subd. 2. [ALLOCATION AND FUNDING FOR MEDICAL EDUCATION AND 19.8 RESEARCH.] (a) The commissioner may establish a trust fund for 19.9 the purposes of funding medical education and research 19.10 activities in the state of Minnesota. 19.11 (b) By January 1, 1997, the commissioner may appoint an 19.12 advisory committee to provide advice and oversight on the 19.13 distribution of funds from the medical education and research 19.14 trust fund. If a committee is appointed, the commissioner 19.15 shall: (1) consider the interest of all stakeholders when 19.16 selecting committee members; (2) select members that represent 19.17 both urban and rural interest; and (3) select members that 19.18 include ambulatory care as well as inpatient perspectives. The 19.19 commissioner shall appoint to the advisory committee 19.20 representatives of the following groups: medical researchers, 19.21 public and private academic medical centers, managed care 19.22 organizations, Blue Cross and Blue Shield of Minnesota, 19.23 commercial carriers, Minnesota Medical Association, Minnesota 19.24 Nurses Association, medical product manufacturers, employers, 19.25 and other relevant stakeholders, including consumers. The 19.26 advisory committee is governed by section 15.059, for membership 19.27 terms and removal of members and will sunset on June 30, 1999. 19.28 (c) Eligible applicants for funds are accredited medical 19.29 education teaching institutions, consortia, and programs 19.30 operating in Minnesota. Applications must be submitted by the 19.31 sponsoring institution on behalf of the teaching program, and 19.32 must be received by September 30 of each year for distribution 19.33 in January of the following year. An application for funds must 19.34 include the following: 19.35 (1) the official name and address of the sponsoring 19.36 institution and the official name and address of the facility or 20.1programprograms on whose behalf the institution is applying for 20.2 funding; 20.3 (2) the name, title, and business address of those persons 20.4 responsible for administering the funds; 20.5 (3)the total number, type, and specialty orientation of20.6eligible Minnesota-based trainees infor each accredited medical 20.7 education program for which funds are being sought the type and 20.8 specialty orientation of trainees in the program, the name, 20.9 address, and medical assistance provider number of each training 20.10 site used in the program, the total number of trainees at each 20.11 site, and the total number of eligible trainees at each training 20.12 site; 20.13 (4) audited clinical training costs per trainee for each 20.14 medical education program where available or estimates of 20.15 clinical training costs based on audited financial data; 20.16 (5) a description of current sources of funding for medical 20.17 education costs including a description and dollar amount of all 20.18 state and federal financial support, including Medicare direct 20.19 and indirect payments; 20.20 (6) other revenue received for the purposes of clinical 20.21 training; and 20.22 (7)a statement identifying unfunded costs; and20.23(8)other supporting information the commissioner, with 20.24 advice from the advisory committee, determines is necessary for 20.25 the equitable distribution of funds. 20.26 (d) The commissioner shall distribute medical education 20.27 funds to all qualifying applicants based on the following basic 20.28 criteria: (1) total medical education funds available; (2) 20.29 total eligible trainees in each eligible education program; and 20.30 (3) the statewide average cost per trainee, by type of trainee, 20.31 in each medical education program. Funds distributed shall not 20.32 be used to displace current funding appropriations from federal 20.33 or state sources. Funds shall be distributed to the sponsoring 20.34 institutions indicating the amount to be paid to each of the 20.35 sponsor's medical education programs based on the criteria in 20.36 this paragraph. Sponsoring institutions which receive funds 21.1 from the trust fund must distribute approved funds to the 21.2 medical education program according to the commissioner's 21.3 approval letter. Further, programs must distribute funds among 21.4 the sites of training based on the percentage of total program 21.5 training performed at each site. Sponsoring institutions that 21.6 fail to distribute funds as directed by the commissioner are 21.7 required to return the full amount of the medical education and 21.8 research trust fund grant to the medical education and research 21.9 trust fund within 30 days of a notice from the commissioner. 21.10 (e) Medical education programs receiving funds from the 21.11 trust fund must submitannual cost and program reportsa medical 21.12 education and research grant verification report (GVR) through 21.13 the sponsoring institution based on criteria established by the 21.14 commissioner. If the sponsoring institution fails to submit the 21.15 GVR by the stated deadline, or to request and meet the deadline 21.16 for an extension, the sponsoring institution is required to 21.17 return the full amount of the medical education and research 21.18 trust fund grant to the medical education and research trust 21.19 fund within 30 days of a notice from the commissioner. The 21.20 reports must include: 21.21 (1) the total number of eligible trainees in the program; 21.22 (2) the programs and residencies funded, the amounts of 21.23 trust fund payments to each program, and within each program, 21.24 thepercentagedollar amount distributed to each training site; 21.25 and 21.26 (3)the average cost per trainee and a detailed breakdown21.27of the components of those costs;21.28(4) other state or federal appropriations received for the21.29purposes of clinical training;21.30(5) other revenue received for the purposes of clinical21.31training; and21.32(6)other information the commissioner, with advice from 21.33 the advisory committee, deems appropriate to evaluate the 21.34 effectiveness of the use of funds for clinical training. 21.35 The commissioner, with advice from the advisory committee, 21.36 will provide an annual summary report to the legislature on 22.1 program implementation due February 15 of each year. 22.2 (f) The commissioner is authorized to distribute funds made 22.3 available through: 22.4 (1) voluntary contributions by employers or other entities; 22.5 (2) allocations for the department of human services to 22.6 support medical education and research; and 22.7 (3) other sources as identified and deemed appropriate by 22.8 the legislature for inclusion in the trust fund. 22.9 (g) The advisory committee shall continue to study and make 22.10 recommendations on: 22.11 (1) the funding of medical research consistent with work 22.12 currently mandated by the legislature and under way at the 22.13 department of health; and 22.14 (2) the costs and benefits associated with medical 22.15 education and research. 22.16 Sec. 4. Minnesota Statutes 1997 Supplement, section 22.17 62J.69, is amended by adding a subdivision to read: 22.18 Subd. 4. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 22.19 SERVICES.] (a) The amount transferred in accordance with section 22.20 256B.69, subdivision 5c, shall be distributed to qualifying 22.21 applicants based on a distribution formula that reflects a 22.22 summation of two factors: 22.23 (1) an education factor, which is determined by the total 22.24 number of eligible trainees and the total statewide average 22.25 costs per trainee, by type of trainee, in each program; and 22.26 (2) a public program volume factor, which is determined by 22.27 the total volume of public program revenue received by each 22.28 training site as a percentage of all public program revenue 22.29 received by all training sites in the trust fund pool. 22.30 In this formula, the education factor shall be weighted at 22.31 50 percent and the public program volume factor shall be 22.32 weighted at 50 percent. 22.33 (b) Public program revenue for the above formula shall 22.34 include revenue from medical assistance, prepaid medical 22.35 assistance, general assistance medical care, and prepaid general 22.36 assistance medical care. 23.1 (c) Training sites that receive no public program revenue 23.2 shall be ineligible for payments from the prepaid medical 23.3 assistance program transfer pool. 23.4 Sec. 5. Minnesota Statutes 1997 Supplement, section 23.5 62J.75, is amended to read: 23.6 62J.75 [CONSUMER ADVISORY BOARD.] 23.7 (a) The consumer advisory board consists of 18 members 23.8 appointed in accordance with paragraph (b). All members must be 23.9 public, consumer members who: 23.10 (1) do not have and never had a material interest in either 23.11 the provision of health care services or in an activity directly 23.12 related to the provision of health care services, such as health 23.13 insurance sales or health plan administration; 23.14 (2) are not registered lobbyists; and 23.15 (3) are not currently responsible for or directly involved 23.16 in the purchasing of health insurance for a business or 23.17 organization. 23.18 (b) The governor, the speaker of the house of 23.19 representatives, and the subcommittee on committees of the 23.20 committee on rules and administration of the senate shall each 23.21 appoint two members. The Indian affairs council, the council on 23.22 affairs of Chicano/Latino people, the council on Black 23.23 Minnesotans, the council on Asian-Pacific Minnesotans, 23.24 mid-Minnesota legal assistance, and the Minnesota chamber of 23.25 commerce shall each appoint one member. The member appointed by 23.26 the Minnesota chamber of commerce must represent small business 23.27 interests. The health care campaign of Minnesota, Minnesotans 23.28 for affordable health care, and consortium for citizens with 23.29 disabilities shall each appoint two members.Members serve23.30without compensation or reimbursement for expenses.Compensation 23.31 for members is governed by section 15.059, subdivision 3. 23.32 (c) The board shall advise the commissioners of health and 23.33 commerce on the following: 23.34 (1) the needs of health care consumers and how to better 23.35 serve and educate the consumers on health care concerns and 23.36 recommend solutions to identified problems; and 24.1 (2) consumer protection issues in the self-insured market, 24.2 including, but not limited to, public education needs. 24.3 The board also may make recommendations to the legislature 24.4 on these issues. 24.5 (d) The board and this section expire June 30, 2001. 24.6 Sec. 6. Minnesota Statutes 1997 Supplement, section 24.7 103I.208, subdivision 2, is amended to read: 24.8 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 24.9 property owner is: 24.10 (1) for a well that is not in use under a maintenance 24.11 permit, $100 annually; 24.12 (2) for construction of a monitoring well, $120, which 24.13 includes the state core function fee; 24.14 (3) for a monitoring well that is unsealed under a 24.15 maintenance permit, $100 annually; 24.16 (4) for monitoring wells used as a leak detection device at 24.17 a single motor fuel retail outletor, a single petroleum bulk 24.18 storage site excluding tank farms, or a single agricultural 24.19 chemical facility site, the construction permit fee is $120, 24.20 which includes the state core function fee, per site regardless 24.21 of the number of wells constructed on the site, and the annual 24.22 fee for a maintenance permit for unsealed monitoring wells is 24.23 $100 per site regardless of the number of monitoring wells 24.24 located on site; 24.25 (5) for a groundwater thermal exchange device, in addition 24.26 to the notification fee for wells, $120, which includes the 24.27 state core function fee; 24.28 (6) for a vertical heat exchanger, $120; 24.29 (7) for a dewatering well that is unsealed under a 24.30 maintenance permit, $100 annually for each well, except a 24.31 dewatering project comprising more than five wells shall be 24.32 issued a single permit for $500 annually for wells recorded on 24.33 the permit; and 24.34 (8) for excavating holes for the purpose of installing 24.35 elevator shafts, $120 for each hole. 24.36 Sec. 7. Minnesota Statutes 1997 Supplement, section 25.1 144.1494, subdivision 1, is amended to read: 25.2 Subdivision 1. [CREATION OF ACCOUNT.] A rural physician 25.3 education account is established in the health care access 25.4 fund. The commissioner shall use money from the account to 25.5 establish a loan forgiveness program for medical residents 25.6 agreeing to practice in designated rural areas, as defined by 25.7 the commissioner. Appropriations made to this account are 25.8 available until expended. 25.9 Sec. 8. Minnesota Statutes 1996, section 144.701, 25.10 subdivision 1, is amended to read: 25.11 Subdivision 1. [CONSUMER INFORMATION.] The commissioner of 25.12 health shall ensure that the total costs, total 25.13 revenues, overall utilization, and total services of each 25.14 hospital and each outpatient surgical center are reported to the 25.15 public in a form understandable to consumers. 25.16 Sec. 9. Minnesota Statutes 1996, section 144.701, 25.17 subdivision 2, is amended to read: 25.18 Subd. 2. [DATA FOR POLICY MAKING.] The commissioner of 25.19 health shall compile relevant financial and accounting, 25.20 utilization, and services data concerning hospitals and 25.21 outpatient surgical centers in order to have statistical 25.22 information available for legislative policy making. 25.23 Sec. 10. Minnesota Statutes 1996, section 144.701, 25.24 subdivision 4, is amended to read: 25.25 Subd. 4. [FILING FEES.] Each report which is required to 25.26 be submitted to the commissioner of health under sections 25.27 144.695 to 144.703 and which is not submitted to a voluntary, 25.28 nonprofit reporting organization in accordance with section 25.29 144.702 shall be accompanied by a filing fee in an amount 25.30 prescribed by rule of the commissioner of health.Fees received25.31pursuant to this subdivision shall be deposited in the general25.32fund of the state treasury.Upon the withdrawal of approval of 25.33 a reporting organization, or the decision of the commissioner to 25.34 not renew a reporting organization, fees collected under section 25.35 144.702 shall be submitted to the commissionerand deposited in25.36the general fund. Fees received under this subdivision shall be 26.1 deposited in a revolving fund and are hereby appropriated to the 26.2 commissioner of health for the purposes of sections 144.695 to 26.3 144.703. The commissioner shall report the termination or 26.4 nonrenewal of the voluntary reporting organization to the chair 26.5 of the health and human services subdivision of the 26.6 appropriations committee of the house of representatives, to the 26.7 chair of the health and human services division of the finance 26.8 committee of the senate, and the commissioner of finance. 26.9 Sec. 11. Minnesota Statutes 1996, section 144.702, 26.10 subdivision 1, is amended to read: 26.11 Subdivision 1. [REPORTING THROUGH A REPORTING 26.12 ORGANIZATION.] A hospital or outpatient surgical center may 26.13 agree to submit its financial, utilization, and services reports 26.14 to a voluntary, nonprofit reporting organization whose reporting 26.15 procedures have been approved by the commissioner of health in 26.16 accordance with this section. Each report submitted under this 26.17 section shall be accompanied by a filing fee to the voluntary, 26.18 nonprofit reporting organization. 26.19 Sec. 12. Minnesota Statutes 1996, section 144.702, 26.20 subdivision 2, is amended to read: 26.21 Subd. 2. [APPROVAL OF ORGANIZATION'S REPORTING 26.22 PROCEDURES.] The commissioner of health may approve voluntary 26.23 reporting procedures consistent with written operating 26.24 requirements for the voluntary, nonprofit reporting organization 26.25 which shall be established annually by the commissioner. These 26.26 written operating requirements shall specify reports, analyses, 26.27 and other deliverables to be produced by the voluntary, 26.28 nonprofit reporting organization, and the dates on which those 26.29 deliverables must be submitted to the commissioner. These 26.30 written operating requirements shall specify deliverable dates 26.31 sufficient to enable the commissioner of health to process and 26.32 report health care cost information system data to the 26.33 commissioner of human services by August 15 of each year. The 26.34 commissioner of health shall, by rule, prescribe standards for 26.35 submission of data by hospitals and outpatient surgical centers 26.36 to the voluntary, nonprofit reporting organization or to the 27.1 commissioner. These standards shall provide for: 27.2 (a) the filing of appropriate financial, utilization, and 27.3 services information with the reporting organization; 27.4 (b) adequate analysis and verification of that financial, 27.5 utilization, and services information; and 27.6 (c) timely publication of the costs, revenues, and rates of 27.7 individual hospitals and outpatient surgical centers prior to 27.8 the effective date of any proposed rate increase. The 27.9 commissioner of health shall annually review the procedures 27.10 approved pursuant to this subdivision. 27.11 Sec. 13. Minnesota Statutes 1996, section 144.702, 27.12 subdivision 8, is amended to read: 27.13 Subd. 8. [TERMINATION OR NONRENEWAL OF REPORTING 27.14 ORGANIZATION.] The commissioner may withdraw approval of any 27.15 voluntary, nonprofit reporting organization for failure on the 27.16 part of the voluntary, nonprofit reporting organization to 27.17 comply with the written operating requirements under subdivision 27.18 2. Upon the effective date of the withdrawal, all funds 27.19 collected by the voluntary, nonprofit reporting organization 27.20 under section144.701144.702, subdivision41, but not expended 27.21 shall be deposited inthe general funda revolving fund and are 27.22 hereby appropriated to the commissioner of health for the 27.23 purposes of sections 144.695 to 144.703. 27.24 The commissioner may choose not to renew approval of a 27.25 voluntary, nonprofit reporting organization if the organization 27.26 has failed to perform its obligations satisfactorily under the 27.27 written operating requirements under subdivision 2. 27.28 Sec. 14. [144.7022] [ADMINISTRATIVE PENALTY ORDERS FOR 27.29 REPORTING ORGANIZATIONS.] 27.30 Subdivision 1. [AUTHORIZATION.] The commissioner may issue 27.31 an order to the voluntary, nonprofit reporting organization 27.32 requiring violations to be corrected and administratively assess 27.33 monetary penalties for violations of this chapter or rules, 27.34 written operating requirements, orders, stipulation agreements, 27.35 settlements, or compliance agreements adopted, enforced, or 27.36 issued by the commissioner. 28.1 Subd. 2. [CONTENTS OF ORDER.] An order assessing an 28.2 administrative penalty under this section must include: 28.3 (1) a concise statement of the facts alleged to constitute 28.4 a violation; 28.5 (2) a reference to the section of law, rule, written 28.6 operating requirement, order, stipulation agreement, settlement, 28.7 or compliance agreement that has been violated; 28.8 (3) a statement of the amount of the administrative penalty 28.9 to be imposed and the factors upon which the penalty is based; 28.10 (4) a statement of the corrective actions necessary to 28.11 correct the violation; and 28.12 (5) a statement of the right to request a hearing according 28.13 to sections 14.57 to 14.62. 28.14 Subd. 3. [CONCURRENT CORRECTIVE ORDER.] The commissioner 28.15 may issue an order assessing an administrative penalty and 28.16 requiring the violations cited in the order be corrected within 28.17 30 calendar days from the date the order is received. The 28.18 voluntary, nonprofit reporting organization that is subject to 28.19 the order shall provide to the commissioner before the 31st day 28.20 after the order was received, information demonstrating that the 28.21 violation has been corrected or that a corrective plan, 28.22 acceptable to the commissioner, has been developed. The 28.23 commissioner shall determine whether the violation has been 28.24 corrected and notify the voluntary, nonprofit reporting 28.25 organization of the commissioner's determination. 28.26 Subd. 4. [PENALTY.] If the commissioner determines that 28.27 the violation has been corrected or an acceptable corrective 28.28 plan has been developed, the penalty may be forgiven, except, 28.29 where there are repeated or serious violations, the commissioner 28.30 may issue an order with a penalty that will not be forgiven 28.31 after corrective action is taken. Unless there is a request for 28.32 review of the order under subdivision 6 before the penalty is 28.33 due, the penalty is due and payable: 28.34 (1) on the 31st calendar day after the order was received, 28.35 if the voluntary, nonprofit reporting organization fails to 28.36 provide information to the commissioner showing that the 29.1 violation has been corrected or that appropriate steps have been 29.2 taken toward correcting the violation; 29.3 (2) on the 20th day after the voluntary, nonprofit 29.4 reporting organization receives the commissioner's determination 29.5 that the information provided is not sufficient to show that 29.6 either the violation has been corrected or that appropriate 29.7 steps have been taken toward correcting the violation; or 29.8 (3) on the 31st day after the order was received where the 29.9 penalty is for repeated or serious violations and, according to 29.10 the order issued, the penalty will not be forgiven after 29.11 corrective action is taken. 29.12 All penalties due under this section are payable to the 29.13 treasurer, state of Minnesota, and shall be credited to the 29.14 general fund. 29.15 Subd. 5. [AMOUNT OF PENALTY; CONSIDERATIONS.] (a) The 29.16 maximum amount of an administrative penalty order is $5,000 for 29.17 each specific violation identified in an inspection, 29.18 investigation, or compliance review, up to an annual maximum 29.19 total for all violations of ten percent of the fees collected by 29.20 the voluntary, nonprofit reporting organization under section 29.21 144.702, subdivision 1. The annual maximum is based on a 29.22 reporting year. 29.23 (b) In determining the amount of the administrative 29.24 penalty, the commissioner shall consider the following: 29.25 (1) the willfulness of the violation; 29.26 (2) the gravity of the violation; 29.27 (3) the history of past violations; 29.28 (4) the number of violations; 29.29 (5) the economic benefit gained by the person allowing or 29.30 committing the violation; and 29.31 (6) other factors as justice may require, if the 29.32 commissioner specifically identifies the additional factors in 29.33 the commissioner's order. 29.34 (c) In determining the amount of a penalty for a violation 29.35 subsequent to an initial violation under paragraph (a), the 29.36 commissioner shall also consider: 30.1 (1) the similarity of the most recent previous violation 30.2 and the violation to be penalized; 30.3 (2) the time elapsed since the last violation; and 30.4 (3) the response of the voluntary, nonprofit reporting 30.5 organization to the most recent previous violation. 30.6 Subd. 6. [REQUEST FOR HEARING; HEARING; AND FINAL 30.7 ORDER.] A request for hearing must be in writing, delivered to 30.8 the commissioner by certified mail within 20 calendar days after 30.9 the receipt of the order, and specifically state the reasons for 30.10 seeking review of the order. The commissioner must initiate a 30.11 hearing within 30 calendar days from the date of receipt of the 30.12 written request for hearing. The hearing shall be conducted 30.13 pursuant to the contested case procedures in sections 14.57 to 30.14 14.62. No earlier than ten calendar days after and within 30 30.15 calendar days of receipt of the presiding administrative law 30.16 judge's report, the commissioner shall, based on all relevant 30.17 facts, issue a final order modifying, vacating, or making the 30.18 original order permanent. If, within 20 calendar days of 30.19 receipt of the original order, the voluntary, nonprofit 30.20 reporting organization fails to request a hearing in writing, 30.21 the order becomes the final order of the commissioner. 30.22 Subd. 7. [REVIEW OF FINAL ORDER AND PAYMENT OF 30.23 PENALTY.] Once the commissioner issues a final order, any 30.24 penalty due under that order shall be paid within 30 calendar 30.25 days after the date of the final order, unless review of the 30.26 final order is requested. The final order of the commissioner 30.27 may be appealed in the manner prescribed in sections 14.63 to 30.28 14.69. If the final order is reviewed and upheld, the penalty 30.29 shall be paid 30 calendar days after the date of the decision of 30.30 the reviewing court. Failure to request an administrative 30.31 hearing pursuant to subdivision 6 shall constitute a waiver of 30.32 the right to further agency or judicial review of the final 30.33 order. 30.34 Subd. 8. [REINSPECTIONS AND EFFECT OF NONCOMPLIANCE.] If, 30.35 upon reinspection, or in the determination of the commissioner, 30.36 it is found that any deficiency specified in the order has not 31.1 been corrected or an acceptable corrective plan has not been 31.2 developed, the voluntary, nonprofit reporting organization is in 31.3 noncompliance. The commissioner shall issue a notice of 31.4 noncompliance and may impose any additional remedy available 31.5 under this chapter. 31.6 Subd. 9. [ENFORCEMENT.] The attorney general may proceed 31.7 on behalf of the commissioner to enforce penalties that are due 31.8 and payable under this section in any manner provided by law for 31.9 the collection of debts. 31.10 Subd. 10. [TERMINATION OR NONRENEWAL OF REPORTING 31.11 ORGANIZATION.] The commissioner may withdraw or not renew 31.12 approval of any voluntary, nonprofit reporting organization for 31.13 failure on the part of the voluntary, nonprofit reporting 31.14 organization to pay penalties owed under this section. 31.15 Subd. 11. [CUMULATIVE REMEDY.] The authority of the 31.16 commissioner to issue an administrative penalty order is in 31.17 addition to other lawfully available remedies. 31.18 Subd. 12. [MEDIATION.] In addition to review under 31.19 subdivision 6, the commissioner is authorized to enter into 31.20 mediation concerning an order issued under this section if the 31.21 commissioner and the voluntary, nonprofit reporting organization 31.22 agree to mediation. 31.23 Sec. 15. Minnesota Statutes 1996, section 144A.44, 31.24 subdivision 2, is amended to read: 31.25 Subd. 2. [INTERPRETATION AND ENFORCEMENT OF RIGHTS.] These 31.26 rights are established for the benefit of persons who receive 31.27 home care services. "Home care services" means home care 31.28 services as defined in section 144A.43, subdivision 3. A home 31.29 care provider may not require a person to surrender these rights 31.30 as a condition of receiving services. A guardian or conservator 31.31 or, when there is no guardian or conservator, a designated 31.32 person, may seek to enforce these rights. This statement of 31.33 rights does not replace or diminish other rights and liberties 31.34 that may exist relative to persons receiving home care services, 31.35 persons providing home care services, or providers licensed 31.36 under Laws 1987, chapter 378. A copy of these rights must be 32.1 provided to an individual at the time home care services are 32.2 initiated. The copy shall also contain the address and phone 32.3 number of the office of health facility complaints and the 32.4 office of the ombudsman for older Minnesotans and a brief 32.5 statement describing how to file a complaint withthat office32.6 these offices. Information about how to contact the office of 32.7 the ombudsman for older Minnesotans shall be included in notices 32.8 of change in client fees and in notices from home care providers 32.9 transferring or discontinuing services. 32.10 Sec. 16. Minnesota Statutes 1996, section 214.03, is 32.11 amended to read: 32.12 214.03 [STANDARDIZED TESTS.] 32.13 (a) All state examining and licensing boards, other than 32.14 the state board of law examiners, the state board of 32.15 professional responsibility or any other board established by 32.16 the supreme court to regulate the practice of law and judicial 32.17 functions, shall use national standardized tests for the 32.18 objective, nonpractical portion of any examination given to 32.19 prospective licensees to the extent that such national 32.20 standardized tests are appropriate, except when the subject 32.21 matter of the examination relates to the application of 32.22 Minnesota law to the profession or calling being licensed. 32.23 (b) The health-related boards may establish an account in 32.24 the special revenue fund to deposit applicant payments for 32.25 national or regional standardized tests. Money in the account 32.26 is appropriated to pay for the use of national or regional 32.27 standardized tests. 32.28 Sec. 17. Minnesota Statutes 1997 Supplement, section 32.29 214.32, subdivision 1, is amended to read: 32.30 Subdivision 1. [MANAGEMENT.] (a) A health professionals 32.31 services program committee is established, consisting of one 32.32 person appointed by each participating board, with each 32.33 participating board having one vote. The committee shall 32.34 designate one board to provide administrative management of the 32.35 program, set the program budget and the pro rata share of 32.36 program expenses to be borne by each participating board, 33.1 provide guidance on the general operation of the program, 33.2 including hiring of program personnel, and ensure that the 33.3 program's direction is in accord with its authority. No more 33.4 than half plus one of the members of the committee may be of one 33.5 gender. If the participating boards change the board designated 33.6 to provide administrative management of the program, any 33.7 appropriation remaining for the program shall transfer to the 33.8 newly designated board. The boards must inform the chairs of 33.9 the senate health and family security budget division and the 33.10 house health and human services finance division, and the 33.11 commissioner of finance of any change in administrative 33.12 management of the program and of the amount transferred to the 33.13 newly designated board. 33.14 (b) The designated board, upon recommendation of the health 33.15 professional services program committee, shall hire the program 33.16 manager and employees and pay expenses of the program from funds 33.17 appropriated for that purpose. The designated board may apply 33.18 for grants to pay program expenses and may enter into contracts 33.19 on behalf of the program to carry out the purposes of the 33.20 program. The participating boards shall enter into written 33.21 agreements with the designated board. 33.22 (c) An advisory committee is established to advise the 33.23 program committee consisting of: 33.24 (1) one member appointed by each of the following: the 33.25 Minnesota Academy of Physician Assistants, the Minnesota Dental 33.26 Association, the Minnesota Chiropractic Association, the 33.27 Minnesota Licensed Practical Nurse Association, the Minnesota 33.28 Medical Association, the Minnesota Nurses Association, and the 33.29 Minnesota Podiatric Medicine Association; 33.30 (2) one member appointed by each of the professional 33.31 associations of the other professions regulated by a 33.32 participating board not specified in clause (1); and 33.33 (3) two public members, as defined by section 214.02. 33.34 Members of the advisory committee shall be appointed for two 33.35 years and members may be reappointed. 33.36 No more than half plus one of the members of the committee 34.1 may be of one gender. 34.2 The advisory committee expires June 30, 2001. 34.3 Sec. 18. [REPORT BY THE UNIVERSITY OF MINNESOTA ACADEMIC 34.4 HEALTH CENTER.] 34.5 The University of Minnesota academic health center, in 34.6 consultation with the health care community, is requested to 34.7 report to the commissioner of health and the legislative 34.8 commission on health care access by January 15, 1999, on plans 34.9 for the strategic direction and vision of the academic health 34.10 center. The report shall address plans for the ongoing 34.11 assessment of health provider workforce needs; plans for the 34.12 ongoing assessment of the educational needs of health 34.13 professionals and the implications for their education and 34.14 training programs; and plans for ongoing, meaningful input from 34.15 the health care community on health-related research and 34.16 education programs administered by the academic health center. 34.17 Sec. 19. [REPEALER.] 34.18 Minnesota Statutes 1997 Supplement, section 62J.685, is 34.19 repealed. 34.20 ARTICLE 3 34.21 LONG-TERM CARE 34.22 Section 1. Minnesota Statutes 1997 Supplement, section 34.23 144A.071, subdivision 4a, is amended to read: 34.24 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 34.25 best interest of the state to ensure that nursing homes and 34.26 boarding care homes continue to meet the physical plant 34.27 licensing and certification requirements by permitting certain 34.28 construction projects. Facilities should be maintained in 34.29 condition to satisfy the physical and emotional needs of 34.30 residents while allowing the state to maintain control over 34.31 nursing home expenditure growth. 34.32 The commissioner of health in coordination with the 34.33 commissioner of human services, may approve the renovation, 34.34 replacement, upgrading, or relocation of a nursing home or 34.35 boarding care home, under the following conditions: 34.36 (a) to license or certify beds in a new facility 35.1 constructed to replace a facility or to make repairs in an 35.2 existing facility that was destroyed or damaged after June 30, 35.3 1987, by fire, lightning, or other hazard provided: 35.4 (i) destruction was not caused by the intentional act of or 35.5 at the direction of a controlling person of the facility; 35.6 (ii) at the time the facility was destroyed or damaged the 35.7 controlling persons of the facility maintained insurance 35.8 coverage for the type of hazard that occurred in an amount that 35.9 a reasonable person would conclude was adequate; 35.10 (iii) the net proceeds from an insurance settlement for the 35.11 damages caused by the hazard are applied to the cost of the new 35.12 facility or repairs; 35.13 (iv) the new facility is constructed on the same site as 35.14 the destroyed facility or on another site subject to the 35.15 restrictions in section 144A.073, subdivision 5; 35.16 (v) the number of licensed and certified beds in the new 35.17 facility does not exceed the number of licensed and certified 35.18 beds in the destroyed facility; and 35.19 (vi) the commissioner determines that the replacement beds 35.20 are needed to prevent an inadequate supply of beds. 35.21 Project construction costs incurred for repairs authorized under 35.22 this clause shall not be considered in the dollar threshold 35.23 amount defined in subdivision 2; 35.24 (b) to license or certify beds that are moved from one 35.25 location to another within a nursing home facility, provided the 35.26 total costs of remodeling performed in conjunction with the 35.27 relocation of beds does not exceed $750,000; 35.28 (c) to license or certify beds in a project recommended for 35.29 approval under section 144A.073; 35.30 (d) to license or certify beds that are moved from an 35.31 existing state nursing home to a different state facility, 35.32 provided there is no net increase in the number of state nursing 35.33 home beds; 35.34 (e) to certify and license as nursing home beds boarding 35.35 care beds in a certified boarding care facility if the beds meet 35.36 the standards for nursing home licensure, or in a facility that 36.1 was granted an exception to the moratorium under section 36.2 144A.073, and if the cost of any remodeling of the facility does 36.3 not exceed $750,000. If boarding care beds are licensed as 36.4 nursing home beds, the number of boarding care beds in the 36.5 facility must not increase beyond the number remaining at the 36.6 time of the upgrade in licensure. The provisions contained in 36.7 section 144A.073 regarding the upgrading of the facilities do 36.8 not apply to facilities that satisfy these requirements; 36.9 (f) to license and certify up to 40 beds transferred from 36.10 an existing facility owned and operated by the Amherst H. Wilder 36.11 Foundation in the city of St. Paul to a new unit at the same 36.12 location as the existing facility that will serve persons with 36.13 Alzheimer's disease and other related disorders. The transfer 36.14 of beds may occur gradually or in stages, provided the total 36.15 number of beds transferred does not exceed 40. At the time of 36.16 licensure and certification of a bed or beds in the new unit, 36.17 the commissioner of health shall delicense and decertify the 36.18 same number of beds in the existing facility. As a condition of 36.19 receiving a license or certification under this clause, the 36.20 facility must make a written commitment to the commissioner of 36.21 human services that it will not seek to receive an increase in 36.22 its property-related payment rate as a result of the transfers 36.23 allowed under this paragraph; 36.24 (g) to license and certify nursing home beds to replace 36.25 currently licensed and certified boarding care beds which may be 36.26 located either in a remodeled or renovated boarding care or 36.27 nursing home facility or in a remodeled, renovated, newly 36.28 constructed, or replacement nursing home facility within the 36.29 identifiable complex of health care facilities in which the 36.30 currently licensed boarding care beds are presently located, 36.31 provided that the number of boarding care beds in the facility 36.32 or complex are decreased by the number to be licensed as nursing 36.33 home beds and further provided that, if the total costs of new 36.34 construction, replacement, remodeling, or renovation exceed ten 36.35 percent of the appraised value of the facility or $200,000, 36.36 whichever is less, the facility makes a written commitment to 37.1 the commissioner of human services that it will not seek to 37.2 receive an increase in its property-related payment rate by 37.3 reason of the new construction, replacement, remodeling, or 37.4 renovation. The provisions contained in section 144A.073 37.5 regarding the upgrading of facilities do not apply to facilities 37.6 that satisfy these requirements; 37.7 (h) to license as a nursing home and certify as a nursing 37.8 facility a facility that is licensed as a boarding care facility 37.9 but not certified under the medical assistance program, but only 37.10 if the commissioner of human services certifies to the 37.11 commissioner of health that licensing the facility as a nursing 37.12 home and certifying the facility as a nursing facility will 37.13 result in a net annual savings to the state general fund of 37.14 $200,000 or more; 37.15 (i) to certify, after September 30, 1992, and prior to July 37.16 1, 1993, existing nursing home beds in a facility that was 37.17 licensed and in operation prior to January 1, 1992; 37.18 (j) to license and certify new nursing home beds to replace 37.19 beds in a facilitycondemnedacquired by the Minneapolis 37.20 Community Development Agency as part ofan economic37.21 redevelopmentplanactivities in a city of the first class, 37.22 provided the new facility is located withinone milethree miles 37.23 of the site of the old facility. Operating and property costs 37.24 for the new facility must be determined and allowed 37.25 underexisting reimbursement rulessection 256B.431 or 256B.434; 37.26 (k) to license and certify up to 20 new nursing home beds 37.27 in a community-operated hospital and attached convalescent and 37.28 nursing care facility with 40 beds on April 21, 1991, that 37.29 suspended operation of the hospital in April 1986. The 37.30 commissioner of human services shall provide the facility with 37.31 the same per diem property-related payment rate for each 37.32 additional licensed and certified bed as it will receive for its 37.33 existing 40 beds; 37.34 (l) to license or certify beds in renovation, replacement, 37.35 or upgrading projects as defined in section 144A.073, 37.36 subdivision 1, so long as the cumulative total costs of the 38.1 facility's remodeling projects do not exceed $750,000; 38.2 (m) to license and certify beds that are moved from one 38.3 location to another for the purposes of converting up to five 38.4 four-bed wards to single or double occupancy rooms in a nursing 38.5 home that, as of January 1, 1993, was county-owned and had a 38.6 licensed capacity of 115 beds; 38.7 (n) to allow a facility that on April 16, 1993, was a 38.8 106-bed licensed and certified nursing facility located in 38.9 Minneapolis to layaway all of its licensed and certified nursing 38.10 home beds. These beds may be relicensed and recertified in a 38.11 newly-constructed teaching nursing home facility affiliated with 38.12 a teaching hospital upon approval by the legislature. The 38.13 proposal must be developed in consultation with the interagency 38.14 committee on long-term care planning. The beds on layaway 38.15 status shall have the same status as voluntarily delicensed and 38.16 decertified beds, except that beds on layaway status remain 38.17 subject to the surcharge in section 256.9657. This layaway 38.18 provision expires July 1, 1998; 38.19 (o) to allow a project which will be completed in 38.20 conjunction with an approved moratorium exception project for a 38.21 nursing home in southern Cass county and which is directly 38.22 related to that portion of the facility that must be repaired, 38.23 renovated, or replaced, to correct an emergency plumbing problem 38.24 for which a state correction order has been issued and which 38.25 must be corrected by August 31, 1993; 38.26 (p) to allow a facility that on April 16, 1993, was a 38.27 368-bed licensed and certified nursing facility located in 38.28 Minneapolis to layaway, upon 30 days prior written notice to the 38.29 commissioner, up to 30 of the facility's licensed and certified 38.30 beds by converting three-bed wards to single or double 38.31 occupancy. Beds on layaway status shall have the same status as 38.32 voluntarily delicensed and decertified beds except that beds on 38.33 layaway status remain subject to the surcharge in section 38.34 256.9657, remain subject to the license application and renewal 38.35 fees under section 144A.07 and shall be subject to a $100 per 38.36 bed reactivation fee. In addition, at any time within three 39.1 years of the effective date of the layaway, the beds on layaway 39.2 status may be: 39.3 (1) relicensed and recertified upon relocation and 39.4 reactivation of some or all of the beds to an existing licensed 39.5 and certified facility or facilities located in Pine River, 39.6 Brainerd, or International Falls; provided that the total 39.7 project construction costs related to the relocation of beds 39.8 from layaway status for any facility receiving relocated beds 39.9 may not exceed the dollar threshold provided in subdivision 2 39.10 unless the construction project has been approved through the 39.11 moratorium exception process under section 144A.073; 39.12 (2) relicensed and recertified, upon reactivation of some 39.13 or all of the beds within the facility which placed the beds in 39.14 layaway status, if the commissioner has determined a need for 39.15 the reactivation of the beds on layaway status. 39.16 The property-related payment rate of a facility placing 39.17 beds on layaway status must be adjusted by the incremental 39.18 change in its rental per diem after recalculating the rental per 39.19 diem as provided in section 256B.431, subdivision 3a, paragraph 39.20 (d). The property-related payment rate for a facility 39.21 relicensing and recertifying beds from layaway status must be 39.22 adjusted by the incremental change in its rental per diem after 39.23 recalculating its rental per diem using the number of beds after 39.24 the relicensing to establish the facility's capacity day 39.25 divisor, which shall be effective the first day of the month 39.26 following the month in which the relicensing and recertification 39.27 became effective. Any beds remaining on layaway status more 39.28 than three years after the date the layaway status became 39.29 effective must be removed from layaway status and immediately 39.30 delicensed and decertified; 39.31 (q) to license and certify beds in a renovation and 39.32 remodeling project to convert 12 four-bed wards into 24 two-bed 39.33 rooms, expand space, and add improvements in a nursing home 39.34 that, as of January 1, 1994, met the following conditions: the 39.35 nursing home was located in Ramsey county; had a licensed 39.36 capacity of 154 beds; and had been ranked among the top 15 40.1 applicants by the 1993 moratorium exceptions advisory review 40.2 panel. The total project construction cost estimate for this 40.3 project must not exceed the cost estimate submitted in 40.4 connection with the 1993 moratorium exception process; 40.5 (r) to license and certify up to 117 beds that are 40.6 relocated from a licensed and certified 138-bed nursing facility 40.7 located in St. Paul to a hospital with 130 licensed hospital 40.8 beds located in South St. Paul, provided that the nursing 40.9 facility and hospital are owned by the same or a related 40.10 organization and that prior to the date the relocation is 40.11 completed the hospital ceases operation of its inpatient 40.12 hospital services at that hospital. After relocation, the 40.13 nursing facility's status under section 256B.431, subdivision 40.14 2j, shall be the same as it was prior to relocation. The 40.15 nursing facility's property-related payment rate resulting from 40.16 the project authorized in this paragraph shall become effective 40.17 no earlier than April 1, 1996. For purposes of calculating the 40.18 incremental change in the facility's rental per diem resulting 40.19 from this project, the allowable appraised value of the nursing 40.20 facility portion of the existing health care facility physical 40.21 plant prior to the renovation and relocation may not exceed 40.22 $2,490,000; 40.23 (s) to license and certify two beds in a facility to 40.24 replace beds that were voluntarily delicensed and decertified on 40.25 June 28, 1991; 40.26 (t) to allow 16 licensed and certified beds located on July 40.27 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 40.28 facility in Minneapolis, notwithstanding the licensure and 40.29 certification after July 1, 1995, of the Minneapolis facility as 40.30 a 147-bed nursing home facility after completion of a 40.31 construction project approved in 1993 under section 144A.073, to 40.32 be laid away upon 30 days' prior written notice to the 40.33 commissioner. Beds on layaway status shall have the same status 40.34 as voluntarily delicensed or decertified beds except that they 40.35 shall remain subject to the surcharge in section 256.9657. The 40.36 16 beds on layaway status may be relicensed as nursing home beds 41.1 and recertified at any time within five years of the effective 41.2 date of the layaway upon relocation of some or all of the beds 41.3 to a licensed and certified facility located in Watertown, 41.4 provided that the total project construction costs related to 41.5 the relocation of beds from layaway status for the Watertown 41.6 facility may not exceed the dollar threshold provided in 41.7 subdivision 2 unless the construction project has been approved 41.8 through the moratorium exception process under section 144A.073. 41.9 The property-related payment rate of the facility placing 41.10 beds on layaway status must be adjusted by the incremental 41.11 change in its rental per diem after recalculating the rental per 41.12 diem as provided in section 256B.431, subdivision 3a, paragraph 41.13 (d). The property-related payment rate for the facility 41.14 relicensing and recertifying beds from layaway status must be 41.15 adjusted by the incremental change in its rental per diem after 41.16 recalculating its rental per diem using the number of beds after 41.17 the relicensing to establish the facility's capacity day 41.18 divisor, which shall be effective the first day of the month 41.19 following the month in which the relicensing and recertification 41.20 became effective. Any beds remaining on layaway status more 41.21 than five years after the date the layaway status became 41.22 effective must be removed from layaway status and immediately 41.23 delicensed and decertified; 41.24 (u) to license and certify beds that are moved within an 41.25 existing area of a facility or to a newly constructed addition 41.26 which is built for the purpose of eliminating three- and 41.27 four-bed rooms and adding space for dining, lounge areas, 41.28 bathing rooms, and ancillary service areas in a nursing home 41.29 that, as of January 1, 1995, was located in Fridley and had a 41.30 licensed capacity of 129 beds; 41.31 (v) to relocate 36 beds in Crow Wing county and four beds 41.32 from Hennepin county to a 160-bed facility in Crow Wing county, 41.33 provided all the affected beds are under common ownership; 41.34 (w) to license and certify a total replacement project of 41.35 up to 49 beds located in Norman county that are relocated from a 41.36 nursing home destroyed by flood and whose residents were 42.1 relocated to other nursing homes. The operating cost payment 42.2 rates for the new nursing facility shall be determined based on 42.3 the interim and settle-up payment provisions of Minnesota Rules, 42.4 part 9549.0057, and the reimbursement provisions of section 42.5 256B.431, except that subdivision 26, paragraphs (a) and (b), 42.6 shall not apply until the second rate year after the settle-up 42.7 cost report is filed. Property-related reimbursement rates 42.8 shall be determined under section 256B.431, taking into account 42.9 any federal or state flood-related loans or grants provided to 42.10 the facility; 42.11 (x) to license and certify a total replacement project of 42.12 up to 129 beds located in Polk county that are relocated from a 42.13 nursing home destroyed by flood and whose residents were 42.14 relocated to other nursing homes. The operating cost payment 42.15 rates for the new nursing facility shall be determined based on 42.16 the interim and settle-up payment provisions of Minnesota Rules, 42.17 part 9549.0057, and the reimbursement provisions of section 42.18 256B.431, except that subdivision 26, paragraphs (a) and (b), 42.19 shall not apply until the second rate year after the settle-up 42.20 cost report is filed. Property-related reimbursement rates 42.21 shall be determined under section 256B.431, taking into account 42.22 any federal or state flood-related loans or grants provided to 42.23 the facility;or42.24 (y) to license and certify beds in a renovation and 42.25 remodeling project to convert 13 three-bed wards into 13 two-bed 42.26 rooms and 13 single-bed rooms, expand space, and add 42.27 improvements in a nursing home that, as of January 1, 1994, met 42.28 the following conditions: the nursing home was located in 42.29 Ramsey county, was not owned by a hospital corporation, had a 42.30 licensed capacity of 64 beds, and had been ranked among the top 42.31 15 applicants by the 1993 moratorium exceptions advisory review 42.32 panel. The total project construction cost estimate for this 42.33 project must not exceed the cost estimate submitted in 42.34 connection with the 1993 moratorium exception process.; or 42.35 (z) to allow the commissioner of human services to license 42.36 an additional 36 beds to provide residential services for the 43.1 physically handicapped under Minnesota Rules, parts 9570.2000 to 43.2 9570.3400, in a 198-bed nursing home located in Red Wing, and to 43.3 allow the commissioner of health to license and certify nursing 43.4 home beds to replace a 74-bed nursing home in Waite Park 43.5 operated under common ownership with the Red Wing facility, 43.6 provided that the new facility is located within five miles of 43.7 the existing site in Waite Park. The commissioner of health may 43.8 license and certify an additional 20 beds at the new site 43.9 provided that the licensed capacity at the Red Wing site is 43.10 decreased by at least 30 beds. 43.11 Sec. 2. Minnesota Statutes 1996, section 144A.09, 43.12 subdivision 1, is amended to read: 43.13 Subdivision 1. [SPIRITUAL MEANS FOR HEALING.]No rule43.14establishedSections 144A.04, subdivision 5, and 144A.18 to 43.15 144A.27, and rules adopted under sections 144A.01 to 144A.16 43.16 other than a rule relating to sanitation and safety of premises, 43.17 to cleanliness of operation, or to physical equipmentshalldo 43.18 not apply to a nursing home conducted by and for the adherents 43.19 of any recognized church or religious denomination for the 43.20 purpose of providing care and treatment for those who select and 43.21 depend upon spiritual means through prayer alone, in lieu of 43.22 medical care, for healing. 43.23 Sec. 3. Minnesota Statutes 1997 Supplement, section 43.24 256B.431, subdivision 3f, is amended to read: 43.25 Subd. 3f. [PROPERTY COSTS AFTER JULY 1, 1988.] (a) 43.26 [INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 43.27 1988, the replacement-cost-new per bed limit must be $32,571 per 43.28 licensed bed in multiple bedrooms and $48,857 per licensed bed 43.29 in a single bedroom. For the rate year beginning July 1, 1989, 43.30 the replacement-cost-new per bed limit for a single bedroom must 43.31 be $49,907 adjusted according to Minnesota Rules, part 43.32 9549.0060, subpart 4, item A, subitem (1). Beginning January 1, 43.33 1990, the replacement-cost-new per bed limits must be adjusted 43.34 annually as specified in Minnesota Rules, part 9549.0060, 43.35 subpart 4, item A, subitem (1). Beginning January 1, 1991, the 43.36 replacement-cost-new per bed limits will be adjusted annually as 44.1 specified in Minnesota Rules, part 9549.0060, subpart 4, item A, 44.2 subitem (1), except that the index utilized will be the Bureau 44.3 of the Census: Composite fixed-weighted price index as 44.4 published in the C30 Report, Value of New Construction Put in 44.5 Place. 44.6 (b) [RENTAL FACTOR.] For the rate year beginning July 1, 44.7 1988, the commissioner shall increase the rental factor as 44.8 established in Minnesota Rules, part 9549.0060, subpart 8, item 44.9 A, by 6.2 percent rounded to the nearest 100th percent for the 44.10 purpose of reimbursing nursing facilities for soft costs and 44.11 entrepreneurial profits not included in the cost valuation 44.12 services used by the state's contracted appraisers. For rate 44.13 years beginning on or after July 1, 1989, the rental factor is 44.14 the amount determined under this paragraph for the rate year 44.15 beginning July 1, 1988. 44.16 (c) [OCCUPANCY FACTOR.] For rate years beginning on or 44.17 after July 1, 1988, in order to determine property-related 44.18 payment rates under Minnesota Rules, part 9549.0060, for all 44.19 nursing facilities except those whose average length of stay in 44.20 a skilled level of care within a nursing facility is 180 days or 44.21 less, the commissioner shall use 95 percent of capacity days. 44.22 For a nursing facility whose average length of stay in a skilled 44.23 level of care within a nursing facility is 180 days or less, the 44.24 commissioner shall use the greater of resident days or 80 44.25 percent of capacity days but in no event shall the divisor 44.26 exceed 95 percent of capacity days. 44.27 (d) [EQUIPMENT ALLOWANCE.] For rate years beginning on 44.28 July 1, 1988, and July 1, 1989, the commissioner shall add ten 44.29 cents per resident per day to each nursing facility's 44.30 property-related payment rate. The ten-cent property-related 44.31 payment rate increase is not cumulative from rate year to rate 44.32 year. For the rate year beginning July 1, 1990, the 44.33 commissioner shall increase each nursing facility's equipment 44.34 allowance as established in Minnesota Rules, part 9549.0060, 44.35 subpart 10, by ten cents per resident per day. For rate years 44.36 beginning on or after July 1, 1991, the adjusted equipment 45.1 allowance must be adjusted annually for inflation as in 45.2 Minnesota Rules, part 9549.0060, subpart 10, item E. For the 45.3 rate period beginning October 1, 1992, the equipment allowance 45.4 for each nursing facility shall be increased by 28 percent. For 45.5 rate years beginning after June 30, 1993, the allowance must be 45.6 adjusted annually for inflation. 45.7 (e) [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND 45.8 INTEREST EXPENSE.] For rate years beginning on or after July 1, 45.9 1990, Minnesota Rules, part 9549.0060, subpart 5, item E, shall 45.10 not apply to outstanding related organization debt incurred 45.11 prior to May 23, 1983, provided that the debt was an allowable 45.12 debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the 45.13 debt is subject to repayment through annual principal payments, 45.14 and the nursing facility demonstrates to the commissioner's 45.15 satisfaction that the interest rate on the debt was less than 45.16 market interest rates for similar arms-length transactions at 45.17 the time the debt was incurred. If the debt was incurred due to 45.18 a sale between family members, the nursing facility must also 45.19 demonstrate that the seller no longer participates in the 45.20 management or operation of the nursing facility. Debts meeting 45.21 the conditions of this paragraph are subject to all other 45.22 provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. 45.23 (f) [BUILDING CAPITAL ALLOWANCE FOR NURSING FACILITIES 45.24 WITH OPERATING LEASES.] For rate years beginning on or after 45.25 July 1, 1990, a nursing facility with operating lease costs 45.26 incurred for the nursing facility's buildings shall receive its 45.27 building capital allowance computed in accordance with Minnesota 45.28 Rules, part 9549.0060, subpart 8. If an operating lease 45.29 provides that the lessee's rent is adjusted to recognize 45.30 improvements made by the lessor and related debt, the costs for 45.31 capital improvements and related debt shall be allowed in the 45.32 computation of the lessee's building capital allowance, provided 45.33 that reimbursement for these costs under an operating lease 45.34 shall not exceed the rate otherwise paid. 45.35 Sec. 4. Minnesota Statutes 1996, section 256B.431, 45.36 subdivision 4, is amended to read: 46.1 Subd. 4. [SPECIAL RATES.] (a) For the rate years beginning 46.2 July 1, 1983, and July 1, 1984, a newly constructed nursing 46.3 facility or one with a capacity increase of 50 percent or more 46.4 may, upon written application to the commissioner, receive an 46.5 interim payment rate for reimbursement for property-related 46.6 costs calculated pursuant to the statutes and rules in effect on 46.7 May 1, 1983, and for operating costs negotiated by the 46.8 commissioner based upon the 60th percentile established for the 46.9 appropriate group under subdivision 2a, to be effective from the 46.10 first day a medical assistance recipient resides in the facility 46.11 or for the added beds. For newly constructed nursing facilities 46.12 which are not included in the calculation of the 60th percentile 46.13 for any group, subdivision 2f, the commissioner shall establish 46.14 by rule procedures for determining interim operating cost 46.15 payment rates and interim property-related cost payment rates. 46.16 The interim payment rate shall not be in effect for more than 17 46.17 months. The commissioner shall establish, by emergency and 46.18 permanent rules, procedures for determining the interim rate and 46.19 for making a retroactive cost settle-up after the first year of 46.20 operation; the cost settled operating cost per diem shall not 46.21 exceed 110 percent of the 60th percentile established for the 46.22 appropriate group. Until procedures determining operating cost 46.23 payment rates according to mix of resident needs are 46.24 established, the commissioner shall establish by rule procedures 46.25 for determining payment rates for nursing facilities which 46.26 provide care under a lesser care level than the level for which 46.27 the nursing facility is certified. 46.28 (b) For the rate years beginning on or after July 1, 1985, 46.29 a newly constructed nursing facility or one with a capacity 46.30 increase of 50 percent or more may, upon written application to 46.31 the commissioner, receive an interim payment rate for 46.32 reimbursement for property related costs, operating costs, and 46.33 real estate taxes and special assessments calculated under rules 46.34 promulgated by the commissioner. 46.35(c) For rate years beginning on or after July 1, 1983, the46.36commissioner may exclude from a provision of 12 MCAR S 2.050 any47.1facility that is licensed by the commissioner of health only as47.2a boarding care home, certified by the commissioner of health as47.3an intermediate care facility, is licensed by the commissioner47.4of human services under Minnesota Rules, parts 9520.0500 to47.59520.0690, and has less than five percent of its licensed47.6boarding care capacity reimbursed by the medical assistance47.7program. Until a permanent rule to establish the payment rates47.8for facilities meeting these criteria is promulgated, the47.9commissioner shall establish the medical assistance payment rate47.10as follows:47.11(1) The desk audited payment rate in effect on June 30,47.121983, remains in effect until the end of the facility's fiscal47.13year. The commissioner shall not allow any amendments to the47.14cost report on which this desk audited payment rate is based.47.15(2) For each fiscal year beginning between July 1, 1983,47.16and June 30, 1985, the facility's payment rate shall be47.17established by increasing the desk audited operating cost47.18payment rate determined in clause (1) at an annual rate of five47.19percent.47.20(3) For fiscal years beginning on or after July 1, 1985,47.21but before January 1, 1988, the facility's payment rate shall be47.22established by increasing the facility's payment rate in the47.23facility's prior fiscal year by the increase indicated by the47.24consumer price index for Minneapolis and St. Paul.47.25(4) For the fiscal year beginning on January 1, 1988, the47.26facility's payment rate must be established using the following47.27method: The commissioner shall divide the real estate taxes and47.28special assessments payable as stated in the facility's current47.29property tax statement by actual resident days to compute a real47.30estate tax and special assessment per diem. Next, the prior47.31year's payment rate must be adjusted by the higher of (1) the47.32percentage change in the consumer price index (CPI-U U.S. city47.33average) as published by the Bureau of Labor Statistics between47.34the previous two Septembers, new series index (1967-100), or (2)47.352.5 percent, to determine an adjusted payment rate. The47.36facility's payment rate is the adjusted prior year's payment48.1rate plus the real estate tax and special assessment per diem.48.2(5) For fiscal years beginning on or after January 1, 1989,48.3the facility's payment rate must be established using the48.4following method: The commissioner shall divide the real estate48.5taxes and special assessments payable as stated in the48.6facility's current property tax statement by actual resident48.7days to compute a real estate tax and special assessment per48.8diem. Next, the prior year's payment rate less the real estate48.9tax and special assessment per diem must be adjusted by the48.10higher of (1) the percentage change in the consumer price index48.11(CPI-U U.S. city average) as published by the Bureau of Labor48.12Statistics between the previous two Septembers, new series index48.13(1967-100), or (2) 2.5 percent, to determine an adjusted payment48.14rate. The facility's payment rate is the adjusted payment rate48.15plus the real estate tax and special assessment per diem.48.16(6) For the purpose of establishing payment rates under48.17this paragraph, the facility's rate and reporting years coincide48.18with the facility's fiscal year.48.19(d) A facility that meets the criteria of paragraph (c)48.20shall submit annual cost reports on forms prescribed by the48.21commissioner.48.22(e)(c) For the rate year beginning July 1, 1985, each 48.23 nursing facility total payment rate must be effective two 48.24 calendar months from the first day of the month after the 48.25 commissioner issues the rate notice to the nursing facility. 48.26 From July 1, 1985, until the total payment rate becomes 48.27 effective, the commissioner shall make payments to each nursing 48.28 facility at a temporary rate that is the prior rate year's 48.29 operating cost payment rate increased by 2.6 percent plus the 48.30 prior rate year's property-related payment rate and the prior 48.31 rate year's real estate taxes and special assessments payment 48.32 rate. The commissioner shall retroactively adjust the 48.33 property-related payment rate and the real estate taxes and 48.34 special assessments payment rate to July 1, 1985, but must not 48.35 retroactively adjust the operating cost payment rate. 48.36(f)(d) For the purposes of Minnesota Rules, part 49.1 9549.0060, subpart 13, item F, the following types of 49.2 transactions shall not be considered a sale or reorganization of 49.3 a provider entity: 49.4 (1) the sale or transfer of a nursing facility upon death 49.5 of an owner; 49.6 (2) the sale or transfer of a nursing facility due to 49.7 serious illness or disability of an owner as defined under the 49.8 social security act; 49.9 (3) the sale or transfer of the nursing facility upon 49.10 retirement of an owner at 62 years of age or older; 49.11 (4) any transaction in which a partner, owner, or 49.12 shareholder acquires an interest or share of another partner, 49.13 owner, or shareholder in a nursing facility business provided 49.14 the acquiring partner, owner, or shareholder has less than 50 49.15 percent ownership after the acquisition; 49.16 (5) a sale and leaseback to the same licensee which does 49.17 not constitute a change in facility license; 49.18 (6) a transfer of an interest to a trust; 49.19 (7) gifts or other transfers for no consideration; 49.20 (8) a merger of two or more related organizations; 49.21 (9) a transfer of interest in a facility held in 49.22 receivership; 49.23 (10) a change in the legal form of doing business other 49.24 than a publicly held organization which becomes privately held 49.25 or vice versa; 49.26 (11) the addition of a new partner, owner, or shareholder 49.27 who owns less than 20 percent of the nursing facility or the 49.28 issuance of stock; or 49.29 (12) an involuntary transfer including foreclosure, 49.30 bankruptcy, or assignment for the benefit of creditors. 49.31 Any increase in allowable debt or allowable interest 49.32 expense or other cost incurred as a result of the foregoing 49.33 transactions shall be a nonallowable cost for purposes of 49.34 reimbursement under Minnesota Rules, parts 9549.0010 to 49.35 9549.0080. 49.36 Sec. 5. Minnesota Statutes 1996, section 256B.431, 50.1 subdivision 11, is amended to read: 50.2 Subd. 11. [SPECIAL PROPERTY RATE SETTING PROCEDURES FOR 50.3 CERTAIN NURSING FACILITIES.] (a) Notwithstanding Minnesota 50.4 Rules, part 9549.0060, subpart 13, item H, to the contrary, for 50.5 the rate year beginning July 1, 1990, a nursing facility leased 50.6 prior to January 1, 1986, and currently subject to adverse 50.7 licensure action under section 144A.04, subdivision 4, paragraph 50.8 (a), or section 144A.11, subdivision 2, and whose ownership 50.9 changes prior to July 1, 1990, shall be allowed a 50.10 property-related payment equal to the lesser of its current 50.11 lease obligation divided by its capacity days as determined in 50.12 Minnesota Rules, part 9549.0060, subpart 11, as modified by 50.13 subdivision 3f, paragraph (c), or the frozen property-related 50.14 payment rate in effect for the rate year beginning July 1, 50.15 1989. For rate years beginning on or after July 1, 1991, the 50.16 property-related payment rate shall be its rental rate computed 50.17 using the previous owner's allowable principal and interest 50.18 expense as allowed by the department prior to that prior owner's 50.19 sale and lease-back transaction of December 1985. 50.20 (b) Notwithstanding other provisions of applicable law, a 50.21 nursing facility licensed for 122 beds on January 1, 1998, and 50.22 located in Columbia Heights shall have its property-related 50.23 payment rate set under this subdivision. The commissioner shall 50.24 make a rate adjustment by adding $2.41 to the facility's July 1, 50.25 1997, property-related payment rate. The adjusted 50.26 property-related payment rate shall be effective for rate years 50.27 beginning on or after July 1, 1998. The adjustment in this 50.28 paragraph shall remain in effect as long as the facility's rates 50.29 are set under this section. If the facility participates in the 50.30 alternative payment system under section 256B.434, the 50.31 adjustment in this paragraph shall be included in the facility's 50.32 contract payment rate. If historical rates or property costs 50.33 recognized under this section become the basis for future 50.34 medical assistance payments to the facility under a managed 50.35 care, capitation, or other alternative payment system, the 50.36 adjustment in this paragraph shall be included in the 51.1 computation of the facility's payments. 51.2 Sec. 6. Minnesota Statutes 1996, section 256B.431, 51.3 subdivision 22, is amended to read: 51.4 Subd. 22. [CHANGES TO NURSING FACILITY REIMBURSEMENT.] The 51.5 nursing facility reimbursement changes in paragraphs (a) to (e) 51.6 apply to Minnesota Rules, parts 9549.0010 to 9549.0080, and this 51.7 section, and are effective for rate years beginning on or after 51.8 July 1, 1993, unless otherwise indicated. 51.9 (a) In addition to the approved pension or profit sharing 51.10 plans allowed by the reimbursement rule, the commissioner shall 51.11 allow those plans specified in Internal Revenue Code, sections 51.12 403(b) and 408(k). 51.13 (b) The commissioner shall allow as workers' compensation 51.14 insurance costs under section 256B.421, subdivision 14, the 51.15 costs of workers' compensation coverage obtained under the 51.16 following conditions: 51.17 (1) a plan approved by the commissioner of commerce as a 51.18 Minnesota group or individual self-insurance plan as provided in 51.19 section 79A.03; 51.20 (2) a plan in which: 51.21 (i) the nursing facility, directly or indirectly, purchases 51.22 workers' compensation coverage in compliance with section 51.23 176.181, subdivision 2, from an authorized insurance carrier; 51.24 (ii) a related organization to the nursing facility 51.25 reinsures the workers' compensation coverage purchased, directly 51.26 or indirectly, by the nursing facility; and 51.27 (iii) all of the conditions in clause (4) are met; 51.28 (3) a plan in which: 51.29 (i) the nursing facility, directly or indirectly, purchases 51.30 workers' compensation coverage in compliance with section 51.31 176.181, subdivision 2, from an authorized insurance carrier; 51.32 (ii) the insurance premium is calculated retrospectively, 51.33 including a maximum premium limit, and paid using the paid loss 51.34 retro method; and 51.35 (iii) all of the conditions in clause (4) are met; 51.36 (4) additional conditions are: 52.1 (i) the costs of the plan are allowable under the federal 52.2 Medicare program; 52.3 (ii) the reserves for the plan are maintained in an account 52.4 controlled and administered by a person which is not a related 52.5 organization to the nursing facility; 52.6 (iii) the reserves for the plan cannot be used, directly or 52.7 indirectly, as collateral for debts incurred or other 52.8 obligations of the nursing facility or related organizations to 52.9 the nursing facility; 52.10 (iv) if the plan provides workers' compensation coverage 52.11 for non-Minnesota nursing facilities, the plan's cost 52.12 methodology must be consistent among all nursing facilities 52.13 covered by the plan, and if reasonable, is allowed 52.14 notwithstanding any reimbursement laws regarding cost allocation 52.15 to the contrary; 52.16 (v) central, affiliated, corporate, or nursing facility 52.17 costs related to their administration of the plan are costs 52.18 which must remain in the nursing facility's administrative cost 52.19 category and must not be allocated to other cost categories;and52.20 (vi) required security deposits, whether in the form of 52.21 cash, investments, securities, assets, letters of credit, or in 52.22 any other form are not allowable costs for purposes of 52.23 establishing the facilities payment rate.; and 52.24 (vii) for rate years beginning on or after July 1, 1998, a 52.25 group of nursing facilities related by common ownership that 52.26 self-insures workers' compensation may allocate its directly 52.27 identified costs of self-insuring its Minnesota nursing facility 52.28 workers among those nursing facilities in the group that are 52.29 reimbursed under this section or section 256B.434. The method 52.30 of cost allocation shall be based on each nursing facility's 52.31 total allowable salaries and wages to that of the nursing 52.32 facility group's total allowable salaries and wages, then 52.33 similarly allocated within each nursing facility's operating 52.34 cost categories. The costs associated with the administration 52.35 of the group's self-insurance plan must remain classified in the 52.36 nursing facility's administrative cost category. A written 53.1 request of the nursing facility group's election to use this 53.2 alternate method of allocation of self-insurance costs must be 53.3 received by the commissioner no later than May 1, 1998, to take 53.4 effect July 1, 1998, or no later than December 31 of any year to 53.5 take effect the following rate year, or such costs shall 53.6 continue to be allocated under the existing cost allocation 53.7 methods. Once a nursing facility group elects this method of 53.8 cost allocation for its workers' compensation self-insurance 53.9 costs, it shall remain in effect until such time as the group no 53.10 longer self-insures these costs; 53.11 (5) any costs allowed pursuant to clauses (1) to (3) are 53.12 subject to the following requirements: 53.13 (i) if the nursing facility is sold or otherwise ceases 53.14 operations, the plan's reserves must be subject to an 53.15 actuarially based settle-up after 36 months from the date of 53.16 sale or the date on which operations ceased. The facility's 53.17 medical assistance portion of the total excess plan reserves 53.18 must be paid to the state within 30 days following the date on 53.19 which excess plan reserves are determined; 53.20 (ii) any distribution of excess plan reserves made to or 53.21 withdrawals made by the nursing facility or a related 53.22 organization are applicable credits and must be used to reduce 53.23 the nursing facility's workers' compensation insurance costs in 53.24 the reporting period in which a distribution or withdrawal is 53.25 received; 53.26 (iii) if reimbursement for the plan is sought under the 53.27 federal Medicare program, and is audited pursuant to the 53.28 Medicare program, the nursing facility must provide a copy of 53.29 Medicare's final audit report, including attachments and 53.30 exhibits, to the commissioner within 30 days of receipt by the 53.31 nursing facility or any related organization. The commissioner 53.32 shall implement the audit findings associated with the plan upon 53.33 receipt of Medicare's final audit report. The department's 53.34 authority to implement the audit findings is independent of its 53.35 authority to conduct a field audit. 53.36 (c) In the determination of incremental increases in the 54.1 nursing facility's rental rate as required in subdivisions 14 to 54.2 21, except for a refinancing permitted under subdivision 19, the 54.3 commissioner must adjust the nursing facility's property-related 54.4 payment rate for both incremental increases and decreases in 54.5 recomputations of its rental rate; 54.6 (d) A nursing facility's administrative cost limitation 54.7 must be modified as follows: 54.8 (1) if the nursing facility's licensed beds exceed 195 54.9 licensed beds, the general and administrative cost category 54.10 limitation shall be 13 percent; 54.11 (2) if the nursing facility's licensed beds are more than 54.12 150 licensed beds, but less than 196 licensed beds, the general 54.13 and administrative cost category limitation shall be 14 percent; 54.14 or 54.15 (3) if the nursing facility's licensed beds is less than 54.16 151 licensed beds, the general and administrative cost category 54.17 limitation shall remain at 15 percent. 54.18 (e) The care related operating rate shall be increased by 54.19 eight cents to reimburse facilities for unfunded federal 54.20 mandates, including costs related to hepatitis B vaccinations. 54.21 (f) For rate years beginning on or after July 1, 1998, a 54.22 group of nursing facilities related by common ownership that 54.23 self-insures group health, dental, or life insurance may 54.24 allocate its directly identified costs of self-insuring its 54.25 Minnesota nursing facility workers among those nursing 54.26 facilities in the group that are reimbursed under this section 54.27 or section 256B.434. The method of cost allocation shall be 54.28 based on each nursing facility's total allowable salaries and 54.29 wages to that of the nursing facility group's total allowable 54.30 salaries and wages, then similarly allocated within each nursing 54.31 facility's operating cost categories. The costs associated with 54.32 the administration of the group's self-insurance plan must 54.33 remain classified in the nursing facility's administrative cost 54.34 category. A written request of the nursing facility group's 54.35 election to use this alternate method of allocation of 54.36 self-insurance costs must be received by the commissioner no 55.1 later than May 1, 1998, to take effect July 1, 1998, or no later 55.2 than December 31 of any year to take effect the following rate 55.3 year, or those self-insurance costs shall continue to be 55.4 allocated under the existing cost allocation methods. Once a 55.5 nursing facility group elects this method of cost allocation for 55.6 its group health, dental, or life insurance self-insurance 55.7 costs, it shall remain in effect until such time as the group no 55.8 longer self-insures these costs. 55.9 Sec. 7. Minnesota Statutes 1997 Supplement, section 55.10 256B.431, subdivision 26, is amended to read: 55.11 Subd. 26. [CHANGES TO NURSING FACILITY REIMBURSEMENT 55.12 BEGINNING JULY 1, 1997.] The nursing facility reimbursement 55.13 changes in paragraphs (a) to (f) shall apply in the sequence 55.14 specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 55.15 this section, beginning July 1, 1997. 55.16 (a) For rate years beginning on or after July 1, 1997, the 55.17 commissioner shall limit a nursing facility's allowable 55.18 operating per diem for each case mix category for each rate year. 55.19 The commissioner shall group nursing facilities into two groups, 55.20 freestanding and nonfreestanding, within each geographic group, 55.21 using their operating cost per diem for the case mix A 55.22 classification. A nonfreestanding nursing facility is a nursing 55.23 facility whose other operating cost per diem is subject to the 55.24 hospital attached, short length of stay, or the rule 80 limits. 55.25 All other nursing facilities shall be considered freestanding 55.26 nursing facilities. The commissioner shall then array all 55.27 nursing facilities in each grouping by their allowable case mix 55.28 A operating cost per diem. In calculating a nursing facility's 55.29 operating cost per diem for this purpose, the commissioner shall 55.30 exclude the raw food cost per diem related to providing special 55.31 diets that are based on religious beliefs, as determined in 55.32 subdivision 2b, paragraph (h). For those nursing facilities in 55.33 each grouping whose case mix A operating cost per diem: 55.34 (1) is at or below the median of the array, the 55.35 commissioner shall limit the nursing facility's allowable 55.36 operating cost per diem for each case mix category to the lesser 56.1 of the prior reporting year's allowable operating cost per diem 56.2 as specified in Laws 1996, chapter 451, article 3, section 11, 56.3 paragraph (h), plus the inflation factor as established in 56.4 paragraph (d), clause (2), increased by two percentage points, 56.5 or the current reporting year's corresponding allowable 56.6 operating cost per diem; or 56.7 (2) is above the median of the array, the commissioner 56.8 shall limit the nursing facility's allowable operating cost per 56.9 diem for each case mix category to the lesser of the prior 56.10 reporting year's allowable operating cost per diem as specified 56.11 in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 56.12 plus the inflation factor as established in paragraph (d), 56.13 clause (2), increased by one percentage point, or the current 56.14 reporting year's corresponding allowable operating cost per diem. 56.15 For rate years beginning on or after July 1, 1999, if a 56.16 facility reports a reduction in costs because of a credit or 56.17 refund received based on costs from prior reporting years, the 56.18 limit shall be increased in the second rate year following that 56.19 reporting year by the amount of the reduction divided by the 56.20 resident days used to compute the rate of the second following 56.21 rate year. 56.22 (b) For rate years beginning on or after July 1, 1997, the 56.23 commissioner shall limit the allowable operating cost per diem 56.24 for high cost nursing facilities. After application of the 56.25 limits in paragraph (a) to each nursing facility's operating 56.26 cost per diem, the commissioner shall group nursing facilities 56.27 into two groups, freestanding or nonfreestanding, within each 56.28 geographic group. A nonfreestanding nursing facility is a 56.29 nursing facility whose other operating cost per diem are subject 56.30 to hospital attached, short length of stay, or rule 80 limits. 56.31 All other nursing facilities shall be considered freestanding 56.32 nursing facilities. The commissioner shall then array all 56.33 nursing facilities within each grouping by their allowable case 56.34 mix A operating cost per diem. In calculating a nursing 56.35 facility's operating cost per diem for this purpose, the 56.36 commissioner shall exclude the raw food cost per diem related to 57.1 providing special diets that are based on religious beliefs, as 57.2 determined in subdivision 2b, paragraph (h). For those nursing 57.3 facilities in each grouping whose case mix A operating cost per 57.4 diem exceeds 1.0 standard deviation above the median, the 57.5 commissioner shall reduce their allowable operating cost per 57.6 diem by three percent. For those nursing facilities in each 57.7 grouping whose case mix A operating cost per diem exceeds 0.5 57.8 standard deviation above the median but is less than or equal to 57.9 1.0 standard deviation above the median, the commissioner shall 57.10 reduce their allowable operating cost per diem by two percent. 57.11 However, in no case shall a nursing facility's operating cost 57.12 per diem be reduced below its grouping's limit established at 57.13 0.5 standard deviations above the median. 57.14 (c) For rate years beginning on or after July 1, 1997, the 57.15 commissioner shall determine a nursing facility's efficiency 57.16 incentive by first computing the allowable difference, which is 57.17 the lesser of $4.50 or the amount by which the facility's other 57.18 operating cost limit exceeds its nonadjusted other operating 57.19 cost per diem for that rate year. The commissioner shall 57.20 compute the efficiency incentive by: 57.21 (1) subtracting the allowable difference from $4.50 and 57.22 dividing the result by $4.50; 57.23 (2) multiplying 0.20 by the ratio resulting from clause 57.24 (1), and then; 57.25 (3) adding 0.50 to the result from clause (2); and 57.26 (4) multiplying the result from clause (3) times the 57.27 allowable difference. 57.28 The nursing facility's efficiency incentive payment shall 57.29 be the lesser of $2.25 or the product obtained in clause (4). 57.30 (d) For rate years beginning on or after July 1, 1997, the 57.31 forecasted price index for a nursing facility's allowable 57.32 operating cost per diem shall be determined under clauses (1) 57.33 and (2) using the change in the Consumer Price Index-All Items 57.34 (United States city average) (CPI-U) as forecasted by Data 57.35 Resources, Inc. The commissioner shall use the indices as 57.36 forecasted in the fourth quarter of the calendar year preceding 58.1 the rate year, subject to subdivision 2l, paragraph (c). 58.2 (1) The CPI-U forecasted index for allowable operating cost 58.3 per diem shall be based on the 21-month period from the midpoint 58.4 of the nursing facility's reporting year to the midpoint of the 58.5 rate year following the reporting year. 58.6 (2) For rate years beginning on or after July 1, 1997, the 58.7 forecasted index for operating cost limits referred to in 58.8 subdivision 21, paragraph (b), shall be based on the CPI-U for 58.9 the 12-month period between the midpoints of the two reporting 58.10 years preceding the rate year. 58.11 (e) After applying these provisions for the respective rate 58.12 years, the commissioner shall index these allowable operating 58.13 cost per diem by the inflation factor provided for in paragraph 58.14 (d), clause (1), and add the nursing facility's efficiency 58.15 incentive as computed in paragraph (c). 58.16 (f) For rate years beginning on or after July 1, 1997, the 58.17 total operating cost payment rates for a nursing facility shall 58.18 be the greater of the total operating cost payment rates 58.19 determined under this section or the total operating cost 58.20 payment rates in effect on June 30, 1997, subject to rate 58.21 adjustments due to field audit or rate appeal resolution. This 58.22 provision shall not apply to subsequent field audit adjustments 58.23 of the nursing facility's operating cost rates for rate years 58.24 beginning on or after July 1, 1997. 58.25 (g) For the rate years beginning on July 1, 1997,andJuly 58.26 1, 1998, and July 1, 1999, a nursing facility licensed for 40 58.27 beds effective May 1, 1992, with a subsequent increase of 20 58.28 Medicare/Medicaid certified beds, effective January 26, 1993, in 58.29 accordance with an increase in licensure is exempt from 58.30 paragraphs (a) and (b). 58.31 (h) For a nursing facility whose construction project was 58.32 authorized according to section 144A.073, subdivision 5, 58.33 paragraph (g), the operating cost payment rates for the third 58.34 location shall be determined based on Minnesota Rules, part 58.35 9549.0057. Paragraphs (a) and (b) shall not apply until the 58.36 second rate year after the settle-up cost report is filed. 59.1 Notwithstanding subdivision 2b, paragraph (g), real estate taxes 59.2 and special assessments payable by the third location, a 59.3 501(c)(3) nonprofit corporation, shall be included in the 59.4 payment rates determined under this subdivision for all 59.5 subsequent rate years. 59.6 (i) For the rate year beginning July 1, 1997, the 59.7 commissioner shall compute the payment rate for a nursing 59.8 facility licensed for 94 beds on September 30, 1996, that 59.9 applied in October 1993 for approval of a total replacement 59.10 under the moratorium exception process in section 144A.073, and 59.11 completed the approved replacement in June 1995, with other 59.12 operating cost spend-up limit under paragraph (a), increased by 59.13 $3.98, and after computing the facility's payment rate according 59.14 to this section, the commissioner shall make a one-year positive 59.15 rate adjustment of $3.19 for operating costs related to the 59.16 newly constructed total replacement, without application of 59.17 paragraphs (a) and (b). The facility's per diem, before the 59.18 $3.19 adjustment, shall be used as the prior reporting year's 59.19 allowable operating cost per diem for payment rate calculation 59.20 for the rate year beginning July 1, 1998. A facility described 59.21 in this paragraph is exempt from paragraph (b) for the rate 59.22 years beginning July 1, 1997, and July 1, 1998. 59.23 (j) For the purpose of applying the limit stated in 59.24 paragraph (a), a nursing facility in Kandiyohi county licensed 59.25 for 86 beds that was granted hospital-attached status on 59.26 December 1, 1994, shall have the prior year's allowable 59.27 care-related per diem increased by $3.207 and the prior year's 59.28 other operating cost per diem increased by $4.777 before adding 59.29 the inflation in paragraph (d), clause (2), for the rate year 59.30 beginning on July 1, 1997. 59.31 (k) For the purpose of applying the limit stated in 59.32 paragraph (a), a 117 bed nursing facility located in Pine county 59.33 shall have the prior year's allowable other operating cost per 59.34 diem increased by $1.50 before adding the inflation in paragraph 59.35 (d), clause (2), for the rate year beginning on July 1, 1997. 59.36 (l) For the purpose of applying the limit under paragraph 60.1 (a), a nursing facility in Hibbing licensed for 192 beds shall 60.2 have the prior year's allowable other operating cost per diem 60.3 increased by $2.67 before adding the inflation in paragraph (d), 60.4 clause (2), for the rate year beginning July 1, 1997. 60.5 (m) For the rate year beginning July 1, 1997, a nursing 60.6 facility in Canby, Minnesota, licensed for 75 beds shall be 60.7 reimbursed without the limitation imposed under paragraph (a), 60.8 and for rate years beginning on or after July 1, 1998, its base 60.9 costs shall be calculated on the basis of its September 30, 60.10 1997, cost report. 60.11 Sec. 8. Minnesota Statutes 1996, section 256B.431, is 60.12 amended by adding a subdivision to read: 60.13 Subd. 27. [CHANGES TO NURSING FACILITY REIMBURSEMENT 60.14 BEGINNING JULY 1, 1998.] (a) For the purpose of applying the 60.15 limit stated in subdivision 26, paragraph (a), a nursing 60.16 facility in Hennepin county licensed for 181 beds on September 60.17 30, 1996, shall have the prior year's allowable care-related per 60.18 diem increased by $1.455 and the prior year's other operating 60.19 cost per diem increased by $0.439 before adding the inflation in 60.20 subdivision 26, paragraph (d), clause (2), for the rate year 60.21 beginning on July 1, 1998. 60.22 (b) For the purpose of applying the limit stated in 60.23 subdivision 26, paragraph (a), a nursing facility in Hennepin 60.24 county licensed for 161 beds on September 30, 1996, shall have 60.25 the prior year's allowable care-related per diem increased by 60.26 $1.154 and the prior year's other operating cost per diem 60.27 increased by $0.256 before adding the inflation in subdivision 60.28 26, paragraph (d), clause (2), for the rate year beginning on 60.29 July 1, 1998. 60.30 (c) For the purpose of applying the limit stated in 60.31 subdivision 26, paragraph (a), a nursing facility in Ramsey 60.32 county licensed for 176 beds on September 30, 1996, shall have 60.33 the prior year's allowable care-related per diem increased by 60.34 $0.803 and the prior year's other operating cost per diem 60.35 increased by $0.272 before adding the inflation in subdivision 60.36 26, paragraph (d), clause (2), for the rate year beginning on 61.1 July 1, 1998. 61.2 (d) For the purpose of applying the limit stated in 61.3 subdivision 26, paragraph (a), a nursing facility in Brown 61.4 county licensed for 86 beds on September 30, 1996, shall have 61.5 the prior year's allowable care-related per diem increased by 61.6 $0.850 and the prior year's other operating cost per diem 61.7 increased by $0.275 before adding the inflation in subdivision 61.8 26, paragraph (d), clause (2), for the rate year beginning on 61.9 July 1, 1998. 61.10 (e) For the rate year beginning July 1, 1998, the 61.11 commissioner shall compute the payment rate for a nursing 61.12 facility, which was licensed for 110 beds on September 8, 1996, 61.13 was granted approval in January 1994 for a replacement and 61.14 remodeling project under the moratorium exception process in 61.15 section 144A.073, and completed the approved replacement and 61.16 remodeling project in April 1997, by computing the facility's 61.17 payment rate for the rate year beginning July 1, 1998, according 61.18 to this section, and then making a one-year positive rate 61.19 adjustment of 48 cents for increased real estate taxes resulting 61.20 from completion of the moratorium exception project, without 61.21 application of subdivision 26, paragraphs (a) and (b). 61.22 (f) For the rate year beginning July 1, 1998, the 61.23 commissioner shall compute the payment rate for a nursing 61.24 facility exempted from care-related limits under subdivision 2b, 61.25 paragraph (d), clause (2), with a minimum of three-quarters of 61.26 its beds licensed to provide residential services for the 61.27 physically handicapped under Minnesota Rules, parts 9570.2000 to 61.28 9570.3400, with the care-related spend-up limit under 61.29 subdivision 26, paragraph (a), increased by $13.21 for the rate 61.30 year beginning July 1, 1998, without application of subdivision 61.31 26, paragraph (b). For rate years beginning on or after July 1, 61.32 1999, the commissioner shall exclude that amount in calculating 61.33 the facility's operating cost per diem for purposes of applying 61.34 subdivision 26, paragraph (b). 61.35 (g) The nursing facility reimbursement changes in 61.36 paragraphs (h) and (i) shall apply in the sequence specified in 62.1 this section and Minnesota Rules, parts 9549.0010 to 9549.0080, 62.2 beginning July 1, 1998. 62.3 (h) For rate years beginning on or after July 1, 1998, the 62.4 operating cost limits established in subdivisions 2, 2b, 2i, 3c, 62.5 and 22, paragraph (d), and any previously effective 62.6 corresponding limits in law or rule shall not apply, except that 62.7 these cost limits shall still be calculated for purposes of 62.8 determining efficiency incentive per diems. For rate years 62.9 beginning on or after July 1, 1998, the total operating cost 62.10 payment rates for a nursing facility shall be the greater of the 62.11 total operating cost payment rates determined under this section 62.12 or the total operating cost payment rates in effect on June 30, 62.13 1998, subject to rate adjustments due to field audit or rate 62.14 appeal resolution. 62.15 (i) For rate years beginning on or after July 1, 1998, the 62.16 operating cost per diem referred to in subdivision 26, paragraph 62.17 (a), clauses (1) and (2), is the sum of the care-related and 62.18 other operating per diems for a given case mix class. Any 62.19 reductions to the combined operating per diem shall be divided 62.20 proportionately between the care-related and other operating per 62.21 diems. 62.22 Sec. 9. Minnesota Statutes 1997 Supplement, section 62.23 256B.433, subdivision 3a, is amended to read: 62.24 Subd. 3a. [EXEMPTION FROM REQUIREMENT FOR SEPARATE THERAPY 62.25 BILLING.] The provisions of subdivision 3 do not apply to 62.26 nursing facilities that are reimbursed according to the 62.27 provisions of section 256B.431 and are located in a county 62.28 participating in the prepaid medical assistance 62.29 program. Nursing facilities that are reimbursed according to 62.30 the provisions of section 256B.434 and are located in a county 62.31 participating in the prepaid medical assistance program are 62.32 exempt from the maximum therapy rent revenue provisions of 62.33 subdivision 3, paragraph (c). 62.34 Sec. 10. Minnesota Statutes 1997 Supplement, section 62.35 256B.434, subdivision 10, is amended to read: 62.36 Subd. 10. [EXEMPTIONS.] (a) To the extent permitted by 63.1 federal law, (1) a facility that has entered into a contract 63.2 under this section is not required to file a cost report, as 63.3 defined in Minnesota Rules, part 9549.0020, subpart 13, for any 63.4 year after the base year that is the basis for the calculation 63.5 of the contract payment rate for the first rate year of the 63.6 alternative payment demonstration project contract; and (2) a 63.7 facility under contract is not subject to audits of historical 63.8 costs or revenues, or paybacks or retroactive adjustments based 63.9 on these costs or revenues, except audits, paybacks, or 63.10 adjustments relating to the cost report that is the basis for 63.11 calculation of the first rate year under the contract. 63.12 (b) A facility that is under contract with the commissioner 63.13 under this section is not subject to the moratorium on licensure 63.14 or certification of new nursing home beds in section 144A.071, 63.15 unless the project results in a net increase in bed capacity or 63.16 involves relocation of beds from one site to another. Contract 63.17 payment rates must not be adjusted to reflect any additional 63.18 costs that a nursing facility incurs as a result of a 63.19 construction project undertaken under this paragraph. In 63.20 addition, as a condition of entering into a contract under this 63.21 section, a nursing facility must agree that any future medical 63.22 assistance payments for nursing facility services will not 63.23 reflect any additional costs attributable to the sale of a 63.24 nursing facility under this section and to construction 63.25 undertaken under this paragraph that otherwise would not be 63.26 authorized under the moratorium in section 144A.073. Nothing in 63.27 this section prevents a nursing facility participating in the 63.28 alternative payment demonstration project under this section 63.29 from seeking approval of an exception to the moratorium through 63.30 the process established in section 144A.073, and if approved the 63.31 facility's rates shall be adjusted to reflect the cost of the 63.32 project. Nothing in this section prevents a nursing facility 63.33 participating in the alternative payment demonstration project 63.34 from seeking legislative approval of an exception to the 63.35 moratorium under section 144A.071, and, if enacted, the 63.36 facility's rates shall be adjusted to reflect the cost of the 64.1 project. 64.2 (c) Notwithstanding section 256B.48, subdivision 6, 64.3 paragraphs (c), (d), and (e), and pursuant to any terms and 64.4 conditions contained in the facility's contract, a nursing 64.5 facility that is under contract with the commissioner under this 64.6 section is in compliance with section 256B.48, subdivision 6, 64.7 paragraph (b), if the facility is Medicare certified. 64.8 (d) Notwithstanding paragraph (a), if by April 1, 1996, the 64.9 health care financing administration has not approved a required 64.10 waiver, or the health care financing administration otherwise 64.11 requires cost reports to be filed prior to the waiver's 64.12 approval, the commissioner shall require a cost report for the 64.13 rate year. 64.14 (e) A facility that is under contract with the commissioner 64.15 under this section shall be allowed to change therapy 64.16 arrangements from an unrelated vendor to a related vendor during 64.17 the term of the contract. The commissioner may develop 64.18 reasonable requirements designed to prevent an increase in 64.19 therapy utilization for residents enrolled in the medical 64.20 assistance program. 64.21 Sec. 11. [256B.435] [NURSING FACILITY REIMBURSEMENT SYSTEM 64.22 EFFECTIVE JULY 1, 2000.] 64.23 Subdivision 1. [IN GENERAL.] Effective July 1, 2000, the 64.24 commissioner shall implement a performance-based contracting 64.25 system to replace the current method of setting operating cost 64.26 payment rates under sections 256B.431 and 256B.434 and Minnesota 64.27 Rules, parts 9549.0010 to 9549.0080. A nursing facility in 64.28 operation on May 1, 1998, with payment rates not established 64.29 under section 256B.431 or 256B.434 on that date, is ineligible 64.30 for this performance-based contracting system. In determining 64.31 prospective payment rates of nursing facility services, the 64.32 commissioner shall distinguish between operating costs and 64.33 property-related costs. The operating cost portion of the 64.34 payment rates shall be indexed annually by an inflation factor 64.35 as specified in subdivision 3, and according to section 64.36 256B.431, subdivision 2i, paragraph (c). Property-related 65.1 payment rates, including real estate taxes and special 65.2 assessments, shall be determined under section 256B.431 or 65.3 256B.434. 65.4 Subd. 2. [CONTRACT PROVISIONS.] (a) The performance-based 65.5 contract with each nursing facility must include provisions that: 65.6 (1) apply the resident case mix assessment provisions of 65.7 Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 65.8 another assessment system, with the goal of moving to a single 65.9 assessment system; 65.10 (2) monitor resident outcomes through various methods, such 65.11 as quality indicators based on the minimum data set and other 65.12 utilization and performance measures; 65.13 (3) require the establishment and use of a continuous 65.14 quality improvement process that integrates information from 65.15 quality indicators and regular resident and family satisfaction 65.16 interviews; 65.17 (4) require annual reporting of facility statistical 65.18 information, including resident days by case mix category, 65.19 productive nursing hours, wages and benefits, and raw food costs 65.20 for use by the commissioner in the development of facility 65.21 profiles that include trends in payment and service utilization; 65.22 (5) require from each nursing facility an annual certified 65.23 audited financial statement consisting of a balance sheet, 65.24 income and expense statements, and an opinion from either a 65.25 licensed or certified public accountant, if a certified audit 65.26 was prepared, or unaudited financial statements if no certified 65.27 audit was prepared; and 65.28 (6) establish additional requirements and penalties for 65.29 nursing facilities not meeting the standards set forth in the 65.30 performance-based contract. 65.31 (b) The commissioner may develop additional incentive-based 65.32 payments for achieving outcomes specified in each contract. The 65.33 specified facility-specific outcomes must be measurable and 65.34 approved by the commissioner. 65.35 (c) The commissioner may also contract with nursing 65.36 facilities in other ways through requests for proposals, 66.1 including contracts on a risk or nonrisk basis, with nursing 66.2 facilities or consortia of nursing facilities, to provide 66.3 comprehensive long-term care coverage on a premium or capitated 66.4 basis. 66.5 Subd. 3. [PAYMENT RATE PROVISIONS.] (a) For rate years 66.6 beginning on or after July 1, 2000, the commissioner shall 66.7 determine operating cost payment rates for each licensed and 66.8 certified nursing facility by indexing its operating cost 66.9 payment rates in effect on June 30, 2000, for inflation. The 66.10 inflation factor to be used must be based on the change in the 66.11 Consumer Price Index-All Items, United States city average 66.12 (CPI-U) as forecasted by Data Resources, Inc. in the fourth 66.13 quarter preceding the rate year. The CPI-U forecasted index for 66.14 operating cost payment rates shall be based on the 12-month 66.15 period from the midpoint of the nursing facility's prior rate 66.16 year to the midpoint of the rate year for which the operating 66.17 payment rate is being determined. 66.18 (b) Beginning July 1, 2000, each nursing facility subject 66.19 to a performance-based contract under this section shall choose 66.20 one of two methods of payment for property-related costs: 66.21 (1) the method established in section 256B.434; or 66.22 (2) the method established in section 256B.431. Once the 66.23 nursing facility has made its election, that election shall 66.24 remain in effect for at least four years or until an alternative 66.25 property payment system is developed. 66.26 Sec. 12. [256B.5011] [ICF/MR REIMBURSEMENT SYSTEM 66.27 EFFECTIVE OCTOBER 1, 2000.] 66.28 Subdivision 1. [IN GENERAL.] Effective October 1, 2000, 66.29 the commissioner shall implement a performance-based contracting 66.30 system to replace the current method of setting total cost 66.31 payment rates under section 256B.501 and Minnesota Rules, parts 66.32 9553.0010 to 9553.0080. In determining prospective payment 66.33 rates of intermediate care facilities for persons with mental 66.34 retardation or related conditions, the commissioner shall index 66.35 each facility's total payment rate by an inflation factor as 66.36 described in subdivision 3. The commissioner of finance shall 67.1 include annual inflation adjustments in operating costs for 67.2 intermediate care facilities for persons with mental retardation 67.3 and related conditions as a budget change request in each 67.4 biennial detailed expenditure budget submitted to the 67.5 legislature under section 16A.11. 67.6 Subd. 2. [CONTRACT PROVISIONS.] The performance-based 67.7 contract with each intermediate care facility must include 67.8 provisions for: 67.9 (1) modifying payments when significant changes occur in 67.10 the needs of the consumers; 67.11 (2) monitoring service quality using performance indicators 67.12 that measure consumer outcomes; 67.13 (3) the establishment and use of continuous quality 67.14 improvement processes using the results attained through service 67.15 quality monitoring; 67.16 (4) the annual reporting of facility statistical 67.17 information on all supervisory personnel, direct care personnel, 67.18 specialized support personnel, hours, wages and benefits, 67.19 staff-to-consumer ratios, and staffing patterns; 67.20 (5) annual aggregate facility financial information or an 67.21 annual certified audited financial statement, including a 67.22 balance sheet and income and expense statements for each 67.23 facility, if a certified audit was prepared; and 67.24 (6) additional requirements and penalties for intermediate 67.25 care facilities not meeting the standards set forth in the 67.26 performance-based contract. 67.27 Subd. 3. [PAYMENT RATE PROVISIONS.] For rate years 67.28 beginning on or after October 1, 2000, the commissioner shall 67.29 determine the total payment rate for each licensed and certified 67.30 intermediate care facility by indexing the total payment rate in 67.31 effect on September 30, 2000, for inflation. The inflation 67.32 factor to be used must be based on the change in the Consumer 67.33 Price Index-All Items (United States city average) (CPI-U) as 67.34 forecasted by Data Resources, Inc. in the first quarter of the 67.35 calendar year during which the rate year begins. The CPI-U 67.36 forecasted index for total payment rates shall be based on the 68.1 12-month period from the midpoint of the ICF/MR's prior rate 68.2 year to the midpoint of the rate year for which the operating 68.3 payment rate is being determined. 68.4 Sec. 13. Minnesota Statutes 1996, section 256B.69, is 68.5 amended by adding a subdivision to read: 68.6 Subd. 26. [CONTINUATION OF PAYMENTS THROUGH 68.7 DISCHARGE.] (a) In the event a medical assistance recipient or 68.8 beneficiary enrolled in a health plan under this section is 68.9 denied nursing facility services after residing in the facility 68.10 for more than 180 days, any denial of medical assistance payment 68.11 to a provider under this section shall be prospective only and 68.12 payments to the provider shall continue until the resident is 68.13 discharged or 30 days after the effective date of the service 68.14 denial, whichever is sooner. 68.15 (b) For a medical assistance recipient or beneficiary who 68.16 is enrolled in a health plan and who has resided in the nursing 68.17 facility for less than 180 days, when a decision to terminate 68.18 nursing facility services is made by the health plan, any appeal 68.19 of the health plan decision must be made under subdivisions 11 68.20 and 18, and section 256.045, subdivision 3, paragraph (a). A 68.21 decision may not be appealed under section 144A.135. All other 68.22 appeals of termination of nursing facility services shall be 68.23 made under section 144A.135. 68.24 Sec. 14. Minnesota Statutes 1996, section 256I.04, 68.25 subdivision 1, is amended to read: 68.26 Subdivision 1. [INDIVIDUAL ELIGIBILITY REQUIREMENTS.] An 68.27 individual is eligible for and entitled to a group residential 68.28 housing payment to be made on the individual's behalf if the 68.29 county agency has approved the individual's residence in a group 68.30 residential housing setting and the individual meets the 68.31 requirements in paragraph (a) or (b). 68.32 (a) The individual is aged, blind, or is over 18 years of 68.33 age and disabled as determined under the criteria used by the 68.34 title II program of the Social Security Act, and meets the 68.35 resource restrictions and standards of the supplemental security 68.36 income program, and the individual's countable income after 69.1 deducting the (1) exclusions and disregards of the SSI 69.2 programand, (2) the medical assistance personal needs allowance 69.3 under section 256B.35, and (3) an amount equal to the allocation 69.4 of income to a spouse living in the community under the 69.5 provisions of section 256B.0915, subdivision 2, is less than the 69.6 monthly rate specified in the county agency's agreement with the 69.7 provider of group residential housing in which the individual 69.8 resides. 69.9 (b) The individual meets a category of eligibility under 69.10 section 256D.05, subdivision 1, paragraph (a), and the 69.11 individual's resources are less than the standards specified by 69.12 section 256D.08, and the individual's countable income as 69.13 determined under sections 256D.01 to 256D.21, less the medical 69.14 assistance personal needs allowance under section 256B.35 is 69.15 less than the monthly rate specified in the county agency's 69.16 agreement with the provider of group residential housing in 69.17 which the individual resides. 69.18 Sec. 15. Minnesota Statutes 1996, section 256I.04, 69.19 subdivision 3, is amended to read: 69.20 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 69.21 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 69.22 into agreements for new group residential housing beds with 69.23 total rates in excess of the MSA equivalent rate except: (1) 69.24 for group residential housing establishments meeting the 69.25 requirements of subdivision 2a, clause (2) with department 69.26 approval; (2) for group residential housing establishments 69.27 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 69.28 provided the facility is needed to meet the census reduction 69.29 targets for persons with mental retardation or related 69.30 conditions at regional treatment centers; (3) to ensure 69.31 compliance with the federal Omnibus Budget Reconciliation Act 69.32 alternative disposition plan requirements for inappropriately 69.33 placed persons with mental retardation or related conditions or 69.34 mental illness; (4) up to 80 beds in a single, specialized 69.35 facility located in Hennepin county that will provide housing 69.36 for chronic inebriates who are repetitive users of 70.1 detoxification centers and are refused placement in emergency 70.2 shelters because of their state of intoxication., and planning 70.3 for the specialized facility must have been initiated before 70.4 July 1, 1991, in anticipation of receiving a grant from the 70.5 housing finance agency under section 462A.05, subdivision 20a, 70.6 paragraph (b); or (5) notwithstanding the provisions of 70.7 subdivision 2a, for up to180200 supportive housing units in 70.8 Anoka, Dakota, Hennepin, or Ramsey county for homeless adults 70.9 with a mental illness, a history of substance abuse, or human 70.10 immunodeficiency virus or acquired immunodeficiency syndrome. 70.11 For purposes of this section, "homeless adult" means a person 70.12 who is living on the street or in a shelteror is evicted from a70.13dwelling unitor discharged from a regional treatment center, 70.14 community hospital, or residential treatment program and has no 70.15 appropriate housing available and lacks the resources and 70.16 support necessary to access appropriate housing. At least 70 70.17 percent of the supportive housing units must serve homeless 70.18 adults with mental illness, substance abuse problems, or human 70.19 immunodeficiency virus or acquired immunodeficiency syndrome who 70.20 are about to be or, within the previous six months, has been 70.21 discharged from a regional treatment center, or a 70.22 state-contracted psychiatric bed in a community hospital, or a 70.23 residential mental health or chemical dependency treatment 70.24 program. If a person meets the requirements of subdivision 1, 70.25 paragraph (a), and receives a federalSection 8or state housing 70.26 subsidy, the group residential housing rate for that person is 70.27 limited to the supplementary rate under section 256I.05, 70.28 subdivision 1a, and is determined by subtracting the amount of 70.29 the person's countable income that exceeds the MSA equivalent 70.30 rate from the group residential housing supplementary rate. A 70.31 resident in a demonstration project site who no longer 70.32 participates in the demonstration program shall retain 70.33 eligibility for a group residential housing payment in an amount 70.34 determined under section 256I.06, subdivision 8, using the MSA 70.35 equivalent rate. Service funding under section 256I.05, 70.36 subdivision 1a, will end June 30, 1997, if federal matching 71.1 funds are available and the services can be provided through a 71.2 managed care entity. If federal matching funds are not 71.3 available, then service funding will continue under section 71.4 256I.05, subdivision 1a. 71.5 (b) A county agency may enter into a group residential 71.6 housing agreement for beds with rates in excess of the MSA 71.7 equivalent rate in addition to those currently covered under a 71.8 group residential housing agreement if the additional beds are 71.9 only a replacement of beds with rates in excess of the MSA 71.10 equivalent rate which have been made available due to closure of 71.11 a setting, a change of licensure or certification which removes 71.12 the beds from group residential housing payment, or as a result 71.13 of the downsizing of a group residential housing setting. The 71.14 transfer of available beds from one county to another can only 71.15 occur by the agreement of both counties. 71.16 Sec. 16. Minnesota Statutes 1996, section 256I.04, is 71.17 amended by adding a subdivision to read: 71.18 Subd. 4. [RENTAL ASSISTANCE.] For participants in the 71.19 Minnesota supportive housing demonstration program under 71.20 subdivision 3, paragraph (a), clause (5), notwithstanding the 71.21 provisions of section 256I.06, subdivision 8, the amount of the 71.22 group residential housing payment for room and board must be 71.23 calculated by subtracting 30 percent of the recipient's adjusted 71.24 income as defined by the United States Department of Housing and 71.25 Urban Development for the Section 8 program from the fair market 71.26 rent established for the recipient's living unit by the federal 71.27 Department of Housing and Urban Development. This payment shall 71.28 be regarded as a state housing subsidy for the purposes of 71.29 subdivision 3. Notwithstanding the provisions of section 71.30 256I.06, subdivision 6, the recipient's countable income will 71.31 only be adjusted when a change of greater than $100 in a month 71.32 occurs or upon annual redetermination of eligibility, whichever 71.33 is sooner. The supportive housing demonstration program with 71.34 rental assistance shall be evaluated by an independent evaluator 71.35 to determine the cost effectiveness of the program in serving 71.36 its formerly homeless disabled clientele. The evaluation and 72.1 report shall be submitted to the commissioner of human services 72.2 no later than December 31, 1998. The commissioner is directed 72.3 to study the feasibility of developing a rental assistance 72.4 program to serve persons traditionally served in group 72.5 residential housing settings and report to the legislature by 72.6 February 15, 1999. 72.7 Sec. 17. Minnesota Statutes 1996, section 256I.05, 72.8 subdivision 2, is amended to read: 72.9 Subd. 2. [MONTHLY RATES; EXEMPTIONS.] The maximum group 72.10 residential housing rate does not apply to a residence that on 72.11 August 1, 1984, was licensed by the commissioner of health only 72.12 as a boarding care home, certified by the commissioner of health 72.13 as an intermediate care facility, and licensed by the 72.14 commissioner of human services under Minnesota Rules, parts 72.15 9520.0500 to 9520.0690. Notwithstanding the provisions of 72.16 subdivision 1c, the rate paid to a facility reimbursed under 72.17 this subdivision shall be determined under Minnesota Rules, 72.18 parts9510.0010 to 9510.04809549.0010 to 9549.0080, or under 72.19 section 256B.434 if the facility is accepted by the commissioner 72.20 for participation in the alternative payment demonstration 72.21 project. 72.22 Sec. 18. [STUDY OF COSTS AND IMPACT OF REGULATION OF 72.23 ASSISTED LIVING HOME CARE PROVIDER LICENSEES.] 72.24 The legislature recommends that by January 15, 1999, the 72.25 legislative auditor, in consultation with owners and operators 72.26 of registered housing establishments under Minnesota Statutes, 72.27 chapter 144D, consumers of registered housing and services, and 72.28 representatives of elderly housing associations, report to the 72.29 health and human services policy and fiscal committees of the 72.30 house and senate on the costs incurred under rules, as proposed 72.31 by the commissioner of health, to implement Laws 1997, chapter 72.32 113, section 6, and: 72.33 (1) provide an analysis of the implications of added 72.34 regulatory costs to the affordability, accessibility, and 72.35 quality of elderly housing; and 72.36 (2) provide recommendations for alternatives to added home 73.1 care regulation for registered with services settings. 73.2 Sec. 19. [RECOMMENDATIONS TO IMPLEMENT NEW REIMBURSEMENT 73.3 SYSTEM.] 73.4 (a) By January 15, 1999, the commissioner shall make 73.5 recommendations to the chairs of the health and human services 73.6 policy and fiscal committees on the repeal of specific statutes 73.7 and rules as well as any other additional recommendations 73.8 related to implementation of sections 11 and 12. 73.9 (b) In developing recommendations for nursing facility 73.10 reimbursement, the commissioner shall consider making each 73.11 nursing facility's total payment rates, both operating and 73.12 property rate components, prospective. The commissioner shall 73.13 involve nursing facility industry and consumer representatives 73.14 in the development of these recommendations. 73.15 (c) In making recommendations for ICF/MR reimbursement, the 73.16 commissioner may consider methods of establishing payment rates 73.17 that take into account individual client costs and needs, 73.18 include provisions to establish links between performance 73.19 indicators and reimbursement and other performance incentives, 73.20 and allow local control over resources necessary for local 73.21 agencies to set rates and contract with ICF/MR facilities. In 73.22 addition, the commissioner may establish methods that provide 73.23 information to consumers regarding service quality as measured 73.24 by performance indicators. The commissioner shall involve 73.25 ICF/MR industry and consumer representatives in the development 73.26 of these recommendations. 73.27 Sec. 20. [APPROVAL EXTENDED.] 73.28 Notwithstanding Minnesota Statutes, section 144A.073, 73.29 subdivision 3, the commissioner of health shall grant an 73.30 additional 18 months of approval for a proposed exception to the 73.31 nursing home licensure and certification moratorium, if the 73.32 proposal is to replace a 96-bed nursing home facility in Carlton 73.33 county and if initial approval for the proposal was granted in 73.34 November 1996. 73.35 Sec. 21. [EFFECTIVE DATE.] 73.36 Section 20 is effective the day following final enactment. 74.1 ARTICLE 4 74.2 HEALTH CARE PROGRAMS 74.3 Section 1. Minnesota Statutes 1996, section 16A.124, 74.4 subdivision 4a, is amended to read: 74.5 Subd. 4a. [INVOICE ERRORS; DEPARTMENT OF HUMAN SERVICES.] 74.6 For purposes of department of human services payments to 74.7 hospitals and home care services providers receiving 74.8 reimbursement under the medical assistanceand, general 74.9 assistance medical care programs, home and community-based 74.10 waiver services under section 256B.501, home and community-based 74.11 services for the elderly under section 256B.0915, community 74.12 alternatives for disabled individuals waiver services under 74.13 section 256B.49, community alternative care waiver services 74.14 under section 256B.49, traumatic brain injury waiver services 74.15 under section 256B.49, and day training and habilitation 74.16 services for adults with mental retardation or related 74.17 conditions under sections 252.40 to 252.46, if an invoice is 74.18 incorrect, defective, or otherwise improper, the department of 74.19 human services must notify the hospital or home care services 74.20 provider of all errors, within 30 days of discovery of the 74.21 errors. Any such notification to home care or day training and 74.22 habilitation providers must be in writing and specify the 74.23 specific codes or problems which are incorrect, defective, or 74.24 otherwise improper; utilize a request for additional information 74.25 based on Medicare form 488; provide a time frame for response; 74.26 and provide the name and telephone number of a department 74.27 contact person. 74.28 Sec. 2. Minnesota Statutes 1997 Supplement, section 74.29 171.29, subdivision 2, is amended to read: 74.30 Subd. 2. [FEES, ALLOCATION.] (a) A person whose driver's 74.31 license has been revoked as provided in subdivision 1, except 74.32 under section 169.121 or 169.123, shall pay a $30 fee before the 74.33 driver's license is reinstated. 74.34 (b) A person whose driver's license has been revoked as 74.35 provided in subdivision 1 under section 169.121 or 169.123 shall 74.36 pay a $250 fee plus a $10 surcharge before the driver's license 75.1 is reinstated. The $250 fee is to be credited as follows: 75.2 (1) Twenty percent shall be credited to the trunk highway 75.3 fund. 75.4 (2) Fifty-five percent shall be credited to the general 75.5 fund. 75.6 (3) Eight percent shall be credited to a separate account 75.7 to be known as the bureau of criminal apprehension account. 75.8 Money in this account may be appropriated to the commissioner of 75.9 public safety and the appropriated amount shall be apportioned 75.10 80 percent for laboratory costs and 20 percent for carrying out 75.11 the provisions of section 299C.065. 75.12 (4) Twelve percent shall be credited to a separate account 75.13 to be known as the alcohol-impaired driver education account. 75.14 Money in the account is appropriated as follows: 75.15 (i) The first $200,000 in a fiscal year is to the 75.16 commissioner of children, families, and learning for programs in 75.17 elementary and secondary schools. 75.18 (ii) The remainder credited in a fiscal year is 75.19 appropriated to the commissioner of transportation to be spent 75.20 as grants to the Minnesota highway safety center at St. Cloud 75.21 State University for programs relating to alcohol and highway 75.22 safety education in elementary and secondary schools. 75.23 (5) Five percent shall be credited to a separate account to 75.24 be known as the traumatic brain injury and spinal cord injury 75.25 account.$100,000 is annually appropriated from the account to75.26the commissioner of human services for traumatic brain injury75.27case management services.Theremainingmoney in the account is 75.28 annually appropriated to the commissioner of health to be used 75.29 as follows: 35 percent for a contract with a qualified 75.30 community-based organization to provide information, resources, 75.31 and support to assist persons with traumatic brain injury and 75.32 their families to access services, and 65 percent toestablish75.33andmaintain the traumatic brain injury and spinal cord injury 75.34 registry created in section 144.662 and to reimburse the 75.35 commissioner of economic security for the reasonable cost of 75.36 services provided under section 268A.03, clause (o). For the 76.1 purposes of this clause, a "qualified community-based 76.2 organization" is a private, not-for-profit organization of 76.3 consumers of traumatic brain injury services and their family 76.4 members. The organization must be registered with the United 76.5 States Internal Revenue Service under the provisions of section 76.6 501(c)(3) as a tax exempt organization and must have as its 76.7 purpose: 76.8 (1) the promotion of public, family, survivor, and 76.9 professional awareness of the incidence and consequences of 76.10 traumatic brain injury; 76.11 (2) the provision of a network of support for persons with 76.12 traumatic brain injury, their families, and friends; 76.13 (3) the development and support of programs and services to 76.14 prevent traumatic brain injury; 76.15 (4) the establishment of education programs for persons 76.16 with traumatic brain injury; and 76.17 (5) the empowerment of persons with traumatic brain injury 76.18 through participation in its governance. 76.19 (c) The $10 surcharge shall be credited to a separate 76.20 account to be known as the remote electronic alcohol monitoring 76.21 pilot program account. The commissioner shall transfer the 76.22 balance of this account to the commissioner of finance on a 76.23 monthly basis for deposit in the general fund. 76.24 Sec. 3. Minnesota Statutes 1996, section 245.462, 76.25 subdivision 4, is amended to read: 76.26 Subd. 4. [CASE MANAGER.] (a) "Case manager" means an 76.27 individual employed by the county or other entity authorized by 76.28 the county board to provide case management services specified 76.29 in section 245.4711. A case manager must have a bachelor's 76.30 degree in one of the behavioral sciences or related fields from 76.31 an accredited college or university and have at least 2,000 76.32 hours of supervised experience in the delivery of services to 76.33 adults with mental illness, must be skilled in the process of 76.34 identifying and assessing a wide range of client needs, and must 76.35 be knowledgeable about local community resources and how to use 76.36 those resources for the benefit of the client. The case manager 77.1 shall meet in person with a mental health professional at least 77.2 once each month to obtain clinical supervision of the case 77.3 manager's activities. Case managers with a bachelor's degree 77.4 but without 2,000 hours of supervised experience in the delivery 77.5 of services to adults with mental illness must complete 40 hours 77.6 of training approved by the commissioner of human services in 77.7 case management skills and in the characteristics and needs of 77.8 adults with serious and persistent mental illness and must 77.9 receive clinical supervision regarding individual service 77.10 delivery from a mental health professional at least once each 77.11 week until the requirement of 2,000 hours of supervised 77.12 experience is met. Clinical supervision must be documented in 77.13 the client record. 77.14 Until June 30, 1999,a refugeean immigrant who does not 77.15 have the qualifications specified in this subdivision may 77.16 provide case management services to adultrefugeesimmigrants 77.17 with serious and persistent mental illness who are members of 77.18 the same ethnic group as the case manager if the person: (1) is 77.19 actively pursuing credits toward the completion of a bachelor's 77.20 degree in one of the behavioral sciences or a related field from 77.21 an accredited college or university; (2) completes 40 hours of 77.22 training as specified in this subdivision; and (3) receives 77.23 clinical supervision at least once a week until the requirements 77.24 ofobtaining a bachelor's degree and 2,000 hours of supervised77.25experiencethis subdivision are met. 77.26 (b) The commissioner may approve waivers submitted by 77.27 counties to allow case managers without a bachelor's degree but 77.28 with 6,000 hours of supervised experience in the delivery of 77.29 services to adults with mental illness if the person: 77.30 (1) meets the qualifications for a mental health 77.31 practitioner in subdivision 26; 77.32 (2) has completed 40 hours of training approved by the 77.33 commissioner in case management skills and in the 77.34 characteristics and needs of adults with serious and persistent 77.35 mental illness; and 77.36 (3) demonstrates that the 6,000 hours of supervised 78.1 experience are in identifying functional needs of persons with 78.2 mental illness, coordinating assessment information and making 78.3 referrals to appropriate service providers, coordinating a 78.4 variety of services to support and treat persons with mental 78.5 illness, and monitoring to ensure appropriate provision of 78.6 services. The county board is responsible to verify that all 78.7 qualifications, including content of supervised experience, have 78.8 been met. 78.9 Sec. 4. Minnesota Statutes 1996, section 245.462, 78.10 subdivision 8, is amended to read: 78.11 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 78.12 treatment services," or "day treatment program" means a 78.13 structured program of treatment and care provided to an adult in 78.14 or by: (1) a hospital accredited by the joint commission on 78.15 accreditation of health organizations and licensed under 78.16 sections 144.50 to 144.55; (2) a community mental health center 78.17 under section 245.62; or (3) an entity that is under contract 78.18 with the county board to operate a program that meets the 78.19 requirements of section 245.4712, subdivision 2, and Minnesota 78.20 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 78.21 group psychotherapy and other intensive therapeutic services 78.22 that are provided at least one day a weekfor a minimum78.23three-hour time blockby a multidisciplinary staff under the 78.24 clinical supervision of a mental health professional. The 78.25 services are aimed at stabilizing the adult's mental health 78.26 status, providing mental health services, and developing and 78.27 improving the adult's independent living and socialization 78.28 skills. The goal of day treatment is to reduce or relieve 78.29 mental illness and to enable the adult to live in the 78.30 community. Day treatment services are not a part of inpatient 78.31 or residential treatment services. Day treatment services are 78.32 distinguished from day care by their structured therapeutic 78.33 program of psychotherapy services. The commissioner may limit 78.34 medical assistance reimbursement for day treatment to 15 hours 78.35 per week per person instead of the three hours per day per 78.36 person specified in Minnesota Rules, part 9505.0323, subpart 15. 79.1 Sec. 5. Minnesota Statutes 1996, section 245.4871, 79.2 subdivision 4, is amended to read: 79.3 Subd. 4. [CASE MANAGER.] (a) "Case manager" means an 79.4 individual employed by the county or other entity authorized by 79.5 the county board to provide case management services specified 79.6 in subdivision 3 for the child with severe emotional disturbance 79.7 and the child's family. A case manager must have experience and 79.8 training in working with children. 79.9 (b) A case manager must: 79.10 (1) have at least a bachelor's degree in one of the 79.11 behavioral sciences or a related field from an accredited 79.12 college or university; 79.13 (2) have at least 2,000 hours of supervised experience in 79.14 the delivery of mental health services to children; 79.15 (3) have experience and training in identifying and 79.16 assessing a wide range of children's needs; and 79.17 (4) be knowledgeable about local community resources and 79.18 how to use those resources for the benefit of children and their 79.19 families. 79.20 (c) The case manager may be a member of any professional 79.21 discipline that is part of the local system of care for children 79.22 established by the county board. 79.23 (d) The case manager must meet in person with a mental 79.24 health professional at least once each month to obtain clinical 79.25 supervision. 79.26 (e) Case managers with a bachelor's degree but without 79.27 2,000 hours of supervised experience in the delivery of mental 79.28 health services to children with emotional disturbance must: 79.29 (1) begin 40 hours of training approved by the commissioner 79.30 of human services in case management skills and in the 79.31 characteristics and needs of children with severe emotional 79.32 disturbance before beginning to provide case management 79.33 services; and 79.34 (2) receive clinical supervision regarding individual 79.35 service delivery from a mental health professional at least once 79.36 each week until the requirement of 2,000 hours of experience is 80.1 met. 80.2 (f) Clinical supervision must be documented in the child's 80.3 record. When the case manager is not a mental health 80.4 professional, the county board must provide or contract for 80.5 needed clinical supervision. 80.6 (g) The county board must ensure that the case manager has 80.7 the freedom to access and coordinate the services within the 80.8 local system of care that are needed by the child. 80.9 (h) Until June 30, 1999, a refugee who does not have the 80.10 qualifications specified in this subdivision may provide case 80.11 management services to child refugees with severe emotional 80.12 disturbance of the same ethnic group as the refugee if the 80.13 person: 80.14 (1) is actively pursuing credits toward the completion of a 80.15 bachelor's degree in one of the behavioral sciences or related 80.16 fields at an accredited college or university; 80.17 (2) completes 40 hours of training as specified in this 80.18 subdivision; and 80.19 (3) receives clinical supervision at least once a week 80.20 until the requirements of obtaining a bachelor's degree and 80.21 2,000 hours of supervised experience are met. 80.22 (i) The commissioner may approve waivers submitted by 80.23 counties to allow case managers without a bachelor's degree but 80.24 with 6,000 hours of supervised experience in the delivery of 80.25 services to children with mental illness if the person: 80.26 (1) meets the qualifications for a mental health 80.27 practitioner in subdivision 26; 80.28 (2) has completed 40 hours of training approved by the 80.29 commissioner in case management skills and in the 80.30 characteristics and needs of children with serious and 80.31 persistent mental illness; and 80.32 (3) demonstrates that the 6,000 hours of supervised 80.33 experience are in identifying functional needs of children with 80.34 mental illness, coordinating assessment information and making 80.35 referrals to appropriate service providers, coordinating a 80.36 variety of services to support and treat children with mental 81.1 illness, and monitoring to ensure appropriate provision of 81.2 services. The county board is responsible to verify that all 81.3 qualifications, including content of supervised experience, have 81.4 been met. 81.5 Sec. 6. [256.9364] [POST-KIDNEY TRANSPLANT DRUG PROGRAM.] 81.6 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 81.7 services shall establish and administer a program to pay for 81.8 costs of drugs prescribed exclusively for post-kidney transplant 81.9 maintenance when those costs are not otherwise reimbursed by a 81.10 third-party payer. The commissioner may contract with a 81.11 nonprofit entity to administer this program. 81.12 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 81.13 the program, an applicant must satisfy the following 81.14 requirements: 81.15 (1) the applicant's family gross income must not exceed 275 81.16 percent of the federal poverty level; and 81.17 (2) the applicant must be a Minnesota resident who has 81.18 resided in Minnesota for at least 12 months. 81.19 An applicant shall not be excluded because the applicant 81.20 received the transplant outside the state of Minnesota, so long 81.21 as the other requirements are met. 81.22 Subd. 3. [PAYMENT AMOUNTS.] (a) The amount of the payments 81.23 made for each eligible recipient shall be based on the following: 81.24 (1) available funds; and 81.25 (2) the cost of the post-kidney transplant maintenance 81.26 drugs. 81.27 (b) The payment rate under this program must be no greater 81.28 than the medical assistance reimbursement rate for the 81.29 prescribed drug. 81.30 (c) Payments shall be made to or on behalf of an eligible 81.31 recipient for the cost of the post-kidney transplant maintenance 81.32 drugs that is not covered, reimbursed, or eligible for 81.33 reimbursement by any other third party or government entity, 81.34 including, but not limited to, private or group health 81.35 insurance, medical assistance, Medicare, the Veterans 81.36 Administration, the senior citizen drug program established 82.1 under section 256.955, or under any waiver arrangement received 82.2 by the state to provide a prescription drug benefit for 82.3 qualified Medicare beneficiaries or service-limited Medicare 82.4 beneficiaries. 82.5 (d) The commissioner may restrict or categorize payments to 82.6 meet the appropriation allocated for this program. 82.7 (e) Any cost of the post-kidney transplant maintenance 82.8 drugs that is not reimbursed under this program is the 82.9 responsibility of the program recipient. 82.10 Subd. 4. [DRUG FORMULARY.] The commissioner shall maintain 82.11 a drug formulary that includes all drugs eligible for 82.12 reimbursement by the program. The commissioner may use the drug 82.13 formulary established under section 256B.0625, subdivision 13. 82.14 The commissioner shall establish an internal review procedure 82.15 for updating the formulary that allows for the addition and 82.16 deletion of drugs to the formulary. The drug formulary must be 82.17 reviewed at least quarterly per fiscal year. 82.18 Subd. 5. [PRIVATE DONATIONS.] The commissioner may accept 82.19 funding from other public or private sources. 82.20 Subd. 6. [SUNSET.] This program expires on July 1, 2000. 82.21 Sec. 7. Minnesota Statutes 1997 Supplement, section 82.22 256.9657, subdivision 3, is amended to read: 82.23 Subd. 3. [HEALTH MAINTENANCE ORGANIZATION; COMMUNITY 82.24 INTEGRATED SERVICE NETWORK SURCHARGE.] (a) Effective October 1, 82.25 1992, each health maintenance organization with a certificate of 82.26 authority issued by the commissioner of health under chapter 62D 82.27 and each community integrated service network licensed by the 82.28 commissioner under chapter 62N shall pay to the commissioner of 82.29 human services a surcharge equal to six-tenths of one percent of 82.30 the total premium revenues of the health maintenance 82.31 organization or community integrated service network as reported 82.32 to the commissioner of health according to the schedule in 82.33 subdivision 4. 82.34 (b) For purposes of this subdivision, total premium revenue 82.35 means: 82.36 (1) premium revenue recognized on a prepaid basis from 83.1 individuals and groups for provision of a specified range of 83.2 health services over a defined period of time which is normally 83.3 one month, excluding premiums paid to a health maintenance 83.4 organization or community integrated service network from the 83.5 Federal Employees Health Benefit Program; 83.6 (2) premiums from Medicare wrap-around subscribers for 83.7 health benefits which supplement Medicare coverage; 83.8 (3) Medicare revenue, as a result of an arrangement between 83.9 a health maintenance organization or a community integrated 83.10 service network and the health care financing administration of 83.11 the federal Department of Health and Human Services, for 83.12 services to a Medicare beneficiary, excluding Medicare revenue 83.13 that states are prohibited from taxing under sections 4001 and 83.14 4002 of Public Law Number 105-33 received by a health 83.15 maintenance organization or community integrated service network 83.16 through risk sharing or Medicare Choice + contracts; and 83.17 (4) medical assistance revenue, as a result of an 83.18 arrangement between a health maintenance organization or 83.19 community integrated service network and a Medicaid state 83.20 agency, for services to a medical assistance beneficiary. 83.21 If advance payments are made under clause (1) or (2) to the 83.22 health maintenance organization or community integrated service 83.23 network for more than one reporting period, the portion of the 83.24 payment that has not yet been earned must be treated as a 83.25 liability. 83.26 (c) When a health maintenance organization or community 83.27 integrated service network merges or consolidates with or is 83.28 acquired by another health maintenance organization or community 83.29 integrated service network, the surviving corporation or the new 83.30 corporation shall be responsible for the annual surcharge 83.31 originally imposed on each of the entities or corporations 83.32 subject to the merger, consolidation, or acquisition, regardless 83.33 of whether one of the entities or corporations does not retain a 83.34 certificate of authority under chapter 62D or a license under 83.35 chapter 62N. 83.36 (d) Effective July 1 of each year, the surviving 84.1 corporation's or the new corporation's surcharge shall be based 84.2 on the revenues earned in the second previous calendar year by 84.3 all of the entities or corporations subject to the merger, 84.4 consolidation, or acquisition regardless of whether one of the 84.5 entities or corporations does not retain a certificate of 84.6 authority under chapter 62D or a license under chapter 62N until 84.7 the total premium revenues of the surviving corporation include 84.8 the total premium revenues of all the merged entities as 84.9 reported to the commissioner of health. 84.10 (e) When a health maintenance organization or community 84.11 integrated service network, which is subject to liability for 84.12 the surcharge under this chapter, transfers, assigns, sells, 84.13 leases, or disposes of all or substantially all of its property 84.14 or assets, liability for the surcharge imposed by this chapter 84.15 is imposed on the transferee, assignee, or buyer of the health 84.16 maintenance organization or community integrated service network. 84.17 (f) In the event a health maintenance organization or 84.18 community integrated service network converts its licensure to a 84.19 different type of entity subject to liability for the surcharge 84.20 under this chapter, but survives in the same or substantially 84.21 similar form, the surviving entity remains liable for the 84.22 surcharge regardless of whether one of the entities or 84.23 corporations does not retain a certificate of authority under 84.24 chapter 62D or a license under chapter 62N. 84.25 (g) The surcharge assessed to a health maintenance 84.26 organization or community integrated service network ends when 84.27 the entity ceases providing services for premiums and the 84.28 cessation is not connected with a merger, consolidation, 84.29 acquisition, or conversion. 84.30 Sec. 8. Minnesota Statutes 1997 Supplement, section 84.31 256.9685, subdivision 1, is amended to read: 84.32 Subdivision 1. [AUTHORITY.] The commissioner shall 84.33 establish procedures for determining medical assistance and 84.34 general assistance medical care payment rates under a 84.35 prospective payment system for inpatient hospital services in 84.36 hospitals that qualify as vendors of medical assistance. The 85.1 commissioner shall establish, by rule, procedures for 85.2 implementing this section and sections 256.9686, 256.969, and 85.3 256.9695.The medical assistance payment rates must be based on85.4methods and standards that the commissioner finds are adequate85.5to provide for the costs that must be incurred for the care of85.6recipients in efficiently and economically operated hospitals.85.7 Services must meet the requirements of section 256B.04, 85.8 subdivision 15, or 256D.03, subdivision 7, paragraph (b), to be 85.9 eligible for payment. 85.10 Sec. 9. Minnesota Statutes 1996, section 256.969, 85.11 subdivision 16, is amended to read: 85.12 Subd. 16. [INDIAN HEALTH SERVICE FACILITIES.]Indian85.13health serviceFacilities of the Indian health service and 85.14 facilities operated by a tribe or tribal organization under 85.15 funding authorized by title III of the Indian Self-Determination 85.16 and Education Assistance Act, Public Law Number 93-638, or by 85.17 United States Code, title 25, chapter 14, subchapter II, 85.18 sections 450f to 450n, are exempt from the rate establishment 85.19 methods required by this section and shall bereimbursed at85.20charges as limited to the amount allowed under federal lawpaid 85.21 according to the rate published by the United States assistant 85.22 secretary for health under authority of United States Code, 85.23 title 42, sections 248A and 248B. 85.24 Sec. 10. Minnesota Statutes 1996, section 256.969, 85.25 subdivision 17, is amended to read: 85.26 Subd. 17. [OUT-OF-STATE HOSPITALS IN LOCAL TRADE AREAS.] 85.27 Out-of-state hospitals that are located within a Minnesota local 85.28 trade area and that have more than 20 admissions in the base 85.29 year shall have rates established using the same procedures and 85.30 methods that apply to Minnesota hospitals. For this subdivision 85.31 and subdivision 18, local trade area means a county contiguous 85.32 to Minnesota and located in a metropolitan statistical area as 85.33 determined by Medicare for October 1 prior to the most current 85.34 rebased rate year. Hospitals that are not required by law to 85.35 file information in a format necessary to establish rates shall 85.36 have rates established based on the commissioner's estimates of 86.1 the information. Relative values of the diagnostic categories 86.2 shall not be redetermined under this subdivision until required 86.3 by rule. Hospitals affected by this subdivision shall then be 86.4 included in determining relative values. However, hospitals 86.5 that have rates established based upon the commissioner's 86.6 estimates of information shall not be included in determining 86.7 relative values. This subdivision is effective for hospital 86.8 fiscal years beginning on or after July 1, 1988. A hospital 86.9 shall provide the information necessary to establish rates under 86.10 this subdivision at least 90 days before the start of the 86.11 hospital's fiscal year. 86.12 Sec. 11. Minnesota Statutes 1996, section 256B.03, 86.13 subdivision 3, is amended to read: 86.14 Subd. 3. [AMERICAN INDIAN HEALTH FUNDINGTRIBAL PURCHASING 86.15 MODEL.] Notwithstanding subdivision 1 and sections 256B.0625 and 86.16 256D.03, subdivision 4, paragraph(f)(i), the commissioner may 86.17 make payments to federally recognized Indian tribes with a 86.18 reservation in the state to provide medical assistance and 86.19 general assistance medical care to Indians, as defined under 86.20 federal law, who reside on or near the reservation. The 86.21 payments may be made in the form of a block grant or other 86.22 payment mechanism determined in consultation with the tribe. 86.23 Any alternative payment mechanism agreed upon by the tribes and 86.24 the commissioner under this subdivision is not dependent upon 86.25 county or health plan agreement but is intended to create a 86.26 direct payment mechanism between the state and the tribe for the 86.27 administration of the medical assistanceprogramand general 86.28 assistance medical care programs, and for covered services. 86.29 A tribe that implements a purchasing model under this 86.30 subdivision shall report to the commissioner at least annually 86.31 on the operation of the model. The commissioner and the tribe 86.32 shall cooperatively determine the data elements, format, and 86.33 timetable for the report. 86.34 For purposes of this subdivision, "Indian tribe" means a 86.35 tribe, band, or nation, or other organized group or community of 86.36 Indians that is recognized as eligible for the special programs 87.1 and services provided by the United States to Indians because of 87.2 their status as Indians and for which a reservation exists as is 87.3 consistent with Public Law Number 100-485, as amended. 87.4 Payments under this subdivision may not result in an 87.5 increase in expenditures that would not otherwise occur in the 87.6 medical assistance program under this chapter or the general 87.7 assistance medical care program under chapter 256D. 87.8 Sec. 12. [256B.038] [PROVIDER RATE INCREASES AFTER JUNE 87.9 30, 1999.] 87.10 (a) For fiscal years beginning on or after July 1, 1999, 87.11 the commissioner shall consider increasing payment rates for the 87.12 services listed in paragraph (b) by indexing the rates in effect 87.13 for inflation based on the change in the Consumer Price 87.14 Index-All Items (United States city average)(CPI-U) as 87.15 forecasted by Data Resources, Inc., in the fourth quarter of the 87.16 prior year for the calendar year during which the rate increase 87.17 occurs. 87.18 (b) The rate increases in paragraph (a) shall apply to home 87.19 and community-based waiver services for persons with mental 87.20 retardation or related conditions under section 256B.501; home 87.21 and community-based waiver services for the elderly under 87.22 section 256B.0915; waivered services under community 87.23 alternatives for disabled individuals under section 256B.49; 87.24 community alternative care waivered services under section 87.25 256B.49; traumatic brain injury waivered services under section 87.26 256B.49; nursing services and home health services under section 87.27 256B.0625, subdivision 6a; personal care services and nursing 87.28 supervision of personal care services under section 256B.0625, 87.29 subdivision 19a; private duty nursing services under section 87.30 256B.0625, subdivision 7; day training and habilitation services 87.31 for adults with mental retardation or related conditions under 87.32 sections 252.40 to 252.46; physical therapy services under 87.33 sections 256B.0625, subdivision 8, and 256D.03, subdivision 4; 87.34 occupational therapy services under sections 256B.0625, 87.35 subdivision 8a, and 256D.03, subdivision 4; speech-language 87.36 therapy services under section 256D.03, subdivision 4, and 88.1 Minnesota Rules, part 9505.0390; respiratory therapy services 88.2 under section 256D.03, subdivision 4, and Minnesota Rules, part 88.3 9505.0295; physician services under section 256B.0625, 88.4 subdivision 3; dental services under sections 256B.0625, 88.5 subdivision 9, and 256D.03, subdivision 4; alternative care 88.6 services under section 256B.0913; adult residential program 88.7 grants under Minnesota Rules, parts 9535.2000 to 9535.3000; 88.8 adult and family community support grants under Minnesota Rules, 88.9 parts 9535.1700 to 9535.1760; and semi-independent living 88.10 services under section 252.275, including SILS funding under 88.11 county social services grants formerly funded under chapter 256I. 88.12 (c) The commissioner shall increase prepaid medical 88.13 assistance program capitation rates as appropriate to reflect 88.14 the rate increases in this section. 88.15 (d) In implementing this section, the commissioner shall 88.16 consider proposing a schedule to equalize rates paid by 88.17 different programs for the same service. 88.18 Sec. 13. Minnesota Statutes 1996, section 256B.04, is 88.19 amended by adding a subdivision to read: 88.20 Subd. 19. [INFORMATION PROVIDED IN SEVERAL 88.21 LANGUAGES.] Upon request, the commissioner shall provide 88.22 applications and other information regarding medical assistance, 88.23 including all notices and disclosures provided to recipients, in 88.24 English, Spanish, Vietnamese, and Hmong. Reasonable effort must 88.25 be made to provide this information to other 88.26 non-English-speaking recipients. 88.27 Sec. 14. Minnesota Statutes 1996, section 256B.055, 88.28 subdivision 7, is amended to read: 88.29 Subd. 7. [AGED, BLIND, OR DISABLED PERSONS.] Medical 88.30 assistance may be paid for a person who meets the categorical 88.31 eligibility requirements of the supplemental security income 88.32 program or, who would meet those requirements except for excess 88.33 income or assets, and who meets the other eligibility 88.34 requirements of this section. 88.35Effective February 1, 1989, and to the extent allowed by88.36federal law the commissioner shall deduct state and federal89.1income taxes and federal insurance contributions act payments89.2withheld from the individual's earned income in determining89.3eligibility under this subdivision.89.4 Sec. 15. Minnesota Statutes 1996, section 256B.055, is 89.5 amended by adding a subdivision to read: 89.6 Subd. 7a. [SPECIAL CATEGORY FOR DISABLED 89.7 CHILDREN.] Medical assistance may be paid for a person who is 89.8 under age 18 and who meets income and asset eligibility 89.9 requirements of the Supplemental Security Income program if the 89.10 person was receiving Supplemental Security Income payments on 89.11 the date of enactment of section 211(a) of Public Law Number 89.12 104-193, the Personal Responsibility and Work Opportunity Act of 89.13 1996, and the person would have continued to receive such 89.14 payments except for the change in the childhood disability 89.15 criteria in section 211(a) of Public Law Number 104-193. 89.16 Sec. 16. Minnesota Statutes 1997 Supplement, section 89.17 256B.056, subdivision 1a, is amended to read: 89.18 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 89.19 specifically required by state law or rule or federal law or 89.20 regulation, the methodologies used in counting income and assets 89.21 to determine eligibility for medical assistance for persons 89.22 whose eligibility category is based on blindness, disability, or 89.23 age of 65 or more years, the methodologies for the supplemental 89.24 security income program shall be used, except that payments made89.25according to a court order for the support of children shall be89.26excluded from income in an amount not to exceed the difference89.27between the applicable income standard used in the state's89.28medical assistance program for aged, blind, and disabled persons89.29and the applicable income standard used in the state's medical89.30assistance program for families with children. Exclusion of89.31court-ordered child support payments is subject to the condition89.32that if there has been a change in the financial circumstances89.33of the person with the legal obligation to pay support since the89.34support order was entered, the person with the legal obligation89.35to pay support has petitioned for modification of the support89.36order. For families and children, which includes all other 90.1 eligibility categories, the methodologies under the state's AFDC 90.2 plan in effect as of July 16, 1996, as required by the Personal 90.3 Responsibility and Work Opportunity Reconciliation Act of 1996 90.4 (PRWORA), Public Law Number 104-193, shall be used. Effective 90.5 upon federal approval, in-kind contributions to, and payments 90.6 made on behalf of, a recipient, by an obligor, in satisfaction 90.7 of or in addition to a temporary or permanent order for child 90.8 support or maintenance, shall be considered income to the 90.9 recipient. For these purposes, a "methodology" does not include 90.10 an asset or income standard, or accounting method, or method of 90.11 determining effective dates. 90.12 Sec. 17. Minnesota Statutes 1997 Supplement, section 90.13 256B.056, subdivision 4, is amended to read: 90.14 Subd. 4. [INCOME.] To be eligible for medical assistance, 90.15 a personmust not have, or anticipate receiving, semiannual90.16income in excess of 120 percent of the income standards by90.17family size used under the aid to families with dependent90.18children state plan as of July 16, 1996, as required by the90.19Personal Responsibility and Work Opportunity Reconciliation Act90.20of 1996 (PRWORA), Public Law Number 104-193, except90.21thateligible under section 256B.055, subdivision 7, and 90.22 families and children may have an income up to 133-1/3 percent 90.23 of the AFDC income standard in effect under the July 16, 1996, 90.24 AFDC state plan. For rate years beginning on or after July 1, 90.25 1999, the commissioner shall consider increasing the base AFDC 90.26 standard in effect July 16, 1996, by an amount equal to the 90.27 percentage increase in the Consumer Price Index for all urban 90.28 consumers for the previous calendar year. In computing income 90.29 to determine eligibility of persons who are not residents of 90.30 long-term care facilities, the commissioner shall disregard 90.31 increases in income as required by Public Law Numbers 94-566, 90.32 section 503; 99-272; and 99-509. Veterans aid and attendance 90.33 benefits and Veterans Administration unusual medical expense 90.34 payments are considered income to the recipient. 90.35 Sec. 18. Minnesota Statutes 1996, section 256B.057, 90.36 subdivision 3a, is amended to read: 91.1 Subd. 3a. [ELIGIBILITY FOR PAYMENT OF MEDICARE PART B 91.2 PREMIUMS.] A person who would otherwise be eligible as a 91.3 qualified Medicare beneficiary under subdivision 3, except the 91.4 person's income is in excess of the limit, is eligible for 91.5 medical assistance reimbursement of Medicare Part B premiums if 91.6 the person's income is less than110120 percent of the official 91.7 federal poverty guidelines for the applicable family size.The91.8income limit shall increase to 120 percent of the official91.9federal poverty guidelines for the applicable family size on91.10January 1, 1995.91.11 Sec. 19. Minnesota Statutes 1996, section 256B.057, is 91.12 amended by adding a subdivision to read: 91.13 Subd. 3b. [QUALIFIED INDIVIDUALS.] Beginning July 1, 1998, 91.14 to the extent of the federal allocation to Minnesota, a person, 91.15 who would otherwise be eligible as a qualified Medicare 91.16 beneficiary under subdivision 3, except that the person's income 91.17 is in excess of the limit, is eligible as a qualified individual 91.18 according to the following criteria: 91.19 (1) if the person's income is greater than 120 percent, but 91.20 less than 135 percent of the official federal poverty guidelines 91.21 for the applicable family size, the person is eligible for 91.22 medical assistance reimbursement of Medicare Part B premiums; or 91.23 (2) if the person's income is greater than 135 percent but 91.24 less than 175 percent of the official federal poverty guidelines 91.25 for the applicable family size, the person is eligible for 91.26 medical assistance reimbursement of that portion of the Medicare 91.27 Part B premium attributable to an increase in Part B 91.28 expenditures which resulted from the shift of home care services 91.29 from Medicare Part A to Medicare Part B under Public Law Number 91.30 105-33, section 4732, the Balanced Budget Act of 1997. 91.31 The commissioner shall limit enrollment of qualifying 91.32 individuals under this subdivision according to the requirements 91.33 of Public Law Number 105-33, section 4732. 91.34 Sec. 20. Minnesota Statutes 1997 Supplement, section 91.35 256B.06, subdivision 4, is amended to read: 91.36 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 92.1 medical assistance is limited to citizens of the United States, 92.2 qualified noncitizens as defined in this subdivision, and other 92.3 persons residing lawfully in the United States. 92.4 (b) "Qualified noncitizen" means a person who meets one of 92.5 the following immigration criteria: 92.6 (1) admitted for lawful permanent residence according to 92.7 United States Code, title 8; 92.8 (2) admitted to the United States as a refugee according to 92.9 United States Code, title 8, section 1157; 92.10 (3) granted asylum according to United States Code, title 92.11 8, section 1158; 92.12 (4) granted withholding of deportation according to United 92.13 States Code, title 8, section 1253(h); 92.14 (5) paroled for a period of at least one year according to 92.15 United States Code, title 8, section 1182(d)(5); 92.16 (6) granted conditional entrant status according to United 92.17 States Code, title 8, section 1153(a)(7);or92.18 (7) determined to be a battered noncitizen by the United 92.19 States Attorney General according to the Illegal Immigration 92.20 Reform and Immigrant Responsibility Act of 1996, title V of the 92.21 Omnibus Consolidated Appropriations Bill, Public Law Number 92.22 104-200; 92.23 (8) is a child of a noncitizen determined to be a battered 92.24 noncitizen by the United States Attorney General according to 92.25 the Illegal Immigration Reform and Immigrant Responsibility Act 92.26 of 1996, title V, of the Omnibus Consolidated Appropriations 92.27 Bill, Public Law Number 104-200; or 92.28 (9) determined to be a Cuban or Haitian entrant as defined 92.29 in section 501(e) of Public Law Number 96-422, the Refugee 92.30 Education Assistance Act of 1980. 92.31 (c) All qualified noncitizens who were residing in the 92.32 United States before August 22, 1996, who otherwise meet the 92.33 eligibility requirements of chapter 256B, are eligible for 92.34 medical assistance with federal financial participation. 92.35 (d) All qualified noncitizens who entered the United States 92.36 on or after August 22, 1996, and who otherwise meet the 93.1 eligibility requirements of chapter 256B, are eligible for 93.2 medical assistance with federal financial participation through 93.3 November 30, 1996. 93.4 Beginning December 1, 1996, qualified noncitizens who 93.5 entered the United States on or after August 22, 1996, and who 93.6 otherwise meet the eligibility requirements of chapter 256B are 93.7 eligible for medical assistance with federal participation for 93.8 five years if they meet one of the following criteria: 93.9 (i) refugees admitted to the United States according to 93.10 United States Code, title 8, section 1157; 93.11 (ii) persons granted asylum according to United States 93.12 Code, title 8, section 1158; 93.13 (iii) persons granted withholding of deportation according 93.14 to United States Code, title 8, section 1253(h); 93.15 (iv) veterans of the United States Armed Forces with an 93.16 honorable discharge for a reason other than noncitizen status, 93.17 their spouses and unmarried minor dependent children; or 93.18 (v) persons on active duty in the United States Armed 93.19 Forces, other than for training, their spouses and unmarried 93.20 minor dependent children. 93.21 Beginning December 1, 1996, qualified noncitizens who do 93.22 not meet one of the criteria in items (i) to (v) are eligible 93.23 for medical assistance without federal financial participation 93.24 as described in paragraph (j). 93.25 (e) Noncitizens who are not qualified noncitizens as 93.26 defined in paragraph (b), who are lawfully residing in the 93.27 United States and who otherwise meet the eligibility 93.28 requirements of chapter 256B, are eligible for medical 93.29 assistance under clauses (1) to (3). These individuals must 93.30 cooperate with the Immigration and Naturalization Service to 93.31 pursue any applicable immigration status, including citizenship, 93.32 that would qualify them for medical assistance with federal 93.33 financial participation. 93.34 (1) Persons who were medical assistance recipients on 93.35 August 22, 1996, are eligible for medical assistance with 93.36 federal financial participation through December 31, 1996. 94.1 (2) Beginning January 1, 1997, persons described in clause 94.2 (1) are eligible for medical assistance without federal 94.3 financial participation as described in paragraph (j). 94.4 (3) Beginning December 1, 1996, persons residing in the 94.5 United States prior to August 22, 1996, who were not receiving 94.6 medical assistance and persons who arrived on or after August 94.7 22, 1996, are eligible for medical assistance without federal 94.8 financial participation as described in paragraph (j). 94.9 (f) Nonimmigrants who otherwise meet the eligibility 94.10 requirements of chapter 256B are eligible for the benefits as 94.11 provided in paragraphs (g) to (i). For purposes of this 94.12 subdivision, a "nonimmigrant" is a person in one of the classes 94.13 listed in United States Code, title 8, section 1101(a)(15). 94.14 (g) Payment shall also be made for care and services that 94.15 are furnished to noncitizens, regardless of immigration status, 94.16 who otherwise meet the eligibility requirements of chapter 256B, 94.17 if such care and services are necessary for the treatment of an 94.18 emergency medical condition, except for organ transplants and 94.19 related care and services and routine prenatal care. 94.20 (h) For purposes of this subdivision, the term "emergency 94.21 medical condition" means a medical condition that meets the 94.22 requirements of United States Code, title 42, section 1396b(v). 94.23 (i) Pregnant noncitizens who are undocumented or 94.24 nonimmigrants, who otherwise meet the eligibility requirements 94.25 of chapter 256B, are eligible for medical assistance payment 94.26 without federal financial participation for care and services 94.27 through the period of pregnancy, and 60 days postpartum, except 94.28 for labor and delivery. 94.29 (j) Qualified noncitizens as described in paragraph (d), 94.30 and all other noncitizens lawfully residing in the United States 94.31 as described in paragraph (e), who are ineligible for medical 94.32 assistance with federal financial participation and who 94.33 otherwise meet the eligibility requirements of chapter 256B and 94.34 of this paragraph, are eligible for medical assistance without 94.35 federal financial participation. Qualified noncitizens as 94.36 described in paragraph (d) are only eligible for medical 95.1 assistance without federal financial participation for five 95.2 years from their date of entry into the United States. 95.3 (k) The commissioner shall submit to the legislature by 95.4 December 31, 1998, a report on the number of recipients and cost 95.5 of coverage of care and services made according to paragraphs 95.6 (i) and (j). 95.7 Sec. 21. Minnesota Statutes 1996, section 256B.0625, 95.8 subdivision 17, is amended to read: 95.9 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 95.10 covers transportation costs incurred solely for obtaining 95.11 emergency medical care or transportation costs incurred by 95.12 nonambulatory persons in obtaining emergency or nonemergency 95.13 medical care when paid directly to an ambulance company, common 95.14 carrier, or other recognized providers of transportation 95.15 services. For the purpose of this subdivision, a person who is 95.16 incapable of transport by taxicab or bus shall be considered to 95.17 be nonambulatory. 95.18 (b) Medical assistance covers special transportation, as 95.19 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 95.20 if the provider receives and maintains a current physician's 95.21 order by the recipient's attending physician certifying that the 95.22 recipient has a physical or mental impairment that would 95.23 prohibit the recipient from safely accessing and using a bus, 95.24 taxi, other commercial transportation, or private automobile. 95.25 Special transportation includes driver-assisted service to 95.26 eligible individuals. Driver-assisted service includes 95.27 passenger pickup at and return to the individual's residence or 95.28 place of business, assistance with admittance of the individual 95.29 to the medical facility, and assistance in passenger securement 95.30 or in securing of wheelchairs or stretchers in the vehicle. The 95.31 commissioner shall establish maximum medical assistance 95.32 reimbursement rates for special transportation services for 95.33 persons who need a wheelchair lift van or stretcher-equipped 95.34 vehicle and for those who do not need a wheelchair lift van or 95.35 stretcher-equipped vehicle. The average of these two rates per 95.36 trip must not exceed$14$16 for the base rate and$1.10$1.30 96.1 per mile. Special transportation provided to nonambulatory 96.2 persons who do not need a wheelchair lift van or 96.3 stretcher-equipped vehicle, may be reimbursed at a lower rate 96.4 than special transportation provided to persons who need a 96.5 wheelchair lift van or stretcher-equipped vehicle. 96.6 Sec. 22. Minnesota Statutes 1996, section 256B.0625, is 96.7 amended by adding a subdivision to read: 96.8 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 96.9 services rendered on or after July 1, 1999, medical assistance 96.10 payments for ambulance services shall be increased by ten 96.11 percent. 96.12 Sec. 23. Minnesota Statutes 1996, section 256B.0625, 96.13 subdivision 20, is amended to read: 96.14 Subd. 20. [MENTALILLNESSHEALTH CASE MANAGEMENT.] (a) To 96.15 the extent authorized by rule of the state agency, medical 96.16 assistance covers case management services to persons with 96.17 serious and persistent mental illnessor subject to federal96.18approval,and children with severe emotional disturbance. 96.19 Services provided under this section must meet the relevant 96.20 standards in sections 245.461 to 245.4888, the Comprehensive 96.21 Adult and Children's Mental Health Acts, Minnesota Rules, parts 96.22 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10. 96.23 (b) Entities meeting program standards set out in rules 96.24 governing family community support services as defined in 96.25 section 245.4871, subdivision 17, are eligible for medical 96.26 assistance reimbursement for case management services for 96.27 children with severe emotional disturbance when these services 96.28 meet the program standards in Minnesota Rules, parts 9520.0900 96.29 to 9520.0926 and 9505.0322, excludingsubpart 6subparts 6 and 96.30 10. 96.31(b) In counties where fewer than 50 percent of children96.32estimated to be eligible under medical assistance to receive96.33case management services for children with severe emotional96.34disturbance actually receive these services in state fiscal year96.351995, community mental health centers serving those counties,96.36entities meeting program standards in Minnesota Rules, parts97.19520.0570 to 9520.0870, and other entities authorized by the97.2commissioner are eligible for medical assistance reimbursement97.3for case management services for children with severe emotional97.4disturbance when these services meet the program standards in97.5Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322,97.6excluding subpart 6.97.7 (c) Medical assistance and MinnesotaCare payment for mental 97.8 health case management shall be made on a monthly basis. In 97.9 order to receive payment for an eligible child, the provider 97.10 must document at least a face-to-face contact with the child, 97.11 the child's parents, or the child's legal representative. To 97.12 receive payment for an eligible adult, the provider must 97.13 document at least a face-to-face contact with the adult or the 97.14 adult's legal representative. 97.15 (d) Payment for mental health case management provided by 97.16 county or state staff shall be based on the monthly rate 97.17 methodology under section 256B.094, subdivision 6, paragraph 97.18 (b), with separate rates calculated for child welfare and mental 97.19 health, and within mental health, separate rates for children 97.20 and adults. 97.21 (e) Payment for mental health case management provided by 97.22 county-contracted vendors shall be based on a monthly rate 97.23 negotiated by the host county. The negotiated rate must not 97.24 exceed the rate charged by the vendor for the same service to 97.25 other payers. If the service is provided by a team of 97.26 contracted vendors, the county may negotiate a team rate with a 97.27 vendor who is a member of the team. The team shall determine 97.28 how to distribute the rate among its members. No reimbursement 97.29 received by contracted vendors shall be returned to the county, 97.30 except to reimburse the county for advance funding provided by 97.31 the county to the vendor. 97.32 (f) If the service is provided by a team which includes 97.33 contracted vendors and county or state staff, the costs for 97.34 county or state staff participation in the team shall be 97.35 included in the rate for county-provided services. In this 97.36 case, the contracted vendor and the county may each receive 98.1 separate payment for services provided by each entity in the 98.2 same month. 98.3 (g) The commissioner shall calculate the nonfederal share 98.4 of actual medical assistance and general assistance medical care 98.5 payments for each county, based on the higher of calendar year 98.6 1995 or 1996, by service date, project that amount forward to 98.7 1999, and transfer the result from medical assistance and 98.8 general assistance medical care to each county's mental health 98.9 grants under sections 245.4886 and 256E.12 for calendar year 98.10 1999. The minimum amount added to each county's mental health 98.11 grant shall be $3,000 per year for children and $5,000 per year 98.12 for adults. The commissioner may reduce the statewide growth 98.13 factor in order to fund these minimums. The total amount 98.14 transferred shall become part of the base for future mental 98.15 health grants for each county. 98.16 (h) Any net increase in revenue to the county as a result 98.17 of the change in this section must be used to provide expanded 98.18 mental health services as defined in sections 245.461 to 98.19 245.4888, the Comprehensive Adult and Children's Mental Health 98.20 Acts, excluding inpatient and residential treatment. For 98.21 adults, increased revenue may also be used for services and 98.22 consumer supports which are part of adult mental health projects 98.23 approved under Laws 1997, chapter 203, article 7, section 25. 98.24 For children, increased revenue may also be used for respite 98.25 care and nonresidential individualized rehabilitation services 98.26 as defined in section 245.492, subdivisions 17 and 23. 98.27 "Increased revenue" has the meaning given in Minnesota Rules, 98.28 part 9520.0903, subpart 3. 98.29 (i) Notwithstanding section 256B.19, subdivision 1, the 98.30 nonfederal share of costs for mental health case management 98.31 shall be provided by the recipient's county of responsibility, 98.32 as defined in sections 256G.01 to 256G.12, from sources other 98.33 than federal funds or funds used to match other federal funds. 98.34 (j) The commissioner may suspend, reduce, or terminate the 98.35 reimbursement to a provider that does not meet the reporting or 98.36 other requirements of this section. The county of 99.1 responsibility, as defined in sections 256G.01 to 256G.12, is 99.2 responsible for any federal disallowances. The county may share 99.3 this responsibility with its contracted vendors. 99.4 (k) The commissioner shall set aside a portion of the 99.5 federal funds earned under this section to repay the special 99.6 revenue maximization account under section 256.01, subdivision 99.7 2, clause (15). The repayment is limited to: 99.8 (1) the costs of developing and implementing this section; 99.9 and 99.10 (2) programming the information systems. 99.11 (l) Notwithstanding section 256.025, subdivision 2, 99.12 payments to counties for case management expenditures under this 99.13 section shall only be made from federal earnings from services 99.14 provided under this section. Payments to contracted vendors 99.15 shall include both the federal earnings and the county share. 99.16 (m) Notwithstanding section 256B.041, county payments for 99.17 the cost of mental health case management services provided by 99.18 county or state staff shall not be made to the state treasurer. 99.19 For the purposes of mental health case management services 99.20 provided by county or state staff under this section, the 99.21 centralized disbursement of payments to counties under section 99.22 256B.041 consists only of federal earnings from services 99.23 provided under this section. 99.24 (n) Case management services under this subdivision do not 99.25 include therapy, treatment, legal, or outreach services. 99.26 (o) If the recipient is a resident of a nursing facility, 99.27 intermediate care facility, or hospital, and the recipient's 99.28 institutional care is paid by medical assistance, payment for 99.29 case management services under this subdivision is limited to 99.30 the last 30 days of the recipient's residency in that facility 99.31 and may not exceed more than two months in a calendar year. 99.32 (p) Payment for case management services under this 99.33 subdivision shall not duplicate payments made under other 99.34 program authorities for the same purpose. 99.35 (q) For each calendar year beginning with the calendar year 99.36 2001, the amount of state funds for each county determined under 100.1 paragraph (g) shall be adjusted by the county's percentage 100.2 change in the average number of clients per month who received 100.3 case management under this section during the fiscal year that 100.4 ended six months prior to the calendar year in question, in 100.5 comparison to the prior fiscal year. 100.6 Sec. 24. Minnesota Statutes 1997 Supplement, section 100.7 256B.0625, subdivision 31a, is amended to read: 100.8 Subd. 31a. [AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 100.9 SYSTEMS.] (a) Medical assistance covers augmentative and 100.10 alternative communication systems consisting of electronic or 100.11 nonelectronic devices and the related components necessary to 100.12 enable a person with severe expressive communication limitations 100.13 to produce or transmit messages or symbols in a manner that 100.14 compensates for that disability. 100.15 (b)By January 1, 1998, the commissioner, in cooperation100.16with the commissioner of administration, shall establish an100.17augmentative and alternative communication system purchasing100.18program within a state agency or by contract with a qualified100.19private entity. The purpose of this service is to facilitate100.20ready availability of the augmentative and alternative100.21communication systems needed to meet the needs of persons with100.22severe expressive communication limitations in an efficient and100.23cost-effective manner. This program shall:100.24(1) coordinate purchase and rental of augmentative and100.25alternative communication systems;100.26(2) negotiate agreements with manufacturers and vendors for100.27purchase of components of these systems, for warranty coverage,100.28and for repair service;100.29(3) when efficient and cost-effective, maintain and100.30refurbish if needed, an inventory of components of augmentative100.31and alternative communication systems for short- or long-term100.32loan to recipients;100.33(4) facilitate training sessions for service providers,100.34consumers, and families on augmentative and alternative100.35communication systems; and100.36(5) develop a recycling program for used augmentative and101.1alternative communications systems to be reissued and used for101.2trials and short-term use, when appropriate.101.3The availability of components of augmentative and101.4alternative communication systems through this program is101.5subject to prior authorization requirements established under101.6subdivision 25Until the volume of systems purchased increases 101.7 to allow a discount price, the commissioner shall reimburse 101.8 augmentative and alternative communication manufacturers and 101.9 vendors at the manufacturer's suggested retail price for 101.10 augmentative and alternative communication systems and related 101.11 components. The commissioner shall separately reimburse 101.12 providers for purchasing and integrating individual 101.13 communication systems which are unavailable as a package from an 101.14 augmentative and alternative communication vendor. 101.15 (c) Reimbursement rates established by this purchasing 101.16 program are not subject to Minnesota Rules, part 9505.0445, item 101.17 S or T. 101.18 Sec. 25. Minnesota Statutes 1996, section 256B.0625, 101.19 subdivision 34, is amended to read: 101.20 Subd. 34. [AMERICAN INDIAN HEALTH SERVICES FACILITIES.] 101.21 Medical assistance payments toAmerican Indian health services101.22facilities for outpatient medical services billed after June 30,101.231990, must befacilities of the Indian health service and 101.24 facilities operated by a tribe or tribal organization under 101.25 funding authorized by United States Code, title 25, sections 101.26 450f to 450n, or title III of the Indian Self-Determination and 101.27 Education Assistance Act, Public Law Number 93-638, shall be at 101.28 the option of the facility in accordance with the rate published 101.29 by the United States Assistant Secretary for Health under the 101.30 authority of United States Code, title 42, sections 248(a) and 101.31 249(b). General assistance medical care payments to facilities 101.32 of the American Indian health services and facilities operated 101.33 by a tribe or tribal organization for the provision of 101.34 outpatient medical care services billed after June 30, 1990, 101.35 must be in accordance with the general assistance medical care 101.36 rates paid for the same services when provided in a facility 102.1 other thanan Americana facility of the Indian health 102.2 service or a facility operated by a tribe or tribal organization. 102.3 Sec. 26. Minnesota Statutes 1996, section 256B.0627, 102.4 subdivision 4, is amended to read: 102.5 Subd. 4. [PERSONAL CARE SERVICES.] (a) The personal care 102.6 services that are eligible for payment are the following: 102.7 (1) bowel and bladder care; 102.8 (2) skin care to maintain the health of the skin; 102.9 (3) repetitive maintenance range of motion, muscle 102.10 strengthening exercises, and other tasks specific to maintaining 102.11 a recipient's optimal level of function; 102.12 (4) respiratory assistance; 102.13 (5) transfers and ambulation; 102.14 (6) bathing, grooming, and hairwashing necessary for 102.15 personal hygiene; 102.16 (7) turning and positioning; 102.17 (8) assistance with furnishing medication that is 102.18 self-administered; 102.19 (9) application and maintenance of prosthetics and 102.20 orthotics; 102.21 (10) cleaning medical equipment; 102.22 (11) dressing or undressing; 102.23 (12) assistance with eating and meal preparation and 102.24 necessary grocery shopping; 102.25 (13) accompanying a recipient to obtain medical diagnosis 102.26 or treatment; 102.27 (14) assisting, monitoring, or prompting the recipient to 102.28 complete the services in clauses (1) to (13); 102.29 (15) redirection, monitoring, and observation that are 102.30 medically necessary and an integral part of completing the 102.31 personal care services described in clauses (1) to (14); 102.32 (16) redirection and intervention for behavior, including 102.33 observation and monitoring; 102.34 (17) interventions for seizure disorders, including 102.35 monitoring and observation if the recipient has had a seizure 102.36 that requires intervention within the past three months;and103.1 (18) tracheostomy suctioning using a clean procedure if the 103.2 procedure is properly delegated by a registered nurse. Before 103.3 this procedure can be delegated to a personal care assistant, a 103.4 registered nurse must determine that the tracheostomy suctioning 103.5 can be accomplished utilizing a clean rather than a sterile 103.6 procedure and must ensure that the personal care assistant has 103.7 been taught the proper procedure; and 103.8 (19) incidental household services that are an integral 103.9 part of a personal care service described in clauses (1) to 103.10(17)(18). 103.11 For purposes of this subdivision, monitoring and observation 103.12 means watching for outward visible signs that are likely to 103.13 occur and for which there is a covered personal care service or 103.14 an appropriate personal care intervention. For purposes of this 103.15 subdivision, a clean procedure refers to a procedure that 103.16 reduces the numbers of microorganisms or prevents or reduces the 103.17 transmission of microorganisms from one person or place to 103.18 another. A clean procedure may be used beginning 14 days after 103.19 insertion. 103.20 (b) The personal care services that are not eligible for 103.21 payment are the following: 103.22 (1) services not ordered by the physician; 103.23 (2) assessments by personal care provider organizations or 103.24 by independently enrolled registered nurses; 103.25 (3) services that are not in the service plan; 103.26 (4) services provided by the recipient's spouse, legal 103.27 guardian for an adult or child recipient, or parent of a 103.28 recipient under age 18; 103.29 (5) services provided by a foster care provider of a 103.30 recipient who cannot direct the recipient's own care, unless 103.31 monitored by a county or state case manager under section 103.32 256B.0625, subdivision 19a; 103.33 (6) services provided by the residential or program license 103.34 holder in a residence for more than four persons; 103.35 (7) services that are the responsibility of a residential 103.36 or program license holder under the terms of a service agreement 104.1 and administrative rules; 104.2 (8) sterile procedures; 104.3 (9) injections of fluids into veins, muscles, or skin; 104.4 (10) services provided by parents of adult recipients, 104.5 adult children or adult siblings of the recipient, unless these 104.6 relatives meet one of the following hardship criteria and the 104.7 commissioner waives this requirement: 104.8 (i) the relative resigns from a part-time or full-time job 104.9 to provide personal care for the recipient; 104.10 (ii) the relative goes from a full-time to a part-time job 104.11 with less compensation to provide personal care for the 104.12 recipient; 104.13 (iii) the relative takes a leave of absence without pay to 104.14 provide personal care for the recipient; 104.15 (iv) the relative incurs substantial expenses by providing 104.16 personal care for the recipient; or 104.17 (v) because of labor conditions or intermittent hours of 104.18 care needed, the relative is needed in order to provide an 104.19 adequate number of qualified personal care assistants to meet 104.20 the medical needs of the recipient; 104.21 (11) homemaker services that are not an integral part of a 104.22 personal care services; 104.23 (12) home maintenance, or chore services; 104.24 (13) services not specified under paragraph (a); and 104.25 (14) services not authorized by the commissioner or the 104.26 commissioner's designee. 104.27 Sec. 27. Minnesota Statutes 1997 Supplement, section 104.28 256B.0627, subdivision 5, is amended to read: 104.29 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 104.30 payments for home care services shall be limited according to 104.31 this subdivision. 104.32 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 104.33 recipient may receive the following home care services during a 104.34 calendar year: 104.35 (1) any initial assessment; 104.36 (2) up to two reassessments per year done to determine a 105.1 recipient's need for personal care services; and 105.2 (3) up to five skilled nurse visits. 105.3 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 105.4 services above the limits in paragraph (a) must receive the 105.5 commissioner's prior authorization, except when: 105.6 (1) the home care services were required to treat an 105.7 emergency medical condition that if not immediately treated 105.8 could cause a recipient serious physical or mental disability, 105.9 continuation of severe pain, or death. The provider must 105.10 request retroactive authorization no later than five working 105.11 days after giving the initial service. The provider must be 105.12 able to substantiate the emergency by documentation such as 105.13 reports, notes, and admission or discharge histories; 105.14 (2) the home care services were provided on or after the 105.15 date on which the recipient's eligibility began, but before the 105.16 date on which the recipient was notified that the case was 105.17 opened. Authorization will be considered if the request is 105.18 submitted by the provider within 20 working days of the date the 105.19 recipient was notified that the case was opened; 105.20 (3) a third-party payor for home care services has denied 105.21 or adjusted a payment. Authorization requests must be submitted 105.22 by the provider within 20 working days of the notice of denial 105.23 or adjustment. A copy of the notice must be included with the 105.24 request; 105.25 (4) the commissioner has determined that a county or state 105.26 human services agency has made an error; or 105.27 (5) the professional nurse determines an immediate need for 105.28 up to 40 skilled nursing or home health aide visits per calendar 105.29 year and submits a request for authorization within 20 working 105.30 days of the initial service date, and medical assistance is 105.31 determined to be the appropriate payer. 105.32 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 105.33 authorization will be evaluated according to the same criteria 105.34 applied to prior authorization requests. 105.35 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 105.36 section 256B.0627, subdivision 1, paragraph (a), shall be 106.1 conducted initially, and at least annually thereafter, in person 106.2 with the recipient and result in a completed service plan using 106.3 forms specified by the commissioner. Within 30 days of 106.4 recipient or responsible party request for home care services, 106.5 the assessment, the service plan, and other information 106.6 necessary to determine medical necessity such as diagnostic or 106.7 testing information, social or medical histories, and hospital 106.8 or facility discharge summaries shall be submitted to the 106.9 commissioner. For personal care services: 106.10 (1) The amount and type of service authorized based upon 106.11 the assessment and service plan will follow the recipient if the 106.12 recipient chooses to change providers. 106.13 (2) If the recipient's medical need changes, the 106.14 recipient's provider may assess the need for a change in service 106.15 authorization and request the change from the county public 106.16 health nurse. Within 30 days of the request, the public health 106.17 nurse will determine whether to request the change in services 106.18 based upon the provider assessment, or conduct a home visit to 106.19 assess the need and determine whether the change is appropriate. 106.20 (3) To continue to receive personal care serviceswhen the106.21recipient displays no significant change, the county public106.22health nurse has the option to review with the commissioner, or106.23the commissioner's designee, the service plan on record and106.24receive authorization for up to an additional 12 months at a106.25time for up to three years.after the first year, the recipient 106.26 or the responsible party, in conjunction with the public health 106.27 nurse, may complete a service update on forms developed by the 106.28 commissioner. The service update may substitute for the annual 106.29 reassessment described in subdivision 1. 106.30 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 106.31 commissioner's designee, shall review the assessment, the 106.32 service plan, and any additional information that is submitted. 106.33 The commissioner shall, within 30 days after receiving a 106.34 complete request, assessment, and service plan, authorize home 106.35 care services as follows: 106.36 (1) [HOME HEALTH SERVICES.] All home health services 107.1 provided by a licensed nurse or a home health aide must be prior 107.2 authorized by the commissioner or the commissioner's designee. 107.3 Prior authorization must be based on medical necessity and 107.4 cost-effectiveness when compared with other care options. When 107.5 home health services are used in combination with personal care 107.6 and private duty nursing, the cost of all home care services 107.7 shall be considered for cost-effectiveness. The commissioner 107.8 shall limit nurse and home health aide visits to no more than 107.9 one visit each per day. 107.10 (2) [PERSONAL CARE SERVICES.] (i) All personal care 107.11 services and registered nurse supervision must be prior 107.12 authorized by the commissioner or the commissioner's designee 107.13 except for the assessments established in paragraph (a). The 107.14 amount of personal care services authorized must be based on the 107.15 recipient's home care rating. A child may not be found to be 107.16 dependent in an activity of daily living if because of the 107.17 child's age an adult would either perform the activity for the 107.18 child or assist the child with the activity and the amount of 107.19 assistance needed is similar to the assistance appropriate for a 107.20 typical child of the same age. Based on medical necessity, the 107.21 commissioner may authorize: 107.22 (A) up to two times the average number of direct care hours 107.23 provided in nursing facilities for the recipient's comparable 107.24 case mix level; or 107.25 (B) up to three times the average number of direct care 107.26 hours provided in nursing facilities for recipients who have 107.27 complex medical needs or are dependent in at least seven 107.28 activities of daily living and need physical assistance with 107.29 eating or have a neurological diagnosis; or 107.30 (C) up to 60 percent of the average reimbursement rate, as 107.31 of July 1, 1991, for care provided in a regional treatment 107.32 center for recipients who have Level I behavior, plus any 107.33 inflation adjustment as provided by the legislature for personal 107.34 care service; or 107.35 (D) up to the amount the commissioner would pay, as of July 107.36 1, 1991, plus any inflation adjustment provided for home care 108.1 services, for care provided in a regional treatment center for 108.2 recipients referred to the commissioner by a regional treatment 108.3 center preadmission evaluation team. For purposes of this 108.4 clause, home care services means all services provided in the 108.5 home or community that would be included in the payment to a 108.6 regional treatment center; or 108.7 (E) up to the amount medical assistance would reimburse for 108.8 facility care for recipients referred to the commissioner by a 108.9 preadmission screening team established under section 256B.0911 108.10 or 256B.092; and 108.11 (F) a reasonable amount of time for the provision of 108.12 nursing supervision of personal care services. 108.13 (ii) The number of direct care hours shall be determined 108.14 according to the annual cost report submitted to the department 108.15 by nursing facilities. The average number of direct care hours, 108.16 as established by May 1, 1992, shall be calculated and 108.17 incorporated into the home care limits on July 1, 1992. These 108.18 limits shall be calculated to the nearest quarter hour. 108.19 (iii) The home care rating shall be determined by the 108.20 commissioner or the commissioner's designee based on information 108.21 submitted to the commissioner by the county public health nurse 108.22 on forms specified by the commissioner. The home care rating 108.23 shall be a combination of current assessment tools developed 108.24 under sections 256B.0911 and 256B.501 with an addition for 108.25 seizure activity that will assess the frequency and severity of 108.26 seizure activity and with adjustments, additions, and 108.27 clarifications that are necessary to reflect the needs and 108.28 conditions of recipients who need home care including children 108.29 and adults under 65 years of age. The commissioner shall 108.30 establish these forms and protocols under this section and shall 108.31 use an advisory group, including representatives of recipients, 108.32 providers, and counties, for consultation in establishing and 108.33 revising the forms and protocols. 108.34 (iv) A recipient shall qualify as having complex medical 108.35 needs if the care required is difficult to perform and because 108.36 of recipient's medical condition requires more time than 109.1 community-based standards allow or requires more skill than 109.2 would ordinarily be required and the recipient needs or has one 109.3 or more of the following: 109.4 (A) daily tube feedings; 109.5 (B) daily parenteral therapy; 109.6 (C) wound or decubiti care; 109.7 (D) postural drainage, percussion, nebulizer treatments, 109.8 suctioning, tracheotomy care, oxygen, mechanical ventilation; 109.9 (E) catheterization; 109.10 (F) ostomy care; 109.11 (G) quadriplegia; or 109.12 (H) other comparable medical conditions or treatments the 109.13 commissioner determines would otherwise require institutional 109.14 care. 109.15 (v) A recipient shall qualify as having Level I behavior if 109.16 there is reasonable supporting evidence that the recipient 109.17 exhibits, or that without supervision, observation, or 109.18 redirection would exhibit, one or more of the following 109.19 behaviors that cause, or have the potential to cause: 109.20 (A) injury to the recipient's own body; 109.21 (B) physical injury to other people; or 109.22 (C) destruction of property. 109.23 (vi) Time authorized for personal care relating to Level I 109.24 behavior in subclause (v), items (A) to (C), shall be based on 109.25 the predictability, frequency, and amount of intervention 109.26 required. 109.27 (vii) A recipient shall qualify as having Level II behavior 109.28 if the recipient exhibits on a daily basis one or more of the 109.29 following behaviors that interfere with the completion of 109.30 personal care services under subdivision 4, paragraph (a): 109.31 (A) unusual or repetitive habits; 109.32 (B) withdrawn behavior; or 109.33 (C) offensive behavior. 109.34 (viii) A recipient with a home care rating of Level II 109.35 behavior in subclause (vii), items (A) to (C), shall be rated as 109.36 comparable to a recipient with complex medical needs under 110.1 subclause (iv). If a recipient has both complex medical needs 110.2 and Level II behavior, the home care rating shall be the next 110.3 complex category up to the maximum rating under subclause (i), 110.4 item (B). 110.5 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 110.6 nursing services shall be prior authorized by the commissioner 110.7 or the commissioner's designee. Prior authorization for private 110.8 duty nursing services shall be based on medical necessity and 110.9 cost-effectiveness when compared with alternative care options. 110.10 The commissioner may authorize medically necessary private duty 110.11 nursing services in quarter-hour units when: 110.12 (i) the recipient requires more individual and continuous 110.13 care than can be provided during a nurse visit; or 110.14 (ii) the cares are outside of the scope of services that 110.15 can be provided by a home health aide or personal care assistant. 110.16 The commissioner may authorize: 110.17 (A) up to two times the average amount of direct care hours 110.18 provided in nursing facilities statewide for case mix 110.19 classification "K" as established by the annual cost report 110.20 submitted to the department by nursing facilities in May 1992; 110.21 (B) private duty nursing in combination with other home 110.22 care services up to the total cost allowed under clause (2); 110.23 (C) up to 16 hours per day if the recipient requires more 110.24 nursing than the maximum number of direct care hours as 110.25 established in item (A) and the recipient meets the hospital 110.26 admission criteria established under Minnesota Rules, parts 110.27 9505.0500 to 9505.0540. 110.28 The commissioner may authorize up to 16 hours per day of 110.29 medically necessary private duty nursing services or up to 24 110.30 hours per day of medically necessary private duty nursing 110.31 services until such time as the commissioner is able to make a 110.32 determination of eligibility for recipients who are 110.33 cooperatively applying for home care services under the 110.34 community alternative care program developed under section 110.35 256B.49, or until it is determined by the appropriate regulatory 110.36 agency that a health benefit plan is or is not required to pay 111.1 for appropriate medically necessary health care services. 111.2 Recipients or their representatives must cooperatively assist 111.3 the commissioner in obtaining this determination. Recipients 111.4 who are eligible for the community alternative care program may 111.5 not receive more hours of nursing under this section than would 111.6 otherwise be authorized under section 256B.49. 111.7 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 111.8 ventilator-dependent, the monthly medical assistance 111.9 authorization for home care services shall not exceed what the 111.10 commissioner would pay for care at the highest cost hospital 111.11 designated as a long-term hospital under the Medicare program. 111.12 For purposes of this clause, home care services means all 111.13 services provided in the home that would be included in the 111.14 payment for care at the long-term hospital. 111.15 "Ventilator-dependent" means an individual who receives 111.16 mechanical ventilation for life support at least six hours per 111.17 day and is expected to be or has been dependent for at least 30 111.18 consecutive days. 111.19 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 111.20 or the commissioner's designee shall determine the time period 111.21 for which a prior authorization shall be effective. If the 111.22 recipient continues to require home care services beyond the 111.23 duration of the prior authorization, the home care provider must 111.24 request a new prior authorization. Under no circumstances, 111.25 other than the exceptions in paragraph (b), shall a prior 111.26 authorization be valid prior to the date the commissioner 111.27 receives the request or for more than 12 months. A recipient 111.28 who appeals a reduction in previously authorized home care 111.29 services may continue previously authorized services, other than 111.30 temporary services under paragraph (h), pending an appeal under 111.31 section 256.045. The commissioner must provide a detailed 111.32 explanation of why the authorized services are reduced in amount 111.33 from those requested by the home care provider. 111.34 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 111.35 the commissioner's designee shall determine the medical 111.36 necessity of home care services, the level of caregiver 112.1 according to subdivision 2, and the institutional comparison 112.2 according to this subdivision, the cost-effectiveness of 112.3 services, and the amount, scope, and duration of home care 112.4 services reimbursable by medical assistance, based on the 112.5 assessment, primary payer coverage determination information as 112.6 required, the service plan, the recipient's age, the cost of 112.7 services, the recipient's medical condition, and diagnosis or 112.8 disability. The commissioner may publish additional criteria 112.9 for determining medical necessity according to section 256B.04. 112.10 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 112.11 The agency nurse, the independently enrolled private duty nurse, 112.12 or county public health nurse may request a temporary 112.13 authorization for home care services by telephone. The 112.14 commissioner may approve a temporary level of home care services 112.15 based on the assessment, and service or care plan information, 112.16 and primary payer coverage determination information as required. 112.17 Authorization for a temporary level of home care services 112.18 including nurse supervision is limited to the time specified by 112.19 the commissioner, but shall not exceed 45 days, unless extended 112.20 because the county public health nurse has not completed the 112.21 required assessment and service plan, or the commissioner's 112.22 determination has not been made. The level of services 112.23 authorized under this provision shall have no bearing on a 112.24 future prior authorization. 112.25 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 112.26 Home care services provided in an adult or child foster care 112.27 setting must receive prior authorization by the department 112.28 according to the limits established in paragraph (a). 112.29 The commissioner may not authorize: 112.30 (1) home care services that are the responsibility of the 112.31 foster care provider under the terms of the foster care 112.32 placement agreement and administrative rules. Requests for home 112.33 care services for recipients residing in a foster care setting 112.34 must include the foster care placement agreement and 112.35 determination of difficulty of care; 112.36 (2) personal care services when the foster care license 113.1 holder is also the personal care provider or personal care 113.2 assistant unless the recipient can direct the recipient's own 113.3 care, or case management is provided as required in section 113.4 256B.0625, subdivision 19a; 113.5 (3) personal care services when the responsible party is an 113.6 employee of, or under contract with, or has any direct or 113.7 indirect financial relationship with the personal care provider 113.8 or personal care assistant, unless case management is provided 113.9 as required in section 256B.0625, subdivision 19a; 113.10 (4) home care services when the number of foster care 113.11 residents is greater than four unless the county responsible for 113.12 the recipient's foster placement made the placement prior to 113.13 April 1, 1992, requests that home care services be provided, and 113.14 case management is provided as required in section 256B.0625, 113.15 subdivision 19a; or 113.16 (5) home care services when combined with foster care 113.17 payments, other than room and board payments that exceed the 113.18 total amount that public funds would pay for the recipient's 113.19 care in a medical institution. 113.20 Sec. 28. Minnesota Statutes 1997 Supplement, section 113.21 256B.0645, is amended to read: 113.22 256B.0645 [PROVIDER PAYMENTS; RETROACTIVE CHANGES IN 113.23 ELIGIBILITY.] 113.24 Payment to a provider for a health care service provided to 113.25 a general assistance medical care recipient who is later 113.26 determined eligible for medical assistance or MinnesotaCare 113.27 according to section 256L.14 for the period in which the health 113.28 care service was provided,shall be considered payment in full,113.29and shall notmay be adjusted due to the change in eligibility. 113.30 This sectionappliesdoes not apply toboth fee-for-service113.31payments andpayments made to health plans on a prepaid 113.32 capitated basis. 113.33 Sec. 29. Minnesota Statutes 1997 Supplement, section 113.34 256B.0911, subdivision 2, is amended to read: 113.35 Subd. 2. [PERSONS REQUIRED TO BE SCREENED; EXEMPTIONS.] 113.36 All applicants to Medicaid certified nursing facilities must be 114.1 screened prior to admission, regardless of income, assets, or 114.2 funding sources, except the following: 114.3 (1) patients who, having entered acute care facilities from 114.4 certified nursing facilities, are returning to a certified 114.5 nursing facility; 114.6 (2) residents transferred from other certified nursing 114.7 facilities located within the state of Minnesota; 114.8 (3) individuals who have a contractual right to have their 114.9 nursing facility care paid for indefinitely by the veteran's 114.10 administration; 114.11 (4) individuals who are enrolled in the Ebenezer/Group 114.12 Health social health maintenance organization project, or 114.13 enrolled in a demonstration project under section 256B.69, 114.14 subdivision188, at the time of application to a nursing home; 114.15 (5) individuals previously screened and currently being 114.16 served under the alternative care program or under a home and 114.17 community-based services waiver authorized under section 1915(c) 114.18 of the Social Security Act; or 114.19 (6) individuals who are admitted to a certified nursing 114.20 facility for a short-term stay, which, based upon a physician's 114.21 certification, is expected to be 14 days or less in duration, 114.22 and who have been screened and approved for nursing facility 114.23 admission within the previous six months. This exemption 114.24 applies only if the screener determines at the time of the 114.25 initial screening of the six-month period that it is appropriate 114.26 to use the nursing facility for short-term stays and that there 114.27 is an adequate plan of care for return to the home or 114.28 community-based setting. If a stay exceeds 14 days, the 114.29 individual must be referred no later than the first county 114.30 working day following the 14th resident day for a screening, 114.31 which must be completed within five working days of the 114.32 referral. Payment limitations in subdivision 7 will apply to an 114.33 individual found at screening to not meet the level of care 114.34 criteria for admission to a certified nursing facility. 114.35 Regardless of the exemptions in clauses (2) to (6), persons 114.36 who have a diagnosis or possible diagnosis of mental illness, 115.1 mental retardation, or a related condition must receive a 115.2 preadmission screening before admission unless the admission 115.3 prior to screening is authorized by the local mental health 115.4 authority or the local developmental disabilities case manager, 115.5 or unless authorized by the county agency according to Public 115.6 Law Number 101-508. 115.7 Before admission to a Medicaid certified nursing home or 115.8 boarding care home, all persons must be screened and approved 115.9 for admission through an assessment process. The nursing 115.10 facility is authorized to conduct case mix assessments which are 115.11 not conducted by the county public health nurse under Minnesota 115.12 Rules, part 9549.0059. The designated county agency is 115.13 responsible for distributing the quality assurance and review 115.14 form for all new applicants to nursing homes. 115.15 Other persons who are not applicants to nursing facilities 115.16 must be screened if a request is made for a screening. 115.17 Sec. 30. Minnesota Statutes 1996, section 256B.0911, 115.18 subdivision 4, is amended to read: 115.19 Subd. 4. [RESPONSIBILITIES OF THE COUNTY AND THE SCREENING 115.20 TEAM.] (a) The county shall: 115.21 (1) provide information and education to the general public 115.22 regarding availability of the preadmission screening program; 115.23 (2) accept referrals from individuals, families, human 115.24 service and health professionals, and hospital and nursing 115.25 facility personnel; 115.26 (3) assess the health, psychological, and social needs of 115.27 referred individuals and identify services needed to maintain 115.28 these persons in the least restrictive environments; 115.29 (4) determine if the individual screened needs nursing 115.30 facility level of care; 115.31 (5) assess specialized service needs based upon an 115.32 evaluation by: 115.33 (i) a qualified independent mental health professional for 115.34 persons with a primary or secondary diagnosis of a serious 115.35 mental illness; and 115.36 (ii) a qualified mental retardation professional for 116.1 persons with a primary or secondary diagnosis of mental 116.2 retardation or related conditions. For purposes of this clause, 116.3 a qualified mental retardation professional must meet the 116.4 standards for a qualified mental retardation professional in 116.5 Code of Federal Regulations, title 42, section 483.430; 116.6 (6) make recommendations for individuals screened regarding 116.7 cost-effective community services which are available to the 116.8 individual; 116.9 (7) make recommendations for individuals screened regarding 116.10 nursing home placement when there are no cost-effective 116.11 community services available; 116.12 (8) develop an individual's community care plan and provide 116.13 follow-up services as needed; and 116.14 (9) prepare and submit reports that may be required by the 116.15 commissioner of human services. 116.16 (b) The screener shall document that the most 116.17 cost-effective alternatives available were offered to the 116.18 individual or the individual's legal representative. For 116.19 purposes of this section, "cost-effective alternatives" means 116.20 community services and living arrangements that cost the same or 116.21 less than nursing facility care. 116.22 (c)Screeners shall adhere to the level of care criteria116.23for admission to a certified nursing facility established under116.24section 144.0721.116.25(d)For persons who are eligible for medical assistance or 116.26 who would be eligible within 180 days of admission to a nursing 116.27 facility and who are admitted to a nursing facility, the nursing 116.28 facility must include a screener or the case manager in the 116.29 discharge planning process for those individuals who the team 116.30 has determined have discharge potential. The screener or the 116.31 case manager must ensure a smooth transition and follow-up for 116.32 the individual's return to the community. 116.33 Screeners shall cooperate with other public and private 116.34 agencies in the community, in order to offer a variety of 116.35 cost-effective services to the disabled and elderly. The 116.36 screeners shall encourage the use of volunteers from families, 117.1 religious organizations, social clubs, and similar civic and 117.2 service organizations to provide services. 117.3 Sec. 31. Minnesota Statutes 1997 Supplement, section 117.4 256B.0911, subdivision 7, is amended to read: 117.5 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 117.6 (a) Medical assistance reimbursement for nursing facilities 117.7 shall be authorized for a medical assistance recipient only if a 117.8 preadmission screening has been conducted prior to admission or 117.9 the local county agency has authorized an exemption. Medical 117.10 assistance reimbursement for nursing facilities shall not be 117.11 provided for any recipient who the local screener has determined 117.12 does not meet the level of care criteria for nursing facility 117.13 placement or, if indicated, has not had a level II PASARR 117.14 evaluation completed unless an admission for a recipient with 117.15 mental illness is approved by the local mental health authority 117.16 or an admission for a recipient with mental retardation or 117.17 related condition is approved by the state mental retardation 117.18 authority.The county preadmission screening team may deny117.19certified nursing facility admission using the level of care117.20criteria established under section 144.0721 and deny medical117.21assistance reimbursement for certified nursing facility care.117.22Persons receiving care in a certified nursing facility or117.23certified boarding care home who are reassessed by the117.24commissioner of health according to section 144.0722 and117.25determined to no longer meet the level of care criteria for a117.26certified nursing facility or certified boarding care home may117.27no longer remain a resident in the certified nursing facility or117.28certified boarding care home and must be relocated to the117.29community if the persons were admitted on or after July 1, 1998.117.30 (b)Persons receiving services under section 256B.0913,117.31subdivisions 1 to 14, or 256B.0915 who are reassessed and found117.32to not meet the level of care criteria for admission to a117.33certified nursing facility or certified boarding care home may117.34no longer receive these services if persons were admitted to the117.35program on or after July 1, 1998.The commissioner shall make a 117.36 request to the health care financing administration for a waiver 118.1 allowing screening team approval of Medicaid payments for 118.2 certified nursing facility care. An individual has a choice and 118.3 makes the final decision between nursing facility placement and 118.4 community placement after the screening team's recommendation, 118.5 except as provided in paragraphs (b) and (c). 118.6 (c) The local county mental health authority or the state 118.7 mental retardation authority under Public Law Numbers 100-203 118.8 and 101-508 may prohibit admission to a nursing facility, if the 118.9 individual does not meet the nursing facility level of care 118.10 criteria or needs specialized services as defined in Public Law 118.11 Numbers 100-203 and 101-508. For purposes of this section, 118.12 "specialized services" for a person with mental retardation or a 118.13 related condition means "active treatment" as that term is 118.14 defined in Code of Federal Regulations, title 42, section 118.15 483.440(a)(1). 118.16 (d) Upon the receipt by the commissioner of approval by the 118.17 Secretary of Health and Human Services of the waiver requested 118.18 under paragraph (a), the local screener shall deny medical 118.19 assistance reimbursement for nursing facility care for an 118.20 individual whose long-term care needs can be met in a 118.21 community-based setting and whose cost of community-based home 118.22 care services is less than 75 percent of the average payment for 118.23 nursing facility care for that individual's case mix 118.24 classification, and who is either: 118.25 (i) a current medical assistance recipient being screened 118.26 for admission to a nursing facility; or 118.27 (ii) an individual who would be eligible for medical 118.28 assistance within 180 days of entering a nursing facility and 118.29 who meets a nursing facility level of care. 118.30 (e) Appeals from the screening team's recommendation or the 118.31 county agency's final decision shall be made according to 118.32 section 256.045, subdivision 3. 118.33 Sec. 32. Minnesota Statutes 1997 Supplement, section 118.34 256B.0913, subdivision 14, is amended to read: 118.35 Subd. 14. [REIMBURSEMENT AND RATE ADJUSTMENTS.] (a) 118.36 Reimbursement for expenditures for the alternative care services 119.1 as approved by the client's case manager shall be through the 119.2 invoice processing procedures of the department's Medicaid 119.3 Management Information System (MMIS). To receive reimbursement, 119.4 the county or vendor must submit invoices within 12 months 119.5 following the date of service. The county agency and its 119.6 vendors under contract shall not be reimbursed for services 119.7 which exceed the county allocation. 119.8 (b) If a county collects less than 50 percent of the client 119.9 premiums due under subdivision 12, the commissioner may withhold 119.10 up to three percent of the county's final alternative care 119.11 program allocation determined under subdivisions 10 and 11. 119.12 (c)For fiscal years beginning on or after July 1, 1993,119.13the commissioner of human services shall not provide automatic119.14annual inflation adjustments for alternative care services. The119.15commissioner of finance shall include as a budget change request119.16in each biennial detailed expenditure budget submitted to the119.17legislature under section 16A.11 annual adjustments in119.18reimbursement rates for alternative care services based on the119.19forecasted percentage change in the Home Health Agency Market119.20Basket of Operating Costs, for the fiscal year beginning July 1,119.21compared to the previous fiscal year, unless otherwise adjusted119.22by statute. The Home Health Agency Market Basket of Operating119.23Costs is published by Data Resources, Inc. The forecast to be119.24used is the one published for the calendar quarter beginning119.25January 1, six months prior to the beginning of the fiscal year119.26for which rates are set.119.27(d)The county shall negotiate individual rates with 119.28 vendors and may be reimbursed for actual costs up to the greater 119.29 of the county's current approved rate or 60 percent of the 119.30 maximum rate in fiscal year 1994 and 65 percent of the maximum 119.31 rate in fiscal year 1995 for each alternative care service. 119.32 Notwithstanding any other rule or statutory provision to the 119.33 contrary, the commissioner shall not be authorized to increase 119.34 rates by an annual inflation factor, unless so authorized by the 119.35 legislature. 119.36(e)(d) On July 1, 1993, the commissioner shall increase 120.1 the maximum rate for home delivered meals to $4.50 per meal. 120.2 Sec. 33. Minnesota Statutes 1997 Supplement, section 120.3 256B.0915, subdivision 1d, is amended to read: 120.4 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 120.5 RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the 120.6 provisions of section 256B.056, the commissioner shall make the 120.7 following amendment to the medical assistance elderly waiver 120.8 program effective July 1,19971999, or upon federal approval, 120.9 whichever is later. 120.10 A recipient's maintenance needs will be an amount equal to 120.11 the Minnesota supplemental aid equivalent rate as defined in 120.12 section 256I.03, subdivision 5, plus the medical assistance 120.13 personal needs allowance as defined in section 256B.35, 120.14 subdivision 1, paragraph (a), when applying posteligibility 120.15 treatment of income rules to the gross income of elderly waiver 120.16 recipients, except for individuals whose income is in excess of 120.17 the special income standard according to Code of Federal 120.18 Regulations, title 42, section 435.236. Recipient maintenance 120.19 needs shall be adjusted under this provision each July 1. 120.20 (b) The commissioner of human services shall secure 120.21 approval of additional elderly waiver slots sufficient to serve 120.22 persons who will qualify under the revised income standard 120.23 described in paragraph (a) before implementing section 120.24 256B.0913, subdivision 16. 120.25 (c) In implementing this subdivision, the commissioner 120.26 shall consider allowing persons who would otherwise be eligible 120.27 for the alternative care program but would qualify for the 120.28 elderly waiver with a spenddown to remain on the alternative 120.29 care program. 120.30 Sec. 34. Minnesota Statutes 1997 Supplement, section 120.31 256B.0915, subdivision 3, is amended to read: 120.32 Subd. 3. [LIMITS OF CASES, RATES, REIMBURSEMENT, AND 120.33 FORECASTING.] (a) The number of medical assistance waiver 120.34 recipients that a county may serve must be allocated according 120.35 to the number of medical assistance waiver cases open on July 1 120.36 of each fiscal year. Additional recipients may be served with 121.1 the approval of the commissioner. 121.2 (b) The monthly limit for the cost of waivered services to 121.3 an individual waiver client shall be the statewide average 121.4 payment rate of the case mix resident class to which the waiver 121.5 client would be assigned under the medical assistance case mix 121.6 reimbursement system. If medical supplies and equipment or 121.7 adaptations are or will be purchased for an elderly waiver 121.8 services recipient, the costs may be prorated on a monthly basis 121.9 throughout the year in which they are purchased. If the monthly 121.10 cost of a recipient's other waivered services exceeds the 121.11 monthly limit established in this paragraph, the annual cost of 121.12 the waivered services shall be determined. In this event, the 121.13 annual cost of waivered services shall not exceed 12 times the 121.14 monthly limit calculated in this paragraph. The statewide 121.15 average payment rate is calculated by determining the statewide 121.16 average monthly nursing home rate, effective July 1 of the 121.17 fiscal year in which the cost is incurred, less the statewide 121.18 average monthly income of nursing home residents who are age 65 121.19 or older, and who are medical assistance recipients in the month 121.20 of March of the previous state fiscal year. The annual cost 121.21 divided by 12 of elderly or disabled waivered services for a 121.22 person who is a nursing facility resident at the time of 121.23 requesting a determination of eligibility for elderly or 121.24 disabled waivered services shall be the greater of the monthly 121.25 payment for: (i) the resident class assigned under Minnesota 121.26 Rules, parts 9549.0050 to 9549.0059, for that resident in the 121.27 nursing facility where the resident currently resides; or (ii) 121.28 the statewide average payment of the case mix resident class to 121.29 which the resident would be assigned under the medical 121.30 assistance case mix reimbursement system, provided that the 121.31 limit under this clause only applies to persons discharged from 121.32 a nursing facility and found eligible for waivered services on 121.33 or after July 1, 1997. The following costs must be included in 121.34 determining the total monthly costs for the waiver client: 121.35 (1) cost of all waivered services, including extended 121.36 medical supplies and equipment; and 122.1 (2) cost of skilled nursing, home health aide, and personal 122.2 care services reimbursable by medical assistance. 122.3 (c) Medical assistance funding for skilled nursing 122.4 services, private duty nursing, home health aide, and personal 122.5 care services for waiver recipients must be approved by the case 122.6 manager and included in the individual care plan. 122.7 (d) For both the elderly waiver and the nursing facility 122.8 disabled waiver, a county may purchase extended supplies and 122.9 equipment without prior approval from the commissioner when 122.10 there is no other funding source and the supplies and equipment 122.11 are specified in the individual's care plan as medically 122.12 necessary to enable the individual to remain in the community 122.13 according to the criteria in Minnesota Rules, part 9505.0210, 122.14 items A and B. A county is not required to contract with a 122.15 provider of supplies and equipment if the monthly cost of the 122.16 supplies and equipment is less than $250. 122.17 (e)For the fiscal year beginning on July 1, 1993, and for122.18subsequent fiscal years, the commissioner of human services122.19shall not provide automatic annual inflation adjustments for122.20home and community-based waivered services. The commissioner of122.21finance shall include as a budget change request in each122.22biennial detailed expenditure budget submitted to the122.23legislature under section 16A.11, annual adjustments in122.24reimbursement rates for home and community-based waivered122.25services, based on the forecasted percentage change in the Home122.26Health Agency Market Basket of Operating Costs, for the fiscal122.27year beginning July 1, compared to the previous fiscal year,122.28unless otherwise adjusted by statute. The Home Health Agency122.29Market Basket of Operating Costs is published by Data Resources,122.30Inc. The forecast to be used is the one published for the122.31calendar quarter beginning January 1, six months prior to the122.32beginning of the fiscal year for which rates are set. The adult122.33foster care rate shall be considered a difficulty of care122.34payment and shall not include room and board.122.35(f)The adult foster care daily rate for the elderly and 122.36 disabled waivers shall be negotiated between the county agency 123.1 and the foster care provider. The rate established under this 123.2 section shall not exceed the state average monthly nursing home 123.3 payment for the case mix classification to which the individual 123.4 receiving foster care is assigned; the rate must allow for other 123.5 waiver and medical assistance home care services to be 123.6 authorized by the case manager. 123.7(g)(f) The assisted living and residential care service 123.8 rates for elderly and community alternatives for disabled 123.9 individuals (CADI) waivers shall be made to the vendor as a 123.10 monthly rate negotiated with the county agency based on an 123.11 individualized service plan for each resident. The rate shall 123.12 not exceed the nonfederal share of the greater of either the 123.13 statewide or any of the geographic groups' weighted average 123.14 monthly medical assistance nursing facility payment rate of the 123.15 case mix resident class to which the elderly or disabled client 123.16 would be assigned under Minnesota Rules, parts 9549.0050 to 123.17 9549.0059, unless the services are provided by a home care 123.18 provider licensed by the department of health and are provided 123.19 in a building that is registered as a housing with services 123.20 establishment under chapter 144D and that provides 24-hour 123.21 supervision. For alternative care assisted living projects 123.22 established under Laws 1988, chapter 689, article 2, section 123.23 256, monthly rates may not exceed 65 percent of the greater of 123.24 either the statewide or any of the geographic groups' weighted 123.25 average monthly medical assistance nursing facility payment rate 123.26 for the case mix resident class to which the elderly or disabled 123.27 client would be assigned under Minnesota Rules, parts 9549.0050 123.28 to 9549.0059. The rate may not cover direct rent or food costs. 123.29(h)(g) The county shall negotiate individual rates with 123.30 vendors and may be reimbursed for actual costs up to the greater 123.31 of the county's current approved rate or 60 percent of the 123.32 maximum rate in fiscal year 1994 and 65 percent of the maximum 123.33 rate in fiscal year 1995 for each service within each program. 123.34(i)(h) On July 1, 1993, the commissioner shall increase 123.35 the maximum rate for home-delivered meals to $4.50 per meal. 123.36(j)(i) Reimbursement for the medical assistance recipients 124.1 under the approved waiver shall be made from the medical 124.2 assistance account through the invoice processing procedures of 124.3 the department's Medicaid Management Information System (MMIS), 124.4 only with the approval of the client's case manager. The budget 124.5 for the state share of the Medicaid expenditures shall be 124.6 forecasted with the medical assistance budget, and shall be 124.7 consistent with the approved waiver. 124.8(k)(j) Beginning July 1, 1991, the state shall reimburse 124.9 counties according to the payment schedule in section 256.025 124.10 for the county share of costs incurred under this subdivision on 124.11 or after January 1, 1991, for individuals who are receiving 124.12 medical assistance. 124.13(l)(k) For the community alternatives for disabled 124.14 individuals waiver, and nursing facility disabled waivers, 124.15 county may use waiver funds for the cost of minor adaptations to 124.16 a client's residence or vehicle without prior approval from the 124.17 commissioner if there is no other source of funding and the 124.18 adaptation: 124.19 (1) is necessary to avoid institutionalization; 124.20 (2) has no utility apart from the needs of the client; and 124.21 (3) meets the criteria in Minnesota Rules, part 9505.0210, 124.22 items A and B. 124.23 For purposes of this subdivision, "residence" means the client's 124.24 own home, the client's family residence, or a family foster 124.25 home. For purposes of this subdivision, "vehicle" means the 124.26 client's vehicle, the client's family vehicle, or the client's 124.27 family foster home vehicle. 124.28(m)(l) The commissioner shall establish a maximum rate 124.29 unit for baths provided by an adult day care provider that are 124.30 not included in the provider's contractual daily or hourly rate. 124.31 This maximum rate must equal the home health aide extended rate 124.32 and shall be paid for baths provided to clients served under the 124.33 elderly and disabled waivers. 124.34 Sec. 35. Minnesota Statutes 1996, section 256B.0916, is 124.35 amended to read: 124.36 256B.0916 [EXPANSION OF HOME AND COMMUNITY-BASED SERVICES; 125.1 MANAGEMENT AND ALLOCATION RESPONSIBILITIES.] 125.2 (a) The commissioner shall expand availability of home and 125.3 community-based services for persons with mental retardation and 125.4 related conditions to the extent allowed by federal law and 125.5 regulation and shall assist counties in transferring persons 125.6 from semi-independent living services to home and 125.7 community-based services. The commissioner may transfer funds 125.8 from the state semi-independent living services account 125.9 available under section 252.275, subdivision 8, and state 125.10 community social services aids available under section 256E.15 125.11 to the medical assistance account to pay for the nonfederal 125.12 share of nonresidential and residential home and community-based 125.13 services authorized under section 256B.092 for persons 125.14 transferring from semi-independent living services. 125.15 (b) Upon federal approval, county boards are not 125.16 responsible for funding semi-independent living services as a 125.17 social service for those persons who have transferred to the 125.18 home and community-based waiver program as a result of the 125.19 expansion under this subdivision. The county responsibility for 125.20 those persons transferred shall be assumed under section 125.21 256B.092. Notwithstanding the provisions of section 252.275, 125.22 the commissioner shall continue to allocate funds under that 125.23 section for semi-independent living services and county boards 125.24 shall continue to fund services under sections 256E.06 and 125.25 256E.14 for those persons who cannot access home and 125.26 community-based services under section 256B.092. 125.27 (c) Eighty percent of the state funds made available to the 125.28 commissioner under section 252.275 as a result of persons 125.29 transferring from the semi-independent living services program 125.30 to the home and community-based services program shall be used 125.31 to fund additional persons in the semi-independent living 125.32 services program. 125.33 (d) Beginning August 1, 1998, the commissioner shall issue 125.34 an annual report on the home and community-based waiver for 125.35 persons with mental retardation or related conditions, that 125.36 includes a list of the counties in which less than 95 percent of 126.1 the allocation provided, excluding the county waivered services 126.2 reserve, has been committed for two or more quarters during the 126.3 previous state fiscal year. For each listed county, the report 126.4 shall include the amount of funds allocated but not used, the 126.5 number and ages of individuals screened and waiting for 126.6 services, the services needed, a description of the technical 126.7 assistance provided by the commissioner to assist the counties 126.8 in jointly planning with other counties in order to serve more 126.9 persons, and additional actions which will be taken to serve 126.10 those screened and waiting for services. 126.11 (e) The commissioner shall make available to interested 126.12 parties, upon request, financial information by county including 126.13 the amount of resources allocated for the home and 126.14 community-based waiver for persons with mental retardation and 126.15 related conditions, the resources committed, the number of 126.16 persons screened and waiting for services, the type of services 126.17 requested by those waiting, and the amount of allocated 126.18 resources not committed. 126.19 Sec. 36. Minnesota Statutes 1997 Supplement, section 126.20 256B.0951, is amended by adding a subdivision to read: 126.21 Subd. 4a. [WAIVER OF RULES.] The commissioner of health 126.22 may exempt residents of intermediate care facilities for persons 126.23 with mental retardation (ICFs/MR) who participate in the 126.24 three-year quality assurance pilot project established in 126.25 section 256B.095 from the requirements of Minnesota Rules, part 126.26 4665, upon approval by the federal government of a waiver of 126.27 federal certification requirements for ICFs/MR. The 126.28 commissioners of health and human services shall apply for any 126.29 necessary waivers as soon as practicable and shall submit the 126.30 concept paper to the federal government by June 1, 1998. 126.31 Sec. 37. Minnesota Statutes 1996, section 256B.41, 126.32 subdivision 1, is amended to read: 126.33 Subdivision 1. [AUTHORITY.] The commissioner shall 126.34 establish, by rule, procedures for determining rates for care of 126.35 residents of nursing facilities which qualify as vendors of 126.36 medical assistance, and for implementing the provisions of this 127.1 section and sections 256B.421, 256B.431, 256B.432, 256B.433, 127.2 256B.47, 256B.48, 256B.50, and 256B.502. The procedures shall 127.3be based on methods and standards that the commissioner finds127.4are adequate to provide for the costs that must be incurred for127.5the care of residents in efficiently and economically operated127.6nursing facilities and shallspecify the costs that are 127.7 allowable for establishing payment rates through medical 127.8 assistance. 127.9 Sec. 38. Minnesota Statutes 1996, section 256B.431, 127.10 subdivision 2b, is amended to read: 127.11 Subd. 2b. [OPERATING COSTS, AFTER JULY 1, 1985.] (a) For 127.12 rate years beginning on or after July 1, 1985, the commissioner 127.13 shall establish procedures for determining per diem 127.14 reimbursement for operating costs. 127.15 (b) The commissioner shall contract with an econometric 127.16 firm with recognized expertise in and access to national 127.17 economic change indices that can be applied to the appropriate 127.18 cost categories when determining the operating cost payment rate. 127.19 (c) The commissioner shall analyze and evaluate each 127.20 nursing facility's cost report of allowable operating costs 127.21 incurred by the nursing facility during the reporting year 127.22 immediately preceding the rate year for which the payment rate 127.23 becomes effective. 127.24 (d) The commissioner shall establish limits on actual 127.25 allowable historical operating cost per diems based on cost 127.26 reports of allowable operating costs for the reporting year that 127.27 begins October 1, 1983, taking into consideration relevant 127.28 factors including resident needs, geographic location, and size 127.29 of the nursing facility, and the costs that must be incurred for127.30the care of residents in an efficiently and economically127.31operated nursing facility. In developing the geographic groups 127.32 for purposes of reimbursement under this section, the 127.33 commissioner shall ensure that nursing facilities in any county 127.34 contiguous to the Minneapolis-St. Paul seven-county metropolitan 127.35 area are included in the same geographic group. The limits 127.36 established by the commissioner shall not be less, in the 128.1 aggregate, than the 60th percentile of total actual allowable 128.2 historical operating cost per diems for each group of nursing 128.3 facilities established under subdivision 1 based on cost reports 128.4 of allowable operating costs in the previous reporting year. 128.5 For rate years beginning on or after July 1, 1989, facilities 128.6 located in geographic group I as described in Minnesota Rules, 128.7 part 9549.0052, on January 1, 1989, may choose to have the 128.8 commissioner apply either the care related limits or the other 128.9 operating cost limits calculated for facilities located in 128.10 geographic group II, or both, if either of the limits calculated 128.11 for the group II facilities is higher. The efficiency incentive 128.12 for geographic group I nursing facilities must be calculated 128.13 based on geographic group I limits. The phase-in must be 128.14 established utilizing the chosen limits. For purposes of these 128.15 exceptions to the geographic grouping requirements, the 128.16 definitions in Minnesota Rules, parts 9549.0050 to 9549.0059 128.17 (Emergency), and 9549.0010 to 9549.0080, apply. The limits 128.18 established under this paragraph remain in effect until the 128.19 commissioner establishes a new base period. Until the new base 128.20 period is established, the commissioner shall adjust the limits 128.21 annually using the appropriate economic change indices 128.22 established in paragraph (e). In determining allowable 128.23 historical operating cost per diems for purposes of setting 128.24 limits and nursing facility payment rates, the commissioner 128.25 shall divide the allowable historical operating costs by the 128.26 actual number of resident days, except that where a nursing 128.27 facility is occupied at less than 90 percent of licensed 128.28 capacity days, the commissioner may establish procedures to 128.29 adjust the computation of the per diem to an imputed occupancy 128.30 level at or below 90 percent. The commissioner shall establish 128.31 efficiency incentives as appropriate. The commissioner may 128.32 establish efficiency incentives for different operating cost 128.33 categories. The commissioner shall consider establishing 128.34 efficiency incentives in care related cost categories. The 128.35 commissioner may combine one or more operating cost categories 128.36 and may use different methods for calculating payment rates for 129.1 each operating cost category or combination of operating cost 129.2 categories. For the rate year beginning on July 1, 1985, the 129.3 commissioner shall: 129.4 (1) allow nursing facilities that have an average length of 129.5 stay of 180 days or less in their skilled nursing level of care, 129.6 125 percent of the care related limit and 105 percent of the 129.7 other operating cost limit established by rule; and 129.8 (2) exempt nursing facilities licensed on July 1, 1983, by 129.9 the commissioner to provide residential services for the 129.10 physically handicapped under Minnesota Rules, parts 9570.2000 to 129.11 9570.3600, from the care related limits and allow 105 percent of 129.12 the other operating cost limit established by rule. 129.13 For the purpose of calculating the other operating cost 129.14 efficiency incentive for nursing facilities referred to in 129.15 clause (1) or (2), the commissioner shall use the other 129.16 operating cost limit established by rule before application of 129.17 the 105 percent. 129.18 (e) The commissioner shall establish a composite index or 129.19 indices by determining the appropriate economic change 129.20 indicators to be applied to specific operating cost categories 129.21 or combination of operating cost categories. 129.22 (f) Each nursing facility shall receive an operating cost 129.23 payment rate equal to the sum of the nursing facility's 129.24 operating cost payment rates for each operating cost category. 129.25 The operating cost payment rate for an operating cost category 129.26 shall be the lesser of the nursing facility's historical 129.27 operating cost in the category increased by the appropriate 129.28 index established in paragraph (e) for the operating cost 129.29 category plus an efficiency incentive established pursuant to 129.30 paragraph (d) or the limit for the operating cost category 129.31 increased by the same index. If a nursing facility's actual 129.32 historic operating costs are greater than the prospective 129.33 payment rate for that rate year, there shall be no retroactive 129.34 cost settle-up. In establishing payment rates for one or more 129.35 operating cost categories, the commissioner may establish 129.36 separate rates for different classes of residents based on their 130.1 relative care needs. 130.2 (g) The commissioner shall include the reported actual real 130.3 estate tax liability or payments in lieu of real estate tax of 130.4 each nursing facility as an operating cost of that nursing 130.5 facility. Allowable costs under this subdivision for payments 130.6 made by a nonprofit nursing facility that are in lieu of real 130.7 estate taxes shall not exceed the amount which the nursing 130.8 facility would have paid to a city or township and county for 130.9 fire, police, sanitation services, and road maintenance costs 130.10 had real estate taxes been levied on that property for those 130.11 purposes. For rate years beginning on or after July 1, 1987, 130.12 the reported actual real estate tax liability or payments in 130.13 lieu of real estate tax of nursing facilities shall be adjusted 130.14 to include an amount equal to one-half of the dollar change in 130.15 real estate taxes from the prior year. The commissioner shall 130.16 include a reported actual special assessment, and reported 130.17 actual license fees required by the Minnesota department of 130.18 health, for each nursing facility as an operating cost of that 130.19 nursing facility. For rate years beginning on or after July 1, 130.20 1989, the commissioner shall include a nursing facility's 130.21 reported public employee retirement act contribution for the 130.22 reporting year as apportioned to the care-related operating cost 130.23 categories and other operating cost categories multiplied by the 130.24 appropriate composite index or indices established pursuant to 130.25 paragraph (e) as costs under this paragraph. Total adjusted 130.26 real estate tax liability, payments in lieu of real estate tax, 130.27 actual special assessments paid, the indexed public employee 130.28 retirement act contribution, and license fees paid as required 130.29 by the Minnesota department of health, for each nursing facility 130.30 (1) shall be divided by actual resident days in order to compute 130.31 the operating cost payment rate for this operating cost 130.32 category, (2) shall not be used to compute the care-related 130.33 operating cost limits or other operating cost limits established 130.34 by the commissioner, and (3) shall not be increased by the 130.35 composite index or indices established pursuant to paragraph 130.36 (e), unless otherwise indicated in this paragraph. 131.1 (h) For rate years beginning on or after July 1, 1987, the 131.2 commissioner shall adjust the rates of a nursing facility that 131.3 meets the criteria for the special dietary needs of its 131.4 residents and the requirements in section 31.651. The 131.5 adjustment for raw food cost shall be the difference between the 131.6 nursing facility's allowable historical raw food cost per diem 131.7 and 115 percent of the median historical allowable raw food cost 131.8 per diem of the corresponding geographic group. 131.9 The rate adjustment shall be reduced by the applicable 131.10 phase-in percentage as provided under subdivision 2h. 131.11(i) For the cost report year ending September 30, 1996, and131.12for all subsequent reporting years, certified nursing facilities131.13must identify, differentiate, and record resident day statistics131.14for residents in case mix classification A who, on or after July131.151, 1996, meet the modified level of care criteria in section131.16144.0721. The resident day statistics shall be separated into131.17case mix classification A-1 for any resident day meeting the131.18high-function class A level of care criteria and case mix131.19classification A-2 for other case mix class A resident days.131.20 Sec. 39. Minnesota Statutes 1996, section 256B.501, 131.21 subdivision 2, is amended to read: 131.22 Subd. 2. [AUTHORITY.] The commissioner shall establish 131.23 procedures and rules for determining rates for care of residents 131.24 of intermediate care facilities for persons with mental 131.25 retardation or related conditions which qualify as providers of 131.26 medical assistance and waivered services.Approved rates shall131.27be established on the basis of methods and standards that the131.28commissioner finds adequate to provide for the costs that must131.29be incurred for the quality care of residents in efficiently and131.30economically operated facilities and services.The procedures 131.31 shall specify the costs that are allowable for payment through 131.32 medical assistance. The commissioner may use experts from 131.33 outside the department in the establishment of the procedures. 131.34 Sec. 40. Minnesota Statutes 1997 Supplement, section 131.35 256B.69, subdivision 2, is amended to read: 131.36 Subd. 2. [DEFINITIONS.] For the purposes of this section, 132.1 the following terms have the meanings given. 132.2 (a) "Commissioner" means the commissioner of human services. 132.3 For the remainder of this section, the commissioner's 132.4 responsibilities for methods and policies for implementing the 132.5 project will be proposed by the project advisory committees and 132.6 approved by the commissioner. 132.7 (b) "Demonstration provider" means a health maintenance 132.8 organizationor, community integrated service network, or 132.9 accountable provider network authorized and operating under 132.10 chapter 62Dor, 62N, or 62T that participates in the 132.11 demonstration project according to criteria, standards, methods, 132.12 and other requirements established for the project and approved 132.13 by the commissioner. Notwithstanding the above, Itasca county 132.14 may continue to participate as a demonstration provider until 132.15 July 1, 2000. 132.16 (c) "Eligible individuals" means those persons eligible for 132.17 medical assistance benefits as defined in sections 256B.055, 132.18 256B.056, and 256B.06. 132.19 (d) "Limitation of choice" means suspending freedom of 132.20 choice while allowing eligible individuals to choose among the 132.21 demonstration providers. 132.22 (e) This paragraph supersedes paragraph (c) as long as the 132.23 Minnesota health care reform waiver remains in effect. When the 132.24 waiver expires, this paragraph expires and the commissioner of 132.25 human services shall publish a notice in the State Register and 132.26 notify the revisor of statutes. "Eligible individuals" means 132.27 those persons eligible for medical assistance benefits as 132.28 defined in sections 256B.055, 256B.056, and 256B.06. 132.29 Notwithstanding sections 256B.055, 256B.056, and 256B.06, an 132.30 individual who becomes ineligible for the program because of 132.31 failure to submit income reports or recertification forms in a 132.32 timely manner, shall remain enrolled in the prepaid health plan 132.33 and shall remain eligible to receive medical assistance coverage 132.34 through the last day of the month following the month in which 132.35 the enrollee became ineligible for the medical assistance 132.36 program. 133.1 Sec. 41. Minnesota Statutes 1997 Supplement, section 133.2 256B.69, subdivision 3a, is amended to read: 133.3 Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when 133.4 implementing the general assistance medical care, or medical 133.5 assistance prepayment program within a county, must include the 133.6 county board in the process of development, approval, and 133.7 issuance of the request for proposals to provide services to 133.8 eligible individuals within the proposed county. County boards 133.9 must be given reasonable opportunity to make recommendations 133.10 regarding the development, issuance, review of responses, and 133.11 changes needed in the request for proposals. The commissioner 133.12 must provide county boards the opportunity to review each 133.13 proposal based on the identification of community needs under 133.14 chapters 145A and 256E and county advocacy activities. If a 133.15 county board finds that a proposal does not address certain 133.16 community needs, the county board and commissioner shall 133.17 continue efforts for improving the proposal and network prior to 133.18 the approval of the contract. The county board shall make 133.19 recommendations regarding the approval of local networks and 133.20 their operations to ensure adequate availability and access to 133.21 covered services. The provider or health plan must respond 133.22 directly to county advocates and the state prepaid medical 133.23 assistance ombudsperson regarding service delivery and must be 133.24 accountable to the state regarding contracts with medical 133.25 assistance and general assistance medical care funds. The 133.26 county board may recommend a maximum number of participating 133.27 health plans after considering the size of the enrolling 133.28 population; ensuring adequate access and capacity; considering 133.29 the client and county administrative complexity; and considering 133.30 the need to promote the viability of locally developed health 133.31 plans. The county board or a single entity representing a group 133.32 of county boards and the commissioner shall mutually select 133.33 health plans for participation at the time of initial 133.34 implementation of the prepaid medical assistance program in that 133.35 county or group of counties and at the time of contract renewal. 133.36 The commissioner shall also seek input for contract requirements 134.1 from the county or single entity representing a group of county 134.2 boards at each contract renewal and incorporate those 134.3 recommendations into the contract negotiation process. The 134.4 commissioner, in conjunction with the county board, shall 134.5 actively seek to develop a mutually agreeable timetable prior to 134.6 the development of the request for proposal, but counties must 134.7 agree to initial enrollment beginning on or before January 1, 134.8 1999, in either the prepaid medical assistance and general 134.9 assistance medical care programs or county-based purchasing 134.10 under section 256B.692. At least 90 days before enrollment in 134.11 the medical assistance and general assistance medical care 134.12 prepaid programs begins in a county in which the prepaid 134.13 programs have not been established, the commissioner shall 134.14 provide a report to the chairs of senate and house committees 134.15 having jurisdiction over state health care programs which 134.16 verifies that the commissioner complied with the requirements 134.17 for county involvement that are specified in this subdivision. 134.18 (b) The commissioner shall seek a federal waiver to allow a 134.19 fee-for-service plan option to MinnesotaCare enrollees. The 134.20 commissioner shall develop an increase of the premium fees 134.21 required under section 256L.06 up to 20 percent of the premium 134.22 fees for the enrollees who elect the fee-for-service option. 134.23 Prior to implementation, the commissioner shall submit this fee 134.24 schedule to the chair and ranking minority member of the senate 134.25 health care committee, the senate health care and family 134.26 services funding division, the house of representatives health 134.27 and human services committee, and the house of representatives 134.28 health and human services finance division. 134.29 (c) At the option of the county board, the board may 134.30 develop contract requirements related to the achievement of 134.31 local public health goals to meet the health needs of medical 134.32 assistance and general assistance medical care enrollees. These 134.33 requirements must be reasonably related to the performance of 134.34 health plan functions and within the scope of the medical 134.35 assistance and general assistance medical care benefit sets. If 134.36 the county board and the commissioner mutually agree to such 135.1 requirements, the department shall include such requirements in 135.2 all health plan contracts governing the prepaid medical 135.3 assistance and general assistance medical care programs in that 135.4 county at initial implementation of the program in that county 135.5 and at the time of contract renewal. The county board may 135.6 participate in the enforcement of the contract provisions 135.7 related to local public health goals. 135.8 (d) For counties in which prepaid medical assistance and 135.9 general assistance medical care programs have not been 135.10 established, the commissioner shall not implement those programs 135.11 if a county board submits acceptable and timely preliminary and 135.12 final proposals under section 256B.692, until county-based 135.13 purchasing is no longer operational in that county. For 135.14 counties in which prepaid medical assistance and general 135.15 assistance medical care programs are in existence on or after 135.16 September 1, 1997, the commissioner must terminate contracts 135.17 with health plans according to section 256B.692, subdivision 5, 135.18 if the county board submits and the commissioner accepts 135.19 preliminary and final proposals according to that subdivision. 135.20 The commissioner is not required to terminate contracts that 135.21 begin on or after September 1, 1997, according to section 135.22 256B.692 until two years have elapsed from the date of initial 135.23 enrollment. 135.24 (e) In the event that a county board or a single entity 135.25 representing a group of county boards and the commissioner 135.26 cannot reach agreement regarding: (i) the selection of 135.27 participating health plans in that county; (ii) contract 135.28 requirements; or (iii) implementation and enforcement of county 135.29 requirements including provisions regarding local public health 135.30 goals, the commissioner shall resolve all disputes after taking 135.31 into account the recommendations of a three-person mediation 135.32 panel. The panel shall be composed of one designee of the 135.33 president of the association of Minnesota counties, one designee 135.34 of the commissioner of human services, and one designee of the 135.35 commissioner of health. 135.36 (f) If a county which elects to implement county-based 136.1 purchasing ceases to implement county-based purchasing, it is 136.2 prohibited from assuming the responsibility of county-based 136.3 purchasing for a period of five years from the date it 136.4 discontinues purchasing. 136.5 (g) Notwithstanding the requirement in this subdivision 136.6 that a county must agree to initial enrollment on or before 136.7 January 1, 1999, the commissioner shall grant a delay of up to 136.8 nine months in the implementation of the county-based purchasing 136.9 authorized in section 256B.692 if the county or group of 136.10 counties has submitted a preliminary proposal for county-based 136.11 purchasing by September 1, 1997, has not already implemented the 136.12 prepaid medical assistance program before January 1, 1998, and 136.13 has submitted a written request for the delay to the 136.14 commissioner by July 1, 1998. In order for the delay to be 136.15 continued, the county or group of counties must also submit to 136.16 the commissioner the following information by December 1, 1998. 136.17 The information must: 136.18 (1) identify the proposed date of implementation, not later 136.19 than October 1, 1999; 136.20 (2) include copies of the county board resolutions which 136.21 demonstrate the continued commitment to the implementation of 136.22 county-based purchasing by the proposed date. County board 136.23 authorization may remain contingent on the submission of a final 136.24 proposal which meets the requirements of section 256B.692, 136.25 subdivision 5, paragraph (b); 136.26 (3) demonstrate the establishment of a governance structure 136.27 between the participating counties and describe how the 136.28 fiduciary responsibilities of county-based purchasing will be 136.29 allocated between the counties, if more than one county is 136.30 involved in the proposal; 136.31 (4) describe how the risk of a deficit will be managed in 136.32 the event expenditures are greater than total capitation 136.33 payments. This description must identify how any of the 136.34 following strategies will be used: 136.35 (i) risk contracts with licensed health plans; 136.36 (ii) risk arrangements with providers who are not licensed 137.1 health plans; 137.2 (iii) risk arrangements with other licensed insurance 137.3 entities; and 137.4 (iv) funding from other county resources; 137.5 (5) include, if county-based purchasing will not contract 137.6 with licensed health plans or provider networks, letters of 137.7 interest from local providers in at least the categories of 137.8 hospital, physician, mental health, and pharmacy which express 137.9 interest in contracting for services. These letters must 137.10 recognize any risk transfer identified in clause (4), item (ii); 137.11 and 137.12 (6) describe the options being considered to obtain the 137.13 administrative services required in section 256B.692, 137.14 subdivision 3, clauses (3) and (5). 137.15 (h) For counties which receive a delay under this 137.16 subdivision, the final proposals required under section 137.17 256B.692, subdivision 5, paragraph (b), must be submitted at 137.18 least six months prior to the requested implementation date. 137.19 Authority to implement county-based purchasing remains 137.20 contingent on approval of the final proposal as required under 137.21 section 256B.692. 137.22 Sec. 42. Minnesota Statutes 1996, section 256B.69, is 137.23 amended by adding a subdivision to read: 137.24 Subd. 25. [EXEMPTION FROM ENROLLMENT.] (a) Beginning on or 137.25 after January 1, 1999, for American Indian recipients of medical 137.26 assistance who live on or near a reservation, as defined in Code 137.27 of Federal Regulations, title 42, section 36.22(a)(6), and who 137.28 are required to enroll with a demonstration provider under 137.29 subdivision 4, medical assistance shall cover health care 137.30 services provided at American Indian health services facilities 137.31 and facilities operated by a tribe or tribal organization under 137.32 funding authorized by United States Code, title 25, sections 137.33 450f to 450n, or title III of the Indian Self-Determination and 137.34 Education Assistance Act, Public Law Number 93-638, if those 137.35 services would otherwise be covered under section 256B.0625. 137.36 Payments for services provided under this subdivision shall be 138.1 made on a fee-for-service basis, and may, at the option of the 138.2 tribe or tribal organization, be made in accordance with rates 138.3 authorized under sections 256.959, subdivision 16, and 138.4 256B.0625, subdivision 34. Implementation of this purchasing 138.5 model is contingent on federal approval. 138.6 (b) For purposes of this subdivision, "American Indian" has 138.7 the meaning given to persons to whom services will be provided 138.8 for in Code of Federal Regulations, title 42, section 36.12. 138.9 (c) This subdivision also applies to American Indian 138.10 recipients of general assistance medical care and to the prepaid 138.11 general assistance medical care program under section 256D.03, 138.12 subdivision 4, paragraph (d). 138.13 (d) The commissioner of human services, in consultation 138.14 with the tribal governments, shall develop a plan for tribes to 138.15 assist in the enrollment process for American Indian recipients 138.16 enrolled in the prepaid medical assistance program under this 138.17 section or the prepaid general assistance program under section 138.18 256D.03, subdivision 4, paragraph (d). This plan also shall 138.19 address how tribes will be included in ensuring the coordination 138.20 of care for American Indian recipients between Indian health 138.21 service or tribal providers and other providers. 138.22 Sec. 43. Minnesota Statutes 1997 Supplement, section 138.23 256B.692, subdivision 2, is amended to read: 138.24 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] 138.25 Notwithstanding chapters 62D and 62N, a county that elects to 138.26 purchase medical assistance and general assistance medical care 138.27 in return for a fixed sum without regard to the frequency or 138.28 extent of services furnished to any particular enrollee is not 138.29 required to obtain a certificate of authority under chapter 62D 138.30 or 62N. A county that elects to purchase medical assistance and 138.31 general assistance medical care services under this section must 138.32 satisfy the commissioner of health that the requirements of 138.33 chapter 62D, applicable to health maintenance organizations, or 138.34 chapter 62N, applicable to community integrated service 138.35 networks, will be met. A county must also assure the 138.36 commissioner of health that the requirements ofsectionsections 139.1 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all 139.2 applicable provisions of chapter 62Q, including sections 62Q.07; 139.3 62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 139.4 62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 139.5 62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 139.6 will be met. All enforcement and rulemaking powers available 139.7 under chapters 62Dand, 62J, 62M, 62N, and 62Q are hereby 139.8 granted to the commissioner of health with respect to counties 139.9 that purchase medical assistance and general assistance medical 139.10 care services under this section. 139.11 Sec. 44. Minnesota Statutes 1997 Supplement, section 139.12 256B.692, subdivision 5, is amended to read: 139.13 Subd. 5. [COUNTY PROPOSALS.] (a) On or before September 1, 139.14 1997, a county board that wishes to purchase or provide health 139.15 care under this section must submit a preliminary proposal that 139.16 substantially demonstrates the county's ability to meet all the 139.17 requirements of this section in response to criteria for 139.18 proposals issued by the department on or before July 1, 1997. 139.19 Counties submitting preliminary proposals must establish a local 139.20 planning process that involves input from medical assistance and 139.21 general assistance medical care recipients, recipient advocates, 139.22 providers and representatives of local school districts, labor, 139.23 and tribal government to advise on the development of a final 139.24 proposal and its implementation. 139.25 (b) The county board must submit a final proposal on or 139.26 before July 1, 1998, that demonstrates the ability to meet all 139.27 the requirements of this section, including beginning enrollment 139.28 on January 1, 1999, unless a delay has been granted under 139.29 section 256B.69, subdivision 3a, paragraph (g). 139.30 (c) After January 1, 1999, for a county in which the 139.31 prepaid medical assistance program is in existence, the county 139.32 board must submit a preliminary proposal at least 15 months 139.33 prior to termination of health plan contracts in that county and 139.34 a final proposal six months prior to the health plan contract 139.35 termination date in order to begin enrollment after the 139.36 termination. Nothing in this section shall impede or delay 140.1 implementation or continuation of the prepaid medical assistance 140.2 and general assistance medical care programs in counties for 140.3 which the board does not submit a proposal, or submits a 140.4 proposal that is not in compliance with this section. 140.5 (d) The commissioner is not required to terminate contracts 140.6 for the prepaid medical assistance and prepaid general 140.7 assistance medical care programs that begin on or after 140.8 September 1, 1997, in a county for which a county board has 140.9 submitted a proposal under this paragraph, until two years have 140.10 elapsed from the date of initial enrollment in the prepaid 140.11 medical assistance and prepaid general assistance medical care 140.12 programs. 140.13 Sec. 45. Minnesota Statutes 1997 Supplement, section 140.14 256B.77, subdivision 3, is amended to read: 140.15 Subd. 3. [ASSURANCES TO THE COMMISSIONER OF HEALTH.] A 140.16 county authority that elects to participate in a demonstration 140.17 project for people with disabilities under this section is not 140.18 required to obtain a certificate of authority under chapter 62D 140.19 or 62N. A county authority that elects to participate in a 140.20 demonstration project for people with disabilities under this 140.21 section must assure the commissioner of health that the 140.22 requirements of chapters 62D and 62N, and section 256B.092, 140.23 subdivision 2, are met. All enforcement and rulemaking powers 140.24 available under chapters 62Dand, 62J, 62M, 62N, and 62Q are 140.25 granted to the commissioner of health with respect to the county 140.26 authorities that contract with the commissioner to purchase 140.27 services in a demonstration project for people with disabilities 140.28 under this section. 140.29 Sec. 46. Minnesota Statutes 1997 Supplement, section 140.30 256B.77, subdivision 7a, is amended to read: 140.31 Subd. 7a. [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 140.32 for the demonstration project as provided in this subdivision. 140.33 (b) "Eligible individuals" means those persons living in 140.34 the demonstration site who are eligible for medical assistance 140.35 and are disabled based on a disability determination under 140.36 section 256B.055, subdivisions 7 and 12, or who are eligible for 141.1 medical assistance and have been diagnosed as having: 141.2 (1) serious and persistent mental illness as defined in 141.3 section 245.462, subdivision 20; 141.4 (2) severe emotional disturbance as defined in section 141.5 245.487, subdivision 6; or 141.6 (3) mental retardation, or being a mentally retarded person 141.7 as defined in section 252A.02, or a related condition as defined 141.8 in section 252.27, subdivision 1a. 141.9 Other individuals may be included at the option of the county 141.10 authority based on agreement with the commissioner. 141.11 (c) Eligible individuals residing on a federally recognized 141.12 Indian reservation may be excluded from participation in the 141.13 demonstration project at the discretion of the tribal government 141.14 based on agreement with the commissioner, in consultation with 141.15 the county authority. 141.16 (d) Eligible individuals include individuals in excluded 141.17 time status, as defined in chapter 256G. Enrollees in excluded 141.18 time at the time of enrollment shall remain in excluded time 141.19 status as long as they live in the demonstration site and shall 141.20 be eligible for 90 days after placement outside the 141.21 demonstration site if they move to excluded time status in a 141.22 county within Minnesota other than their county of financial 141.23 responsibility. 141.24 (e) A person who is a sexual psychopathic personality as 141.25 defined in section 253B.02, subdivision 18a, or a sexually 141.26 dangerous person as defined in section 253B.02, subdivision 18b, 141.27 is excluded from enrollment in the demonstration project. 141.28 Sec. 47. Minnesota Statutes 1997 Supplement, section 141.29 256B.77, subdivision 10, is amended to read: 141.30 Subd. 10. [CAPITATION PAYMENT.] (a) The commissioner shall 141.31 pay a capitation payment to the county authority and, when 141.32 applicable under subdivision 6, paragraph (a), to the service 141.33 delivery organization for each medical assistance eligible 141.34 enrollee. The commissioner shall develop capitation payment 141.35 rates for the initial contract period for each demonstration 141.36 site in consultation with an independent actuary, to ensure that 142.1 the cost of services under the demonstration project does not 142.2 exceed the estimated cost for medical assistance services for 142.3 the covered population under the fee-for-service system for the 142.4 demonstration period. For each year of the demonstration 142.5 project, the capitation payment rate shall be based on 96 142.6 percent of the projected per person costs that would otherwise 142.7 have been paid under medical assistance fee-for-service during 142.8 each of those years. Rates shall be adjusted within the limits 142.9 of the available risk adjustment technology, as mandated by 142.10 section 62Q.03. In addition, the commissioner shall implement 142.11 appropriate risk and savings sharing provisions with county 142.12 administrative entities and, when applicable under subdivision 142.13 6, paragraph (a), service delivery organizations within the 142.14 projected budget limits. Capitation rates shall be adjusted, at 142.15 least annually, to include any rate increases and payments for 142.16 expanded or newly covered services for eligible individuals. 142.17 The initial demonstration project rate shall include an amount 142.18 in addition to the fee-for-service payments to adjust for 142.19 underutilization of dental services. Any savings beyond those 142.20 allowed for the county authority, county administrative entity, 142.21 or service delivery organization shall be first used to meet the 142.22 unmet needs of eligible individuals. Payments to providers 142.23 participating in the project are exempt from the requirements of 142.24 sections 256.966 and 256B.03, subdivision 2. 142.25 (b) The commissioner shall monitor and evaluate annually 142.26 the effect of the discount on consumers, the county authority, 142.27 and providers of disability services. Findings shall be 142.28 reported and recommendations made, as appropriate, to ensure 142.29 that the discount effect does not adversely affect the ability 142.30 of the county administrative entity or providers of services to 142.31 provide appropriate services to eligible individuals, and does 142.32 not result in cost shifting of eligible individuals to the 142.33 county authority. 142.34 Sec. 48. Minnesota Statutes 1997 Supplement, section 142.35 256B.77, subdivision 12, is amended to read: 142.36 Subd. 12. [SERVICE COORDINATION.] (a) For purposes of this 143.1 section, "service coordinator" means an individual selected by 143.2 the enrollee or the enrollee's legal representative and 143.3 authorized by the county administrative entity or service 143.4 delivery organization to work in partnership with the enrollee 143.5 to develop, coordinate, and in some instances, provide supports 143.6 and services identified in the personal support plan. Service 143.7 coordinators may only provide services and supports if the 143.8 enrollee is informed of potential conflicts of interest, is 143.9 given alternatives, and gives informed consent. Eligible 143.10 service coordinators are individuals age 18 or older who meet 143.11 the qualifications as described in paragraph (b). Enrollees, 143.12 their legal representatives, or their advocates are eligible to 143.13 be service coordinators if they have the capabilities to perform 143.14 the activities and functions outlined in paragraph (b). 143.15 Providers licensed under chapter 245A to provide residential 143.16 services, or providers who are providing residential services 143.17 covered under the group residential housing program may not act 143.18 as service coordinator for enrollees for whom they provide 143.19 residential services. This does not apply to providers of 143.20 short-term detoxification services. Each county administrative 143.21 entity or service delivery organization may develop further 143.22 criteria for eligible vendors of service coordination during the 143.23 demonstration period and shall determine whom it contracts with 143.24 or employs to provide service coordination. County 143.25 administrative entities and service delivery organizations may 143.26 pay enrollees or their advocates or legal representatives for 143.27 service coordination activities. 143.28 (b) The service coordinator shall act as a facilitator, 143.29 working in partnership with the enrollee to ensure that their 143.30 needs are identified and addressed. The level of involvement of 143.31 the service coordinator shall depend on the needs and desires of 143.32 the enrollee. The service coordinator shall have the knowledge, 143.33 skills, and abilities to, and is responsible for: 143.34 (1) arranging for an initial assessment, and periodic 143.35 reassessment as necessary, of supports and services based on the 143.36 enrollee's strengths, needs, choices, and preferences in life 144.1 domain areas; 144.2 (2) developing and updating the personal support plan based 144.3 on relevant ongoing assessment; 144.4 (3) arranging for and coordinating the provisions of 144.5 supports and services, including knowledgeable and skilled 144.6 specialty services and prevention and early intervention 144.7 services, within the limitations negotiated with the county 144.8 administrative entity or service delivery organization; 144.9 (4) assisting the enrollee and the enrollee's legal 144.10 representative, if any, to maximize informed choice of and 144.11 control over services and supports and to exercise the 144.12 enrollee's rights and advocate on behalf of the enrollee; 144.13 (5) monitoring the progress toward achieving the enrollee's 144.14 outcomes in order to evaluate and adjust the timeliness and 144.15 adequacy of the implementation of the personal support plan; 144.16 (6) facilitating meetings and effectively collaborating 144.17 with a variety of agencies and persons, including attending 144.18 individual family service plan and individual education plan 144.19 meetings when requested by the enrollee or the enrollee's legal 144.20 representative; 144.21 (7) soliciting and analyzing relevant information; 144.22 (8) communicating effectively with the enrollee and with 144.23 other individuals participating in the enrollee's plan; 144.24 (9) educating and communicating effectively with the 144.25 enrollee about good health care practices and risk to the 144.26 enrollee's health with certain behaviors; 144.27 (10) having knowledge of basic enrollee protection 144.28 requirements, including data privacy; 144.29 (11) informing, educating, and assisting the enrollee in 144.30 identifying available service providers and accessing needed 144.31 resources and services beyond the limitations of the medical 144.32 assistance benefit set covered services; and 144.33 (12) providing other services as identified in the personal 144.34 support plan. 144.35 (c) For the demonstration project, the qualifications and 144.36 standards for service coordination in this section shall replace 145.1 comparable existing provisions of existing statutes and rules 145.2 governing case management for eligible individuals. 145.3 (d) The provisions of this subdivision apply only to the 145.4 demonstration sitesthat begin implementation on July 1,145.51998designated by the commissioner under subdivision 5. All 145.6 other demonstration sites must comply with laws and rules 145.7 governing case management services for eligible individuals in 145.8 effect when the site begins the demonstration project. 145.9 Sec. 49. Minnesota Statutes 1997 Supplement, section 145.10 256D.03, subdivision 3, is amended to read: 145.11 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 145.12 (a) General assistance medical care may be paid for any person 145.13 who is not eligible for medical assistance under chapter 256B, 145.14 including eligibility for medical assistance based on a 145.15 spenddown of excess income according to section 256B.056, 145.16 subdivision 5, or MinnesotaCare as defined in clause(4)(5), 145.17 except as provided in paragraph (b); and: 145.18 (1) who is receiving assistance under section 256D.05, 145.19 except for families with children who are eligible under 145.20 Minnesota family investment program-statewide (MFIP-S), who is 145.21 having a payment made on the person's behalf under sections 145.22 256I.01 to 256I.06, or who resides in group residential housing 145.23 as defined in chapter 256I and can meet a spenddown using the 145.24 cost of remedial services received through group residential 145.25 housing; or 145.26 (2)(i) who is a resident of Minnesota; and whose equity in 145.27 assets is not in excess of $1,000 per assistance unit. Exempt 145.28 assets, the reduction of excess assets, and the waiver of excess 145.29 assets must conform to the medical assistance program in chapter 145.30 256B, with the following exception: the maximum amount of 145.31 undistributed funds in a trust that could be distributed to or 145.32 on behalf of the beneficiary by the trustee, assuming the full 145.33 exercise of the trustee's discretion under the terms of the 145.34 trust, must be applied toward the asset maximum; and 145.35 (ii) who has countable income not in excess of the 145.36 assistance standards established in section 256B.056, 146.1 subdivision 4, or whose excess income is spent down according to 146.2 section 256B.056, subdivision 5, using a six-month budget 146.3 period. The method for calculating earned income disregards and 146.4 deductions for a person who resides with a dependent child under 146.5 age 21 shall follow section 256B.056, subdivision 1a. However, 146.6 if a disregard of $30 and one-third of the remainder has been 146.7 applied to the wage earner's income, the disregard shall not be 146.8 applied again until the wage earner's income has not been 146.9 considered in an eligibility determination for general 146.10 assistance, general assistance medical care, medical assistance, 146.11 or MFIP-S for 12 consecutive months. The earned income and work 146.12 expense deductions for a person who does not reside with a 146.13 dependent child under age 21 shall be the same as the method 146.14 used to determine eligibility for a person under section 146.15 256D.06, subdivision 1, except the disregard of the first $50 of 146.16 earned income is not allowed;or146.17 (3) who would be eligible for medical assistance except 146.18 that the person resides in a facility that is determined by the 146.19 commissioner or the federal Health Care Financing Administration 146.20 to be an institution for mental diseases.; or 146.21 (4) who is receiving care and rehabilitation services from 146.22 a nonprofit center established to serve victims of torture. 146.23 These individuals are eligible for general assistance medical 146.24 care only for the period during which they are receiving 146.25 services from the center. During this period of eligibility, 146.26 individuals eligible under this clause shall not be required to 146.27 participate in prepaid general assistance medical care. 146.28 (5) Beginning July 1, 1998, applicants or recipients who 146.29 meet all eligibility requirements of MinnesotaCare as defined in 146.30 sections 256L.01 to 256L.16, and are: 146.31 (i) adults with dependent children under 21 whose gross 146.32 family income is equal to or less than 275 percent of the 146.33 federal poverty guidelines; or 146.34 (ii) adults without children with earned income and whose 146.35 family gross income is between 75 percent of the federal poverty 146.36 guidelines and the amount set by section 256L.04, subdivision 7, 147.1 shall be terminated from general assistance medical care upon 147.2 enrollment in MinnesotaCare. 147.3 (b) For services rendered on or after July 1, 1997, 147.4 eligibility is limited to one month prior to application if the 147.5 person is determined eligible in the prior month. A 147.6 redetermination of eligibility must occur every 12 months. 147.7 Beginning July 1, 1998, Minnesota health care program 147.8 applications completed by recipients and applicants who are 147.9 persons described in paragraph (a), clause(4)(5), may be 147.10 returned to the county agency to be forwarded to the department 147.11 of human services or sent directly to the department of human 147.12 services for enrollment in MinnesotaCare. If all other 147.13 eligibility requirements of this subdivision are met, 147.14 eligibility for general assistance medical care shall be 147.15 available in any month during which a MinnesotaCare eligibility 147.16 determination and enrollment are pending. Upon notification of 147.17 eligibility for MinnesotaCare, notice of termination for 147.18 eligibility for general assistance medical care shall be sent to 147.19 an applicant or recipient. If all other eligibility 147.20 requirements of this subdivision are met, eligibility for 147.21 general assistance medical care shall be available until 147.22 enrollment in MinnesotaCare subject to the provisions of 147.23 paragraph (d). 147.24 (c) The date of an initial Minnesota health care program 147.25 application necessary to begin a determination of eligibility 147.26 shall be the date the applicant has provided a name, address, 147.27 and social security number, signed and dated, to the county 147.28 agency or the department of human services. If the applicant is 147.29 unable to provide an initial application when health care is 147.30 delivered due to a medical condition or disability, a health 147.31 care provider may act on the person's behalf to complete the 147.32 initial application. The applicant must complete the remainder 147.33 of the application and provide necessary verification before 147.34 eligibility can be determined. The county agency must assist 147.35 the applicant in obtaining verification if necessary. 147.36 (d) County agencies are authorized to use all automated 148.1 databases containing information regarding recipients' or 148.2 applicants' income in order to determine eligibility for general 148.3 assistance medical care or MinnesotaCare. Such use shall be 148.4 considered sufficient in order to determine eligibility and 148.5 premium payments by the county agency. 148.6 (e) General assistance medical care is not available for a 148.7 person in a correctional facility unless the person is detained 148.8 by law for less than one year in a county correctional or 148.9 detention facility as a person accused or convicted of a crime, 148.10 or admitted as an inpatient to a hospital on a criminal hold 148.11 order, and the person is a recipient of general assistance 148.12 medical care at the time the person is detained by law or 148.13 admitted on a criminal hold order and as long as the person 148.14 continues to meet other eligibility requirements of this 148.15 subdivision. 148.16 (f) General assistance medical care is not available for 148.17 applicants or recipients who do not cooperate with the county 148.18 agency to meet the requirements of medical assistance. General 148.19 assistance medical care is limited to payment of emergency 148.20 services only for applicants or recipients as described in 148.21 paragraph (a), clause(4)(5), whose MinnesotaCare coverage is 148.22 denied or terminated for nonpayment of premiums as required by 148.23 sections 256L.06 to 256L.08. 148.24 (g) In determining the amount of assets of an individual, 148.25 there shall be included any asset or interest in an asset, 148.26 including an asset excluded under paragraph (a), that was given 148.27 away, sold, or disposed of for less than fair market value 148.28 within the 60 months preceding application for general 148.29 assistance medical care or during the period of eligibility. 148.30 Any transfer described in this paragraph shall be presumed to 148.31 have been for the purpose of establishing eligibility for 148.32 general assistance medical care, unless the individual furnishes 148.33 convincing evidence to establish that the transaction was 148.34 exclusively for another purpose. For purposes of this 148.35 paragraph, the value of the asset or interest shall be the fair 148.36 market value at the time it was given away, sold, or disposed 149.1 of, less the amount of compensation received. For any 149.2 uncompensated transfer, the number of months of ineligibility, 149.3 including partial months, shall be calculated by dividing the 149.4 uncompensated transfer amount by the average monthly per person 149.5 payment made by the medical assistance program to skilled 149.6 nursing facilities for the previous calendar year. The 149.7 individual shall remain ineligible until this fixed period has 149.8 expired. The period of ineligibility may exceed 30 months, and 149.9 a reapplication for benefits after 30 months from the date of 149.10 the transfer shall not result in eligibility unless and until 149.11 the period of ineligibility has expired. The period of 149.12 ineligibility begins in the month the transfer was reported to 149.13 the county agency, or if the transfer was not reported, the 149.14 month in which the county agency discovered the transfer, 149.15 whichever comes first. For applicants, the period of 149.16 ineligibility begins on the date of the first approved 149.17 application. 149.18 (h) When determining eligibility for any state benefits 149.19 under this subdivision, the income and resources of all 149.20 noncitizens shall be deemed to include their sponsor's income 149.21 and resources as defined in the Personal Responsibility and Work 149.22 Opportunity Reconciliation Act of 1996, title IV, Public Law 149.23 Number 104-193, sections 421 and 422, and subsequently set out 149.24 in federal rules. 149.25 (i) (1) An undocumented noncitizen or a nonimmigrant is 149.26 ineligible for general assistance medical care other than 149.27 emergency services. For purposes of this subdivision, a 149.28 nonimmigrant is an individual in one or more of the classes 149.29 listed in United States Code, title 8, section 1101(a)(15), and 149.30 an undocumented noncitizen is an individual who resides in the 149.31 United States without the approval or acquiescence of the 149.32 Immigration and Naturalization Service. 149.33(j)(2) This paragraph does not apply to a child under age 149.34 18, to a Cuban or Haitian entrant as defined in Public Law 149.35 Number 96-422, section 501(e)(1) or (2)(a), or to a noncitizen 149.36 who is aged, blind, or disabled as defined in Code of Federal 150.1 Regulations, title 42, sections 435.520, 435.530, 435.531, 150.2 435.540, and 435.541, or to an individual eligible for general 150.3 assistance medical care under paragraph (a), clause (4), who 150.4 cooperates with the Immigration and Naturalization Service to 150.5 pursue any applicable immigration status, including citizenship, 150.6 that would qualify the individual for medical assistance with 150.7 federal financial participation. 150.8(k)(3) For purposes ofparagraphs (f) and (i)this 150.9 paragraph, "emergency services" has the meaning given in Code of 150.10 Federal Regulations, title 42, section 440.255(b)(1), except 150.11 that it also means services rendered because of suspected or 150.12 actual pesticide poisoning. 150.13(l)(j) Notwithstanding any other provision of law, a 150.14 noncitizen who is ineligible for medical assistance due to the 150.15 deeming of a sponsor's income and resources, is ineligible for 150.16 general assistance medical care. 150.17 Sec. 50. Minnesota Statutes 1996, section 256D.03, 150.18 subdivision 4, is amended to read: 150.19 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 150.20 For a person who is eligible under subdivision 3, paragraph (a), 150.21 clause (3), general assistance medical care covers, except as 150.22 provided in paragraph (c): 150.23 (1) inpatient hospital services; 150.24 (2) outpatient hospital services; 150.25 (3) services provided by Medicare certified rehabilitation 150.26 agencies; 150.27 (4) prescription drugs and other products recommended 150.28 through the process established in section 256B.0625, 150.29 subdivision 13; 150.30 (5) equipment necessary to administer insulin and 150.31 diagnostic supplies and equipment for diabetics to monitor blood 150.32 sugar level; 150.33 (6) eyeglasses and eye examinations provided by a physician 150.34 or optometrist; 150.35 (7) hearing aids; 150.36 (8) prosthetic devices; 151.1 (9) laboratory and X-ray services; 151.2 (10) physician's services; 151.3 (11) medical transportation; 151.4 (12) chiropractic services as covered under the medical 151.5 assistance program; 151.6 (13) podiatric services; 151.7 (14) dental services; 151.8 (15) outpatient services provided by a mental health center 151.9 or clinic that is under contract with the county board and is 151.10 established under section 245.62; 151.11 (16) day treatment services for mental illness provided 151.12 under contract with the county board; 151.13 (17) prescribed medications for persons who have been 151.14 diagnosed as mentally ill as necessary to prevent more 151.15 restrictive institutionalization; 151.16 (18)case management services for a person with serious and151.17persistent mental illness who would be eligible for medical151.18assistance except that the person resides in an institution for151.19mental diseases;151.20(19)psychological services, medical supplies and 151.21 equipment, and Medicare premiums, coinsurance and deductible 151.22 payments; 151.23(20)(19) medical equipment not specifically listed in this 151.24 paragraph when the use of the equipment will prevent the need 151.25 for costlier services that are reimbursable under this 151.26 subdivision; 151.27(21)(20) services performed by a certified pediatric nurse 151.28 practitioner, a certified family nurse practitioner, a certified 151.29 adult nurse practitioner, a certified obstetric/gynecological 151.30 nurse practitioner, or a certified geriatric nurse practitioner 151.31 in independent practice, if the services are otherwise covered 151.32 under this chapter as a physician service, and if the service is 151.33 within the scope of practice of the nurse practitioner's license 151.34 as a registered nurse, as defined in section 148.171; and 151.35(22)(21) services of a certified public health nurse or a 151.36 registered nurse practicing in a public health nursing clinic 152.1 that is a department of, or that operates under the direct 152.2 authority of, a unit of government, if the service is within the 152.3 scope of practice of the public health nurse's license as a 152.4 registered nurse, as defined in section 148.171. 152.5 (b) Except as provided in paragraph (c), for a recipient 152.6 who is eligible under subdivision 3, paragraph (a), clause (1) 152.7 or (2), general assistance medical care covers the services 152.8 listed in paragraph (a) with the exception of special 152.9 transportation services. 152.10 (c) Gender reassignment surgery and related services are 152.11 not covered services under this subdivision unless the 152.12 individual began receiving gender reassignment services prior to 152.13 July 1, 1995. 152.14 (d) In order to contain costs, the commissioner of human 152.15 services shall select vendors of medical care who can provide 152.16 the most economical care consistent with high medical standards 152.17 and shall where possible contract with organizations on a 152.18 prepaid capitation basis to provide these services. The 152.19 commissioner shall consider proposals by counties and vendors 152.20 for prepaid health plans, competitive bidding programs, block 152.21 grants, or other vendor payment mechanisms designed to provide 152.22 services in an economical manner or to control utilization, with 152.23 safeguards to ensure that necessary services are provided. 152.24 Before implementing prepaid programs in counties with a county 152.25 operated or affiliated public teaching hospital or a hospital or 152.26 clinic operated by the University of Minnesota, the commissioner 152.27 shall consider the risks the prepaid program creates for the 152.28 hospital and allow the county or hospital the opportunity to 152.29 participate in the program in a manner that reflects the risk of 152.30 adverse selection and the nature of the patients served by the 152.31 hospital, provided the terms of participation in the program are 152.32 competitive with the terms of other participants considering the 152.33 nature of the population served. Payment for services provided 152.34 pursuant to this subdivision shall be as provided to medical 152.35 assistance vendors of these services under sections 256B.02, 152.36 subdivision 8, and 256B.0625. For payments made during fiscal 153.1 year 1990 and later years, the commissioner shall consult with 153.2 an independent actuary in establishing prepayment rates, but 153.3 shall retain final control over the rate methodology. 153.4 Notwithstanding the provisions of subdivision 3, an individual 153.5 who becomes ineligible for general assistance medical care 153.6 because of failure to submit income reports or recertification 153.7 forms in a timely manner, shall remain enrolled in the prepaid 153.8 health plan and shall remain eligible for general assistance 153.9 medical care coverage through the last day of the month in which 153.10 the enrollee became ineligible for general assistance medical 153.11 care. 153.12 (e) The commissioner of human services may reduce payments 153.13 provided under sections 256D.01 to 256D.21 and 261.23 in order 153.14 to remain within the amount appropriated for general assistance 153.15 medical care, within the following restrictions.: 153.16 (i) For the period July 1, 1985 to December 31, 1985, 153.17 reductions below the cost per service unit allowable under 153.18 section 256.966, are permitted only as follows: payments for 153.19 inpatient and outpatient hospital care provided in response to a 153.20 primary diagnosis of chemical dependency or mental illness may 153.21 be reduced no more than 30 percent; payments for all other 153.22 inpatient hospital care may be reduced no more than 20 percent. 153.23 Reductions below the payments allowable under general assistance 153.24 medical care for the remaining general assistance medical care 153.25 services allowable under this subdivision may be reduced no more 153.26 than ten percent. 153.27 (ii) For the period January 1, 1986 to December 31, 1986, 153.28 reductions below the cost per service unit allowable under 153.29 section 256.966 are permitted only as follows: payments for 153.30 inpatient and outpatient hospital care provided in response to a 153.31 primary diagnosis of chemical dependency or mental illness may 153.32 be reduced no more than 20 percent; payments for all other 153.33 inpatient hospital care may be reduced no more than 15 percent. 153.34 Reductions below the payments allowable under general assistance 153.35 medical care for the remaining general assistance medical care 153.36 services allowable under this subdivision may be reduced no more 154.1 than five percent. 154.2 (iii) For the period January 1, 1987 to June 30, 1987, 154.3 reductions below the cost per service unit allowable under 154.4 section 256.966 are permitted only as follows: payments for 154.5 inpatient and outpatient hospital care provided in response to a 154.6 primary diagnosis of chemical dependency or mental illness may 154.7 be reduced no more than 15 percent; payments for all other 154.8 inpatient hospital care may be reduced no more than ten 154.9 percent. Reductions below the payments allowable under medical 154.10 assistance for the remaining general assistance medical care 154.11 services allowable under this subdivision may be reduced no more 154.12 than five percent. 154.13 (iv) For the period July 1, 1987 to June 30, 1988, 154.14 reductions below the cost per service unit allowable under 154.15 section 256.966 are permitted only as follows: payments for 154.16 inpatient and outpatient hospital care provided in response to a 154.17 primary diagnosis of chemical dependency or mental illness may 154.18 be reduced no more than 15 percent; payments for all other 154.19 inpatient hospital care may be reduced no more than five percent. 154.20 Reductions below the payments allowable under medical assistance 154.21 for the remaining general assistance medical care services 154.22 allowable under this subdivision may be reduced no more than 154.23 five percent. 154.24 (v) For the period July 1, 1988 to June 30, 1989, 154.25 reductions below the cost per service unit allowable under 154.26 section 256.966 are permitted only as follows: payments for 154.27 inpatient and outpatient hospital care provided in response to a 154.28 primary diagnosis of chemical dependency or mental illness may 154.29 be reduced no more than 15 percent; payments for all other 154.30 inpatient hospital care may not be reduced. Reductions below 154.31 the payments allowable under medical assistance for the 154.32 remaining general assistance medical care services allowable 154.33 under this subdivision may be reduced no more than five percent. 154.34 (f) There shall be no copayment required of any recipient 154.35 of benefits for any services provided under this subdivision. A 154.36 hospital receiving a reduced payment as a result of this section 155.1 may apply the unpaid balance toward satisfaction of the 155.2 hospital's bad debts. 155.3(f)(g) Any county may, from its own resources, provide 155.4 medical payments for which state payments are not made. 155.5(g)(h) Chemical dependency services that are reimbursed 155.6 under chapter 254B must not be reimbursed under general 155.7 assistance medical care. 155.8(h)(i) The maximum payment for new vendors enrolled in the 155.9 general assistance medical care program after the base year 155.10 shall be determined from the average usual and customary charge 155.11 of the same vendor type enrolled in the base year. 155.12(i)(j) The conditions of payment for services under this 155.13 subdivision are the same as the conditions specified in rules 155.14 adopted under chapter 256B governing the medical assistance 155.15 program, unless otherwise provided by statute or rule. 155.16 Sec. 51. Minnesota Statutes 1996, section 256D.03, is 155.17 amended by adding a subdivision to read: 155.18 Subd. 9. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 155.19 services rendered on or after July 1, 1999, general assistance 155.20 medical care payments for ambulance services shall be increased 155.21 by ten percent. 155.22 Sec. 52. Minnesota Statutes 1996, section 256D.03, is 155.23 amended by adding a subdivision to read: 155.24 Subd. 10. [INFORMATION PROVIDED IN SEVERAL 155.25 LANGUAGES.] Upon request, the commissioner shall provide 155.26 applications and other information regarding general assistance 155.27 medical care, including all notices and disclosures provided to 155.28 recipients, in English, Spanish, Vietnamese, and Hmong. 155.29 Reasonable effort must be made to provide this information to 155.30 other non-English-speaking recipients. 155.31 Sec. 53. Laws 1995, chapter 234, article 6, section 45, is 155.32 amended to read: 155.33 Sec. 45. [WAIVER REQUEST.] 155.34 (a) The commissioner of human services shall seek federal 155.35 approval to add the benefit of drug coverage for qualified 155.36 Medicare beneficiaries with incomes up to 150 percent of the 156.1 federal poverty guidelines and to charge a copayment for this 156.2 benefit. The commissioner may seek approval for a higher 156.3 copayment for eligible persons with income above 100 percent of 156.4 the federal poverty guidelines. 156.5 (b) If, by September 15, 1998, federal approval is obtained 156.6 to provide a prescription drug benefit for qualified Medicare 156.7 beneficiaries at no less than 100 percent of the federal poverty 156.8 guidelines and service-limited Medicare beneficiaries under 156.9 Minnesota Statutes, section 256B.057, subdivision 3a, at no less 156.10 than 120 percent of federal poverty guidelines, the commissioner 156.11 of human services shallreport to the legislature and present156.12draft legislation expanding the qualified Medicare beneficiary156.13program to the legislature for approvalnot implement the senior 156.14 citizen drug program under Minnesota Statutes, section 256.955, 156.15 but shall implement a drug benefit in accordance with the 156.16 approved waiver. Upon approval of this waiver, the total 156.17 appropriation for the senior citizen drug program under Laws 156.18 1997, chapter 225, article 7, section 2, shall be transferred to 156.19 the medical assistance account to supplement funding for the 156.20 federally approved coverage for eligible persons effective on or 156.21 before January 1, 1999. 156.22 (c) The commissioner shall report by October 15, 1998, to 156.23 the chairs of the health and human services policy and fiscal 156.24 committees of the house and senate whether the waiver referred 156.25 to in paragraph (a) has been approved and will be implemented or 156.26 whether the state senior citizen drug program will be 156.27 implemented. 156.28 (d) If the commissioner does not receive federal waiver 156.29 approval at or above the level of eligibility defined in 156.30 paragraph (b), the commissioner shall implement the program 156.31 under section 256.955. The commissioner may transfer funds 156.32 appropriated to implement the waiver to the senior drug program 156.33 account. 156.34 Sec. 54. Laws 1997, chapter 203, article 4, section 64, is 156.35 amended to read: 156.36 Sec. 64. [STUDY OF ELDERLY WAIVER EXPANSION.] 157.1 The commissioner of human services shall appoint a task 157.2 force that includes representatives of counties, health plans, 157.3 consumers, and legislators to study the impact of the expansion 157.4 of the elderly waiver program under section 4 and to make 157.5 recommendations for any changes in law necessary to facilitate 157.6 an efficient and equitable relationship between the elderly 157.7 waiver program and the Minnesota senior health options project. 157.8 Based on the results of the task force study, the commissioner 157.9 may seek any federal waivers needed to improve the relationship 157.10 between the elderly waiver and the Minnesota senior health 157.11 options project. The commissioner shall report the results of 157.12 the task force study to the legislature byJanuary 15, 1998July 157.13 1, 2000. 157.14 Sec. 55. [ELIMINATION OF CASE MIX SCORES.] 157.15 It is the intent of the legislature to repeal the unneeded, 157.16 unused, and costly requirement that persons with mental 157.17 retardation be assessed by case mix scores for the following 157.18 reasons: the scores are incomplete measures of a person's 157.19 needs, the scores are exempt from the rate setting process at 157.20 least to October 1, 1999, and the department of human services 157.21 has no plans to use the instrument in a managed care/capitated 157.22 payment arrangement. 157.23 Sec. 56. [OFFSET OF HMO SURCHARGE.] 157.24 Beginning October 1, 1998, and ending December 31, 1998, 157.25 the commissioner of human services shall offset monthly charges 157.26 for the health maintenance organization surcharge by the monthly 157.27 amount the health maintenance organization overpaid from August 157.28 1, 1997, to September 30, 1998, due to taxation of Medicare 157.29 revenues prohibited by Minnesota Statutes, section 256.9657, 157.30 subdivision 3. 157.31 Sec. 57. [MR/RC WAIVER PROPOSAL.] 157.32 By November 15, 1998, the commissioner of human services 157.33 shall provide to the chairs of the house health and human 157.34 services finance division and the senate health and family 157.35 security finance division a detailed budget proposal for 157.36 providing services under the home and community-based waiver for 158.1 persons with mental retardation or related conditions to those 158.2 individuals who are screened and waiting for services. 158.3 Sec. 58. [HIV HEALTH CARE ACCESS STUDY.] 158.4 The commissioner of human services shall study, in 158.5 consultation with the commissioner of health and a task force of 158.6 affected community stakeholders, the impact of positive patient 158.7 responses to new HIV treatment on re-entry to the workplace, 158.8 including, but not limited to, addressing continued access to 158.9 health care and disability benefits. The commissioner shall 158.10 submit a report on the study with recommendations to the 158.11 legislature by January 15, 1999. 158.12 Sec. 59. [MENTAL HEALTH REPORT.] 158.13 (a) By December 1, 1998, the commissioner of human services 158.14 shall report to the legislature on recommendations to maximize 158.15 federal funding for mental health services for children and 158.16 adults. In developing the recommendations, the commissioner 158.17 shall seek advice from a children's and adults' mental health 158.18 services stakeholders advisory group including representatives 158.19 of state and county government, private and state-operated 158.20 mental health providers, mental health consumers, family 158.21 members, and advocates. 158.22 (b) The report shall include a proposal developed in 158.23 conjunction with the counties that does not shift caseload 158.24 growth to counties after July 1, 1999, and recommendations on 158.25 whether the state should directly participate in medical 158.26 assistance mental health case management by funding a portion of 158.27 the nonfederal share of Medicaid. 158.28 Sec. 60. [AFFILIATION OF THE HEALTH-RELATED OMBUDSMAN AND 158.29 ADVOCACY SERVICES.] 158.30 The ombudsman for mental health and mental retardation, the 158.31 ombudsman for older Minnesotans, the Minnesota managed care/PMAP 158.32 ombudsman, and the office of health care consumer assistance, 158.33 advocacy, and information shall enter into an interagency 158.34 agreement to create a formal affiliation of the health-related 158.35 ombudsman and advocacy services. 158.36 Sec. 61. [CONSUMER PRICE INDEX REPORT.] 159.1 By January 15, 1999, and each year thereafter, the 159.2 commissioner of human services shall report to the chair of the 159.3 senate health and family security budget division and the chair 159.4 of the house health and human services budget division on the 159.5 cost of increasing the income standard under Minnesota Statutes, 159.6 section 256B.056, subdivision 4, and the provider rates under 159.7 Minnesota Statutes, section 256B.038, by an amount equal to the 159.8 percentage increase in the Consumer Price Index for all urban 159.9 consumers for the previous calendar year. 159.10 Sec. 62. [REPEALER.] 159.11 Minnesota Statutes 1996, section 144.0721, subdivision 3a; 159.12 and Minnesota Statutes 1997 Supplement, sections 144.0721, 159.13 subdivision 3; and 256B.0913, subdivision 15, are repealed. 159.14 Minnesota Statutes 1996, section 256B.501, subdivision 3g, is 159.15 repealed effective October 1, 2000. 159.16 Sec. 63. [EFFECTIVE DATES.] 159.17 (a) Section 7 is effective retroactive to August 1, 1997. 159.18 (b) Sections 15 and 20 are effective retroactive to July 1, 159.19 1997. 159.20 (c) Sections 23 and 50 are effective January 1, 1999. 159.21 (d) Section 28 is effective for changes in eligibility that 159.22 occur on or after July 1, 1998. 159.23 (e) Sections 41, 44, and 53 are effective the day following 159.24 final enactment. 159.25 ARTICLE 5 159.26 MINNESOTACARE 159.27 Section 1. Minnesota Statutes 1997 Supplement, section 159.28 256B.04, subdivision 18, is amended to read: 159.29 Subd. 18. [APPLICATIONS FOR MEDICAL ASSISTANCE.] The state 159.30 agency may take applications for medical assistance and conduct 159.31 eligibility determinations for MinnesotaCare enrolleeswho are159.32required to apply for medical assistance according to section159.33256L.03, subdivision 3, paragraph (b). 159.34 Sec. 2. Minnesota Statutes 1996, section 256B.057, is 159.35 amended by adding a subdivision to read: 159.36 Subd. 7. [WAIVER OF MAINTENANCE OF EFFORT 160.1 REQUIREMENT.] Unless a federal waiver of the maintenance of 160.2 effort requirement of section 2105(d) of title XXI of the 160.3 Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 160.4 at Large, volume 111, page 251, is granted by the federal 160.5 Department of Health and Human Services by September 30, 1998, 160.6 eligibility for children under age 21 must be determined without 160.7 regard to asset standards established in section 256B.056, 160.8 subdivision 3. The commissioner of human services shall publish 160.9 a notice in the State Register upon receipt of a federal waiver. 160.10 Sec. 3. Minnesota Statutes 1997 Supplement, section 160.11 256D.03, subdivision 3, is amended to read: 160.12 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 160.13 (a) General assistance medical care may be paid for any person 160.14 who is not eligible for medical assistance under chapter 256B, 160.15 including eligibility for medical assistance based on a 160.16 spenddown of excess income according to section 256B.056, 160.17 subdivision 5, or MinnesotaCare as defined in clause (4), except 160.18 as provided in paragraph (b); and: 160.19 (1) who is receiving assistance under section 256D.05, 160.20 except for families with children who are eligible under 160.21 Minnesota family investment program-statewide (MFIP-S), who is 160.22 having a payment made on the person's behalf under sections 160.23 256I.01 to 256I.06, or who resides in group residential housing 160.24 as defined in chapter 256I and can meet a spenddown using the 160.25 cost of remedial services received through group residential 160.26 housing; or 160.27 (2)(i) who is a resident of Minnesota; and whose equity in 160.28 assets is not in excess of $1,000 per assistance unit. Exempt 160.29 assets, the reduction of excess assets, and the waiver of excess 160.30 assets must conform to the medical assistance program in chapter 160.31 256B, with the following exception: the maximum amount of 160.32 undistributed funds in a trust that could be distributed to or 160.33 on behalf of the beneficiary by the trustee, assuming the full 160.34 exercise of the trustee's discretion under the terms of the 160.35 trust, must be applied toward the asset maximum; and 160.36 (ii) who has countable income not in excess of the 161.1 assistance standards established in section 256B.056, 161.2 subdivision 4, or whose excess income is spent down according to 161.3 section 256B.056, subdivision 5, using a six-month budget 161.4 period. The method for calculating earned income disregards and 161.5 deductions for a person who resides with a dependent child under 161.6 age 21 shall follow section 256B.056, subdivision 1a. However, 161.7 if a disregard of $30 and one-third of the remainder has been 161.8 applied to the wage earner's income, the disregard shall not be 161.9 applied again until the wage earner's income has not been 161.10 considered in an eligibility determination for general 161.11 assistance, general assistance medical care, medical assistance, 161.12 or MFIP-S for 12 consecutive months. The earned income and work 161.13 expense deductions for a person who does not reside with a 161.14 dependent child under age 21 shall be the same as the method 161.15 used to determine eligibility for a person under section 161.16 256D.06, subdivision 1, except the disregard of the first $50 of 161.17 earned income is not allowed; or 161.18 (3) who would be eligible for medical assistance except 161.19 that the person resides in a facility that is determined by the 161.20 commissioner or the federal Health Care Financing Administration 161.21 to be an institution for mental diseases.; or 161.22 (4) beginningJuly 1, 1998January 1, 2000, applicants or 161.23 recipients who meet all eligibility requirements of 161.24 MinnesotaCare as defined in sections 256L.01 to 256L.16, and are: 161.25 (i) adults with dependent children under 21 whose gross 161.26 family income is equal to or less than 275 percent of the 161.27 federal poverty guidelines; or 161.28 (ii) adults without children with earned income and whose 161.29 family gross income is between 75 percent of the federal poverty 161.30 guidelines and the amount set by section 256L.04, subdivision 7, 161.31 shall be terminated from general assistance medical care upon 161.32 enrollment in MinnesotaCare. 161.33 (b) For services rendered on or after July 1, 1997, 161.34 eligibility is limited to one month prior to application if the 161.35 person is determined eligible in the prior month. A 161.36 redetermination of eligibility must occur every 12 months. 162.1 BeginningJuly 1, 1998January 1, 2000, Minnesota health care 162.2 program applications completed by recipients and applicants who 162.3 are persons described in paragraph (a), clause (4), may be 162.4 returned to the county agency to be forwarded to the department 162.5 of human services or sent directly to the department of human 162.6 services for enrollment in MinnesotaCare. If all other 162.7 eligibility requirements of this subdivision are met, 162.8 eligibility for general assistance medical care shall be 162.9 available in any month during which a MinnesotaCare eligibility 162.10 determination and enrollment are pending. Upon notification of 162.11 eligibility for MinnesotaCare, notice of termination for 162.12 eligibility for general assistance medical care shall be sent to 162.13 an applicant or recipient. If all other eligibility 162.14 requirements of this subdivision are met, eligibility for 162.15 general assistance medical care shall be available until 162.16 enrollment in MinnesotaCare subject to the provisions of 162.17 paragraph (d). 162.18 (c) The date of an initial Minnesota health care program 162.19 application necessary to begin a determination of eligibility 162.20 shall be the date the applicant has provided a name, address, 162.21 and social security number, signed and dated, to the county 162.22 agency or the department of human services. If the applicant is 162.23 unable to provide an initial application when health care is 162.24 delivered due to a medical condition or disability, a health 162.25 care provider may act on the person's behalf to complete the 162.26 initial application. The applicant must complete the remainder 162.27 of the application and provide necessary verification before 162.28 eligibility can be determined. The county agency must assist 162.29 the applicant in obtaining verification if necessary. 162.30 (d) County agencies are authorized to use all automated 162.31 databases containing information regarding recipients' or 162.32 applicants' income in order to determine eligibility for general 162.33 assistance medical care or MinnesotaCare. Such use shall be 162.34 considered sufficient in order to determine eligibility and 162.35 premium payments by the county agency. 162.36 (e) General assistance medical care is not available for a 163.1 person in a correctional facility unless the person is detained 163.2 by law for less than one year in a county correctional or 163.3 detention facility as a person accused or convicted of a crime, 163.4 or admitted as an inpatient to a hospital on a criminal hold 163.5 order, and the person is a recipient of general assistance 163.6 medical care at the time the person is detained by law or 163.7 admitted on a criminal hold order and as long as the person 163.8 continues to meet other eligibility requirements of this 163.9 subdivision. 163.10 (f) General assistance medical care is not available for 163.11 applicants or recipients who do not cooperate with the county 163.12 agency to meet the requirements of medical assistance. General 163.13 assistance medical care is limited to payment of emergency 163.14 services only for applicants or recipients as described in 163.15 paragraph (a), clause (4), whose MinnesotaCare coverage is 163.16 denied or terminated for nonpayment of premiums as required by 163.17 sections 256L.06to 256L.08and 256L.07. 163.18 (g) In determining the amount of assets of an individual, 163.19 there shall be included any asset or interest in an asset, 163.20 including an asset excluded under paragraph (a), that was given 163.21 away, sold, or disposed of for less than fair market value 163.22 within the 60 months preceding application for general 163.23 assistance medical care or during the period of eligibility. 163.24 Any transfer described in this paragraph shall be presumed to 163.25 have been for the purpose of establishing eligibility for 163.26 general assistance medical care, unless the individual furnishes 163.27 convincing evidence to establish that the transaction was 163.28 exclusively for another purpose. For purposes of this 163.29 paragraph, the value of the asset or interest shall be the fair 163.30 market value at the time it was given away, sold, or disposed 163.31 of, less the amount of compensation received. For any 163.32 uncompensated transfer, the number of months of ineligibility, 163.33 including partial months, shall be calculated by dividing the 163.34 uncompensated transfer amount by the average monthly per person 163.35 payment made by the medical assistance program to skilled 163.36 nursing facilities for the previous calendar year. The 164.1 individual shall remain ineligible until this fixed period has 164.2 expired. The period of ineligibility may exceed 30 months, and 164.3 a reapplication for benefits after 30 months from the date of 164.4 the transfer shall not result in eligibility unless and until 164.5 the period of ineligibility has expired. The period of 164.6 ineligibility begins in the month the transfer was reported to 164.7 the county agency, or if the transfer was not reported, the 164.8 month in which the county agency discovered the transfer, 164.9 whichever comes first. For applicants, the period of 164.10 ineligibility begins on the date of the first approved 164.11 application. 164.12 (h) When determining eligibility for any state benefits 164.13 under this subdivision, the income and resources of all 164.14 noncitizens shall be deemed to include their sponsor's income 164.15 and resources as defined in the Personal Responsibility and Work 164.16 Opportunity Reconciliation Act of 1996, title IV, Public Law 164.17 Number 104-193, sections 421 and 422, and subsequently set out 164.18 in federal rules. 164.19 (i) An undocumented noncitizen or a nonimmigrant is 164.20 ineligible for general assistance medical care other than 164.21 emergency services. For purposes of this subdivision, a 164.22 nonimmigrant is an individual in one or more of the classes 164.23 listed in United States Code, title 8, section 1101(a)(15), and 164.24 an undocumented noncitizen is an individual who resides in the 164.25 United States without the approval or acquiescence of the 164.26 Immigration and Naturalization Service. 164.27 (j) This paragraph does not apply to a child under age 18, 164.28 to a Cuban or Haitian entrant as defined in Public Law Number 164.29 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 164.30 aged, blind, or disabled as defined in Code of Federal 164.31 Regulations, title 42, sections 435.520, 435.530, 435.531, 164.32 435.540, and 435.541, who cooperates with the Immigration and 164.33 Naturalization Service to pursue any applicable immigration 164.34 status, including citizenship, that would qualify the individual 164.35 for medical assistance with federal financial participation. 164.36 (k) For purposes of paragraphs (f) and (i), "emergency 165.1 services" has the meaning given in Code of Federal Regulations, 165.2 title 42, section 440.255(b)(1), except that it also means 165.3 services rendered because of suspected or actual pesticide 165.4 poisoning. 165.5 (l) Notwithstanding any other provision of law, a 165.6 noncitizen who is ineligible for medical assistance due to the 165.7 deeming of a sponsor's income and resources, is ineligible for 165.8 general assistance medical care. 165.9 Sec. 4. Minnesota Statutes 1997 Supplement, section 165.10 256L.01, is amended to read: 165.11 256L.01 [DEFINITIONS.] 165.12 Subdivision 1. [SCOPE.] For purposes of sections 256L.01 165.13 to256L.10256L.18, the following terms shall have the meanings 165.14 given them. 165.15 Subd. 1a. [CHILD.] "Child" means an individual under 21 165.16 years of age, including the unborn child of a pregnant woman, an 165.17 emancipated minor, and an emancipated minor's spouse. 165.18 Subd. 2. [COMMISSIONER.] "Commissioner" means the 165.19 commissioner of human services. 165.20 Subd. 3. [ELIGIBLE PROVIDERS.] "Eligible providers" means 165.21 those health care providers who provide covered health services 165.22 to medical assistance recipients under rules established by the 165.23 commissioner for that program. 165.24 Subd. 3a. [FAMILY WITH CHILDREN.] (a) "Family with 165.25 children" means: 165.26 (1) parents, their children, and dependent siblings 165.27 residing in the same household; or 165.28 (2) grandparents, foster parents, relative caretakers as 165.29 defined in the medical assistance program, or legal guardians; 165.30 their wards who are children; and dependent siblings residing in 165.31 the same household. 165.32 (b) The term includes children and dependent siblings who 165.33 are temporarily absent from the household in settings such as 165.34 schools, camps, or visitation with noncustodial parents. 165.35 (c) For purposes of this subdivision, a dependent sibling 165.36 means an unmarried child who is a full-time student under the 166.1 age of 25 years who is financially dependent upon a parent, 166.2 grandparent, foster parent, relative caretaker, or legal 166.3 guardian. Proof of school enrollment is required. 166.4 Subd. 4. [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] "Gross 166.5 individual or gross family income" for farm and nonfarm 166.6 self-employed means income calculated using as the baseline the 166.7 adjusted gross income reported on the applicant's federal income 166.8 tax form for the previous year and adding back in reported 166.9 depreciation, carryover loss, and net operating loss amounts 166.10 that apply to the business in which the family is currently 166.11 engaged. Applicants shall report the most recent financial 166.12 situation of the family if it has changed from the period of 166.13 time covered by the federal income tax form. The report may be 166.14 in the form of percentage increase or decrease. 166.15 Subd. 5. [INCOME.] "Income" has the meaning given for 166.16 earned and unearned income for families and children in the 166.17 medical assistance program, according to the state's aid to 166.18 families with dependent children plan in effect as of July 16, 166.19 1996. The definition does not include medical assistance income 166.20 methodologies and deeming requirements. The earned income of 166.21 full-time and part-time students under age 19 is not counted as 166.22 income. Public assistance payments and supplemental security 166.23 income are not excluded income. 166.24 Sec. 5. Minnesota Statutes 1997 Supplement, section 166.25 256L.02, subdivision 2, is amended to read: 166.26 Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall 166.27 establish an office for the state administration of this plan. 166.28 The plan shall be used to provide covered health services for 166.29 eligible persons. Payment for these services shall be made to 166.30 all eligible providers. The commissioner shall adopt rules to 166.31 administer the MinnesotaCare program. The commissioner shall 166.32 establish marketing efforts to encourage potentially eligible 166.33 persons to receive information about the program and about other 166.34 medical care programs administered or supervised by the 166.35 department of human services. A toll-free telephone number must 166.36 be used to provide information about medical programs and to 167.1 promote access to the covered services. 167.2 Upon request, the commissioner shall provide applications 167.3 and other information regarding the MinnesotaCare program, 167.4 including all notices and disclosures provided to enrollees, in 167.5 English, Spanish, Vietnamese, and Hmong. Reasonable efforts 167.6 must be made to provide this information to other 167.7 non-English-speaking applicants and enrollees. 167.8 Sec. 6. Minnesota Statutes 1997 Supplement, section 167.9 256L.02, subdivision 3, is amended to read: 167.10 Subd. 3. [FINANCIAL MANAGEMENT.] (a) The commissioner 167.11 shall manage spending for the MinnesotaCare program in a manner 167.12 that maintains a minimum reserve in accordance with section 167.13 16A.76. As part of each state revenue and expenditure forecast, 167.14 the commissioner must makea quarterlyan assessment of the 167.15 expected expenditures for the covered services for the remainder 167.16 of the current biennium and for the following biennium. The 167.17 estimated expenditure, including the reserve requirements 167.18 described in section 16A.76, shall be compared to an estimate of 167.19 the revenues that will bedepositedavailable in the health care 167.20 access fund. Based on this comparison, and after consulting 167.21 with the chairs of the house ways and means committee and the 167.22 senate finance committee, and the legislative commission on 167.23 health care access, the commissioner shall, as necessary, make 167.24 the adjustments specified in paragraph (b) to ensure that 167.25 expenditures remain within the limits of available revenues for 167.26 the remainder of the current biennium and for the following 167.27 biennium. The commissioner shall not hire additional staff 167.28 using appropriations from the health care access fund until the 167.29 commissioner of finance makes a determination that the 167.30 adjustments implemented under paragraph (b) are sufficient to 167.31 allow MinnesotaCare expenditures to remain within the limits of 167.32 available revenues for the remainder of the current biennium and 167.33 for the following biennium. 167.34 (b) The adjustments the commissioner shall use must be 167.35 implemented in this order: first, stop enrollment of single 167.36 adults and households without children; second, upon 45 days' 168.1 notice, stop coverage of single adults and households without 168.2 children already enrolled in the MinnesotaCare program; third, 168.3 upon 90 days' notice, decrease the premium subsidy amounts by 168.4 ten percent for families with gross annual income above 200 168.5 percent of the federal poverty guidelines; fourth, upon 90 days' 168.6 notice, decrease the premium subsidy amounts by ten percent for 168.7 families with gross annual income at or below 200 percent; and 168.8 fifth, require applicants to be uninsured for at least six 168.9 months prior to eligibility in the MinnesotaCare program. If 168.10 these measures are insufficient to limit the expenditures to the 168.11 estimated amount of revenue, the commissioner shall further 168.12 limit enrollment or decrease premium subsidies. 168.13 Sec. 7. Minnesota Statutes 1997 Supplement, section 168.14 256L.03, subdivision 1, is amended to read: 168.15 Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health 168.16 services" means the health services reimbursed under chapter 168.17 256B, with the exception of inpatient hospital services, special 168.18 education services, private duty nursing services, adult dental 168.19 care services other than preventive services, orthodontic 168.20 services, nonemergency medical transportation services, personal 168.21 care assistant and case management services, nursing home or 168.22 intermediate care facilities services, inpatient mental health 168.23 services, and chemical dependency services. Effective July 1, 168.24 1998, adult dental care for nonpreventive services with the 168.25 exception of orthodontic services is available to persons who 168.26 qualify under section 256L.04, subdivisions 1 to 7,or 256L.13,168.27 with family gross income equal to or less than 175 percent of 168.28 the federal poverty guidelines. Outpatient mental health 168.29 services covered under the MinnesotaCare program are limited to 168.30 diagnostic assessments, psychological testing, explanation of 168.31 findings, medication management by a physician, day treatment, 168.32 partial hospitalization, and individual, family, and group 168.33 psychotherapy. 168.34 No public funds shall be used for coverage of abortion 168.35 under MinnesotaCare except where the life of the female would be 168.36 endangered or substantial and irreversible impairment of a major 169.1 bodily function would result if the fetus were carried to term; 169.2 or where the pregnancy is the result of rape or incest. 169.3 Covered health services shall be expanded as provided in 169.4 this section. 169.5 Sec. 8. Minnesota Statutes 1997 Supplement, section 169.6 256L.03, is amended by adding a subdivision to read: 169.7 Subd. 1a. [COVERED SERVICES FOR PREGNANT WOMEN AND 169.8 CHILDREN UNDER MINNESOTACARE HEALTH CARE REFORM 169.9 WAIVER.] Children and pregnant women are eligible for coverage 169.10 of all services that are eligible for reimbursement under the 169.11 medical assistance program according to chapter 256B. Pregnant 169.12 women and children are exempt from the provisions of subdivision 169.13 5, regarding copayments. Pregnant women and children who are 169.14 lawfully residing in the United States but who are not 169.15 "qualified noncitizens" under title IV of the Personal 169.16 Responsibility and Work Opportunity Reconciliation Act of 1996, 169.17 Public Law Number 104-193, Statutes at Large, volume 110, page 169.18 2105, are eligible for coverage of all services provided under 169.19 the medical assistance program according to chapter 256B. 169.20 Sec. 9. Minnesota Statutes 1997 Supplement, section 169.21 256L.03, is amended by adding a subdivision to read: 169.22 Subd. 1b. [PREGNANT WOMEN; ELIGIBILITY FOR FULL MEDICAL 169.23 ASSISTANCE SERVICES.] A woman who is enrolled in MinnesotaCare 169.24 when her pregnancy is diagnosed is eligible for coverage of all 169.25 services provided under the medical assistance program according 169.26 to chapter 256B retroactive to the date the pregnancy is 169.27 medically diagnosed. Copayments totaling $30 or more, paid 169.28 after the date the pregnancy is diagnosed, shall be refunded. 169.29 Sec. 10. Minnesota Statutes 1997 Supplement, section 169.30 256L.03, subdivision 3, is amended to read: 169.31 Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a)Beginning July169.321, 1993,Covered health services shall include inpatient 169.33 hospital services, including inpatient hospital mental health 169.34 services and inpatient hospital and residential chemical 169.35 dependency treatment, subject to those limitations necessary to 169.36 coordinate the provision of these services with eligibility 170.1 under the medical assistance spenddown. Prior to July 1, 1997, 170.2 the inpatient hospital benefit for adult enrollees is subject to 170.3 an annual benefit limit of $10,000.Effective July 1, 1997,The 170.4 inpatient hospital benefit for adult enrollees who qualify under 170.5 section 256L.04, subdivision 7, or who qualify under section 170.6 256L.04, subdivisions 1to 6and 2,or 256L.13with family gross 170.7 income that exceeds 175 percent of the federal poverty 170.8 guidelines and who are not pregnant, is subject to an annual 170.9 limit of $10,000. 170.10 (b)Enrollees who qualify under section 256L.04,170.11subdivision 7, or who qualify under section 256L.04,170.12subdivisions 1 to 6, or 256L.13 with family gross income that170.13exceeds 175 percent of the federal poverty guidelines and who170.14are not pregnant, and are determined by the commissioner to have170.15a basis of eligibility for medical assistance shall apply for170.16and cooperate with the requirements of medical assistance by the170.17last day of the third month following admission to an inpatient170.18hospital. If an enrollee fails to apply for medical assistance170.19within this time period, the enrollee and the enrollee's family170.20shall be disenrolled from the plan and they may not reenroll170.21until 12 calendar months have elapsed. Enrollees and enrollees'170.22families disenrolled for not applying for or not cooperating170.23with medical assistance may not reenroll.170.24(c)Admissions for inpatient hospital services paid for 170.25 under section 256L.11, subdivision 3, must be certified as 170.26 medically necessary in accordance with Minnesota Rules, parts 170.27 9505.0500 to 9505.0540, except as provided in clauses (1) and 170.28 (2): 170.29 (1) all admissions must be certified, except those 170.30 authorized under rules established under section 254A.03, 170.31 subdivision 3, or approved under Medicare; and 170.32 (2) payment under section 256L.11, subdivision 3, shall be 170.33 reduced by five percent for admissions for which certification 170.34 is requested more than 30 days after the day of admission. The 170.35 hospital may not seek payment from the enrollee for the amount 170.36 of the payment reduction under this clause. 171.1(d) Any enrollee or family member of an enrollee who has171.2previously been permanently disenrolled from MinnesotaCare for171.3not applying for and cooperating with medical assistance shall171.4be eligible to reenroll if 12 calendar months have elapsed since171.5the date of disenrollment.171.6 Sec. 11. Minnesota Statutes 1997 Supplement, section 171.7 256L.03, is amended by adding a subdivision to read: 171.8 Subd. 3a. [INTERPRETER SERVICES.] Covered services include 171.9 sign and spoken language interpreter services that assist an 171.10 enrollee in obtaining covered health care services. 171.11 Sec. 12. Minnesota Statutes 1997 Supplement, section 171.12 256L.03, subdivision 4, is amended to read: 171.13 Subd. 4. [COORDINATION WITH MEDICAL ASSISTANCE.] The 171.14 commissioner shall coordinate the provision of hospital 171.15 inpatient services under the MinnesotaCare program with enrollee 171.16 eligibility under the medical assistance spenddown, and shall171.17apply to the secretary of health and human services for any171.18necessary federal waivers or approvals. 171.19 Sec. 13. Minnesota Statutes 1997 Supplement, section 171.20 256L.03, subdivision 5, is amended to read: 171.21 Subd. 5. [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 171.22 benefit plan shall include the following copayments and 171.23 coinsurance requirements: 171.24 (1) ten percent of the paid charges for inpatient hospital 171.25 services for adult enrolleesnot eligible for medical171.26assistance, subject to an annual inpatient out-of-pocket maximum 171.27 of $1,000 per individual and $3,000 per family; 171.28 (2) $3 per prescription for adult enrollees; 171.29 (3) $25 for eyeglasses for adult enrollees; and 171.30 (4) effective July 1, 1998, 50 percent of the 171.31 fee-for-service rate for adult dental care services other than 171.32 preventive care services for persons eligible under section 171.33 256L.04, subdivisions 1 to 7,or 256L.13,with income equal to 171.34 or less than 175 percent of the federal poverty guidelines. 171.35Prior to July 1, 1997, enrollees who are not eligible for171.36medical assistance with or without a spenddown shall be172.1financially responsible for the coinsurance amount and amounts172.2which exceed the $10,000 benefit limit.Effective July 1, 1997, 172.3 adult enrolleeswho qualify under section 256L.04, subdivision172.47, or who qualify under section 256L.04, subdivisions 1 to 6, or172.5256L.13with family gross income that exceeds 175 percent of the 172.6 federal poverty guidelines and who are not pregnant, and who are172.7not eligible for medical assistance with or without a spenddown,172.8 shall be financially responsible for the coinsurance amount and 172.9 amounts which exceed the $10,000 inpatient hospital benefit 172.10 limit. 172.11 When a MinnesotaCare enrollee becomes a member of a prepaid 172.12 health plan, or changes from one prepaid health plan to another 172.13 during a calendar year, any charges submitted towards the 172.14 $10,000 annual inpatient benefit limit, and any out-of-pocket 172.15 expenses incurred by the enrollee for inpatient services, that 172.16 were submitted or incurred prior to enrollment, or prior to the 172.17 change in health plans, shall be disregarded. 172.18 Sec. 14. Minnesota Statutes 1997 Supplement, section 172.19 256L.04, subdivision 1, is amended to read: 172.20 Subdivision 1. [CHILDREN; EXPANSION AND CONTINUATION OF172.21ELIGIBILITYFAMILIES WITH CHILDREN.] (a)[CHILDREN.] Prior to172.22October 1, 1992, "eligible persons" means children who are one172.23year of age or older but less than 18 years of age who have172.24gross family incomes that are equal to or less than 185 percent172.25of the federal poverty guidelines and who are not eligible for172.26medical assistance without a spenddown under chapter 256B and172.27who are not otherwise insured for the covered services. The172.28period of eligibility extends from the first day of the month in172.29which the child's first birthday occurs to the last day of the172.30month in which the child becomes 18 years old.Families with 172.31 children with family income equal to or less than 275 percent of 172.32 the federal poverty guidelines for the applicable family size 172.33 shall be eligible for MinnesotaCare according to this section. 172.34 All other provisions of sections 256L.01 to 256L.18, including 172.35 the insurance-related barriers to enrollment under section 172.36 256L.07, shall apply unless otherwise specified. 173.1 (b)[EXPANSION OF ELIGIBILITY.] Eligibility for173.2MinnesotaCare shall be expanded as provided in subdivisions 3 to173.37, except children who meet the criteria in this subdivision173.4shall continue to be enrolled pursuant to this subdivision. The173.5enrollment requirements in this paragraph apply to enrollment173.6under subdivisions 1 to 7.Parents who enroll in the 173.7 MinnesotaCare program must also enroll their children and 173.8 dependent siblings, if the children and their dependent siblings 173.9 are eligible. Children and dependent siblings may be enrolled 173.10 separately without enrollment by parents. However, if one 173.11 parent in the household enrolls, both parents must enroll, 173.12 unless other insurance is available. If one child from a family 173.13 is enrolled, all children must be enrolled, unless other 173.14 insurance is available. If one spouse in a household enrolls, 173.15 the other spouse in the household must also enroll, unless other 173.16 insurance is available. Families cannot choose to enroll only 173.17 certain uninsured members.For purposes of this section, a173.18"dependent sibling" means an unmarried child who is a full-time173.19student under the age of 25 years who is financially dependent173.20upon a parent. Proof of school enrollment will be required.173.21(c) [CONTINUATION OF ELIGIBILITY.] Individuals who173.22initially enroll in the MinnesotaCare program under the173.23eligibility criteria in subdivisions 3 to 7 remain eligible for173.24the MinnesotaCare program, regardless of age, place of173.25residence, or the presence or absence of children in the same173.26household, as long as all other eligibility criteria are met and173.27residence in Minnesota and continuous enrollment in the173.28MinnesotaCare program or medical assistance are maintained. In173.29order for either parent or either spouse in a household to173.30remain enrolled, both must remain enrolled, unless other173.31insurance is available.173.32 Sec. 15. Minnesota Statutes 1997 Supplement, section 173.33 256L.04, subdivision 2, is amended to read: 173.34 Subd. 2. [COOPERATION IN ESTABLISHING THIRD PARTY 173.35 LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 173.36 eligible for MinnesotaCare, individuals and families must 174.1 cooperate with the state agency to identify potentially liable 174.2 third party payers and assist the state in obtaining third party 174.3 payments. "Cooperation" includes, but is not limited to, 174.4 identifying any third party who may be liable for care and 174.5 services provided under MinnesotaCare to the enrollee, providing 174.6 relevant information to assist the state in pursuing a 174.7 potentially liable third party, and completing forms necessary 174.8 to recover third party payments. 174.9 (b) A parent, guardian, or child enrolled in the 174.10 MinnesotaCare program must cooperate with the department of 174.11 human services and the local agency in establishing the 174.12 paternity of an enrolled child and in obtaining medical care 174.13 support and payments for the child and any other person for whom 174.14 the person can legally assign rights, in accordance with 174.15 applicable laws and rules governing the medical assistance 174.16 program. A child shall not be ineligible for or disenrolled 174.17 from the MinnesotaCare program solely because the child's parent 174.18 or guardian fails to cooperate in establishing paternity or 174.19 obtaining medical support. 174.20 Sec. 16. Minnesota Statutes 1997 Supplement, section 174.21 256L.04, subdivision 7, is amended to read: 174.22 Subd. 7. [ADDITION OFSINGLE ADULTS AND HOUSEHOLDS WITH NO 174.23 CHILDREN.](a) Beginning October 1, 1994, the definition of174.24"eligible persons" is expanded to include all individuals and174.25households with no children who have gross family incomes that174.26are equal to or less than 125 percent of the federal poverty174.27guidelines and who are not eligible for medical assistance174.28without a spenddown under chapter 256B.174.29(b) Beginning July 1, 1997,The definition of eligible 174.30 personsis expanded to includeincludes all individuals and 174.31 households with no children who have gross family incomes that 174.32 are equal to or less than 175 percent of the federal poverty 174.33 guidelinesand who are not eligible for medical assistance174.34without a spenddown under chapter 256B. 174.35(c) All eligible persons under paragraphs (a) and (b) are174.36eligible for coverage through the MinnesotaCare program but must175.1pay a premium as determined under sections 256L.07 and 256L.08.175.2Individuals and families whose income is greater than the limits175.3established under section 256L.08 may not enroll in the175.4MinnesotaCare program.175.5 Sec. 17. Minnesota Statutes 1997 Supplement, section 175.6 256L.04, is amended by adding a subdivision to read: 175.7 Subd. 7a. [INELIGIBILITY.] Applicants whose income is 175.8 greater than the limits established under this section may not 175.9 enroll in the MinnesotaCare program. 175.10 Sec. 18. Minnesota Statutes 1997 Supplement, section 175.11 256L.04, subdivision 8, is amended to read: 175.12 Subd. 8. [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 175.13 ASSISTANCE.] (a) Individuals whoapply for MinnesotaCarereceive 175.14 supplemental security income or retirement, survivors, or 175.15 disability benefits due to a disability, or other 175.16 disability-based pension, who qualify under section 256L.04, 175.17 subdivision 7, but who are potentially eligible for medical 175.18 assistance without a spenddown shall be allowed to enroll in 175.19 MinnesotaCare for a period of 60 days, so long as the applicant 175.20 meets all other conditions of eligibility. The commissioner 175.21 shall identify and refer the applications of such individuals to 175.22 their county social service agency. The county and the 175.23 commissioner shall cooperate to ensure that the individuals 175.24 obtain medical assistance coverage for any months for which they 175.25 are eligible. 175.26 (b) The enrollee must cooperate with the county social 175.27 service agency in determining medical assistance eligibility 175.28 within the 60-day enrollment period. Enrollees who do notapply175.29for andcooperate with medical assistance within the 60-day 175.30 enrollment period, and their other family members,shall be 175.31 disenrolled from the plan within one calendar month. Persons 175.32 disenrolled for nonapplication for medical assistance may not 175.33 reenroll until they have obtained a medical assistance 175.34 eligibility determinationfor the family member or members who175.35were referred to the county agency. Persons disenrolled for 175.36 noncooperation with medical assistance may not reenroll until 176.1 they have cooperated with the county agency and have obtained a 176.2 medical assistance eligibility determination. 176.3 (c) Beginning January 1, 2000, counties that choose to 176.4 become MinnesotaCare enrollment sites shall consider 176.5 MinnesotaCare applications of individuals described in paragraph 176.6 (a) to also be applications for medical assistance and shall 176.7 first determine whether medical assistance eligibility exists. 176.8 Adults with children with family income under 175 percent of the 176.9 federal poverty guidelines for the applicable family size, 176.10 pregnant women, and children who qualify under subdivision 1 who 176.11 are potentially eligible for medical assistance without a 176.12 spenddown may choose to enroll in either MinnesotaCare or 176.13 medical assistance. 176.14 (d) The commissioner shall redetermine provider payments 176.15 made under MinnesotaCare to the appropriate medical assistance 176.16 payments for those enrollees who subsequently become eligible 176.17 for medical assistance. 176.18 Sec. 19. Minnesota Statutes 1997 Supplement, section 176.19 256L.04, subdivision 9, is amended to read: 176.20 Subd. 9. [GENERAL ASSISTANCE MEDICAL CARE.] A person 176.21 cannot have coverage under both MinnesotaCare and general 176.22 assistance medical care in the same month. Eligibility for 176.23 MinnesotaCare cannot be replaced by eligibility for general 176.24 assistance medical care, and eligibility for general assistance 176.25 medical care cannot be replaced by eligibility for MinnesotaCare. 176.26 Sec. 20. Minnesota Statutes 1997 Supplement, section 176.27 256L.04, subdivision 10, is amended to read: 176.28 Subd. 10. [SPONSOR'S INCOME AND RESOURCES DEEMED 176.29 AVAILABLE; DOCUMENTATION.] When determining eligibility for any 176.30 federal or state benefits under sections 256L.01 to256L.16176.31 256L.18, the income and resources of all noncitizens whose 176.32 sponsor signed an affidavit of support as defined under United 176.33 States Code, title 8, section 1183a, shall be deemed to include 176.34 their sponsors' income and resources as defined in the Personal 176.35 Responsibility and Work Opportunity Reconciliation Act of 1996, 176.36 title IV, Public Law Number 104-193, sections 421 and 422, and 177.1 subsequently set out in federal rules. To be eligible for the 177.2 program, noncitizens must provide documentation of their 177.3 immigration status. 177.4 Sec. 21. Minnesota Statutes 1997 Supplement, section 177.5 256L.04, is amended by adding a subdivision to read: 177.6 Subd. 12. [PERSONS IN DETENTION.] An applicant residing in 177.7 a correctional or detention facility is not eligible for 177.8 MinnesotaCare. An enrollee residing in a correctional or 177.9 detention facility is not eligible at renewal of eligibility 177.10 under section 256L.05, subdivision 3b. 177.11 Sec. 22. Minnesota Statutes 1997 Supplement, section 177.12 256L.04, is amended by adding a subdivision to read: 177.13 Subd. 13. [FAMILIES WITH GRANDPARENTS, RELATIVE 177.14 CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] In families 177.15 that include a grandparent, relative caretaker as defined in the 177.16 medical assistance program, foster parent, or legal guardian, 177.17 the grandparent, relative caretaker, foster parent, or legal 177.18 guardian may apply as a family or may apply separately for the 177.19 child. If the grandparent, relative caretaker, foster parent, 177.20 or legal guardian applies with the family, their income is 177.21 included in the gross family income for determining eligibility 177.22 and premium amount. 177.23 Sec. 23. Minnesota Statutes 1997 Supplement, section 177.24 256L.05, is amended by adding a subdivision to read: 177.25 Subd. 1a. [PERSON AUTHORIZED TO APPLY ON APPLICANT'S 177.26 BEHALF.] A family member who is age 18 or over or who is an 177.27 authorized representative, as defined in the medical assistance 177.28 program, may apply on an applicant's behalf. 177.29 Sec. 24. Minnesota Statutes 1997 Supplement, section 177.30 256L.05, subdivision 2, is amended to read: 177.31 Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall 177.32 use individuals' social security numbers as identifiers for 177.33 purposes of administering the plan and conduct data matches to 177.34 verify income. Applicants shall submit evidence of individual 177.35 and family income, earned and unearned,includingsuch as the 177.36 most recent income tax return, wage slips, or other 178.1 documentation that is determined by the commissioner as 178.2 necessary to verify income eligibility. The commissioner shall 178.3 perform random audits to verify reported income and 178.4 eligibility. The commissioner may execute data sharing 178.5 arrangements with the department of revenue and any other 178.6 governmental agency in order to perform income verification 178.7 related to eligibility and premium payment under the 178.8 MinnesotaCare program. 178.9 Sec. 25. Minnesota Statutes 1997 Supplement, section 178.10 256L.05, subdivision 3, is amended to read: 178.11 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] The effective date 178.12 of coverage is the first day of the month following the month in 178.13 which eligibility is approved and the first premium payment has 178.14 been received. As provided in section 256B.057, coverage for 178.15 newborns is automatic from the date of birth and must be 178.16 coordinated with other health coverage. The effective date of 178.17 coverage foreligible newborns oreligible newly adoptive 178.18 children added to a family receiving covered health services is 178.19 the date of entry into the family. The effective date of 178.20 coverage for other new recipients added to the family receiving 178.21 covered health services is the first day of the month following 178.22 the month in which eligibility is approvedand the first premium178.23payment has been receivedor at renewal, whichever the family 178.24 receiving covered health services prefers. All eligibility 178.25 criteria must be met by the family at the time the new family 178.26 member is added. The income of the new family member is 178.27 included with the family's gross income and the adjusted premium 178.28 begins in the month the new family member is added. The premium 178.29 must be received eight working days prior to the end of the 178.30 month for coverage to begin the following month. Benefits are 178.31 not available until the day following discharge if an enrollee 178.32 is hospitalized on the first day of coverage. Notwithstanding 178.33 any other law to the contrary, benefits under sections 256L.01 178.34 to256L.10256L.18 are secondary to a plan of insurance or 178.35 benefit program under which an eligible person may have coverage 178.36 and the commissioner shall use cost avoidance techniques to 179.1 ensure coordination of any other health coverage for eligible 179.2 persons. The commissioner shall identify eligible persons who 179.3 may have coverage or benefits under other plans of insurance or 179.4 who become eligible for medical assistance. 179.5 Sec. 26. Minnesota Statutes 1997 Supplement, section 179.6 256L.05, is amended by adding a subdivision to read: 179.7 Subd. 3a. [RENEWAL OF ELIGIBILITY.] An enrollee's 179.8 eligibility must be renewed every 12 months. The 12-month 179.9 period begins in the month after the month the application is 179.10 approved. Individuals who initially enroll in the MinnesotaCare 179.11 program under section 256L.04, subdivision 1 or 7, remain 179.12 eligible for the MinnesotaCare program regardless of age, place 179.13 of residence, or the presence or absence of children in the same 179.14 household, as long as all other eligibility criteria are met, 179.15 and residence in Minnesota and continuous enrollment in the 179.16 MinnesotaCare program are maintained. 179.17 Sec. 27. Minnesota Statutes 1997 Supplement, section 179.18 256L.05, is amended by adding a subdivision to read: 179.19 Subd. 3b. [REAPPLICATION.] Families and individuals must 179.20 reapply after a lapse in coverage of one calendar month or more 179.21 and must meet all eligibility criteria. 179.22 Sec. 28. Minnesota Statutes 1997 Supplement, section 179.23 256L.05, subdivision 4, is amended to read: 179.24 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 179.25 human services shall determine an applicant's eligibility for 179.26 MinnesotaCare no more than 30 days from the date that the 179.27 application is received by the department of human services. 179.28 Beginning January 1, 2000, this requirement also applies to 179.29 local county human services agencies that determine eligibility 179.30 for MinnesotaCare. To prevent processing delays, applicants who 179.31 appear to meet eligibility requirements shall be enrolled. The 179.32 enrollee must provide all required verifications within 30 days 179.33 of enrollment or coverage from the program shall be terminated. 179.34 Enrollees who are determined to be ineligible when verifications 179.35 are provided shall be disenrolled from the program. 179.36 Sec. 29. Minnesota Statutes 1997 Supplement, section 180.1 256L.06, subdivision 3, is amended to read: 180.2 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 180.3 Premiums are dedicated to the commissioner for MinnesotaCare. 180.4The commissioner shall make an annual redetermination of180.5continued eligibility and identify people who may become180.6eligible for medical assistance.180.7 (b) The commissioner shall develop and implement procedures 180.8 to: (1) require enrollees to report changes in income; (2) 180.9 adjust sliding scale premium payments, based upon changes in 180.10 enrollee income; and (3) disenroll enrollees from MinnesotaCare 180.11 for failure to pay required premiums. Failure to pay includes 180.12 payment with a dishonored check. The commissioner may demand a 180.13 guaranteed form of payment as the only means to replace a 180.14 dishonored check. 180.15 (c) Premiums are calculated on a calendar month basis and 180.16 may be paid on a monthly, quarterly, or annual basis, with the 180.17 first payment due upon notice from the commissioner of the 180.18 premium amount required. Premium payment is required before 180.19 enrollment is complete and to maintain eligibility in 180.20 MinnesotaCare. 180.21 (d) Nonpayment of the premium will result in disenrollment 180.22 from the plan within one calendar month after the due date. 180.23 Persons disenrolled for nonpayment or who voluntarily terminate 180.24 coverage from the program may not reenroll until four calendar 180.25 months have elapsed. Persons disenrolled for nonpayment or who 180.26 voluntarily terminate coverage from the program may not reenroll 180.27 for four calendar months unless the person demonstrates good 180.28 cause for nonpayment. Good cause does not exist if a person 180.29 chooses to pay other family expenses instead of the premium. 180.30 The commissioner shall define good cause in rule. 180.31 Sec. 30. Minnesota Statutes 1997 Supplement, section 180.32 256L.07, is amended to read: 180.33 256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON 180.34 SLIDING SCALE.] 180.35 Subdivision 1. [GENERAL REQUIREMENTS.]Families and180.36individuals who enroll on or after October 1, 1992, are eligible181.1for subsidized premium payments based on a sliding scale under181.2section 256L.08 only if the family or individual meets the181.3requirements in subdivisions 2 and 3. Children already enrolled181.4in the children's health plan as of September 30, 1992, eligible181.5under section 256L.04, subdivision 1, paragraph (a), children181.6who enroll in the MinnesotaCare program after September 30,181.71992, pursuant to Laws 1992, chapter 549, article 4, section 17,181.8and children who enroll under section 256L.04, subdivision 6,181.9are eligible for subsidized premium payments without meeting181.10these requirements, as long as they maintain continuous coverage181.11in the MinnesotaCare plan or medical assistance.(a) Children 181.12 enrolled in the original children's health plan as of September 181.13 30, 1992, children who enrolled in the MinnesotaCare program 181.14 after September 30, 1992, pursuant to Laws 1992, chapter 549, 181.15 article 4, section 17, and children who have family gross 181.16 incomes that are equal to or less than 150 percent of the 181.17 federal poverty guidelines are eligible for subsidized premium 181.18 payments without meeting the requirements of subdivision 2, as 181.19 long as they maintain continuous coverage in the MinnesotaCare 181.20 program or medical assistance. 181.21 (b) Families and individuals who initially enrolled in 181.22 MinnesotaCare under section 256L.04,andsubdivision 1 or 7, 181.23 whose income increases abovethe limits established in section181.24256L.08275 percent of the federal poverty guidelines, may 181.25 continue enrollment and pay the full cost of coverage. 181.26 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 181.27 COVERAGE.] (a) To be eligible for subsidized premium payments 181.28 based on a sliding scale, a family or individual must not have 181.29 access to subsidized health coverage through an employer, and181.30must not have had access to subsidized health coverage through181.31an employer for the 18 months prior to application for181.32subsidized coverage under the MinnesotaCare program. The181.33requirement that the family or individual must not have had181.34access to employer-subsidized coverage during the previous 18181.35months does not apply if: (1) employer-subsidized coverage was181.36lost due to the death of an employee or divorce; (2)182.1employer-subsidized coverage was lost because an individual182.2became ineligible for coverage as a child or dependent; or (3)182.3employer-subsidized coverage was lost for reasons that would not182.4disqualify the individual for unemployment benefits under182.5section 268.09 and the family or individual has not had access182.6to employer-subsidized coverage since the loss of coverage. If182.7employer-subsidized coverage was lost for reasons that182.8disqualify an individual for unemployment benefits under section182.9268.09, children of that individual are exempt from the182.10requirement of no access to employer subsidized coverage for the182.1118 months prior to application, as long as the children have not182.12had access to employer subsidized coverage since the182.13disqualifying event. The requirement that the. A family or 182.14 individualmust not have had access to employer-subsidized182.15coverage during the previous 18 months does apply ifwhose 182.16 employer-subsidized coverage is lost due to an employer 182.17 terminating health care coverage as an employee benefit during 182.18 the previous 18 months is not eligible. 182.19 (b) For purposes of this requirement, subsidized health 182.20 coverage means health coverage for which the employer pays at 182.21 least 50 percent of the cost of coverage for the employee,182.22excluding dependent coverageor dependent, or a higher 182.23 percentage as specified by the commissioner. Children are 182.24 eligible for employer-subsidized coverage through either parent, 182.25 including the noncustodial parent. The commissioner must treat 182.26 employer contributions to Internal Revenue Code Section 125 182.27 plans and any other employer benefits intended to pay health 182.28 care costs as qualified employer subsidies toward the cost of 182.29 health coverage for employees for purposes of this subdivision. 182.30 Subd. 3. [PERIOD UNINSUREDOTHER HEALTH COVERAGE.]To be182.31eligible for subsidized premium payments based on a sliding182.32scale,(a) Families and individualsinitiallyenrolled in the 182.33 MinnesotaCare programunder section 256L.04, subdivisions 5 and182.347,must havehadno health coverage while enrolled or for at 182.35 least four months prior to application and renewal. A child in 182.36 a family with income equal to or less than 150 percent of the 183.1 federal poverty guidelines, who has other health insurance, is 183.2 eligible if the other health coverage meets the requirements of 183.3 Minnesota Rules, part 9506.0020, subpart 3, item B. The 183.4 commissioner may change this eligibility criterion for sliding 183.5 scale premiums in order to remain within the limits of available 183.6 appropriations. The requirement ofat least four months ofno 183.7 health coverageprior to application for the MinnesotaCare183.8programdoes not apply to:newborns. 183.9(1) families, children, and individuals who apply for the183.10MinnesotaCare program upon termination from or as required by183.11the medical assistance program, general assistance medical care183.12program, or coverage under a regional demonstration project for183.13the uninsured funded under section 256B.73, the Hennepin county183.14assured care program, or the Group Health, Inc., community183.15health plan;183.16(2) families and individuals initially enrolled under183.17section 256L.04, subdivisions 1, paragraph (a), and 3;183.18(3) children enrolled pursuant to Laws 1992, chapter 549,183.19article 4, section 17; or183.20(4) individuals currently serving or who have served in the183.21military reserves, and dependents of these individuals, if these183.22individuals: (i) reapply for MinnesotaCare coverage after a183.23period of active military service during which they had been183.24covered by the Civilian Health and Medical Program of the183.25Uniformed Services (CHAMPUS); (ii) were covered under183.26MinnesotaCare immediately prior to obtaining coverage under183.27CHAMPUS; and (iii) have maintained continuous coverage.183.28 (b) For purposes of this section, medical assistance, 183.29 general assistance medical care, and civilian health and medical 183.30 program of the uniformed service, CHAMPUS, are not considered 183.31 insurance or health coverage. 183.32 (c) For purposes of this section, Medicare part A or B 183.33 coverage under title XVIII of the Social Security Act, United 183.34 States Code, title 42, sections 1395c to 1395w-4, is considered 183.35 health coverage. An applicant or enrollee may not refuse 183.36 Medicare coverage to establish eligibility for MinnesotaCare. 184.1 Sec. 31. Minnesota Statutes 1997 Supplement, section 184.2 256L.09, subdivision 2, is amended to read: 184.3 Subd. 2. [RESIDENCY REQUIREMENT.] (a)Prior to July 1,184.41997, to be eligible for health coverage under the MinnesotaCare184.5program, families and individuals must be permanent residents of184.6Minnesota.184.7(b) Effective July 1, 1997,To be eligible for health 184.8 coverage under the MinnesotaCare program, adults without 184.9 children must be permanent residents of Minnesota. 184.10(c) Effective July 1, 1997,(b) To be eligible for health 184.11 coverage under the MinnesotaCare program, pregnant women, 184.12 families, and children must meet the residency requirements as 184.13 provided by Code of Federal Regulations, title 42, section 184.14 435.403, except that the provisions of section 256B.056, 184.15 subdivision 1, shall apply upon receipt of federal approval. 184.16 Sec. 32. Minnesota Statutes 1997 Supplement, section 184.17 256L.09, subdivision 4, is amended to read: 184.18 Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 184.19 purposes of this section, a permanent Minnesota resident is a 184.20 person who has demonstrated, through persuasive and objective 184.21 evidence, that the person is domiciled in the state and intends 184.22 to live in the state permanently. 184.23 (b) To be eligible as a permanent resident,all applicants184.24 an applicant must demonstrate the requisite intent to live in 184.25 the state permanently by: 184.26 (1) showing that the applicant maintains a residence at a 184.27 verified address other than a place of public accommodation, 184.28 through the use of evidence of residence described in section 184.29 256D.02, subdivision 12a, clause (1); 184.30 (2) demonstrating that the applicant has been continuously 184.31 domiciled in the state for no less than 180 days immediately 184.32 before the application; and 184.33 (3) signing an affidavit declaring that (A) the applicant 184.34 currently resides in the state and intends to reside in the 184.35 state permanently; and (B) the applicant did not come to the 184.36 state for the primary purpose of obtaining medical coverage or 185.1 treatment. 185.2 (c) A person who is temporarily absent from the state does 185.3 not lose eligibility for MinnesotaCare. "Temporarily absent 185.4 from the state" means the person is out of the state for a 185.5 temporary purpose and intends to return when the purpose of the 185.6 absence has been accomplished. A person is not temporarily 185.7 absent from the state if another state has determined that the 185.8 person is a resident for any purpose. If temporarily absent 185.9 from the state, the person must follow the requirements of the 185.10 health plan in which he or she is enrolled to receive services. 185.11 Sec. 33. Minnesota Statutes 1997 Supplement, section 185.12 256L.09, subdivision 6, is amended to read: 185.13 Subd. 6. [12-MONTH PREEXISTING EXCLUSION.] If the 180-day 185.14 requirement in subdivision 4, paragraph (b), clause (2), is 185.15 determined by a court to be unconstitutional, the commissioner 185.16 of human services shall impose a 12-month preexisting condition 185.17 exclusion on coverage for persons who have been domiciled in the 185.18 state for less than 180 days. 185.19 Sec. 34. Minnesota Statutes 1997 Supplement, section 185.20 256L.11, subdivision 6, is amended to read: 185.21 Subd. 6. [ENROLLEES 18 OR OLDER.] Payment by the 185.22 MinnesotaCare program for inpatient hospital services provided 185.23 to MinnesotaCare enrollees eligible under section 256L.04, 185.24 subdivision 7, or who qualify under section 256L.04, 185.25 subdivisions 1to 6and 2,or 256L.13with family gross income 185.26 that exceeds 175 percent of the federal poverty guidelines and 185.27 who are not pregnant, who are 18 years old or older on the date 185.28 of admission to the inpatient hospital must be in accordance 185.29 with paragraphs (a) and (b). Payment for adults who are not 185.30 pregnant and are eligible under section 256L.04, subdivisions 185.31 1to 6and 2,or 256L.13,and whose incomes are equal to or less 185.32 than 175 percent of the federal poverty guidelines, shall be as 185.33 provided for under paragraph (c). 185.34 (a) If the medical assistance rate minus any copayment 185.35 required under section 256L.03, subdivision 4, is less than or 185.36 equal to the amount remaining in the enrollee's benefit limit 186.1 under section 256L.03, subdivision 3, payment must be the 186.2 medical assistance rate minus any copayment required under 186.3 section 256L.03, subdivision 4. The hospital must not seek 186.4 payment from the enrollee in addition to the copayment. The 186.5 MinnesotaCare payment plus the copayment must be treated as 186.6 payment in full. 186.7 (b) If the medical assistance rate minus any copayment 186.8 required under section 256L.03, subdivision 4, is greater than 186.9 the amount remaining in the enrollee's benefit limit under 186.10 section 256L.03, subdivision 3, payment must be the lesser of: 186.11 (1) the amount remaining in the enrollee's benefit limit; 186.12 or 186.13 (2) charges submitted for the inpatient hospital services 186.14 less any copayment established under section 256L.03, 186.15 subdivision 4. 186.16 The hospital may seek payment from the enrollee for the 186.17 amount by which usual and customary charges exceed the payment 186.18 under this paragraph. If payment is reduced under section 186.19 256L.03, subdivision 3, paragraph(c)(b), the hospital may not 186.20 seek payment from the enrollee for the amount of the reduction. 186.21 (c) For admissions occurring during the period of July 1, 186.22 1997, through June 30, 1998, for adults who are not pregnant and 186.23 are eligible under section 256L.04, subdivisions 1to 6and 186.24 2,or 256L.13,and whose incomes are equal to or less than 175 186.25 percent of the federal poverty guidelines, the commissioner 186.26 shall pay hospitals directly, up to the medical assistance 186.27 payment rate, for inpatient hospital benefits in excess of the 186.28 $10,000 annual inpatient benefit limit. 186.29 Sec. 35. Minnesota Statutes 1997 Supplement, section 186.30 256L.12, subdivision 5, is amended to read: 186.31 Subd. 5. [ELIGIBILITY FOR OTHER STATE PROGRAMS.] 186.32 MinnesotaCare enrollees who become eligible for medical 186.33 assistance or general assistance medical care will remain in the 186.34 same managed care plan if the managed care plan has a contract 186.35 for that population. Effective January 1, 1998, MinnesotaCare 186.36 enrollees who were formerly eligible for general assistance 187.1 medical care pursuant to section 256D.03, subdivision 3, within 187.2 six months of MinnesotaCare enrollment and were enrolled in a 187.3 prepaid health plan pursuant to section 256D.03, subdivision 4, 187.4 paragraph (d), must remain in the same managed care plan if the 187.5 managed care plan has a contract for that population.Contracts187.6between the department of human services and managed care plans187.7must include MinnesotaCare, and medical assistance and may, at187.8the option of the commissioner of human services, also include187.9general assistance medical care.Managed care plans must 187.10 participate in the MinnesotaCare and general assistance medical 187.11 care programs under a contract with the department of human 187.12 services in service areas where they participate in the medical 187.13 assistance program. 187.14 Sec. 36. Minnesota Statutes 1997 Supplement, section 187.15 256L.15, is amended to read: 187.16 256L.15 [PREMIUMS.] 187.17 Subdivision 1. [PREMIUM DETERMINATION.] Familiesandwith 187.18 childrenenrolled according to sections 256L.13 to 256L.16and 187.19 individuals shall pay a premium determined according to a 187.20 sliding fee based on the cost of coverage as a percentage of the 187.21 family's gross family income. Pregnant women and children under 187.22 age two are exempt from the provisions of section 256L.06, 187.23 subdivision 3, paragraph (b), clause (3), requiring 187.24 disenrollment for failure to pay premiums. For pregnant women, 187.25 this exemption continues until the first day of the month 187.26 following the 60th day postpartum. Women who remain enrolled 187.27 during pregnancy or the postpartum period, despite nonpayment of 187.28 premiums, shall be disenrolled on the first of the month 187.29 following the 60th day postpartum for the penalty period that 187.30 otherwise applies under section 256L.06, unless they begin 187.31 paying premiums. 187.32 Subd. 1a. [PAYMENT OPTIONS.] The commissioner may offer 187.33 the following payment options to an enrollee: 187.34 (1) payment by check; 187.35 (2) payment by credit card; 187.36 (3) payment by recurring automatic checking withdrawal; 188.1 (4) payment by one-time electronic transfer of funds; 188.2 (5) payment by wage withholding with the consent of the 188.3 employer and the employee; or 188.4 (6) payment by using state tax refund payments. 188.5 At application or reapplication, a MinnesotaCare applicant 188.6 or enrollee may authorize the commissioner to use the Revenue 188.7 Recapture Act in chapter 270A to collect funds from the 188.8 applicant's or enrollee's state income tax refund for the 188.9 purposes of meeting all or part of the applicant's or enrollee's 188.10 MinnesotaCare premium obligation for the forthcoming year. The 188.11 applicant or enrollee may authorize the commissioner to apply 188.12 for the state working family tax credit on behalf of the 188.13 applicant or enrollee. The setoff due under this subdivision 188.14 shall not be subject to the $10 fee under section 270A.07, 188.15 subdivision 1. 188.16 Subd. 1b. [PAYMENTS NONREFUNDABLE.] MinnesotaCare premiums 188.17 are not refundable. 188.18 Subd. 2. [SLIDING SCALE TO DETERMINE PERCENTAGE OF GROSS 188.19 INDIVIDUAL OR FAMILY INCOME.] The commissioner shall establish a 188.20 sliding fee scale to determine the percentage of 188.21 gross individual or family income that households at different 188.22 income levels must pay to obtain coverage through the 188.23 MinnesotaCare program. The sliding fee scale must be based on 188.24 the enrollee's gross individual or family income during the 188.25 previous four months. The sliding fee scale begins with a 188.26 premium of 1.5 percent of gross individual or family income for 188.27 individuals or families with incomes below the limits for the 188.28 medical assistance program for families and children and 188.29 proceeds through the following evenly spaced steps: 1.8, 2.3, 188.30 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. These percentages are 188.31 matched to evenly spaced income steps ranging from the medical 188.32 assistance income limit for families and children to 275 percent 188.33 of the federal poverty guidelines for the applicable family 188.34 size. An adult without children whose income is equal to or 188.35 less than 175 percent of the federal poverty guidelines shall 188.36 pay premiums according to the sliding fee scale. When an 189.1 enrollee's income exceeds 275 percent of the federal poverty 189.2 guidelines, the enrollee must pay the full cost of coverage as 189.3 required under section 256L.07, subdivision 1. The sliding fee 189.4 scale and percentages are not subject to the provisions of 189.5 chapter 14. If a family or individual reports increased income 189.6 after enrollment, premiums shall not be adjusted until 189.7 eligibility renewal. 189.8 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 189.9 of $48 is required for all childrenwho are eligible according189.10to section 256L.13, subdivision 4in families with income at or 189.11 less than 150 percent of federal poverty guidelines. 189.12 Sec. 37. Minnesota Statutes 1997 Supplement, section 189.13 256L.17, is amended by adding a subdivision to read: 189.14 Subd. 6. [WAIVER OF MAINTENANCE OF EFFORT 189.15 REQUIREMENT.] Unless a federal waiver of the maintenance of 189.16 effort requirements of section 2105(d) of title XXI of the 189.17 Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 189.18 at Large, volume 111, page 251, is granted by the federal 189.19 Department of Health and Human Services by September 30, 1998, 189.20 this section does not apply to children. The commissioner shall 189.21 publish a notice in the State Register upon receipt of a federal 189.22 waiver. 189.23 Sec. 38. Minnesota Statutes 1997 Supplement, section 189.24 270A.03, subdivision 5, is amended to read: 189.25 Subd. 5. [DEBT.] "Debt" means a legal obligation of a 189.26 natural person to pay a fixed and certain amount of money, which 189.27 equals or exceeds $25 and which is due and payable to a claimant 189.28 agency. The term includes criminal fines imposed under section 189.29 609.10 or 609.125 and restitution. A debt may arise under a 189.30 contractual or statutory obligation, a court order, or other 189.31 legal obligation, but need not have been reduced to judgment. 189.32 A debt includes any legal obligation of a current recipient 189.33 of assistance which is based on overpayment of an assistance 189.34 grant where that payment is based on a client waiver or an 189.35 administrative or judicial finding of an intentional program 189.36 violation; or where the debt is owed to a program wherein the 190.1 debtor is not a client at the time notification is provided to 190.2 initiate recovery under this chapter and the debtor is not a 190.3 current recipient of food stamps, transitional child care, or 190.4 transitional medical assistance. 190.5 A debt does not include any legal obligation to pay a 190.6 claimant agency for medical care, including hospitalization if 190.7 the income of the debtor at the time when the medical care was 190.8 rendered does not exceed the following amount: 190.9 (1) for an unmarried debtor, an income of $6,400 or less; 190.10 (2) for a debtor with one dependent, an income of $8,200 or 190.11 less; 190.12 (3) for a debtor with two dependents, an income of $9,700 190.13 or less; 190.14 (4) for a debtor with three dependents, an income of 190.15 $11,000 or less; 190.16 (5) for a debtor with four dependents, an income of $11,600 190.17 or less; and 190.18 (6) for a debtor with five or more dependents, an income of 190.19 $12,100 or less. 190.20 The income amounts in this subdivision shall be adjusted 190.21 for inflation for debts incurred in calendar years 1991 and 190.22 thereafter. The dollar amount of each income level that applied 190.23 to debts incurred in the prior year shall be increased in the 190.24 same manner as provided in section 290.06, subdivision 2d, for 190.25 the expansion of the tax rate brackets. 190.26 Debt also includes an agreement to pay a MinnesotaCare 190.27 premium, regardless of the dollar amount of the premium 190.28 authorized under section 256L.15, subdivision 1a. 190.29 Sec. 39. Laws 1997, chapter 225, article 2, section 64, is 190.30 amended to read: 190.31 Sec. 64. [EFFECTIVE DATE.] 190.32 Section 8 is effective for payments made for MinnesotaCare 190.33 services on or after July 1, 1996. Section 23 is effective the 190.34 day following final enactment. Section 46 is effective January 190.35 1, 1998, and applies to high deductible health plans issued or 190.36 renewed on or after that date. 191.1 Sec. 40. [FEDERAL EARNED INCOME TAX CREDIT.] 191.2 The commissioner of human services shall seek a federal 191.3 waiver from the appropriate federal agency to allow the state to 191.4 use the federal earned income tax credit for payment of state 191.5 subsidized health care premiums. 191.6 Sec. 41. [INPATIENT HOSPITAL COPAYMENT.] 191.7 If federal approval of a waiver to obtain federal Medicaid 191.8 funding for coverage provided to parents enrolled in the 191.9 MinnesotaCare program is contingent upon not applying the 191.10 inpatient hospital services copayment under section 256L.03, 191.11 subdivision 5, clause (1), the inpatient hospital services 191.12 copayment shall not be applied to enrollees for whom the state 191.13 receives federal Medicaid funding. 191.14 Sec. 42. [AUTHORIZATION TO SUBMIT PLANS AND REQUESTS FOR 191.15 WAIVERS TO OBTAIN FEDERAL FUNDS UNDER TITLE XXI.] 191.16 (a) The commissioner of human services is authorized to 191.17 claim enhanced federal matching funds available under sections 191.18 2105(a)(2) and 2110 of the Balanced Budget Act of 1997, Public 191.19 Law Number 105-33, for any and all state or local expenditures 191.20 eligible as child health assistance for targeted low-income 191.21 children and health service initiatives for low-income 191.22 children. If required by federal law or regulation, the 191.23 commissioner is authorized to establish accounts, make 191.24 appropriate payments, and receive reimbursement from any and all 191.25 state and local entities providing child health assistance or 191.26 health services for low-income children in order to obtain 191.27 federal matching funds. Federal matching funds received under 191.28 this section shall be deposited in the health care access fund. 191.29 (b) The commissioner of human services shall submit to the 191.30 health care financing administration all necessary plans or 191.31 requests for waivers in order to obtain enhanced matching funds 191.32 under the state children's health insurance program for 191.33 expenditures made under the MinnesotaCare program. The 191.34 commissioner shall report to the 1999 legislature all changes to 191.35 the MinnesotaCare program that may be required in order to 191.36 receive enhanced matching funds. 192.1 Sec. 43. [REVISOR'S INSTRUCTION.] 192.2 In each section of Minnesota Statutes referred to in column 192.3 A, the revisor of statutes shall delete the reference in column 192.4 B and insert the reference in column C. 192.5 Column A Column B Column C 192.6 256B.057, subd. 1a 256L.08 256L.15 192.7 256B.0645 256L.14 256L.03, subd. 1a 192.8 256L.16 256L.14 256L.03, subd. 1a 192.9 Sec. 44. [REPEALER.] 192.10 Minnesota Statutes 1997 Supplement, sections 256B.057, 192.11 subdivision 1a; 256L.04, subdivisions 3, 4, 5, and 6; 256L.06, 192.12 subdivisions 1 and 2; 256L.08; 256L.09, subdivision 3; 256L.13; 192.13 256L.14; and 256L.15, subdivision 3, are repealed. 192.14 Sec. 45. [EFFECTIVE DATE.] 192.15 Sections 1, 3 to 10, 12 to 36, 38, 43, and 44 are effective 192.16 January 1, 1999. Sections 2 and 37 are effective September 30, 192.17 1998. Sections 11, 39, 40, 41, and 42 are effective the day 192.18 following final enactment. 192.19 ARTICLE 6 192.20 WELFARE REFORM 192.21 Section 1. Minnesota Statutes 1996, section 119B.24, is 192.22 amended to read: 192.23 119B.24 [DUTIES OF COMMISSIONER.] 192.24 In addition to the powers and duties already conferred by 192.25 law, the commissioner of children, families, and learning shall: 192.26 (1) by September 1, 1998, and every five years thereafter, 192.27 survey and report on all components of the child care system, 192.28 including, but not limited to, availability of licensed child 192.29 care slots, the number of children in various kinds of child 192.30 care settings, staff wages, rate of staff turnover, 192.31 qualifications of child care workers, cost of child care by type 192.32 of service and ages of children, and child care availability 192.33 through school systems; 192.34 (2) by September 1, 1998, and every five years thereafter, 192.35 survey and report on the extent to which existing child care 192.36 services fulfill the need for child care, giving particular 193.1 attention to the need for part-time care and for care of 193.2 infants, sick children, children with special needs, low-income 193.3 children, toddlers, and school-age children; 193.4 (3) administer the child care fund, including the sliding 193.5 fee program authorized under sections 119B.01 to 119B.16; 193.6 (4) monitor the child care resource and referral programs 193.7 established under section 119B.19; and 193.8 (5) encourage child care providers to participate in a 193.9 nationally recognized accreditation system for early childhood 193.10 programs. The commissioner shall reimburse licensed child care 193.11 providers for one-half of the direct cost of accreditation fees, 193.12 upon successful completion of accreditation. 193.13 The commissioner may enter into contractual agreements with 193.14 a federally recognized Indian tribe with a reservation in 193.15 Minnesota to carry out any of the responsibilities of county 193.16 human service agencies to the extent necessary for the tribe to 193.17 operate a child care assistance program under the supervision of 193.18 the commissioner. 193.19 Funding to support services under section 119B.03 may be 193.20 transferred to the federally recognized Indian tribe with a 193.21 reservation in Minnesota from allocations available to counties 193.22 in which reservation boundaries lie. When funding is 193.23 transferred, the amount shall be commensurate to estimates of 193.24 the proportion of reservation residents to the total population 193.25 of county residents with characteristics identified in section 193.26 119B.03. 193.27 Sec. 2. Minnesota Statutes 1996, section 245A.03, is 193.28 amended by adding a subdivision to read: 193.29 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 193.30 clause (2), does not apply to: 193.31 (1) a child care provider who as an applicant for licensure 193.32 or as a license holder has received a license denial under 193.33 section 245A.05, a fine under section 245A.06, or a sanction 193.34 under section 245A.07 from the commissioner that has not been 193.35 reversed on appeal; or 193.36 (2) a child care provider, or a child care provider who has 194.1 a household member who, as a result of a licensing process, has 194.2 a disqualification under this chapter that has not been set 194.3 aside by the commissioner. 194.4 Sec. 3. Minnesota Statutes 1996, section 245A.14, 194.5 subdivision 4, is amended to read: 194.6 Subd. 4. [SPECIAL FAMILY DAY CARE HOMES.] (a) 194.7 Nonresidential child care programs serving 14 or fewer children 194.8 that are conducted at a location other than the license holder's 194.9 own residence shall be licensed under this section and the rules 194.10 governing family day care or group family day care if: 194.11(a)(1) the license holder is the primary provider of care;194.12(b)and the nonresidential child care program is conducted 194.13 in a dwelling that is located on a residential lot;andor 194.14(c) the license holder complies with all other requirements194.15of sections 245A.01 to 245A.15 and the rules governing family194.16day care or group family day care.194.17 (2) the license holder is an employer who may or may not be 194.18 the primary provider of care, and the purpose for the child care 194.19 program is to provide child care services to children of the 194.20 license holder's employees. 194.21 (b) Notwithstanding section 245A.16, subdivision 1, the 194.22 commissioner shall not delegate the authority to licensing 194.23 facilities under this section to county agencies or other 194.24 private agencies. 194.25 Sec. 4. Minnesota Statutes 1997 Supplement, section 194.26 245B.06, subdivision 2, is amended to read: 194.27 Subd. 2. [RISK MANAGEMENT PLAN.] The license holder must 194.28 develop and document in writing a risk management plan that 194.29 incorporates the individual abuse prevention plan as required in 194.30chapter 245Csection 245A.65. License holders jointly providing 194.31 services to a consumer shall coordinate and use the resulting 194.32 assessment of risk areas for the development of this plan. Upon 194.33 initiation of services, the license holder will have in place an 194.34 initial risk management plan that identifies areas in which the 194.35 consumer is vulnerable, including health, safety, and 194.36 environmental issues and the supports the provider will have in 195.1 place to protect the consumer and to minimize these risks. The 195.2 plan must be changed based on the needs of the individual 195.3 consumer and reviewed at least annually. 195.4 Sec. 5. Minnesota Statutes 1997 Supplement, section 195.5 256.01, subdivision 2, is amended to read: 195.6 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 195.7 section 241.021, subdivision 2, the commissioner of human 195.8 services shall: 195.9 (1) Administer and supervise all forms of public assistance 195.10 provided for by state law and other welfare activities or 195.11 services as are vested in the commissioner. Administration and 195.12 supervision of human services activities or services includes, 195.13 but is not limited to, assuring timely and accurate distribution 195.14 of benefits, completeness of service, and quality program 195.15 management. In addition to administering and supervising human 195.16 services activities vested by law in the department, the 195.17 commissioner shall have the authority to: 195.18 (a) require county agency participation in training and 195.19 technical assistance programs to promote compliance with 195.20 statutes, rules, federal laws, regulations, and policies 195.21 governing human services; 195.22 (b) monitor, on an ongoing basis, the performance of county 195.23 agencies in the operation and administration of human services, 195.24 enforce compliance with statutes, rules, federal laws, 195.25 regulations, and policies governing welfare services and promote 195.26 excellence of administration and program operation; 195.27 (c) develop a quality control program or other monitoring 195.28 program to review county performance and accuracy of benefit 195.29 determinations; 195.30 (d) require county agencies to make an adjustment to the 195.31 public assistance benefits issued to any individual consistent 195.32 with federal law and regulation and state law and rule and to 195.33 issue or recover benefits as appropriate; 195.34 (e) delay or deny payment of all or part of the state and 195.35 federal share of benefits and administrative reimbursement 195.36 according to the procedures set forth in section 256.017;and196.1 (f) make contracts with and grants to public and private 196.2 agencies and organizations, both profit and nonprofit, and 196.3 individuals, using appropriated funds; and 196.4 (g) enter into contractual agreements with federally 196.5 recognized Indian tribes with a reservation in Minnesota to the 196.6 extent necessary for the tribe to operate a federally approved 196.7 family assistance program or any other program under the 196.8 supervision of the commissioner. The commissioner may establish 196.9 necessary accounts for the purposes of receiving and disbursing 196.10 funds as necessary for the operation of the programs. 196.11 (2) Inform county agencies, on a timely basis, of changes 196.12 in statute, rule, federal law, regulation, and policy necessary 196.13 to county agency administration of the programs. 196.14 (3) Administer and supervise all child welfare activities; 196.15 promote the enforcement of laws protecting handicapped, 196.16 dependent, neglected and delinquent children, and children born 196.17 to mothers who were not married to the children's fathers at the 196.18 times of the conception nor at the births of the children; 196.19 license and supervise child-caring and child-placing agencies 196.20 and institutions; supervise the care of children in boarding and 196.21 foster homes or in private institutions; and generally perform 196.22 all functions relating to the field of child welfare now vested 196.23 in the state board of control. 196.24 (4) Administer and supervise all noninstitutional service 196.25 to handicapped persons, including those who are visually 196.26 impaired, hearing impaired, or physically impaired or otherwise 196.27 handicapped. The commissioner may provide and contract for the 196.28 care and treatment of qualified indigent children in facilities 196.29 other than those located and available at state hospitals when 196.30 it is not feasible to provide the service in state hospitals. 196.31 (5) Assist and actively cooperate with other departments, 196.32 agencies and institutions, local, state, and federal, by 196.33 performing services in conformity with the purposes of Laws 196.34 1939, chapter 431. 196.35 (6) Act as the agent of and cooperate with the federal 196.36 government in matters of mutual concern relative to and in 197.1 conformity with the provisions of Laws 1939, chapter 431, 197.2 including the administration of any federal funds granted to the 197.3 state to aid in the performance of any functions of the 197.4 commissioner as specified in Laws 1939, chapter 431, and 197.5 including the promulgation of rules making uniformly available 197.6 medical care benefits to all recipients of public assistance, at 197.7 such times as the federal government increases its participation 197.8 in assistance expenditures for medical care to recipients of 197.9 public assistance, the cost thereof to be borne in the same 197.10 proportion as are grants of aid to said recipients. 197.11 (7) Establish and maintain any administrative units 197.12 reasonably necessary for the performance of administrative 197.13 functions common to all divisions of the department. 197.14 (8) Act as designated guardian of both the estate and the 197.15 person of all the wards of the state of Minnesota, whether by 197.16 operation of law or by an order of court, without any further 197.17 act or proceeding whatever, except as to persons committed as 197.18 mentally retarded. For children under the guardianship of the 197.19 commissioner whose interests would be best served by adoptive 197.20 placement, the commissioner may contract with a licensed 197.21 child-placing agency to provide adoption services. A contract 197.22 with a licensed child-placing agency must be designed to 197.23 supplement existing county efforts and may not replace existing 197.24 county programs, unless the replacement is agreed to by the 197.25 county board and the appropriate exclusive bargaining 197.26 representative or the commissioner has evidence that child 197.27 placements of the county continue to be substantially below that 197.28 of other counties. 197.29 (9) Act as coordinating referral and informational center 197.30 on requests for service for newly arrived immigrants coming to 197.31 Minnesota. 197.32 (10) The specific enumeration of powers and duties as 197.33 hereinabove set forth shall in no way be construed to be a 197.34 limitation upon the general transfer of powers herein contained. 197.35 (11) Establish county, regional, or statewide schedules of 197.36 maximum fees and charges which may be paid by county agencies 198.1 for medical, dental, surgical, hospital, nursing and nursing 198.2 home care and medicine and medical supplies under all programs 198.3 of medical care provided by the state and for congregate living 198.4 care under the income maintenance programs. 198.5 (12) Have the authority to conduct and administer 198.6 experimental projects to test methods and procedures of 198.7 administering assistance and services to recipients or potential 198.8 recipients of public welfare. To carry out such experimental 198.9 projects, it is further provided that the commissioner of human 198.10 services is authorized to waive the enforcement of existing 198.11 specific statutory program requirements, rules, and standards in 198.12 one or more counties. The order establishing the waiver shall 198.13 provide alternative methods and procedures of administration, 198.14 shall not be in conflict with the basic purposes, coverage, or 198.15 benefits provided by law, and in no event shall the duration of 198.16 a project exceed four years. It is further provided that no 198.17 order establishing an experimental project as authorized by the 198.18 provisions of this section shall become effective until the 198.19 following conditions have been met: 198.20 (a) The secretary of health, education, and welfare of the 198.21 United States has agreed, for the same project, to waive state 198.22 plan requirements relative to statewide uniformity. 198.23 (b) A comprehensive plan, including estimated project 198.24 costs, shall be approved by the legislative advisory commission 198.25 and filed with the commissioner of administration. 198.26 (13) According to federal requirements, establish 198.27 procedures to be followed by local welfare boards in creating 198.28 citizen advisory committees, including procedures for selection 198.29 of committee members. 198.30 (14) Allocate federal fiscal disallowances or sanctions 198.31 which are based on quality control error rates for the aid to 198.32 families with dependent children, Minnesota family investment 198.33 program-statewide, medical assistance, or food stamp program in 198.34 the following manner: 198.35 (a) One-half of the total amount of the disallowance shall 198.36 be borne by the county boards responsible for administering the 199.1 programs. For the medical assistance, MFIP-S, and AFDC 199.2 programs, disallowances shall be shared by each county board in 199.3 the same proportion as that county's expenditures for the 199.4 sanctioned program are to the total of all counties' 199.5 expenditures for the AFDC, MFIP-S, and medical assistance 199.6 programs. For the food stamp program, sanctions shall be shared 199.7 by each county board, with 50 percent of the sanction being 199.8 distributed to each county in the same proportion as that 199.9 county's administrative costs for food stamps are to the total 199.10 of all food stamp administrative costs for all counties, and 50 199.11 percent of the sanctions being distributed to each county in the 199.12 same proportion as that county's value of food stamp benefits 199.13 issued are to the total of all benefits issued for all 199.14 counties. Each county shall pay its share of the disallowance 199.15 to the state of Minnesota. When a county fails to pay the 199.16 amount due hereunder, the commissioner may deduct the amount 199.17 from reimbursement otherwise due the county, or the attorney 199.18 general, upon the request of the commissioner, may institute 199.19 civil action to recover the amount due. 199.20 (b) Notwithstanding the provisions of paragraph (a), if the 199.21 disallowance results from knowing noncompliance by one or more 199.22 counties with a specific program instruction, and that knowing 199.23 noncompliance is a matter of official county board record, the 199.24 commissioner may require payment or recover from the county or 199.25 counties, in the manner prescribed in paragraph (a), an amount 199.26 equal to the portion of the total disallowance which resulted 199.27 from the noncompliance, and may distribute the balance of the 199.28 disallowance according to paragraph (a). 199.29 (15) Develop and implement special projects that maximize 199.30 reimbursements and result in the recovery of money to the 199.31 state. For the purpose of recovering state money, the 199.32 commissioner may enter into contracts with third parties. Any 199.33 recoveries that result from projects or contracts entered into 199.34 under this paragraph shall be deposited in the state treasury 199.35 and credited to a special account until the balance in the 199.36 account reaches $1,000,000. When the balance in the account 200.1 exceeds $1,000,000, the excess shall be transferred and credited 200.2 to the general fund. All money in the account is appropriated 200.3 to the commissioner for the purposes of this paragraph. 200.4 (16) Have the authority to make direct payments to 200.5 facilities providing shelter to women and their children 200.6 according to section 256D.05, subdivision 3. Upon the written 200.7 request of a shelter facility that has been denied payments 200.8 under section 256D.05, subdivision 3, the commissioner shall 200.9 review all relevant evidence and make a determination within 30 200.10 days of the request for review regarding issuance of direct 200.11 payments to the shelter facility. Failure to act within 30 days 200.12 shall be considered a determination not to issue direct payments. 200.13 (17) Have the authority to establish and enforce the 200.14 following county reporting requirements: 200.15 (a) The commissioner shall establish fiscal and statistical 200.16 reporting requirements necessary to account for the expenditure 200.17 of funds allocated to counties for human services programs. 200.18 When establishing financial and statistical reporting 200.19 requirements, the commissioner shall evaluate all reports, in 200.20 consultation with the counties, to determine if the reports can 200.21 be simplified or the number of reports can be reduced. 200.22 (b) The county board shall submit monthly or quarterly 200.23 reports to the department as required by the commissioner. 200.24 Monthly reports are due no later than 15 working days after the 200.25 end of the month. Quarterly reports are due no later than 30 200.26 calendar days after the end of the quarter, unless the 200.27 commissioner determines that the deadline must be shortened to 200.28 20 calendar days to avoid jeopardizing compliance with federal 200.29 deadlines or risking a loss of federal funding. Only reports 200.30 that are complete, legible, and in the required format shall be 200.31 accepted by the commissioner. 200.32 (c) If the required reports are not received by the 200.33 deadlines established in clause (b), the commissioner may delay 200.34 payments and withhold funds from the county board until the next 200.35 reporting period. When the report is needed to account for the 200.36 use of federal funds and the late report results in a reduction 201.1 in federal funding, the commissioner shall withhold from the 201.2 county boards with late reports an amount equal to the reduction 201.3 in federal funding until full federal funding is received. 201.4 (d) A county board that submits reports that are late, 201.5 illegible, incomplete, or not in the required format for two out 201.6 of three consecutive reporting periods is considered 201.7 noncompliant. When a county board is found to be noncompliant, 201.8 the commissioner shall notify the county board of the reason the 201.9 county board is considered noncompliant and request that the 201.10 county board develop a corrective action plan stating how the 201.11 county board plans to correct the problem. The corrective 201.12 action plan must be submitted to the commissioner within 45 days 201.13 after the date the county board received notice of noncompliance. 201.14 (e) The final deadline for fiscal reports or amendments to 201.15 fiscal reports is one year after the date the report was 201.16 originally due. If the commissioner does not receive a report 201.17 by the final deadline, the county board forfeits the funding 201.18 associated with the report for that reporting period and the 201.19 county board must repay any funds associated with the report 201.20 received for that reporting period. 201.21 (f) The commissioner may not delay payments, withhold 201.22 funds, or require repayment under paragraph (c) or (e) if the 201.23 county demonstrates that the commissioner failed to provide 201.24 appropriate forms, guidelines, and technical assistance to 201.25 enable the county to comply with the requirements. If the 201.26 county board disagrees with an action taken by the commissioner 201.27 under paragraph (c) or (e), the county board may appeal the 201.28 action according to sections 14.57 to 14.69. 201.29 (g) Counties subject to withholding of funds under 201.30 paragraph (c) or forfeiture or repayment of funds under 201.31 paragraph (e) shall not reduce or withhold benefits or services 201.32 to clients to cover costs incurred due to actions taken by the 201.33 commissioner under paragraph (c) or (e). 201.34 (18) Allocate federal fiscal disallowances or sanctions for 201.35 audit exceptions when federal fiscal disallowances or sanctions 201.36 are based on a statewide random sample for the foster care 202.1 program under title IV-E of the Social Security Act, United 202.2 States Code, title 42, in direct proportion to each county's 202.3 title IV-E foster care maintenance claim for that period. 202.4 (19) Be responsible for ensuring the detection, prevention, 202.5 investigation, and resolution of fraudulent activities or 202.6 behavior by applicants, recipients, and other participants in 202.7 the human services programs administered by the department. 202.8 (20) Require county agencies to identify overpayments, 202.9 establish claims, and utilize all available and cost-beneficial 202.10 methodologies to collect and recover these overpayments in the 202.11 human services programs administered by the department. 202.12 (21) Have the authority to administer a drug rebate program 202.13 for drugs purchased pursuant to the senior citizen drug program 202.14 established under section 256.955 after the beneficiary's 202.15 satisfaction of any deductible established in the program. The 202.16 commissioner shall require a rebate agreement from all 202.17 manufacturers of covered drugs as defined in section 256B.0625, 202.18 subdivision 13. For each drug, the amount of the rebate shall 202.19 be equal to the basic rebate as defined for purposes of the 202.20 federal rebate program in United States Code, title 42, section 202.21 1396r-8(c)(1). This basic rebate shall be applied to 202.22 single-source and multiple-source drugs. The manufacturers must 202.23 provide full payment within 30 days of receipt of the state 202.24 invoice for the rebate within the terms and conditions used for 202.25 the federal rebate program established pursuant to section 1927 202.26 of title XIX of the Social Security Act. The manufacturers must 202.27 provide the commissioner with any information necessary to 202.28 verify the rebate determined per drug. The rebate program shall 202.29 utilize the terms and conditions used for the federal rebate 202.30 program established pursuant to section 1927 of title XIX of the 202.31 Social Security Act. 202.32 Sec. 6. Minnesota Statutes 1996, section 256.014, 202.33 subdivision 1, is amended to read: 202.34 Subdivision 1. [ESTABLISHMENT OF SYSTEMS.] The 202.35 commissioner of human services shall establish and enhance 202.36 computer systems necessary for the efficient operation of the 203.1 programs the commissioner supervises, including: 203.2 (1) management and administration of the food stamp and 203.3 income maintenance programs, including the electronic 203.4 distribution of benefits; 203.5 (2) management and administration of the child support 203.6 enforcement program; and 203.7 (3) administration of medical assistance and general 203.8 assistance medical care. 203.9 The commissioner shall distribute the nonfederal share of 203.10 the costs of operating and maintaining the systems to the 203.11 commissioner and to the counties participating in the system in 203.12 a manner that reflects actual system usage, except that the 203.13 nonfederal share of the costs of the MAXIS computer system and 203.14 child support enforcement systems shall be borne entirely by the 203.15 commissioner. Development costs must not be assessed against 203.16 county agencies. 203.17 The commissioner may enter into contractual agreements with 203.18 federally recognized Indian tribes with a reservation in 203.19 Minnesota to participate in state-operated computer systems 203.20 related to the management and administration of the food stamp, 203.21 income maintenance, child support enforcement, and medical 203.22 assistance and general assistance medical care programs to the 203.23 extent necessary for the tribe to operate a federally approved 203.24 family assistance program or any other program under the 203.25 supervision of the commissioner. 203.26 Sec. 7. Minnesota Statutes 1997 Supplement, section 203.27 256.031, subdivision 6, is amended to read: 203.28 Subd. 6. [END OF FIELD TRIALS.] (a) Upon agreement with 203.29 the federal government, the field trials of the Minnesota family 203.30 investment plan will end June 30, 1998. 203.31 (b) Families in the comparison group under subdivision 3, 203.32 paragraph (d), clause (i), receiving aid to families with 203.33 dependent children under sections 256.72 to 256.87, and STRIDE 203.34 services under section 256.736 will continue in those programs 203.35 until June 30, 1998. After June 30, 1998, families who cease 203.36 receiving assistance under the Minnesota family investment plan 204.1 and comparison group families who cease receiving assistance 204.2 under AFDC and STRIDE who are eligible for the Minnesota family 204.3 investment program-statewide (MFIP-S), medical assistance, 204.4 general assistance medical care, or the food stamp program shall 204.5 be placed with their consent on the programs for which they are 204.6 eligible. 204.7 (c) Families who cease receiving assistance under the MFIP 204.8 and comparison families who cease receiving assistance under 204.9 AFDC and STRIDE who are ineligible for MFIP-S due to increased 204.10 income from employment, or increased child or spousal support or 204.11 a combination of employment income and child or spousal support, 204.12 will be eligible for extended medical assistance under section 204.13 256B.0635. For the purpose of determining receipt of extended 204.14 medical assistance, receipt of AFDC and MFIP will be the same as 204.15 receipt of MFIP-S. 204.16 Sec. 8. Minnesota Statutes 1997 Supplement, section 204.17 256.9864, is amended to read: 204.18 256.9864 [REPORTS BY RECIPIENT.] 204.19 (a) An assistance unit with a recent work history or with 204.20 earned income shall report monthly to the county agency on 204.21 income received and other circumstances affecting eligibility or 204.22 assistance amounts. All other assistance units shall report on 204.23 income and other circumstances affecting eligibility and 204.24 assistance amounts, as specified by the state agency. 204.25 (b) An assistance unit required to submit a report on the 204.26 form designated by the commissioner and within ten days of the 204.27 due date or the date of the significant change, whichever is 204.28 later, or otherwise report significant changes which would 204.29 affect eligibility or assistance amounts, is considered to have 204.30 continued its application for assistance effective the date the 204.31 required report is received by the county agency, if a complete 204.32 report is received within a calendar month in which assistance 204.33 was received, except that no assistance shall be paid for the204.34period beginning with the end of the month in which the report204.35was due and ending with the date the report was received by the204.36county agency. 205.1 Sec. 9. Minnesota Statutes 1997 Supplement, section 205.2 256B.062, is amended to read: 205.3 256B.062 [CONTINUED ELIGIBILITY.] 205.4 Medical assistance may be paid for persons who received aid 205.5 to families with dependent children in at least three of the six 205.6 months preceding the month in which the person became ineligible 205.7 for aid to families with dependent children, if the 205.8 ineligibility was due to an increase in hours of employment or 205.9 employment income or due to the loss of an earned income 205.10 disregard. A person who is eligible for extended medical 205.11 assistance is entitled to six months of assistance without 205.12 reapplication, unless the assistance unit ceases to include a 205.13 dependent child. For a person under 21 years of age, medical 205.14 assistance may not be discontinued within the six-month period 205.15 of extended eligibility until it has been determined that the 205.16 person is not otherwise eligible for medical assistance. 205.17 Medical assistance may be continued for an additional six months 205.18 if the person meets all requirements for the additional six 205.19 months, according to Title XIX of the Social Security Act, as 205.20 amended by section 303 of the Family Support Act of 1988, Public 205.21 Law Number 100-485. This section is repealed effectiveMarch 31205.22 July 1, 1998. 205.23 Sec. 10. Minnesota Statutes 1997 Supplement, section 205.24 256D.05, subdivision 8, is amended to read: 205.25 Subd. 8. [CITIZENSHIP.] (a) Effective July 1, 1997, 205.26 citizenship requirements for applicants and recipients under 205.27 sections 256D.01 to 256D.03, subdivision 2, and 256D.04 to 205.28 256D.21 shall be determined the same as under section 256J.11,205.29except that legal noncitizens who are applicants or recipients205.30must have been residents of Minnesota on March 1, 1997. Legal205.31noncitizens who arrive in Minnesota after March 1, 1997, and205.32become elderly or disabled after that date, and are otherwise205.33eligible for general assistance can receive benefits under this205.34section. The income and assets of sponsors of noncitizens shall 205.35 be deemed available to general assistance applicants and 205.36 recipients according to the Personal Responsibility and Work 206.1 Opportunity Reconciliation Act of 1996, Public Law Number 206.2 104-193, title IV, sections 421 and 422, and subsequently set 206.3 out in federal rules. 206.4 (b) As a condition of eligibility, each legal adult 206.5 noncitizen in the assistance unit who has resided in the country 206.6 for four years or more and who is under 70 years of age must: 206.7 (1) be enrolled in a literacy class, English as a second 206.8 language class, or a citizen class; 206.9 (2) be applying for admission to a literacy class, English 206.10 as a second language class, and is on a waiting list; 206.11 (3) be in the process of applying for a waiver from the 206.12 Immigration and Naturalization Service of the English language 206.13 or civics requirements of the citizenship test; 206.14 (4) have submitted an application for citizenship to the 206.15 Immigration and Naturalization Service and is waiting for a 206.16 testing date or a subsequent swearing in ceremony; or 206.17 (5) have been denied citizenship due to a failure to pass 206.18 the test after two attempts or because of an inability to 206.19 understand the rights and responsibilities of becoming a United 206.20 States citizen, as documented by the Immigration and 206.21 Naturalization Service or the county. 206.22 If the county social service agency determines that a legal 206.23 noncitizen subject to the requirements of this subdivision will 206.24 require more than one year of English language training, then 206.25 the requirements of clause (1) or (2) shall be imposed after the 206.26 legal noncitizen has resided in the country for three years. 206.27 Individuals who reside in a facility licensed under chapter 206.28 144A, 144D, 245A, or 256I are exempt from the requirements of 206.29 this section. 206.30 Sec. 11. Minnesota Statutes 1996, section 256D.051, is 206.31 amended by adding a subdivision to read: 206.32 Subd. 19. [WAIVER OF SERVICE COST REIMBURSEMENT LIMIT FOR 206.33 PARTICIPANTS WITH SIGNIFICANT BARRIERS TO EMPLOYMENT.] To the 206.34 extent of available resources, the commissioner may waive the 206.35 $400 service cost limit specified in subdivision 6 for county 206.36 agencies that propose to provide enhanced services under the 207.1 food stamp employment and training program for hard-to-employ 207.2 individuals. A "hard-to-employ individual" is defined as: 207.3 (1) a recipient of general assistance under chapter 256D; 207.4 or 207.5 (2) an individual with at least two of the following three 207.6 barriers to employment: 207.7 (i) the individual has not completed secondary school or 207.8 obtained a certificate of general equivalency, and has low 207.9 skills in reading or mathematics; 207.10 (ii) the individual requires substance abuse treatment for 207.11 employment; and 207.12 (iii) the individual has a poor work history. 207.13 To obtain a waiver, the county agency must submit a waiver 207.14 request to the commissioner. The request must specify: 207.15 (1) the number of hard-to-employ individuals the agency 207.16 plans to serve; and 207.17 (2) the nature of the enhanced employment and training 207.18 services the agency will provide. 207.19 Sec. 12. [256D.053] [MINNESOTA FOOD ASSISTANCE PROGRAM.] 207.20 Subdivision 1. [PROGRAM ESTABLISHED.] For the period of 207.21 July 1, 1998, to June 30, 1999, the Minnesota food assistance 207.22 program is established to provide food assistance to legal 207.23 noncitizens residing in this state who are ineligible to 207.24 participate in the federal Food Stamp Program solely due to the 207.25 provisions of section 402 or 403 of Public Law Number 104-193, 207.26 as authorized by Title VII of the 1997 Emergency Supplemental 207.27 Appropriations Act, Public Law Number 105-18. 207.28 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 207.29 the Minnesota food assistance program, all of the following 207.30 conditions must be met: 207.31 (1) the applicant must meet the initial and ongoing 207.32 eligibility requirements for the federal Food Stamp Program, 207.33 except for the applicant's ineligible immigration status; 207.34 (2) the applicant must be either a qualified noncitizen as 207.35 defined in section 256J.08, subdivision 73, or a noncitizen 207.36 otherwise residing lawfully in the United States; 208.1 (3) the applicant must be a resident of the state; and 208.2 (4) the applicant must not be receiving assistance under 208.3 the MFIP-S or the work first program. 208.4 Subd. 3. [PROGRAM ADMINISTRATION.] (a) The rules for the 208.5 Minnesota food assistance program shall follow exactly the 208.6 regulations for the federal Food Stamp Program, except for the 208.7 provisions pertaining to immigration status under sections 402 208.8 or 403 of Public Law Number 104-193. 208.9 (b) The county agency shall use the income, budgeting, and 208.10 benefit allotment regulations of the federal Food Stamp Program 208.11 to calculate an eligible recipient's monthly Minnesota food 208.12 assistance program benefit. Until September 30, 1998, eligible 208.13 recipients under this subdivision shall receive the average per 208.14 person food stamp issuance in Minnesota in the fiscal year 208.15 ending June 30, 1997. Beginning October 1, 1998, eligible 208.16 recipients shall receive the same level of benefits as those 208.17 provided by the federal Food Stamp Program to similarly situated 208.18 citizen recipients. The monthly Minnesota food assistance 208.19 program benefits shall not exceed an amount equal to the amount 208.20 of federal Food Stamp Program benefits the household would 208.21 receive if all members of the household were eligible for the 208.22 federal Food Stamp Program. 208.23 (c) Minnesota food assistance program benefits must be 208.24 disregarded as income in all programs that do not count food 208.25 stamps as income. 208.26 (d) The county agency must redetermine a Minnesota food 208.27 assistance program recipient's eligibility for the federal Food 208.28 Stamp Program when the agency receives information that the 208.29 recipient's legal immigration status has changed in such a way 208.30 that would make the recipient potentially eligible for the 208.31 federal Food Stamp Program. 208.32 (e) Until October 1, 1998, the commissioner may provide 208.33 benefits under this section in cash. 208.34 Subd. 4. [STATE PLAN REQUIRED.] The commissioner shall 208.35 submit a state plan to the secretary of agriculture to allow the 208.36 commissioner to purchase federal Food Stamp Program benefits for 209.1 each Minnesota food assistance program recipient who is 209.2 ineligible to participate in the federal Food Stamp Program 209.3 solely due to the provisions of section 402 or 403 of Public Law 209.4 Number 104-193, as authorized by Title VII of the 1997 Emergency 209.5 Supplemental Appropriations Act, Public Law Number 105-18. The 209.6 commissioner shall enter into a contract as necessary with the 209.7 secretary to use the existing federal Food Stamp Program 209.8 benefits delivery system for the purposes of administering the 209.9 Minnesota food assistance program under this section. 209.10 Sec. 13. Minnesota Statutes 1996, section 256D.46, 209.11 subdivision 2, is amended to read: 209.12 Subd. 2. [INCOME AND RESOURCE TEST.] All income and 209.13 resources available to the recipient must be considered in 209.14 determining the recipient's ability to meet the emergency need. 209.15 Property that can be liquidated in time to resolve the emergency 209.16 and income,(excludingMinnesota supplemental aid issued for209.17current month's need)an amount equal to the Minnesota 209.18 supplemental aid standard of assistance, that is normally 209.19 disregarded or excluded under the Minnesota supplemental aid 209.20 program must be considered available to meet the emergency need. 209.21 Sec. 14. Minnesota Statutes 1997 Supplement, section 209.22 256J.02, subdivision 4, is amended to read: 209.23 Subd. 4. [AUTHORITY TO TRANSFER.] Subject to limitations 209.24 of title I of Public Law Number 104-193, the Personal 209.25 Responsibility and Work Opportunity Reconciliation Act of 209.26 1996, as amended, the legislature may transfer money from the 209.27 TANF block grant to the child care fund under chapter 119B, or 209.28 the Title XX block grant under section 256E.07. 209.29 Sec. 15. Minnesota Statutes 1997 Supplement, section 209.30 256J.03, is amended to read: 209.31 256J.03 [TANF RESERVE ACCOUNT.] 209.32 Subdivision 1. TheMinnesota family investment209.33program-statewide/TANFTANF reserve account is created in the 209.34 state treasury. Funds retained or deposited in the TANF reserve 209.35 shall include: (1) funds designated by the legislatureand; (2) 209.36 unexpended state funds resulting from the acceleration of TANF 210.1 expenditures under subdivision 2; (3) earnings available from 210.2 the federal TANF block grant appropriated to the commissioner 210.3 but not expended in the biennium beginning July 1, 1997, shall210.4be retained; and (4) TANF funds available in fiscal years 1998, 210.5 1999, 2000, and 2001 that are not spent or not budgeted to be 210.6 spent in those years. 210.7 Funds deposited in the reserve accounttomust be expended 210.8 for the Minnesota family investment program-statewidein fiscal210.9year 2000 and subsequent fiscal yearsand directly related state 210.10 programs for the purposes in subdivision 3. 210.11 Subd. 2. [AUTHORIZATION TO ACCELERATE EXPENDITURE OF TANF 210.12 FUNDS.] The commissioner may expend federal TANF block grant 210.13 funds in excess of appropriated levels for the purpose of 210.14 accelerating federal funding of the MFIP program. By the end of 210.15 the fiscal year in which the additional federal expenditures are 210.16 made, the commissioner must deposit into the reserve account an 210.17 amount of unexpended state funds appropriated for assistance to 210.18 families grants, AFDC, and MFIP equal to the additional federal 210.19 expenditures. Reserve funds may be spent as TANF appropriations 210.20 if insufficient TANF funds are available because of acceleration. 210.21 Subd. 3. [ALLOWED TRANSFER PURPOSE.] Funds from the 210.22 reserve account may be used for the following purposes: 210.23 (1) unanticipated TANF block grant maintenance of effort 210.24 shortfalls; 210.25 (2) MFIP cost increases due to reduced federal revenues and 210.26 federal law changes; 210.27 (3) one-half of the MFIP general fund cost increase in 210.28 fiscal year 2000 and subsequent fiscal years due to caseload 210.29 increases over fiscal year 1999; and 210.30 (4) transfers allowed under section 256J.02, subdivision 4. 210.31 Sec. 16. Minnesota Statutes 1997 Supplement, section 210.32 256J.08, subdivision 11, is amended to read: 210.33 Subd. 11. [CAREGIVER.] "Caregiver" means a minor child's 210.34 natural or adoptive parent or parents and stepparent who live in 210.35 the home with the minor child. For purposes of determining 210.36 eligibility for this program, caregiver also means any of the 211.1 following individuals, if adults, who live with and provide care 211.2 and support to a minor child when the minor child's natural or 211.3 adoptive parent or parents or stepparents do not reside in the 211.4 same home: legalcustodianscustodian or guardian, grandfather, 211.5 grandmother, brother, sister,stepfather, stepmother,211.6 stepbrother, stepsister, uncle, aunt, first cousin, nephew, 211.7 niece, person of preceding generation as denoted by prefixes of 211.8 "great," "great-great," or "great-great-great," or a spouse of 211.9 any person named in the above groups even after the marriage 211.10 ends by death or divorce. 211.11 Sec. 17. Minnesota Statutes 1997 Supplement, section 211.12 256J.08, is amended by adding a subdivision to read: 211.13 Subd. 24a. [DISQUALIFIED.] "Disqualified" means being 211.14 ineligible to receive MFIP-S due to noncooperation with program 211.15 requirements. Except for persons whose disqualification is 211.16 based on fraud, a disqualified person can take action to correct 211.17 the reason for ineligibility. 211.18 Sec. 18. Minnesota Statutes 1997 Supplement, section 211.19 256J.08, subdivision 26, is amended to read: 211.20 Subd. 26. [EARNED INCOME.] "Earned income" means cash or 211.21 in-kind income earned through the receipt of wages, salary, 211.22 commissions, profit from employment activities, net profit from 211.23 self-employment activities, payments made by an employer for 211.24 regularly accrued vacation or sick leave, and any other profit 211.25 from activity earned through effort or labor. The income must 211.26 be in return for, or as a result of, legal activity. 211.27 Sec. 19. Minnesota Statutes 1997 Supplement, section 211.28 256J.08, subdivision 28, is amended to read: 211.29 Subd. 28. [EMERGENCY.] "Emergency" means a situation or a 211.30 set of circumstances that causes or threatens to cause 211.31 destitution to aminor childfamily with a child under age 21. 211.32 Sec. 20. Minnesota Statutes 1997 Supplement, section 211.33 256J.08, subdivision 40, is amended to read: 211.34 Subd. 40. [GROSS EARNED INCOME.] "Gross earned income" 211.35 means earned income from employment before mandatory and 211.36 voluntary payroll deductions. Gross earned income includes 212.1 salaries, wages, tips, gratuities, commissions, incentive 212.2 payments from work or training programs, payments made by an 212.3 employer for regularly accrued vacation or sick leave, and 212.4 profits from other activity earned by an individual's effort or 212.5 labor. Gross earned income includes uniform and meal allowances 212.6 if federal income tax is deducted from the allowance. Gross 212.7 earned income includes flexible work benefits received from an 212.8 employer if the employee has the option of receiving the benefit 212.9 or benefits in cash. For self-employment, gross earned income 212.10 is the nonexcluded income minus expenses for the business. 212.11 Sec. 21. Minnesota Statutes 1997 Supplement, section 212.12 256J.08, is amended by adding a subdivision to read: 212.13 Subd. 50a. [INTERSTATE TRANSITIONAL STANDARD.] "Interstate 212.14 transitional standard" means a combination of the cash 212.15 assistance a family with no other income would have received in 212.16 the state of previous residence and the Minnesota food portion 212.17 for the appropriate size family. 212.18 Sec. 22. Minnesota Statutes 1997 Supplement, section 212.19 256J.08, is amended by adding a subdivision to read: 212.20 Subd. 51a. [LEGAL CUSTODIAN.] "Legal custodian" means any 212.21 person who is under a legal obligation to provide care and 212.22 support for a minor and who is in fact providing care and 212.23 support for a minor. For an Indian child, "custodian" means any 212.24 Indian person who has legal custody of an Indian child under 212.25 tribal law or custom, under state law, or to whom temporary 212.26 physical care, custody, and control has been transferred by the 212.27 parent of the child, as provided in section 257.351, subdivision 212.28 8. 212.29 Sec. 23. Minnesota Statutes 1997 Supplement, section 212.30 256J.08, subdivision 60, is amended to read: 212.31 Subd. 60. [MINOR CHILD.] "Minor child" means a child who 212.32 is living in the same home of a parent or other caregiver, is 212.33 not the parent of a child in the home, and is either less than 212.34 18 years of age or is under the age of 19 years and isregularly212.35attending asa full-time studentand is expected to complete a212.36high school orin a secondary school or pursuing a full-time 213.1 secondary level course of vocational or technical training 213.2 designed to fit students for gainful employmentbefore reaching213.3age 19. 213.4 Sec. 24. Minnesota Statutes 1997 Supplement, section 213.5 256J.08, is amended by adding a subdivision to read: 213.6 Subd. 61a. [NONCUSTODIAL PARENT.] "Noncustodial parent" 213.7 means a minor child's parent who does not live in the same home 213.8 as the child. 213.9 Sec. 25. Minnesota Statutes 1997 Supplement, section 213.10 256J.08, subdivision 68, is amended to read: 213.11 Subd. 68. [PERSONAL PROPERTY.] "Personal property" means 213.12 an item of value that is not real property, including the value 213.13 of a contract for deed held by a seller, assets held in trust on 213.14 behalf of members of an assistance unit,cash surrender value of213.15life insurance,value of a prepaid burial, savings account, 213.16 value of stocks and bonds, and value of retirement accounts. 213.17 Sec. 26. Minnesota Statutes 1997 Supplement, section 213.18 256J.08, subdivision 73, is amended to read: 213.19 Subd. 73. [QUALIFIED NONCITIZEN.] "Qualified noncitizen" 213.20 means a person: 213.21 (1) who was lawfully admitted for permanent residence 213.22 pursuant to United States Code, title 8; 213.23 (2) who was admitted to the United States as a refugee 213.24 pursuant to United States Code, title 8; section 1157; 213.25 (3) whose deportation is being withheld pursuant to United 213.26 States Code, title 8, section 1253(h); 213.27 (4) who was paroled for a period of at least one year 213.28 pursuant to United States Code, title 8, section 1182(d)(5); 213.29 (5) who was granted conditional entry pursuant to United 213.30 State Code, title 8, section 1153(a)(7); 213.31 (6) who was granted asylum pursuant to United States Code, 213.32 title 8, section 1158;or213.33 (7) determined to be a battered noncitizen by the United 213.34 States Attorney General according to the Illegal Immigration 213.35 Reform and Immigrant Responsibility Act of 1996, Title V of the 213.36 Omnibus Consolidated Appropriations Bill, Public Law Number 214.1 104-208; or 214.2 (8) who was admitted as a Cuban or Haitian entrant. 214.3 Sec. 27. Minnesota Statutes 1997 Supplement, section 214.4 256J.08, is amended by adding a subdivision to read: 214.5 Subd. 82a. [SHELTER COSTS.] "Shelter costs" means rent, 214.6 manufactured home lot rental costs, or monthly principal, 214.7 interest, insurance premiums, and property taxes due for 214.8 mortgages or contracts for deed. 214.9 Sec. 28. Minnesota Statutes 1997 Supplement, section 214.10 256J.08, subdivision 83, is amended to read: 214.11 Subd. 83. [SIGNIFICANT CHANGE.] "Significant change" means 214.12 a decline in gross income of3536 percent or more from the 214.13 income used to determine the grant for the current month. 214.14 Sec. 29. Minnesota Statutes 1997 Supplement, section 214.15 256J.09, subdivision 6, is amended to read: 214.16 Subd. 6. [INVALID REASON FOR DELAY.] A county agency must 214.17 not delay a decision on eligibility or delay issuing the 214.18 assistance payment except to establish state residence as 214.19 provided in section 256J.12 by: 214.20 (1) treating the 30-day processing period as a waiting 214.21 period; 214.22 (2) delaying approval or issuance of the assistance payment 214.23 pending the decision of the county board; or 214.24 (3) awaiting the result of a referral to a county agency in 214.25 another county when the county receiving the application does 214.26 not believe it is the county of financial responsibility. 214.27 Sec. 30. Minnesota Statutes 1997 Supplement, section 214.28 256J.09, subdivision 9, is amended to read: 214.29 Subd. 9. [ADDENDUM TO AN EXISTING APPLICATION.] (a) An 214.30 addendum to an existing application must be used to add persons 214.31 to an assistance unit regardless of whether the persons being 214.32 added are required to be in the assistance unit. When a person 214.33 is added by addendum to an assistance unit, eligibility for that 214.34 person begins on the first of the month the addendum was filed 214.35 except as provided in section 256J.74, subdivision 2, clause (1). 214.36 (b) An overpayment must be determined when a change in 215.1 household composition is not reported within the deadlines in 215.2 section 256J.30, subdivision 9. Any overpayment must be 215.3 calculated from the month of the change including the needs, 215.4 income, and assets of any individual who is required to be 215.5 included in the assistance unit under section 256J.24, 215.6 subdivision 2. Individuals not included in the assistance unit 215.7 who are identified in section 256J.37, subdivisions 1 to 2, must 215.8 have their income and assets considered when determining the 215.9 amount of the overpayment. 215.10 Sec. 31. Minnesota Statutes 1997 Supplement, section 215.11 256J.11, subdivision 2, as amended by Laws 1997, Third Special 215.12 Session chapter 1, is amended to read: 215.13 Subd. 2. [NONCITIZENS; FOOD PORTION.] (a) For the period 215.14 September 1, 1997, to October 31, 1997, noncitizens who do not 215.15 meet one of the exemptions in section 412 of the Personal 215.16 Responsibility and Work Opportunity Reconciliation Act of 1996, 215.17 but were residing in this state as of July 1, 1997, are eligible 215.18 for the 6/10 of the average value of food stamps for the same 215.19 family size and composition until MFIP-S is operative in the 215.20 noncitizen's county of financial responsibility and thereafter, 215.21 the 6/10 of the food portion of MFIP-S. However, federal food 215.22 stamp dollars cannot be used to fund the food portion of MFIP-S 215.23 benefits for an individual under this subdivision. 215.24 (b) For the period November 1, 1997, to June 30,19981999, 215.25 noncitizens who do not meet one of the exemptions in section 412 215.26 of the Personal Responsibility and Work Opportunity 215.27 Reconciliation Act of 1996,but were residing in this state as215.28of July 1, 1997,and are receiving cash assistance under the 215.29 AFDC, family general assistance, MFIP or MFIP-S programs are 215.30 eligible for the average value of food stamps for the same 215.31 family size and composition until MFIP-S is operative in the 215.32 noncitizen's county of financial responsibility and thereafter, 215.33 the food portion of MFIP-S. However, federal food stamp dollars 215.34 cannot be used to fund the food portion of MFIP-S benefits for 215.35 an individual under this subdivision. The assistance provided 215.36 under this subdivision, which is designated as a supplement to 216.1 replace lost benefits under the federal food stamp program, must 216.2 be disregarded as income in all programs that do not count food 216.3 stamps as income where the commissioner has the authority to 216.4 make the income disregard determination for the program. 216.5 (c) The commissioner shall submit a state plan to the 216.6 secretary of agriculture to allow the commissioner to purchase 216.7 federal Food Stamp Program benefits in an amount equal to the 216.8 MFIP-S food portion for each legal noncitizen receiving MFIP-S 216.9 assistance who is ineligible to participate in the federal Food 216.10 Stamp Program solely due to the provisions of section 402 or 403 216.11 of Public Law Number 104-193, as authorized by Title VII of the 216.12 1997 Emergency Supplemental Appropriations Act, Public Law 216.13 Number 105-18. The commissioner shall enter into a contract as 216.14 necessary with the secretary to use the existing federal Food 216.15 Stamp Program benefits delivery system for the purposes of 216.16 administering the food portion of MFIP-S under this subdivision. 216.17 Sec. 32. Minnesota Statutes 1997 Supplement, section 216.18 256J.12, is amended to read: 216.19 256J.12 [MINNESOTA RESIDENCE.] 216.20 Subdivision 1. [SIMPLE RESIDENCY.] To be eligible for AFDC 216.21 or MFIP-S, whichever is in effect,a familyan assistance unit 216.22 must have established residency in this state which means 216.23 thefamilyassistance unit is present in the state and intends 216.24 to remain here. A person who lives in this state and who 216.25 entered this state with a job commitment or to seek employment 216.26 in this state, whether or not that person is currently employed, 216.27 meets the criteria in this subdivision. 216.28 Subd. 1a. [30-DAY RESIDENCY REQUIREMENT.]A familyAn 216.29 assistance unit is considered to have established residency in 216.30 this state only when a child or caregiver has resided in this 216.31 state for at least 30 days with the intention of making the 216.32 person's home here and not for any temporary purpose. The birth 216.33 of a child in Minnesota to a member of the assistance unit does 216.34 not automatically meet the 30-day residency requirement for the 216.35 members of the assistance unit. Time spent in a shelter for 216.36 battered women shall count toward satisfying the 30-day 217.1 residency requirement. 217.2 Subd. 2. [EXCEPTIONS.] (a) A county shall waive the 30-day 217.3 residency requirement where unusual hardship would result from 217.4 denial of assistance. 217.5 (b) For purposes of this section, unusual hardship meansa217.6familyan assistance unit: 217.7 (1) is without alternative shelter; or 217.8 (2) is without available resources for food. 217.9 (c) For purposes of this subdivision, the following 217.10 definitions apply (1) "metropolitan statistical area" is as 217.11 defined by the U.S. Census Bureau; (2) "alternative shelter" 217.12 includes any shelter that is located within the metropolitan 217.13 statistical area containing the county and for which the family 217.14 is eligible, provided thefamilyassistance unit does not have 217.15 to travel more than 20 miles to reach the shelter and has access 217.16 to transportation to the shelter. Clause (2) does not apply to 217.17 counties in the Minneapolis-St. Paul metropolitan statistical 217.18 area. 217.19 (d) Applicants meet the residency requirement if they once 217.20 resided in Minnesota and: 217.21 (1) joined the United States armed services, returned to 217.22 Minnesota within 30 days of leaving the armed services, and 217.23 intend to remain in Minnesota; or 217.24 (2) left to attend school in another state, paid 217.25 nonresident tuition or Minnesota tuition rates under a 217.26 reciprocity agreement, and returned to Minnesota within 30 days 217.27 of graduation with the intent to remain in Minnesota. 217.28 (e) The 30-day residence requirement is met when: 217.29 (1) a minor child or a minor caregiver moves from another 217.30 state to the residence of a relative caregiver; 217.31 (2) the minor caregiver applies for and receives family 217.32 cash assistance; 217.33 (3) the relative caregiver chooses not to be part of the 217.34 MFIP-S assistance unit; and 217.35 (4) the relative caregiver has resided in Minnesota for at 217.36 least 30 days prior to the date the assistance unit applies for 218.1 cash assistance. 218.2 (f) Ineligible mandatory unit members who have resided in 218.3 Minnesota for 12 months immediately before the date of 218.4 application meet eligibility for the Minnesota payment standard 218.5 for the other assistance unit members. 218.6 Subd. 2a. [MIGRANT WORKERS.] Migrant workers, as defined 218.7 in section 256J.08, and their immediate families are exempt from 218.8 the requirements of subdivisions 1 and 1a, provided the migrant 218.9 worker provides verification that the migrant family worked in 218.10 this state within the last 12 months and earned at least $1,000 218.11 in gross wages during the time the migrant worker worked in this 218.12 state. 218.13 Subd. 3. [PAYMENT PLAN FOR NEW RESIDENTS.] Assistance paid 218.14 to an eligiblefamilyassistance unit in which all members have 218.15 resided in this state for fewer than 12 consecutive calendar 218.16 months immediately preceding the date of application shall be at 218.17 the standard and in the form specified in section 256J.43. 218.18 Subd. 4. [SEVERABILITY CLAUSE.] If any subdivision in this 218.19 section is enjoined from implementation or found 218.20 unconstitutional by any court of competent jurisdiction, the 218.21 remaining subdivisions shall remain valid and shall be given 218.22 full effect. 218.23 Sec. 33. Minnesota Statutes 1997 Supplement, section 218.24 256J.14, is amended to read: 218.25 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 218.26 (a) The definitions in this paragraph only apply to this 218.27 subdivision. 218.28 (1) "Household of a parent, legal guardian, or other adult 218.29 relative" means the place of residence of: 218.30 (i) a natural or adoptive parent; 218.31 (ii) a legal guardian according to appointment or 218.32 acceptance under section 260.242, 525.615, or 525.6165, and 218.33 related laws;or218.34 (iii) a caregiver as defined in section 256J.08, 218.35 subdivision 11; or 218.36 (iv) an appropriate adult relative designated by a county 219.1 agency. 219.2 (2) "Adult-supervised supportive living arrangement" means 219.3 a private family setting which assumes responsibility for the 219.4 care and control of the minor parent and minor child, or other 219.5 living arrangement, not including a public institution, licensed 219.6 by the commissioner of human services which ensures that the 219.7 minor parent receives adult supervision and supportive services, 219.8 such as counseling, guidance, independent living skills 219.9 training, or supervision. 219.10 (b) A minor parent and the minor child who is in the care 219.11 of the minor parent must reside in the household of a parent, 219.12 legal guardian, otherappropriateadult relative,or other219.13caregiver,or in an adult-supervised supportive living 219.14 arrangement in order to receive MFIP-S unless: 219.15 (1) the minor parent has no living parent, other 219.16appropriateadult relative, or legal guardian whose whereabouts 219.17 is known; 219.18 (2) no living parent, otherappropriateadult relative, or 219.19 legal guardian of the minor parent allows the minor parent to 219.20 live in the parent's,appropriateother adult relative's, or 219.21 legal guardian's home; 219.22 (3) the minor parent lived apart from the minor parent's 219.23 own parent or legal guardian for a period of at least one year 219.24 before either the birth of the minor child or the minor parent's 219.25 application for MFIP-S; 219.26 (4) the physical or emotional health or safety of the minor 219.27 parent or minor child would be jeopardized if the minor parent 219.28 and the minor child resided in the same residence with the minor 219.29 parent's parent, otherappropriateadult relative, or legal 219.30 guardian; or 219.31 (5) an adult supervised supportive living arrangement is 219.32 not available for the minor parent andthe dependentchild in 219.33 the county in which the minor parent and child currentlyresides219.34 reside. If an adult supervised supportive living arrangement 219.35 becomes available within the county, the minor parent and child 219.36 must reside in that arrangement. 220.1 (c) Minor applicants must be informed orally and in writing 220.2 about the eligibility requirements and their rights and 220.3 obligations under the MFIP-S program. The county must advise 220.4 the minor of the possible exemptions and specifically ask 220.5 whether one or more of these exemptions is applicable. If the 220.6 minor alleges one or more of these exemptions, then the county 220.7 must assist the minor in obtaining the necessary verifications 220.8 to determine whether or not these exemptions apply. 220.9 (d) If the county worker has reason to suspect that the 220.10 physical or emotional health or safety of the minor parent or 220.11 minor child would be jeopardized if they resided with the minor 220.12 parent's parent, other adult relative, or legal guardian, then 220.13 the county worker must make a referral to child protective 220.14 services to determine if paragraph (b), clause (4), applies. A 220.15 new determination by the county worker is not necessary if one 220.16 has been made within the last six months, unless there has been 220.17 a significant change in circumstances which justifies a new 220.18 referral and determination. 220.19 (e) If a minor parent is not living with a parentor, legal 220.20 guardian, or other adult relative due to paragraph (b), clause 220.21 (1), (2), or (4), the minor parent must reside, when possible, 220.22 in a living arrangement that meets the standards of paragraph 220.23 (a), clause (2). 220.24 (f) When a minor parent and minor child live withanothera 220.25 parent, other adult relative, legal guardian, or in an 220.26 adult-supervised supportive living arrangement, MFIP-S must be 220.27 paid, when possible, in the form of a protective payment on 220.28 behalf of the minor parent and minor childin accordance with220.29 according to section 256J.39, subdivisions 2 to 4. 220.30 Sec. 34. Minnesota Statutes 1997 Supplement, section 220.31 256J.15, subdivision 2, is amended to read: 220.32 Subd. 2. [ELIGIBILITY DURING LABOR DISPUTES.]To receive220.33assistance under MFIP-S, a member of an assistance unit who is220.34on strike must have been an MFIP-S participant on the day before220.35the strike, or have been eligible for MFIP-S on the day before220.36the strike.221.1The county agency must count the striker's prestrike221.2earnings as current earnings. When a member of an assistance221.3unit who is not in the bargaining unit that voted for the strike221.4does not cross the picket line for fear of personal injury, the221.5assistance unit member is not a striker. Except for a member of221.6an assistance unit who is not in the bargaining unit that voted221.7for the strike and who does not cross the picket line for fear221.8of personal injury, a significant change cannot be invoked as a221.9result of a labor dispute.To receive assistance when a member 221.10 of an assistance unit is on strike or an individual identified 221.11 in section 256J.37, subdivisions 1 to 2, whose income and assets 221.12 must be considered when determining eligibility for the unit is 221.13 on strike, an assistance unit must have been receiving or been 221.14 eligible for MFIP-S on the day before the strike. The county 221.15 agency must count the striker's prestrike earnings as current 221.16 earnings. A significant change cannot be invoked when a member 221.17 of an assistance unit, or an individual identified in section 221.18 256J.37, subdivisions 1 to 2, is on strike. A member of an 221.19 assistance unit, or an individual identified in section 256J.37, 221.20 is not considered a striker when that person is not in the 221.21 bargaining unit that voted for the strike and does not cross the 221.22 picket line for fear of personal injury. 221.23 Sec. 35. Minnesota Statutes 1997 Supplement, section 221.24 256J.20, subdivision 2, is amended to read: 221.25 Subd. 2. [REAL PROPERTY LIMITATIONS.] Ownership of real 221.26 property by an applicant or participant is subject to the 221.27 limitations in paragraphs (a) and (b). 221.28 (a) A county agency shall exclude the homestead of an 221.29 applicant or participant according to clauses (1) to(4)(5): 221.30 (1) an applicant or participant who is purchasing real 221.31 property through a contract for deed and using that property as 221.32 a home is considered the owner of real property; 221.33 (2) the total amount of land that can be excluded under 221.34 this subdivision is limited to surrounding property which is not 221.35 separated from the home by intervening property owned by 221.36 others. Additional property must be assessed as to its legal 222.1 and actual availability according to subdivision 1; 222.2 (3) when real property that has been used as a home by a 222.3 participant is sold, the county agency must treat the cash 222.4 proceeds from the sale as excluded property for six months when 222.5 the participant intends to reinvest the proceeds in another home 222.6 and maintains those proceeds, unused for other purposes, in a 222.7 separate account;and222.8 (4) when the homestead is jointly owned, but the client 222.9 does not reside in it because of legal separation, pending 222.10 divorce, or battering or abuse by the spouse or partner, the 222.11 homestead is excluded; and 222.12 (5) the homestead shall continue to be excluded if it is 222.13 temporarily unoccupied due to employment, illness, or a 222.14 county-approved employability plan. The education, training, or 222.15 job search must be within the state, but can be outside the 222.16 immediate geographic area. A homestead temporarily unoccupied 222.17 because it is not habitable due to a casualty or natural 222.18 disaster is excluded. The homestead is excluded during periods 222.19 only if the client intends to return to it. 222.20 (b) The equity value of real property that is not excluded 222.21 under paragraph (a) and which is legally available must be 222.22 applied against the limits in subdivision 3. When the equity 222.23 value of the real property exceeds the limits under subdivision 222.24 3, the applicant or participant may qualify to receive 222.25 assistance when the applicant or participant continues to make a 222.26 good faith effort to sell the property and signs a legally 222.27 binding agreement to repay the amount of assistance, less child 222.28 support collected by the agency. Repayment must be made within 222.29 five working days after the property is sold. Repayment to the 222.30 county agency must be in the amount of assistance received or 222.31 the proceeds of the sale, whichever is less. 222.32 Sec. 36. Minnesota Statutes 1997 Supplement, section 222.33 256J.20, subdivision 3, is amended to read: 222.34 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 222.35 MFIP-S, the equity value of all nonexcluded real and personal 222.36 property of the assistance unit must not exceed $2,000 for 223.1 applicants and $5,000 for ongoingrecipientsparticipants. The 223.2 value of assets in clauses (1) to (18) must be excluded when 223.3 determining the equity value of real and personal property: 223.4 (1) a licensedvehiclesvehicle up to atotal marketloan 223.5 value of less than or equal to $7,500. The county agency shall 223.6 apply any excessmarketloan value as if it were equity value to 223.7 the asset limit described in this section. If the assistance 223.8 unit owns more than one licensed vehicle, the county agency 223.9 shall determine the vehicle with the highestmarketloan value 223.10 and count only themarketloan value over $7,500. The county 223.11 agency shall count themarketloan value of all other vehicles 223.12 and apply this amount as if it were equity value to the asset 223.13 limit described in this section. The value of special equipment 223.14 for a handicapped member of the assistance unit is excluded. To 223.15 establish themarketloan value of vehicles, a county agency 223.16 must use the N.A.D.A. Official Used Car Guide, Midwest Edition, 223.17 for newer model cars.The N.A.D.A. Official Used Car Guide,223.18Midwest Edition, is incorporated by reference.When a vehicle 223.19 is not listed in the guidebook, or when the applicant or 223.20 participant disputes the loan value listed in the guidebook as 223.21 unreasonable given the condition of the particular vehicle, the 223.22 county agency may require the applicant or participantto223.23 document the loan value by securing a written statement from a 223.24 motor vehicle dealer licensed under section 168.27, stating the 223.25 amount that the dealer would pay to purchase the vehicle. The 223.26 county agency shall reimburse the applicant or participant for 223.27 the cost of a written statement that documents a lower loan 223.28 value. If the loan value exceeds $7,500, the county agency 223.29 shall determine the equity value of the vehicle and exclude a 223.30 vehicle with a total equity value of less than or equal to 223.31 $7,500. "Equity value" is equal to loan value minus any 223.32 outstanding encumbrances; 223.33 (2) the value of life insurance policies for members of the 223.34 assistance unit; 223.35 (3) one burial plot per member of an assistance unit; 223.36 (4) the value of personal property needed to produce earned 224.1 income, including tools, implements, farm animals, inventory, 224.2 business loans, business checking and savings accounts used at 224.3 least annually and used exclusively for the operation of a 224.4 self-employment business, and any motor vehicles if the vehicles 224.5 are essential for the self-employment business; 224.6 (5) the value of personal property not otherwise specified 224.7 which is commonly used by household members in day-to-day living 224.8 such as clothing, necessary household furniture, equipment, and 224.9 other basic maintenance items essential for daily living; 224.10 (6) the value of real and personal property owned by a 224.11 recipient of Supplemental Security Income or Minnesota 224.12 supplemental aid; 224.13 (7) the value of corrective payments, but only for the 224.14 month in which the payment is received and for the following 224.15 month; 224.16 (8) a mobile home used by an applicant or participant as 224.17 the applicant's or participant's home; 224.18 (9) money in a separate escrow account that is needed to 224.19 pay real estate taxes or insurance and that is used for this 224.20 purpose; 224.21 (10) money held in escrow to cover employee FICA, employee 224.22 tax withholding, sales tax withholding, employee worker 224.23 compensation, business insurance, property rental, property 224.24 taxes, and other costs that are paid at least annually, but less 224.25 often than monthly; 224.26 (11) monthly assistanceand, emergency assistance, and 224.27 diversionary payments for the current month's needs; 224.28 (12) the value of school loans, grants, or scholarships for 224.29 the period they are intended to cover; 224.30 (13) payments listed in section 256J.21, subdivision 2, 224.31 clause (9), which are held in escrow for a period not to exceed 224.32 three months to replace or repair personal or real property; 224.33 (14) income received in a budget month through the end of 224.34 thebudgetpayment month; 224.35 (15) savings from earned income of a minor child or a minor 224.36 parent that are set aside in a separate account designated 225.1 specifically for future education or employment costs; 225.2 (16) the federal earned incometaxcreditand, Minnesota 225.3 working family credit, state and federal income tax refunds, 225.4 state homeowners' credit, and state renters' credit in the month 225.5 received and the following month; 225.6 (17) payments excluded under federal law as long as those 225.7 payments are held in a separate account from any nonexcluded 225.8 funds; and 225.9 (18) money received by a participant of the corps to career 225.10 program under section 84.0887, subdivision 2, paragraph (b), as 225.11 a postservice benefit under the federal Americorps Act. 225.12 Sec. 37. Minnesota Statutes 1997 Supplement, section 225.13 256J.21, is amended to read: 225.14 256J.21 [INCOME LIMITATIONS.] 225.15 Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP-S 225.16 eligibility, the county agency must evaluate income received by 225.17 members of an assistance unit, or by other persons whose income 225.18 is considered available to the assistance unit, and only count 225.19 income that is available to the member of the assistance unit. 225.20 Income is available if the individual has legal access to the 225.21 income. All payments, unless specifically excluded in 225.22 subdivision 2, must be counted as income. 225.23 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 225.24 excluded in determining a family's available income: 225.25 (1) payments for basic care, difficulty of care, and 225.26 clothing allowances received for providing family foster care to 225.27 children or adults under Minnesota Rules, parts 9545.0010 to 225.28 9545.0260 and 9555.5050 to 9555.6265, and payments received and 225.29 used for care and maintenance of a third-party beneficiary who 225.30 is not a household member; 225.31 (2) reimbursements for employment training received through 225.32 the Job Training Partnership Act, United States Code, title 29, 225.33 chapter 19, sections 1501 to 1792b; 225.34 (3) reimbursement for out-of-pocket expenses incurred while 225.35 performing volunteer services, jury duty, or employment; 225.36 (4) all educational assistance, except the county agency 226.1 must count graduate student teaching assistantships, 226.2 fellowships, and other similar paid work as earned income and, 226.3 after allowing deductions for any unmet and necessary 226.4 educational expenses, shall count scholarships or grants awarded 226.5 to graduate students that do not require teaching or research as 226.6 unearned income; 226.7 (5) loans, regardless of purpose, from public or private 226.8 lending institutions, governmental lending institutions, or 226.9 governmental agencies; 226.10 (6) loans from private individuals, regardless of purpose, 226.11 provided an applicant or participant documents that the lender 226.12 expects repayment; 226.13 (7)(i) stateand federalincome tax refunds; and 226.14 (ii) federal income tax refunds; 226.15 (8)state and(i) federal earned income credits; 226.16 (ii) Minnesota working family credits; 226.17 (iii) state homeowners' credits; 226.18 (iv) state renters' credits; and 226.19 (v) federal or state tax rebates; 226.20 (9) funds received for reimbursement, replacement, or 226.21 rebate of personal or real property when these payments are made 226.22 by public agencies, awarded by a court, solicited through public 226.23 appeal, or made as a grant by a federal agency, state or local 226.24 government, or disaster assistance organizations, subsequent to 226.25 a presidential declaration of disaster; 226.26 (10) the portion of an insurance settlement that is used to 226.27 pay medical, funeral, and burial expenses, or to repair or 226.28 replace insured property; 226.29 (11) reimbursements for medical expenses that cannot be 226.30 paid by medical assistance; 226.31 (12) payments by a vocational rehabilitation program 226.32 administered by the state under chapter 268A, except those 226.33 payments that are for current living expenses; 226.34 (13) in-kind income, including any payments directly made 226.35 by a third party to a provider of goods and services; 226.36 (14) assistance payments to correct underpayments, but only 227.1 for the month in which the payment is received; 227.2 (15) emergency assistance payments; 227.3 (16) funeral and cemetery payments as provided by section 227.4 256.935; 227.5 (17) nonrecurring cash gifts of $30 or less, not exceeding 227.6 $30 per participant in a calendar month; 227.7 (18) any form of energy assistance payment made through 227.8 Public Law Number 97-35, Low-Income Home Energy Assistance Act 227.9 of 1981, payments made directly to energy providers by other 227.10 public and private agencies, and any form of credit or rebate 227.11 payment issued by energy providers; 227.12 (19) Supplemental Security Income, including retroactive 227.13 payments; 227.14 (20) Minnesota supplemental aid, including retroactive 227.15 payments; 227.16 (21) proceeds from the sale of real or personal property; 227.17 (22) adoption assistance payments under section 259.67; 227.18 (23) state-funded family subsidy program payments made 227.19 under section 252.32 to help families care for children with 227.20 mental retardation or related conditions; 227.21 (24) interest payments and dividends from property that is 227.22 not excluded from and that does not exceed the asset limit; 227.23 (25) rent rebates; 227.24 (26) income earned by a minor caregiver or minor child who 227.25 is at least a half-time student in an approved secondary 227.26 education program; 227.27 (27) income earned by a caregiver under age 20 who is at 227.28 least a half-time student in an approved secondary education 227.29 program; 227.30 (28) MFIP-S child care payments under section 119B.05; 227.31 (29) all other payments made through MFIP-S to support a 227.32 caregiver's pursuit of greater self-support; 227.33 (30) income a participant receives related to shared living 227.34 expenses; 227.35 (31) reverse mortgages; 227.36 (32) benefits provided by the Child Nutrition Act of 1966, 228.1 United States Code, title 42, chapter 13A, sections 1771 to 228.2 1790; 228.3 (33) benefits provided by the women, infants, and children 228.4 (WIC) nutrition program, United States Code, title 42, chapter 228.5 13A, section 1786; 228.6 (34) benefits from the National School Lunch Act, United 228.7 States Code, title 42, chapter 13, sections 1751 to 1769e; 228.8 (35) relocation assistance for displaced persons under the 228.9 Uniform Relocation Assistance and Real Property Acquisition 228.10 Policies Act of 1970, United States Code, title 42, chapter 61, 228.11 subchapter II, section 4636, or the National Housing Act, United 228.12 States Code, title 12, chapter 13, sections 1701 to 1750jj; 228.13 (36) benefits from the Trade Act of 1974, United States 228.14 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 228.15 (37) war reparations payments to Japanese Americans and 228.16 Aleuts under United States Code, title 50, sections 1989 to 228.17 1989d; 228.18 (38) payments to veterans or their dependents as a result 228.19 of legal settlements regarding Agent Orange or other chemical 228.20 exposure under Public Law Number 101-239, section 10405, 228.21 paragraph (a)(2)(E); 228.22 (39) income that is otherwise specifically excluded from 228.23 the MFIP-S program consideration in federal law, state law, or 228.24 federal regulation; 228.25 (40) security and utility deposit refunds; 228.26 (41) American Indian tribal land settlements excluded under 228.27 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 228.28 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 228.29 reservations and payments to members of the White Earth Band, 228.30 under United States Code, title 25, chapter 9, section 331, and 228.31 chapter 16, section 1407; 228.32 (42) all income of the minor parent's parent and stepparent 228.33 when determining the grant for the minor parent in households 228.34 that include a minor parent living with a parent or stepparent 228.35 on MFIP-S with otherdependentchildren; and 228.36 (43) income of the minor parent's parent and stepparent 229.1 equal to 200 percent of the federal poverty guideline for a 229.2 family size not including the minor parent and the minor 229.3 parent's child in households that include a minor parent living 229.4 with a parent or stepparent not on MFIP-S when determining the 229.5 grant for the minor parent. The remainder of income is deemed 229.6 as specified in section 256J.37, subdivision11b; 229.7 (44) payments made to children eligible for relative 229.8 custody assistance under section 257.85; 229.9 (45) vendor payments for goods and services made on behalf 229.10 of a client unless the client has the option of receiving the 229.11 payment in cash; and 229.12 (46) the principal portion of a contract for deed payment. 229.13 Subd. 3. [INITIAL INCOME TEST.] The county agency shall 229.14 determine initial eligibility by considering all earned and 229.15 unearned income that is not excluded under subdivision 2. To be 229.16 eligible for MFIP-S, the assistance unit's countable income 229.17 minus the disregards in paragraphs (a) and (b) must be below the 229.18 transitional standard of assistance according to section 256J.24 229.19 for that size assistance unit. 229.20 (a) The initial eligibility determination must disregard 229.21 the following items: 229.22 (1) the employment disregard is 18 percent of the gross 229.23 earned income whether or not the member is working full time or 229.24 part time; 229.25 (2) dependent care costs must be deducted from gross earned 229.26 income for the actual amount paid for dependent care up tothea 229.27 maximumdisregard allowedof $200 per month for each child less 229.28 than two years of age, and $175 per month for each child two 229.29 years of age and older under this chapter and chapter 119B;and229.30 (3) all payments made according to a court order 229.31 for spousal support or the support of children or a spouse not 229.32 living in the assistance unit's household shall be disregarded 229.33 from the income of the person with the legal obligation to pay 229.34 support, provided that, if there has been a change in the 229.35 financial circumstances of the person with the legal obligation 229.36 to pay support since the support order was entered, the person 230.1 with the legal obligation to pay support has petitioned for a 230.2 modification of the support order; and 230.3 (4) an allocation for the unmet need of an ineligible 230.4 spouse or an ineligible child under the age of 21 for whom the 230.5 caregiver is financially responsible and who lives with the 230.6 caregiver according to section 256J.36. 230.7 (b) Notwithstanding paragraph (a), when determining initial 230.8 eligibility forapplicants who haveapplicant units when at 230.9 least one member has received AFDC, family general assistance, 230.10 MFIP, MFIP-R, work first, or MFIP-S in this state within four 230.11 months of the most recent application for MFIP-S, the employment 230.12 disregard for all unit members is 36 percent of the gross earned 230.13 income. 230.14 After initial eligibility is established, the assistance 230.15 payment calculation is based on the monthly income test. 230.16 Subd. 4. [MONTHLY INCOME TEST AND DETERMINATION OF 230.17 ASSISTANCE PAYMENT.] The county agency shall determine ongoing 230.18 eligibility and the assistance payment amount according to the 230.19 monthly income test. To be eligible for MFIP-S, the result of 230.20 the computations in paragraphs (a) to (e) must be at least $1. 230.21 (a) Apply a 36 percent income disregard to gross earnings 230.22 and subtract this amount from the family wage level. If the 230.23 difference is equal to or greater than the transitional 230.24 standard, the assistance payment is equal to the transitional 230.25 standard. If the difference is less than the transitional 230.26 standard, the assistance payment is equal to the difference. 230.27 The employment disregard in this paragraph must be deducted 230.28 every month there is earned income. 230.29 (b) All payments made according to a court order 230.30 for spousal support or the support of children or a spouse not 230.31 living in the assistance unit's household must be disregarded 230.32 from the income of the person with the legal obligation to pay 230.33 support, provided that, if there has been a change in the 230.34 financial circumstances of the person with the legal obligation 230.35 to pay support since the support order was entered, the person 230.36 with the legal obligation to pay support has petitioned for a 231.1 modification of the court order. 231.2 (c) An allocation for the unmet need of an ineligible 231.3 spouse or an ineligible child under the age of 21 for whom the 231.4 caregiver is financially responsible and who lives with the 231.5 caregiver according to section 256J.36. 231.6 (d) Subtract unearned income dollar for dollar from the 231.7 transitional standard to determine the assistance payment amount. 231.8(d)(e) When income is both earned and unearned, the amount 231.9 of the assistance payment must be determined by first treating 231.10 gross earned income as specified in paragraph (a). After 231.11 determining the amount of the assistance payment under paragraph 231.12 (a), unearned income must be subtracted from that amount dollar 231.13 for dollar to determine the assistance payment amount. 231.14(e)(f) When the monthly income is greater than the 231.15 transitional or family wage level standard after applicable 231.16 deductions and the income will only exceed the standard for one 231.17 month, the county agency must suspend the assistance payment for 231.18 the payment month. 231.19 Subd. 5. [DISTRIBUTION OF INCOME.] The income of all 231.20 members of the assistance unit must be counted. Income may also 231.21 be deemed from ineligible persons to the assistance unit. 231.22 Income must be attributed to the person who earns it or to the 231.23 assistance unit according to paragraphs (a) to (c). 231.24 (a) Funds distributed from a trust, whether from the 231.25 principal holdings or sale of trust property or from the 231.26 interest and other earnings of the trust holdings, must be 231.27 considered income when the income is legally available to an 231.28 applicant or participant. Trusts are presumed legally available 231.29 unless an applicant or participant can document that the trust 231.30 is not legally available. 231.31 (b) Income from jointly owned property must be divided 231.32 equally among property owners unless the terms of ownership 231.33 provide for a different distribution. 231.34 (c) Deductions are not allowed from the gross income of a 231.35 financially responsible household member or by the members of an 231.36 assistance unit to meet a current or prior debt. 232.1 Sec. 38. Minnesota Statutes 1997 Supplement, section 232.2 256J.24, subdivision 1, is amended to read: 232.3 Subdivision 1. [MFIP-S ASSISTANCE UNIT.] An MFIP-S 232.4 assistance unit is either a group of individuals with at least 232.5 one minor child who live together whose needs, assets, and 232.6 income are considered together and who receive MFIP-S 232.7 assistance, or a pregnant woman and her spouse whoreceives232.8 receive MFIP-S assistance. 232.9 Individuals identified in subdivision 2 must be included in 232.10 the MFIP-S assistance unit. Individuals identified in 232.11 subdivision 3must be excluded from the assistance unitare 232.12 ineligible to receive MFIP-S. Individuals identified in 232.13 subdivision 4 may be included in the assistance unit at their 232.14 option. Individuals not included in the assistance unit who are 232.15 identified in section 256J.37,subdivisionsubdivisions 1orto 232.16 2, must have their income and assets considered when determining 232.17 eligibility and benefits for an MFIP-S assistance unit. All 232.18 assistance unit members, whether mandatory or elective, who live 232.19 together and for whom one caregiver or two caregivers apply must 232.20 be included in a single assistance unit. 232.21 Sec. 39. Minnesota Statutes 1997 Supplement, section 232.22 256J.24, subdivision 2, is amended to read: 232.23 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 232.24 for minor caregivers and their children whoaremust be in a 232.25 separate assistance unit from the other persons in the 232.26 household, when the following individuals live together, they 232.27 must be included in the assistance unit: 232.28 (1) a minor child, including a pregnant minor; 232.29 (2) the minor child's siblings, half-siblings, and 232.30 step-siblings;and232.31 (3) the minor child's natural, adoptive parents, and 232.32 stepparents; 232.33 (4) the spouse of a pregnant woman; and 232.34 (5) a pregnant minor with no other children receiving 232.35 assistance in a mandatory unit in clause (3). 232.36 Sec. 40. Minnesota Statutes 1997 Supplement, section 233.1 256J.24, subdivision 3, is amended to read: 233.2 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 233.3 ASSISTANCE UNIT.] The following individualsmust be excluded233.4from an assistance unitwho are part of the assistance unit 233.5 determined under subdivision 2 are ineligible to receive MFIP-S: 233.6 (1) individuals receiving Supplemental Security Income or 233.7 Minnesota supplemental aid; 233.8 (2) individuals living at home while performing 233.9 court-imposed, unpaid community service work due to a criminal 233.10 conviction; 233.11 (3) individuals disqualified from the food stamp program or 233.12 MFIP-S, until the disqualification ends; 233.13 (4) children on whose behalf federal, state, or local 233.14 foster care paymentsunder title IV-E of the Social Security Act233.15 are made, except as provided insectionsections 256J.13, 233.16 subdivision 2, and 256J.74, subdivision 2; and 233.17 (5) children receiving ongoing monthly adoption assistance 233.18 payments under section269.67259.67. 233.19 The exclusion of a person under this subdivision does not 233.20 alter the mandatory assistance unit composition. 233.21 Sec. 41. Minnesota Statutes 1997 Supplement, section 233.22 256J.24, subdivision 4, is amended to read: 233.23 Subd. 4. [INDIVIDUALS WHO MAY ELECT TO BE INCLUDED IN THE 233.24 ASSISTANCE UNIT.] (a) The minor child's eligible caregiver may 233.25 choose to be in the assistance unit, if the caregiver is not 233.26 required to be in the assistance unit under subdivision 2. If 233.27 the relative caregiver chooses to be in the assistance unit, 233.28 that person's spouse must also be in the unit. 233.29 (b) Any minor child not related as a sibling, stepsibling, 233.30 or adopted sibling to the minor child in the unit, but for whom 233.31 there is an eligible caregiver may elect to be in the unit. 233.32 (c) A foster care provider of a minor child who is 233.33 receiving federal, state, or local foster care maintenance 233.34 payments may elect to receive MFIP-S if the provider meets the 233.35 definition of caregiver under section 256J.08, subdivision 11. 233.36 If the provider chooses to receive MFIP-S, the spouse of the 234.1 provider must also be included in the assistance unit with the 234.2 provider. The provider and spouse are eligible for assistance 234.3 even though the only minor child living in the provider's home 234.4 is receiving foster care maintenance payments. 234.5 (d) The adult parent or parents of a minor parent are 234.6 eligible to be a separate assistance unit from the minor parent 234.7 and the minor parent's child when: 234.8 (1) the adult parent or parents have no other minor 234.9 children in the household; 234.10 (2) the minor parent and the minor parent's child are 234.11 living together with the adult parent or parents; and 234.12 (3) the minor parent and the minor parent's child receive 234.13 MFIP-S or would be eligible to receive MFIP-S if they were not 234.14 receiving SSI benefits. 234.15 Sec. 42. Minnesota Statutes 1997 Supplement, section 234.16 256J.24, is amended by adding a subdivision to read: 234.17 Subd. 5a. [FOOD PORTION OF MFIP-S TRANSITIONAL 234.18 STANDARD.] The commissioner shall increase the food portion of 234.19 the MFIP-S transitional standard by October 1 each year 234.20 beginning October 1998 to reflect the cost-of-living adjustments 234.21 to the Food Stamp Program. The commissioner shall annually 234.22 publish in the State Register the transitional standard for an 234.23 assistance unit of sizes 1 to 10. 234.24 Sec. 43. Minnesota Statutes 1997 Supplement, section 234.25 256J.26, subdivision 1, is amended to read: 234.26 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 234.27 Applicants orrecipientsparticipants who have been convicted of 234.28 a drug offense after July 1, 1997, may, if otherwise eligible, 234.29 receive AFDC or MFIP-S benefits subject to the following 234.30 conditions: 234.31 (1) Benefits for the entire assistance unit must be paid in 234.32 vendor form for shelter and utilities during any time the 234.33 applicant is part of the assistance unit;. 234.34 (2) The convicted applicant orrecipientparticipant shall 234.35 be subject to random drug testing as a condition of continued 234.36 eligibility andis subject to sanctions under section 256J.46235.1 following any positive test for an illegal controlled substance,235.2except that the grant must continue to be vendor paid under235.3clause (1).235.4For purposes of this subdivision, section 256J.46 is235.5effective July 1, 1997.235.6This subdivision also applies to persons who receive food235.7stamps under section 115 of the Personal Responsibility and Work235.8Opportunity Reconciliation Act of 1996.is subject to the 235.9 following sanctions: 235.10 (i) for failing a drug test the first time, the 235.11 participant's grant shall be reduced by ten percent of the 235.12 MFIP-S transitional standard or the interstate transitional 235.13 standard, whichever is applicable, prior to making vendor 235.14 payments for shelter and utility costs; or 235.15 (ii) for failing a drug test more than once, the residual 235.16 amount of the participant's grant after making vendor payments 235.17 for shelter and utility costs, if any, must be reduced by an 235.18 amount equal to 30 percent of the MFIP-S transitional standard 235.19 or the interstate transitional standard, whichever is applicable. 235.20 (b) Applicants or participants who have been convicted of a 235.21 drug offense after July 1, 1997, may, if otherwise eligible, 235.22 receive food stamps if the convicted applicant or participant is 235.23 subject to random drug testing as a condition of continued 235.24 eligibility. Following a positive test for an illegal 235.25 controlled substance, the applicant is subject to the following 235.26 sanctions: 235.27 (1) for failing a drug test the first time, food stamps 235.28 shall be reduced by ten percent of the applicable food stamp 235.29 allotment; and 235.30 (2) for failing a drug test more than once, food stamps 235.31 shall be reduced by an amount equal to 30 percent of the 235.32 applicable food stamp allotment. 235.33(b)(c) For the purposes of this subdivision, "drug offense" 235.34 means a conviction that occurred after July 1, 1997, of sections 235.35 152.021 to 152.025, 152.0261, or 152.096. Drug offense also 235.36 means a conviction in another jurisdiction of the possession, 236.1 use, or distribution of a controlled substance, or conspiracy to 236.2 commit any of these offenses, if the offense occurred after July 236.3 1, 1997, and the conviction is a felony offense in that 236.4 jurisdiction, or in the case of New Jersey, a high misdemeanor. 236.5 Sec. 44. Minnesota Statutes 1997 Supplement, section 236.6 256J.26, subdivision 2, is amended to read: 236.7 Subd. 2. [PAROLE VIOLATORS.] An individual violating a 236.8 condition of probation or parole or supervised release imposed 236.9 under federal law or the law of any state isineligible to236.10receivedisqualified from receiving AFDC or MFIP-S. 236.11 Sec. 45. Minnesota Statutes 1997 Supplement, section 236.12 256J.26, subdivision 3, is amended to read: 236.13 Subd. 3. [FLEEING FELONS.] An individual who is fleeing to 236.14 avoid prosecution, or custody, or confinement after conviction 236.15 for a crime that is a felony under the laws of the jurisdiction 236.16 from which the individual flees, or in the case of New Jersey, 236.17 is a high misdemeanor, isineligible to receivedisqualified 236.18 from receiving AFDC or MFIP-S. 236.19 Sec. 46. Minnesota Statutes 1997 Supplement, section 236.20 256J.26, subdivision 4, is amended to read: 236.21 Subd. 4. [DENIAL OF ASSISTANCE FOR TEN YEARS TO A PERSON 236.22 FOUND TO HAVE FRAUDULENTLY MISREPRESENTED RESIDENCY.] An 236.23 individual who is convicted in federal or state court of having 236.24 made a fraudulent statement or representation with respect to 236.25 the place of residence of the individual in order to receive 236.26 assistance simultaneously from two or more states isineligible236.27to receivedisqualified from receiving AFDC or MFIP-S for ten 236.28 years beginning on the date of the conviction. 236.29 Sec. 47. Minnesota Statutes 1997 Supplement, section 236.30 256J.28, subdivision 1, is amended to read: 236.31 Subdivision 1. [EXPEDITED ISSUANCE OF FOOD STAMP 236.32 ASSISTANCE.] The following households are entitled to expedited 236.33 issuance of food stamp assistance: 236.34 (1) households with less than $150 in monthly gross income 236.35 provided their liquid assets do not exceed $100; 236.36 (2) migrant or seasonal farm worker households who are 237.1 destitute as defined in Code of Federal Regulations, title 7, 237.2 subtitle B, chapter 2, subchapter C, part 273, section 273.10, 237.3 paragraph (e)(3), provided their liquid assets do not exceed 237.4 $100; and 237.5 (3) eligible households whose combined monthly gross income 237.6 and liquid resources are less than the household's monthly rent 237.7 or mortgage and utilities. 237.8The benefits issued through expedited issuance of food237.9stamp assistance must be deducted from the amount of the full237.10monthly MFIP-S assistance payment and a supplemental payment for237.11the difference must be issued.For any month an individual 237.12 receives expedited Food Stamp Program benefits, the individual 237.13 is not eligible for the MFIP-S food portion of assistance. 237.14 Sec. 48. Minnesota Statutes 1997 Supplement, section 237.15 256J.28, subdivision 2, is amended to read: 237.16 Subd. 2. [FOOD STAMPS FOR HOUSEHOLD MEMBERS NOT IN THE 237.17 ASSISTANCE UNIT.] (a) For household members who purchase and 237.18 prepare food with the MFIP-S assistance unit but are not part of 237.19 the assistance unit, the county agency must determine a separate 237.20 food stamp benefit based on regulations agreed upon with the 237.21 United States Department of Agriculture. 237.22(b) This subdivision does not apply to optional members who237.23have chosen not to be in the assistance unit.237.24(c)(b) Fair hearing requirements for persons who receive 237.25 food stamps under this subdivision are governed by section 237.26 256.045, and Code of Federal Regulations, title 7, subtitle B, 237.27 chapter II, part 273, section 273.15. 237.28 Sec. 49. Minnesota Statutes 1997 Supplement, section 237.29 256J.28, is amended by adding a subdivision to read: 237.30 Subd. 5. [FOOD STAMPS FOR PERSONS RESIDING IN A BATTERED 237.31 WOMAN'S SHELTER.] Members of an MFIP-S assistance unit residing 237.32 in a battered woman's shelter may receive food stamps or the 237.33 food portion twice in a month if the unit that initially 237.34 received the food stamps or food portion included the alleged 237.35 abuser. 237.36 Sec. 50. Minnesota Statutes 1997 Supplement, section 238.1 256J.30, subdivision 10, is amended to read: 238.2 Subd. 10. [COOPERATION WITH HEALTH CARE BENEFITS.] (a) The 238.3 caregiver of a minor child must cooperate with the county agency 238.4 to identify and provide information to assist the county agency 238.5 in pursuing third-party liability for medical services. 238.6 (b) A caregiver must assign to the department any rights to 238.7 health insurance policy benefits the caregiver has during the 238.8 period of MFIP-S eligibility. 238.9 (c) A caregiver must identify any third party who may be 238.10 liable for care and services available under the medical 238.11 assistance program on behalf of the applicant or participant and 238.12 all other assistance unit members. 238.13 (d) When a participant refuses to identify any third party 238.14 who may be liable for care and services, the recipient must be 238.15 sanctioned as provided in section 256J.46, subdivision 1. The 238.16 recipient is also ineligible for medical assistancefor a238.17minimum of one month anduntil the recipient cooperates with the 238.18 requirements of this subdivision. 238.19 Sec. 51. Minnesota Statutes 1997 Supplement, section 238.20 256J.30, subdivision 11, is amended to read: 238.21 Subd. 11. [REQUIREMENT TO ASSIGN SUPPORT AND MAINTENANCE 238.22 RIGHTS.]To be eligibleAn assistance unit is ineligible for 238.23 MFIP-S,unless the caregivermust assignassigns all rights to 238.24 child support and spousal maintenance benefits according 238.25 tosections 256.74, subdivision 5, andsection 256.741, if238.26enacted. 238.27 Sec. 52. Minnesota Statutes 1997 Supplement, section 238.28 256J.31, subdivision 5, is amended to read: 238.29 Subd. 5. [MAILING OF NOTICE.] The notice of adverse action 238.30 shall be issued according to paragraphs (a) to (c). 238.31 (a) A county agency shall mail a notice of adverse action 238.32 at least ten days before the effective date of the adverse 238.33 action, except as provided in paragraphs (b) and (c). 238.34 (b) A county agency must mail a notice of adverse action at 238.35 least five days before the effective date of the adverse action 238.36 when the county agency has factual information that requires an 239.1 action to reduce, suspend, or terminate assistance based on 239.2 probable fraud. 239.3 (c) A county agency shall mail a notice of adverse action 239.4 before or on the effective date of the adverse action when the 239.5 county agency: 239.6 (1) receives the caregiver's signed monthly MFIP-S 239.7 household report form that includes information that requires 239.8 payment reduction, suspension, or termination; 239.9 (2) is informed of the death of a participant or the payee; 239.10 (3) receives a signed statement from the caregiver that 239.11 assistance is no longer wanted; 239.12 (4) receives a signed statement from the caregiver that 239.13 provides information that requires the termination or reduction 239.14 of assistance; 239.15 (5) verifies that a member of the assistance unit is absent 239.16 from the home and does not meet temporary absence provisions in 239.17 section 256J.13; 239.18 (6) verifies that a member of the assistance unit has 239.19 entered a regional treatment center or a licensed residential 239.20 facility for medical or psychological treatment or 239.21 rehabilitation; 239.22 (7) verifies that a member of an assistance unit has been 239.23 placed in foster care, and the provisions of section 256J.13, 239.24 subdivision 2, paragraph(b)(c), clause (2), do not apply; 239.25 (8) verifies that a member of an assistance unit has been 239.26 approved to receive assistance by another state; or 239.27 (9) cannot locate a caregiver. 239.28 Sec. 53. Minnesota Statutes 1997 Supplement, section 239.29 256J.31, subdivision 10, is amended to read: 239.30 Subd. 10. [PROTECTION FROM GARNISHMENT.] MFIP-S grants or 239.31 earnings of a caregiverwhile participating in full or part-time239.32employment or trainingshall be protected from garnishment. 239.33 This protection for earnings shall extend for a period of six 239.34 months from the date of termination from MFIP-S. 239.35 Sec. 54. Minnesota Statutes 1997 Supplement, section 239.36 256J.32, subdivision 4, is amended to read: 240.1 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 240.2 verify the following at application: 240.3 (1) identity of adults; 240.4 (2) presence of the minor child in the home, if 240.5 questionable; 240.6 (3) relationship of a minor child to caregivers in the 240.7 assistance unit; 240.8 (4) age, if necessary to determine MFIP-S eligibility; 240.9 (5) immigration status; 240.10 (6) social security numberin accordance withaccording to 240.11 the requirements of section 256J.30, subdivision 12; 240.12 (7) income; 240.13 (8) self-employment expenses used as a deduction; 240.14 (9) source and purpose of deposits and withdrawals from 240.15 business accounts; 240.16 (10) spousal support and child support payments made to 240.17 persons outside the household; 240.18 (11) real property; 240.19 (12) vehicles; 240.20 (13) checking and savings accounts; 240.21 (14) savings certificates, savings bonds, stocks, and 240.22 individual retirement accounts; 240.23 (15) pregnancy, if related to eligibility; 240.24 (16) inconsistent information, if related to eligibility; 240.25 (17) medical insurance; 240.26 (18) anticipated graduation date of an 18-year-old; 240.27 (19) burial accounts; 240.28 (20) school attendance, if related to eligibility;and240.29 (21) residence; 240.30 (22) a claim of domestic violence if used as a basis for a 240.31 deferral or exemption from the 60-month time limit in section 240.32 256J.42 or employment and training services requirements in 240.33 section 256J.56; and 240.34 (23) disability if used as an exemption from employment and 240.35 training services requirements under section 256J.56. 240.36 Sec. 55. Minnesota Statutes 1997 Supplement, section 241.1 256J.32, subdivision 6, is amended to read: 241.2 Subd. 6. [RECERTIFICATION.] The county agency shall 241.3 recertify eligibility in an annual face-to-face interview with 241.4 the participant and verify the following: 241.5 (1) presence of the minor child in the home, if 241.6 questionable; 241.7 (2) income, unless excluded, including self-employment 241.8 expenses used as a deduction or deposits or withdrawals from 241.9 business accounts; 241.10 (3) assets when the value is within $200 of the asset 241.11 limit; and 241.12 (4) inconsistent information, if related to eligibility. 241.13 Sec. 56. Minnesota Statutes 1997 Supplement, section 241.14 256J.32, is amended by adding a subdivision to read: 241.15 Subd. 7. [NOTICE TO UNDOCUMENTED PERSONS; RELEASE OF 241.16 PRIVATE DATA.] County agencies in consultation with the 241.17 commissioner of human services shall provide notification to 241.18 undocumented persons regarding the release of personal data to 241.19 the Immigration and Naturalization Service and develop protocol 241.20 regarding the release or sharing of data about undocumented 241.21 persons with the Immigration and Naturalization Service as 241.22 required under sections 404, 434, and 411A of the Personal 241.23 Responsibility and Work Opportunity Reconciliation Act of 1996. 241.24 Sec. 57. Minnesota Statutes 1997 Supplement, section 241.25 256J.33, subdivision 1, is amended to read: 241.26 Subdivision 1. [DETERMINATION OF ELIGIBILITY.] A county 241.27 agency must determine MFIP-S eligibility prospectively for a 241.28 payment month based on retrospectively assessing income and the 241.29 county agency's best estimate of the circumstances that will 241.30 exist in the payment month. 241.31 Except as described in section 256J.34, subdivision 1, when 241.32 prospective eligibility exists, a county agency must calculate 241.33 the amount of the assistance payment using retrospective 241.34 budgeting. To determine MFIP-S eligibility and the assistance 241.35 payment amount, a county agency must apply countable income, 241.36 described in section 256J.37, subdivisions 3 to 10, received by 242.1 members of an assistance unit or by other persons whose income 242.2 is counted for the assistance unit, described under sections 242.3 256J.21 and 256J.37, subdivisions 1andto 2. 242.4 This income must be applied to the transitional standard or 242.5 family wage standard subject to this section and sections 242.6 256J.34 to 256J.36. Income received in a calendar month and not 242.7 otherwise excluded under section 256J.21, subdivision 2, must be 242.8 applied to the needs of an assistance unit. 242.9 Sec. 58. Minnesota Statutes 1997 Supplement, section 242.10 256J.33, subdivision 4, is amended to read: 242.11 Subd. 4. [MONTHLY INCOME TEST.] A county agency must apply 242.12 the monthly income test retrospectively for each month of MFIP-S 242.13 eligibility. An assistance unit is not eligible when the 242.14 countable income equals or exceeds the transitional standard or 242.15 the family wage level for the assistance unit. The income 242.16 applied against the monthly income test must include: 242.17 (1) gross earned income from employment, prior to mandatory 242.18 payroll deductions, voluntary payroll deductions, wage 242.19 authorizations, and after the disregards in section 256J.21, 242.20 subdivision34, and the allocations in section 256J.36, unless 242.21 the employment income is specifically excluded under section 242.22 256J.21, subdivision 2; 242.23 (2) gross earned income from self-employment less 242.24 deductions for self-employment expenses in section 256J.37, 242.25 subdivision 5, but prior to any reductions for personal or 242.26 business state and federal income taxes, personal FICA, personal 242.27 health and life insurance, and after the disregards in section 242.28 256J.21, subdivision34, and the allocations in section 242.29 256J.36; 242.30 (3) unearned income after deductions for allowable expenses 242.31 in section 256J.37, subdivision 9, and allocations in section 242.32 256J.36, unless the income has been specifically excluded in 242.33 section 256J.21, subdivision 2; 242.34 (4) gross earned income from employment as determined under 242.35 clause (1) which is received by a member of an assistance unit 242.36 who is a minor child or minor caregiver and less than a 243.1 half-time student; 243.2 (5) child support and spousal support received or 243.3 anticipated to be received by an assistance unit; 243.4 (6) the income of a parent when that parent is not included 243.5 in the assistance unit; 243.6 (7) the income of an eligible relative and spouse who seek 243.7 to be included in the assistance unit; and 243.8 (8) the unearned income of a minor child included in the 243.9 assistance unit. 243.10 Sec. 59. Minnesota Statutes 1997 Supplement, section 243.11 256J.35, is amended to read: 243.12 256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 243.13 Except as provided in paragraphs (a) to(c)(d), the amount 243.14 of an assistance payment is equal to the difference between the 243.15 transitional standard or the Minnesota family wage level in 243.16 section 256J.24, whichever is less, and countable income. 243.17 (a) When MFIP-S eligibility exists for the month of 243.18 application, the amount of the assistance payment for the month 243.19 of application must be prorated from the date of application or 243.20 the date all other eligibility factors are met for that 243.21 applicant, whichever is later. This provision applies when an 243.22 applicant loses at least one day of MFIP-S eligibility. 243.23 (b) MFIP-S overpayments to an assistance unit must be 243.24 recouped according to section 256J.38, subdivision 4. 243.25 (c) An initial assistance payment must not be made to an 243.26 applicant who is not eligible on the date payment is made. 243.27 (d) An individual whose needs have been otherwise provided 243.28 for in another state, in whole or in part by county, state, or 243.29 federal dollars during a month, is ineligible to receive MFIP-S 243.30 for the month. 243.31 Sec. 60. Minnesota Statutes 1997 Supplement, section 243.32 256J.36, is amended to read: 243.33 256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 243.34 MEMBERS.] 243.35 Except as prohibited in paragraphs (a) and (b), an 243.36 allocation of income is allowed from the caregiver's income to 244.1 meet the unmet need of an ineligible spouse or an ineligible 244.2 child under the age of 21 for whom the caregiver is financially 244.3 responsible who also lives with the caregiver.An allocation is244.4allowed from the caregiver's income to meet the need of an244.5ineligible or excluded person.That allocation is allowed in an 244.6 amount up to the difference between the MFIP-Sfamily allowance244.7 transitional standard for the assistance unit when thatexcluded244.8orineligible person is included in the assistance unit and the 244.9 MFIP-S family allowance for the assistance unit when 244.10 theexcluded orineligible person is not included in the 244.11 assistance unit. These allocations must be deducted from the 244.12 caregiver's counted earnings and from unearned income subject to 244.13 paragraphs (a) and (b). 244.14 (a) Income of a minor child in the assistance unit must not 244.15 be allocated to meet the need ofaan ineligible personwho is244.16not a member of the assistance unit, including the child's 244.17 parent, even when that parent is the payee of the child's income. 244.18 (b) Income ofan assistance unita caregiver must not be 244.19 allocated to meet the needs of a disqualified personineligible244.20for failure to cooperate with program requirements including244.21child support requirements, a person ineligible due to fraud, or244.22a relative caregiver and the caregiver's spouse who opt out of244.23the assistance unit. 244.24 Sec. 61. Minnesota Statutes 1997 Supplement, section 244.25 256J.37, subdivision 1, is amended to read: 244.26 Subdivision 1. [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 244.27 MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 244.28 the income of ineligible household members must be deemed after 244.29 allowing the following disregards: 244.30 (1) the first 18 percent of theexcludedineligible family 244.31 member's gross earned income; 244.32 (2) amounts the ineligible person actually paid to 244.33 individuals not living in the same household but whom the 244.34 ineligible person claims or could claim as dependents for 244.35 determining federal personal income tax liability; 244.36 (3)child or spousal support paid to a person who lives245.1outside of the householdall payments made by the ineligible 245.2 person according to a court order for spousal support or the 245.3 support of children or a spouse not living in the assistance 245.4 unit's household, provided that, if there has been a change in 245.5 the financial circumstances of the ineligible person since the 245.6 support order was entered, the ineligible person has petitioned 245.7 for a modification of the support order; and 245.8 (4) an amount for the needs of the ineligible person and 245.9 other persons who live in the household but are not included in 245.10 the assistance unit and are or could be claimed by an ineligible 245.11 person as dependents for determining federal personal income tax 245.12 liability. This amount is equal to the difference between the 245.13 MFIP-Sneedtransitional standard when theexcludedineligible 245.14 person is included in the assistance unit and the MFIP-Sneed245.15 transitional standard when theexcludedineligible person is not 245.16 included in the assistance unit. 245.17 Sec. 62. Minnesota Statutes 1997 Supplement, section 245.18 256J.37, is amended by adding a subdivision to read: 245.19 Subd. 1a. [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 245.20 income of disqualified members must be deemed after allowing the 245.21 following disregards: 245.22 (1) the first 18 percent of the disqualified member's gross 245.23 earned income; 245.24 (2) amounts the disqualified member actually paid to 245.25 individuals not living in the same household but whom the 245.26 disqualified member claims or could claim as dependents for 245.27 determining federal personal income tax liability; 245.28 (3) all payments made by the disqualified member according 245.29 to a court order for spousal support or the support of children 245.30 or a spouse not living in the assistance unit's household, 245.31 provided that, if there has been a change in the financial 245.32 circumstances of the disqualified member's legal obligation to 245.33 pay support since the support order was entered, the 245.34 disqualified member has petitioned for a modification of the 245.35 support order; and 245.36 (4) an amount for the needs of other persons who live in 246.1 the household but are not included in the assistance unit and 246.2 are or could be claimed by the disqualified member as dependents 246.3 for determining federal personal income tax liability. This 246.4 amount is equal to the difference between the MFIP-S 246.5 transitional standard when the ineligible person is included in 246.6 the assistance unit and the MFIP-S transitional standard when 246.7 the ineligible person is not included in the assistance unit. 246.8 An amount shall not be allowed for the needs of a disqualified 246.9 member. 246.10 Sec. 63. Minnesota Statutes 1997 Supplement, section 246.11 256J.37, is amended by adding a subdivision to read: 246.12 Subd. 1b. [DEEMED INCOME FROM PARENTS OF MINOR 246.13 CAREGIVERS.] In households where minor caregivers live with a 246.14 parent or parents who do not receive MFIP-S, the income of the 246.15 parents must be deemed after allowing the following disregards: 246.16 (1) income of the parents equal to 200 percent of the 246.17 federal poverty guideline for a family size not including the 246.18 minor parent and the minor parent's child in the household 246.19 according to section 256J.21, subdivision 2, clause (43); 246.20 (2) 18 percent of the parent's gross earned income; 246.21 (3) amounts the parents actually paid to individuals not 246.22 living in the same household but whom the parents claim or could 246.23 claim as dependents for determining federal personal income tax 246.24 liability; and 246.25 (4) all payments made by parents according to a court order 246.26 for spousal support or the support of children or spouse not 246.27 living in the parent's household, provided that, if there has 246.28 been a change in the financial circumstances of the parent's 246.29 legal obligation to pay support since the support order was 246.30 entered, the parents have petitioned for a modification of the 246.31 support order. 246.32 Sec. 64. Minnesota Statutes 1997 Supplement, section 246.33 256J.37, subdivision 2, is amended to read: 246.34 Subd. 2. [DEEMED INCOME AND ASSETS OF SPONSOR OF 246.35 NONCITIZENS.]All income and assets of a sponsor, or sponsor's246.36spouse, who executed an affidavit of support for a noncitizen247.1must be deemed to be unearned income of the noncitizen as247.2specified in the Personal Responsibility and Work Opportunity247.3Reconciliation Act of 1996, title IV, Public Law Number 104-193,247.4sections 421 and 422, and subsequently set out in federal247.5rules.If a noncitizen applies for or receives MFIP-S, the 247.6 county must deem the income and assets of the noncitizen's 247.7 sponsor and the sponsor's spouse who have signed an affidavit of 247.8 support for the noncitizen as specified in Public Law Number 247.9 104-193, title IV, sections 421 and 422, the Personal 247.10 Responsibility and Work Opportunity Reconciliation Act of 1996. 247.11 The income of a sponsor and the sponsor's spouse is considered 247.12 unearned income of the noncitizen. The assets of a sponsor and 247.13 the sponsor's spouse are considered available assets of the 247.14 noncitizen. 247.15 Sec. 65. Minnesota Statutes 1997 Supplement, section 247.16 256J.37, subdivision 9, is amended to read: 247.17 Subd. 9. [UNEARNED INCOME.] (a) The county agency must 247.18 apply unearned income, including housing subsidies as in247.19paragraph (b),to the transitional standard. When determining 247.20 the amount of unearned income, the county agency must deduct the 247.21 costs necessary to secure payments of unearned income. These 247.22 costs include legal fees, medical fees, and mandatory deductions 247.23 such as federal and state income taxes. 247.24 (b) Effective July 1,19981999, the county agency shall 247.25 count $100 of the value of public and assisted rental subsidies 247.26 provided through the Department of Housing and Urban Development 247.27 (HUD) as unearned income. The full amount of the subsidy must 247.28 be counted as unearned income when the subsidy is less than $100. 247.29 Sec. 66. Minnesota Statutes 1997 Supplement, section 247.30 256J.38, subdivision 1, is amended to read: 247.31 Subdivision 1. [SCOPE OF OVERPAYMENT.] When a participant 247.32 or former participant receives an overpayment due to agency, 247.33 client, or ATM error, or due to assistance received while an 247.34 appeal is pending and the participant or former participant is 247.35 determined ineligible for assistance or for less assistance than 247.36 was received, the county agency must recoup or recover the 248.1 overpaymentunderusing theconditions of this248.2section.following methods: 248.3 (1) reconstruct each affected budget month and 248.4 corresponding payment month; 248.5 (2) use the policies and procedures that were in effect for 248.6 the payment month; and 248.7 (3) do not allow employment disregards in section 256J.21, 248.8 subdivision 3 or 4, in the calculation of the overpayment when 248.9 the unit has not reported within two calendar months following 248.10 the end of the month in which the income was received. 248.11 Sec. 67. Minnesota Statutes 1997 Supplement, section 248.12 256J.39, subdivision 2, is amended to read: 248.13 Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 248.14 paying assistance directly to a participant may be used when: 248.15 (1) a county agency determines that a vendor payment is the 248.16 most effective way to resolve an emergency situation pertaining 248.17 to basic needs; 248.18 (2) a caregiver makes a written request to the county 248.19 agency asking that part or all of the assistance payment be 248.20 issued by protective or vendor payments for shelter and utility 248.21 service only. The caregiver may withdraw this request in 248.22 writing at any time; 248.23 (3)a caregiver has exhibited a continuing pattern of248.24mismanaging funds as determined by the county agency;248.25(4)the vendor payment is part of a sanction under section 248.26 256J.46, subdivision 2;or248.27(5)(4) the vendor payment is required under section 248.28256J.24256J.26 or 256J.43; 248.29 (5) protective payments are required for minor parents 248.30 under section 256J.14; or 248.31 (6) a caregiver has exhibited a continuing pattern of 248.32 mismanaging funds as determined by the county agency. 248.33 The director of a county agency must approve a proposal for 248.34 protective or vendor payment for money mismanagement when there 248.35 is a pattern of mismanagement under clause (6). During the time 248.36 a protective or vendor payment is being made, the county agency 249.1 must provide services designed to alleviate the causes of the 249.2 mismanagement. 249.3 The continuing need for and method of payment must be 249.4 documented and reviewed every 12 months. The director of a 249.5 county agency must approve the continuation of protective or 249.6 vendor payments. when it appears that the need for protective or 249.7 vendor payments will continue or is likely to continue beyond 249.8 two years because the county agency's efforts have not resulted 249.9 in sufficiently improved use of assistance on behalf of the 249.10 minor child, judicial appointment of a legal guardian or other 249.11 legal representative must be sought by the county agency. 249.12 Sec. 68. Minnesota Statutes 1997 Supplement, section 249.13 256J.395, is amended to read: 249.14 256J.395 [VENDOR PAYMENT OFRENTSHELTER COSTS AND 249.15 UTILITIES.] 249.16 Subdivision 1. [VENDOR PAYMENT.] (a) Effective July 1, 249.17 1997, when a county is required to provide assistance to 249.18 arecipientparticipant in vendor form forrentshelter costs 249.19 and utilities under this chapter, or chapter 256, 256D, or 256K, 249.20 the cost of utilities for a given family may be assumed to be: 249.21 (1) the average of the actual monthly cost of utilities for 249.22 that family for the prior 12 months at the family's current 249.23 residence, if applicable; 249.24 (2) the monthly plan amount, if any, set by the local 249.25 utilities for that family at the family's current residence; or 249.26 (3) the estimated monthly utility costs for the dwelling in 249.27 which the family currently resides. 249.28 (b) For purposes of this section, "utility" means any of 249.29 the following: municipal water and sewer service; electric, 249.30 gas, or heating fuel service; or wood, if that is the heating 249.31 source. 249.32 (c) In any instance where a vendor payment for rent is 249.33 directed to a landlord not legally entitled to the payment, the 249.34 county social services agency shall immediately institute 249.35 proceedings to collect the amount of the vendored rent payment, 249.36 which shall be considered a debt under section 270A.03, 250.1 subdivision 5. 250.2 Subd. 2. [VENDOR PAYMENT NOTIFICATION.] (a) When a county 250.3 agency is required to provide assistance to a participant in 250.4 vendor payment form for housing costs or utilities under 250.5 subdivision 1, and the participant does not give the agency the 250.6 information needed to pay the vendor, the county agency shall 250.7 notify the participant of the intent to terminate assistance by 250.8 mail at least ten days before the effective date of the adverse 250.9 action. 250.10 (b) The notice of action shall include a request for 250.11 information about: 250.12 (1) the amount of the participant's housing costs or 250.13 utilities; 250.14 (2) the due date of the housing costs or utilities; and 250.15 (3) the name and address of the landlord, contract for deed 250.16 holder, mortgage company, and utility vendor. 250.17 (c) If the participant fails to provide the requested 250.18 information by the effective date of the adverse action, the 250.19 county must terminate the MFIP-S grant. If the applicant or 250.20 participant verifies they do not have housing costs or utility 250.21 obligations, the county shall not terminate assistance if the 250.22 assistance unit is otherwise eligible. 250.23 Sec. 69. Minnesota Statutes 1997 Supplement, section 250.24 256J.42, is amended to read: 250.25 256J.42 [60-MONTH TIME LIMIT.] 250.26 Subdivision 1. [TIME LIMIT.] (a) Except for the exemptions 250.27 in this section and in section 256J.11, subdivision 2, an 250.28 assistance unit in which any adult caregiver has received 60 250.29 months of cash assistance funded in whole or in part by the TANF 250.30 block grant in this or any other state or United States 250.31 territory, MFIP-S, AFDC, or family general assistance, funded in 250.32 whole or in part by state appropriations, is ineligible to 250.33 receive MFIP-S. Any cash assistance funded with TANF dollars in 250.34 this or any other state or United States territory, or MFIP-S 250.35 assistance funded in whole or in part by state appropriations, 250.36 that was received by the unit on or after the date TANF was 251.1 implemented, including any assistance received in states or 251.2 United States territories of prior residence, counts toward the 251.3 60-month limitation. The 60-month limit applies to a minor who 251.4 is the head of a household or who is married to the head of a 251.5 household except under subdivision 5. The 60-month time period 251.6 does not need to be consecutive months for this provision to 251.7 apply. 251.8 (b) Months before July 1998 in which individuals receive 251.9 assistance as part of an MFIP, MFIP-R, or MFIP or MFIP-R 251.10 comparison group family under sections 256.031 to 256.0361 or 251.11 sections 256.047 to 256.048 are not included in the 60-month 251.12 time limit. 251.13Subd. 2. [ASSISTANCE FROM ANOTHER STATE.] An individual251.14whose needs have been otherwise provided for in another state,251.15in whole or in part by the TANF block grant during a month, is251.16ineligible to receive MFIP-S for the month.251.17 Subd. 3. [ADULTS LIVING ON AN INDIAN RESERVATION.] In 251.18 determining the number of months for which an adult has received 251.19 assistance under MFIP-S, the county agency must disregard any 251.20 month during which the adult lived on an Indian reservation if,251.21 during the month:251.22(1) at least 1,000 individuals were living on the251.23reservation; and251.24(2)at least 50 percent of the adults living on the 251.25 reservation wereunemployednot employed. 251.26 Subd. 4. [VICTIMS OF DOMESTIC VIOLENCE.] Any cash 251.27 assistance received by an assistance unit in a month when a 251.28 caregiver is complying with a safety plan under the MFIP-S 251.29 employment and training component does not count toward the 251.30 60-month limitation on assistance. 251.31 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 251.32 assistance received by an assistance unit does not count toward 251.33 the 60-month limit on assistance during a month in which 251.34 theparentalcaregiver is in the category in section 256J.56, 251.35 clause (1). The exemption applies for the period of time the 251.36 caregiver belongs to one of the categories specified in this 252.1 subdivision. 252.2 (b) From July 1, 1997, until the date MFIP-S is operative 252.3 in the caregiver's county of financial responsibility, any cash 252.4 assistance received by a caregiver who is complying with 252.5 sections 256.73, subdivision 5a, and 256.736, if applicable, 252.6 does not count toward the 60-month limit on assistance. 252.7 Thereafter, any cash assistance received by a minor caregiver 252.8 who is complying with the requirements of sections 256J.14 and 252.9 256J.54, if applicable, does not count towards the 60-month 252.10 limit on assistance. 252.11 (c) The receipt of diversionary assistance or emergency 252.12 assistance does not count toward the 60-month limit. 252.13 (d) Any cash assistance received by an 18- or 19-year-old 252.14 caregiver who is complying with the requirements of section 252.15 256J.54 does not count toward the 60-month limit. 252.16 Sec. 70. Minnesota Statutes 1997 Supplement, section 252.17 256J.43, is amended to read: 252.18 256J.43 [INTERSTATE PAYMENT STANDARDS.] 252.19 Subdivision 1. [PAYMENT.] (a) Effective July 1, 1997, the 252.20 amount of assistance paid to an eligiblefamilyunit in which 252.21 all members have resided in this state for fewer than 12 252.22 consecutive calendar months immediately preceding the date of 252.23 application shall be the lesser of either thepaymentinterstate 252.24 transitional standard that would have been received by 252.25 thefamilyassistance unit from the state of immediate prior 252.26 residence, or the amount calculated in accordance with AFDC or 252.27 MFIP-S standards. The lesser payment must continue until 252.28 thefamilyassistance unit meets the 12-month requirement. An 252.29 assistance unit that has not resided in Minnesota for 12 months 252.30 from the date of application is not exempt from the interstate 252.31 payment provisions solely because a child is born in Minnesota 252.32 to a member of the assistance unit. Payment must be calculated 252.33 by applying this state's budgeting policies, and the unit's net 252.34 income must be deducted from the payment standard in the other 252.35 state or in this state, whichever is lower. Payment shall be 252.36 made in vendor form for rent and utilities, up to the limit of 253.1 the grant amount, and residual amounts, if any, shall be paid 253.2 directly to the assistance unit. 253.3 (b) During the first 12 monthsa familyan assistance unit 253.4 resides in this state, the number of months that afamilyunit 253.5 is eligible to receive AFDC or MFIP-S benefits is limited to the 253.6 number of months thefamilyassistance unit would have been 253.7 eligible to receive similar benefits in the state of immediate 253.8 prior residence. 253.9 (c) This policy applies whether or not thefamily253.10 assistance unit received similar benefits while residing in the 253.11 state of previous residence. 253.12 (d) Whena familyan assistance unit moves to this state 253.13 from another state where thefamilyassistance unit has 253.14 exhausted that state's time limit for receiving benefits under 253.15 that state's TANF program, thefamilyunit will not be eligible 253.16 to receive any AFDC or MFIP-S benefits in this state for 12 253.17 months from the date thefamilyassistance unit moves here. 253.18 (e) For the purposes of this section, "state of immediate 253.19 prior residence" means: 253.20 (1) the state in which the applicant declares the applicant 253.21 spent the most time in the 30 days prior to moving to this 253.22 state; or 253.23 (2) the state in which an applicant who is a migrant worker 253.24 maintains a home. 253.25 (f) The commissioner shall annually verify and update all 253.26 other states' payment standards as they are to be in effect in 253.27 July of each year. 253.28 (g) Applicants must provide verification of their state of 253.29 immediate prior residence, in the form of tax statements, a 253.30 driver's license, automobile registration, rent receipts, or 253.31 other forms of verification approved by the commissioner. 253.32 (h) Migrant workers, as defined in section 256J.08, and 253.33 their immediate families are exempt from this section, provided 253.34 the migrant worker provides verification that the migrant family 253.35 worked in this state within the last 12 months and earned at 253.36 least $1,000 in gross wages during the time the migrant worker 254.1 worked in this state. 254.2 Subd. 2. [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 254.3 assistance unit that has met the requirements of section 254.4 256J.12, the number of months that the assistance unit receives 254.5 benefits under the interstate payment standards in this section 254.6 is not affected by an absence from Minnesota for fewer than 30 254.7 consecutive days. 254.8 (b) For an assistance unit that has met the requirements of 254.9 section 256J.12, the number of months that the assistance unit 254.10 receives benefits under the interstate payment standards in this 254.11 section is not affected by an absence from Minnesota for more 254.12 than 30 consecutive days but fewer than 90 consecutive days, 254.13 provided the assistance unit continues to maintain a residence 254.14 in Minnesota during the period of absence. 254.15 Subd. 3. [EXCEPTIONS TO THE INTERSTATE PAYMENT 254.16 POLICY.] Applicants who lived in another state in the 12 months 254.17 previous to application for assistance are exempt from the 254.18 interstate payment policy for the months that a member of the 254.19 unit: 254.20 (1) served in the United States armed services, provided 254.21 the person returned to Minnesota within 30 days of leaving the 254.22 armed forces, and intends to remain in Minnesota; 254.23 (2) attended school in another state, paid nonresident 254.24 tuition or Minnesota tuition rates under a reciprocity 254.25 agreement, provided the person left Minnesota specifically to 254.26 attend school and returned to Minnesota within 30 days of 254.27 graduation with the intent to remain in Minnesota; or 254.28 (3) meets the following criteria: 254.29 (i) a minor child or a minor caregiver moves from another 254.30 state to the residence of a relative caregiver; 254.31 (ii) the minor caregiver applies for and receives family 254.32 cash assistance; 254.33 (iii) the relative caregiver chooses not to be part of the 254.34 MFIP-S assistance unit; and 254.35 (iv) the relative caregiver has resided in Minnesota for at 254.36 least 12 months from the date the assistance unit applies for 255.1 cash assistance. 255.2 Subd. 4. [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 255.3 mandatory unit members who have resided in Minnesota for 12 255.4 months immediately before the date of application meet 255.5 eligibility for the Minnesota payment standard for the other 255.6 assistance unit members. 255.7 Sec. 71. Minnesota Statutes 1997 Supplement, section 255.8 256J.45, subdivision 1, is amended to read: 255.9 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 255.10 county agency must provide each MFIP-S caregiver with a 255.11 face-to-face orientation. The caregiver must attend the 255.12 orientation. The county agency must inform the caregiver that 255.13 failure to attend the orientation is considereda firstan 255.14 occurrence of noncompliance with program requirements, and will 255.15 result in the imposition of a sanction under section 255.16 256J.46. If the client complies with the orientation 255.17 requirement prior to the effective date of the sanction, the 255.18 orientation sanction shall be lifted. 255.19 Sec. 72. Minnesota Statutes 1997 Supplement, section 255.20 256J.45, subdivision 2, is amended to read: 255.21 Subd. 2. [GENERAL INFORMATION.] The MFIP-S orientation 255.22 must consist of a presentation that informs caregivers of: 255.23 (1) the necessity to obtain immediate employment; 255.24 (2) the work incentives under MFIP-S; 255.25 (3) the requirement to comply with the employment plan and 255.26 other requirements of the employment and training services 255.27 component of MFIP-S; 255.28 (4) the consequences for failing to comply with the 255.29 employment plan and other program requirements; 255.30 (5) the rights, responsibilities, and obligations of 255.31 participants; 255.32 (6) the types and locations of child care services 255.33 available through the county agency; 255.34 (7) the availability and the benefits of the early 255.35 childhood health and developmental screening under sections 255.36 123.701 to 123.74; 256.1 (8) the caregiver's eligibility for transition year child 256.2 care assistance under section 119B.05; 256.3 (9) the caregiver's eligibility for extended medical 256.4 assistance when the caregiver loses eligibility for MFIP-S due 256.5 to increased earnings or increased child or spousal support;and256.6 (10) the caregiver's option to choose an employment and 256.7 training provider and information about each provider, including 256.8 but not limited to, services offered, program components, job 256.9 placement rates, job placement wages, and job retention rates; 256.10 (11) the caregiver's option to request approval of an 256.11 education and training plan pursuant to section 256J.52; and 256.12 (12) the work study programs available under the higher 256.13 educational system. 256.14 Sec. 73. Minnesota Statutes 1997 Supplement, section 256.15 256J.45, is amended by adding a subdivision to read: 256.16 Subd. 3. [GOOD CAUSE EXEMPTIONS FOR NOT ATTENDING 256.17 ORIENTATION.] (a) The county agency shall not impose the 256.18 sanction under section 256J.46 if it determines that the 256.19 participant has good cause for failing to attend orientation. 256.20 Good cause exists when: 256.21 (1) appropriate child care is not available; 256.22 (2) the participant is ill or injured; 256.23 (3) a family member is ill and needs care by the 256.24 participant that prevents the participant from attending 256.25 orientation; 256.26 (4) the caregiver is unable to secure necessary 256.27 transportation; 256.28 (5) the caregiver is in an emergency situation that 256.29 prevents orientation attendance; 256.30 (6) the orientation conflicts with the caregiver's work, 256.31 training, or school schedule; or 256.32 (7) the caregiver documents other verifiable impediments to 256.33 orientation attendance beyond the caregiver's control. 256.34 (b) Counties must work with clients to provide child care 256.35 and transportation necessary to ensure a caregiver has every 256.36 opportunity to attend orientation. 257.1 Sec. 74. Minnesota Statutes 1997 Supplement, section 257.2 256J.46, subdivision 1, is amended to read: 257.3 Subdivision 1. [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 257.4 WITH PROGRAM REQUIREMENTS.] (a) The following participants are 257.5 subject to a sanction under this subdivision: 257.6 (1) a participant who fails without good cause to comply 257.7 with the requirements of this chapter, and who is not subject to 257.8 a sanction under subdivision 2, shall be subject to a sanction257.9as provided in this subdivision; and 257.10 (2) a participant who has not complied with the orientation 257.11 requirement before the effective date of the sanction. 257.12 A sanction under this subdivision becomes effective ten 257.13 days after the required notice is given. For purposes of this 257.14 subdivision, each month that a participant fails to comply with 257.15 a requirement of this chapter shall be considered a separate 257.16 occurrence of noncompliance. A participant who has had one or 257.17 more sanctions imposed must remain in compliance with the 257.18 provisions of this chapter for six months in order for a 257.19 subsequent occurrence of noncompliance to be considered a first 257.20 occurrence. 257.21 (b) Sanctions for noncompliance shall be imposed as follows: 257.22 (1) For the first occurrence of noncompliance by a 257.23 participant in a single-parent household or by one participant 257.24 in a two-parent household, theparticipant'sfamily's grant 257.25 shall be reduced by ten percent of theapplicableMFIP-S 257.26 transitional standard or the interstate transitional standard 257.27 for an assistance unit of the same size, whichever is 257.28 applicable, with the residual paid to the participant. The 257.29 reduction in the grant amount must be in effect for a minimum of 257.30 one month and shall be removed in the month following the month 257.31 that the participant returns to compliance or in the month 257.32 following the minimum one-month sanction, whichever is later. 257.33 (2) For a second or subsequent occurrence of noncompliance, 257.34 or when both participants in a two-parent household are out of 257.35 compliance at the same time, theparticipant's rentfamily's 257.36 shelter costs shall be vendor paid up to the amount of the cash 258.1 portion of the MFIP-S grant for which the participant's 258.2 assistance unit is eligible. At county option, 258.3 theparticipant'sfamily's utilities may also be vendor paid up 258.4 to the amount of the cash portion of the MFIP-S grant remaining 258.5 after vendor payment of theparticipant's rentfamily's shelter 258.6 costs.The vendor payment of rent and, if in effect, utilities,258.7must be in effect for six months from the date that a sanction258.8is imposed under this clause.The residual amount of the grant 258.9 after vendor payment, if any, must be reduced by an amount equal 258.10 to 30 percent of theapplicableMFIP-S transitional standard, or 258.11 the interstate transitional standard for an assistance unit of 258.12 the same size, whichever is applicable, before the residual is 258.13 paid to theparticipantfamily. The reduction in the grant 258.14 amount must be in effect for a minimum of one month and shall be 258.15 removed in the month following the month thatthea participant 258.16 in a one-parent household returns to compliance or in the month 258.17 following the minimum one-month sanction, whichever is later. 258.18 In a two-parent household, the grant reduction shall be removed 258.19 in the month following the month both participants return to 258.20 compliance or in the month following the minimum one-month 258.21 sanction, whichever is later. The vendor payment of 258.22rentshelter costs and, if applicable, utilities shall be 258.23 removed six months after the month in which the 258.24 participantreturnsor participants return to compliance. 258.25 (c) No later than during the second month that a sanction 258.26 under paragraph (b), clause (2), is in effect due to 258.27 noncompliance with employment services, the participant's case 258.28 file must be reviewed to determine if: 258.29 (i) the continued noncompliance can be explained and 258.30 mitigated by providing a needed preemployment activity, as 258.31 defined in section 256J.49, subdivision 13, clause (16); 258.32 (ii) the participant qualifies for a good cause exception 258.33 under section 256J.57; or 258.34 (iii) the participant qualifies for an exemption under 258.35 section 256J.56. 258.36 If the lack of an identified activity can explain the 259.1 noncompliance, the county must work with the participant to 259.2 provide the identified activity, and the county must restore the 259.3 participant's grant amount to the full amount for which the 259.4 assistance unit is eligible. The grant must be restored 259.5 retroactively to the first day of the month in which the 259.6 participant was found to lack preemployment activities or to 259.7 qualify for an exemption or good cause exception. 259.8 If the participant is found to qualify for a good cause 259.9 exception or an exemption, the county must restore the 259.10 participant's grant to the full amount for which the assistance 259.11 unit is eligible.If the participant's grant is restored under259.12this paragraph, the vendor payment of rent and if applicable,259.13utilities, shall be removed six months after the month in which259.14the sanction was imposed and the county must consider a259.15subsequent occurrence of noncompliance to be a first occurrence.259.16 Sec. 75. Minnesota Statutes 1997 Supplement, section 259.17 256J.46, subdivision 2, is amended to read: 259.18 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 259.19 REQUIREMENTS.] The grant of an MFIP-S caregiver who refuses to 259.20 cooperate, as determined by the child support enforcement 259.21 agency, with support requirements under section 256.741, if 259.22 enacted, shall be subject to sanction as specified in this 259.23 subdivision. The assistance unit's grant must be reduced by 25 259.24 percent of the applicable transitional standard. The residual 259.25 amount of the grant, if any, must be paid to the caregiver. A 259.26 sanction under this subdivision becomes effective ten days after 259.27 the required notice is given. The sanction must be in effect 259.28 for a minimum of one month and shall be removed only when the 259.29 caregiver cooperates with the support requirements or in the 259.30 month following the minimum one-month sanction, whichever is 259.31 later. Each month that an MFIP-S caregiver fails to comply with 259.32 the requirements of section 256.741 must be considered a 259.33 separate occurrence of noncompliance. An MFIP-S caregiver who 259.34 has had one or more sanctions imposed must remain in compliance 259.35 with the requirements of section 256.741 for six months in order 259.36 for a subsequent sanction to be considered a first occurrence. 260.1 Sec. 76. Minnesota Statutes 1997 Supplement, section 260.2 256J.47, subdivision 4, is amended to read: 260.3 Subd. 4. [INELIGIBILITY FOR MFIP-S; EMERGENCY ASSISTANCE; 260.4 AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of diversionary 260.5 assistance, the family is ineligible for MFIP-S, emergency 260.6 assistance, and emergency general assistance for a period of 260.7 time. To determine the period of ineligibility, the county 260.8 shall use the following formula: regardless of household 260.9 changes, the county agency must calculate the number of days of 260.10 ineligibility by dividing the diversionary assistance issued by 260.11 the transitional standard a family of the same size and 260.12 composition would have received under MFIP-S, or if applicable 260.13 the interstate transitional standard, multiplied by 30, 260.14 truncating the result. The ineligibility period begins the date 260.15 the diversionary assistance is issued. 260.16 Sec. 77. Minnesota Statutes 1997 Supplement, section 260.17 256J.48, subdivision 2, is amended to read: 260.18 Subd. 2. [ELIGIBILITY.] Notwithstanding other eligibility 260.19 provisions of this chapter, any family without resources 260.20 immediately available to meet emergency needs identified in 260.21 subdivision 3 shall be eligible for an emergency grant under the 260.22 following conditions: 260.23 (1) a family member has resided in this state for at least 260.24 30 days; 260.25 (2) the family is without resources immediately available 260.26 to meet emergency needs; 260.27 (3) assistance is necessary to avoid destitution or provide 260.28 emergency shelter arrangements;and260.29 (4) the family's destitution or need for shelter or 260.30 utilities did not arise because the child or relative caregiver 260.31 refused without good cause under section 256J.57 to accept 260.32 employment or training for employment in this state or another 260.33 state; and 260.34 (5) at least one child or pregnant woman in the emergency 260.35 assistance unit meets MFIP-S citizenship requirements in section 260.36 256J.11. 261.1 Sec. 78. Minnesota Statutes 1997 Supplement, section 261.2 256J.48, is amended by adding a subdivision to read: 261.3 Subd. 2a. [MIGRANT WORKER ELIGIBILITY.] Notwithstanding 261.4 other eligibility provisions of this chapter, migrant workers, 261.5 as defined in section 256J.08, and their immediate families, who 261.6 meet the eligibility requirements in subdivision 2, except the 261.7 30-day residency requirement, are eligible for emergency 261.8 assistance, if the migrant worker provides verification to the 261.9 county agency that the migrant worker worked in this state 261.10 within the last 12 months and earned at least $1,000 in gross 261.11 wages during the time the migrant worker worked in this state. 261.12 Sec. 79. Minnesota Statutes 1997 Supplement, section 261.13 256J.48, subdivision 3, is amended to read: 261.14 Subd. 3. [EMERGENCY NEEDS.] Emergency needs are limited to 261.15 the following: 261.16 (a) [RENT.] A county agency may deny assistance to prevent 261.17 eviction from rented or leased shelter of an otherwise eligible 261.18 applicant when the county agency determines that an applicant's 261.19 anticipated income will not cover continued payment for shelter, 261.20 subject to conditions in clauses (1) to (3): 261.21 (1) a county agency must not deny assistance when an 261.22 applicant can document that the applicant is unable to locate 261.23 habitable shelter, unless the county agency can document that 261.24 one or more habitable shelters are available in the community 261.25 that will result in at least a 20 percent reduction in monthly 261.26 expense for shelter and that this shelter will be cost-effective 261.27 for the applicant; 261.28 (2) when no alternative shelter can be identified by either 261.29 the applicant or the county agency, the county agency shall not 261.30 deny assistance because anticipated income will not cover rental 261.31 obligation; and 261.32 (3) when cost-effective alternative shelter is identified, 261.33 the county agency shall issue assistance for moving expenses as 261.34 provided in paragraph(d)(e). 261.35 (b) [DEFINITIONS.] For purposes of paragraph (a), the 261.36 following definitions apply (1) "metropolitan statistical area" 262.1 is as defined by the United States Census Bureau; (2) 262.2 "alternative shelter" includes any shelter that is located 262.3 within the metropolitan statistical area containing the county 262.4 and for which the applicant is eligible, provided the applicant 262.5 does not have to travel more than 20 miles to reach the shelter 262.6 and has access to transportation to the shelter. Clause (2) 262.7 does not apply to counties in the Minneapolis-St. Paul 262.8 metropolitan statistical area. 262.9 (c) [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 262.10 agency shall issue assistance for mortgage or contract for deed 262.11 arrearages on behalf of an otherwise eligible applicant 262.12 according to clauses (1) to (4): 262.13 (1) assistance for arrearages must be issued only when a 262.14 home is owned, occupied, and maintained by the applicant; 262.15 (2) assistance for arrearages must be issued only when no 262.16 subsequent foreclosure action is expected within the 12 months 262.17 following the issuance; 262.18 (3) assistance for arrearages must be issued only when an 262.19 applicant has been refused refinancing through a bank or other 262.20 lending institution and the amount payable, when combined with 262.21 any payments made by the applicant, will be accepted by the 262.22 creditor as full payment of the arrearage; 262.23 (4) costs paid by a family which are counted toward the 262.24 payment requirements in this clause are: principle and interest 262.25 payments on mortgages or contracts for deed, balloon payments, 262.26 homeowner's insurance payments, manufactured home lot rental 262.27 payments, and tax or special assessment payments related to the 262.28 homestead. Costs which are not counted include closing costs 262.29 related to the sale or purchase of real property. 262.30 To be eligible for assistance for costs specified in clause 262.31 (4) which are outstanding at the time of foreclosure, an 262.32 applicant must have paid at least 40 percent of the family's 262.33 gross income toward these costs in the month of application and 262.34 the 11-month period immediately preceding the month of 262.35 application. 262.36 When an applicant is eligible under clause (4), a county 263.1 agency shall issue assistance up to a maximum of four times the 263.2 MFIP-S transitional standard for a comparable assistance unit. 263.3 (d) [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 263.4 issue assistance for damage or utility deposits when necessary 263.5 to alleviate the emergency. The county may require that 263.6 assistance paid in the form of a damage depositor a utility263.7deposit, less any amount retained by the landlord to remedy a 263.8 tenant's default in payment of rent or other funds due to the 263.9 landlord under a rental agreement, or to restore the premises to 263.10 the condition at the commencement of the tenancy, ordinary wear 263.11 and tear excepted, be returned to the county when the individual 263.12 vacates the premises or be paid to the recipient's new landlord 263.13 as a vendor payment. The county may require that assistance 263.14 paid in the form of a utility deposit less any amount retained 263.15 to satisfy outstanding utility costs be returned to the county 263.16 when the person vacates the premises, or be paid for the 263.17 person's new housing unit as a vendor payment. The vendor 263.18 payment of returned funds shall not be considered a new use of 263.19 emergency assistance. 263.20 (e) [MOVING EXPENSES.] A county agency shall issue 263.21 assistance for expenses incurred when a family must move to a 263.22 different shelter according to clauses (1) to (4): 263.23 (1) moving expenses include the cost to transport personal 263.24 property belonging to a family, the cost for utility connection, 263.25 and the cost for securing different shelter; 263.26 (2) moving expenses must be paid only when the county 263.27 agency determines that a move is cost-effective; 263.28 (3) moving expenses must be paid at the request of an 263.29 applicant, but only when destitution or threatened destitution 263.30 exists; and 263.31 (4) moving expenses must be paid when a county agency 263.32 denies assistance to prevent an eviction because the county 263.33 agency has determined that an applicant's anticipated income 263.34 will not cover continued shelter obligation in paragraph (a). 263.35 (f) [HOME REPAIRS.] A county agency shall pay for repairs 263.36 to the roof, foundation, wiring, heating system, chimney, and 264.1 water and sewer system of a home that is owned and lived in by 264.2 an applicant. 264.3 The applicant shall document, and the county agency shall 264.4 verify the need for and method of repair. 264.5 The payment must be cost-effective in relation to the 264.6 overall condition of the home and in relation to the cost and 264.7 availability of alternative housing. 264.8 (g) [UTILITY COSTS.] Assistance for utility costs must be 264.9 made when an otherwise eligible family has had a termination or 264.10 is threatened with a termination of municipal water and sewer 264.11 service, electric, gas or heating fuel service, or lacks wood 264.12 when that is the heating source, subject to the conditions in 264.13 clauses (1) and (2): 264.14 (1) a county agency must not issue assistance unless the 264.15 county agency receives confirmation from the utility provider 264.16 that assistance combined with payment by the applicant will 264.17 continue or restore the utility; and 264.18 (2) a county agency shall not issue assistance for utility 264.19 costs unless a family paid at least eight percent of the 264.20 family's gross income toward utility costs due during the 264.21 preceding 12 months. 264.22 Clauses (1) and (2) must not be construed to prevent the 264.23 issuance of assistance when a county agency must take immediate 264.24 and temporary action necessary to protect the life or health of 264.25 a child. 264.26 (h) [SPECIAL DIETS.] Effective January 1, 1998, a county 264.27 shall pay for special diets or dietary items for MFIP-S 264.28 participants. Persons receiving emergency assistance funds for 264.29 special diets or dietary items are also eligible to receive 264.30 emergency assistance for shelter and utility emergencies, if 264.31 otherwise eligible. The need for special diets or dietary items 264.32 must be prescribed by a licensed physician. Costs for special 264.33 diets shall be determined as percentages of the allotment for a 264.34 one-person household under the Thrifty Food Plan as defined by 264.35 the United States Department of Agriculture. The types of diets 264.36 and the percentages of the Thrifty Food Plan that are covered 265.1 are as follows: 265.2 (1) high protein diet, at least 80 grams daily, 25 percent 265.3 of Thrifty Food Plan; 265.4 (2) controlled protein diet, 40 to 60 grams and requires 265.5 special products, 100 percent of Thrifty Food Plan; 265.6 (3) controlled protein diet, less than 40 grams and 265.7 requires special products, 125 percent of Thrifty Food Plan; 265.8 (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 265.9 (5) high residue diet, 20 percent of Thrifty Food Plan; 265.10 (6) pregnancy and lactation diet, 35 percent of Thrifty 265.11 Food Plan; 265.12 (7) gluten-free diet, 25 percent of Thrifty Food Plan; 265.13 (8) lactose-free diet, 25 percent of Thrifty Food Plan; 265.14 (9) antidumping diet, 15 percent of Thrifty Food Plan; 265.15 (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 265.16 (11) ketogenic diet, 25 percent of Thrifty Food Plan. 265.17 Sec. 80. Minnesota Statutes 1997 Supplement, section 265.18 256J.49, subdivision 4, is amended to read: 265.19 Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 265.20 "Employment and training service provider" means: 265.21 (1) a public, private, or nonprofit employment and training 265.22 agency certified by the commissioner of economic security under 265.23 sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 265.24 is approved under section 256J.51 and is included in the county 265.25 plan submitted under section 256J.50, subdivision 7;or265.26 (2) a public, private, or nonprofit agency that is not 265.27 certified by the commissioner under clause (1), but with which a 265.28 county has contracted to provide employment and training 265.29 services and which is included in the county's plan submitted 265.30 under section 256J.50, subdivision 7; or 265.31 (3) a county agency, if the countyis certified under265.32clause (1)has opted to provide employment and training services 265.33 and the county has indicated that fact in the plan submitted 265.34 under section 256J.50, subdivision 7. 265.35 Notwithstanding section 268.871, an employment and training 265.36 services provider meeting this definition may deliver employment 266.1 and training services under this chapter. 266.2 Sec. 81. Minnesota Statutes 1997 Supplement, section 266.3 256J.50, subdivision 5, is amended to read: 266.4 Subd. 5. [PARTICIPATION REQUIREMENTS FOR SINGLE-PARENT AND 266.5 TWO-PARENT CASES.] (a) A county must establish a uniform 266.6 schedule for requiring participation by single parents. 266.7 Mandatory participation must be required within six months of 266.8 eligibility for cash assistance. For two-parent cases, 266.9 participation is required concurrent with the receipt of MFIP-S 266.10 cash assistance. 266.11 (b) Beginning January 1, 1998, with the exception of 266.12 caregivers required to attend high school under the provisions 266.13 of section 256J.54, subdivision 5, MFIP caregivers, upon 266.14 completion of the secondary assessment, must develop an 266.15 employment plan and participate in work activities. 266.16 (c) In single-parent families with no children under six 266.17 years of age, the job counselor and the caregiver must develop 266.18 an employment plan that includes 20 to 35 hours per week of work 266.19 activities for the period January 1, 1998, to September 30, 266.20 1998; 25 to 35 hours of work activities per week in federal 266.21 fiscal year 1999; and 30 to 35 hours per week of work activities 266.22 in federal fiscal year 2000 and thereafter. 266.23 (d) In single-parent families with a child under six years 266.24 of age, the job counselor and the caregiver must develop an 266.25 employment plan that includes 20 to 35 hours per week of work 266.26 activities. 266.27 (e) In two-parent families, the job counselor and the 266.28 caregivers must develop employment plans that include at least 266.29 35 hours per week of work activities for the first parent and 20 266.30 hours per week of work activities for the second parent. 266.31 (f) Notwithstanding paragraphs (c) to (e), an MFIP 266.32 caregiver who is meeting the hourly work participation 266.33 requirements under the Personal Responsibility and Work 266.34 Opportunity Reconciliation Act of 1996 through employment and is 266.35 enrolled in training or education that meets the requirements of 266.36 section 256J.53, subdivision 2, concurrent with employment, 267.1 cannot be required to work additional hours under this section. 267.2 Sec. 82. Minnesota Statutes 1997 Supplement, section 267.3 256J.50, is amended by adding a subdivision to read: 267.4 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OF DOMESTIC 267.5 VIOLENCE.] County agencies and their contractors must provide 267.6 universal notification to all applicants and recipients of 267.7 MFIP-S that: 267.8 (1) referrals to counseling and supportive services are 267.9 available for victims of domestic violence; 267.10 (2) nonpermanent resident battered individuals married to 267.11 United States citizens or permanent residents may be eligible to 267.12 petition for permanent residency under the Violence Against 267.13 Women Act, and that referrals to appropriate legal services are 267.14 available; 267.15 (3) victims of domestic violence are exempt from the 267.16 60-month limit on assistance while the individual is complying 267.17 with an approved safety plan, as defined in section 256J.49, 267.18 subdivision 11; and 267.19 (4) victims of domestic violence may choose to be exempt or 267.20 deferred from work requirements for up to 12 months while the 267.21 individual is complying with an approved safety plan as defined 267.22 in section 256J.49, subdivision 11. 267.23 Notification must be in writing and orally at the time of 267.24 application and recertification, when the individual is referred 267.25 to the title IV-D child support agency, and at the beginning of 267.26 any job training or work placement assistance program. 267.27 Sec. 83. Minnesota Statutes 1997 Supplement, section 267.28 256J.52, subdivision 4, is amended to read: 267.29 Subd. 4. [SECONDARY ASSESSMENT.] (a) The job counselor 267.30 must conduct a secondary assessment for those participants who: 267.31 (1) in the judgment of the job counselor, have barriers to 267.32 obtaining employment that will not be overcome with a job search 267.33 support plan under subdivision 3; 267.34 (2) have completed eight weeks of job search under 267.35 subdivision 3 without obtaining suitable employment;or267.36 (3) have not received a secondary assessment, are working 268.1 at least 20 hours per week, and the participant, job counselor, 268.2 or county agency requests a secondary assessment; or 268.3 (4) have an existing plan or are already involved in 268.4 training or education activities under section 256J.55, 268.5 subdivision 5. 268.6 (b) In the secondary assessment the job counselor must 268.7 evaluate the participant's skills and prior work experience, 268.8 family circumstances, interests and abilities, need for 268.9 preemployment activities, supportive or educational services, 268.10 and the extent of any barriers to employment. The job counselor 268.11 must use the information gathered through the secondary 268.12 assessment to develop an employment plan under subdivision 5. 268.13 (c) The provider shall make available to participants 268.14 information regarding additional vendors or resources which 268.15 provide employment and training services that may be available 268.16 to the participant under a plan developed under this section. 268.17 The information must include a brief summary of services 268.18 provided and related performance indicators. Performance 268.19 indicators must include, but are not limited to, the average 268.20 time to complete program offerings, placement rates, entry and 268.21 average wages, and retention rates. To be included in the 268.22 information given to participants, a vendor or resource must 268.23 provide counties with relevant information in the format 268.24 required by the county. 268.25 Sec. 84. Minnesota Statutes 1997 Supplement, section 268.26 256J.54, subdivision 2, is amended to read: 268.27 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 268.28 PLAN.] For caregivers who are under age 18 without a high school 268.29 diploma or its equivalent, the assessment under subdivision 1 268.30 and the employment plan under subdivision 3 must be completed by 268.31 the social services agency under section 257.33. For caregivers 268.32 who are age 18 or 19 without a high school diploma or its 268.33 equivalent, the assessment under subdivision 1 and the 268.34 employment plan under subdivision 3 must be completed by the job 268.35 counselor. The social services agency or the job counselor 268.36 shall consult with representatives of educational agencies that 269.1 are required to assist in developing educational plans under 269.2 section 126.235. 269.3 Sec. 85. Minnesota Statutes 1997 Supplement, section 269.4 256J.54, subdivision 3, is amended to read: 269.5 Subd. 3. [EDUCATIONAL OPTION DEVELOPED.] If the job 269.6 counselor or county social services agency identifies an 269.7 appropriate educational option for a caregiver under the age of 269.8 20 without a high school diploma or its equivalent,itthe job 269.9 counselor or agency must develop an employment plan which 269.10 reflects the identified option. The plan must specify that 269.11 participation in an educational activity is required, what 269.12 school or educational program is most appropriate, the services 269.13 that will be provided, the activities the caregiver will take 269.14 part in, including child care and supportive services, the 269.15 consequences to the caregiver for failing to participate or 269.16 comply with the specified requirements, and the right to appeal 269.17 any adverse action. The employment plan must, to the extent 269.18 possible, reflect the preferences of the caregiver. 269.19 Sec. 86. Minnesota Statutes 1997 Supplement, section 269.20 256J.54, subdivision 4, is amended to read: 269.21 Subd. 4. [NO APPROPRIATE EDUCATIONAL OPTION.] If the job 269.22 counselor determines that there is no appropriate educational 269.23 option for a caregiver who is age 18 or 19 without a high school 269.24 diploma or its equivalent, the job counselor must develop an 269.25 employment plan, as defined in section 256J.49, subdivision 5, 269.26 for the caregiver. If the county social services agency 269.27 determines that school attendance is not appropriate for a 269.28 caregiver under age 18 without a high school diploma or its 269.29 equivalent, the county agency shall refer the caregiver to 269.30 social services for services as provided in section 257.33. 269.31 Sec. 87. Minnesota Statutes 1997 Supplement, section 269.32 256J.54, subdivision 5, is amended to read: 269.33 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 269.34 the provisions of section 256J.56, minor parents, or 18- or 269.35 19-year-old parents without a high school diploma or its 269.36 equivalent must attend school unless: 270.1 (1) transportation services needed to enable the caregiver 270.2 to attend school are not available; 270.3 (2) appropriate child care services needed to enable the 270.4 caregiver to attend school are not available; 270.5 (3) the caregiver is ill or incapacitated seriously enough 270.6 to prevent attendance at school; or 270.7 (4) the caregiver is needed in the home because of the 270.8 illness or incapacity of another member of the household. This 270.9 includes a caregiver of a child who is younger than six weeks of 270.10 age. 270.11 (b) The caregiver must be enrolled in a secondary school 270.12 and meeting the school's attendance requirements. The county, 270.13 social service agency, or job counselor must verify that the 270.14 caregiver is meeting the school's attendance requirements at 270.15 least once per quarter. An enrolled caregiver is considered to 270.16 be meeting the attendance requirements when the school is not in 270.17 regular session, including during holiday and summer breaks. 270.18 Sec. 88. Minnesota Statutes 1997 Supplement, section 270.19 256J.55, subdivision 5, is amended to read: 270.20 Subd. 5. [OPTION TO UTILIZE EXISTING PLAN.] With job 270.21 counselor approval, if a participant is already complying with a 270.22 job search support or employment plan that was developed for a 270.23 different program or is already involved in education or 270.24 training activities, the participant may utilize that plan and 270.25 that program's services, subject to the requirements of 270.26 subdivision 3, to be in compliance with sections 256J.52 to 270.27 256J.57 so long as the plan meets, or is modified to meet, the 270.28 requirements of those sections. 270.29 Sec. 89. Minnesota Statutes 1997 Supplement, section 270.30 256J.56, is amended to read: 270.31 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 270.32 EXEMPTIONS.] 270.33 An MFIP-S caregiver is exempt from the requirements of 270.34 sections 256J.52 to 256J.55 if the caregiver belongs to any of 270.35 the following groups: 270.36 (1) individuals who are age 60 or older; 271.1 (2) individuals who are suffering from a professionally 271.2 certified permanent or temporary illness, injury, or incapacity 271.3 which is expected to continue for more than 30 days and which 271.4 prevents the person from obtaining or retaining employment. 271.5 Persons in this category with a temporary illness, injury, or 271.6 incapacity must be reevaluated at least quarterly; 271.7 (3) caregivers whose presence in the home is required 271.8 because of the professionally certified illness or incapacity of 271.9 another member in the assistance unit, a relative in the 271.10 household, or a foster child in the household; 271.11 (4) women who are pregnant, if the pregnancy has resulted 271.12 in a professionally certified incapacity that prevents the woman 271.13 from obtaining or retaining employment; 271.14 (5) caregivers of a child under the age of one year who 271.15 personally provide full-time care for the child. This exemption 271.16 may be used for only 12 months in a lifetime. In two-parent 271.17 households, only one parent or other relative may qualify for 271.18 this exemption; 271.19 (6) individuals in single-parent families employed at least 271.2040 hours per week or at least 30 hours per week and engaged in271.21job search for at least an additional ten35 hours per week; 271.22 (7) individuals experiencing a personal or family crisis 271.23 that makes them incapable of participating in the program, as 271.24 determined by the county agency. If the participant does not 271.25 agree with the county agency's determination, the participant 271.26 may seek professional certification, as defined in section 271.27 256J.08, that the participant is incapable of participating in 271.28 the program. 271.29 Persons in this exemption category must be reevaluated 271.30 every 60 days; or 271.31 (8) second parents in two-parent families, provided the 271.32 second parent is employed for 20 or more hours per week. 271.33 A caregiver who is exempt under clause (5) must enroll in 271.34 and attend an early childhood and family education class, a 271.35 parenting class, or some similar activity, if available, during 271.36 the period of time the caregiver is exempt under this section. 272.1 Notwithstanding section 256J.46, failure to attend the required 272.2 activity shall not result in the imposition of a sanction. 272.3 Sec. 90. Minnesota Statutes 1997 Supplement, section 272.4 256J.57, subdivision 1, is amended to read: 272.5 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 272.6 county agency shall not impose the sanction under section 272.7 256J.46 if it determines that the participant has good cause for 272.8 failing to comply with the requirements ofsection 256J.45 or272.9 sections 256J.52 to 256J.55. Good cause exists when: 272.10 (1) appropriate child care is not available; 272.11 (2) the job does not meet the definition of suitable 272.12 employment; 272.13 (3) the participant is ill or injured; 272.14 (4) afamilymember of the assistance unit, a relative in 272.15 the household, or a foster child in the household is ill and 272.16 needs care by the participant that prevents the participant from 272.17 complying with the job search support plan or employment plan; 272.18 (5) the parental caregiver is unable to secure necessary 272.19 transportation; 272.20 (6) the parental caregiver is in an emergency situation 272.21 that prevents compliance with the job search support plan or 272.22 employment plan; 272.23 (7) the schedule of compliance with the job search support 272.24 plan or employment plan conflicts with judicial proceedings; 272.25 (8) the parental caregiver is already participating in 272.26 acceptable work activities; 272.27 (9) the employment plan requires an educational program for 272.28 a caregiver under age 20, but the educational program is not 272.29 available; 272.30 (10) activities identified in the job search support plan 272.31 or employment plan are not available; 272.32 (11) the parental caregiver is willing to accept suitable 272.33 employment, but suitable employment is not available; or 272.34 (12) the parental caregiver documents other verifiable 272.35 impediments to compliance with the job search support plan or 272.36 employment plan beyond the parental caregiver's control. 273.1 Sec. 91. Minnesota Statutes 1997 Supplement, section 273.2 256J.74, subdivision 2, is amended to read: 273.3 Subd. 2. [CONCURRENT ELIGIBILITY, LIMITATIONS.] A county 273.4 agency must not count an applicant or participant as a member of 273.5 more than one assistance unit in a given payment month, except 273.6 as provided in clauses (1) and (2). 273.7 (1) A participant who is a member of an assistance unit in 273.8 this state is eligible to be included in a second assistance 273.9 unitinthe first full monththatafter the month the 273.10 participantleaves the first assistance unit and lives with273.11ajoins the secondassistanceunit. 273.12 (2) An applicant whose needs are met through foster care 273.13 that is reimbursed under title IV-E of the Social Security Act 273.14 for the first part of an application month is eligible to 273.15 receive assistance for the remaining part of the month in which 273.16 the applicant returns home. Title IV-E payments and adoption 273.17 assistance payments must be considered prorated payments rather 273.18 than a duplication of MFIP-S need. 273.19 Sec. 92. Minnesota Statutes 1997 Supplement, section 273.20 256J.75, is amended by adding a subdivision to read: 273.21 Subd. 5. [FOOD STAMPS.] For any month an individual 273.22 receives Food Stamp Program benefits, the individual is not 273.23 eligible for the MFIP-S food portion of assistance, except under 273.24 section 256J.28, subdivision 5. 273.25 Sec. 93. [256J.77] [AGING OF CASH BENEFITS.] 273.26 Cash benefits under chapters 256D, 256J, and 256K by 273.27 warrants or electronic benefit transfer that have not been 273.28 accessed within 90 days of issuance shall be canceled. Cash 273.29 benefits may be replaced after they are canceled, for up to one 273.30 year after the date of issuance, if failure to do so would place 273.31 the client or family at risk. For purposes of this section, 273.32 "accessed" means cashing a warrant or making at least one 273.33 withdrawal from benefits deposited in an electronic benefit 273.34 account. 273.35 Sec. 94. Minnesota Statutes 1997 Supplement, section 273.36 256K.03, subdivision 5, is amended to read: 274.1 Subd. 5. [EXEMPTION CATEGORIES.] (a) The applicant will be 274.2 exempt from the job search requirements and development of a job 274.3 search plan and an employability development plan under 274.4 subdivisions 3, 4, and 8 if the applicant belongs to any of the 274.5 following groups: 274.6 (1)caregivers under age 20 who have not completed a high274.7school education and are attending high school on a full-time274.8basis;274.9(2)individuals who are age 60 or older; 274.10(3)(2) individuals who are suffering from a professionally 274.11 certified permanent or temporary illness, injury, or incapacity 274.12 which is expected to continue for more than 30 days and which 274.13 prevents the person from obtaining or retaining employment. 274.14 Persons in this category with a temporary illness, injury, or 274.15 incapacity must be reevaluated at least quarterly; 274.16(4)(3) caregivers whose presence in the home is needed 274.17 because of the professionally certified illness or incapacity of 274.18 another member in the assistance unit, a relative in the 274.19 household, or a foster child in the household; 274.20(5)(4) women who are pregnant, ifitthe pregnancy has 274.21been medically verifiedresulted in a professionally certified 274.22 incapacity thatthe child is expected to be born within the next274.23six monthsprevents the woman from obtaining and retaining 274.24 employment; 274.25(6)(5) caregiversor other caregiver relativesof a child 274.26 under the age ofthreeone year who personally provide full-time 274.27 care for the child. This exemption may be used for only 12 274.28 months in a lifetime. In two-parent households, only one parent 274.29 or other relative may qualify for this exemption; 274.30(7)(6) individuals in single-parent families employed at 274.31 least3035 hours per week; 274.32(8) individuals for whom participation would require a274.33round trip commuting time by available transportation of more274.34than two hours, excluding transporting of children for child274.35care;274.36(9) individuals for whom lack of proficiency in English is275.1a barrier to employment, provided such individuals are275.2participating in an intensive program which lasts no longer than275.3six months and is designed to remedy their language deficiency;275.4(10) individuals who, because of advanced age or lack of275.5ability, are incapable of gaining proficiency in English, as275.6determined by the county social worker, shall continue to be275.7exempt under this subdivision and are not subject to the275.8requirement that they be participating in a language program;275.9(11)(7) individualsunder such duress that they are275.10incapable of participating in the program, as determined by the275.11county social workerexperiencing a personal or family crisis 275.12 that makes them incapable of participating in the program, as 275.13 determined by the county agency. If the participant does not 275.14 agree with the county agency's determination, the participant 275.15 may seek professional certification, as defined in section 275.16 256J.08, that the participant is incapable of participating in 275.17 the program. Persons in this exemption category must be 275.18 reevaluated every 60 days; or 275.19(12) individuals in need of refresher courses for purposes275.20of obtaining professional certification or licensure.275.21(b) In a two-parent family, only one caregiver may be275.22exempted under paragraph (a), clauses (4) and (6).275.23 (8) second parents in two-parent families, provided the 275.24 second parent is employed for 20 or more hours per week. 275.25 (b) A caregiver who is exempt under clause (5) must enroll 275.26 in and attend an early childhood and family education class, a 275.27 parenting class, or some similar activity, if available, during 275.28 the period of time the caregiver is exempt under this section. 275.29 Notwithstanding section 256J.46, failure to attend the required 275.30 activity shall not result in the imposition of a sanction. 275.31 Sec. 95. Laws 1997, chapter 203, article 9, section 21, is 275.32 amended to read: 275.33 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMSUNSPENT 275.34 STATE MONEY.] 275.35(a) Beginning July 1, 1999, the following persons will be275.36ineligible for general assistance and general assistance medical276.1care under Minnesota Statutes, chapter 256D, group residential276.2housing under Minnesota Statutes, chapter 256I, and MFIP-S276.3assistance under Minnesota Statutes, chapter 256J, funded with276.4state money:276.5(1) persons who are terminated from or denied Supplemental276.6Security Income due to the 1996 changes in the federal law276.7making persons whose alcohol or drug addiction is a material276.8factor contributing to the person's disability ineligible for276.9Supplemental Security Income, and are eligible for general276.10assistance under Minnesota Statutes, section 256D.05,276.11subdivision 1, paragraph (a), clause (17), general assistance276.12medical care under Minnesota Statutes, chapter 256D, or group276.13residential housing under Minnesota Statutes, chapter 256I;276.14(2) legal noncitizens who are ineligible for Supplemental276.15Security Income due to the 1996 changes in federal law making276.16certain noncitizens ineligible for these programs due to their276.17noncitizen status; and276.18(3) legal noncitizens who are eligible for MFIP-S276.19assistance, either the cash assistance portion or the food276.20assistance portion, funded entirely with state money.276.21(b)State money that remains unspenton June 30, 1999, due 276.22 to changes in federal law enacted after May 12, 1997, that 276.23 reduce state spending for legal noncitizens or for persons whose 276.24 alcohol or drug addiction is a material factor contributing to 276.25 the person's disability, or enacted after February 1, 1998, that 276.26 reduce state spending for food benefits for legal noncitizens 276.27 shall not cancel and shall be deposited in the TANF reserve 276.28 account. 276.29 Sec. 96. Laws 1997, chapter 248, section 46, as amended by 276.30 Laws 1997, First Special Session chapter 5, section 10, is 276.31 amended to read: 276.32 Sec. 46. [UNLICENSED CHILD CARE PROVIDERS; INTERIM 276.33 EXPANSION.] 276.34 (a) Notwithstanding Minnesota Statutes, section 245A.03, 276.35 subdivision 2, clause (2), until June 30, 1999, nonresidential 276.36 child care programs or services that are provided by an 277.1 unrelated individual to persons from two or three other 277.2 unrelated families are excluded from the licensure provisions of 277.3 Minnesota Statutes, chapter 245A, provided that: 277.4 (1) the individual provides services at any one time to no 277.5 more than four children who are unrelated to the individual; 277.6 (2) no more than two of the children are under two years of 277.7 age; and 277.8 (3) the total number of children being cared for at any one 277.9 time does not exceed five. 277.10 (b) Paragraph (a), clauses (1) to (3), do not apply to: 277.11 (1) nonresidential programs that are provided by an 277.12 unrelated individual to persons from a single related family.; 277.13 (2) a child care provider whose child care services meet 277.14 the criteria in paragraph (a), clauses (1) to (3), but who 277.15 chooses to apply for licensure; 277.16 (3) a child care provider who, as an applicant for 277.17 licensure or as a license holder, has received a license denial 277.18 under Minnesota Statutes, section 245A.05, a fine under 277.19 Minnesota Statutes, section 245A.06, or a sanction under 277.20 Minnesota Statutes, section 245A.07 from the commissioner that 277.21 has not been reversed on appeal; or 277.22 (4) a child care provider, or a child care provider who has 277.23 a household member who, as a result of a licensing process, has 277.24 a disqualification under Minnesota Statutes, chapter 245A, that 277.25 has not been set aside by the commissioner. 277.26 Sec. 97. [REPEALER.] 277.27 (a) Minnesota Statutes 1997 Supplement, section 256J.28, 277.28 subdivision 4, is repealed effective January 1, 1998. 277.29 (b) Minnesota Statutes 1997 Supplement, sections 256J.25; 277.30 and 256J.76; Laws 1997, chapter 85, article 1, sections 61 and 277.31 71, and article 3, section 55, are repealed. 277.32 (c) Minnesota Statutes 1996, sections 256.031, subdivisions 277.33 1, 2, 3, and 4; 256.032; 256.033, subdivisions 2, 3, 4, 5, and 277.34 6; 256.034; 256.035; 256.036; 256.0361; 256.047; 256.0475; 277.35 256.048; and 256.049; and Minnesota Statutes 1997 Supplement, 277.36 sections 256.031, subdivisions 5 and 6; 256.033, subdivisions 1 278.1 and 1a; 256B.062; 256J.32, subdivision 5; and 256J.34, 278.2 subdivision 5, are repealed effective July 1, 1998. 278.3 (d) Minnesota Rules (Exempt), parts 9500.9100; 9500.9110; 278.4 9500.9120; 9500.9130; 9500.9140; 9500.9150; 9500.9160; 278.5 9500.9170; 9500.9180; 9500.9190; 9500.9200; 9500.9210; and 278.6 9500.9220, are repealed effective July 1, 1998. 278.7 Sec. 98. [EFFECTIVE DATE.] 278.8 Sections 2 and 96 are effective the day following final 278.9 enactment. 278.10 ARTICLE 7 278.11 REGIONAL TREATMENT CENTERS 278.12 Section 1. [CONVEYANCE OF STATE LAND; ANOKA COUNTY.] 278.13 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 278.14 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 278.15 subdivision 3, or any other law to the contrary, the 278.16 commissioner of administration may convey all, or any part of, 278.17 the land and associated buildings described in subdivision 3 to 278.18 Anoka county after the commissioner of human services declares 278.19 said property surplus to its needs. 278.20 Subd. 2. [FORM.] (a) The conveyance shall be in a form 278.21 approved by the attorney general. 278.22 (b) The conveyance is subject to a scenic easement, as 278.23 defined in Minnesota Statutes, section 103F.311, subdivision 6, 278.24 to be under the custodial control of the commissioner of natural 278.25 resources, on that portion of the conveyed land that is 278.26 designated for inclusion in the wild and scenic river system 278.27 under Minnesota Statutes, section 103F.325. The scenic easement 278.28 shall allow for continued use of the structures located within 278.29 the easement and for development of a walking path within the 278.30 easement. 278.31 (c) The conveyance shall restrict use of the land to 278.32 governmental, including recreational, purposes and shall provide 278.33 that ownership of any portion of the land that ceases to be used 278.34 for such purposes shall revert to the state of Minnesota. 278.35 (d) The commissioner of administration may convey any part 278.36 of the property described in subdivision 3 any time after the 279.1 land is declared surplus by the commissioner of human services 279.2 and the execution and recording of the scenic easement under 279.3 paragraph (b) has been completed. 279.4 (e) Notwithstanding any law, regulation, or ordinance to 279.5 the contrary, the instrument of conveyance to Anoka county may 279.6 be recorded in the office of the Anoka county recorder without 279.7 compliance with any subdivision requirement. 279.8 Subd. 3. [LAND DESCRIPTION.] Subject to right-of-way for 279.9 Grant Street, Northview Lane, Garfield Street, 5th Avenue, and 279.10 state trunk highway No. 288, also known as 4th Avenue, the land 279.11 to be conveyed may include all, or part of, that which is 279.12 described as follows: 279.13 (1) all that part of Government Lots 3 and 4 and that part 279.14 of the Southeast Quarter of the Southwest Quarter, all in 279.15 Section 31, Township 32 North, Range 24 West, Anoka county, 279.16 Minnesota, described as follows: 279.17 Beginning at the southwest corner of said Southeast Quarter 279.18 of the Southwest Quarter of Section 31; thence North 13 279.19 degrees 16 minutes 11 seconds East, assumed bearing, 473.34 279.20 feet; thence North 07 degrees 54 minutes 43 seconds East 279.21 186.87 feet; thence North 14 degrees 08 minutes 33 seconds 279.22 West 154.77 feet; thence North 62 degrees 46 minutes 44 279.23 seconds West 526.92 feet; thence North 25 degrees 45 279.24 minutes 30 seconds East 74.43 feet; thence northerly 88.30 279.25 feet along a tangential curve concave to the west having a 279.26 radius of 186.15 feet and a central angle of 27 degrees 10 279.27 minutes 50 seconds; thence North 01 degrees 25 minutes 20 279.28 seconds West, tangent to said curve, 140.53 feet; thence 279.29 North 71 degrees 56 minutes 34 seconds West to the 279.30 southeasterly shoreline of the Rum river; thence 279.31 southwesterly along said shoreline to the south line of 279.32 said Government Lot 4; thence easterly along said south 279.33 line to the point of beginning. For the purpose of this 279.34 description the south line of said Southeast Quarter of the 279.35 Southwest Quarter of Section 31 has an assumed bearing of 279.36 North 89 degrees 08 minutes 19 seconds East; 280.1 (2) Government Lot 1, Section 6, Township 31 North, Range 280.2 24 West, Anoka county, Minnesota; EXCEPT that part platted as 280.3 Grant Properties, Anoka county, Minnesota; ALSO EXCEPT that part 280.4 lying southerly of the westerly extension of the south line of 280.5 Block 6, Woodbury's Addition to the city of Anoka, Anoka county, 280.6 Minnesota, and lying westerly of the west line of said plat of 280.7 Grant Properties, said line also being the centerline of 4th 280.8 Avenue; 280.9 (3) all that part of said Block 6, Woodbury's Addition to 280.10 the city of Anoka lying westerly of Northview 1st Addition, 280.11 Anoka county, Minnesota; 280.12 (4) all that part of said Northview 1st Addition lying 280.13 westerly of the east line of Lots 11 through 20, Block 1, 280.14 inclusive, thereof; and 280.15 (5) all that part of the Northeast Quarter of the Northwest 280.16 Quarter of said Section 6, Township 31 North, Range 24 West, 280.17 Anoka county, Minnesota, lying northerly of the centerline of 280.18 Grant Street as defined by said plat of Grant Properties and 280.19 lying westerly of said east line of Lots 11 through 20, Block 1, 280.20 inclusive, Northview 1st Addition and said line's extension 280.21 north and south. 280.22 Subd. 4. [DETERMINATION.] The commissioner of human 280.23 services has determined that the land described in subdivision 3 280.24 will no longer be needed for the Anoka metro regional treatment 280.25 center upon the completion of the state facilities currently 280.26 under construction and the completion of renovation work to 280.27 state buildings that are not located on the land described in 280.28 subdivision 3. The state's land and building management 280.29 interests may best be served by conveying all, or part of, the 280.30 land and associated buildings located on the land described in 280.31 subdivision 3. 280.32 Sec. 2. [CONVEYANCE OF STATE LAND; CROW WING COUNTY.] 280.33 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 280.34 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 280.35 subdivision 3, or any other law to the contrary, the 280.36 commissioner of administration may convey all, or any part of, 281.1 the land and the state building located on the land described in 281.2 subdivision 3, to Crow Wing county after the commissioner of 281.3 human services declares the property surplus to its needs. 281.4 Subd. 2. [FORM.] (a) The conveyance shall be in a form 281.5 approved by the attorney general. 281.6 (b) The conveyance shall restrict use of the land to county 281.7 governmental purposes, including community corrections programs, 281.8 and shall provide that ownership of any portion of the land or 281.9 building that ceases to be used for such purposes shall revert 281.10 to the state of Minnesota. 281.11 Subd. 3. [LAND DESCRIPTION.] That part of the Northeast 281.12 Quarter (NE l/4) of Section 30, Township 45 North, Range 30 281.13 West, Crow Wing county, Minnesota, described as follows: 281.14 Commencing at the southeast corner of said Northeast 281.15 quarter; thence North 00 degrees 46 minutes 05 seconds 281.16 West, bearing based on the Crow Wing county Coordinate 281.17 Database NAD 83/94, 1520.06 feet along the east line of 281.18 said Northeast quarter to the point of beginning; thence 281.19 continue North 00 degrees 46 minutes 05 seconds West 634.14 281.20 feet along said east line of the Northeast quarter; thence 281.21 South 89 degrees 13 minutes 20 seconds West 550.00 feet; 281.22 thence South 18 degrees 57 minutes 23 seconds East 115.59 281.23 feet; thence South 42 degrees 44 minutes 39 seconds East 281.24 692.37 feet; thence South 62 degrees 46 minutes 19 seconds 281.25 East 20.24 feet; thence North 89 degrees 13 minutes 55 281.26 seconds East 33.00 feet to the point of beginning. 281.27 Containing 4.69 acres, more or less. Subject to the 281.28 right-of-way of the Township road along the east side 281.29 thereof, subject to other easements, reservations, and 281.30 restrictions of record, if any. 281.31 Subd. 4. [DETERMINATION.] The commissioner of human 281.32 services has determined that the land, and the building on this 281.33 land, described in subdivision 3 will not be needed for future 281.34 operations of the Brainerd regional human services center.