Skip to main content Skip to office menu Skip to footer
Capital IconMinnesota 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 
 18.14  and was historically funded in part by inpatient patient care 
 18.15  revenues and that occurs in both either an inpatient and or 
 18.16  ambulatory patient care settings training 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 
 20.1   program programs 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 of 
 20.6   eligible Minnesota-based trainees in for 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; and 
 20.23     (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 submit annual cost and program reports a 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  the percentage dollar amount distributed to each training site; 
 21.25  and 
 21.26     (3) the average cost per trainee and a detailed breakdown 
 21.27  of the components of those costs; 
 21.28     (4) other state or federal appropriations received for the 
 21.29  purposes of clinical training; 
 21.30     (5) other revenue received for the purposes of clinical 
 21.31  training; and 
 21.32     (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 serve 
 23.30  without 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 outlet or, 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 received 
 25.31  pursuant to this subdivision shall be deposited in the general 
 25.32  fund 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 commissioner and deposited in 
 25.36  the 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 section 144.701 144.702, subdivision 4 1, but not expended 
 27.21  shall be deposited in the general fund a 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 with that office 
 32.6   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 facility condemned acquired by the Minneapolis 
 37.20  Community Development Agency as part of an economic 
 37.21  redevelopment plan activities in a city of the first class, 
 37.22  provided the new facility is located within one mile three 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  under existing reimbursement rules section 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; or 
 42.24     (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 rule 
 43.14  established Sections 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 equipment shall do 
 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, the 
 46.36  commissioner may exclude from a provision of 12 MCAR S 2.050 any 
 47.1   facility that is licensed by the commissioner of health only as 
 47.2   a boarding care home, certified by the commissioner of health as 
 47.3   an intermediate care facility, is licensed by the commissioner 
 47.4   of human services under Minnesota Rules, parts 9520.0500 to 
 47.5   9520.0690, and has less than five percent of its licensed 
 47.6   boarding care capacity reimbursed by the medical assistance 
 47.7   program.  Until a permanent rule to establish the payment rates 
 47.8   for facilities meeting these criteria is promulgated, the 
 47.9   commissioner shall establish the medical assistance payment rate 
 47.10  as follows:  
 47.11     (1) The desk audited payment rate in effect on June 30, 
 47.12  1983, remains in effect until the end of the facility's fiscal 
 47.13  year.  The commissioner shall not allow any amendments to the 
 47.14  cost report on which this desk audited payment rate is based.  
 47.15     (2) For each fiscal year beginning between July 1, 1983, 
 47.16  and June 30, 1985, the facility's payment rate shall be 
 47.17  established by increasing the desk audited operating cost 
 47.18  payment rate determined in clause (1) at an annual rate of five 
 47.19  percent.  
 47.20     (3) For fiscal years beginning on or after July 1, 1985, 
 47.21  but before January 1, 1988, the facility's payment rate shall be 
 47.22  established by increasing the facility's payment rate in the 
 47.23  facility's prior fiscal year by the increase indicated by the 
 47.24  consumer price index for Minneapolis and St. Paul.  
 47.25     (4) For the fiscal year beginning on January 1, 1988, the 
 47.26  facility's payment rate must be established using the following 
 47.27  method:  The commissioner shall divide the real estate taxes and 
 47.28  special assessments payable as stated in the facility's current 
 47.29  property tax statement by actual resident days to compute a real 
 47.30  estate tax and special assessment per diem.  Next, the prior 
 47.31  year's payment rate must be adjusted by the higher of (1) the 
 47.32  percentage change in the consumer price index (CPI-U U.S. city 
 47.33  average) as published by the Bureau of Labor Statistics between 
 47.34  the previous two Septembers, new series index (1967-100), or (2) 
 47.35  2.5 percent, to determine an adjusted payment rate.  The 
 47.36  facility's payment rate is the adjusted prior year's payment 
 48.1   rate plus the real estate tax and special assessment per diem. 
 48.2      (5) For fiscal years beginning on or after January 1, 1989, 
 48.3   the facility's payment rate must be established using the 
 48.4   following method:  The commissioner shall divide the real estate 
 48.5   taxes and special assessments payable as stated in the 
 48.6   facility's current property tax statement by actual resident 
 48.7   days to compute a real estate tax and special assessment per 
 48.8   diem.  Next, the prior year's payment rate less the real estate 
 48.9   tax and special assessment per diem must be adjusted by the 
 48.10  higher of (1) the percentage change in the consumer price index 
 48.11  (CPI-U U.S. city average) as published by the Bureau of Labor 
 48.12  Statistics between the previous two Septembers, new series index 
 48.13  (1967-100), or (2) 2.5 percent, to determine an adjusted payment 
 48.14  rate.  The facility's payment rate is the adjusted payment rate 
 48.15  plus the real estate tax and special assessment per diem. 
 48.16     (6) For the purpose of establishing payment rates under 
 48.17  this paragraph, the facility's rate and reporting years coincide 
 48.18  with the facility's fiscal year.  
 48.19     (d) A facility that meets the criteria of paragraph (c) 
 48.20  shall submit annual cost reports on forms prescribed by the 
 48.21  commissioner.  
 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; and 
 52.20     (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, and July 
 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   program and, (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 to 180 200 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 shelter or is evicted from a 
 70.13  dwelling unit or 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 federal Section 8 or 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  parts 9510.0010 to 9510.0480 9549.0010 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 assistance and, 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 to 
 75.26  the commissioner of human services for traumatic brain injury 
 75.27  case management services.  The remaining money 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 to establish 
 75.33  and maintain 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 refugee an immigrant who does not 
 77.15  have the qualifications specified in this subdivision may 
 77.16  provide case management services to adult refugees immigrants 
 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  of obtaining a bachelor's degree and 2,000 hours of supervised 
 77.25  experience this 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 week for a minimum 
 78.23  three-hour time block by 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 on 
 85.4   methods and standards that the commissioner finds are adequate 
 85.5   to provide for the costs that must be incurred for the care of 
 85.6   recipients 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.] Indian 
 85.13  health service Facilities 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 be reimbursed at 
 85.20  charges as limited to the amount allowed under federal law paid 
 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 FUNDING TRIBAL 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 assistance program and 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.  
 88.35     Effective February 1, 1989, and to the extent allowed by 
 88.36  federal law the commissioner shall deduct state and federal 
 89.1   income taxes and federal insurance contributions act payments 
 89.2   withheld from the individual's earned income in determining 
 89.3   eligibility 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 made 
 89.25  according to a court order for the support of children shall be 
 89.26  excluded from income in an amount not to exceed the difference 
 89.27  between the applicable income standard used in the state's 
 89.28  medical assistance program for aged, blind, and disabled persons 
 89.29  and the applicable income standard used in the state's medical 
 89.30  assistance program for families with children.  Exclusion of 
 89.31  court-ordered child support payments is subject to the condition 
 89.32  that if there has been a change in the financial circumstances 
 89.33  of the person with the legal obligation to pay support since the 
 89.34  support order was entered, the person with the legal obligation 
 89.35  to pay support has petitioned for modification of the support 
 89.36  order.  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 person must not have, or anticipate receiving, semiannual 
 90.16  income in excess of 120 percent of the income standards by 
 90.17  family size used under the aid to families with dependent 
 90.18  children state plan as of July 16, 1996, as required by the 
 90.19  Personal Responsibility and Work Opportunity Reconciliation Act 
 90.20  of 1996 (PRWORA), Public Law Number 104-193, except 
 90.21  that eligible 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 than 110 120 percent of the official 
 91.7   federal poverty guidelines for the applicable family size.  The 
 91.8   income limit shall increase to 120 percent of the official 
 91.9   federal poverty guidelines for the applicable family size on 
 91.10  January 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); or 
 92.18     (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.  [MENTAL ILLNESS HEALTH 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 illness or subject to federal 
 96.18  approval, 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, excluding subpart 6 subparts 6 and 
 96.30  10. 
 96.31     (b) In counties where fewer than 50 percent of children 
 96.32  estimated to be eligible under medical assistance to receive 
 96.33  case management services for children with severe emotional 
 96.34  disturbance actually receive these services in state fiscal year 
 96.35  1995, community mental health centers serving those counties, 
 96.36  entities meeting program standards in Minnesota Rules, parts 
 97.1   9520.0570 to 9520.0870, and other entities authorized by the 
 97.2   commissioner are eligible for medical assistance reimbursement 
 97.3   for case management services for children with severe emotional 
 97.4   disturbance when these services meet the program standards in 
 97.5   Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322, 
 97.6   excluding 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 cooperation 
100.16  with the commissioner of administration, shall establish an 
100.17  augmentative and alternative communication system purchasing 
100.18  program within a state agency or by contract with a qualified 
100.19  private entity.  The purpose of this service is to facilitate 
100.20  ready availability of the augmentative and alternative 
100.21  communication systems needed to meet the needs of persons with 
100.22  severe expressive communication limitations in an efficient and 
100.23  cost-effective manner.  This program shall: 
100.24     (1) coordinate purchase and rental of augmentative and 
100.25  alternative communication systems; 
100.26     (2) negotiate agreements with manufacturers and vendors for 
100.27  purchase of components of these systems, for warranty coverage, 
100.28  and for repair service; 
100.29     (3) when efficient and cost-effective, maintain and 
100.30  refurbish if needed, an inventory of components of augmentative 
100.31  and alternative communication systems for short- or long-term 
100.32  loan to recipients; 
100.33     (4) facilitate training sessions for service providers, 
100.34  consumers, and families on augmentative and alternative 
100.35  communication systems; and 
100.36     (5) develop a recycling program for used augmentative and 
101.1   alternative communications systems to be reissued and used for 
101.2   trials and short-term use, when appropriate. 
101.3      The availability of components of augmentative and 
101.4   alternative communication systems through this program is 
101.5   subject to prior authorization requirements established under 
101.6   subdivision 25 Until 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 to American Indian health services 
101.22  facilities for outpatient medical services billed after June 30, 
101.23  1990, must be facilities 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 than an American a 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; and 
103.1      (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 services when the 
106.21  recipient displays no significant change, the county public 
106.22  health nurse has the option to review with the commissioner, or 
106.23  the commissioner's designee, the service plan on record and 
106.24  receive authorization for up to an additional 12 months at a 
106.25  time 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, 
113.29  and shall not may be adjusted due to the change in eligibility.  
113.30  This section applies does not apply to both fee-for-service 
113.31  payments and payments 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  subdivision 18 8, 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 criteria 
116.23  for admission to a certified nursing facility established under 
116.24  section 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 deny 
117.19  certified nursing facility admission using the level of care 
117.20  criteria established under section 144.0721 and deny medical 
117.21  assistance reimbursement for certified nursing facility care.  
117.22  Persons receiving care in a certified nursing facility or 
117.23  certified boarding care home who are reassessed by the 
117.24  commissioner of health according to section 144.0722 and 
117.25  determined to no longer meet the level of care criteria for a 
117.26  certified nursing facility or certified boarding care home may 
117.27  no longer remain a resident in the certified nursing facility or 
117.28  certified boarding care home and must be relocated to the 
117.29  community if the persons were admitted on or after July 1, 1998. 
117.30     (b) Persons receiving services under section 256B.0913, 
117.31  subdivisions 1 to 14, or 256B.0915 who are reassessed and found 
117.32  to not meet the level of care criteria for admission to a 
117.33  certified nursing facility or certified boarding care home may 
117.34  no longer receive these services if persons were admitted to the 
117.35  program 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, 
119.13  the commissioner of human services shall not provide automatic 
119.14  annual inflation adjustments for alternative care services.  The 
119.15  commissioner of finance shall include as a budget change request 
119.16  in each biennial detailed expenditure budget submitted to the 
119.17  legislature under section 16A.11 annual adjustments in 
119.18  reimbursement rates for alternative care services based on the 
119.19  forecasted percentage change in the Home Health Agency Market 
119.20  Basket of Operating Costs, for the fiscal year beginning July 1, 
119.21  compared to the previous fiscal year, unless otherwise adjusted 
119.22  by statute.  The Home Health Agency Market Basket of Operating 
119.23  Costs is published by Data Resources, Inc.  The forecast to be 
119.24  used is the one published for the calendar quarter beginning 
119.25  January 1, six months prior to the beginning of the fiscal year 
119.26  for 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, 1997 1999, 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 for 
122.18  subsequent fiscal years, the commissioner of human services 
122.19  shall not provide automatic annual inflation adjustments for 
122.20  home and community-based waivered services.  The commissioner of 
122.21  finance shall include as a budget change request in each 
122.22  biennial detailed expenditure budget submitted to the 
122.23  legislature under section 16A.11, annual adjustments in 
122.24  reimbursement rates for home and community-based waivered 
122.25  services, based on the forecasted percentage change in the Home 
122.26  Health Agency Market Basket of Operating Costs, for the fiscal 
122.27  year beginning July 1, compared to the previous fiscal year, 
122.28  unless otherwise adjusted by statute.  The Home Health Agency 
122.29  Market Basket of Operating Costs is published by Data Resources, 
122.30  Inc.  The forecast to be used is the one published for the 
122.31  calendar quarter beginning January 1, six months prior to the 
122.32  beginning of the fiscal year for which rates are set.  The adult 
122.33  foster care rate shall be considered a difficulty of care 
122.34  payment 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 
127.3   be based on methods and standards that the commissioner finds 
127.4   are adequate to provide for the costs that must be incurred for 
127.5   the care of residents in efficiently and economically operated 
127.6   nursing facilities and shall specify 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 for 
127.30  the care of residents in an efficiently and economically 
127.31  operated 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, and 
131.12  for all subsequent reporting years, certified nursing facilities 
131.13  must identify, differentiate, and record resident day statistics 
131.14  for residents in case mix classification A who, on or after July 
131.15  1, 1996, meet the modified level of care criteria in section 
131.16  144.0721.  The resident day statistics shall be separated into 
131.17  case mix classification A-1 for any resident day meeting the 
131.18  high-function class A level of care criteria and case mix 
131.19  classification 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 shall 
131.27  be established on the basis of methods and standards that the 
131.28  commissioner finds adequate to provide for the costs that must 
131.29  be incurred for the quality care of residents in efficiently and 
131.30  economically 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   organization or, community integrated service network, or 
132.9   accountable provider network authorized and operating under 
132.10  chapter 62D or, 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 of section sections 
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 62D and, 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 62D and, 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 sites that begin implementation on July 1, 
145.5   1998 designated 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; or 
146.17     (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 of paragraphs (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 and 
151.17  persistent mental illness who would be eligible for medical 
151.18  assistance except that the person resides in an institution for 
151.19  mental 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 shall report to the legislature and present 
156.12  draft legislation expanding the qualified Medicare beneficiary 
156.13  program to the legislature for approval not 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 by January 15, 1998 July 
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 enrollees who are 
159.32  required to apply for medical assistance according to section 
159.33  256L.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) beginning July 1, 1998 January 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   Beginning July 1, 1998 January 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.06 to 256L.08 and 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  to 256L.10 256L.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 make a quarterly an 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 be deposited available 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 July 
169.32  1, 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 1 to 6 and 2, or 256L.13 with 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, 
170.11  subdivision 7, or who qualify under section 256L.04, 
170.12  subdivisions 1 to 6, or 256L.13 with family gross income that 
170.13  exceeds 175 percent of the federal poverty guidelines and who 
170.14  are not pregnant, and are determined by the commissioner to have 
170.15  a basis of eligibility for medical assistance shall apply for 
170.16  and cooperate with the requirements of medical assistance by the 
170.17  last day of the third month following admission to an inpatient 
170.18  hospital.  If an enrollee fails to apply for medical assistance 
170.19  within this time period, the enrollee and the enrollee's family 
170.20  shall be disenrolled from the plan and they may not reenroll 
170.21  until 12 calendar months have elapsed.  Enrollees and enrollees' 
170.22  families disenrolled for not applying for or not cooperating 
170.23  with 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 has 
171.2   previously been permanently disenrolled from MinnesotaCare for 
171.3   not applying for and cooperating with medical assistance shall 
171.4   be eligible to reenroll if 12 calendar months have elapsed since 
171.5   the 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 shall 
171.17  apply to the secretary of health and human services for any 
171.18  necessary 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 enrollees not eligible for medical 
171.26  assistance, 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. 
171.35     Prior to July 1, 1997, enrollees who are not eligible for 
171.36  medical assistance with or without a spenddown shall be 
172.1   financially responsible for the coinsurance amount and amounts 
172.2   which exceed the $10,000 benefit limit.  Effective July 1, 1997, 
172.3   adult enrollees who qualify under section 256L.04, subdivision 
172.4   7, or who qualify under section 256L.04, subdivisions 1 to 6, or 
172.5   256L.13 with family gross income that exceeds 175 percent of the 
172.6   federal poverty guidelines and who are not pregnant, and who are 
172.7   not 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 OF 
172.21  ELIGIBILITY FAMILIES WITH CHILDREN.] (a) [CHILDREN.] Prior to 
172.22  October 1, 1992, "eligible persons" means children who are one 
172.23  year of age or older but less than 18 years of age who have 
172.24  gross family incomes that are equal to or less than 185 percent 
172.25  of the federal poverty guidelines and who are not eligible for 
172.26  medical assistance without a spenddown under chapter 256B and 
172.27  who are not otherwise insured for the covered services.  The 
172.28  period of eligibility extends from the first day of the month in 
172.29  which the child's first birthday occurs to the last day of the 
172.30  month 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 for 
173.2   MinnesotaCare shall be expanded as provided in subdivisions 3 to 
173.3   7, except children who meet the criteria in this subdivision 
173.4   shall continue to be enrolled pursuant to this subdivision.  The 
173.5   enrollment requirements in this paragraph apply to enrollment 
173.6   under 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, a 
173.18  "dependent sibling" means an unmarried child who is a full-time 
173.19  student under the age of 25 years who is financially dependent 
173.20  upon a parent.  Proof of school enrollment will be required.  
173.21     (c)  [CONTINUATION OF ELIGIBILITY.] Individuals who 
173.22  initially enroll in the MinnesotaCare program under the 
173.23  eligibility criteria in subdivisions 3 to 7 remain eligible for 
173.24  the MinnesotaCare program, regardless of age, place of 
173.25  residence, or the presence or absence of children in the same 
173.26  household, as long as all other eligibility criteria are met and 
173.27  residence in Minnesota and continuous enrollment in the 
173.28  MinnesotaCare program or medical assistance are maintained.  In 
173.29  order for either parent or either spouse in a household to 
173.30  remain enrolled, both must remain enrolled, unless other 
173.31  insurance 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 OF SINGLE ADULTS AND HOUSEHOLDS WITH NO 
174.23  CHILDREN.] (a) Beginning October 1, 1994, the definition of 
174.24  "eligible persons" is expanded to include all individuals and 
174.25  households with no children who have gross family incomes that 
174.26  are equal to or less than 125 percent of the federal poverty 
174.27  guidelines and who are not eligible for medical assistance 
174.28  without a spenddown under chapter 256B.  
174.29     (b) Beginning July 1, 1997, The definition of eligible 
174.30  persons is expanded to include includes 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  guidelines and who are not eligible for medical assistance 
174.34  without a spenddown under chapter 256B. 
174.35     (c) All eligible persons under paragraphs (a) and (b) are 
174.36  eligible for coverage through the MinnesotaCare program but must 
175.1   pay a premium as determined under sections 256L.07 and 256L.08.  
175.2   Individuals and families whose income is greater than the limits 
175.3   established under section 256L.08 may not enroll in the 
175.4   MinnesotaCare 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 who apply for MinnesotaCare receive 
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 not apply 
175.29  for and cooperate 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 determination for the family member or members who 
175.35  were 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 to 256L.16 
176.31  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, including such 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 for eligible newborns or eligible 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 approved and the first premium 
178.23  payment has been received or 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  to 256L.10 256L.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.  
180.4   The commissioner shall make an annual redetermination of 
180.5   continued eligibility and identify people who may become 
180.6   eligible 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 and 
180.36  individuals who enroll on or after October 1, 1992, are eligible 
181.1   for subsidized premium payments based on a sliding scale under 
181.2   section 256L.08 only if the family or individual meets the 
181.3   requirements in subdivisions 2 and 3.  Children already enrolled 
181.4   in the children's health plan as of September 30, 1992, eligible 
181.5   under section 256L.04, subdivision 1, paragraph (a), children 
181.6   who enroll in the MinnesotaCare program after September 30, 
181.7   1992, pursuant to Laws 1992, chapter 549, article 4, section 17, 
181.8   and children who enroll under section 256L.04, subdivision 6, 
181.9   are eligible for subsidized premium payments without meeting 
181.10  these requirements, as long as they maintain continuous coverage 
181.11  in 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, and subdivision 1 or 7, 
181.23  whose income increases above the limits established in section 
181.24  256L.08 275 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, and 
181.30  must not have had access to subsidized health coverage through 
181.31  an employer for the 18 months prior to application for 
181.32  subsidized coverage under the MinnesotaCare program.  The 
181.33  requirement that the family or individual must not have had 
181.34  access to employer-subsidized coverage during the previous 18 
181.35  months does not apply if:  (1) employer-subsidized coverage was 
181.36  lost due to the death of an employee or divorce; (2) 
182.1   employer-subsidized coverage was lost because an individual 
182.2   became ineligible for coverage as a child or dependent; or (3) 
182.3   employer-subsidized coverage was lost for reasons that would not 
182.4   disqualify the individual for unemployment benefits under 
182.5   section 268.09 and the family or individual has not had access 
182.6   to employer-subsidized coverage since the loss of coverage.  If 
182.7   employer-subsidized coverage was lost for reasons that 
182.8   disqualify an individual for unemployment benefits under section 
182.9   268.09, children of that individual are exempt from the 
182.10  requirement of no access to employer subsidized coverage for the 
182.11  18 months prior to application, as long as the children have not 
182.12  had access to employer subsidized coverage since the 
182.13  disqualifying event.  The requirement that the.  A family or 
182.14  individual must not have had access to employer-subsidized 
182.15  coverage during the previous 18 months does apply if whose 
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, 
182.22  excluding dependent coverage or 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 UNINSURED OTHER HEALTH COVERAGE.] To be 
182.31  eligible for subsidized premium payments based on a sliding 
182.32  scale, (a) Families and individuals initially enrolled in the 
182.33  MinnesotaCare program under section 256L.04, subdivisions 5 and 
182.34  7, must have had no 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 of at least four months of no 
183.7   health coverage prior to application for the MinnesotaCare 
183.8   program does not apply to: newborns. 
183.9      (1) families, children, and individuals who apply for the 
183.10  MinnesotaCare program upon termination from or as required by 
183.11  the medical assistance program, general assistance medical care 
183.12  program, or coverage under a regional demonstration project for 
183.13  the uninsured funded under section 256B.73, the Hennepin county 
183.14  assured care program, or the Group Health, Inc., community 
183.15  health plan; 
183.16     (2) families and individuals initially enrolled under 
183.17  section 256L.04, subdivisions 1, paragraph (a), and 3; 
183.18     (3) children enrolled pursuant to Laws 1992, chapter 549, 
183.19  article 4, section 17; or 
183.20     (4) individuals currently serving or who have served in the 
183.21  military reserves, and dependents of these individuals, if these 
183.22  individuals:  (i) reapply for MinnesotaCare coverage after a 
183.23  period of active military service during which they had been 
183.24  covered by the Civilian Health and Medical Program of the 
183.25  Uniformed Services (CHAMPUS); (ii) were covered under 
183.26  MinnesotaCare immediately prior to obtaining coverage under 
183.27  CHAMPUS; 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, 
184.4   1997, to be eligible for health coverage under the MinnesotaCare 
184.5   program, families and individuals must be permanent residents of 
184.6   Minnesota.  
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 applicants 
184.24  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 1 to 6 and 2, or 256L.13 with 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  1 to 6 and 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 1 to 6 and 
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.  Contracts 
187.6   between the department of human services and managed care plans 
187.7   must include MinnesotaCare, and medical assistance and may, at 
187.8   the option of the commissioner of human services, also include 
187.9   general 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.] Families and with 
187.18  children enrolled according to sections 256L.13 to 256L.16 and 
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 children who are eligible according 
189.10  to section 256L.13, subdivision 4 in 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; and or 
194.14     (c) the license holder complies with all other requirements 
194.15  of sections 245A.01 to 245A.15 and the rules governing family 
194.16  day 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 
194.30  chapter 245C section 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; and 
196.1      (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 the 
204.34  period beginning with the end of the month in which the report 
204.35  was due and ending with the date the report was received by the 
204.36  county 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 effective March 31 
205.22  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, 
205.29  except that legal noncitizens who are applicants or recipients 
205.30  must have been residents of Minnesota on March 1, 1997.  Legal 
205.31  noncitizens who arrive in Minnesota after March 1, 1997, and 
205.32  become elderly or disabled after that date, and are otherwise 
205.33  eligible for general assistance can receive benefits under this 
205.34  section.  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, (excluding Minnesota supplemental aid issued for 
209.17  current 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.  The Minnesota family investment 
209.33  program-statewide/TANF TANF 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 legislature and; (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, shall 
210.4   be 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 account to must be expended 
210.8   for the Minnesota family investment program-statewide in fiscal 
210.9   year 2000 and subsequent fiscal years and 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:  legal custodians custodian 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 a minor child family 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 is regularly 
212.35  attending as a full-time student and is expected to complete a 
212.36  high school or in 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 employment before reaching 
213.3   age 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 of 
213.15  life 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; or 
213.33     (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 of 35 36 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, 1998 1999, 
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 as 
215.28  of 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 family an assistance unit 
216.22  must have established residency in this state which means 
216.23  the family assistance 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 family An 
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 means a 
217.6   family an 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 the family assistance 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 eligible family assistance 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; or 
218.34     (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, other appropriate adult relative, or other 
219.13  caregiver, 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 
219.16  appropriate adult relative, or legal guardian whose whereabouts 
219.17  is known; 
219.18     (2) no living parent, other appropriate adult relative, or 
219.19  legal guardian of the minor parent allows the minor parent to 
219.20  live in the parent's, appropriate other 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, other appropriate adult 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 and the dependent child in 
219.33  the county in which the minor parent and child currently resides 
219.34  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 parent or, 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 with another a 
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 child in accordance with 
220.29  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 receive 
220.33  assistance under MFIP-S, a member of an assistance unit who is 
220.34  on strike must have been an MFIP-S participant on the day before 
220.35  the strike, or have been eligible for MFIP-S on the day before 
220.36  the strike. 
221.1      The county agency must count the striker's prestrike 
221.2   earnings as current earnings.  When a member of an assistance 
221.3   unit who is not in the bargaining unit that voted for the strike 
221.4   does not cross the picket line for fear of personal injury, the 
221.5   assistance unit member is not a striker.  Except for a member of 
221.6   an assistance unit who is not in the bargaining unit that voted 
221.7   for the strike and who does not cross the picket line for fear 
221.8   of personal injury, a significant change cannot be invoked as a 
221.9   result 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; and 
222.8      (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 ongoing recipients participants.  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 licensed vehicles vehicle up to a total market loan 
223.5   value of less than or equal to $7,500.  The county agency shall 
223.6   apply any excess market loan 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 highest market loan value 
223.10  and count only the market loan value over $7,500.  The county 
223.11  agency shall count the market loan 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 the market loan 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, 
223.18  Midwest 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 participant to 
223.23  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 assistance and, 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  the budget payment 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 income tax credit and, 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) state and federal income 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 other dependent children; 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, subdivision 1 1b; 
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 to the a 
229.27  maximum disregard allowed of $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; and 
229.30     (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 for applicants who have applicant 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 who receives 
232.8   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 3 must be excluded from the assistance unit are 
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, subdivision subdivisions 1 or to 
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 who are must 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; and 
232.31     (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 individuals must be excluded 
233.4   from an assistance unit who 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 payments under title IV-E of the Social Security Act 
233.15  are made, except as provided in section sections 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 section 269.67 259.67. 
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 or recipients participants 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 or recipient participant shall 
234.35  be subject to random drug testing as a condition of continued 
234.36  eligibility and is subject to sanctions under section 256J.46 
235.1   following any positive test for an illegal controlled substance, 
235.2   except that the grant must continue to be vendor paid under 
235.3   clause (1).  
235.4      For purposes of this subdivision, section 256J.46 is 
235.5   effective July 1, 1997. 
235.6      This subdivision also applies to persons who receive food 
235.7   stamps under section 115 of the Personal Responsibility and Work 
235.8   Opportunity 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 is ineligible to 
236.10  receive disqualified 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, is ineligible to receive disqualified 
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 is ineligible 
236.27  to receive disqualified 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. 
237.8      The benefits issued through expedited issuance of food 
237.9   stamp assistance must be deducted from the amount of the full 
237.10  monthly MFIP-S assistance payment and a supplemental payment for 
237.11  the 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 who 
237.23  have 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 assistance for a 
238.17  minimum of one month and until 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 eligible An assistance unit is ineligible for 
238.23  MFIP-S, unless the caregiver must assign assigns all rights to 
238.24  child support and spousal maintenance benefits according 
238.25  to sections 256.74, subdivision 5, and section 256.741, if 
238.26  enacted. 
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 caregiver while participating in full or part-time 
239.32  employment or training shall 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 number in accordance with according 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; and 
240.29     (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 1 and to 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  subdivision 3 4, 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, subdivision 3 4, 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 is 
244.4   allowed from the caregiver's income to meet the need of an 
244.5   ineligible or excluded person.  That allocation is allowed in an 
244.6   amount up to the difference between the MFIP-S family allowance 
244.7   transitional standard for the assistance unit when that excluded 
244.8   or ineligible person is included in the assistance unit and the 
244.9   MFIP-S family allowance for the assistance unit when 
244.10  the excluded or ineligible 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 of a an ineligible person who is 
244.16  not 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 of an assistance unit a caregiver must not be 
244.19  allocated to meet the needs of a disqualified person ineligible 
244.20  for failure to cooperate with program requirements including 
244.21  child support requirements, a person ineligible due to fraud, or 
244.22  a relative caregiver and the caregiver's spouse who opt out of 
244.23  the 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 the excluded ineligible 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 lives 
245.1   outside of the household all 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-S need transitional standard when the excluded ineligible 
245.14  person is included in the assistance unit and the MFIP-S need 
245.15  transitional standard when the excluded ineligible 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's 
246.36  spouse, who executed an affidavit of support for a noncitizen 
247.1   must be deemed to be unearned income of the noncitizen as 
247.2   specified in the Personal Responsibility and Work Opportunity 
247.3   Reconciliation Act of 1996, title IV, Public Law Number 104-193, 
247.4   sections 421 and 422, and subsequently set out in federal 
247.5   rules.  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 in 
247.19  paragraph (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, 1998 1999, 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   overpayment under using the conditions of this 
248.2   section. 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 of 
248.24  mismanaging 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; or 
248.27     (5) (4) the vendor payment is required under section 
248.28  256J.24 256J.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 OF RENT SHELTER 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  a recipient participant in vendor form for rent shelter 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. 
251.13     Subd. 2.  [ASSISTANCE FROM ANOTHER STATE.] An individual 
251.14  whose needs have been otherwise provided for in another state, 
251.15  in whole or in part by the TANF block grant during a month, is 
251.16  ineligible 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 the 
251.23  reservation; and 
251.24     (2) at least 50 percent of the adults living on the 
251.25  reservation were unemployed not 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  the parental caregiver 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 eligible family unit 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 the payment interstate 
252.24  transitional standard that would have been received by 
252.25  the family assistance 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  the family assistance 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 months a family an assistance unit 
253.4   resides in this state, the number of months that a family unit 
253.5   is eligible to receive AFDC or MFIP-S benefits is limited to the 
253.6   number of months the family assistance 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 the family 
253.10  assistance unit received similar benefits while residing in the 
253.11  state of previous residence. 
253.12     (d) When a family an assistance unit moves to this state 
253.13  from another state where the family assistance unit has 
253.14  exhausted that state's time limit for receiving benefits under 
253.15  that state's TANF program, the family unit 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 the family assistance 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 considered a first an 
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; and 
256.6      (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 sanction 
257.9   as 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, the participant's family's grant 
257.25  shall be reduced by ten percent of the applicable MFIP-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, the participant's rent family'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   the participant's family'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 the participant's rent family's shelter 
258.6   costs.  The vendor payment of rent and, if in effect, utilities, 
258.7   must be in effect for six months from the date that a sanction 
258.8   is 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 the applicable MFIP-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 the participant family.  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 that the a 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 
258.22  rent shelter costs and, if applicable, utilities shall be 
258.23  removed six months after the month in which the 
258.24  participant returns or 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 under 
259.12  this paragraph, the vendor payment of rent and if applicable, 
259.13  utilities, shall be removed six months after the month in which 
259.14  the sanction was imposed and the county must consider a 
259.15  subsequent 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; and 
260.29     (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 deposit or a utility 
263.7   deposit, 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; or 
265.26     (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 county is certified under 
265.32  clause (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; or 
267.36     (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, it the 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 
271.20  40 hours per week or at least 30 hours per week and engaged in 
271.21  job search for at least an additional ten 35 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 of section 256J.45 or 
272.9   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) a family member 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   unit in the first full month that after the month the 
273.10  participant leaves the first assistance unit and lives with 
273.11  a joins the second assistance unit. 
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 high 
274.7   school education and are attending high school on a full-time 
274.8   basis; 
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, if it the pregnancy has 
274.21  been medically verified resulted in a professionally certified 
274.22  incapacity that the child is expected to be born within the next 
274.23  six months prevents the woman from obtaining and retaining 
274.24  employment; 
274.25     (6) (5) caregivers or other caregiver relatives of a child 
274.26  under the age of three one 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  least 30 35 hours per week; 
274.32     (8) individuals for whom participation would require a 
274.33  round trip commuting time by available transportation of more 
274.34  than two hours, excluding transporting of children for child 
274.35  care; 
274.36     (9) individuals for whom lack of proficiency in English is 
275.1   a barrier to employment, provided such individuals are 
275.2   participating in an intensive program which lasts no longer than 
275.3   six months and is designed to remedy their language deficiency; 
275.4      (10) individuals who, because of advanced age or lack of 
275.5   ability, are incapable of gaining proficiency in English, as 
275.6   determined by the county social worker, shall continue to be 
275.7   exempt under this subdivision and are not subject to the 
275.8   requirement that they be participating in a language program; 
275.9      (11) (7) individuals under such duress that they are 
275.10  incapable of participating in the program, as determined by the 
275.11  county social worker experiencing 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 purposes 
275.20  of obtaining professional certification or licensure. 
275.21     (b) In a two-parent family, only one caregiver may be 
275.22  exempted 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 PROGRAMS UNSPENT 
275.34  STATE MONEY.] 
275.35     (a) Beginning July 1, 1999, the following persons will be 
275.36  ineligible for general assistance and general assistance medical 
276.1   care under Minnesota Statutes, chapter 256D, group residential 
276.2   housing under Minnesota Statutes, chapter 256I, and MFIP-S 
276.3   assistance under Minnesota Statutes, chapter 256J, funded with 
276.4   state money: 
276.5      (1) persons who are terminated from or denied Supplemental 
276.6   Security Income due to the 1996 changes in the federal law 
276.7   making persons whose alcohol or drug addiction is a material 
276.8   factor contributing to the person's disability ineligible for 
276.9   Supplemental Security Income, and are eligible for general 
276.10  assistance under Minnesota Statutes, section 256D.05, 
276.11  subdivision 1, paragraph (a), clause (17), general assistance 
276.12  medical care under Minnesota Statutes, chapter 256D, or group 
276.13  residential housing under Minnesota Statutes, chapter 256I; 
276.14     (2) legal noncitizens who are ineligible for Supplemental 
276.15  Security Income due to the 1996 changes in federal law making 
276.16  certain noncitizens ineligible for these programs due to their 
276.17  noncitizen status; and 
276.18     (3) legal noncitizens who are eligible for MFIP-S 
276.19  assistance, either the cash assistance portion or the food 
276.20  assistance portion, funded entirely with state money. 
276.21     (b) State money that remains unspent on 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.