Minnesota Legislature
SF 3346
1st Engrossment - 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 119B.24; 144.701, subdivisions 1.8 1, 2, and 4; 144.702, subdivisions 1, 2, and 8; 1.9 144A.09, subdivision 1; 144A.44, subdivision 2; 1.10 214.03; 245.462, subdivisions 4 and 8; 245.4871, 1.11 subdivision 4; 245A.03, by adding a subdivision; 1.12 245A.14, subdivision 4; 256.014, subdivision 1; 1.13 256.969, subdivisions 16 and 17; 256B.03, subdivision 1.14 3; 256B.04, by adding a subdivision; 256B.055, 1.15 subdivision 7, and by adding a subdivision; 256B.057, 1.16 subdivision 3a, and by adding subdivisions; 256B.0625, 1.17 subdivisions 17, 20, 34, and by adding a subdivision; 1.18 256B.0627, subdivision 4; 256B.0911, subdivision 4; 1.19 256B.0916; 256B.41, subdivision 1; 256B.431, 1.20 subdivisions 2b, 4, 11, 22, and by adding a 1.21 subdivision; 256B.501, subdivision 2; 256B.69, by 1.22 adding subdivisions; 256D.03, subdivision 4, and by 1.23 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 60A.15, subdivision 1; 62J.685; 1.28 62J.69, subdivisions 1, 2, and by adding a 1.29 subdivision; 62J.75; 103I.208, subdivision 2; 1.30 144.1494, subdivision 1; 144A.071, subdivision 4a; 1.31 171.29, subdivision 2; 214.32, subdivision 1; 245B.06, 1.32 subdivision 2; 256.01, subdivision 2; 256.031, 1.33 subdivision 6; 256.9657, subdivision 3; 256.9685, 1.34 subdivision 1; 256.9864; 256B.04, subdivision 18; 1.35 256B.056, subdivisions 1a and 4; 256B.06, subdivision 1.36 4; 256B.062; 256B.0625, subdivision 31a; 256B.0627, 1.37 subdivision 5; 256B.0645; 256B.0911, subdivisions 2 1.38 and 7; 256B.0913, subdivision 14; 256B.0915, 1.39 subdivisions 1d and 3; 256B.0951, by adding a 1.40 subdivision; 256B.431, subdivisions 3f and 26; 1.41 256B.433, subdivision 3a; 256B.434, subdivision 10; 1.42 256B.69, subdivisions 2 and 3a; 256B.692, subdivisions 1.43 2 and 5; 256B.77, subdivisions 3, 7a, 10, and 12; 1.44 256D.05, subdivision 8; 256J.02, subdivision 4; 1.45 256J.03; 256J.08, subdivisions 11, 26, 28, 40, 60, 68, 1.46 73, 83, and by adding subdivisions; 256J.09, 2.1 subdivisions 6 and 9; 256J.11, subdivision 2, as 2.2 amended; 256J.12; 256J.14; 256J.15, subdivision 2; 2.3 256J.20, subdivisions 2 and 3; 256J.21; 256J.24, 2.4 subdivisions 1, 2, 3, 4, and by adding a subdivision; 2.5 256J.26, subdivisions 1, 2, 3, and 4; 256J.28, 2.6 subdivisions 1, 2, and by adding a subdivision; 2.7 256J.30, subdivisions 10 and 11; 256J.31, subdivisions 2.8 5 and 10; 256J.32, subdivisions 4, 6, and by adding a 2.9 subdivision; 256J.33, subdivisions 1 and 4; 256J.35; 2.10 256J.36; 256J.37, subdivisions 1, 2, 9, and by adding 2.11 subdivisions; 256J.38, subdivision 1; 256J.39, 2.12 subdivision 2; 256J.395; 256J.42; 256J.43; 256J.45, 2.13 subdivisions 1, 2, and by adding a subdivision; 2.14 256J.46, subdivisions 1, 2, and 2a; 256J.47, 2.15 subdivision 4; 256J.48, subdivisions 2, 3, and by 2.16 adding a subdivision; 256J.49, subdivision 4; 256J.50, 2.17 subdivision 5, and by adding a subdivision; 256J.52, 2.18 subdivision 4; 256J.54, subdivisions 2, 3, 4, and 5; 2.19 256J.55, subdivision 5; 256J.56; 256J.57, subdivision 2.20 1; 256J.645, subdivision 3; 256J.74, subdivision 2, 2.21 and by adding a subdivision; 256K.03, subdivision 5; 2.22 256L.01; 256L.02, subdivisions 2 and 3; 256L.03, 2.23 subdivisions 1, 3, 4, 5, and by adding subdivisions; 2.24 256L.04, subdivisions 1, 2, 7, 8, 9, 10, and by adding 2.25 subdivisions; 256L.05, subdivisions 2, 3, 4, and by 2.26 adding subdivisions; 256L.06, subdivision 3; 256L.07; 2.27 256L.09, subdivisions 2, 4, and 6; 256L.11, 2.28 subdivision 6; 256L.12, subdivision 5; 256L.15; 2.29 256L.17, by adding a subdivision; and 270A.03, 2.30 subdivision 5; Laws 1997, chapter 203, article 4, 2.31 section 64; and article 9, section 21; chapter 225, 2.32 article 2, section 64; and chapter 248, section 46, as 2.33 amended; proposing coding for new law in Minnesota 2.34 Statutes, chapters 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; and 256L.14; Laws 1997, 2.49 chapter 85, article 1, sections 61 and 71; and article 2.50 3, section 55; Minnesota Rules (Exempt), parts 2.51 9500.9100; 9500.9110; 9500.9120; 9500.9130; 9500.9140; 2.52 9500.9150; 9500.9160; 9500.9170; 9500.9180; 9500.9190; 2.53 9500.9200; 9500.9210; and 9500.9220. 2.54 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 2.55 ARTICLE 1 2.56 APPROPRIATIONS 2.57 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 2.58 The sums shown in the columns marked "APPROPRIATIONS" are 2.59 appropriated from the general fund, or any other fund named, to 2.60 the agencies and for the purposes specified in the following 2.61 sections of this article, to be available for the fiscal years 2.62 indicated for each purpose. The figures "1998" and "1999" where 3.1 used in this article, mean that the appropriation or 3.2 appropriations listed under them are available for the fiscal 3.3 year ending June 30, 1998, or June 30, 1999, respectively. 3.4 Where a dollar amount appears in parentheses, it means a 3.5 reduction of an appropriation. 3.6 SUMMARY BY FUND 3.7 APPROPRIATIONS BIENNIAL 3.8 1998 1999 TOTAL 3.9 General $ (119,518,000)$ (120,237,000)$ (239,755,000) 3.10 State Government 3.11 Special Revenue 113,000 224,000 337,000 3.12 Health Care Access 3.13 Fund 6,616,000 (255,000) 6,361,000 3.14 TOTAL $ (112,789,000)$ (120,268,000)$ (233,057,000) 3.15 APPROPRIATIONS 3.16 Available for the Year 3.17 Ending June 30 3.18 1998 1999 3.19 Sec. 2. COMMISSIONER OF 3.20 HUMAN SERVICES 3.21 Subdivision 1. Total 3.22 Appropriation $ (112,902,000)$ (127,343,000) 3.23 Summary by Fund 3.24 General (119,518,000) (126,579,000) 3.25 Health Care Access 6,616,000 (764,000) 3.26 This appropriation is taken from the 3.27 appropriation in Laws 1997, chapter 3.28 203, article 1, section 2. 3.29 The amounts that are added to or 3.30 reduced from the appropriation for each 3.31 program are specified in the following 3.32 subdivisions. 3.33 Subd. 2. Agency Management 3.34 -0- 80,000 3.35 Subd. 3. Children's Grants 3.36 (600,000) 2,771,000 3.37 [CRISIS NURSERY PROGRAMS.] Of this 3.38 appropriation, $200,000 in fiscal year 3.39 1999 is from the general fund to the 3.40 commissioner to contract for technical 3.41 assistance with counties that are 3.42 interested in developing a crisis 3.43 nursery program. The technical 3.44 assistance must be designed to assist 3.45 interested counties in building 3.46 capacity to develop and maintain a 3.47 crisis nursery program in the county. 3.48 The grant amounts to counties must 4.1 range from $10,000 to $20,000. To be 4.2 eligible to receive a grant under this 4.3 program, the county must not have an 4.4 existing crisis nursery program and 4.5 must not be a metropolitan county, as 4.6 that term is defined in Minnesota 4.7 Statutes, section 473.121. This 4.8 appropriation shall not become part of 4.9 base level funding for the 2000-2001 4.10 biennium. 4.11 [CHILDREN'S MENTAL HEALTH SERVICES.] 4.12 (1) Of this appropriation, $500,000 in 4.13 fiscal year 1999 from the general fund 4.14 is to the commissioner for the purpose 4.15 of awarding grants to counties for 4.16 children's mental health services. 4.17 (2) Funds shall be used to provide 4.18 services according to an individual 4.19 family community support plan as 4.20 described in Minnesota Statutes, 4.21 section 245.4881, subdivision 4. The 4.22 plan must be developed using a process 4.23 that enhances consumer empowerment. 4.24 (3) In awarding grants to counties, the 4.25 commissioner shall follow the process 4.26 established in Minnesota Statutes, 4.27 section 245.4886, subdivision 2. The 4.28 commissioner shall ensure that grant 4.29 funds are not used to replace existing 4.30 funds. 4.31 [INDIAN FAMILY PRESERVATION ACT.] Of 4.32 this appropriation, $100,000 from the 4.33 general fund for fiscal year 1999 is to 4.34 provide a grant under Minnesota 4.35 Statutes, section 257.3571, subdivision 4.36 1, to an Indian organization licensed 4.37 as an adoption agency. The grant must 4.38 be used to provide primary support for 4.39 implementation of the Minnesota Indian 4.40 Family Preservation Act and compliance 4.41 with the Indian Child Welfare Act. 4.42 [FAMILY PRESERVATION PROGRAM TANF 4.43 FUNDING.] $10,000,000 of federal funds 4.44 shall be transferred from TANF to the 4.45 family preservation program in the 4.46 fiscal year beginning July 1, 1998. 4.47 Notwithstanding Minnesota Statutes, 4.48 section 256E.07, the commissioner shall 4.49 distribute this money according to the 4.50 family preservation formula in 4.51 Minnesota Statutes, section 256F.05, 4.52 subdivision 3. Counties may use the 4.53 allocation for the purposes of family 4.54 preservation services, the child 4.55 protection assessments, and community 4.56 collaborations pilot program under 4.57 Minnesota Statutes, section 626.5551, 4.58 and the concurrent permanency planning 4.59 pilot program under Minnesota Statutes, 4.60 section 257.0711, provided county staff 4.61 have received necessary training and 4.62 the pilot programs have been approved 4.63 by the commissioner. Prior to 4.64 distributing these funds to the 4.65 counties, the commissioner may allocate 4.66 up to $150,000 for departmental 5.1 administrative costs associated with 5.2 training county staff and approval of 5.3 county plans for the pilot programs. 5.4 Funds allocated to the counties must be 5.5 used in accordance with federal TANF 5.6 requirements and Minnesota Statutes, 5.7 chapter 256F. 5.8 Subd. 4. Children's Services Management 5.9 [SOCIAL SERVICES INFORMATION SYSTEM.] 5.10 Notwithstanding Laws 1997, chapter 203, 5.11 article 1, section 2, subdivision 4, 5.12 the appropriation in that subdivision 5.13 for the social services information 5.14 system shall become part of the base 5.15 for the biennium beginning July 1, 1999. 5.16 Subd. 5. Basic Health Care Grants 5.17 (67,836,000) (88,240,000) 5.18 Summary by Fund 5.19 General (74,644,000) (84,818,000) 5.20 Health Care Access 6,808,000 (3,422,000) 5.21 The amounts that may be spent from this 5.22 appropriation for each purpose are as 5.23 follows: 5.24 (a) Minnesota Care Grants 5.25 Health Care Access Fund 5.26 6,808,000 (3,422,000) 5.27 [SUBSIDIZED FAMILY HEALTH COVERAGE.] 5.28 (1) Of this appropriation, $500,000 5.29 from the health care access fund in 5.30 fiscal year 1999 is to implement the 5.31 program described in Minnesota 5.32 Statutes, section 256L.07, subdivision 5.33 2, paragraph (b). 5.34 (2) The commissioner shall submit to 5.35 the health care financing 5.36 administration a plan to obtain federal 5.37 funding, according to section 5.38 2105(c)(3) of the Balanced Budget Act 5.39 of 1997, Public Law Number 105-33, to 5.40 subsidize health insurance coverage for 5.41 families who are ineligible for 5.42 MinnesotaCare under Minnesota Statutes, 5.43 section 256L.07, subdivision 2, 5.44 paragraph (b), due to the availability 5.45 of employer subsidized insurance for 5.46 which the employer pays 50 percent or 5.47 more of the cost of the coverage. Upon 5.48 federal approval of the plan, the 5.49 commissioner shall implement a program 5.50 to pay the difference of the 5.51 MinnesotaCare sliding premium scale as 5.52 specified in Minnesota Statutes, 5.53 section 256L.08, up to a maximum of 5.54 five percent of a qualifying family's 5.55 income and the employee share of the 5.56 cost of health insurance coverage. To 5.57 qualify, a family must meet all 5.58 MinnesotaCare eligibility criteria 5.59 according to Minnesota Statutes, 6.1 sections 256L.01 to 256L.18, except the 6.2 requirements of Minnesota Statutes, 6.3 section 256L.07, subdivision 2, 6.4 paragraph (b). Implementation of the 6.5 program shall be limited to the funds 6.6 appropriated from the health care 6.7 access fund for the fiscal year ending 6.8 June 30, 1999. 6.9 (b) MA Basic Health Care Grants- 6.10 Families and Children 6.11 General (23,231,000) (38,768,000) 6.12 [RESERVE ACCOUNT.] The commissioner 6.13 shall establish a reserve account for 6.14 the deposit of savings in prepaid 6.15 medical assistance and prepaid general 6.16 assistance medical care programs in 6.17 fiscal year 1999 as a result of the 6.18 delayed implementation of those 6.19 programs in certain counties. The 6.20 savings, in the amount of $7,943,000 in 6.21 medical assistance and $2,964,000 in 6.22 general assistance medical care, shall 6.23 be used in fiscal year 2000 for costs 6.24 in the prepaid programs. 6.25 Notwithstanding section 7, this 6.26 paragraph shall not expire. 6.27 (c) MA Basic Health Care Grants- 6.28 Elderly and Disabled 6.29 General (23,784,000) (37,807,000) 6.30 [MEDICAL EDUCATION RESEARCH TRUST FUND 6.31 BASE.] The appropriation in Laws 1997, 6.32 chapter 203, article 1. section 2, 6.33 subdivision 5, to the medical 6.34 assistance account for distribution to 6.35 medical assistance providers using the 6.36 methodology in Minnesota Statutes, 6.37 section 62J.69, shall become part of 6.38 the base for the biennium beginning 6.39 July 1, 1999, at the level of 6.40 $2,500,000 per year. Notwithstanding 6.41 section 7, this paragraph shall not 6.42 expire. 6.43 (d) General Assistance Medical Care 6.44 General (27,629,000) (8,243,000) 6.45 [PRESCRIPTION DRUG BENEFIT.] (a) If, by 6.46 September 15, 1998, federal approval is 6.47 obtained to provide a prescription drug 6.48 benefit for qualified Medicare 6.49 beneficiaries at no less than 100 6.50 percent of the federal poverty 6.51 guidelines and service-limited Medicare 6.52 beneficiaries under Minnesota Statutes, 6.53 section 256B.057, subdivision 3a, at no 6.54 less than 120 percent of federal 6.55 poverty guidelines, the commissioner of 6.56 human services shall not implement the 6.57 senior citizen drug program under 6.58 Minnesota Statutes, section 256.955, 6.59 but shall implement a drug benefit in 6.60 accordance with the approved waiver. 6.61 Upon approval of this waiver, the total 6.62 appropriation for the senior citizen 7.1 drug program under Laws 1997, chapter 7.2 225, article 7, section 2, shall be 7.3 transferred to the medical assistance 7.4 account to supplement funding for the 7.5 federally approved coverage for 7.6 eligible persons. 7.7 (b) The commissioner may seek approval 7.8 for a higher copayment for eligible 7.9 persons above 100 percent of the 7.10 federal poverty guidelines. 7.11 (c) The commissioner shall report by 7.12 October 15, 1998, to the chairs of the 7.13 health and human services policy and 7.14 fiscal committees of the house and 7.15 senate whether the waiver referred to 7.16 in paragraph (a) has been approved and 7.17 will be implemented or whether the 7.18 state senior citizen drug program will 7.19 be implemented. 7.20 (d) If the commissioner does not 7.21 receive federal waiver approval at or 7.22 above the level of eligibility defined 7.23 in paragraph (b), the commissioner 7.24 shall implement the program under 7.25 Minnesota Statutes, section 256.955. 7.26 The commissioner may transfer funds 7.27 appropriated to implement the waiver to 7.28 the senior drug program account. 7.29 [HEALTH CARE ACCESS FUND TRANSFERS TO 7.30 THE GENERAL FUND.] Notwithstanding Laws 7.31 1997, chapter 203, article 1, section 7.32 2, subdivision 5, the commissioner 7.33 shall transfer funds from the health 7.34 care access fund to the general fund to 7.35 offset the projected savings to general 7.36 assistance medical care (GAMC) that 7.37 would result from the transition of 7.38 GAMC parents and adults without 7.39 children to MinnesotaCare. For fiscal 7.40 year 1998, the amount transferred from 7.41 the health care access fund to the 7.42 general fund shall be $13,700,000. The 7.43 amount of transfer for fiscal year 1999 7.44 shall be $2,659,000. 7.45 Subd. 6. Basic Health Care Management 7.46 (192,000) 2,448,000 7.47 Summary by Fund 7.48 General -0- 874,000 7.49 Health Care Access (192,000) 1,574,000 7.50 The amounts that may be spent from this 7.51 appropriation for each purpose are as 7.52 follows: 7.53 (a) Health Care Policy Administration 7.54 General -0- 786,000 7.55 Health Care Access (192,000) 37,000 7.56 [DELAY IN TRANSFERRING GAMC CLIENTS.] 7.57 Due to the delay in transferring GAMC 8.1 clients to MinnesotaCare until January 8.2 1, 2000, $192,000 in fiscal year 1998 8.3 health care access fund administrative 8.4 funds, appropriated in Laws 1997, 8.5 chapter 225, article 7, section 2, 8.6 subdivision 1, are canceled. 8.7 [HEALTH CARE MANUAL PRODUCTION COSTS.] 8.8 For the biennium ending June 30, 1999, 8.9 the difference between the cost of 8.10 producing and distributing the 8.11 department of human services health 8.12 care manual and the subsidized price 8.13 charged to individuals and private 8.14 entities on January 1, 1998, is 8.15 appropriated to the commissioner to 8.16 defray manual production and 8.17 distribution costs. 8.18 [TRANSFER.] For fiscal years 2000 and 8.19 2001, the commissioner of finance shall 8.20 transfer from the health care access 8.21 fund to the general fund an amount to 8.22 cover the expenditures associated with 8.23 the services provided to pregnant women 8.24 and children under the age of two 8.25 enrolled in the MinnesotaCare program. 8.26 [PAYMENTS FOR PREGNANT WOMEN AND 8.27 CHILDREN UNDER THE AGE OF TWO.] 8.28 Beginning in fiscal year 2000, the 8.29 expenditures for pregnant women and 8.30 children under the age of two enrolled 8.31 in the MinnesotaCare program shall be 8.32 paid out of the general fund. 8.33 [FEDERAL CONTINGENCY RESERVE LIMIT.] 8.34 Notwithstanding Minnesota Statutes, 8.35 section 16A.76, subdivision 2, the 8.36 federal contingency reserve limit shall 8.37 be reduced for fiscal years 1999, 2000, 8.38 and 2001 by the cumulative amount of 8.39 the expenditures associated with 8.40 services provided to pregnant women and 8.41 children enrolled in the MinnesotaCare 8.42 program in these fiscal years. 8.43 (b) Health Care Operations 8.44 General -0- 88,000 8.45 Health Care Access -0- 1,537,000 8.46 [MINNESOTACARE OUTREACH.] Unexpended 8.47 money in fiscal year 1998 for 8.48 MinnesotaCare outreach activities 8.49 appropriated in Laws 1997, chapter 225, 8.50 article 7, section 2, subdivision 1, 8.51 does not cancel, but is available for 8.52 those purposes in fiscal year 1999. 8.53 Subd. 7. State-Operated Services 8.54 -0- 508,000 8.55 The amounts that may be spent from this 8.56 appropriation for each purpose are as 8.57 follows: 8.58 (a) RTC Facilities 9.1 -0- 825,000 9.2 [LEAVE LIABILITIES.] The accrued leave 9.3 liabilities of state employees 9.4 transferred to state-operated services 9.5 programs may be paid from the 9.6 appropriation for state-operated 9.7 services in Laws 1997, chapter 203, 9.8 article 1, section 2, subdivision 7a. 9.9 Funds set aside for this purpose shall 9.10 not exceed the amount of the actual 9.11 leave liability calculated as of June 9.12 30, 1999, and shall be available until 9.13 expended. This paragraph is effective 9.14 the day following final enactment. 9.15 [GRAVE MARKERS.] Of the $195,000 9.16 retained by the commissioner out of the 9.17 $200,000 appropriation in Laws 1997, 9.18 chapter 203, article 1, section 2, 9.19 subdivision 7, paragraph (a), for grave 9.20 markers at regional treatment centers, 9.21 $29,250 is for community organizing, 9.22 coordination, fundraising, and 9.23 administration. 9.24 [RTC BUILDING AND SPACE ANALYSIS.] Of 9.25 this appropriation, $175,000 from the 9.26 general fund in fiscal year 1999 is for 9.27 the commissioner to conduct an analysis 9.28 of surplus land and buildings on the 9.29 regional treatment center campuses and 9.30 to develop recommendations for future 9.31 utilization of this property. The 9.32 commissioner shall report to the 9.33 legislature by January 15, 1999, with 9.34 recommendations for an orderly process 9.35 to sell, lease, demolish, transfer, or 9.36 otherwise dispose of unneeded buildings 9.37 and land. 9.38 (b) State-Operated Community 9.39 Services - DD 9.40 -0- (317,000) 9.41 Subd. 8. Continuing Care and 9.42 Community Support Grants 9.43 (35,100,000) (22,107,000) 9.44 The amounts that may be spent from this 9.45 appropriation for each purpose are as 9.46 follows: 9.47 (a) Community Services Block Grants 9.48 130,000 280,000 9.49 [WILKIN COUNTY FLOOD COSTS.] Of this 9.50 appropriation, $130,000 for fiscal year 9.51 1998 is to reimburse Wilkin county for 9.52 flood-related human service and public 9.53 health costs which cannot be reimbursed 9.54 through any other source. 9.55 (b) Aging Adult Service Grants 9.56 -0- 350,000 9.57 [METROPOLITAN AREA AGENCY ON AGING.] Of 10.1 this appropriation, $100,000 in fiscal 10.2 year 1999 from the general fund is for 10.3 the commissioner for the metropolitan 10.4 area agency on aging to provide 10.5 technical support and planning services 10.6 to enable older adults to remain living 10.7 in the community. This appropriation 10.8 shall not cancel but is available until 10.9 expended. 10.10 [HOME SHARING.] Of this appropriation, 10.11 $250,000 in fiscal year 1999 is from 10.12 the general fund to the commissioner 10.13 for the home-sharing program under 10.14 Minnesota Statutes, section 256.973, 10.15 which links elderly, disabled, and 10.16 families together to share a home. 10.17 (c) Deaf and Hard-of-Hearing 10.18 Services Grants 10.19 -0- 200,000 10.20 This appropriation is in addition to 10.21 the appropriation in Laws 1997, chapter 10.22 203, article 1, section 2, subdivision 10.23 8, paragraph (d), for a grant to a 10.24 nonprofit agency that currently 10.25 provides these services. 10.26 [SERVICES FOR DEAF-BLIND PERSONS.] Of 10.27 this appropriation, $200,000 in fiscal 10.28 year 1999 is for the following: 10.29 (1) $125,000 for a grant to Deaf Blind 10.30 Services Minnesota, Inc., in order to 10.31 provide services to deaf-blind children 10.32 and their families. The services 10.33 include providing intervenors to assist 10.34 deaf-blind children in participating in 10.35 their community and providing family 10.36 education specialists to teach siblings 10.37 and parents skills to support the 10.38 deaf-blind child in the family. 10.39 (2) $75,000 is for a grant to Deaf 10.40 Blind Services Minnesota, Inc., and 10.41 Duluth Lighthouse for the Blind, Inc., 10.42 in order to provide assistance to 10.43 deaf-blind persons who are working 10.44 toward establishing and maintaining 10.45 independence. 10.46 (d) Mental Health Grants 10.47 300,000 2,226,000 10.48 [FLOOD COSTS.] Of this appropriation, 10.49 $300,000 for fiscal year 1998 and 10.50 $1,000,000 for fiscal year 1999 is to 10.51 pay for flood-related mental health 10.52 services and to reimburse mental health 10.53 centers for the cost of disruptions in 10.54 the mental health centers' other 10.55 services that were caused by diversion 10.56 of staff to flood efforts. Funding is 10.57 limited to costs for services which 10.58 cannot be reimbursed through any other 10.59 source in counties officially declared 10.60 as disaster areas. 11.1 [COMPULSIVE GAMBLING CARRYFORWARD.] 11.2 Unexpended funds appropriated to the 11.3 commissioner for compulsive gambling 11.4 programs for fiscal year 1998 do not 11.5 cancel but are available for these 11.6 purposes for fiscal year 1999. 11.7 (e) Developmental Disabilities 11.8 Support Grants 11.9 -0- 54,000 11.10 (f) Medical Assistance Long-Term 11.11 Care Waivers and Home Care 11.12 (8,463,000) (12,308,000) 11.13 [JANUARY 1, 1999, PROVIDER RATE 11.14 INCREASE.] (1) Effective for services 11.15 rendered on or after January 1, 1999, 11.16 the commissioner shall increase 11.17 reimbursement or allocation rates by 11.18 two percent, and county boards shall 11.19 adjust provider contracts as needed, 11.20 for home and community-based waiver 11.21 services for persons with mental 11.22 retardation or related conditions under 11.23 Minnesota Statutes, section 256B.501; 11.24 home and community-based waiver 11.25 services for the elderly under 11.26 Minnesota Statutes, section 256B.0915; 11.27 waivered services under community 11.28 alternatives for disabled individuals 11.29 under Minnesota Statutes, section 11.30 256B.49; community alternative care 11.31 waivered services under Minnesota 11.32 Statutes, section 256B.49; traumatic 11.33 brain injury waivered services under 11.34 Minnesota Statutes, section 256B.49; 11.35 nursing services and home health 11.36 services under Minnesota Statutes, 11.37 section 256B.0625, subdivision 6a; 11.38 personal care services and nursing 11.39 supervision of personal care services 11.40 under Minnesota Statutes, section 11.41 256B.0625, subdivision 19a; private 11.42 duty nursing services under Minnesota 11.43 Statutes, section 256B.0625, 11.44 subdivision 7; day training and 11.45 habilitation services for adults with 11.46 mental retardation or related 11.47 conditions under Minnesota Statutes, 11.48 sections 252.40 to 252.46; physical 11.49 therapy services under Minnesota 11.50 Statutes, sections 256B.0625, 11.51 subdivision 8, and 256D.03, subdivision 11.52 4; occupational therapy services under 11.53 Minnesota Statutes, sections 256B.0625, 11.54 subdivision 8a, and 256D.03, 11.55 subdivision 4; speech-language therapy 11.56 services under Minnesota Statutes, 11.57 section 256D.03, subdivision 4, and 11.58 Minnesota Rules, part 9505.0390; 11.59 respiratory therapy services under 11.60 Minnesota Statutes, section 256D.03, 11.61 subdivision 4, and Minnesota Rules, 11.62 part 9505.0295; dental services under 11.63 Minnesota Statutes, sections 256B.0625, 11.64 subdivision 9, and 256D.03, subdivision 11.65 4; alternative care services under 11.66 Minnesota Statutes, section 256B.0913; 12.1 adult residential program grants under 12.2 Minnesota Rules, parts 9535.2000 to 12.3 9535.3000; adult and family community 12.4 support grants under Minnesota Rules, 12.5 parts 9535.1700 to 9535.1760; and 12.6 semi-independent living services under 12.7 Minnesota Statutes, section 252.275, 12.8 including SILS funding under county 12.9 social services grants formerly funded 12.10 under Minnesota Statutes, chapter 256I. 12.11 (2) The commissioner shall increase 12.12 prepaid medical assistance program 12.13 capitation rates as appropriate to 12.14 reflect the rate increases in paragraph 12.15 (l). 12.16 (g) Medical Assistance Long-Term 12.17 Care Facilities 12.18 (18,272,000) (18,426,000) 12.19 [ICFs/MR AND NURSING FACILITY 12.20 FLOOD-RELATED REPORTING.] For the 12.21 reporting year ending December 31, 12.22 1997, for ICFs/MR that temporarily 12.23 admitted victims of the flood of 1997, 12.24 the resident days related to the 12.25 temporary placement of persons not 12.26 formally admitted who continued to be 12.27 billed under the evacuated facility's 12.28 provider number will not be counted in 12.29 the cost report submitted to calculate 12.30 October 1, 1998, rates, and the 12.31 additional expenditures will be 12.32 considered nonallowable. 12.33 For the reporting year ending September 12.34 30, 1997, for nursing facilities that 12.35 temporarily admitted victims of the 12.36 flood of 1997, the resident days 12.37 related to the temporary placement of 12.38 persons not formally admitted who 12.39 continued to be billed under the 12.40 evacuated facility's provider number 12.41 will not be counted in the cost report 12.42 submitted to calculate July 1, 1998, 12.43 rates, and the additional expenditures 12.44 will be considered nonallowable. 12.45 [NURSING HOME MORATORIUM EXCEPTIONS.] 12.46 Base level funding for medical 12.47 assistance long-term care facilities is 12.48 increased by $255,000 in fiscal year 12.49 2000 and by $278,000 in fiscal year 12.50 2001 for the additional medical 12.51 assistance costs of the nursing home 12.52 moratorium exceptions under Minnesota 12.53 Statutes, section 144A.071, subdivision 12.54 4a, paragraphs (w) and (x). 12.55 Notwithstanding the provisions of 12.56 section 7, this paragraph shall not 12.57 expire. 12.58 (h) Alternative Care Grants 12.59 -0- 21,986,000 12.60 (i) Group Residential Housing 12.61 (8,795,000) (8,971,000) 13.1 [SERVICES TO DEAF PERSONS WITH MENTAL 13.2 ILLNESS.] Of this appropriation, 13.3 $70,000 in fiscal year 1999 is for a 13.4 grant to a nonprofit agency that 13.5 currently serves deaf and 13.6 hard-of-hearing adults with mental 13.7 illness through residential programs 13.8 and supported housing outreach 13.9 activities to increase by five percent, 13.10 retroactive to July 1, 1997, the 13.11 compensation packages of staff at the 13.12 nonprofit agency that currently 13.13 provides these services. 13.14 (j) Chemical Dependency 13.15 Entitlement Grants 13.16 -0- (7,498,000) 13.17 Subd. 9. Continuing Care and 13.18 Community Support Management 13.19 -0- 75,000 13.20 [REGION 10 COMMISSION CARRYOVER 13.21 AUTHORITY.] Any unspent portion of the 13.22 appropriation to the commissioner in 13.23 Laws 1997, chapter 203, article 1, 13.24 section 2, subdivision 9, for the 13.25 region 10 quality assurance commission 13.26 for fiscal year 1998 shall not cancel 13.27 but shall be available for the 13.28 commission for fiscal year 1999. 13.29 [STUDY OF DAY TRAINING CAPITAL NEEDS.] 13.30 (a) Of this appropriation, $25,000 in 13.31 fiscal year 1999 is from the general 13.32 fund to the commissioner to conduct a 13.33 study to: 13.34 (1) determine the extent to which day 13.35 training and habilitation programs have 13.36 unmet capital improvement needs; 13.37 (2) ascertain the degree to which these 13.38 unmet capital needs impact consumers of 13.39 day training and habilitation programs; 13.40 (3) determine the state's role and 13.41 responsibility in meeting the capital 13.42 improvement needs of day training and 13.43 habilitation programs; and 13.44 (4) examine the relationship among the 13.45 state, counties, and community 13.46 resources in meeting the capital 13.47 improvement needs of day training and 13.48 habilitation programs. 13.49 (b) The commissioner shall report to 13.50 the legislature by January 15, 1999, 13.51 the results of the study along with 13.52 recommendations for involving the 13.53 state, counties, and community 13.54 resources in collaborative initiatives 13.55 to assist in meeting the capital 13.56 improvement needs of day training and 13.57 habilitation programs. 13.58 (c) This appropriation shall not become 13.59 part of base level funding for the 14.1 2000-2001 biennium. 14.2 Subd. 10. Economic Support Grants 14.3 (9,174,000) (23,997,000) 14.4 The amounts that may be spent from this 14.5 appropriation for each purpose are as 14.6 follows: 14.7 (a) Assistance to Families Grants 14.8 -0- (20,343,000) 14.9 [FEDERAL TANF FUNDS.] Notwithstanding 14.10 any contrary provisions of Laws 1997, 14.11 chapter 203, article 1, section 2, 14.12 subdivision 12, federal TANF block 14.13 grant funds are appropriated to the 14.14 commissioner in amounts up to 14.15 $241,027,000 in fiscal year 1998 and 14.16 $294,860,000 in fiscal year 1999. 14.17 Additional federal TANF funds may be 14.18 expended but only to the extent that an 14.19 equal amount of state funds have been 14.20 transferred to the TANF reserve under 14.21 Minnesota Statutes, section 256J.03. 14.22 The commissioner may use TANF reserve 14.23 funds to meet TANF maintenance of 14.24 effort requirements and to offset 14.25 federal TANF block grants reduction. 14.26 Notwithstanding Minnesota Statutes, 14.27 section 256J.03, the commissioner shall 14.28 transfer $3,500,000 from the state TANF 14.29 reserve to the general fund for the 14.30 food stamp costs for legal noncitizens 14.31 who do not receive TANF benefits. This 14.32 paragraph is effective the day 14.33 following final enactment. 14.34 (b) General Assistance 14.35 (6,933,000) (905,000) 14.36 (c) Minnesota Supplemental Aid 14.37 (2,241,000) (2,749,000) 14.38 Subd. 11. Economic Support 14.39 Management 14.40 -0- 1,119,000 14.41 Summary by Fund 14.42 General -0- 35,000 14.43 Health Care Access -0- 1,084,000 14.44 [EBT TRANSACTION COSTS.] Retailers 14.45 electing to integrate electronic 14.46 benefit transfer (EBT) with other 14.47 commercial systems, such as credit or 14.48 debit, on the retailer's own equipment, 14.49 shall be paid two cents by the 14.50 commissioner for each food stamp 14.51 withdrawal transaction. 14.52 Sec. 3. COMMISSIONER OF HEALTH 14.53 Subdivision 1. Total 15.1 Appropriation -0- 6,874,000 15.2 Summary by Fund 15.3 General -0- 6,264,000 15.4 State Government 15.5 Special Revenue -0- 101,000 15.6 Health Care Access -0- 509,000 15.7 This appropriation is added to the 15.8 appropriation in Laws 1997, chapter 15.9 203, article 1, section 3. 15.10 The amounts that may be spent from this 15.11 appropriation for each program are 15.12 specified in the following subdivisions. 15.13 Subd. 2. Health Systems 15.14 and Special Populations -0- 3,584,000 15.15 Summary by Fund 15.16 General -0- 3,075,000 15.17 Health Care Access -0- 509,000 15.18 [FETAL ALCOHOL SYNDROME.] (a) of the 15.19 general fund appropriation, $3,000,000 15.20 is for the following: 15.21 (1) $750,000 to administer community 15.22 grants for fetal alcohol syndrome 15.23 prevention and intervention as defined 15.24 in Minnesota Statutes, section 15.25 145.9266, subdivision 4; 15.26 (2) $750,000 to expand maternal and 15.27 child service programs under Minnesota 15.28 Statutes, section 254A.17, subdivision 15.29 1; 15.30 (3) $750,000 to expand treatment 15.31 services and halfway houses for 15.32 pregnant women and women with children; 15.33 and 15.34 (4) $750,000 to develop and implement a 15.35 public awareness campaign. 15.36 (b) The commissioner shall transfer 15.37 money appropriated in paragraph (a) to 15.38 the appropriate agencies involved in 15.39 implementing fetal alcohol syndrome 15.40 initiatives. 15.41 [GRANTS TO MEDICAL CLINICS.] Of the 15.42 appropriation for fiscal year 1999 from 15.43 the health care access fund to the 15.44 commissioner, $250,000 is for grants to 15.45 medical clinics receiving federal funds 15.46 under Public Law Number 91-572, title X 15.47 of the Public Health Service Act. 15.48 Subd. 3. Health Protection -0- 3,290,000 15.49 Summary by Fund 15.50 General -0- 3,189,000 16.1 State Government 16.2 Special Revenue -0- 101,000 16.3 [RESPIRATORY DISEASE STUDY.] Of the 16.4 general fund appropriation, $250,000 is 16.5 to collect and analyze information 16.6 regarding the increased incidence of 16.7 respiratory diseases, including 16.8 mesothelioma and asbestosis, in 16.9 northeastern and central Minnesota to 16.10 determine the cause of these diseases. 16.11 The commissioner shall also make 16.12 recommendations for the implementation 16.13 of a statewide occupational respiratory 16.14 disease information system. The 16.15 commissioner shall submit a report on 16.16 the findings and recommendations to the 16.17 legislature by January 15, 1999. 16.18 [LEAD-SAFE HOUSING.] Of this 16.19 appropriation, $50,000 in fiscal year 16.20 1999 from the general fund is to the 16.21 commissioner to create a lead-safe 16.22 housing certification program within 16.23 the private sector. This appropriation 16.24 shall be used to recruit and train 16.25 individuals certified as independent 16.26 home inspectors and truth-in-sale-of 16.27 housing evaluators to be lead risk 16.28 assessors, and to subsidize the cost of 16.29 assessing and doing follow-up research 16.30 on 300 single family and rental units 16.31 that are demonstration cases for the 16.32 lead-safe property certification 16.33 program. 16.34 [CANCER SCREENING.] Of the general fund 16.35 appropriation, $910,000 is for 16.36 increased cancer screening and 16.37 diagnostic services for women, 16.38 particularly underserved women, and to 16.39 improve cancer screening rates for the 16.40 general population. Of this amount, at 16.41 least $700,000 is for grants and up to 16.42 $210,000 is for technical assistance, 16.43 consultation, and outreach. The grants 16.44 support local boards of health in 16.45 providing outreach and coordination and 16.46 reimburse health care providers for 16.47 screening and diagnostic tests. 16.48 [SEXUALLY TRANSMITTED DISEASE.](a) of 16.49 this appropriation, $350,000 in fiscal 16.50 year 1999 is from the general fund to 16.51 the commissioner to do the following, 16.52 in consultation with the HIV/STD 16.53 prevention task force and the 16.54 commissioner of children, families, and 16.55 learning: 16.56 (1) $150,000 to conduct a statewide 16.57 assessment of need and capacity to 16.58 prevent and treat sexually transmitted 16.59 diseases and prepare a comprehensive 16.60 plan for how to prevent and treat 16.61 sexually transmitted diseases, 16.62 including strategies for reducing 16.63 infection and for increasing access to 16.64 treatment; and 16.65 (2) $200,000 to conduct research on the 17.1 prevalence of sexually transmitted 17.2 diseases among populations at highest 17.3 risk for infection. The research may 17.4 be done in collaboration with the 17.5 University of Minnesota and nonprofit 17.6 community health clinics. 17.7 (b) This appropriation shall not become 17.8 part of the base for the 2000-2001 17.9 biennium. 17.10 [DIABETES PREVENTION.] Of this 17.11 appropriation, $75,000 in fiscal year 17.12 1999 from the general fund is to the 17.13 commissioner for statewide activities 17.14 related to general diabetes prevention, 17.15 the development and dissemination of 17.16 prevention materials to health care 17.17 providers, and for other statewide 17.18 activities related to diabetes 17.19 prevention and control for targeted 17.20 populations who are at high risk for 17.21 developing diabetes or health 17.22 complications from diabetes. 17.23 Sec. 4. HEALTH-RELATED BOARDS 17.24 Subdivision 1. Total 17.25 Appropriation 113,000 123,000 17.26 This appropriation is added to the 17.27 appropriation in Laws 1997, chapter 17.28 203, article 1, section 5. 17.29 [STATE GOVERNMENT SPECIAL REVENUE 17.30 FUND.] The appropriations in this 17.31 section are from the state government 17.32 special revenue fund. 17.33 [NO SPENDING IN EXCESS OF REVENUES.] 17.34 The commissioner of finance shall not 17.35 permit the allotment, encumbrance, or 17.36 expenditure of money appropriated in 17.37 this section in excess of the 17.38 anticipated biennial revenues or 17.39 accumulated surplus revenues from fees 17.40 collected by the boards. Neither this 17.41 provision nor Minnesota Statutes, 17.42 section 214.06, applies to transfers 17.43 from the general contingent account. 17.44 Subd. 2. Board of Medical 17.45 Practice 80,000 90,000 17.46 Subd. 3. Board of Veterinary 17.47 Medicine 33,000 33,000 17.48 Sec. 5. EMERGENCY MEDICAL 17.49 SERVICES BOARD -0- 78,000 17.50 This appropriation is added to the 17.51 appropriation in Laws 1997, chapter 17.52 203, article 1, section 6. 17.53 [EMERGENCY MEDICAL SERVICES 17.54 COMMUNICATIONS NEEDS ASSESSMENT.] (a) 17.55 Of this appropriation, $78,000 in 17.56 fiscal year 1999 is from the general 17.57 fund to the board to conduct an 17.58 emergency medical services needs 17.59 assessment for areas outside the 18.1 seven-county metropolitan area. The 18.2 assessment shall determine the current 18.3 status of and need for emergency 18.4 medical services communications 18.5 equipment. All regional emergency 18.6 medical services programs designated by 18.7 the board under Minnesota Statutes, 18.8 section 144.8093, shall cooperate in 18.9 the preparation of the assessment. 18.10 (b) The appropriation for this project 18.11 shall be distributed through the 18.12 emergency medical services system fund 18.13 under Minnesota Statutes, section 18.14 144E.50, through a request-for-proposal 18.15 process. The commissioner must select 18.16 a regional EMS program that receives at 18.17 least 20 percent of its funding from 18.18 nonstate sources to conduct the 18.19 assessment. The request for proposals 18.20 must be issued by August 1, 1998. 18.21 (c) A final report with recommendations 18.22 shall be presented to the board and the 18.23 legislature by July 1, 1999. 18.24 (d) This appropriation shall not become 18.25 part of base level funding for the 18.26 2000-2001 biennium. 18.27 Sec. 6. [CARRYOVER LIMITATION.] None 18.28 of the appropriations in this act which 18.29 are allowed to be carried forward from 18.30 fiscal year 1998 to fiscal year 1999 18.31 shall become part of the base level 18.32 funding for the 2000-2001 biennial 18.33 budget, unless specifically directed by 18.34 the legislature. 18.35 Sec. 7. [SUNSET OF UNCODIFIED 18.36 LANGUAGE.] All uncodified language 18.37 contained in this article expires on 18.38 June 30, 1999, unless a different 18.39 expiration date is explicit. 18.40 ARTICLE 2 18.41 HEALTH DEPARTMENT AND MISCELLANEOUS HEALTH PROVISIONS 18.42 Section 1. Minnesota Statutes 1997 Supplement, section 18.43 62J.685, is amended to read: 18.44 62J.685 [PRESCRIPTION DRUG PRICE DISCLOSURE.] 18.45 By January 1, 1998, and annually thereafter, a health plan 18.46 company or hospital licensed under chapter 144 must submit to 18.47 theattorney generalcommissioner of health the total amount of: 18.48 (1) aggregate purchases of prescription drugs, and (2) discount, 18.49 rebate, or other payment received during the previous calendar 18.50 year for aggregate purchases of prescription drugs, including 18.51 any fee associated with education, data collection, research, 18.52 training or market share movement received from a manufacturer 19.1 as defined under section 151.44, paragraph (c), or wholesale 19.2 drug distributor as defined under section 151.44, paragraph 19.3 (d). The identification of individual manufacturers or 19.4 wholesalers or specific drugs is not required. Theattorney19.5generalcommissioner shall make this information available to 19.6 the public through the information clearinghouse under section 19.7 62J.2930. 19.8 Sec. 2. Minnesota Statutes 1997 Supplement, section 19.9 62J.69, subdivision 1, is amended to read: 19.10 Subdivision 1. [DEFINITIONS.] For purposes of this 19.11 section, the following definitions apply: 19.12 (a) "Medical education" means the accredited clinical 19.13 training of physicians (medical students and residents), doctor 19.14 of pharmacy practitioners, dentists, advanced practice nurses 19.15 (clinical nurse specialist, certified registered nurse 19.16 anesthetists, nurse practitioners, and certified nurse 19.17 midwives), and physician assistants. 19.18 (b) "Clinical training" means accredited training for the 19.19 health care practitioners listed in paragraph (a) that is funded 19.20and was historically fundedin part byinpatientpatient care 19.21 revenues and that occurs inbotheither an inpatientandor 19.22 ambulatory patient caresettingstraining site. 19.23 (c) "Trainee" means students involved in an accredited 19.24 clinical training program for medical education as defined in 19.25 paragraph (a). 19.26 (d) "Eligible trainee" means a student involved in an 19.27 accredited training program for medical education as defined in 19.28 paragraph (a), which meets the definition of clinical training 19.29 in paragraph (b), who is in a training site that is located in 19.30 Minnesota and which has a medical assistance provider number. 19.31 (e) "Health care research" means approved clinical, 19.32 outcomes, and health services investigations that are funded by 19.33 patient out-of-pocket expenses or a third-party payer. 19.34(e)(f) "Commissioner" means the commissioner of health. 19.35(f)(g) "Teaching institutions" means any hospital, medical 19.36 center, clinic, or other organization that currently sponsors or 20.1 conducts accredited medical education programs or clinical 20.2 research in Minnesota. 20.3 (h) "Accredited training" means training provided by a 20.4 program that is accredited through an organization recognized by 20.5 the department of education or the health care financing 20.6 administration as the official accrediting body for that program. 20.7 (i) "Sponsoring institution" means a hospital, school, or 20.8 consortium that sponsors and maintains primary organizational 20.9 and financial responsibility for an accredited medical education 20.10 program in Minnesota and which is accountable to the accrediting 20.11 body. 20.12 Sec. 3. Minnesota Statutes 1997 Supplement, section 20.13 62J.69, subdivision 2, is amended to read: 20.14 Subd. 2. [ALLOCATION AND FUNDING FOR MEDICAL EDUCATION AND 20.15 RESEARCH.] (a) The commissioner may establish a trust fund for 20.16 the purposes of funding medical education and research 20.17 activities in the state of Minnesota. 20.18 (b) By January 1, 1997, the commissioner may appoint an 20.19 advisory committee to provide advice and oversight on the 20.20 distribution of funds from the medical education and research 20.21 trust fund. If a committee is appointed, the commissioner 20.22 shall: (1) consider the interest of all stakeholders when 20.23 selecting committee members; (2) select members that represent 20.24 both urban and rural interest; and (3) select members that 20.25 include ambulatory care as well as inpatient perspectives. The 20.26 commissioner shall appoint to the advisory committee 20.27 representatives of the following groups: medical researchers, 20.28 public and private academic medical centers, managed care 20.29 organizations, Blue Cross and Blue Shield of Minnesota, 20.30 commercial carriers, Minnesota Medical Association, Minnesota 20.31 Nurses Association, medical product manufacturers, employers, 20.32 and other relevant stakeholders, including consumers. The 20.33 advisory committee is governed by section 15.059, for membership 20.34 terms and removal of members and will sunset on June 30, 1999. 20.35 (c) Eligible applicants for funds are accredited medical 20.36 education teaching institutions, consortia, and programs 21.1 operating in Minnesota. Applications must be submitted by the 21.2 sponsoring institution on behalf of the teaching program, and 21.3 must be received by September 30 of each year for distribution 21.4 in January of the following year. An application for funds must 21.5 include the following: 21.6 (1) the official name and address of the sponsoring 21.7 institution and the official name and address of the facility or 21.8programprograms on whose behalf the institution is applying for 21.9 funding; 21.10 (2) the name, title, and business address of those persons 21.11 responsible for administering the funds; 21.12 (3)the total number, type, and specialty orientation of21.13eligible Minnesota-based trainees infor each accredited medical 21.14 education program for which funds are being sought the type and 21.15 specialty orientation of trainees in the program, the name, 21.16 address, and medical assistance provider number of each training 21.17 site used in the program, the total number of trainees at each 21.18 site, and the total number of eligible trainees at each training 21.19 site; 21.20 (4) audited clinical training costs per trainee for each 21.21 medical education program where available or estimates of 21.22 clinical training costs based on audited financial data; 21.23 (5) a description of current sources of funding for medical 21.24 education costs including a description and dollar amount of all 21.25 state and federal financial support, including Medicare direct 21.26 and indirect payments; 21.27 (6) other revenue received for the purposes of clinical 21.28 training; and 21.29 (7)a statement identifying unfunded costs; and21.30(8)other supporting information the commissioner, with 21.31 advice from the advisory committee, determines is necessary for 21.32 the equitable distribution of funds. 21.33 (d) The commissioner shall distribute medical education 21.34 funds to all qualifying applicants based on the following basic 21.35 criteria: (1) total medical education funds available; (2) 21.36 total eligible trainees in each eligible education program; and 22.1 (3) the statewide average cost per trainee, by type of trainee, 22.2 in each medical education program. Funds distributed shall not 22.3 be used to displace current funding appropriations from federal 22.4 or state sources. Funds shall be distributed to the sponsoring 22.5 institutions indicating the amount to be paid to each of the 22.6 sponsor's medical education programs based on the criteria in 22.7 this paragraph. Sponsoring institutions which receive funds 22.8 from the trust fund must distribute approved funds to the 22.9 medical education program according to the commissioner's 22.10 approval letter. Further, programs must distribute funds among 22.11 the sites of trainingbased on the percentage of total program22.12training performed at each site.as specified in the 22.13 commissioner's approval letter. Any funds not distributed as 22.14 directed by the commissioner's approval letter shall be returned 22.15 to the medical education and research trust fund within 30 days 22.16 of a notice from the commissioner. The commissioner shall 22.17 distribute returned funds to the appropriate entities in 22.18 accordance with the commissioner's approval letter. 22.19 (e) Medical education programs receiving funds from the 22.20 trust fund must submitannual cost and program reportsa medical 22.21 education and research grant verification report (GVR) through 22.22 the sponsoring institution based on criteria established by the 22.23 commissioner. If the sponsoring institution fails to submit the 22.24 GVR by the stated deadline, or to request and meet the deadline 22.25 for an extension, the sponsoring institution is required to 22.26 return the full amount of the medical education and research 22.27 trust fund grant to the medical education and research trust 22.28 fund within 30 days of a notice from the commissioner. The 22.29 commissioner shall distribute returned funds to the appropriate 22.30 entities in accordance with the commissioner's approval letter. 22.31 The reports must include: 22.32 (1) the total number of eligible trainees in the program; 22.33 (2) the programs and residencies funded, the amounts of 22.34 trust fund payments to each program, and within each program, 22.35 thepercentagedollar amount distributed to each training site; 22.36 and 23.1 (3)the average cost per trainee and a detailed breakdown23.2of the components of those costs;23.3(4) other state or federal appropriations received for the23.4purposes of clinical training;23.5(5) other revenue received for the purposes of clinical23.6training; and23.7(6)other information the commissioner, with advice from 23.8 the advisory committee, deems appropriate to evaluate the 23.9 effectiveness of the use of funds for clinical training. 23.10 The commissioner, with advice from the advisory committee, 23.11 will provide an annual summary report to the legislature on 23.12 program implementation due February 15 of each year. 23.13 (f) The commissioner is authorized to distribute funds made 23.14 available through: 23.15 (1) voluntary contributions by employers or other entities; 23.16 (2) allocations for the department of human services to 23.17 support medical education and research; and 23.18 (3) other sources as identified and deemed appropriate by 23.19 the legislature for inclusion in the trust fund. 23.20 (g) The advisory committee shall continue to study and make 23.21 recommendations on: 23.22 (1) the funding of medical research consistent with work 23.23 currently mandated by the legislature and under way at the 23.24 department of health; and 23.25 (2) the costs and benefits associated with medical 23.26 education and research. 23.27 Sec. 4. Minnesota Statutes 1997 Supplement, section 23.28 62J.69, is amended by adding a subdivision to read: 23.29 Subd. 4. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 23.30 SERVICES.] (a) The amount transferred in accordance with section 23.31 256B.69, subdivision 5c, shall be distributed to qualifying 23.32 applicants based on a distribution formula that reflects a 23.33 summation of two factors: 23.34 (1) an education factor, which is determined by the total 23.35 number of eligible trainees and the total statewide average 23.36 costs per trainee, by type of trainee, in each program; and 24.1 (2) a public program volume factor, which is determined by 24.2 the total volume of public program revenue received by each 24.3 training site as a percentage of all public program revenue 24.4 received by all training sites in the trust fund pool. 24.5 In this formula, the education factor shall be weighted at 24.6 50 percent and the public program volume factor shall be 24.7 weighted at 50 percent. 24.8 (b) Public program revenue for the above formula shall 24.9 include revenue from medical assistance, prepaid medical 24.10 assistance, general assistance medical care, and prepaid general 24.11 assistance medical care. 24.12 (c) Training sites that receive no public program revenue 24.13 shall be ineligible for payments from the prepaid medical 24.14 assistance program transfer pool. 24.15 Sec. 5. Minnesota Statutes 1997 Supplement, section 24.16 62J.75, is amended to read: 24.17 62J.75 [CONSUMER ADVISORY BOARD.] 24.18 (a) The consumer advisory board consists of 18 members 24.19 appointed in accordance with paragraph (b). All members must be 24.20 public, consumer members who: 24.21 (1) do not have and never had a material interest in either 24.22 the provision of health care services or in an activity directly 24.23 related to the provision of health care services, such as health 24.24 insurance sales or health plan administration; 24.25 (2) are not registered lobbyists; and 24.26 (3) are not currently responsible for or directly involved 24.27 in the purchasing of health insurance for a business or 24.28 organization. 24.29 (b) The governor, the speaker of the house of 24.30 representatives, and the subcommittee on committees of the 24.31 committee on rules and administration of the senate shall each 24.32 appoint two members. The Indian affairs council, the council on 24.33 affairs of Chicano/Latino people, the council on Black 24.34 Minnesotans, the council on Asian-Pacific Minnesotans, 24.35 mid-Minnesota legal assistance, and the Minnesota chamber of 24.36 commerce shall each appoint one member. The member appointed by 25.1 the Minnesota chamber of commerce must represent small business 25.2 interests. The health care campaign of Minnesota, Minnesotans 25.3 for affordable health care, and consortium for citizens with 25.4 disabilities shall each appoint two members.Members serve25.5without compensation or reimbursement for expenses.Compensation 25.6 for members is governed by section 15.059, subdivision 3. 25.7 (c) The board shall advise the commissioners of health and 25.8 commerce on the following: 25.9 (1) the needs of health care consumers and how to better 25.10 serve and educate the consumers on health care concerns and 25.11 recommend solutions to identified problems; and 25.12 (2) consumer protection issues in the self-insured market, 25.13 including, but not limited to, public education needs. 25.14 The board also may make recommendations to the legislature 25.15 on these issues. 25.16 (d) The board and this section expire June 30, 2001. 25.17 Sec. 6. Minnesota Statutes 1997 Supplement, section 25.18 103I.208, subdivision 2, is amended to read: 25.19 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 25.20 property owner is: 25.21 (1) for a well that is not in use under a maintenance 25.22 permit, $100 annually; 25.23 (2) for construction of a monitoring well, $120, which 25.24 includes the state core function fee; 25.25 (3) for a monitoring well that is unsealed under a 25.26 maintenance permit, $100 annually; 25.27 (4) for monitoring wells used as a leak detection device at 25.28 a single motor fuel retail outletor, a single petroleum bulk 25.29 storage site excluding tank farms, or a single agricultural 25.30 chemical facility site, the construction permit fee is $120, 25.31 which includes the state core function fee, per site regardless 25.32 of the number of wells constructed on the site, and the annual 25.33 fee for a maintenance permit for unsealed monitoring wells is 25.34 $100 per site regardless of the number of monitoring wells 25.35 located on site; 25.36 (5) for a groundwater thermal exchange device, in addition 26.1 to the notification fee for wells, $120, which includes the 26.2 state core function fee; 26.3 (6) for a vertical heat exchanger, $120; 26.4 (7) for a dewatering well that is unsealed under a 26.5 maintenance permit, $100 annually for each well, except a 26.6 dewatering project comprising more than five wells shall be 26.7 issued a single permit for $500 annually for wells recorded on 26.8 the permit; and 26.9 (8) for excavating holes for the purpose of installing 26.10 elevator shafts, $120 for each hole. 26.11 Sec. 7. Minnesota Statutes 1997 Supplement, section 26.12 144.1494, subdivision 1, is amended to read: 26.13 Subdivision 1. [CREATION OF ACCOUNT.] A rural physician 26.14 education account is established in the health care access 26.15 fund. The commissioner shall use money from the account to 26.16 establish a loan forgiveness program for medical residents 26.17 agreeing to practice in designated rural areas, as defined by 26.18 the commissioner. Appropriations made to this account are 26.19 available until expended. 26.20 Sec. 8. Minnesota Statutes 1996, section 144.701, 26.21 subdivision 1, is amended to read: 26.22 Subdivision 1. [CONSUMER INFORMATION.] The commissioner of 26.23 health shall ensure that the total costs, total 26.24 revenues, overall utilization, and total services of each 26.25 hospital and each outpatient surgical center are reported to the 26.26 public in a form understandable to consumers. 26.27 Sec. 9. Minnesota Statutes 1996, section 144.701, 26.28 subdivision 2, is amended to read: 26.29 Subd. 2. [DATA FOR POLICY MAKING.] The commissioner of 26.30 health shall compile relevant financial and accounting, 26.31 utilization, and services data concerning hospitals and 26.32 outpatient surgical centers in order to have statistical 26.33 information available for legislative policy making. 26.34 Sec. 10. Minnesota Statutes 1996, section 144.701, 26.35 subdivision 4, is amended to read: 26.36 Subd. 4. [FILING FEES.] Each report which is required to 27.1 be submitted to the commissioner of health under sections 27.2 144.695 to 144.703 and which is not submitted to a voluntary, 27.3 nonprofit reporting organization in accordance with section 27.4 144.702 shall be accompanied by a filing fee in an amount 27.5 prescribed by rule of the commissioner of health.Fees received27.6pursuant to this subdivision shall be deposited in the general27.7fund of the state treasury.Upon the withdrawal of approval of 27.8 a reporting organization, or the decision of the commissioner to 27.9 not renew a reporting organization, fees collected under section 27.10 144.702 shall be submitted to the commissionerand deposited in27.11the general fund. Fees received under this subdivision shall be 27.12 deposited in a revolving fund and are hereby appropriated to the 27.13 commissioner of health for the purposes of sections 144.695 to 27.14 144.703. The commissioner shall report the termination or 27.15 nonrenewal of the voluntary reporting organization to the chair 27.16 of the health and human services subdivision of the 27.17 appropriations committee of the house of representatives, to the 27.18 chair of the health and human services division of the finance 27.19 committee of the senate, and the commissioner of finance. 27.20 Sec. 11. Minnesota Statutes 1996, section 144.702, 27.21 subdivision 1, is amended to read: 27.22 Subdivision 1. [REPORTING THROUGH A REPORTING 27.23 ORGANIZATION.] A hospital or outpatient surgical center may 27.24 agree to submit its financial, utilization, and services reports 27.25 to a voluntary, nonprofit reporting organization whose reporting 27.26 procedures have been approved by the commissioner of health in 27.27 accordance with this section. Each report submitted under this 27.28 section shall be accompanied by a filing fee to the voluntary, 27.29 nonprofit reporting organization. 27.30 Sec. 12. Minnesota Statutes 1996, section 144.702, 27.31 subdivision 2, is amended to read: 27.32 Subd. 2. [APPROVAL OF ORGANIZATION'S REPORTING 27.33 PROCEDURES.] The commissioner of health may approve voluntary 27.34 reporting procedures consistent with written operating 27.35 requirements for the voluntary, nonprofit reporting organization 27.36 which shall be established annually by the commissioner. These 28.1 written operating requirements shall specify reports, analyses, 28.2 and other deliverables to be produced by the voluntary, 28.3 nonprofit reporting organization, and the dates on which those 28.4 deliverables must be submitted to the commissioner. These 28.5 written operating requirements shall specify deliverable dates 28.6 sufficient to enable the commissioner of health to process and 28.7 report health care cost information system data to the 28.8 commissioner of human services by August 15 of each year. The 28.9 commissioner of health shall, by rule, prescribe standards for 28.10 submission of data by hospitals and outpatient surgical centers 28.11 to the voluntary, nonprofit reporting organization or to the 28.12 commissioner. These standards shall provide for: 28.13 (a) the filing of appropriate financial, utilization, and 28.14 services information with the reporting organization; 28.15 (b) adequate analysis and verification of that financial, 28.16 utilization, and services information; and 28.17 (c) timely publication of the costs, revenues, and rates of 28.18 individual hospitals and outpatient surgical centers prior to 28.19 the effective date of any proposed rate increase. The 28.20 commissioner of health shall annually review the procedures 28.21 approved pursuant to this subdivision. 28.22 Sec. 13. Minnesota Statutes 1996, section 144.702, 28.23 subdivision 8, is amended to read: 28.24 Subd. 8. [TERMINATION OR NONRENEWAL OF REPORTING 28.25 ORGANIZATION.] The commissioner may withdraw approval of any 28.26 voluntary, nonprofit reporting organization for failure on the 28.27 part of the voluntary, nonprofit reporting organization to 28.28 comply with the written operating requirements under subdivision 28.29 2. Upon the effective date of the withdrawal, all funds 28.30 collected by the voluntary, nonprofit reporting organization 28.31 under section144.701144.702, subdivision41, but not expended 28.32 shall be deposited inthe general funda revolving fund and are 28.33 hereby appropriated to the commissioner of health for the 28.34 purposes of sections 144.695 to 144.703. 28.35 The commissioner may choose not to renew approval of a 28.36 voluntary, nonprofit reporting organization if the organization 29.1 has failed to perform its obligations satisfactorily under the 29.2 written operating requirements under subdivision 2. 29.3 Sec. 14. [144.7022] [ADMINISTRATIVE PENALTY ORDERS FOR 29.4 REPORTING ORGANIZATIONS.] 29.5 Subdivision 1. [AUTHORIZATION.] The commissioner may issue 29.6 an order to the voluntary, nonprofit reporting organization 29.7 requiring violations to be corrected and administratively assess 29.8 monetary penalties for violations of this chapter or rules, 29.9 written operating requirements, orders, stipulation agreements, 29.10 settlements, or compliance agreements adopted, enforced, or 29.11 issued by the commissioner. 29.12 Subd. 2. [CONTENTS OF ORDER.] An order assessing an 29.13 administrative penalty under this section must include: 29.14 (1) a concise statement of the facts alleged to constitute 29.15 a violation; 29.16 (2) a reference to the section of law, rule, written 29.17 operating requirement, order, stipulation agreement, settlement, 29.18 or compliance agreement that has been violated; 29.19 (3) a statement of the amount of the administrative penalty 29.20 to be imposed and the factors upon which the penalty is based; 29.21 (4) a statement of the corrective actions necessary to 29.22 correct the violation; and 29.23 (5) a statement of the right to request a hearing according 29.24 to sections 14.57 to 14.62. 29.25 Subd. 3. [CONCURRENT CORRECTIVE ORDER.] The commissioner 29.26 may issue an order assessing an administrative penalty and 29.27 requiring the violations cited in the order be corrected within 29.28 30 calendar days from the date the order is received. The 29.29 voluntary, nonprofit reporting organization that is subject to 29.30 the order shall provide to the commissioner before the 31st day 29.31 after the order was received, information demonstrating that the 29.32 violation has been corrected or that a corrective plan, 29.33 acceptable to the commissioner, has been developed. The 29.34 commissioner shall determine whether the violation has been 29.35 corrected and notify the voluntary, nonprofit reporting 29.36 organization of the commissioner's determination. 30.1 Subd. 4. [PENALTY.] If the commissioner determines that 30.2 the violation has been corrected or an acceptable corrective 30.3 plan has been developed, the penalty may be forgiven, except, 30.4 where there are repeated or serious violations, the commissioner 30.5 may issue an order with a penalty that will not be forgiven 30.6 after corrective action is taken. Unless there is a request for 30.7 review of the order under subdivision 6 before the penalty is 30.8 due, the penalty is due and payable: 30.9 (1) on the 31st calendar day after the order was received, 30.10 if the voluntary, nonprofit reporting organization fails to 30.11 provide information to the commissioner showing that the 30.12 violation has been corrected or that appropriate steps have been 30.13 taken toward correcting the violation; 30.14 (2) on the 20th day after the voluntary, nonprofit 30.15 reporting organization receives the commissioner's determination 30.16 that the information provided is not sufficient to show that 30.17 either the violation has been corrected or that appropriate 30.18 steps have been taken toward correcting the violation; or 30.19 (3) on the 31st day after the order was received where the 30.20 penalty is for repeated or serious violations and, according to 30.21 the order issued, the penalty will not be forgiven after 30.22 corrective action is taken. 30.23 All penalties due under this section are payable to the 30.24 treasurer, state of Minnesota, and shall be credited to the 30.25 general fund. 30.26 Subd. 5. [AMOUNT OF PENALTY; CONSIDERATIONS.] (a) The 30.27 maximum amount of an administrative penalty order is $5,000 for 30.28 each specific violation identified in an inspection, 30.29 investigation, or compliance review, up to an annual maximum 30.30 total for all violations of ten percent of the fees collected by 30.31 the voluntary, nonprofit reporting organization under section 30.32 144.702, subdivision 1. The annual maximum is based on a 30.33 reporting year. 30.34 (b) In determining the amount of the administrative 30.35 penalty, the commissioner shall consider the following: 30.36 (1) the willfulness of the violation; 31.1 (2) the gravity of the violation; 31.2 (3) the history of past violations; 31.3 (4) the number of violations; 31.4 (5) the economic benefit gained by the person allowing or 31.5 committing the violation; and 31.6 (6) other factors as justice may require, if the 31.7 commissioner specifically identifies the additional factors in 31.8 the commissioner's order. 31.9 (c) In determining the amount of a penalty for a violation 31.10 subsequent to an initial violation under paragraph (a), the 31.11 commissioner shall also consider: 31.12 (1) the similarity of the most recent previous violation 31.13 and the violation to be penalized; 31.14 (2) the time elapsed since the last violation; and 31.15 (3) the response of the voluntary, nonprofit reporting 31.16 organization to the most recent previous violation. 31.17 Subd. 6. [REQUEST FOR HEARING; HEARING; AND FINAL 31.18 ORDER.] A request for hearing must be in writing, delivered to 31.19 the commissioner by certified mail within 20 calendar days after 31.20 the receipt of the order, and specifically state the reasons for 31.21 seeking review of the order. The commissioner must initiate a 31.22 hearing within 30 calendar days from the date of receipt of the 31.23 written request for hearing. The hearing shall be conducted 31.24 pursuant to the contested case procedures in sections 14.57 to 31.25 14.62. No earlier than ten calendar days after and within 30 31.26 calendar days of receipt of the presiding administrative law 31.27 judge's report, the commissioner shall, based on all relevant 31.28 facts, issue a final order modifying, vacating, or making the 31.29 original order permanent. If, within 20 calendar days of 31.30 receipt of the original order, the voluntary, nonprofit 31.31 reporting organization fails to request a hearing in writing, 31.32 the order becomes the final order of the commissioner. 31.33 Subd. 7. [REVIEW OF FINAL ORDER AND PAYMENT OF 31.34 PENALTY.] Once the commissioner issues a final order, any 31.35 penalty due under that order shall be paid within 30 calendar 31.36 days after the date of the final order, unless review of the 32.1 final order is requested. The final order of the commissioner 32.2 may be appealed in the manner prescribed in sections 14.63 to 32.3 14.69. If the final order is reviewed and upheld, the penalty 32.4 shall be paid 30 calendar days after the date of the decision of 32.5 the reviewing court. Failure to request an administrative 32.6 hearing pursuant to subdivision 6 shall constitute a waiver of 32.7 the right to further agency or judicial review of the final 32.8 order. 32.9 Subd. 8. [REINSPECTIONS AND EFFECT OF NONCOMPLIANCE.] If, 32.10 upon reinspection, or in the determination of the commissioner, 32.11 it is found that any deficiency specified in the order has not 32.12 been corrected or an acceptable corrective plan has not been 32.13 developed, the voluntary, nonprofit reporting organization is in 32.14 noncompliance. The commissioner shall issue a notice of 32.15 noncompliance and may impose any additional remedy available 32.16 under this chapter. 32.17 Subd. 9. [ENFORCEMENT.] The attorney general may proceed 32.18 on behalf of the commissioner to enforce penalties that are due 32.19 and payable under this section in any manner provided by law for 32.20 the collection of debts. 32.21 Subd. 10. [TERMINATION OR NONRENEWAL OF REPORTING 32.22 ORGANIZATION.] The commissioner may withdraw or not renew 32.23 approval of any voluntary, nonprofit reporting organization for 32.24 failure on the part of the voluntary, nonprofit reporting 32.25 organization to pay penalties owed under this section. 32.26 Subd. 11. [CUMULATIVE REMEDY.] The authority of the 32.27 commissioner to issue an administrative penalty order is in 32.28 addition to other lawfully available remedies. 32.29 Subd. 12. [MEDIATION.] In addition to review under 32.30 subdivision 6, the commissioner is authorized to enter into 32.31 mediation concerning an order issued under this section if the 32.32 commissioner and the voluntary, nonprofit reporting organization 32.33 agree to mediation. 32.34 Sec. 15. Minnesota Statutes 1996, section 144A.44, 32.35 subdivision 2, is amended to read: 32.36 Subd. 2. [INTERPRETATION AND ENFORCEMENT OF RIGHTS.] These 33.1 rights are established for the benefit of persons who receive 33.2 home care services. "Home care services" means home care 33.3 services as defined in section 144A.43, subdivision 3. A home 33.4 care provider may not require a person to surrender these rights 33.5 as a condition of receiving services. A guardian or conservator 33.6 or, when there is no guardian or conservator, a designated 33.7 person, may seek to enforce these rights. This statement of 33.8 rights does not replace or diminish other rights and liberties 33.9 that may exist relative to persons receiving home care services, 33.10 persons providing home care services, or providers licensed 33.11 under Laws 1987, chapter 378. A copy of these rights must be 33.12 provided to an individual at the time home care services are 33.13 initiated. The copy shall also contain the address and phone 33.14 number of the office of health facility complaints and the 33.15 office of the ombudsman for older Minnesotans and a brief 33.16 statement describing how to file a complaint withthat office33.17 these offices. Information about how to contact the office of 33.18 the ombudsman for older Minnesotans shall be included in notices 33.19 of change in client fees and in notices from home care providers 33.20 transferring or discontinuing services. 33.21 Sec. 16. Minnesota Statutes 1996, section 214.03, is 33.22 amended to read: 33.23 214.03 [STANDARDIZED TESTS.] 33.24 (a) All state examining and licensing boards, other than 33.25 the state board of law examiners, the state board of 33.26 professional responsibility or any other board established by 33.27 the supreme court to regulate the practice of law and judicial 33.28 functions, shall use national standardized tests for the 33.29 objective, nonpractical portion of any examination given to 33.30 prospective licensees to the extent that such national 33.31 standardized tests are appropriate, except when the subject 33.32 matter of the examination relates to the application of 33.33 Minnesota law to the profession or calling being licensed. 33.34 (b) The health-related boards may establish an account in 33.35 the special revenue fund to deposit applicant payments for 33.36 national or regional standardized tests. Money in the account 34.1 is appropriated to pay for the use of national or regional 34.2 standardized tests. 34.3 Sec. 17. Minnesota Statutes 1997 Supplement, section 34.4 214.32, subdivision 1, is amended to read: 34.5 Subdivision 1. [MANAGEMENT.] (a) A health professionals 34.6 services program committee is established, consisting of one 34.7 person appointed by each participating board, with each 34.8 participating board having one vote. The committee shall 34.9 designate one board to provide administrative management of the 34.10 program, set the program budget and the pro rata share of 34.11 program expenses to be borne by each participating board, 34.12 provide guidance on the general operation of the program, 34.13 including hiring of program personnel, and ensure that the 34.14 program's direction is in accord with its authority. No more 34.15 than half plus one of the members of the committee may be of one 34.16 gender. If the participating boards change the board designated 34.17 to provide administrative management of the program, any 34.18 appropriation remaining for the program shall transfer to the 34.19 newly designated board. The boards must inform the chairs of 34.20 the senate health and family security budget division and the 34.21 house health and human services finance division, and the 34.22 commissioner of finance of any change in administrative 34.23 management of the program and of the amount transferred to the 34.24 newly designated board. 34.25 (b) The designated board, upon recommendation of the health 34.26 professional services program committee, shall hire the program 34.27 manager and employees and pay expenses of the program from funds 34.28 appropriated for that purpose. The designated board may apply 34.29 for grants to pay program expenses and may enter into contracts 34.30 on behalf of the program to carry out the purposes of the 34.31 program. The participating boards shall enter into written 34.32 agreements with the designated board. 34.33 (c) An advisory committee is established to advise the 34.34 program committee consisting of: 34.35 (1) one member appointed by each of the following: the 34.36 Minnesota Academy of Physician Assistants, the Minnesota Dental 35.1 Association, the Minnesota Chiropractic Association, the 35.2 Minnesota Licensed Practical Nurse Association, the Minnesota 35.3 Medical Association, the Minnesota Nurses Association, and the 35.4 Minnesota Podiatric Medicine Association; 35.5 (2) one member appointed by each of the professional 35.6 associations of the other professions regulated by a 35.7 participating board not specified in clause (1); and 35.8 (3) two public members, as defined by section 214.02. 35.9 Members of the advisory committee shall be appointed for two 35.10 years and members may be reappointed. 35.11 No more than half plus one of the members of the committee 35.12 may be of one gender. 35.13 The advisory committee expires June 30, 2001. 35.14 Sec. 18. [REPORT BY THE UNIVERSITY OF MINNESOTA ACADEMIC 35.15 HEALTH CENTER.] 35.16 The University of Minnesota academic health center, after 35.17 consultation with the health care community and the medical 35.18 education and research costs advisory committee, is requested to 35.19 report to the commissioner of health and the legislative 35.20 commission on health care access by January 15, 1999, on plans 35.21 for the strategic direction and vision of the academic health 35.22 center. The report shall address plans for the ongoing 35.23 assessment of health provider workforce needs; plans for the 35.24 ongoing assessment of the educational needs of health 35.25 professionals and the implications for their education and 35.26 training programs; and plans for ongoing, meaningful input from 35.27 the health care community on health-related research and 35.28 education programs administered by the academic health center. 35.29 Sec. 19. [REPEALER.] 35.30 Minnesota Statutes 1997 Supplement, section 62J.685, is 35.31 repealed. 35.32 ARTICLE 3 35.33 LONG-TERM CARE 35.34 Section 1. Minnesota Statutes 1997 Supplement, section 35.35 144A.071, subdivision 4a, is amended to read: 35.36 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 36.1 best interest of the state to ensure that nursing homes and 36.2 boarding care homes continue to meet the physical plant 36.3 licensing and certification requirements by permitting certain 36.4 construction projects. Facilities should be maintained in 36.5 condition to satisfy the physical and emotional needs of 36.6 residents while allowing the state to maintain control over 36.7 nursing home expenditure growth. 36.8 The commissioner of health in coordination with the 36.9 commissioner of human services, may approve the renovation, 36.10 replacement, upgrading, or relocation of a nursing home or 36.11 boarding care home, under the following conditions: 36.12 (a) to license or certify beds in a new facility 36.13 constructed to replace a facility or to make repairs in an 36.14 existing facility that was destroyed or damaged after June 30, 36.15 1987, by fire, lightning, or other hazard provided: 36.16 (i) destruction was not caused by the intentional act of or 36.17 at the direction of a controlling person of the facility; 36.18 (ii) at the time the facility was destroyed or damaged the 36.19 controlling persons of the facility maintained insurance 36.20 coverage for the type of hazard that occurred in an amount that 36.21 a reasonable person would conclude was adequate; 36.22 (iii) the net proceeds from an insurance settlement for the 36.23 damages caused by the hazard are applied to the cost of the new 36.24 facility or repairs; 36.25 (iv) the new facility is constructed on the same site as 36.26 the destroyed facility or on another site subject to the 36.27 restrictions in section 144A.073, subdivision 5; 36.28 (v) the number of licensed and certified beds in the new 36.29 facility does not exceed the number of licensed and certified 36.30 beds in the destroyed facility; and 36.31 (vi) the commissioner determines that the replacement beds 36.32 are needed to prevent an inadequate supply of beds. 36.33 Project construction costs incurred for repairs authorized under 36.34 this clause shall not be considered in the dollar threshold 36.35 amount defined in subdivision 2; 36.36 (b) to license or certify beds that are moved from one 37.1 location to another within a nursing home facility, provided the 37.2 total costs of remodeling performed in conjunction with the 37.3 relocation of beds does not exceed $750,000; 37.4 (c) to license or certify beds in a project recommended for 37.5 approval under section 144A.073; 37.6 (d) to license or certify beds that are moved from an 37.7 existing state nursing home to a different state facility, 37.8 provided there is no net increase in the number of state nursing 37.9 home beds; 37.10 (e) to certify and license as nursing home beds boarding 37.11 care beds in a certified boarding care facility if the beds meet 37.12 the standards for nursing home licensure, or in a facility that 37.13 was granted an exception to the moratorium under section 37.14 144A.073, and if the cost of any remodeling of the facility does 37.15 not exceed $750,000. If boarding care beds are licensed as 37.16 nursing home beds, the number of boarding care beds in the 37.17 facility must not increase beyond the number remaining at the 37.18 time of the upgrade in licensure. The provisions contained in 37.19 section 144A.073 regarding the upgrading of the facilities do 37.20 not apply to facilities that satisfy these requirements; 37.21 (f) to license and certify up to 40 beds transferred from 37.22 an existing facility owned and operated by the Amherst H. Wilder 37.23 Foundation in the city of St. Paul to a new unit at the same 37.24 location as the existing facility that will serve persons with 37.25 Alzheimer's disease and other related disorders. The transfer 37.26 of beds may occur gradually or in stages, provided the total 37.27 number of beds transferred does not exceed 40. At the time of 37.28 licensure and certification of a bed or beds in the new unit, 37.29 the commissioner of health shall delicense and decertify the 37.30 same number of beds in the existing facility. As a condition of 37.31 receiving a license or certification under this clause, the 37.32 facility must make a written commitment to the commissioner of 37.33 human services that it will not seek to receive an increase in 37.34 its property-related payment rate as a result of the transfers 37.35 allowed under this paragraph; 37.36 (g) to license and certify nursing home beds to replace 38.1 currently licensed and certified boarding care beds which may be 38.2 located either in a remodeled or renovated boarding care or 38.3 nursing home facility or in a remodeled, renovated, newly 38.4 constructed, or replacement nursing home facility within the 38.5 identifiable complex of health care facilities in which the 38.6 currently licensed boarding care beds are presently located, 38.7 provided that the number of boarding care beds in the facility 38.8 or complex are decreased by the number to be licensed as nursing 38.9 home beds and further provided that, if the total costs of new 38.10 construction, replacement, remodeling, or renovation exceed ten 38.11 percent of the appraised value of the facility or $200,000, 38.12 whichever is less, the facility makes a written commitment to 38.13 the commissioner of human services that it will not seek to 38.14 receive an increase in its property-related payment rate by 38.15 reason of the new construction, replacement, remodeling, or 38.16 renovation. The provisions contained in section 144A.073 38.17 regarding the upgrading of facilities do not apply to facilities 38.18 that satisfy these requirements; 38.19 (h) to license as a nursing home and certify as a nursing 38.20 facility a facility that is licensed as a boarding care facility 38.21 but not certified under the medical assistance program, but only 38.22 if the commissioner of human services certifies to the 38.23 commissioner of health that licensing the facility as a nursing 38.24 home and certifying the facility as a nursing facility will 38.25 result in a net annual savings to the state general fund of 38.26 $200,000 or more; 38.27 (i) to certify, after September 30, 1992, and prior to July 38.28 1, 1993, existing nursing home beds in a facility that was 38.29 licensed and in operation prior to January 1, 1992; 38.30 (j) to license and certify new nursing home beds to replace 38.31 beds in a facilitycondemnedacquired by the Minneapolis 38.32 Community Development Agency as part ofan economic38.33 redevelopmentplanactivities in a city of the first class, 38.34 provided the new facility is located withinone milethree miles 38.35 of the site of the old facility. Operating and property costs 38.36 for the new facility must be determined and allowed 39.1 underexisting reimbursement rulessection 256B.431 or 256B.434; 39.2 (k) to license and certify up to 20 new nursing home beds 39.3 in a community-operated hospital and attached convalescent and 39.4 nursing care facility with 40 beds on April 21, 1991, that 39.5 suspended operation of the hospital in April 1986. The 39.6 commissioner of human services shall provide the facility with 39.7 the same per diem property-related payment rate for each 39.8 additional licensed and certified bed as it will receive for its 39.9 existing 40 beds; 39.10 (l) to license or certify beds in renovation, replacement, 39.11 or upgrading projects as defined in section 144A.073, 39.12 subdivision 1, so long as the cumulative total costs of the 39.13 facility's remodeling projects do not exceed $750,000; 39.14 (m) to license and certify beds that are moved from one 39.15 location to another for the purposes of converting up to five 39.16 four-bed wards to single or double occupancy rooms in a nursing 39.17 home that, as of January 1, 1993, was county-owned and had a 39.18 licensed capacity of 115 beds; 39.19 (n) to allow a facility that on April 16, 1993, was a 39.20 106-bed licensed and certified nursing facility located in 39.21 Minneapolis to layaway all of its licensed and certified nursing 39.22 home beds. These beds may be relicensed and recertified in a 39.23 newly-constructed teaching nursing home facility affiliated with 39.24 a teaching hospital upon approval by the legislature. The 39.25 proposal must be developed in consultation with the interagency 39.26 committee on long-term care planning. The beds on layaway 39.27 status shall have the same status as voluntarily delicensed and 39.28 decertified beds, except that beds on layaway status remain 39.29 subject to the surcharge in section 256.9657. This layaway 39.30 provision expires July 1, 1998; 39.31 (o) to allow a project which will be completed in 39.32 conjunction with an approved moratorium exception project for a 39.33 nursing home in southern Cass county and which is directly 39.34 related to that portion of the facility that must be repaired, 39.35 renovated, or replaced, to correct an emergency plumbing problem 39.36 for which a state correction order has been issued and which 40.1 must be corrected by August 31, 1993; 40.2 (p) to allow a facility that on April 16, 1993, was a 40.3 368-bed licensed and certified nursing facility located in 40.4 Minneapolis to layaway, upon 30 days prior written notice to the 40.5 commissioner, up to 30 of the facility's licensed and certified 40.6 beds by converting three-bed wards to single or double 40.7 occupancy. Beds on layaway status shall have the same status as 40.8 voluntarily delicensed and decertified beds except that beds on 40.9 layaway status remain subject to the surcharge in section 40.10 256.9657, remain subject to the license application and renewal 40.11 fees under section 144A.07 and shall be subject to a $100 per 40.12 bed reactivation fee. In addition, at any time within three 40.13 years of the effective date of the layaway, the beds on layaway 40.14 status may be: 40.15 (1) relicensed and recertified upon relocation and 40.16 reactivation of some or all of the beds to an existing licensed 40.17 and certified facility or facilities located in Pine River, 40.18 Brainerd, or International Falls; provided that the total 40.19 project construction costs related to the relocation of beds 40.20 from layaway status for any facility receiving relocated beds 40.21 may not exceed the dollar threshold provided in subdivision 2 40.22 unless the construction project has been approved through the 40.23 moratorium exception process under section 144A.073; 40.24 (2) relicensed and recertified, upon reactivation of some 40.25 or all of the beds within the facility which placed the beds in 40.26 layaway status, if the commissioner has determined a need for 40.27 the reactivation of the beds on layaway status. 40.28 The property-related payment rate of a facility placing 40.29 beds on layaway status must be adjusted by the incremental 40.30 change in its rental per diem after recalculating the rental per 40.31 diem as provided in section 256B.431, subdivision 3a, paragraph 40.32 (d). The property-related payment rate for a facility 40.33 relicensing and recertifying beds from layaway status must be 40.34 adjusted by the incremental change in its rental per diem after 40.35 recalculating its rental per diem using the number of beds after 40.36 the relicensing to establish the facility's capacity day 41.1 divisor, which shall be effective the first day of the month 41.2 following the month in which the relicensing and recertification 41.3 became effective. Any beds remaining on layaway status more 41.4 than three years after the date the layaway status became 41.5 effective must be removed from layaway status and immediately 41.6 delicensed and decertified; 41.7 (q) to license and certify beds in a renovation and 41.8 remodeling project to convert 12 four-bed wards into 24 two-bed 41.9 rooms, expand space, and add improvements in a nursing home 41.10 that, as of January 1, 1994, met the following conditions: the 41.11 nursing home was located in Ramsey county; had a licensed 41.12 capacity of 154 beds; and had been ranked among the top 15 41.13 applicants by the 1993 moratorium exceptions advisory review 41.14 panel. The total project construction cost estimate for this 41.15 project must not exceed the cost estimate submitted in 41.16 connection with the 1993 moratorium exception process; 41.17 (r) to license and certify up to 117 beds that are 41.18 relocated from a licensed and certified 138-bed nursing facility 41.19 located in St. Paul to a hospital with 130 licensed hospital 41.20 beds located in South St. Paul, provided that the nursing 41.21 facility and hospital are owned by the same or a related 41.22 organization and that prior to the date the relocation is 41.23 completed the hospital ceases operation of its inpatient 41.24 hospital services at that hospital. After relocation, the 41.25 nursing facility's status under section 256B.431, subdivision 41.26 2j, shall be the same as it was prior to relocation. The 41.27 nursing facility's property-related payment rate resulting from 41.28 the project authorized in this paragraph shall become effective 41.29 no earlier than April 1, 1996. For purposes of calculating the 41.30 incremental change in the facility's rental per diem resulting 41.31 from this project, the allowable appraised value of the nursing 41.32 facility portion of the existing health care facility physical 41.33 plant prior to the renovation and relocation may not exceed 41.34 $2,490,000; 41.35 (s) to license and certify two beds in a facility to 41.36 replace beds that were voluntarily delicensed and decertified on 42.1 June 28, 1991; 42.2 (t) to allow 16 licensed and certified beds located on July 42.3 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 42.4 facility in Minneapolis, notwithstanding the licensure and 42.5 certification after July 1, 1995, of the Minneapolis facility as 42.6 a 147-bed nursing home facility after completion of a 42.7 construction project approved in 1993 under section 144A.073, to 42.8 be laid away upon 30 days' prior written notice to the 42.9 commissioner. Beds on layaway status shall have the same status 42.10 as voluntarily delicensed or decertified beds except that they 42.11 shall remain subject to the surcharge in section 256.9657. The 42.12 16 beds on layaway status may be relicensed as nursing home beds 42.13 and recertified at any time within five years of the effective 42.14 date of the layaway upon relocation of some or all of the beds 42.15 to a licensed and certified facility located in Watertown, 42.16 provided that the total project construction costs related to 42.17 the relocation of beds from layaway status for the Watertown 42.18 facility may not exceed the dollar threshold provided in 42.19 subdivision 2 unless the construction project has been approved 42.20 through the moratorium exception process under section 144A.073. 42.21 The property-related payment rate of the facility placing 42.22 beds on layaway status must be adjusted by the incremental 42.23 change in its rental per diem after recalculating the rental per 42.24 diem as provided in section 256B.431, subdivision 3a, paragraph 42.25 (d). The property-related payment rate for the facility 42.26 relicensing and recertifying beds from layaway status must be 42.27 adjusted by the incremental change in its rental per diem after 42.28 recalculating its rental per diem using the number of beds after 42.29 the relicensing to establish the facility's capacity day 42.30 divisor, which shall be effective the first day of the month 42.31 following the month in which the relicensing and recertification 42.32 became effective. Any beds remaining on layaway status more 42.33 than five years after the date the layaway status became 42.34 effective must be removed from layaway status and immediately 42.35 delicensed and decertified; 42.36 (u) to license and certify beds that are moved within an 43.1 existing area of a facility or to a newly constructed addition 43.2 which is built for the purpose of eliminating three- and 43.3 four-bed rooms and adding space for dining, lounge areas, 43.4 bathing rooms, and ancillary service areas in a nursing home 43.5 that, as of January 1, 1995, was located in Fridley and had a 43.6 licensed capacity of 129 beds; 43.7 (v) to relocate 36 beds in Crow Wing county and four beds 43.8 from Hennepin county to a 160-bed facility in Crow Wing county, 43.9 provided all the affected beds are under common ownership; 43.10 (w) to license and certify a total replacement project of 43.11 up to 49 beds located in Norman county that are relocated from a 43.12 nursing home destroyed by flood and whose residents were 43.13 relocated to other nursing homes. The operating cost payment 43.14 rates for the new nursing facility shall be determined based on 43.15 the interim and settle-up payment provisions of Minnesota Rules, 43.16 part 9549.0057, and the reimbursement provisions of section 43.17 256B.431, except that subdivision 26, paragraphs (a) and (b), 43.18 shall not apply until the second rate year after the settle-up 43.19 cost report is filed. Property-related reimbursement rates 43.20 shall be determined under section 256B.431, taking into account 43.21 any federal or state flood-related loans or grants provided to 43.22 the facility; 43.23 (x) to license and certify a total replacement project of 43.24 up to 129 beds located in Polk county that are relocated from a 43.25 nursing home destroyed by flood and whose residents were 43.26 relocated to other nursing homes. The operating cost payment 43.27 rates for the new nursing facility shall be determined based on 43.28 the interim and settle-up payment provisions of Minnesota Rules, 43.29 part 9549.0057, and the reimbursement provisions of section 43.30 256B.431, except that subdivision 26, paragraphs (a) and (b), 43.31 shall not apply until the second rate year after the settle-up 43.32 cost report is filed. Property-related reimbursement rates 43.33 shall be determined under section 256B.431, taking into account 43.34 any federal or state flood-related loans or grants provided to 43.35 the facility;or43.36 (y) to license and certify beds in a renovation and 44.1 remodeling project to convert 13 three-bed wards into 13 two-bed 44.2 rooms and 13 single-bed rooms, expand space, and add 44.3 improvements in a nursing home that, as of January 1, 1994, met 44.4 the following conditions: the nursing home was located in 44.5 Ramsey county, was not owned by a hospital corporation, had a 44.6 licensed capacity of 64 beds, and had been ranked among the top 44.7 15 applicants by the 1993 moratorium exceptions advisory review 44.8 panel. The total project construction cost estimate for this 44.9 project must not exceed the cost estimate submitted in 44.10 connection with the 1993 moratorium exception process.; or 44.11 (z) to allow the commissioner of human services to license 44.12 an additional 36 beds to provide residential services for the 44.13 physically handicapped under Minnesota Rules, parts 9570.2000 to 44.14 9570.3400, in a 198-bed nursing home located in Red Wing, and to 44.15 allow the commissioner of health to license and certify nursing 44.16 home beds to replace a 74-bed nursing home in Waite Park 44.17 operated under common ownership with the Red Wing facility, 44.18 provided that the new facility is located within five miles of 44.19 the existing site in Waite Park. The commissioner of health may 44.20 license and certify an additional 20 beds at the new site 44.21 provided that the licensed capacity at the Red Wing site is 44.22 decreased by at least 30 beds. 44.23 Sec. 2. Minnesota Statutes 1996, section 144A.09, 44.24 subdivision 1, is amended to read: 44.25 Subdivision 1. [SPIRITUAL MEANS FOR HEALING.]No rule44.26establishedSections 144A.04, subdivision 5, and 144A.18 to 44.27 144A.27, and rules adopted under sections 144A.01 to 144A.16 44.28 other than a rule relating to sanitation and safety of premises, 44.29 to cleanliness of operation, or to physical equipmentshalldo 44.30 not apply to a nursing home conducted by and for the adherents 44.31 of any recognized church or religious denomination for the 44.32 purpose of providing care and treatment for those who select and 44.33 depend upon spiritual means through prayer alone, in lieu of 44.34 medical care, for healing. 44.35 Sec. 3. Minnesota Statutes 1997 Supplement, section 44.36 256B.431, subdivision 3f, is amended to read: 45.1 Subd. 3f. [PROPERTY COSTS AFTER JULY 1, 1988.] (a) 45.2 [INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 45.3 1988, the replacement-cost-new per bed limit must be $32,571 per 45.4 licensed bed in multiple bedrooms and $48,857 per licensed bed 45.5 in a single bedroom. For the rate year beginning July 1, 1989, 45.6 the replacement-cost-new per bed limit for a single bedroom must 45.7 be $49,907 adjusted according to Minnesota Rules, part 45.8 9549.0060, subpart 4, item A, subitem (1). Beginning January 1, 45.9 1990, the replacement-cost-new per bed limits must be adjusted 45.10 annually as specified in Minnesota Rules, part 9549.0060, 45.11 subpart 4, item A, subitem (1). Beginning January 1, 1991, the 45.12 replacement-cost-new per bed limits will be adjusted annually as 45.13 specified in Minnesota Rules, part 9549.0060, subpart 4, item A, 45.14 subitem (1), except that the index utilized will be the Bureau 45.15 of the Census: Composite fixed-weighted price index as 45.16 published in the C30 Report, Value of New Construction Put in 45.17 Place. 45.18 (b) [RENTAL FACTOR.] For the rate year beginning July 1, 45.19 1988, the commissioner shall increase the rental factor as 45.20 established in Minnesota Rules, part 9549.0060, subpart 8, item 45.21 A, by 6.2 percent rounded to the nearest 100th percent for the 45.22 purpose of reimbursing nursing facilities for soft costs and 45.23 entrepreneurial profits not included in the cost valuation 45.24 services used by the state's contracted appraisers. For rate 45.25 years beginning on or after July 1, 1989, the rental factor is 45.26 the amount determined under this paragraph for the rate year 45.27 beginning July 1, 1988. 45.28 (c) [OCCUPANCY FACTOR.] For rate years beginning on or 45.29 after July 1, 1988, in order to determine property-related 45.30 payment rates under Minnesota Rules, part 9549.0060, for all 45.31 nursing facilities except those whose average length of stay in 45.32 a skilled level of care within a nursing facility is 180 days or 45.33 less, the commissioner shall use 95 percent of capacity days. 45.34 For a nursing facility whose average length of stay in a skilled 45.35 level of care within a nursing facility is 180 days or less, the 45.36 commissioner shall use the greater of resident days or 80 46.1 percent of capacity days but in no event shall the divisor 46.2 exceed 95 percent of capacity days. 46.3 (d) [EQUIPMENT ALLOWANCE.] For rate years beginning on 46.4 July 1, 1988, and July 1, 1989, the commissioner shall add ten 46.5 cents per resident per day to each nursing facility's 46.6 property-related payment rate. The ten-cent property-related 46.7 payment rate increase is not cumulative from rate year to rate 46.8 year. For the rate year beginning July 1, 1990, the 46.9 commissioner shall increase each nursing facility's equipment 46.10 allowance as established in Minnesota Rules, part 9549.0060, 46.11 subpart 10, by ten cents per resident per day. For rate years 46.12 beginning on or after July 1, 1991, the adjusted equipment 46.13 allowance must be adjusted annually for inflation as in 46.14 Minnesota Rules, part 9549.0060, subpart 10, item E. For the 46.15 rate period beginning October 1, 1992, the equipment allowance 46.16 for each nursing facility shall be increased by 28 percent. For 46.17 rate years beginning after June 30, 1993, the allowance must be 46.18 adjusted annually for inflation. 46.19 (e) [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND 46.20 INTEREST EXPENSE.] For rate years beginning on or after July 1, 46.21 1990, Minnesota Rules, part 9549.0060, subpart 5, item E, shall 46.22 not apply to outstanding related organization debt incurred 46.23 prior to May 23, 1983, provided that the debt was an allowable 46.24 debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the 46.25 debt is subject to repayment through annual principal payments, 46.26 and the nursing facility demonstrates to the commissioner's 46.27 satisfaction that the interest rate on the debt was less than 46.28 market interest rates for similar arms-length transactions at 46.29 the time the debt was incurred. If the debt was incurred due to 46.30 a sale between family members, the nursing facility must also 46.31 demonstrate that the seller no longer participates in the 46.32 management or operation of the nursing facility. Debts meeting 46.33 the conditions of this paragraph are subject to all other 46.34 provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. 46.35 (f) [BUILDING CAPITAL ALLOWANCE FOR NURSING FACILITIES 46.36 WITH OPERATING LEASES.] For rate years beginning on or after 47.1 July 1, 1990, a nursing facility with operating lease costs 47.2 incurred for the nursing facility's buildings shall receive its 47.3 building capital allowance computed in accordance with Minnesota 47.4 Rules, part 9549.0060, subpart 8. If an operating lease 47.5 provides that the lessee's rent is adjusted to recognize 47.6 improvements made by the lessor and related debt, the costs for 47.7 capital improvements and related debt shall be allowed in the 47.8 computation of the lessee's building capital allowance, provided 47.9 that reimbursement for these costs under an operating lease 47.10 shall not exceed the rate otherwise paid. 47.11 Sec. 4. Minnesota Statutes 1996, section 256B.431, 47.12 subdivision 4, is amended to read: 47.13 Subd. 4. [SPECIAL RATES.] (a) For the rate years beginning 47.14 July 1, 1983, and July 1, 1984, a newly constructed nursing 47.15 facility or one with a capacity increase of 50 percent or more 47.16 may, upon written application to the commissioner, receive an 47.17 interim payment rate for reimbursement for property-related 47.18 costs calculated pursuant to the statutes and rules in effect on 47.19 May 1, 1983, and for operating costs negotiated by the 47.20 commissioner based upon the 60th percentile established for the 47.21 appropriate group under subdivision 2a, to be effective from the 47.22 first day a medical assistance recipient resides in the facility 47.23 or for the added beds. For newly constructed nursing facilities 47.24 which are not included in the calculation of the 60th percentile 47.25 for any group, subdivision 2f, the commissioner shall establish 47.26 by rule procedures for determining interim operating cost 47.27 payment rates and interim property-related cost payment rates. 47.28 The interim payment rate shall not be in effect for more than 17 47.29 months. The commissioner shall establish, by emergency and 47.30 permanent rules, procedures for determining the interim rate and 47.31 for making a retroactive cost settle-up after the first year of 47.32 operation; the cost settled operating cost per diem shall not 47.33 exceed 110 percent of the 60th percentile established for the 47.34 appropriate group. Until procedures determining operating cost 47.35 payment rates according to mix of resident needs are 47.36 established, the commissioner shall establish by rule procedures 48.1 for determining payment rates for nursing facilities which 48.2 provide care under a lesser care level than the level for which 48.3 the nursing facility is certified. 48.4 (b) For the rate years beginning on or after July 1, 1985, 48.5 a newly constructed nursing facility or one with a capacity 48.6 increase of 50 percent or more may, upon written application to 48.7 the commissioner, receive an interim payment rate for 48.8 reimbursement for property related costs, operating costs, and 48.9 real estate taxes and special assessments calculated under rules 48.10 promulgated by the commissioner. 48.11(c) For rate years beginning on or after July 1, 1983, the48.12commissioner may exclude from a provision of 12 MCAR S 2.050 any48.13facility that is licensed by the commissioner of health only as48.14a boarding care home, certified by the commissioner of health as48.15an intermediate care facility, is licensed by the commissioner48.16of human services under Minnesota Rules, parts 9520.0500 to48.179520.0690, and has less than five percent of its licensed48.18boarding care capacity reimbursed by the medical assistance48.19program. Until a permanent rule to establish the payment rates48.20for facilities meeting these criteria is promulgated, the48.21commissioner shall establish the medical assistance payment rate48.22as follows:48.23(1) The desk audited payment rate in effect on June 30,48.241983, remains in effect until the end of the facility's fiscal48.25year. The commissioner shall not allow any amendments to the48.26cost report on which this desk audited payment rate is based.48.27(2) For each fiscal year beginning between July 1, 1983,48.28and June 30, 1985, the facility's payment rate shall be48.29established by increasing the desk audited operating cost48.30payment rate determined in clause (1) at an annual rate of five48.31percent.48.32(3) For fiscal years beginning on or after July 1, 1985,48.33but before January 1, 1988, the facility's payment rate shall be48.34established by increasing the facility's payment rate in the48.35facility's prior fiscal year by the increase indicated by the48.36consumer price index for Minneapolis and St. Paul.49.1(4) For the fiscal year beginning on January 1, 1988, the49.2facility's payment rate must be established using the following49.3method: The commissioner shall divide the real estate taxes and49.4special assessments payable as stated in the facility's current49.5property tax statement by actual resident days to compute a real49.6estate tax and special assessment per diem. Next, the prior49.7year's payment rate must be adjusted by the higher of (1) the49.8percentage change in the consumer price index (CPI-U U.S. city49.9average) as published by the Bureau of Labor Statistics between49.10the previous two Septembers, new series index (1967-100), or (2)49.112.5 percent, to determine an adjusted payment rate. The49.12facility's payment rate is the adjusted prior year's payment49.13rate plus the real estate tax and special assessment per diem.49.14(5) For fiscal years beginning on or after January 1, 1989,49.15the facility's payment rate must be established using the49.16following method: The commissioner shall divide the real estate49.17taxes and special assessments payable as stated in the49.18facility's current property tax statement by actual resident49.19days to compute a real estate tax and special assessment per49.20diem. Next, the prior year's payment rate less the real estate49.21tax and special assessment per diem must be adjusted by the49.22higher of (1) the percentage change in the consumer price index49.23(CPI-U U.S. city average) as published by the Bureau of Labor49.24Statistics between the previous two Septembers, new series index49.25(1967-100), or (2) 2.5 percent, to determine an adjusted payment49.26rate. The facility's payment rate is the adjusted payment rate49.27plus the real estate tax and special assessment per diem.49.28(6) For the purpose of establishing payment rates under49.29this paragraph, the facility's rate and reporting years coincide49.30with the facility's fiscal year.49.31(d) A facility that meets the criteria of paragraph (c)49.32shall submit annual cost reports on forms prescribed by the49.33commissioner.49.34(e)(c) For the rate year beginning July 1, 1985, each 49.35 nursing facility total payment rate must be effective two 49.36 calendar months from the first day of the month after the 50.1 commissioner issues the rate notice to the nursing facility. 50.2 From July 1, 1985, until the total payment rate becomes 50.3 effective, the commissioner shall make payments to each nursing 50.4 facility at a temporary rate that is the prior rate year's 50.5 operating cost payment rate increased by 2.6 percent plus the 50.6 prior rate year's property-related payment rate and the prior 50.7 rate year's real estate taxes and special assessments payment 50.8 rate. The commissioner shall retroactively adjust the 50.9 property-related payment rate and the real estate taxes and 50.10 special assessments payment rate to July 1, 1985, but must not 50.11 retroactively adjust the operating cost payment rate. 50.12(f)(d) For the purposes of Minnesota Rules, part 50.13 9549.0060, subpart 13, item F, the following types of 50.14 transactions shall not be considered a sale or reorganization of 50.15 a provider entity: 50.16 (1) the sale or transfer of a nursing facility upon death 50.17 of an owner; 50.18 (2) the sale or transfer of a nursing facility due to 50.19 serious illness or disability of an owner as defined under the 50.20 social security act; 50.21 (3) the sale or transfer of the nursing facility upon 50.22 retirement of an owner at 62 years of age or older; 50.23 (4) any transaction in which a partner, owner, or 50.24 shareholder acquires an interest or share of another partner, 50.25 owner, or shareholder in a nursing facility business provided 50.26 the acquiring partner, owner, or shareholder has less than 50 50.27 percent ownership after the acquisition; 50.28 (5) a sale and leaseback to the same licensee which does 50.29 not constitute a change in facility license; 50.30 (6) a transfer of an interest to a trust; 50.31 (7) gifts or other transfers for no consideration; 50.32 (8) a merger of two or more related organizations; 50.33 (9) a transfer of interest in a facility held in 50.34 receivership; 50.35 (10) a change in the legal form of doing business other 50.36 than a publicly held organization which becomes privately held 51.1 or vice versa; 51.2 (11) the addition of a new partner, owner, or shareholder 51.3 who owns less than 20 percent of the nursing facility or the 51.4 issuance of stock; or 51.5 (12) an involuntary transfer including foreclosure, 51.6 bankruptcy, or assignment for the benefit of creditors. 51.7 Any increase in allowable debt or allowable interest 51.8 expense or other cost incurred as a result of the foregoing 51.9 transactions shall be a nonallowable cost for purposes of 51.10 reimbursement under Minnesota Rules, parts 9549.0010 to 51.11 9549.0080. 51.12 Sec. 5. Minnesota Statutes 1996, section 256B.431, 51.13 subdivision 11, is amended to read: 51.14 Subd. 11. [SPECIAL PROPERTY RATE SETTING PROCEDURES FOR 51.15 CERTAIN NURSING FACILITIES.] (a) Notwithstanding Minnesota 51.16 Rules, part 9549.0060, subpart 13, item H, to the contrary, for 51.17 the rate year beginning July 1, 1990, a nursing facility leased 51.18 prior to January 1, 1986, and currently subject to adverse 51.19 licensure action under section 144A.04, subdivision 4, paragraph 51.20 (a), or section 144A.11, subdivision 2, and whose ownership 51.21 changes prior to July 1, 1990, shall be allowed a 51.22 property-related payment equal to the lesser of its current 51.23 lease obligation divided by its capacity days as determined in 51.24 Minnesota Rules, part 9549.0060, subpart 11, as modified by 51.25 subdivision 3f, paragraph (c), or the frozen property-related 51.26 payment rate in effect for the rate year beginning July 1, 51.27 1989. For rate years beginning on or after July 1, 1991, the 51.28 property-related payment rate shall be its rental rate computed 51.29 using the previous owner's allowable principal and interest 51.30 expense as allowed by the department prior to that prior owner's 51.31 sale and lease-back transaction of December 1985. 51.32 (b) Notwithstanding other provisions of applicable law, a 51.33 nursing facility licensed for 122 beds on January 1, 1998, and 51.34 located in Columbia Heights shall have its property-related 51.35 payment rate set under this subdivision. The commissioner shall 51.36 make a rate adjustment by adding $2.41 to the facility's July 1, 52.1 1997, property-related payment rate. The adjusted 52.2 property-related payment rate shall be effective for rate years 52.3 beginning on or after July 1, 1998. The adjustment in this 52.4 paragraph shall remain in effect as long as the facility's rates 52.5 are set under this section. If the facility participates in the 52.6 alternative payment system under section 256B.434, the 52.7 adjustment in this paragraph shall be included in the facility's 52.8 contract payment rate. If historical rates or property costs 52.9 recognized under this section become the basis for future 52.10 medical assistance payments to the facility under a managed 52.11 care, capitation, or other alternative payment system, the 52.12 adjustment in this paragraph shall be included in the 52.13 computation of the facility's payments. 52.14 Sec. 6. Minnesota Statutes 1996, section 256B.431, 52.15 subdivision 22, is amended to read: 52.16 Subd. 22. [CHANGES TO NURSING FACILITY REIMBURSEMENT.] The 52.17 nursing facility reimbursement changes in paragraphs (a) to (e) 52.18 apply to Minnesota Rules, parts 9549.0010 to 9549.0080, and this 52.19 section, and are effective for rate years beginning on or after 52.20 July 1, 1993, unless otherwise indicated. 52.21 (a) In addition to the approved pension or profit sharing 52.22 plans allowed by the reimbursement rule, the commissioner shall 52.23 allow those plans specified in Internal Revenue Code, sections 52.24 403(b) and 408(k). 52.25 (b) The commissioner shall allow as workers' compensation 52.26 insurance costs under section 256B.421, subdivision 14, the 52.27 costs of workers' compensation coverage obtained under the 52.28 following conditions: 52.29 (1) a plan approved by the commissioner of commerce as a 52.30 Minnesota group or individual self-insurance plan as provided in 52.31 section 79A.03; 52.32 (2) a plan in which: 52.33 (i) the nursing facility, directly or indirectly, purchases 52.34 workers' compensation coverage in compliance with section 52.35 176.181, subdivision 2, from an authorized insurance carrier; 52.36 (ii) a related organization to the nursing facility 53.1 reinsures the workers' compensation coverage purchased, directly 53.2 or indirectly, by the nursing facility; and 53.3 (iii) all of the conditions in clause (4) are met; 53.4 (3) a plan in which: 53.5 (i) the nursing facility, directly or indirectly, purchases 53.6 workers' compensation coverage in compliance with section 53.7 176.181, subdivision 2, from an authorized insurance carrier; 53.8 (ii) the insurance premium is calculated retrospectively, 53.9 including a maximum premium limit, and paid using the paid loss 53.10 retro method; and 53.11 (iii) all of the conditions in clause (4) are met; 53.12 (4) additional conditions are: 53.13 (i) the costs of the plan are allowable under the federal 53.14 Medicare program; 53.15 (ii) the reserves for the plan are maintained in an account 53.16 controlled and administered by a person which is not a related 53.17 organization to the nursing facility; 53.18 (iii) the reserves for the plan cannot be used, directly or 53.19 indirectly, as collateral for debts incurred or other 53.20 obligations of the nursing facility or related organizations to 53.21 the nursing facility; 53.22 (iv) if the plan provides workers' compensation coverage 53.23 for non-Minnesota nursing facilities, the plan's cost 53.24 methodology must be consistent among all nursing facilities 53.25 covered by the plan, and if reasonable, is allowed 53.26 notwithstanding any reimbursement laws regarding cost allocation 53.27 to the contrary; 53.28 (v) central, affiliated, corporate, or nursing facility 53.29 costs related to their administration of the plan are costs 53.30 which must remain in the nursing facility's administrative cost 53.31 category and must not be allocated to other cost categories;and53.32 (vi) required security deposits, whether in the form of 53.33 cash, investments, securities, assets, letters of credit, or in 53.34 any other form are not allowable costs for purposes of 53.35 establishing the facilities payment rate.; and 53.36 (vii) for rate years beginning on or after July 1, 1998, a 54.1 group of nursing facilities related by common ownership that 54.2 self-insures workers' compensation may allocate its directly 54.3 identified costs of self-insuring its Minnesota nursing facility 54.4 workers among those nursing facilities in the group that are 54.5 reimbursed under this section or section 256B.434. The method 54.6 of cost allocation shall be based on each nursing facility's 54.7 total allowable salaries and wages to that of the nursing 54.8 facility group's total allowable salaries and wages, then 54.9 similarly allocated within each nursing facility's operating 54.10 cost categories. The costs associated with the administration 54.11 of the group's self-insurance plan must remain classified in the 54.12 nursing facility's administrative cost category. A written 54.13 request of the nursing facility group's election to use this 54.14 alternate method of allocation of self-insurance costs must be 54.15 received by the commissioner no later than May 1, 1998, to take 54.16 effect July 1, 1998, or no later than December 31 of any year to 54.17 take effect the following rate year, or such costs shall 54.18 continue to be allocated under the existing cost allocation 54.19 methods. Once a nursing facility group elects this method of 54.20 cost allocation for its workers' compensation self-insurance 54.21 costs, it shall remain in effect until such time as the group no 54.22 longer self-insures these costs; 54.23 (5) any costs allowed pursuant to clauses (1) to (3) are 54.24 subject to the following requirements: 54.25 (i) if the nursing facility is sold or otherwise ceases 54.26 operations, the plan's reserves must be subject to an 54.27 actuarially based settle-up after 36 months from the date of 54.28 sale or the date on which operations ceased. The facility's 54.29 medical assistance portion of the total excess plan reserves 54.30 must be paid to the state within 30 days following the date on 54.31 which excess plan reserves are determined; 54.32 (ii) any distribution of excess plan reserves made to or 54.33 withdrawals made by the nursing facility or a related 54.34 organization are applicable credits and must be used to reduce 54.35 the nursing facility's workers' compensation insurance costs in 54.36 the reporting period in which a distribution or withdrawal is 55.1 received; 55.2 (iii) if reimbursement for the plan is sought under the 55.3 federal Medicare program, and is audited pursuant to the 55.4 Medicare program, the nursing facility must provide a copy of 55.5 Medicare's final audit report, including attachments and 55.6 exhibits, to the commissioner within 30 days of receipt by the 55.7 nursing facility or any related organization. The commissioner 55.8 shall implement the audit findings associated with the plan upon 55.9 receipt of Medicare's final audit report. The department's 55.10 authority to implement the audit findings is independent of its 55.11 authority to conduct a field audit. 55.12 (c) In the determination of incremental increases in the 55.13 nursing facility's rental rate as required in subdivisions 14 to 55.14 21, except for a refinancing permitted under subdivision 19, the 55.15 commissioner must adjust the nursing facility's property-related 55.16 payment rate for both incremental increases and decreases in 55.17 recomputations of its rental rate; 55.18 (d) A nursing facility's administrative cost limitation 55.19 must be modified as follows: 55.20 (1) if the nursing facility's licensed beds exceed 195 55.21 licensed beds, the general and administrative cost category 55.22 limitation shall be 13 percent; 55.23 (2) if the nursing facility's licensed beds are more than 55.24 150 licensed beds, but less than 196 licensed beds, the general 55.25 and administrative cost category limitation shall be 14 percent; 55.26 or 55.27 (3) if the nursing facility's licensed beds is less than 55.28 151 licensed beds, the general and administrative cost category 55.29 limitation shall remain at 15 percent. 55.30 (e) The care related operating rate shall be increased by 55.31 eight cents to reimburse facilities for unfunded federal 55.32 mandates, including costs related to hepatitis B vaccinations. 55.33 (f) For rate years beginning on or after July 1, 1998, a 55.34 group of nursing facilities related by common ownership that 55.35 self-insures group health, dental, or life insurance may 55.36 allocate its directly identified costs of self-insuring its 56.1 Minnesota nursing facility workers among those nursing 56.2 facilities in the group that are reimbursed under this section 56.3 or section 256B.434. The method of cost allocation shall be 56.4 based on each nursing facility's total allowable salaries and 56.5 wages to that of the nursing facility group's total allowable 56.6 salaries and wages, then similarly allocated within each nursing 56.7 facility's operating cost categories. The costs associated with 56.8 the administration of the group's self-insurance plan must 56.9 remain classified in the nursing facility's administrative cost 56.10 category. A written request of the nursing facility group's 56.11 election to use this alternate method of allocation of 56.12 self-insurance costs must be received by the commissioner no 56.13 later than May 1, 1998, to take effect July 1, 1998, or no later 56.14 than December 31 of any year to take effect the following rate 56.15 year, or those self-insurance costs shall continue to be 56.16 allocated under the existing cost allocation methods. Once a 56.17 nursing facility group elects this method of cost allocation for 56.18 its group health, dental, or life insurance self-insurance 56.19 costs, it shall remain in effect until such time as the group no 56.20 longer self-insures these costs. 56.21 Sec. 7. Minnesota Statutes 1997 Supplement, section 56.22 256B.431, subdivision 26, is amended to read: 56.23 Subd. 26. [CHANGES TO NURSING FACILITY REIMBURSEMENT 56.24 BEGINNING JULY 1, 1997.] The nursing facility reimbursement 56.25 changes in paragraphs (a) to (f) shall apply in the sequence 56.26 specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 56.27 this section, beginning July 1, 1997. 56.28 (a) For rate years beginning on or after July 1, 1997, the 56.29 commissioner shall limit a nursing facility's allowable 56.30 operating per diem for each case mix category for each rate year. 56.31 The commissioner shall group nursing facilities into two groups, 56.32 freestanding and nonfreestanding, within each geographic group, 56.33 using their operating cost per diem for the case mix A 56.34 classification. A nonfreestanding nursing facility is a nursing 56.35 facility whose other operating cost per diem is subject to the 56.36 hospital attached, short length of stay, or the rule 80 limits. 57.1 All other nursing facilities shall be considered freestanding 57.2 nursing facilities. The commissioner shall then array all 57.3 nursing facilities in each grouping by their allowable case mix 57.4 A operating cost per diem. In calculating a nursing facility's 57.5 operating cost per diem for this purpose, the commissioner shall 57.6 exclude the raw food cost per diem related to providing special 57.7 diets that are based on religious beliefs, as determined in 57.8 subdivision 2b, paragraph (h). For those nursing facilities in 57.9 each grouping whose case mix A operating cost per diem: 57.10 (1) is at or below the median of the array, the 57.11 commissioner shall limit the nursing facility's allowable 57.12 operating cost per diem for each case mix category to the lesser 57.13 of the prior reporting year's allowable operating cost per diem 57.14 as specified in Laws 1996, chapter 451, article 3, section 11, 57.15 paragraph (h), plus the inflation factor as established in 57.16 paragraph (d), clause (2), increased by two percentage points, 57.17 or the current reporting year's corresponding allowable 57.18 operating cost per diem; or 57.19 (2) is above the median of the array, the commissioner 57.20 shall limit the nursing facility's allowable operating cost per 57.21 diem for each case mix category to the lesser of the prior 57.22 reporting year's allowable operating cost per diem as specified 57.23 in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 57.24 plus the inflation factor as established in paragraph (d), 57.25 clause (2), increased by one percentage point, or the current 57.26 reporting year's corresponding allowable operating cost per diem. 57.27 For rate years beginning on or after July 1, 1999, if a 57.28 facility reports a reduction in costs because of a credit or 57.29 refund received based on costs from prior reporting years, the 57.30 limit shall be increased in the second rate year following that 57.31 reporting year by the amount of the reduction divided by the 57.32 resident days used to compute the rate of the second following 57.33 rate year. 57.34 (b) For rate years beginning on or after July 1, 1997, the 57.35 commissioner shall limit the allowable operating cost per diem 57.36 for high cost nursing facilities. After application of the 58.1 limits in paragraph (a) to each nursing facility's operating 58.2 cost per diem, the commissioner shall group nursing facilities 58.3 into two groups, freestanding or nonfreestanding, within each 58.4 geographic group. A nonfreestanding nursing facility is a 58.5 nursing facility whose other operating cost per diem are subject 58.6 to hospital attached, short length of stay, or rule 80 limits. 58.7 All other nursing facilities shall be considered freestanding 58.8 nursing facilities. The commissioner shall then array all 58.9 nursing facilities within each grouping by their allowable case 58.10 mix A operating cost per diem. In calculating a nursing 58.11 facility's operating cost per diem for this purpose, the 58.12 commissioner shall exclude the raw food cost per diem related to 58.13 providing special diets that are based on religious beliefs, as 58.14 determined in subdivision 2b, paragraph (h). For those nursing 58.15 facilities in each grouping whose case mix A operating cost per 58.16 diem exceeds 1.0 standard deviation above the median, the 58.17 commissioner shall reduce their allowable operating cost per 58.18 diem by three percent. For those nursing facilities in each 58.19 grouping whose case mix A operating cost per diem exceeds 0.5 58.20 standard deviation above the median but is less than or equal to 58.21 1.0 standard deviation above the median, the commissioner shall 58.22 reduce their allowable operating cost per diem by two percent. 58.23 However, in no case shall a nursing facility's operating cost 58.24 per diem be reduced below its grouping's limit established at 58.25 0.5 standard deviations above the median. 58.26 (c) For rate years beginning on or after July 1, 1997, the 58.27 commissioner shall determine a nursing facility's efficiency 58.28 incentive by first computing the allowable difference, which is 58.29 the lesser of $4.50 or the amount by which the facility's other 58.30 operating cost limit exceeds its nonadjusted other operating 58.31 cost per diem for that rate year. The commissioner shall 58.32 compute the efficiency incentive by: 58.33 (1) subtracting the allowable difference from $4.50 and 58.34 dividing the result by $4.50; 58.35 (2) multiplying 0.20 by the ratio resulting from clause 58.36 (1), and then; 59.1 (3) adding 0.50 to the result from clause (2); and 59.2 (4) multiplying the result from clause (3) times the 59.3 allowable difference. 59.4 The nursing facility's efficiency incentive payment shall 59.5 be the lesser of $2.25 or the product obtained in clause (4). 59.6 (d) For rate years beginning on or after July 1, 1997, the 59.7 forecasted price index for a nursing facility's allowable 59.8 operating cost per diem shall be determined under clauses (1) 59.9 and (2) using the change in the Consumer Price Index-All Items 59.10 (United States city average) (CPI-U) as forecasted by Data 59.11 Resources, Inc. The commissioner shall use the indices as 59.12 forecasted in the fourth quarter of the calendar year preceding 59.13 the rate year, subject to subdivision 2l, paragraph (c). 59.14 (1) The CPI-U forecasted index for allowable operating cost 59.15 per diem shall be based on the 21-month period from the midpoint 59.16 of the nursing facility's reporting year to the midpoint of the 59.17 rate year following the reporting year. 59.18 (2) For rate years beginning on or after July 1, 1997, the 59.19 forecasted index for operating cost limits referred to in 59.20 subdivision 21, paragraph (b), shall be based on the CPI-U for 59.21 the 12-month period between the midpoints of the two reporting 59.22 years preceding the rate year. 59.23 (e) After applying these provisions for the respective rate 59.24 years, the commissioner shall index these allowable operating 59.25 cost per diem by the inflation factor provided for in paragraph 59.26 (d), clause (1), and add the nursing facility's efficiency 59.27 incentive as computed in paragraph (c). 59.28 (f) For rate years beginning on or after July 1, 1997, the 59.29 total operating cost payment rates for a nursing facility shall 59.30 be the greater of the total operating cost payment rates 59.31 determined under this section or the total operating cost 59.32 payment rates in effect on June 30, 1997, subject to rate 59.33 adjustments due to field audit or rate appeal resolution. This 59.34 provision shall not apply to subsequent field audit adjustments 59.35 of the nursing facility's operating cost rates for rate years 59.36 beginning on or after July 1, 1997. 60.1 (g) For the rate years beginning on July 1, 1997,andJuly 60.2 1, 1998, and July 1, 1999, a nursing facility licensed for 40 60.3 beds effective May 1, 1992, with a subsequent increase of 20 60.4 Medicare/Medicaid certified beds, effective January 26, 1993, in 60.5 accordance with an increase in licensure is exempt from 60.6 paragraphs (a) and (b). 60.7 (h) For a nursing facility whose construction project was 60.8 authorized according to section 144A.073, subdivision 5, 60.9 paragraph (g), the operating cost payment rates for the third 60.10 location shall be determined based on Minnesota Rules, part 60.11 9549.0057. Paragraphs (a) and (b) shall not apply until the 60.12 second rate year after the settle-up cost report is filed. 60.13 Notwithstanding subdivision 2b, paragraph (g), real estate taxes 60.14 and special assessments payable by the third location, a 60.15 501(c)(3) nonprofit corporation, shall be included in the 60.16 payment rates determined under this subdivision for all 60.17 subsequent rate years. 60.18 (i) For the rate year beginning July 1, 1997, the 60.19 commissioner shall compute the payment rate for a nursing 60.20 facility licensed for 94 beds on September 30, 1996, that 60.21 applied in October 1993 for approval of a total replacement 60.22 under the moratorium exception process in section 144A.073, and 60.23 completed the approved replacement in June 1995, with other 60.24 operating cost spend-up limit under paragraph (a), increased by 60.25 $3.98, and after computing the facility's payment rate according 60.26 to this section, the commissioner shall make a one-year positive 60.27 rate adjustment of $3.19 for operating costs related to the 60.28 newly constructed total replacement, without application of 60.29 paragraphs (a) and (b). The facility's per diem, before the 60.30 $3.19 adjustment, shall be used as the prior reporting year's 60.31 allowable operating cost per diem for payment rate calculation 60.32 for the rate year beginning July 1, 1998. A facility described 60.33 in this paragraph is exempt from paragraph (b) for the rate 60.34 years beginning July 1, 1997, and July 1, 1998. 60.35 (j) For the purpose of applying the limit stated in 60.36 paragraph (a), a nursing facility in Kandiyohi county licensed 61.1 for 86 beds that was granted hospital-attached status on 61.2 December 1, 1994, shall have the prior year's allowable 61.3 care-related per diem increased by $3.207 and the prior year's 61.4 other operating cost per diem increased by $4.777 before adding 61.5 the inflation in paragraph (d), clause (2), for the rate year 61.6 beginning on July 1, 1997. 61.7 (k) For the purpose of applying the limit stated in 61.8 paragraph (a), a 117 bed nursing facility located in Pine county 61.9 shall have the prior year's allowable other operating cost per 61.10 diem increased by $1.50 before adding the inflation in paragraph 61.11 (d), clause (2), for the rate year beginning on July 1, 1997. 61.12 (l) For the purpose of applying the limit under paragraph 61.13 (a), a nursing facility in Hibbing licensed for 192 beds shall 61.14 have the prior year's allowable other operating cost per diem 61.15 increased by $2.67 before adding the inflation in paragraph (d), 61.16 clause (2), for the rate year beginning July 1, 1997. 61.17 (m) For the rate year beginning July 1, 1997, a nursing 61.18 facility in Canby, Minnesota, licensed for 75 beds shall be 61.19 reimbursed without the limitation imposed under paragraph (a), 61.20 and for rate years beginning on or after July 1, 1998, its base 61.21 costs shall be calculated on the basis of its September 30, 61.22 1997, cost report. 61.23 Sec. 8. Minnesota Statutes 1996, section 256B.431, is 61.24 amended by adding a subdivision to read: 61.25 Subd. 27. [CHANGES TO NURSING FACILITY REIMBURSEMENT 61.26 BEGINNING JULY 1, 1998.] (a) For the purpose of applying the 61.27 limit stated in subdivision 26, paragraph (a), a nursing 61.28 facility in Hennepin county licensed for 181 beds on September 61.29 30, 1996, shall have the prior year's allowable care-related per 61.30 diem increased by $1.455 and the prior year's other operating 61.31 cost per diem increased by $0.439 before adding the inflation in 61.32 subdivision 26, paragraph (d), clause (2), for the rate year 61.33 beginning on July 1, 1998. 61.34 (b) For the purpose of applying the limit stated in 61.35 subdivision 26, paragraph (a), a nursing facility in Hennepin 61.36 county licensed for 161 beds on September 30, 1996, shall have 62.1 the prior year's allowable care-related per diem increased by 62.2 $1.154 and the prior year's other operating cost per diem 62.3 increased by $0.256 before adding the inflation in subdivision 62.4 26, paragraph (d), clause (2), for the rate year beginning on 62.5 July 1, 1998. 62.6 (c) For the purpose of applying the limit stated in 62.7 subdivision 26, paragraph (a), a nursing facility in Ramsey 62.8 county licensed for 176 beds on September 30, 1996, shall have 62.9 the prior year's allowable care-related per diem increased by 62.10 $0.803 and the prior year's other operating cost per diem 62.11 increased by $0.272 before adding the inflation in subdivision 62.12 26, paragraph (d), clause (2), for the rate year beginning on 62.13 July 1, 1998. 62.14 (d) For the purpose of applying the limit stated in 62.15 subdivision 26, paragraph (a), a nursing facility in Brown 62.16 county licensed for 86 beds on September 30, 1996, shall have 62.17 the prior year's allowable care-related per diem increased by 62.18 $0.850 and the prior year's other operating cost per diem 62.19 increased by $0.275 before adding the inflation in subdivision 62.20 26, paragraph (d), clause (2), for the rate year beginning on 62.21 July 1, 1998. 62.22 (e) For the rate year beginning July 1, 1998, the 62.23 commissioner shall compute the payment rate for a nursing 62.24 facility, which was licensed for 110 beds on September 8, 1996, 62.25 was granted approval in January 1994 for a replacement and 62.26 remodeling project under the moratorium exception process in 62.27 section 144A.073, and completed the approved replacement and 62.28 remodeling project in April 1997, by computing the facility's 62.29 payment rate for the rate year beginning July 1, 1998, according 62.30 to this section, and then making a one-year positive rate 62.31 adjustment of 48 cents for increased real estate taxes resulting 62.32 from completion of the moratorium exception project, without 62.33 application of subdivision 26, paragraphs (a) and (b). 62.34 (f) For the rate year beginning July 1, 1998, the 62.35 commissioner shall compute the payment rate for a nursing 62.36 facility exempted from care-related limits under subdivision 2b, 63.1 paragraph (d), clause (2), with a minimum of three-quarters of 63.2 its beds licensed to provide residential services for the 63.3 physically handicapped under Minnesota Rules, parts 9570.2000 to 63.4 9570.3400, with the care-related spend-up limit under 63.5 subdivision 26, paragraph (a), increased by $13.21 for the rate 63.6 year beginning July 1, 1998, without application of subdivision 63.7 26, paragraph (b). For rate years beginning on or after July 1, 63.8 1999, the commissioner shall exclude that amount in calculating 63.9 the facility's operating cost per diem for purposes of applying 63.10 subdivision 26, paragraph (b). 63.11 (g) The nursing facility reimbursement changes in 63.12 paragraphs (h) and (i) shall apply in the sequence specified in 63.13 this section and Minnesota Rules, parts 9549.0010 to 9549.0080, 63.14 beginning July 1, 1998. 63.15 (h) For rate years beginning on or after July 1, 1998, the 63.16 operating cost limits established in subdivisions 2, 2b, 2i, 3c, 63.17 and 22, paragraph (d), and any previously effective 63.18 corresponding limits in law or rule shall not apply, except that 63.19 these cost limits shall still be calculated for purposes of 63.20 determining efficiency incentive per diems. For rate years 63.21 beginning on or after July 1, 1998, the total operating cost 63.22 payment rates for a nursing facility shall be the greater of the 63.23 total operating cost payment rates determined under this section 63.24 or the total operating cost payment rates in effect on June 30, 63.25 1998, subject to rate adjustments due to field audit or rate 63.26 appeal resolution. 63.27 (i) For rate years beginning on or after July 1, 1998, the 63.28 operating cost per diem referred to in subdivision 26, paragraph 63.29 (a), clauses (1) and (2), is the sum of the care-related and 63.30 other operating per diems for a given case mix class. Any 63.31 reductions to the combined operating per diem shall be divided 63.32 proportionately between the care-related and other operating per 63.33 diems. 63.34 Sec. 9. Minnesota Statutes 1997 Supplement, section 63.35 256B.433, subdivision 3a, is amended to read: 63.36 Subd. 3a. [EXEMPTION FROM REQUIREMENT FOR SEPARATE THERAPY 64.1 BILLING.] The provisions of subdivision 3 do not apply to 64.2 nursing facilities that are reimbursed according to the 64.3 provisions of section 256B.431 and are located in a county 64.4 participating in the prepaid medical assistance 64.5 program. Nursing facilities that are reimbursed according to 64.6 the provisions of section 256B.434 and are located in a county 64.7 participating in the prepaid medical assistance program are 64.8 exempt from the maximum therapy rent revenue provisions of 64.9 subdivision 3, paragraph (c). 64.10 Sec. 10. Minnesota Statutes 1997 Supplement, section 64.11 256B.434, subdivision 10, is amended to read: 64.12 Subd. 10. [EXEMPTIONS.] (a) To the extent permitted by 64.13 federal law, (1) a facility that has entered into a contract 64.14 under this section is not required to file a cost report, as 64.15 defined in Minnesota Rules, part 9549.0020, subpart 13, for any 64.16 year after the base year that is the basis for the calculation 64.17 of the contract payment rate for the first rate year of the 64.18 alternative payment demonstration project contract; and (2) a 64.19 facility under contract is not subject to audits of historical 64.20 costs or revenues, or paybacks or retroactive adjustments based 64.21 on these costs or revenues, except audits, paybacks, or 64.22 adjustments relating to the cost report that is the basis for 64.23 calculation of the first rate year under the contract. 64.24 (b) A facility that is under contract with the commissioner 64.25 under this section is not subject to the moratorium on licensure 64.26 or certification of new nursing home beds in section 144A.071, 64.27 unless the project results in a net increase in bed capacity or 64.28 involves relocation of beds from one site to another. Contract 64.29 payment rates must not be adjusted to reflect any additional 64.30 costs that a nursing facility incurs as a result of a 64.31 construction project undertaken under this paragraph. In 64.32 addition, as a condition of entering into a contract under this 64.33 section, a nursing facility must agree that any future medical 64.34 assistance payments for nursing facility services will not 64.35 reflect any additional costs attributable to the sale of a 64.36 nursing facility under this section and to construction 65.1 undertaken under this paragraph that otherwise would not be 65.2 authorized under the moratorium in section 144A.073. Nothing in 65.3 this section prevents a nursing facility participating in the 65.4 alternative payment demonstration project under this section 65.5 from seeking approval of an exception to the moratorium through 65.6 the process established in section 144A.073, and if approved the 65.7 facility's rates shall be adjusted to reflect the cost of the 65.8 project. Nothing in this section prevents a nursing facility 65.9 participating in the alternative payment demonstration project 65.10 from seeking legislative approval of an exception to the 65.11 moratorium under section 144A.071, and, if enacted, the 65.12 facility's rates shall be adjusted to reflect the cost of the 65.13 project. 65.14 (c) Notwithstanding section 256B.48, subdivision 6, 65.15 paragraphs (c), (d), and (e), and pursuant to any terms and 65.16 conditions contained in the facility's contract, a nursing 65.17 facility that is under contract with the commissioner under this 65.18 section is in compliance with section 256B.48, subdivision 6, 65.19 paragraph (b), if the facility is Medicare certified. 65.20 (d) Notwithstanding paragraph (a), if by April 1, 1996, the 65.21 health care financing administration has not approved a required 65.22 waiver, or the health care financing administration otherwise 65.23 requires cost reports to be filed prior to the waiver's 65.24 approval, the commissioner shall require a cost report for the 65.25 rate year. 65.26 (e) A facility that is under contract with the commissioner 65.27 under this section shall be allowed to change therapy 65.28 arrangements from an unrelated vendor to a related vendor during 65.29 the term of the contract. The commissioner may develop 65.30 reasonable requirements designed to prevent an increase in 65.31 therapy utilization for residents enrolled in the medical 65.32 assistance program. 65.33 Sec. 11. [256B.435] [NURSING FACILITY REIMBURSEMENT SYSTEM 65.34 EFFECTIVE JULY 1, 2000.] 65.35 Subdivision 1. [IN GENERAL.] Effective July 1, 2000, the 65.36 commissioner shall implement a performance-based contracting 66.1 system to replace the current method of setting operating cost 66.2 payment rates under sections 256B.431 and 256B.434 and Minnesota 66.3 Rules, parts 9549.0010 to 9549.0080. A nursing facility in 66.4 operation on May 1, 1998, with payment rates not established 66.5 under section 256B.431 or 256B.434 on that date, is ineligible 66.6 for this performance-based contracting system. In determining 66.7 prospective payment rates of nursing facility services, the 66.8 commissioner shall distinguish between operating costs and 66.9 property-related costs. The operating cost portion of the 66.10 payment rates shall be indexed annually by an inflation factor 66.11 as specified in subdivision 3, and according to section 66.12 256B.431, subdivision 2i, paragraph (c). Property-related 66.13 payment rates, including real estate taxes and special 66.14 assessments, shall be determined under section 256B.431 or 66.15 256B.434. 66.16 Subd. 2. [CONTRACT PROVISIONS.] (a) The performance-based 66.17 contract with each nursing facility must include provisions that: 66.18 (1) apply the resident case mix assessment provisions of 66.19 Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 66.20 another assessment system, with the goal of moving to a single 66.21 assessment system; 66.22 (2) monitor resident outcomes through various methods, such 66.23 as quality indicators based on the minimum data set and other 66.24 utilization and performance measures; 66.25 (3) require the establishment and use of a continuous 66.26 quality improvement process that integrates information from 66.27 quality indicators and regular resident and family satisfaction 66.28 interviews; 66.29 (4) require annual reporting of facility statistical 66.30 information, including resident days by case mix category, 66.31 productive nursing hours, wages and benefits, and raw food costs 66.32 for use by the commissioner in the development of facility 66.33 profiles that include trends in payment and service utilization; 66.34 (5) require from each nursing facility an annual certified 66.35 audited financial statement consisting of a balance sheet, 66.36 income and expense statements, and an opinion from either a 67.1 licensed or certified public accountant, if a certified audit 67.2 was prepared, or unaudited financial statements if no certified 67.3 audit was prepared; and 67.4 (6) establish additional requirements and penalties for 67.5 nursing facilities not meeting the standards set forth in the 67.6 performance-based contract. 67.7 (b) The commissioner may develop additional incentive-based 67.8 payments for achieving outcomes specified in each contract. The 67.9 specified facility-specific outcomes must be measurable and 67.10 approved by the commissioner. 67.11 (c) The commissioner may also contract with nursing 67.12 facilities in other ways through requests for proposals, 67.13 including contracts on a risk or nonrisk basis, with nursing 67.14 facilities or consortia of nursing facilities, to provide 67.15 comprehensive long-term care coverage on a premium or capitated 67.16 basis. 67.17 Subd. 3. [PAYMENT RATE PROVISIONS.] (a) For rate years 67.18 beginning on or after July 1, 2000, the commissioner shall 67.19 determine operating cost payment rates for each licensed and 67.20 certified nursing facility by indexing its operating cost 67.21 payment rates in effect on June 30, 2000, for inflation. The 67.22 inflation factor to be used must be based on the change in the 67.23 Consumer Price Index-All Items, United States city average 67.24 (CPI-U) as forecasted by Data Resources, Inc. in the fourth 67.25 quarter preceding the rate year. The CPI-U forecasted index for 67.26 operating cost payment rates shall be based on the 12-month 67.27 period from the midpoint of the nursing facility's prior rate 67.28 year to the midpoint of the rate year for which the operating 67.29 payment rate is being determined. 67.30 (b) Beginning July 1, 2000, each nursing facility subject 67.31 to a performance-based contract under this section shall choose 67.32 one of two methods of payment for property-related costs: 67.33 (1) the method established in section 256B.434; or 67.34 (2) the method established in section 256B.431. Once the 67.35 nursing facility has made its election, that election shall 67.36 remain in effect for at least four years or until an alternative 68.1 property payment system is developed. 68.2 Sec. 12. [256B.5011] [ICF/MR REIMBURSEMENT SYSTEM 68.3 EFFECTIVE OCTOBER 1, 2000.] 68.4 Subdivision 1. [IN GENERAL.] Effective October 1, 2000, 68.5 the commissioner shall implement a performance-based contracting 68.6 system to replace the current method of setting total cost 68.7 payment rates under section 256B.501 and Minnesota Rules, parts 68.8 9553.0010 to 9553.0080. In determining prospective payment 68.9 rates of intermediate care facilities for persons with mental 68.10 retardation or related conditions, the commissioner shall index 68.11 each facility's total payment rate by an inflation factor as 68.12 described in subdivision 3. The commissioner of finance shall 68.13 include annual inflation adjustments in operating costs for 68.14 intermediate care facilities for persons with mental retardation 68.15 and related conditions as a budget change request in each 68.16 biennial detailed expenditure budget submitted to the 68.17 legislature under section 16A.11. 68.18 Subd. 2. [CONTRACT PROVISIONS.] The performance-based 68.19 contract with each intermediate care facility must include 68.20 provisions for: 68.21 (1) modifying payments when significant changes occur in 68.22 the needs of the consumers; 68.23 (2) monitoring service quality using performance indicators 68.24 that measure consumer outcomes; 68.25 (3) the establishment and use of continuous quality 68.26 improvement processes using the results attained through service 68.27 quality monitoring; 68.28 (4) the annual reporting of facility statistical 68.29 information on all supervisory personnel, direct care personnel, 68.30 specialized support personnel, hours, wages and benefits, 68.31 staff-to-consumer ratios, and staffing patterns; 68.32 (5) annual aggregate facility financial information or an 68.33 annual certified audited financial statement, including a 68.34 balance sheet and income and expense statements for each 68.35 facility, if a certified audit was prepared; and 68.36 (6) additional requirements and penalties for intermediate 69.1 care facilities not meeting the standards set forth in the 69.2 performance-based contract. 69.3 Subd. 3. [PAYMENT RATE PROVISIONS.] For rate years 69.4 beginning on or after October 1, 2000, the commissioner shall 69.5 determine the total payment rate for each licensed and certified 69.6 intermediate care facility by indexing the total payment rate in 69.7 effect on September 30, 2000, for inflation. The inflation 69.8 factor to be used must be based on the change in the Consumer 69.9 Price Index-All Items (United States city average) (CPI-U) as 69.10 forecasted by Data Resources, Inc. in the first quarter of the 69.11 calendar year during which the rate year begins. The CPI-U 69.12 forecasted index for total payment rates shall be based on the 69.13 12-month period from the midpoint of the ICF/MR's prior rate 69.14 year to the midpoint of the rate year for which the operating 69.15 payment rate is being determined. 69.16 Sec. 13. Minnesota Statutes 1996, section 256B.69, is 69.17 amended by adding a subdivision to read: 69.18 Subd. 26. [CONTINUATION OF PAYMENTS THROUGH 69.19 DISCHARGE.] (a) In the event a medical assistance recipient or 69.20 beneficiary enrolled in a health plan under this section is 69.21 denied nursing facility services after residing in the facility 69.22 for more than 180 days, any denial of medical assistance payment 69.23 to a provider under this section shall be prospective only and 69.24 payments to the provider shall continue until the resident is 69.25 discharged or 30 days after the effective date of the service 69.26 denial, whichever is sooner. 69.27 (b) For a medical assistance recipient or beneficiary who 69.28 is enrolled in a health plan and who has resided in the nursing 69.29 facility for less than 180 days, when a decision to terminate 69.30 nursing facility services is made by the health plan, any appeal 69.31 of the health plan decision must be made under subdivisions 11 69.32 and 18, and section 256.045, subdivision 3, paragraph (a). A 69.33 decision may not be appealed under section 144A.135. All other 69.34 appeals of termination of nursing facility services shall be 69.35 made under section 144A.135. 69.36 Sec. 14. Minnesota Statutes 1996, section 256I.04, 70.1 subdivision 1, is amended to read: 70.2 Subdivision 1. [INDIVIDUAL ELIGIBILITY REQUIREMENTS.] An 70.3 individual is eligible for and entitled to a group residential 70.4 housing payment to be made on the individual's behalf if the 70.5 county agency has approved the individual's residence in a group 70.6 residential housing setting and the individual meets the 70.7 requirements in paragraph (a) or (b). 70.8 (a) The individual is aged, blind, or is over 18 years of 70.9 age and disabled as determined under the criteria used by the 70.10 title II program of the Social Security Act, and meets the 70.11 resource restrictions and standards of the supplemental security 70.12 income program, and the individual's countable income after 70.13 deducting the (1) exclusions and disregards of the SSI 70.14 programand, (2) the medical assistance personal needs allowance 70.15 under section 256B.35, and (3) an amount equal to the allocation 70.16 of income to a spouse living in the community under the 70.17 provisions of section 256B.0915, subdivision 2, is less than the 70.18 monthly rate specified in the county agency's agreement with the 70.19 provider of group residential housing in which the individual 70.20 resides. 70.21 (b) The individual meets a category of eligibility under 70.22 section 256D.05, subdivision 1, paragraph (a), and the 70.23 individual's resources are less than the standards specified by 70.24 section 256D.08, and the individual's countable income as 70.25 determined under sections 256D.01 to 256D.21, less the medical 70.26 assistance personal needs allowance under section 256B.35 is 70.27 less than the monthly rate specified in the county agency's 70.28 agreement with the provider of group residential housing in 70.29 which the individual resides. 70.30 Sec. 15. Minnesota Statutes 1996, section 256I.04, 70.31 subdivision 3, is amended to read: 70.32 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 70.33 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 70.34 into agreements for new group residential housing beds with 70.35 total rates in excess of the MSA equivalent rate except: (1) 70.36 for group residential housing establishments meeting the 71.1 requirements of subdivision 2a, clause (2) with department 71.2 approval; (2) for group residential housing establishments 71.3 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 71.4 provided the facility is needed to meet the census reduction 71.5 targets for persons with mental retardation or related 71.6 conditions at regional treatment centers; (3) to ensure 71.7 compliance with the federal Omnibus Budget Reconciliation Act 71.8 alternative disposition plan requirements for inappropriately 71.9 placed persons with mental retardation or related conditions or 71.10 mental illness; (4) up to 80 beds in a single, specialized 71.11 facility located in Hennepin county that will provide housing 71.12 for chronic inebriates who are repetitive users of 71.13 detoxification centers and are refused placement in emergency 71.14 shelters because of their state of intoxication., and planning 71.15 for the specialized facility must have been initiated before 71.16 July 1, 1991, in anticipation of receiving a grant from the 71.17 housing finance agency under section 462A.05, subdivision 20a, 71.18 paragraph (b); or (5) notwithstanding the provisions of 71.19 subdivision 2a, for up to180200 supportive housing units in 71.20 Anoka, Dakota, Hennepin, or Ramsey county for homeless adults 71.21 with a mental illness, a history of substance abuse, or human 71.22 immunodeficiency virus or acquired immunodeficiency syndrome. 71.23 For purposes of this section, "homeless adult" means a person 71.24 who is living on the street or in a shelteror is evicted from a71.25dwelling unitor discharged from a regional treatment center, 71.26 community hospital, or residential treatment program and has no 71.27 appropriate housing available and lacks the resources and 71.28 support necessary to access appropriate housing. At least 70 71.29 percent of the supportive housing units must serve homeless 71.30 adults with mental illness, substance abuse problems, or human 71.31 immunodeficiency virus or acquired immunodeficiency syndrome who 71.32 are about to be or, within the previous six months, has been 71.33 discharged from a regional treatment center, or a 71.34 state-contracted psychiatric bed in a community hospital, or a 71.35 residential mental health or chemical dependency treatment 71.36 program. If a person meets the requirements of subdivision 1, 72.1 paragraph (a), and receives a federalSection 8or state housing 72.2 subsidy, the group residential housing rate for that person is 72.3 limited to the supplementary rate under section 256I.05, 72.4 subdivision 1a, and is determined by subtracting the amount of 72.5 the person's countable income that exceeds the MSA equivalent 72.6 rate from the group residential housing supplementary rate. A 72.7 resident in a demonstration project site who no longer 72.8 participates in the demonstration program shall retain 72.9 eligibility for a group residential housing payment in an amount 72.10 determined under section 256I.06, subdivision 8, using the MSA 72.11 equivalent rate. Service funding under section 256I.05, 72.12 subdivision 1a, will end June 30, 1997, if federal matching 72.13 funds are available and the services can be provided through a 72.14 managed care entity. If federal matching funds are not 72.15 available, then service funding will continue under section 72.16 256I.05, subdivision 1a. 72.17 (b) A county agency may enter into a group residential 72.18 housing agreement for beds with rates in excess of the MSA 72.19 equivalent rate in addition to those currently covered under a 72.20 group residential housing agreement if the additional beds are 72.21 only a replacement of beds with rates in excess of the MSA 72.22 equivalent rate which have been made available due to closure of 72.23 a setting, a change of licensure or certification which removes 72.24 the beds from group residential housing payment, or as a result 72.25 of the downsizing of a group residential housing setting. The 72.26 transfer of available beds from one county to another can only 72.27 occur by the agreement of both counties. 72.28 Sec. 16. Minnesota Statutes 1996, section 256I.04, is 72.29 amended by adding a subdivision to read: 72.30 Subd. 4. [RENTAL ASSISTANCE.] For participants in the 72.31 Minnesota supportive housing demonstration program under 72.32 subdivision 3, paragraph (a), clause (5), notwithstanding the 72.33 provisions of section 256I.06, subdivision 8, the amount of the 72.34 group residential housing payment for room and board must be 72.35 calculated by subtracting 30 percent of the recipient's adjusted 72.36 income as defined by the United States Department of Housing and 73.1 Urban Development for the Section 8 program from the fair market 73.2 rent established for the recipient's living unit by the federal 73.3 Department of Housing and Urban Development. This payment shall 73.4 be regarded as a state housing subsidy for the purposes of 73.5 subdivision 3. Notwithstanding the provisions of section 73.6 256I.06, subdivision 6, the recipient's countable income will 73.7 only be adjusted when a change of greater than $100 in a month 73.8 occurs or upon annual redetermination of eligibility, whichever 73.9 is sooner. The supportive housing demonstration program with 73.10 rental assistance shall be evaluated by an independent evaluator 73.11 to determine the cost effectiveness of the program in serving 73.12 its formerly homeless disabled clientele. The evaluation and 73.13 report shall be submitted to the commissioner of human services 73.14 no later than December 31, 1998. The commissioner is directed 73.15 to study the feasibility of developing a rental assistance 73.16 program to serve persons traditionally served in group 73.17 residential housing settings and report to the legislature by 73.18 February 15, 1999. 73.19 Sec. 17. Minnesota Statutes 1996, section 256I.05, 73.20 subdivision 2, is amended to read: 73.21 Subd. 2. [MONTHLY RATES; EXEMPTIONS.] The maximum group 73.22 residential housing rate does not apply to a residence that on 73.23 August 1, 1984, was licensed by the commissioner of health only 73.24 as a boarding care home, certified by the commissioner of health 73.25 as an intermediate care facility, and licensed by the 73.26 commissioner of human services under Minnesota Rules, parts 73.27 9520.0500 to 9520.0690. Notwithstanding the provisions of 73.28 subdivision 1c, the rate paid to a facility reimbursed under 73.29 this subdivision shall be determined under Minnesota Rules, 73.30 parts9510.0010 to 9510.04809549.0010 to 9549.0080, or under 73.31 section 256B.434 if the facility is accepted by the commissioner 73.32 for participation in the alternative payment demonstration 73.33 project. 73.34 Sec. 18. [STUDY OF COSTS AND IMPACT OF REGULATION OF 73.35 ASSISTED LIVING HOME CARE PROVIDER LICENSEES.] 73.36 The legislature recommends that by January 15, 1999, the 74.1 legislative auditor, in consultation with owners and operators 74.2 of registered housing establishments under Minnesota Statutes, 74.3 chapter 144D, consumers of registered housing and services, and 74.4 representatives of elderly housing associations, report to the 74.5 health and human services policy and fiscal committees of the 74.6 house and senate on the costs incurred under rules, as proposed 74.7 by the commissioner of health, to implement Laws 1997, chapter 74.8 113, section 6, and: 74.9 (1) provide an analysis of the implications of added 74.10 regulatory costs to the affordability, accessibility, and 74.11 quality of elderly housing; and 74.12 (2) provide recommendations for alternatives to added home 74.13 care regulation for registered with services settings. 74.14 Sec. 19. [RECOMMENDATIONS TO IMPLEMENT NEW REIMBURSEMENT 74.15 SYSTEM.] 74.16 (a) By January 15, 1999, the commissioner shall make 74.17 recommendations to the chairs of the health and human services 74.18 policy and fiscal committees on the repeal of specific statutes 74.19 and rules as well as any other additional recommendations 74.20 related to implementation of sections 11 and 12. 74.21 (b) In developing recommendations for nursing facility 74.22 reimbursement, the commissioner shall consider making each 74.23 nursing facility's total payment rates, both operating and 74.24 property rate components, prospective. The commissioner shall 74.25 involve nursing facility industry and consumer representatives 74.26 in the development of these recommendations. 74.27 (c) In making recommendations for ICF/MR reimbursement, the 74.28 commissioner may consider methods of establishing payment rates 74.29 that take into account individual client costs and needs, 74.30 include provisions to establish links between performance 74.31 indicators and reimbursement and other performance incentives, 74.32 and allow local control over resources necessary for local 74.33 agencies to set rates and contract with ICF/MR facilities. In 74.34 addition, the commissioner may establish methods that provide 74.35 information to consumers regarding service quality as measured 74.36 by performance indicators. The commissioner shall involve 75.1 ICF/MR industry and consumer representatives in the development 75.2 of these recommendations. 75.3 Sec. 20. [APPROVAL EXTENDED.] 75.4 Notwithstanding Minnesota Statutes, section 144A.073, 75.5 subdivision 3, the commissioner of health shall grant an 75.6 additional 18 months of approval for a proposed exception to the 75.7 nursing home licensure and certification moratorium, if the 75.8 proposal is to replace a 96-bed nursing home facility in Carlton 75.9 county and if initial approval for the proposal was granted in 75.10 November 1996. 75.11 Sec. 21. [EFFECTIVE DATE.] 75.12 Section 20 is effective the day following final enactment. 75.13 ARTICLE 4 75.14 HEALTH CARE PROGRAMS 75.15 Section 1. Minnesota Statutes 1997 Supplement, section 75.16 171.29, subdivision 2, is amended to read: 75.17 Subd. 2. [FEES, ALLOCATION.] (a) A person whose driver's 75.18 license has been revoked as provided in subdivision 1, except 75.19 under section 169.121 or 169.123, shall pay a $30 fee before the 75.20 driver's license is reinstated. 75.21 (b) A person whose driver's license has been revoked as 75.22 provided in subdivision 1 under section 169.121 or 169.123 shall 75.23 pay a $250 fee plus a $10 surcharge before the driver's license 75.24 is reinstated. The $250 fee is to be credited as follows: 75.25 (1) Twenty percent shall be credited to the trunk highway 75.26 fund. 75.27 (2) Fifty-five percent shall be credited to the general 75.28 fund. 75.29 (3) Eight percent shall be credited to a separate account 75.30 to be known as the bureau of criminal apprehension account. 75.31 Money in this account may be appropriated to the commissioner of 75.32 public safety and the appropriated amount shall be apportioned 75.33 80 percent for laboratory costs and 20 percent for carrying out 75.34 the provisions of section 299C.065. 75.35 (4) Twelve percent shall be credited to a separate account 75.36 to be known as the alcohol-impaired driver education account. 76.1 Money in the account is appropriated as follows: 76.2 (i) The first $200,000 in a fiscal year is to the 76.3 commissioner of children, families, and learning for programs in 76.4 elementary and secondary schools. 76.5 (ii) The remainder credited in a fiscal year is 76.6 appropriated to the commissioner of transportation to be spent 76.7 as grants to the Minnesota highway safety center at St. Cloud 76.8 State University for programs relating to alcohol and highway 76.9 safety education in elementary and secondary schools. 76.10 (5) Five percent shall be credited to a separate account to 76.11 be known as the traumatic brain injury and spinal cord injury 76.12 account.$100,000 is annually appropriated from the account to76.13the commissioner of human services for traumatic brain injury76.14case management services.Theremainingmoney in the account is 76.15 annually appropriated to the commissioner of health to be used 76.16 as follows: 35 percent for a contract with a qualified 76.17 community-based organization to provide information, resources, 76.18 and support to assist persons with traumatic brain injury and 76.19 their families to access services, and 65 percent toestablish76.20andmaintain the traumatic brain injury and spinal cord injury 76.21 registry created in section 144.662 and to reimburse the 76.22 commissioner of economic security for the reasonable cost of 76.23 services provided under section 268A.03, clause (o). For the 76.24 purposes of this clause, a "qualified community-based 76.25 organization" is a private, not-for-profit organization of 76.26 consumers of traumatic brain injury services and their family 76.27 members. The organization must be registered with the United 76.28 States Internal Revenue Service under the provisions of section 76.29 501(c)(3) as a tax exempt organization and must have as its 76.30 purpose: 76.31 (1) the promotion of public, family, survivor, and 76.32 professional awareness of the incidence and consequences of 76.33 traumatic brain injury; 76.34 (2) the provision of a network of support for persons with 76.35 traumatic brain injury, their families, and friends; 76.36 (3) the development and support of programs and services to 77.1 prevent traumatic brain injury; 77.2 (4) the establishment of education programs for persons 77.3 with traumatic brain injury; and 77.4 (5) the empowerment of persons with traumatic brain injury 77.5 through participation in its governance. 77.6 (c) The $10 surcharge shall be credited to a separate 77.7 account to be known as the remote electronic alcohol monitoring 77.8 pilot program account. The commissioner shall transfer the 77.9 balance of this account to the commissioner of finance on a 77.10 monthly basis for deposit in the general fund. 77.11 Sec. 2. Minnesota Statutes 1996, section 245.462, 77.12 subdivision 4, is amended to read: 77.13 Subd. 4. [CASE MANAGER.] (a) "Case manager" means an 77.14 individual employed by the county or other entity authorized by 77.15 the county board to provide case management services specified 77.16 in section 245.4711. A case manager must have a bachelor's 77.17 degree in one of the behavioral sciences or related fields from 77.18 an accredited college or university and have at least 2,000 77.19 hours of supervised experience in the delivery of services to 77.20 adults with mental illness, must be skilled in the process of 77.21 identifying and assessing a wide range of client needs, and must 77.22 be knowledgeable about local community resources and how to use 77.23 those resources for the benefit of the client. The case manager 77.24 shall meet in person with a mental health professional at least 77.25 once each month to obtain clinical supervision of the case 77.26 manager's activities. Case managers with a bachelor's degree 77.27 but without 2,000 hours of supervised experience in the delivery 77.28 of services to adults with mental illness must complete 40 hours 77.29 of training approved by the commissioner of human services in 77.30 case management skills and in the characteristics and needs of 77.31 adults with serious and persistent mental illness and must 77.32 receive clinical supervision regarding individual service 77.33 delivery from a mental health professional at least once each 77.34 week until the requirement of 2,000 hours of supervised 77.35 experience is met. Clinical supervision must be documented in 77.36 the client record. 78.1 Until June 30, 1999,a refugeean immigrant who does not 78.2 have the qualifications specified in this subdivision may 78.3 provide case management services to adultrefugeesimmigrants 78.4 with serious and persistent mental illness who are members of 78.5 the same ethnic group as the case manager if the person: (1) is 78.6 actively pursuing credits toward the completion of a bachelor's 78.7 degree in one of the behavioral sciences or a related field from 78.8 an accredited college or university; (2) completes 40 hours of 78.9 training as specified in this subdivision; and (3) receives 78.10 clinical supervision at least once a week until the requirements 78.11 ofobtaining a bachelor's degree and 2,000 hours of supervised78.12experiencethis subdivision are met. 78.13 (b) The commissioner may approve waivers submitted by 78.14 counties to allow case managers without a bachelor's degree but 78.15 with 6,000 hours of supervised experience in the delivery of 78.16 services to adults with mental illness if the person: 78.17 (1) meets the qualifications for a mental health 78.18 practitioner in subdivision 26; 78.19 (2) has completed 40 hours of training approved by the 78.20 commissioner in case management skills and in the 78.21 characteristics and needs of adults with serious and persistent 78.22 mental illness; and 78.23 (3) demonstrates that the 6,000 hours of supervised 78.24 experience are in identifying functional needs of persons with 78.25 mental illness, coordinating assessment information and making 78.26 referrals to appropriate service providers, coordinating a 78.27 variety of services to support and treat persons with mental 78.28 illness, and monitoring to ensure appropriate provision of 78.29 services. The county board is responsible to verify that all 78.30 qualifications, including content of supervised experience, have 78.31 been met. 78.32 Sec. 3. Minnesota Statutes 1996, section 245.462, 78.33 subdivision 8, is amended to read: 78.34 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 78.35 treatment services," or "day treatment program" means a 78.36 structured program of treatment and care provided to an adult in 79.1 or by: (1) a hospital accredited by the joint commission on 79.2 accreditation of health organizations and licensed under 79.3 sections 144.50 to 144.55; (2) a community mental health center 79.4 under section 245.62; or (3) an entity that is under contract 79.5 with the county board to operate a program that meets the 79.6 requirements of section 245.4712, subdivision 2, and Minnesota 79.7 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 79.8 group psychotherapy and other intensive therapeutic services 79.9 that are provided at least one day a weekfor a minimum79.10three-hour time blockby a multidisciplinary staff under the 79.11 clinical supervision of a mental health professional. The 79.12 services are aimed at stabilizing the adult's mental health 79.13 status, providing mental health services, and developing and 79.14 improving the adult's independent living and socialization 79.15 skills. The goal of day treatment is to reduce or relieve 79.16 mental illness and to enable the adult to live in the 79.17 community. Day treatment services are not a part of inpatient 79.18 or residential treatment services. Day treatment services are 79.19 distinguished from day care by their structured therapeutic 79.20 program of psychotherapy services. The commissioner may limit 79.21 medical assistance reimbursement for day treatment to 15 hours 79.22 per week per person instead of the three hours per day per 79.23 person specified in Minnesota Rules, part 9505.0323, subpart 15. 79.24 Sec. 4. Minnesota Statutes 1996, section 245.4871, 79.25 subdivision 4, is amended to read: 79.26 Subd. 4. [CASE MANAGER.] (a) "Case manager" means an 79.27 individual employed by the county or other entity authorized by 79.28 the county board to provide case management services specified 79.29 in subdivision 3 for the child with severe emotional disturbance 79.30 and the child's family. A case manager must have experience and 79.31 training in working with children. 79.32 (b) A case manager must: 79.33 (1) have at least a bachelor's degree in one of the 79.34 behavioral sciences or a related field from an accredited 79.35 college or university; 79.36 (2) have at least 2,000 hours of supervised experience in 80.1 the delivery of mental health services to children; 80.2 (3) have experience and training in identifying and 80.3 assessing a wide range of children's needs; and 80.4 (4) be knowledgeable about local community resources and 80.5 how to use those resources for the benefit of children and their 80.6 families. 80.7 (c) The case manager may be a member of any professional 80.8 discipline that is part of the local system of care for children 80.9 established by the county board. 80.10 (d) The case manager must meet in person with a mental 80.11 health professional at least once each month to obtain clinical 80.12 supervision. 80.13 (e) Case managers with a bachelor's degree but without 80.14 2,000 hours of supervised experience in the delivery of mental 80.15 health services to children with emotional disturbance must: 80.16 (1) begin 40 hours of training approved by the commissioner 80.17 of human services in case management skills and in the 80.18 characteristics and needs of children with severe emotional 80.19 disturbance before beginning to provide case management 80.20 services; and 80.21 (2) receive clinical supervision regarding individual 80.22 service delivery from a mental health professional at least once 80.23 each week until the requirement of 2,000 hours of experience is 80.24 met. 80.25 (f) Clinical supervision must be documented in the child's 80.26 record. When the case manager is not a mental health 80.27 professional, the county board must provide or contract for 80.28 needed clinical supervision. 80.29 (g) The county board must ensure that the case manager has 80.30 the freedom to access and coordinate the services within the 80.31 local system of care that are needed by the child. 80.32 (h) Until June 30, 1999, a refugee who does not have the 80.33 qualifications specified in this subdivision may provide case 80.34 management services to child refugees with severe emotional 80.35 disturbance of the same ethnic group as the refugee if the 80.36 person: 81.1 (1) is actively pursuing credits toward the completion of a 81.2 bachelor's degree in one of the behavioral sciences or related 81.3 fields at an accredited college or university; 81.4 (2) completes 40 hours of training as specified in this 81.5 subdivision; and 81.6 (3) receives clinical supervision at least once a week 81.7 until the requirements of obtaining a bachelor's degree and 81.8 2,000 hours of supervised experience are met. 81.9 (i) The commissioner may approve waivers submitted by 81.10 counties to allow case managers without a bachelor's degree but 81.11 with 6,000 hours of supervised experience in the delivery of 81.12 services to children with severe emotional disturbance if the 81.13 person: 81.14 (1) meets the qualifications for a mental health 81.15 practitioner in subdivision 26; 81.16 (2) has completed 40 hours of training approved by the 81.17 commissioner in case management skills and in the 81.18 characteristics and needs of children with severe emotional 81.19 disturbance; and 81.20 (3) demonstrates that the 6,000 hours of supervised 81.21 experience are in identifying functional needs of children with 81.22 severe emotional disturbance, coordinating assessment 81.23 information and making referrals to appropriate service 81.24 providers, coordinating a variety of services to support and 81.25 treat children with severe emotional disturbance, and monitoring 81.26 to ensure appropriate provision of services. The county board 81.27 is responsible to verify that all qualifications, including 81.28 content of supervised experience, have been met. 81.29 Sec. 5. [256.9364] [POST-KIDNEY TRANSPLANT DRUG PROGRAM.] 81.30 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 81.31 services shall establish and administer a program to pay for 81.32 costs of drugs prescribed exclusively for post-kidney transplant 81.33 maintenance when those costs are not otherwise reimbursed by a 81.34 third-party payer. The commissioner may contract with a 81.35 nonprofit entity to administer this program. 81.36 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 82.1 the program, an applicant must satisfy the following 82.2 requirements: 82.3 (1) the applicant's family gross income must not exceed 275 82.4 percent of the federal poverty level; and 82.5 (2) the applicant must be a Minnesota resident who has 82.6 resided in Minnesota for at least 12 months. 82.7 An applicant shall not be excluded because the applicant 82.8 received the transplant outside the state of Minnesota, so long 82.9 as the other requirements are met. 82.10 Subd. 3. [PAYMENT AMOUNTS.] (a) The amount of the payments 82.11 made for each eligible recipient shall be based on the following: 82.12 (1) available funds; and 82.13 (2) the cost of the post-kidney transplant maintenance 82.14 drugs. 82.15 (b) The payment rate under this program must be no greater 82.16 than the medical assistance reimbursement rate for the 82.17 prescribed drug. 82.18 (c) Payments shall be made to or on behalf of an eligible 82.19 recipient for the cost of the post-kidney transplant maintenance 82.20 drugs that is not covered, reimbursed, or eligible for 82.21 reimbursement by any other third party or government entity, 82.22 including, but not limited to, private or group health 82.23 insurance, medical assistance, Medicare, the Veterans 82.24 Administration, the senior citizen drug program established 82.25 under section 256.955, or under any waiver arrangement received 82.26 by the state to provide a prescription drug benefit for 82.27 qualified Medicare beneficiaries or service-limited Medicare 82.28 beneficiaries. 82.29 (d) The commissioner may restrict or categorize payments to 82.30 meet the appropriation allocated for this program. 82.31 (e) Any cost of the post-kidney transplant maintenance 82.32 drugs that is not reimbursed under this program is the 82.33 responsibility of the program recipient. 82.34 Subd. 4. [DRUG FORMULARY.] The commissioner shall maintain 82.35 a drug formulary that includes all drugs eligible for 82.36 reimbursement by the program. The commissioner may use the drug 83.1 formulary established under section 256B.0625, subdivision 13. 83.2 The commissioner shall establish an internal review procedure 83.3 for updating the formulary that allows for the addition and 83.4 deletion of drugs to the formulary. The drug formulary must be 83.5 reviewed at least quarterly per fiscal year. 83.6 Subd. 5. [PRIVATE DONATIONS.] The commissioner may accept 83.7 funding from other public or private sources. 83.8 Subd. 6. [SUNSET.] This program expires on July 1, 2000. 83.9 Sec. 6. Minnesota Statutes 1997 Supplement, section 83.10 256.9657, subdivision 3, is amended to read: 83.11 Subd. 3. [HEALTH MAINTENANCE ORGANIZATION; COMMUNITY 83.12 INTEGRATED SERVICE NETWORK SURCHARGE.] (a) Effective October 1, 83.13 1992, each health maintenance organization with a certificate of 83.14 authority issued by the commissioner of health under chapter 62D 83.15 and each community integrated service network licensed by the 83.16 commissioner under chapter 62N shall pay to the commissioner of 83.17 human services a surcharge equal to six-tenths of one percent of 83.18 the total premium revenues of the health maintenance 83.19 organization or community integrated service network as reported 83.20 to the commissioner of health according to the schedule in 83.21 subdivision 4. 83.22 (b) For purposes of this subdivision, total premium revenue 83.23 means: 83.24 (1) premium revenue recognized on a prepaid basis from 83.25 individuals and groups for provision of a specified range of 83.26 health services over a defined period of time which is normally 83.27 one month, excluding premiums paid to a health maintenance 83.28 organization or community integrated service network from the 83.29 Federal Employees Health Benefit Program; 83.30 (2) premiums from Medicare wrap-around subscribers for 83.31 health benefits which supplement Medicare coverage; 83.32 (3) Medicare revenue, as a result of an arrangement between 83.33 a health maintenance organization or a community integrated 83.34 service network and the health care financing administration of 83.35 the federal Department of Health and Human Services, for 83.36 services to a Medicare beneficiary, excluding Medicare revenue 84.1 that states are prohibited from taxing under sections 4001 and 84.2 4002 of Public Law Number 105-33 received by a health 84.3 maintenance organization or community integrated service network 84.4 through risk sharing or Medicare Choice + contracts; and 84.5 (4) medical assistance revenue, as a result of an 84.6 arrangement between a health maintenance organization or 84.7 community integrated service network and a Medicaid state 84.8 agency, for services to a medical assistance beneficiary. 84.9 If advance payments are made under clause (1) or (2) to the 84.10 health maintenance organization or community integrated service 84.11 network for more than one reporting period, the portion of the 84.12 payment that has not yet been earned must be treated as a 84.13 liability. 84.14 (c) When a health maintenance organization or community 84.15 integrated service network merges or consolidates with or is 84.16 acquired by another health maintenance organization or community 84.17 integrated service network, the surviving corporation or the new 84.18 corporation shall be responsible for the annual surcharge 84.19 originally imposed on each of the entities or corporations 84.20 subject to the merger, consolidation, or acquisition, regardless 84.21 of whether one of the entities or corporations does not retain a 84.22 certificate of authority under chapter 62D or a license under 84.23 chapter 62N. 84.24 (d) Effective July 1 of each year, the surviving 84.25 corporation's or the new corporation's surcharge shall be based 84.26 on the revenues earned in the second previous calendar year by 84.27 all of the entities or corporations subject to the merger, 84.28 consolidation, or acquisition regardless of whether one of the 84.29 entities or corporations does not retain a certificate of 84.30 authority under chapter 62D or a license under chapter 62N until 84.31 the total premium revenues of the surviving corporation include 84.32 the total premium revenues of all the merged entities as 84.33 reported to the commissioner of health. 84.34 (e) When a health maintenance organization or community 84.35 integrated service network, which is subject to liability for 84.36 the surcharge under this chapter, transfers, assigns, sells, 85.1 leases, or disposes of all or substantially all of its property 85.2 or assets, liability for the surcharge imposed by this chapter 85.3 is imposed on the transferee, assignee, or buyer of the health 85.4 maintenance organization or community integrated service network. 85.5 (f) In the event a health maintenance organization or 85.6 community integrated service network converts its licensure to a 85.7 different type of entity subject to liability for the surcharge 85.8 under this chapter, but survives in the same or substantially 85.9 similar form, the surviving entity remains liable for the 85.10 surcharge regardless of whether one of the entities or 85.11 corporations does not retain a certificate of authority under 85.12 chapter 62D or a license under chapter 62N. 85.13 (g) The surcharge assessed to a health maintenance 85.14 organization or community integrated service network ends when 85.15 the entity ceases providing services for premiums and the 85.16 cessation is not connected with a merger, consolidation, 85.17 acquisition, or conversion. 85.18 Sec. 7. Minnesota Statutes 1997 Supplement, section 85.19 256.9685, subdivision 1, is amended to read: 85.20 Subdivision 1. [AUTHORITY.] The commissioner shall 85.21 establish procedures for determining medical assistance and 85.22 general assistance medical care payment rates under a 85.23 prospective payment system for inpatient hospital services in 85.24 hospitals that qualify as vendors of medical assistance. The 85.25 commissioner shall establish, by rule, procedures for 85.26 implementing this section and sections 256.9686, 256.969, and 85.27 256.9695.The medical assistance payment rates must be based on85.28methods and standards that the commissioner finds are adequate85.29to provide for the costs that must be incurred for the care of85.30recipients in efficiently and economically operated hospitals.85.31 Services must meet the requirements of section 256B.04, 85.32 subdivision 15, or 256D.03, subdivision 7, paragraph (b), to be 85.33 eligible for payment. 85.34 Sec. 8. Minnesota Statutes 1996, section 256.969, 85.35 subdivision 16, is amended to read: 85.36 Subd. 16. [INDIAN HEALTH SERVICE FACILITIES.]Indian86.1health serviceFacilities of the Indian health service and 86.2 facilities operated by a tribe or tribal organization under 86.3 funding authorized by title III of the Indian Self-Determination 86.4 and Education Assistance Act, Public Law Number 93-638, or by 86.5 United States Code, title 25, chapter 14, subchapter II, 86.6 sections 450f to 450n, are exempt from the rate establishment 86.7 methods required by this section and shall bereimbursed at86.8charges as limited to the amount allowed under federal lawpaid 86.9 according to the rate published by the United States assistant 86.10 secretary for health under authority of United States Code, 86.11 title 42, sections 248A and 248B. 86.12 Sec. 9. Minnesota Statutes 1996, section 256.969, 86.13 subdivision 17, is amended to read: 86.14 Subd. 17. [OUT-OF-STATE HOSPITALS IN LOCAL TRADE AREAS.] 86.15 Out-of-state hospitals that are located within a Minnesota local 86.16 trade area and that have more than 20 admissions in the base 86.17 year shall have rates established using the same procedures and 86.18 methods that apply to Minnesota hospitals. For this subdivision 86.19 and subdivision 18, local trade area means a county contiguous 86.20 to Minnesota and located in a metropolitan statistical area as 86.21 determined by Medicare for October 1 prior to the most current 86.22 rebased rate year. Hospitals that are not required by law to 86.23 file information in a format necessary to establish rates shall 86.24 have rates established based on the commissioner's estimates of 86.25 the information. Relative values of the diagnostic categories 86.26 shall not be redetermined under this subdivision until required 86.27 by rule. Hospitals affected by this subdivision shall then be 86.28 included in determining relative values. However, hospitals 86.29 that have rates established based upon the commissioner's 86.30 estimates of information shall not be included in determining 86.31 relative values. This subdivision is effective for hospital 86.32 fiscal years beginning on or after July 1, 1988. A hospital 86.33 shall provide the information necessary to establish rates under 86.34 this subdivision at least 90 days before the start of the 86.35 hospital's fiscal year. 86.36 Sec. 10. Minnesota Statutes 1996, section 256B.03, 87.1 subdivision 3, is amended to read: 87.2 Subd. 3. [AMERICAN INDIAN HEALTH FUNDINGTRIBAL PURCHASING 87.3 MODEL.] Notwithstanding subdivision 1 and sections 256B.0625 and 87.4 256D.03, subdivision 4, paragraph(f)(i), the commissioner may 87.5 make payments to federally recognized Indian tribes with a 87.6 reservation in the state to provide medical assistance and 87.7 general assistance medical care to Indians, as defined under 87.8 federal law, who reside on or near the reservation. The 87.9 payments may be made in the form of a block grant or other 87.10 payment mechanism determined in consultation with the tribe. 87.11 Any alternative payment mechanism agreed upon by the tribes and 87.12 the commissioner under this subdivision is not dependent upon 87.13 county or health plan agreement but is intended to create a 87.14 direct payment mechanism between the state and the tribe for the 87.15 administration of the medical assistanceprogramand general 87.16 assistance medical care programs, and for covered services. 87.17 A tribe that implements a purchasing model under this 87.18 subdivision shall report to the commissioner at least annually 87.19 on the operation of the model. The commissioner and the tribe 87.20 shall cooperatively determine the data elements, format, and 87.21 timetable for the report. 87.22 For purposes of this subdivision, "Indian tribe" means a 87.23 tribe, band, or nation, or other organized group or community of 87.24 Indians that is recognized as eligible for the special programs 87.25 and services provided by the United States to Indians because of 87.26 their status as Indians and for which a reservation exists as is 87.27 consistent with Public Law Number 100-485, as amended. 87.28 Payments under this subdivision may not result in an 87.29 increase in expenditures that would not otherwise occur in the 87.30 medical assistance program under this chapter or the general 87.31 assistance medical care program under chapter 256D. 87.32 Sec. 11. [256B.038] [PROVIDER RATE INCREASES AFTER JUNE 87.33 30, 1999.] 87.34 (a) For fiscal years beginning on or after July 1, 1999, 87.35 the commissioner shall consider increasing payment rates for the 87.36 services listed in paragraph (b) by indexing the rates in effect 88.1 for inflation based on the change in the Consumer Price 88.2 Index-All Items (United States city average)(CPI-U) as 88.3 forecasted by Data Resources, Inc., in the fourth quarter of the 88.4 prior year for the calendar year during which the rate increase 88.5 occurs. 88.6 (b) The rate increases in paragraph (a) shall apply to home 88.7 and community-based waiver services for persons with mental 88.8 retardation or related conditions under section 256B.501; home 88.9 and community-based waiver services for the elderly under 88.10 section 256B.0915; waivered services under community 88.11 alternatives for disabled individuals under section 256B.49; 88.12 community alternative care waivered services under section 88.13 256B.49; traumatic brain injury waivered services under section 88.14 256B.49; nursing services and home health services under section 88.15 256B.0625, subdivision 6a; personal care services and nursing 88.16 supervision of personal care services under section 256B.0625, 88.17 subdivision 19a; private duty nursing services under section 88.18 256B.0625, subdivision 7; day training and habilitation services 88.19 for adults with mental retardation or related conditions under 88.20 sections 252.40 to 252.46; physical therapy services under 88.21 sections 256B.0625, subdivision 8, and 256D.03, subdivision 4; 88.22 occupational therapy services under sections 256B.0625, 88.23 subdivision 8a, and 256D.03, subdivision 4; speech-language 88.24 therapy services under section 256D.03, subdivision 4, and 88.25 Minnesota Rules, part 9505.0390; respiratory therapy services 88.26 under section 256D.03, subdivision 4, and Minnesota Rules, part 88.27 9505.0295; physician services under section 256B.0625, 88.28 subdivision 3; dental services under sections 256B.0625, 88.29 subdivision 9, and 256D.03, subdivision 4; alternative care 88.30 services under section 256B.0913; adult residential program 88.31 grants under Minnesota Rules, parts 9535.2000 to 9535.3000; 88.32 adult and family community support grants under Minnesota Rules, 88.33 parts 9535.1700 to 9535.1760; and semi-independent living 88.34 services under section 252.275, including SILS funding under 88.35 county social services grants formerly funded under chapter 256I. 88.36 (c) The commissioner shall increase prepaid medical 89.1 assistance program capitation rates as appropriate to reflect 89.2 the rate increases in this section. 89.3 (d) In implementing this section, the commissioner shall 89.4 consider proposing a schedule to equalize rates paid by 89.5 different programs for the same service. 89.6 Sec. 12. Minnesota Statutes 1996, section 256B.04, is 89.7 amended by adding a subdivision to read: 89.8 Subd. 19. [INFORMATION PROVIDED IN SEVERAL 89.9 LANGUAGES.] Upon request, the commissioner shall provide 89.10 applications and other information regarding medical assistance, 89.11 including all notices and disclosures provided to applicants and 89.12 recipients, in English, Spanish, Vietnamese, and Hmong. 89.13 Reasonable effort must be made to provide this information to 89.14 other non-English-speaking applicants and recipients. 89.15 Sec. 13. Minnesota Statutes 1996, section 256B.055, 89.16 subdivision 7, is amended to read: 89.17 Subd. 7. [AGED, BLIND, OR DISABLED PERSONS.] Medical 89.18 assistance may be paid for a person who meets the categorical 89.19 eligibility requirements of the supplemental security income 89.20 program or, who would meet those requirements except for excess 89.21 income or assets, and who meets the other eligibility 89.22 requirements of this section. 89.23Effective February 1, 1989, and to the extent allowed by89.24federal law the commissioner shall deduct state and federal89.25income taxes and federal insurance contributions act payments89.26withheld from the individual's earned income in determining89.27eligibility under this subdivision.89.28 Sec. 14. Minnesota Statutes 1996, section 256B.055, is 89.29 amended by adding a subdivision to read: 89.30 Subd. 7a. [SPECIAL CATEGORY FOR DISABLED 89.31 CHILDREN.] Medical assistance may be paid for a person who is 89.32 under age 18 and who meets income and asset eligibility 89.33 requirements of the Supplemental Security Income program if the 89.34 person was receiving Supplemental Security Income payments on 89.35 the date of enactment of section 211(a) of Public Law Number 89.36 104-193, the Personal Responsibility and Work Opportunity Act of 90.1 1996, and the person would have continued to receive such 90.2 payments except for the change in the childhood disability 90.3 criteria in section 211(a) of Public Law Number 104-193. 90.4 Sec. 15. Minnesota Statutes 1997 Supplement, section 90.5 256B.056, subdivision 1a, is amended to read: 90.6 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 90.7 specifically required by state law or rule or federal law or 90.8 regulation, the methodologies used in counting income and assets 90.9 to determine eligibility for medical assistance for persons 90.10 whose eligibility category is based on blindness, disability, or 90.11 age of 65 or more years, the methodologies for the supplemental 90.12 security income program shall be used, except that payments made90.13according to a court order for the support of children shall be90.14excluded from income in an amount not to exceed the difference90.15between the applicable income standard used in the state's90.16medical assistance program for aged, blind, and disabled persons90.17and the applicable income standard used in the state's medical90.18assistance program for families with children. Exclusion of90.19court-ordered child support payments is subject to the condition90.20that if there has been a change in the financial circumstances90.21of the person with the legal obligation to pay support since the90.22support order was entered, the person with the legal obligation90.23to pay support has petitioned for modification of the support90.24order. For families and children, which includes all other 90.25 eligibility categories, the methodologies under the state's AFDC 90.26 plan in effect as of July 16, 1996, as required by the Personal 90.27 Responsibility and Work Opportunity Reconciliation Act of 1996 90.28 (PRWORA), Public Law Number 104-193, shall be used. Effective 90.29 upon federal approval, in-kind contributions to, and payments 90.30 made on behalf of, a recipient, by an obligor, in satisfaction 90.31 of or in addition to a temporary or permanent order for child 90.32 support or maintenance, shall be considered income to the 90.33 recipient. For these purposes, a "methodology" does not include 90.34 an asset or income standard, or accounting method, or method of 90.35 determining effective dates. 90.36 Sec. 16. Minnesota Statutes 1997 Supplement, section 91.1 256B.056, subdivision 4, is amended to read: 91.2 Subd. 4. [INCOME.] To be eligible for medical assistance, 91.3 a personmust not have, or anticipate receiving, semiannual91.4income in excess of 120 percent of the income standards by91.5family size used under the aid to families with dependent91.6children state plan as of July 16, 1996, as required by the91.7Personal Responsibility and Work Opportunity Reconciliation Act91.8of 1996 (PRWORA), Public Law Number 104-193, except91.9thateligible under section 256B.055, subdivision 7, and 91.10 families and children may have an income up to 133-1/3 percent 91.11 of the AFDC income standard in effect under the July 16, 1996, 91.12 AFDC state plan. For rate years beginning on or after July 1, 91.13 1999, the commissioner shall consider increasing the base AFDC 91.14 standard in effect July 16, 1996, by an amount equal to the 91.15 percentage increase in the Consumer Price Index for all urban 91.16 consumers for the previous calendar year. In computing income 91.17 to determine eligibility of persons who are not residents of 91.18 long-term care facilities, the commissioner shall disregard 91.19 increases in income as required by Public Law Numbers 94-566, 91.20 section 503; 99-272; and 99-509. Veterans aid and attendance 91.21 benefits and Veterans Administration unusual medical expense 91.22 payments are considered income to the recipient. 91.23 Sec. 17. Minnesota Statutes 1996, section 256B.057, 91.24 subdivision 3a, is amended to read: 91.25 Subd. 3a. [ELIGIBILITY FOR PAYMENT OF MEDICARE PART B 91.26 PREMIUMS.] A person who would otherwise be eligible as a 91.27 qualified Medicare beneficiary under subdivision 3, except the 91.28 person's income is in excess of the limit, is eligible for 91.29 medical assistance reimbursement of Medicare Part B premiums if 91.30 the person's income is less than110120 percent of the official 91.31 federal poverty guidelines for the applicable family size.The91.32income limit shall increase to 120 percent of the official91.33federal poverty guidelines for the applicable family size on91.34January 1, 1995.91.35 Sec. 18. Minnesota Statutes 1996, section 256B.057, is 91.36 amended by adding a subdivision to read: 92.1 Subd. 3b. [QUALIFYING INDIVIDUALS.] Beginning July 1, 92.2 1998, to the extent of the federal allocation to Minnesota, a 92.3 person, who would otherwise be eligible as a qualified Medicare 92.4 beneficiary under subdivision 3, except that the person's income 92.5 is in excess of the limit, is eligible as a qualifying 92.6 individual according to the following criteria: 92.7 (1) if the person's income is greater than 120 percent, but 92.8 less than 135 percent of the official federal poverty guidelines 92.9 for the applicable family size, the person is eligible for 92.10 medical assistance reimbursement of Medicare Part B premiums; or 92.11 (2) if the person's income is greater than 135 percent but 92.12 less than 175 percent of the official federal poverty guidelines 92.13 for the applicable family size, the person is eligible for 92.14 medical assistance reimbursement of that portion of the Medicare 92.15 Part B premium attributable to an increase in Part B 92.16 expenditures which resulted from the shift of home care services 92.17 from Medicare Part A to Medicare Part B under Public Law Number 92.18 105-33, section 4732, the Balanced Budget Act of 1997. 92.19 The commissioner shall limit enrollment of qualifying 92.20 individuals under this subdivision according to the requirements 92.21 of Public Law Number 105-33, section 4732. 92.22 Sec. 19. Minnesota Statutes 1997 Supplement, section 92.23 256B.06, subdivision 4, is amended to read: 92.24 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 92.25 medical assistance is limited to citizens of the United States, 92.26 qualified noncitizens as defined in this subdivision, and other 92.27 persons residing lawfully in the United States. 92.28 (b) "Qualified noncitizen" means a person who meets one of 92.29 the following immigration criteria: 92.30 (1) admitted for lawful permanent residence according to 92.31 United States Code, title 8; 92.32 (2) admitted to the United States as a refugee according to 92.33 United States Code, title 8, section 1157; 92.34 (3) granted asylum according to United States Code, title 92.35 8, section 1158; 92.36 (4) granted withholding of deportation according to United 93.1 States Code, title 8, section 1253(h); 93.2 (5) paroled for a period of at least one year according to 93.3 United States Code, title 8, section 1182(d)(5); 93.4 (6) granted conditional entrant status according to United 93.5 States Code, title 8, section 1153(a)(7);or93.6 (7) determined to be a battered noncitizen by the United 93.7 States Attorney General according to the Illegal Immigration 93.8 Reform and Immigrant Responsibility Act of 1996, title V of the 93.9 Omnibus Consolidated Appropriations Bill, Public Law Number 93.10 104-200; 93.11 (8) is a child of a noncitizen determined to be a battered 93.12 noncitizen by the United States Attorney General according to 93.13 the Illegal Immigration Reform and Immigrant Responsibility Act 93.14 of 1996, title V, of the Omnibus Consolidated Appropriations 93.15 Bill, Public Law Number 104-200; or 93.16 (9) determined to be a Cuban or Haitian entrant as defined 93.17 in section 501(e) of Public Law Number 96-422, the Refugee 93.18 Education Assistance Act of 1980. 93.19 (c) All qualified noncitizens who were residing in the 93.20 United States before August 22, 1996, who otherwise meet the 93.21 eligibility requirements of chapter 256B, are eligible for 93.22 medical assistance with federal financial participation. 93.23 (d) All qualified noncitizens who entered the United States 93.24 on or after August 22, 1996, and who otherwise meet the 93.25 eligibility requirements of chapter 256B, are eligible for 93.26 medical assistance with federal financial participation through 93.27 November 30, 1996. 93.28 Beginning December 1, 1996, qualified noncitizens who 93.29 entered the United States on or after August 22, 1996, and who 93.30 otherwise meet the eligibility requirements of chapter 256B are 93.31 eligible for medical assistance with federal participation for 93.32 five years if they meet one of the following criteria: 93.33 (i) refugees admitted to the United States according to 93.34 United States Code, title 8, section 1157; 93.35 (ii) persons granted asylum according to United States 93.36 Code, title 8, section 1158; 94.1 (iii) persons granted withholding of deportation according 94.2 to United States Code, title 8, section 1253(h); 94.3 (iv) veterans of the United States Armed Forces with an 94.4 honorable discharge for a reason other than noncitizen status, 94.5 their spouses and unmarried minor dependent children; or 94.6 (v) persons on active duty in the United States Armed 94.7 Forces, other than for training, their spouses and unmarried 94.8 minor dependent children. 94.9 Beginning December 1, 1996, qualified noncitizens who do 94.10 not meet one of the criteria in items (i) to (v) are eligible 94.11 for medical assistance without federal financial participation 94.12 as described in paragraph (j). 94.13 (e) Noncitizens who are not qualified noncitizens as 94.14 defined in paragraph (b), who are lawfully residing in the 94.15 United States and who otherwise meet the eligibility 94.16 requirements of chapter 256B, are eligible for medical 94.17 assistance under clauses (1) to (3). These individuals must 94.18 cooperate with the Immigration and Naturalization Service to 94.19 pursue any applicable immigration status, including citizenship, 94.20 that would qualify them for medical assistance with federal 94.21 financial participation. 94.22 (1) Persons who were medical assistance recipients on 94.23 August 22, 1996, are eligible for medical assistance with 94.24 federal financial participation through December 31, 1996. 94.25 (2) Beginning January 1, 1997, persons described in clause 94.26 (1) are eligible for medical assistance without federal 94.27 financial participation as described in paragraph (j). 94.28 (3) Beginning December 1, 1996, persons residing in the 94.29 United States prior to August 22, 1996, who were not receiving 94.30 medical assistance and persons who arrived on or after August 94.31 22, 1996, are eligible for medical assistance without federal 94.32 financial participation as described in paragraph (j). 94.33 (f) Nonimmigrants who otherwise meet the eligibility 94.34 requirements of chapter 256B are eligible for the benefits as 94.35 provided in paragraphs (g) to (i). For purposes of this 94.36 subdivision, a "nonimmigrant" is a person in one of the classes 95.1 listed in United States Code, title 8, section 1101(a)(15). 95.2 (g) Payment shall also be made for care and services that 95.3 are furnished to noncitizens, regardless of immigration status, 95.4 who otherwise meet the eligibility requirements of chapter 256B, 95.5 if such care and services are necessary for the treatment of an 95.6 emergency medical condition, except for organ transplants and 95.7 related care and services and routine prenatal care. 95.8 (h) For purposes of this subdivision, the term "emergency 95.9 medical condition" means a medical condition that meets the 95.10 requirements of United States Code, title 42, section 1396b(v). 95.11 (i) Pregnant noncitizens who are undocumented or 95.12 nonimmigrants, who otherwise meet the eligibility requirements 95.13 of chapter 256B, are eligible for medical assistance payment 95.14 without federal financial participation for care and services 95.15 through the period of pregnancy, and 60 days postpartum, except 95.16 for labor and delivery. 95.17 (j) Qualified noncitizens as described in paragraph (d), 95.18 and all other noncitizens lawfully residing in the United States 95.19 as described in paragraph (e), who are ineligible for medical 95.20 assistance with federal financial participation and who 95.21 otherwise meet the eligibility requirements of chapter 256B and 95.22 of this paragraph, are eligible for medical assistance without 95.23 federal financial participation. Qualified noncitizens as 95.24 described in paragraph (d) are only eligible for medical 95.25 assistance without federal financial participation for five 95.26 years from their date of entry into the United States. 95.27 (k) The commissioner shall submit to the legislature by 95.28 December 31, 1998, a report on the number of recipients and cost 95.29 of coverage of care and services made according to paragraphs 95.30 (i) and (j). 95.31 Sec. 20. Minnesota Statutes 1996, section 256B.0625, 95.32 subdivision 17, is amended to read: 95.33 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 95.34 covers transportation costs incurred solely for obtaining 95.35 emergency medical care or transportation costs incurred by 95.36 nonambulatory persons in obtaining emergency or nonemergency 96.1 medical care when paid directly to an ambulance company, common 96.2 carrier, or other recognized providers of transportation 96.3 services. For the purpose of this subdivision, a person who is 96.4 incapable of transport by taxicab or bus shall be considered to 96.5 be nonambulatory. 96.6 (b) Medical assistance covers special transportation, as 96.7 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 96.8 if the provider receives and maintains a current physician's 96.9 order by the recipient's attending physician certifying that the 96.10 recipient has a physical or mental impairment that would 96.11 prohibit the recipient from safely accessing and using a bus, 96.12 taxi, other commercial transportation, or private automobile. 96.13 Special transportation includes driver-assisted service to 96.14 eligible individuals. Driver-assisted service includes 96.15 passenger pickup at and return to the individual's residence or 96.16 place of business, assistance with admittance of the individual 96.17 to the medical facility, and assistance in passenger securement 96.18 or in securing of wheelchairs or stretchers in the vehicle. The 96.19 commissioner shall establish maximum medical assistance 96.20 reimbursement rates for special transportation services for 96.21 persons who need a wheelchair lift van or stretcher-equipped 96.22 vehicle and for those who do not need a wheelchair lift van or 96.23 stretcher-equipped vehicle. The average of these two rates per 96.24 trip must not exceed$14$16 for the base rate and$1.10$1.30 96.25 per mile. Special transportation provided to nonambulatory 96.26 persons who do not need a wheelchair lift van or 96.27 stretcher-equipped vehicle, may be reimbursed at a lower rate 96.28 than special transportation provided to persons who need a 96.29 wheelchair lift van or stretcher-equipped vehicle. 96.30 Sec. 21. Minnesota Statutes 1996, section 256B.0625, is 96.31 amended by adding a subdivision to read: 96.32 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 96.33 services rendered on or after July 1, 1999, medical assistance 96.34 payments for ambulance services shall be increased by ten 96.35 percent. 96.36 Sec. 22. Minnesota Statutes 1996, section 256B.0625, 97.1 subdivision 20, is amended to read: 97.2 Subd. 20. [MENTALILLNESSHEALTH CASE MANAGEMENT.] (a) To 97.3 the extent authorized by rule of the state agency, medical 97.4 assistance covers case management services to persons with 97.5 serious and persistent mental illnessor subject to federal97.6approval,and children with severe emotional disturbance. 97.7 Services provided under this section must meet the relevant 97.8 standards in sections 245.461 to 245.4888, the Comprehensive 97.9 Adult and Children's Mental Health Acts, Minnesota Rules, parts 97.10 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10. 97.11 (b) Entities meeting program standards set out in rules 97.12 governing family community support services as defined in 97.13 section 245.4871, subdivision 17, are eligible for medical 97.14 assistance reimbursement for case management services for 97.15 children with severe emotional disturbance when these services 97.16 meet the program standards in Minnesota Rules, parts 9520.0900 97.17 to 9520.0926 and 9505.0322, excludingsubpart 6subparts 6 and 97.18 10. 97.19(b) In counties where fewer than 50 percent of children97.20estimated to be eligible under medical assistance to receive97.21case management services for children with severe emotional97.22disturbance actually receive these services in state fiscal year97.231995, community mental health centers serving those counties,97.24entities meeting program standards in Minnesota Rules, parts97.259520.0570 to 9520.0870, and other entities authorized by the97.26commissioner are eligible for medical assistance reimbursement97.27for case management services for children with severe emotional97.28disturbance when these services meet the program standards in97.29Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322,97.30excluding subpart 6.97.31 (c) Medical assistance and MinnesotaCare payment for mental 97.32 health case management shall be made on a monthly basis. In 97.33 order to receive payment for an eligible child, the provider 97.34 must document at least a face-to-face contact with the child, 97.35 the child's parents, or the child's legal representative. To 97.36 receive payment for an eligible adult, the provider must 98.1 document at least a face-to-face contact with the adult or the 98.2 adult's legal representative. 98.3 (d) Payment for mental health case management provided by 98.4 county or state staff shall be based on the monthly rate 98.5 methodology under section 256B.094, subdivision 6, paragraph 98.6 (b), with separate rates calculated for child welfare and mental 98.7 health, and within mental health, separate rates for children 98.8 and adults. 98.9 (e) Payment for mental health case management provided by 98.10 county-contracted vendors shall be based on a monthly rate 98.11 negotiated by the host county. The negotiated rate must not 98.12 exceed the rate charged by the vendor for the same service to 98.13 other payers. If the service is provided by a team of 98.14 contracted vendors, the county may negotiate a team rate with a 98.15 vendor who is a member of the team. The team shall determine 98.16 how to distribute the rate among its members. No reimbursement 98.17 received by contracted vendors shall be returned to the county, 98.18 except to reimburse the county for advance funding provided by 98.19 the county to the vendor. 98.20 (f) If the service is provided by a team which includes 98.21 contracted vendors and county or state staff, the costs for 98.22 county or state staff participation in the team shall be 98.23 included in the rate for county-provided services. In this 98.24 case, the contracted vendor and the county may each receive 98.25 separate payment for services provided by each entity in the 98.26 same month. 98.27 (g) The commissioner shall calculate the nonfederal share 98.28 of actual medical assistance and general assistance medical care 98.29 payments for each county, based on the higher of calendar year 98.30 1995 or 1996, by service date, project that amount forward to 98.31 1999, and transfer the result from medical assistance and 98.32 general assistance medical care to each county's mental health 98.33 grants under sections 245.4886 and 256E.12 for calendar year 98.34 1999. The minimum amount added to each county's mental health 98.35 grant shall be $3,000 per year for children and $5,000 per year 98.36 for adults. The commissioner may reduce the statewide growth 99.1 factor in order to fund these minimums. The total amount 99.2 transferred shall become part of the base for future mental 99.3 health grants for each county. 99.4 (h) Any net increase in revenue to the county as a result 99.5 of the change in this section must be used to provide expanded 99.6 mental health services as defined in sections 245.461 to 99.7 245.4888, the Comprehensive Adult and Children's Mental Health 99.8 Acts, excluding inpatient and residential treatment. For 99.9 adults, increased revenue may also be used for services and 99.10 consumer supports which are part of adult mental health projects 99.11 approved under Laws 1997, chapter 203, article 7, section 25. 99.12 For children, increased revenue may also be used for respite 99.13 care and nonresidential individualized rehabilitation services 99.14 as defined in section 245.492, subdivisions 17 and 23. 99.15 "Increased revenue" has the meaning given in Minnesota Rules, 99.16 part 9520.0903, subpart 3. 99.17 (i) Notwithstanding section 256B.19, subdivision 1, the 99.18 nonfederal share of costs for mental health case management 99.19 shall be provided by the recipient's county of responsibility, 99.20 as defined in sections 256G.01 to 256G.12, from sources other 99.21 than federal funds or funds used to match other federal funds. 99.22 (j) The commissioner may suspend, reduce, or terminate the 99.23 reimbursement to a provider that does not meet the reporting or 99.24 other requirements of this section. The county of 99.25 responsibility, as defined in sections 256G.01 to 256G.12, is 99.26 responsible for any federal disallowances. The county may share 99.27 this responsibility with its contracted vendors. 99.28 (k) The commissioner shall set aside a portion of the 99.29 federal funds earned under this section to repay the special 99.30 revenue maximization account under section 256.01, subdivision 99.31 2, clause (15). The repayment is limited to: 99.32 (1) the costs of developing and implementing this section; 99.33 and 99.34 (2) programming the information systems. 99.35 (l) Notwithstanding section 256.025, subdivision 2, 99.36 payments to counties for case management expenditures under this 100.1 section shall only be made from federal earnings from services 100.2 provided under this section. Payments to contracted vendors 100.3 shall include both the federal earnings and the county share. 100.4 (m) Notwithstanding section 256B.041, county payments for 100.5 the cost of mental health case management services provided by 100.6 county or state staff shall not be made to the state treasurer. 100.7 For the purposes of mental health case management services 100.8 provided by county or state staff under this section, the 100.9 centralized disbursement of payments to counties under section 100.10 256B.041 consists only of federal earnings from services 100.11 provided under this section. 100.12 (n) Case management services under this subdivision do not 100.13 include therapy, treatment, legal, or outreach services. 100.14 (o) If the recipient is a resident of a nursing facility, 100.15 intermediate care facility, or hospital, and the recipient's 100.16 institutional care is paid by medical assistance, payment for 100.17 case management services under this subdivision is limited to 100.18 the last 30 days of the recipient's residency in that facility 100.19 and may not exceed more than two months in a calendar year. 100.20 (p) Payment for case management services under this 100.21 subdivision shall not duplicate payments made under other 100.22 program authorities for the same purpose. 100.23 (q) For each calendar year beginning with the calendar year 100.24 2001, the amount of state funds for each county determined under 100.25 paragraph (g) shall be adjusted by the county's percentage 100.26 change in the average number of clients per month who received 100.27 case management under this section during the fiscal year that 100.28 ended six months prior to the calendar year in question, in 100.29 comparison to the prior fiscal year. 100.30 Sec. 23. Minnesota Statutes 1997 Supplement, section 100.31 256B.0625, subdivision 31a, is amended to read: 100.32 Subd. 31a. [AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 100.33 SYSTEMS.] (a) Medical assistance covers augmentative and 100.34 alternative communication systems consisting of electronic or 100.35 nonelectronic devices and the related components necessary to 100.36 enable a person with severe expressive communication limitations 101.1 to produce or transmit messages or symbols in a manner that 101.2 compensates for that disability. 101.3 (b)By January 1, 1998, the commissioner, in cooperation101.4with the commissioner of administration, shall establish an101.5augmentative and alternative communication system purchasing101.6program within a state agency or by contract with a qualified101.7private entity. The purpose of this service is to facilitate101.8ready availability of the augmentative and alternative101.9communication systems needed to meet the needs of persons with101.10severe expressive communication limitations in an efficient and101.11cost-effective manner. This program shall:101.12(1) coordinate purchase and rental of augmentative and101.13alternative communication systems;101.14(2) negotiate agreements with manufacturers and vendors for101.15purchase of components of these systems, for warranty coverage,101.16and for repair service;101.17(3) when efficient and cost-effective, maintain and101.18refurbish if needed, an inventory of components of augmentative101.19and alternative communication systems for short- or long-term101.20loan to recipients;101.21(4) facilitate training sessions for service providers,101.22consumers, and families on augmentative and alternative101.23communication systems; and101.24(5) develop a recycling program for used augmentative and101.25alternative communications systems to be reissued and used for101.26trials and short-term use, when appropriate.101.27The availability of components of augmentative and101.28alternative communication systems through this program is101.29subject to prior authorization requirements established under101.30subdivision 25Until the volume of systems purchased increases 101.31 to allow a discount price, the commissioner shall reimburse 101.32 augmentative and alternative communication manufacturers and 101.33 vendors at the manufacturer's suggested retail price for 101.34 augmentative and alternative communication systems and related 101.35 components. The commissioner shall separately reimburse 101.36 providers for purchasing and integrating individual 102.1 communication systems which are unavailable as a package from an 102.2 augmentative and alternative communication vendor. 102.3 (c) Reimbursement rates established by this purchasing 102.4 program are not subject to Minnesota Rules, part 9505.0445, item 102.5 S or T. 102.6 Sec. 24. Minnesota Statutes 1996, section 256B.0625, 102.7 subdivision 34, is amended to read: 102.8 Subd. 34. [AMERICAN INDIAN HEALTH SERVICES FACILITIES.] 102.9 Medical assistance payments toAmerican Indian health services102.10facilities for outpatient medical services billed after June 30,102.111990, must befacilities of the Indian health service and 102.12 facilities operated by a tribe or tribal organization under 102.13 funding authorized by United States Code, title 25, sections 102.14 450f to 450n, or title III of the Indian Self-Determination and 102.15 Education Assistance Act, Public Law Number 93-638, shall be at 102.16 the option of the facility in accordance with the rate published 102.17 by the United States Assistant Secretary for Health under the 102.18 authority of United States Code, title 42, sections 248(a) and 102.19 249(b). General assistance medical care payments to facilities 102.20 of the American Indian health services and facilities operated 102.21 by a tribe or tribal organization for the provision of 102.22 outpatient medical care services billed after June 30, 1990, 102.23 must be in accordance with the general assistance medical care 102.24 rates paid for the same services when provided in a facility 102.25 other thanan Americana facility of the Indian health 102.26 service or a facility operated by a tribe or tribal organization. 102.27 Sec. 25. Minnesota Statutes 1996, section 256B.0627, 102.28 subdivision 4, is amended to read: 102.29 Subd. 4. [PERSONAL CARE SERVICES.] (a) The personal care 102.30 services that are eligible for payment are the following: 102.31 (1) bowel and bladder care; 102.32 (2) skin care to maintain the health of the skin; 102.33 (3) repetitive maintenance range of motion, muscle 102.34 strengthening exercises, and other tasks specific to maintaining 102.35 a recipient's optimal level of function; 102.36 (4) respiratory assistance; 103.1 (5) transfers and ambulation; 103.2 (6) bathing, grooming, and hairwashing necessary for 103.3 personal hygiene; 103.4 (7) turning and positioning; 103.5 (8) assistance with furnishing medication that is 103.6 self-administered; 103.7 (9) application and maintenance of prosthetics and 103.8 orthotics; 103.9 (10) cleaning medical equipment; 103.10 (11) dressing or undressing; 103.11 (12) assistance with eating and meal preparation and 103.12 necessary grocery shopping; 103.13 (13) accompanying a recipient to obtain medical diagnosis 103.14 or treatment; 103.15 (14) assisting, monitoring, or prompting the recipient to 103.16 complete the services in clauses (1) to (13); 103.17 (15) redirection, monitoring, and observation that are 103.18 medically necessary and an integral part of completing the 103.19 personal care services described in clauses (1) to (14); 103.20 (16) redirection and intervention for behavior, including 103.21 observation and monitoring; 103.22 (17) interventions for seizure disorders, including 103.23 monitoring and observation if the recipient has had a seizure 103.24 that requires intervention within the past three months;and103.25 (18) tracheostomy suctioning using a clean procedure if the 103.26 procedure is properly delegated by a registered nurse. Before 103.27 this procedure can be delegated to a personal care assistant, a 103.28 registered nurse must determine that the tracheostomy suctioning 103.29 can be accomplished utilizing a clean rather than a sterile 103.30 procedure and must ensure that the personal care assistant has 103.31 been taught the proper procedure; and 103.32 (19) incidental household services that are an integral 103.33 part of a personal care service described in clauses (1) to 103.34(17)(18). 103.35 For purposes of this subdivision, monitoring and observation 103.36 means watching for outward visible signs that are likely to 104.1 occur and for which there is a covered personal care service or 104.2 an appropriate personal care intervention. For purposes of this 104.3 subdivision, a clean procedure refers to a procedure that 104.4 reduces the numbers of microorganisms or prevents or reduces the 104.5 transmission of microorganisms from one person or place to 104.6 another. A clean procedure may be used beginning 14 days after 104.7 insertion. 104.8 (b) The personal care services that are not eligible for 104.9 payment are the following: 104.10 (1) services not ordered by the physician; 104.11 (2) assessments by personal care provider organizations or 104.12 by independently enrolled registered nurses; 104.13 (3) services that are not in the service plan; 104.14 (4) services provided by the recipient's spouse, legal 104.15 guardian for an adult or child recipient, or parent of a 104.16 recipient under age 18; 104.17 (5) services provided by a foster care provider of a 104.18 recipient who cannot direct the recipient's own care, unless 104.19 monitored by a county or state case manager under section 104.20 256B.0625, subdivision 19a; 104.21 (6) services provided by the residential or program license 104.22 holder in a residence for more than four persons; 104.23 (7) services that are the responsibility of a residential 104.24 or program license holder under the terms of a service agreement 104.25 and administrative rules; 104.26 (8) sterile procedures; 104.27 (9) injections of fluids into veins, muscles, or skin; 104.28 (10) services provided by parents of adult recipients, 104.29 adult children or adult siblings of the recipient, unless these 104.30 relatives meet one of the following hardship criteria and the 104.31 commissioner waives this requirement: 104.32 (i) the relative resigns from a part-time or full-time job 104.33 to provide personal care for the recipient; 104.34 (ii) the relative goes from a full-time to a part-time job 104.35 with less compensation to provide personal care for the 104.36 recipient; 105.1 (iii) the relative takes a leave of absence without pay to 105.2 provide personal care for the recipient; 105.3 (iv) the relative incurs substantial expenses by providing 105.4 personal care for the recipient; or 105.5 (v) because of labor conditions or intermittent hours of 105.6 care needed, the relative is needed in order to provide an 105.7 adequate number of qualified personal care assistants to meet 105.8 the medical needs of the recipient; 105.9 (11) homemaker services that are not an integral part of a 105.10 personal care services; 105.11 (12) home maintenance, or chore services; 105.12 (13) services not specified under paragraph (a); and 105.13 (14) services not authorized by the commissioner or the 105.14 commissioner's designee. 105.15 Sec. 26. Minnesota Statutes 1997 Supplement, section 105.16 256B.0627, subdivision 5, is amended to read: 105.17 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 105.18 payments for home care services shall be limited according to 105.19 this subdivision. 105.20 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 105.21 recipient may receive the following home care services during a 105.22 calendar year: 105.23 (1) any initial assessment; 105.24 (2) up to two reassessments per year done to determine a 105.25 recipient's need for personal care services; and 105.26 (3) up to five skilled nurse visits. 105.27 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 105.28 services above the limits in paragraph (a) must receive the 105.29 commissioner's prior authorization, except when: 105.30 (1) the home care services were required to treat an 105.31 emergency medical condition that if not immediately treated 105.32 could cause a recipient serious physical or mental disability, 105.33 continuation of severe pain, or death. The provider must 105.34 request retroactive authorization no later than five working 105.35 days after giving the initial service. The provider must be 105.36 able to substantiate the emergency by documentation such as 106.1 reports, notes, and admission or discharge histories; 106.2 (2) the home care services were provided on or after the 106.3 date on which the recipient's eligibility began, but before the 106.4 date on which the recipient was notified that the case was 106.5 opened. Authorization will be considered if the request is 106.6 submitted by the provider within 20 working days of the date the 106.7 recipient was notified that the case was opened; 106.8 (3) a third-party payor for home care services has denied 106.9 or adjusted a payment. Authorization requests must be submitted 106.10 by the provider within 20 working days of the notice of denial 106.11 or adjustment. A copy of the notice must be included with the 106.12 request; 106.13 (4) the commissioner has determined that a county or state 106.14 human services agency has made an error; or 106.15 (5) the professional nurse determines an immediate need for 106.16 up to 40 skilled nursing or home health aide visits per calendar 106.17 year and submits a request for authorization within 20 working 106.18 days of the initial service date, and medical assistance is 106.19 determined to be the appropriate payer. 106.20 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 106.21 authorization will be evaluated according to the same criteria 106.22 applied to prior authorization requests. 106.23 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 106.24 section 256B.0627, subdivision 1, paragraph (a), shall be 106.25 conducted initially, and at least annually thereafter, in person 106.26 with the recipient and result in a completed service plan using 106.27 forms specified by the commissioner. Within 30 days of 106.28 recipient or responsible party request for home care services, 106.29 the assessment, the service plan, and other information 106.30 necessary to determine medical necessity such as diagnostic or 106.31 testing information, social or medical histories, and hospital 106.32 or facility discharge summaries shall be submitted to the 106.33 commissioner. For personal care services: 106.34 (1) The amount and type of service authorized based upon 106.35 the assessment and service plan will follow the recipient if the 106.36 recipient chooses to change providers. 107.1 (2) If the recipient's medical need changes, the 107.2 recipient's provider may assess the need for a change in service 107.3 authorization and request the change from the county public 107.4 health nurse. Within 30 days of the request, the public health 107.5 nurse will determine whether to request the change in services 107.6 based upon the provider assessment, or conduct a home visit to 107.7 assess the need and determine whether the change is appropriate. 107.8 (3) To continue to receive personal care serviceswhen the107.9recipient displays no significant change, the county public107.10health nurse has the option to review with the commissioner, or107.11the commissioner's designee, the service plan on record and107.12receive authorization for up to an additional 12 months at a107.13time for up to three years.after the first year, the recipient 107.14 or the responsible party, in conjunction with the public health 107.15 nurse, may complete a service update on forms developed by the 107.16 commissioner. The service update may substitute for the annual 107.17 reassessment described in subdivision 1. 107.18 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 107.19 commissioner's designee, shall review the assessment, the 107.20 service plan, and any additional information that is submitted. 107.21 The commissioner shall, within 30 days after receiving a 107.22 complete request, assessment, and service plan, authorize home 107.23 care services as follows: 107.24 (1) [HOME HEALTH SERVICES.] All home health services 107.25 provided by a licensed nurse or a home health aide must be prior 107.26 authorized by the commissioner or the commissioner's designee. 107.27 Prior authorization must be based on medical necessity and 107.28 cost-effectiveness when compared with other care options. When 107.29 home health services are used in combination with personal care 107.30 and private duty nursing, the cost of all home care services 107.31 shall be considered for cost-effectiveness. The commissioner 107.32 shall limit nurse and home health aide visits to no more than 107.33 one visit each per day. 107.34 (2) [PERSONAL CARE SERVICES.] (i) All personal care 107.35 services and registered nurse supervision must be prior 107.36 authorized by the commissioner or the commissioner's designee 108.1 except for the assessments established in paragraph (a). The 108.2 amount of personal care services authorized must be based on the 108.3 recipient's home care rating. A child may not be found to be 108.4 dependent in an activity of daily living if because of the 108.5 child's age an adult would either perform the activity for the 108.6 child or assist the child with the activity and the amount of 108.7 assistance needed is similar to the assistance appropriate for a 108.8 typical child of the same age. Based on medical necessity, the 108.9 commissioner may authorize: 108.10 (A) up to two times the average number of direct care hours 108.11 provided in nursing facilities for the recipient's comparable 108.12 case mix level; or 108.13 (B) up to three times the average number of direct care 108.14 hours provided in nursing facilities for recipients who have 108.15 complex medical needs or are dependent in at least seven 108.16 activities of daily living and need physical assistance with 108.17 eating or have a neurological diagnosis; or 108.18 (C) up to 60 percent of the average reimbursement rate, as 108.19 of July 1, 1991, for care provided in a regional treatment 108.20 center for recipients who have Level I behavior, plus any 108.21 inflation adjustment as provided by the legislature for personal 108.22 care service; or 108.23 (D) up to the amount the commissioner would pay, as of July 108.24 1, 1991, plus any inflation adjustment provided for home care 108.25 services, for care provided in a regional treatment center for 108.26 recipients referred to the commissioner by a regional treatment 108.27 center preadmission evaluation team. For purposes of this 108.28 clause, home care services means all services provided in the 108.29 home or community that would be included in the payment to a 108.30 regional treatment center; or 108.31 (E) up to the amount medical assistance would reimburse for 108.32 facility care for recipients referred to the commissioner by a 108.33 preadmission screening team established under section 256B.0911 108.34 or 256B.092; and 108.35 (F) a reasonable amount of time for the provision of 108.36 nursing supervision of personal care services. 109.1 (ii) The number of direct care hours shall be determined 109.2 according to the annual cost report submitted to the department 109.3 by nursing facilities. The average number of direct care hours, 109.4 as established by May 1, 1992, shall be calculated and 109.5 incorporated into the home care limits on July 1, 1992. These 109.6 limits shall be calculated to the nearest quarter hour. 109.7 (iii) The home care rating shall be determined by the 109.8 commissioner or the commissioner's designee based on information 109.9 submitted to the commissioner by the county public health nurse 109.10 on forms specified by the commissioner. The home care rating 109.11 shall be a combination of current assessment tools developed 109.12 under sections 256B.0911 and 256B.501 with an addition for 109.13 seizure activity that will assess the frequency and severity of 109.14 seizure activity and with adjustments, additions, and 109.15 clarifications that are necessary to reflect the needs and 109.16 conditions of recipients who need home care including children 109.17 and adults under 65 years of age. The commissioner shall 109.18 establish these forms and protocols under this section and shall 109.19 use an advisory group, including representatives of recipients, 109.20 providers, and counties, for consultation in establishing and 109.21 revising the forms and protocols. 109.22 (iv) A recipient shall qualify as having complex medical 109.23 needs if the care required is difficult to perform and because 109.24 of recipient's medical condition requires more time than 109.25 community-based standards allow or requires more skill than 109.26 would ordinarily be required and the recipient needs or has one 109.27 or more of the following: 109.28 (A) daily tube feedings; 109.29 (B) daily parenteral therapy; 109.30 (C) wound or decubiti care; 109.31 (D) postural drainage, percussion, nebulizer treatments, 109.32 suctioning, tracheotomy care, oxygen, mechanical ventilation; 109.33 (E) catheterization; 109.34 (F) ostomy care; 109.35 (G) quadriplegia; or 109.36 (H) other comparable medical conditions or treatments the 110.1 commissioner determines would otherwise require institutional 110.2 care. 110.3 (v) A recipient shall qualify as having Level I behavior if 110.4 there is reasonable supporting evidence that the recipient 110.5 exhibits, or that without supervision, observation, or 110.6 redirection would exhibit, one or more of the following 110.7 behaviors that cause, or have the potential to cause: 110.8 (A) injury to the recipient's own body; 110.9 (B) physical injury to other people; or 110.10 (C) destruction of property. 110.11 (vi) Time authorized for personal care relating to Level I 110.12 behavior in subclause (v), items (A) to (C), shall be based on 110.13 the predictability, frequency, and amount of intervention 110.14 required. 110.15 (vii) A recipient shall qualify as having Level II behavior 110.16 if the recipient exhibits on a daily basis one or more of the 110.17 following behaviors that interfere with the completion of 110.18 personal care services under subdivision 4, paragraph (a): 110.19 (A) unusual or repetitive habits; 110.20 (B) withdrawn behavior; or 110.21 (C) offensive behavior. 110.22 (viii) A recipient with a home care rating of Level II 110.23 behavior in subclause (vii), items (A) to (C), shall be rated as 110.24 comparable to a recipient with complex medical needs under 110.25 subclause (iv). If a recipient has both complex medical needs 110.26 and Level II behavior, the home care rating shall be the next 110.27 complex category up to the maximum rating under subclause (i), 110.28 item (B). 110.29 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 110.30 nursing services shall be prior authorized by the commissioner 110.31 or the commissioner's designee. Prior authorization for private 110.32 duty nursing services shall be based on medical necessity and 110.33 cost-effectiveness when compared with alternative care options. 110.34 The commissioner may authorize medically necessary private duty 110.35 nursing services in quarter-hour units when: 110.36 (i) the recipient requires more individual and continuous 111.1 care than can be provided during a nurse visit; or 111.2 (ii) the cares are outside of the scope of services that 111.3 can be provided by a home health aide or personal care assistant. 111.4 The commissioner may authorize: 111.5 (A) up to two times the average amount of direct care hours 111.6 provided in nursing facilities statewide for case mix 111.7 classification "K" as established by the annual cost report 111.8 submitted to the department by nursing facilities in May 1992; 111.9 (B) private duty nursing in combination with other home 111.10 care services up to the total cost allowed under clause (2); 111.11 (C) up to 16 hours per day if the recipient requires more 111.12 nursing than the maximum number of direct care hours as 111.13 established in item (A) and the recipient meets the hospital 111.14 admission criteria established under Minnesota Rules, parts 111.15 9505.0500 to 9505.0540. 111.16 The commissioner may authorize up to 16 hours per day of 111.17 medically necessary private duty nursing services or up to 24 111.18 hours per day of medically necessary private duty nursing 111.19 services until such time as the commissioner is able to make a 111.20 determination of eligibility for recipients who are 111.21 cooperatively applying for home care services under the 111.22 community alternative care program developed under section 111.23 256B.49, or until it is determined by the appropriate regulatory 111.24 agency that a health benefit plan is or is not required to pay 111.25 for appropriate medically necessary health care services. 111.26 Recipients or their representatives must cooperatively assist 111.27 the commissioner in obtaining this determination. Recipients 111.28 who are eligible for the community alternative care program may 111.29 not receive more hours of nursing under this section than would 111.30 otherwise be authorized under section 256B.49. 111.31 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 111.32 ventilator-dependent, the monthly medical assistance 111.33 authorization for home care services shall not exceed what the 111.34 commissioner would pay for care at the highest cost hospital 111.35 designated as a long-term hospital under the Medicare program. 111.36 For purposes of this clause, home care services means all 112.1 services provided in the home that would be included in the 112.2 payment for care at the long-term hospital. 112.3 "Ventilator-dependent" means an individual who receives 112.4 mechanical ventilation for life support at least six hours per 112.5 day and is expected to be or has been dependent for at least 30 112.6 consecutive days. 112.7 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 112.8 or the commissioner's designee shall determine the time period 112.9 for which a prior authorization shall be effective. If the 112.10 recipient continues to require home care services beyond the 112.11 duration of the prior authorization, the home care provider must 112.12 request a new prior authorization. Under no circumstances, 112.13 other than the exceptions in paragraph (b), shall a prior 112.14 authorization be valid prior to the date the commissioner 112.15 receives the request or for more than 12 months. A recipient 112.16 who appeals a reduction in previously authorized home care 112.17 services may continue previously authorized services, other than 112.18 temporary services under paragraph (h), pending an appeal under 112.19 section 256.045. The commissioner must provide a detailed 112.20 explanation of why the authorized services are reduced in amount 112.21 from those requested by the home care provider. 112.22 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 112.23 the commissioner's designee shall determine the medical 112.24 necessity of home care services, the level of caregiver 112.25 according to subdivision 2, and the institutional comparison 112.26 according to this subdivision, the cost-effectiveness of 112.27 services, and the amount, scope, and duration of home care 112.28 services reimbursable by medical assistance, based on the 112.29 assessment, primary payer coverage determination information as 112.30 required, the service plan, the recipient's age, the cost of 112.31 services, the recipient's medical condition, and diagnosis or 112.32 disability. The commissioner may publish additional criteria 112.33 for determining medical necessity according to section 256B.04. 112.34 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 112.35 The agency nurse, the independently enrolled private duty nurse, 112.36 or county public health nurse may request a temporary 113.1 authorization for home care services by telephone. The 113.2 commissioner may approve a temporary level of home care services 113.3 based on the assessment, and service or care plan information, 113.4 and primary payer coverage determination information as required. 113.5 Authorization for a temporary level of home care services 113.6 including nurse supervision is limited to the time specified by 113.7 the commissioner, but shall not exceed 45 days, unless extended 113.8 because the county public health nurse has not completed the 113.9 required assessment and service plan, or the commissioner's 113.10 determination has not been made. The level of services 113.11 authorized under this provision shall have no bearing on a 113.12 future prior authorization. 113.13 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 113.14 Home care services provided in an adult or child foster care 113.15 setting must receive prior authorization by the department 113.16 according to the limits established in paragraph (a). 113.17 The commissioner may not authorize: 113.18 (1) home care services that are the responsibility of the 113.19 foster care provider under the terms of the foster care 113.20 placement agreement and administrative rules. Requests for home 113.21 care services for recipients residing in a foster care setting 113.22 must include the foster care placement agreement and 113.23 determination of difficulty of care; 113.24 (2) personal care services when the foster care license 113.25 holder is also the personal care provider or personal care 113.26 assistant unless the recipient can direct the recipient's own 113.27 care, or case management is provided as required in section 113.28 256B.0625, subdivision 19a; 113.29 (3) personal care services when the responsible party is an 113.30 employee of, or under contract with, or has any direct or 113.31 indirect financial relationship with the personal care provider 113.32 or personal care assistant, unless case management is provided 113.33 as required in section 256B.0625, subdivision 19a; 113.34 (4) home care services when the number of foster care 113.35 residents is greater than four unless the county responsible for 113.36 the recipient's foster placement made the placement prior to 114.1 April 1, 1992, requests that home care services be provided, and 114.2 case management is provided as required in section 256B.0625, 114.3 subdivision 19a; or 114.4 (5) home care services when combined with foster care 114.5 payments, other than room and board payments that exceed the 114.6 total amount that public funds would pay for the recipient's 114.7 care in a medical institution. 114.8 Sec. 27. Minnesota Statutes 1997 Supplement, section 114.9 256B.0645, is amended to read: 114.10 256B.0645 [PROVIDER PAYMENTS; RETROACTIVE CHANGES IN 114.11 ELIGIBILITY.] 114.12 Payment to a provider for a health care service provided to 114.13 a general assistance medical care recipient who is later 114.14 determined eligible for medical assistance or MinnesotaCare 114.15 according to section 256L.14 for the period in which the health 114.16 care service was provided,shall be considered payment in full,114.17and shall notmay be adjusted due to the change in eligibility. 114.18 This sectionappliesdoes not apply toboth fee-for-service114.19payments andpayments made to health plans on a prepaid 114.20 capitated basis. 114.21 Sec. 28. Minnesota Statutes 1997 Supplement, section 114.22 256B.0911, subdivision 2, is amended to read: 114.23 Subd. 2. [PERSONS REQUIRED TO BE SCREENED; EXEMPTIONS.] 114.24 All applicants to Medicaid certified nursing facilities must be 114.25 screened prior to admission, regardless of income, assets, or 114.26 funding sources, except the following: 114.27 (1) patients who, having entered acute care facilities from 114.28 certified nursing facilities, are returning to a certified 114.29 nursing facility; 114.30 (2) residents transferred from other certified nursing 114.31 facilities located within the state of Minnesota; 114.32 (3) individuals who have a contractual right to have their 114.33 nursing facility care paid for indefinitely by the veteran's 114.34 administration; 114.35 (4) individuals who are enrolled in the Ebenezer/Group 114.36 Health social health maintenance organization project, or 115.1 enrolled in a demonstration project under section 256B.69, 115.2 subdivision188, at the time of application to a nursing home; 115.3 (5) individuals previously screened and currently being 115.4 served under the alternative care program or under a home and 115.5 community-based services waiver authorized under section 1915(c) 115.6 of the Social Security Act; or 115.7 (6) individuals who are admitted to a certified nursing 115.8 facility for a short-term stay, which, based upon a physician's 115.9 certification, is expected to be 14 days or less in duration, 115.10 and who have been screened and approved for nursing facility 115.11 admission within the previous six months. This exemption 115.12 applies only if the screener determines at the time of the 115.13 initial screening of the six-month period that it is appropriate 115.14 to use the nursing facility for short-term stays and that there 115.15 is an adequate plan of care for return to the home or 115.16 community-based setting. If a stay exceeds 14 days, the 115.17 individual must be referred no later than the first county 115.18 working day following the 14th resident day for a screening, 115.19 which must be completed within five working days of the 115.20 referral. Payment limitations in subdivision 7 will apply to an 115.21 individual found at screening to not meet the level of care 115.22 criteria for admission to a certified nursing facility. 115.23 Regardless of the exemptions in clauses (2) to (6), persons 115.24 who have a diagnosis or possible diagnosis of mental illness, 115.25 mental retardation, or a related condition must receive a 115.26 preadmission screening before admission unless the admission 115.27 prior to screening is authorized by the local mental health 115.28 authority or the local developmental disabilities case manager, 115.29 or unless authorized by the county agency according to Public 115.30 Law Number 101-508. 115.31 Before admission to a Medicaid certified nursing home or 115.32 boarding care home, all persons must be screened and approved 115.33 for admission through an assessment process. The nursing 115.34 facility is authorized to conduct case mix assessments which are 115.35 not conducted by the county public health nurse under Minnesota 115.36 Rules, part 9549.0059. The designated county agency is 116.1 responsible for distributing the quality assurance and review 116.2 form for all new applicants to nursing homes. 116.3 Other persons who are not applicants to nursing facilities 116.4 must be screened if a request is made for a screening. 116.5 Sec. 29. Minnesota Statutes 1996, section 256B.0911, 116.6 subdivision 4, is amended to read: 116.7 Subd. 4. [RESPONSIBILITIES OF THE COUNTY AND THE SCREENING 116.8 TEAM.] (a) The county shall: 116.9 (1) provide information and education to the general public 116.10 regarding availability of the preadmission screening program; 116.11 (2) accept referrals from individuals, families, human 116.12 service and health professionals, and hospital and nursing 116.13 facility personnel; 116.14 (3) assess the health, psychological, and social needs of 116.15 referred individuals and identify services needed to maintain 116.16 these persons in the least restrictive environments; 116.17 (4) determine if the individual screened needs nursing 116.18 facility level of care; 116.19 (5) assess specialized service needs based upon an 116.20 evaluation by: 116.21 (i) a qualified independent mental health professional for 116.22 persons with a primary or secondary diagnosis of a serious 116.23 mental illness; and 116.24 (ii) a qualified mental retardation professional for 116.25 persons with a primary or secondary diagnosis of mental 116.26 retardation or related conditions. For purposes of this clause, 116.27 a qualified mental retardation professional must meet the 116.28 standards for a qualified mental retardation professional in 116.29 Code of Federal Regulations, title 42, section 483.430; 116.30 (6) make recommendations for individuals screened regarding 116.31 cost-effective community services which are available to the 116.32 individual; 116.33 (7) make recommendations for individuals screened regarding 116.34 nursing home placement when there are no cost-effective 116.35 community services available; 116.36 (8) develop an individual's community care plan and provide 117.1 follow-up services as needed; and 117.2 (9) prepare and submit reports that may be required by the 117.3 commissioner of human services. 117.4 (b) The screener shall document that the most 117.5 cost-effective alternatives available were offered to the 117.6 individual or the individual's legal representative. For 117.7 purposes of this section, "cost-effective alternatives" means 117.8 community services and living arrangements that cost the same or 117.9 less than nursing facility care. 117.10 (c)Screeners shall adhere to the level of care criteria117.11for admission to a certified nursing facility established under117.12section 144.0721.117.13(d)For persons who are eligible for medical assistance or 117.14 who would be eligible within 180 days of admission to a nursing 117.15 facility and who are admitted to a nursing facility, the nursing 117.16 facility must include a screener or the case manager in the 117.17 discharge planning process for those individuals who the team 117.18 has determined have discharge potential. The screener or the 117.19 case manager must ensure a smooth transition and follow-up for 117.20 the individual's return to the community. 117.21 Screeners shall cooperate with other public and private 117.22 agencies in the community, in order to offer a variety of 117.23 cost-effective services to the disabled and elderly. The 117.24 screeners shall encourage the use of volunteers from families, 117.25 religious organizations, social clubs, and similar civic and 117.26 service organizations to provide services. 117.27 Sec. 30. Minnesota Statutes 1997 Supplement, section 117.28 256B.0911, subdivision 7, is amended to read: 117.29 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 117.30 (a) Medical assistance reimbursement for nursing facilities 117.31 shall be authorized for a medical assistance recipient only if a 117.32 preadmission screening has been conducted prior to admission or 117.33 the local county agency has authorized an exemption. Medical 117.34 assistance reimbursement for nursing facilities shall not be 117.35 provided for any recipient who the local screener has determined 117.36 does not meet the level of care criteria for nursing facility 118.1 placement or, if indicated, has not had a level II PASARR 118.2 evaluation completed unless an admission for a recipient with 118.3 mental illness is approved by the local mental health authority 118.4 or an admission for a recipient with mental retardation or 118.5 related condition is approved by the state mental retardation 118.6 authority.The county preadmission screening team may deny118.7certified nursing facility admission using the level of care118.8criteria established under section 144.0721 and deny medical118.9assistance reimbursement for certified nursing facility care.118.10Persons receiving care in a certified nursing facility or118.11certified boarding care home who are reassessed by the118.12commissioner of health according to section 144.0722 and118.13determined to no longer meet the level of care criteria for a118.14certified nursing facility or certified boarding care home may118.15no longer remain a resident in the certified nursing facility or118.16certified boarding care home and must be relocated to the118.17community if the persons were admitted on or after July 1, 1998.118.18 (b)Persons receiving services under section 256B.0913,118.19subdivisions 1 to 14, or 256B.0915 who are reassessed and found118.20to not meet the level of care criteria for admission to a118.21certified nursing facility or certified boarding care home may118.22no longer receive these services if persons were admitted to the118.23program on or after July 1, 1998.The commissioner shall make a 118.24 request to the health care financing administration for a waiver 118.25 allowing screening team approval of Medicaid payments for 118.26 certified nursing facility care. An individual has a choice and 118.27 makes the final decision between nursing facility placement and 118.28 community placement after the screening team's recommendation, 118.29 except as provided in paragraphs (b) and (c). 118.30 (c) The local county mental health authority or the state 118.31 mental retardation authority under Public Law Numbers 100-203 118.32 and 101-508 may prohibit admission to a nursing facility, if the 118.33 individual does not meet the nursing facility level of care 118.34 criteria or needs specialized services as defined in Public Law 118.35 Numbers 100-203 and 101-508. For purposes of this section, 118.36 "specialized services" for a person with mental retardation or a 119.1 related condition means "active treatment" as that term is 119.2 defined in Code of Federal Regulations, title 42, section 119.3 483.440(a)(1). 119.4 (d) Upon the receipt by the commissioner of approval by the 119.5 Secretary of Health and Human Services of the waiver requested 119.6 under paragraph (a), the local screener shall deny medical 119.7 assistance reimbursement for nursing facility care for an 119.8 individual whose long-term care needs can be met in a 119.9 community-based setting and whose cost of community-based home 119.10 care services is less than 75 percent of the average payment for 119.11 nursing facility care for that individual's case mix 119.12 classification, and who is either: 119.13 (i) a current medical assistance recipient being screened 119.14 for admission to a nursing facility; or 119.15 (ii) an individual who would be eligible for medical 119.16 assistance within 180 days of entering a nursing facility and 119.17 who meets a nursing facility level of care. 119.18 (e) Appeals from the screening team's recommendation or the 119.19 county agency's final decision shall be made according to 119.20 section 256.045, subdivision 3. 119.21 Sec. 31. Minnesota Statutes 1997 Supplement, section 119.22 256B.0913, subdivision 14, is amended to read: 119.23 Subd. 14. [REIMBURSEMENT AND RATE ADJUSTMENTS.] (a) 119.24 Reimbursement for expenditures for the alternative care services 119.25 as approved by the client's case manager shall be through the 119.26 invoice processing procedures of the department's Medicaid 119.27 Management Information System (MMIS). To receive reimbursement, 119.28 the county or vendor must submit invoices within 12 months 119.29 following the date of service. The county agency and its 119.30 vendors under contract shall not be reimbursed for services 119.31 which exceed the county allocation. 119.32 (b) If a county collects less than 50 percent of the client 119.33 premiums due under subdivision 12, the commissioner may withhold 119.34 up to three percent of the county's final alternative care 119.35 program allocation determined under subdivisions 10 and 11. 119.36 (c)For fiscal years beginning on or after July 1, 1993,120.1the commissioner of human services shall not provide automatic120.2annual inflation adjustments for alternative care services. The120.3commissioner of finance shall include as a budget change request120.4in each biennial detailed expenditure budget submitted to the120.5legislature under section 16A.11 annual adjustments in120.6reimbursement rates for alternative care services based on the120.7forecasted percentage change in the Home Health Agency Market120.8Basket of Operating Costs, for the fiscal year beginning July 1,120.9compared to the previous fiscal year, unless otherwise adjusted120.10by statute. The Home Health Agency Market Basket of Operating120.11Costs is published by Data Resources, Inc. The forecast to be120.12used is the one published for the calendar quarter beginning120.13January 1, six months prior to the beginning of the fiscal year120.14for which rates are set.120.15(d)The county shall negotiate individual rates with 120.16 vendors and may be reimbursed for actual costs up to the greater 120.17 of the county's current approved rate or 60 percent of the 120.18 maximum rate in fiscal year 1994 and 65 percent of the maximum 120.19 rate in fiscal year 1995 for each alternative care service. 120.20 Notwithstanding any other rule or statutory provision to the 120.21 contrary, the commissioner shall not be authorized to increase 120.22 rates by an annual inflation factor, unless so authorized by the 120.23 legislature. 120.24(e)(d) On July 1, 1993, the commissioner shall increase 120.25 the maximum rate for home delivered meals to $4.50 per meal. 120.26 Sec. 32. Minnesota Statutes 1997 Supplement, section 120.27 256B.0915, subdivision 1d, is amended to read: 120.28 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 120.29 RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the 120.30 provisions of section 256B.056, the commissioner shall make the 120.31 following amendment to the medical assistance elderly waiver 120.32 program effective July 1,19971999, or upon federal approval, 120.33 whichever is later. 120.34 A recipient's maintenance needs will be an amount equal to 120.35 the Minnesota supplemental aid equivalent rate as defined in 120.36 section 256I.03, subdivision 5, plus the medical assistance 121.1 personal needs allowance as defined in section 256B.35, 121.2 subdivision 1, paragraph (a), when applying posteligibility 121.3 treatment of income rules to the gross income of elderly waiver 121.4 recipients, except for individuals whose income is in excess of 121.5 the special income standard according to Code of Federal 121.6 Regulations, title 42, section 435.236. Recipient maintenance 121.7 needs shall be adjusted under this provision each July 1. 121.8 (b) The commissioner of human services shall secure 121.9 approval of additional elderly waiver slots sufficient to serve 121.10 persons who will qualify under the revised income standard 121.11 described in paragraph (a) before implementing section 121.12 256B.0913, subdivision 16. 121.13 (c) In implementing this subdivision, the commissioner 121.14 shall consider allowing persons who would otherwise be eligible 121.15 for the alternative care program but would qualify for the 121.16 elderly waiver with a spenddown to remain on the alternative 121.17 care program. 121.18 Sec. 33. Minnesota Statutes 1997 Supplement, section 121.19 256B.0915, subdivision 3, is amended to read: 121.20 Subd. 3. [LIMITS OF CASES, RATES, REIMBURSEMENT, AND 121.21 FORECASTING.] (a) The number of medical assistance waiver 121.22 recipients that a county may serve must be allocated according 121.23 to the number of medical assistance waiver cases open on July 1 121.24 of each fiscal year. Additional recipients may be served with 121.25 the approval of the commissioner. 121.26 (b) The monthly limit for the cost of waivered services to 121.27 an individual waiver client shall be the statewide average 121.28 payment rate of the case mix resident class to which the waiver 121.29 client would be assigned under the medical assistance case mix 121.30 reimbursement system. If medical supplies and equipment or 121.31 adaptations are or will be purchased for an elderly waiver 121.32 services recipient, the costs may be prorated on a monthly basis 121.33 throughout the year in which they are purchased. If the monthly 121.34 cost of a recipient's other waivered services exceeds the 121.35 monthly limit established in this paragraph, the annual cost of 121.36 the waivered services shall be determined. In this event, the 122.1 annual cost of waivered services shall not exceed 12 times the 122.2 monthly limit calculated in this paragraph. The statewide 122.3 average payment rate is calculated by determining the statewide 122.4 average monthly nursing home rate, effective July 1 of the 122.5 fiscal year in which the cost is incurred, less the statewide 122.6 average monthly income of nursing home residents who are age 65 122.7 or older, and who are medical assistance recipients in the month 122.8 of March of the previous state fiscal year. The annual cost 122.9 divided by 12 of elderly or disabled waivered services for a 122.10 person who is a nursing facility resident at the time of 122.11 requesting a determination of eligibility for elderly or 122.12 disabled waivered services shall be the greater of the monthly 122.13 payment for: (i) the resident class assigned under Minnesota 122.14 Rules, parts 9549.0050 to 9549.0059, for that resident in the 122.15 nursing facility where the resident currently resides; or (ii) 122.16 the statewide average payment of the case mix resident class to 122.17 which the resident would be assigned under the medical 122.18 assistance case mix reimbursement system, provided that the 122.19 limit under this clause only applies to persons discharged from 122.20 a nursing facility and found eligible for waivered services on 122.21 or after July 1, 1997. The following costs must be included in 122.22 determining the total monthly costs for the waiver client: 122.23 (1) cost of all waivered services, including extended 122.24 medical supplies and equipment; and 122.25 (2) cost of skilled nursing, home health aide, and personal 122.26 care services reimbursable by medical assistance. 122.27 (c) Medical assistance funding for skilled nursing 122.28 services, private duty nursing, home health aide, and personal 122.29 care services for waiver recipients must be approved by the case 122.30 manager and included in the individual care plan. 122.31 (d) For both the elderly waiver and the nursing facility 122.32 disabled waiver, a county may purchase extended supplies and 122.33 equipment without prior approval from the commissioner when 122.34 there is no other funding source and the supplies and equipment 122.35 are specified in the individual's care plan as medically 122.36 necessary to enable the individual to remain in the community 123.1 according to the criteria in Minnesota Rules, part 9505.0210, 123.2 items A and B. A county is not required to contract with a 123.3 provider of supplies and equipment if the monthly cost of the 123.4 supplies and equipment is less than $250. 123.5 (e)For the fiscal year beginning on July 1, 1993, and for123.6subsequent fiscal years, the commissioner of human services123.7shall not provide automatic annual inflation adjustments for123.8home and community-based waivered services. The commissioner of123.9finance shall include as a budget change request in each123.10biennial detailed expenditure budget submitted to the123.11legislature under section 16A.11, annual adjustments in123.12reimbursement rates for home and community-based waivered123.13services, based on the forecasted percentage change in the Home123.14Health Agency Market Basket of Operating Costs, for the fiscal123.15year beginning July 1, compared to the previous fiscal year,123.16unless otherwise adjusted by statute. The Home Health Agency123.17Market Basket of Operating Costs is published by Data Resources,123.18Inc. The forecast to be used is the one published for the123.19calendar quarter beginning January 1, six months prior to the123.20beginning of the fiscal year for which rates are set. The adult123.21foster care rate shall be considered a difficulty of care123.22payment and shall not include room and board.123.23(f)The adult foster care daily rate for the elderly and 123.24 disabled waivers shall be negotiated between the county agency 123.25 and the foster care provider. The rate established under this 123.26 section shall not exceed the state average monthly nursing home 123.27 payment for the case mix classification to which the individual 123.28 receiving foster care is assigned; the rate must allow for other 123.29 waiver and medical assistance home care services to be 123.30 authorized by the case manager. 123.31(g)(f) The assisted living and residential care service 123.32 rates for elderly and community alternatives for disabled 123.33 individuals (CADI) waivers shall be made to the vendor as a 123.34 monthly rate negotiated with the county agency based on an 123.35 individualized service plan for each resident. The rate shall 123.36 not exceed the nonfederal share of the greater of either the 124.1 statewide or any of the geographic groups' weighted average 124.2 monthly medical assistance nursing facility payment rate of the 124.3 case mix resident class to which the elderly or disabled client 124.4 would be assigned under Minnesota Rules, parts 9549.0050 to 124.5 9549.0059, unless the services are provided by a home care 124.6 provider licensed by the department of health and are provided 124.7 in a building that is registered as a housing with services 124.8 establishment under chapter 144D and that provides 24-hour 124.9 supervision. For alternative care assisted living projects 124.10 established under Laws 1988, chapter 689, article 2, section 124.11 256, monthly rates may not exceed 65 percent of the greater of 124.12 either the statewide or any of the geographic groups' weighted 124.13 average monthly medical assistance nursing facility payment rate 124.14 for the case mix resident class to which the elderly or disabled 124.15 client would be assigned under Minnesota Rules, parts 9549.0050 124.16 to 9549.0059. The rate may not cover direct rent or food costs. 124.17(h)(g) The county shall negotiate individual rates with 124.18 vendors and may be reimbursed for actual costs up to the greater 124.19 of the county's current approved rate or 60 percent of the 124.20 maximum rate in fiscal year 1994 and 65 percent of the maximum 124.21 rate in fiscal year 1995 for each service within each program. 124.22(i)(h) On July 1, 1993, the commissioner shall increase 124.23 the maximum rate for home-delivered meals to $4.50 per meal. 124.24(j)(i) Reimbursement for the medical assistance recipients 124.25 under the approved waiver shall be made from the medical 124.26 assistance account through the invoice processing procedures of 124.27 the department's Medicaid Management Information System (MMIS), 124.28 only with the approval of the client's case manager. The budget 124.29 for the state share of the Medicaid expenditures shall be 124.30 forecasted with the medical assistance budget, and shall be 124.31 consistent with the approved waiver. 124.32(k)(j) Beginning July 1, 1991, the state shall reimburse 124.33 counties according to the payment schedule in section 256.025 124.34 for the county share of costs incurred under this subdivision on 124.35 or after January 1, 1991, for individuals who are receiving 124.36 medical assistance. 125.1(l)(k) For the community alternatives for disabled 125.2 individuals waiver, and nursing facility disabled waivers, 125.3 county may use waiver funds for the cost of minor adaptations to 125.4 a client's residence or vehicle without prior approval from the 125.5 commissioner if there is no other source of funding and the 125.6 adaptation: 125.7 (1) is necessary to avoid institutionalization; 125.8 (2) has no utility apart from the needs of the client; and 125.9 (3) meets the criteria in Minnesota Rules, part 9505.0210, 125.10 items A and B. 125.11 For purposes of this subdivision, "residence" means the client's 125.12 own home, the client's family residence, or a family foster 125.13 home. For purposes of this subdivision, "vehicle" means the 125.14 client's vehicle, the client's family vehicle, or the client's 125.15 family foster home vehicle. 125.16(m)(l) The commissioner shall establish a maximum rate 125.17 unit for baths provided by an adult day care provider that are 125.18 not included in the provider's contractual daily or hourly rate. 125.19 This maximum rate must equal the home health aide extended rate 125.20 and shall be paid for baths provided to clients served under the 125.21 elderly and disabled waivers. 125.22 Sec. 34. Minnesota Statutes 1996, section 256B.0916, is 125.23 amended to read: 125.24 256B.0916 [EXPANSION OF HOME AND COMMUNITY-BASED SERVICES; 125.25 MANAGEMENT AND ALLOCATION RESPONSIBILITIES.] 125.26 (a) The commissioner shall expand availability of home and 125.27 community-based services for persons with mental retardation and 125.28 related conditions to the extent allowed by federal law and 125.29 regulation and shall assist counties in transferring persons 125.30 from semi-independent living services to home and 125.31 community-based services. The commissioner may transfer funds 125.32 from the state semi-independent living services account 125.33 available under section 252.275, subdivision 8, and state 125.34 community social services aids available under section 256E.15 125.35 to the medical assistance account to pay for the nonfederal 125.36 share of nonresidential and residential home and community-based 126.1 services authorized under section 256B.092 for persons 126.2 transferring from semi-independent living services. 126.3 (b) Upon federal approval, county boards are not 126.4 responsible for funding semi-independent living services as a 126.5 social service for those persons who have transferred to the 126.6 home and community-based waiver program as a result of the 126.7 expansion under this subdivision. The county responsibility for 126.8 those persons transferred shall be assumed under section 126.9 256B.092. Notwithstanding the provisions of section 252.275, 126.10 the commissioner shall continue to allocate funds under that 126.11 section for semi-independent living services and county boards 126.12 shall continue to fund services under sections 256E.06 and 126.13 256E.14 for those persons who cannot access home and 126.14 community-based services under section 256B.092. 126.15 (c) Eighty percent of the state funds made available to the 126.16 commissioner under section 252.275 as a result of persons 126.17 transferring from the semi-independent living services program 126.18 to the home and community-based services program shall be used 126.19 to fund additional persons in the semi-independent living 126.20 services program. 126.21 (d) Beginning August 1, 1998, the commissioner shall issue 126.22 an annual report on the home and community-based waiver for 126.23 persons with mental retardation or related conditions, that 126.24 includes a list of the counties in which less than 95 percent of 126.25 the allocation provided, excluding the county waivered services 126.26 reserve, has been committed for two or more quarters during the 126.27 previous state fiscal year. For each listed county, the report 126.28 shall include the amount of funds allocated but not used, the 126.29 number and ages of individuals screened and waiting for 126.30 services, the services needed, a description of the technical 126.31 assistance provided by the commissioner to assist the counties 126.32 in jointly planning with other counties in order to serve more 126.33 persons, and additional actions which will be taken to serve 126.34 those screened and waiting for services. 126.35 (e) The commissioner shall make available to interested 126.36 parties, upon request, financial information by county including 127.1 the amount of resources allocated for the home and 127.2 community-based waiver for persons with mental retardation and 127.3 related conditions, the resources committed, the number of 127.4 persons screened and waiting for services, the type of services 127.5 requested by those waiting, and the amount of allocated 127.6 resources not committed. 127.7 Sec. 35. Minnesota Statutes 1997 Supplement, section 127.8 256B.0951, is amended by adding a subdivision to read: 127.9 Subd. 4a. [WAIVER OF RULES.] The commissioner of health 127.10 may exempt residents of intermediate care facilities for persons 127.11 with mental retardation (ICFs/MR) who participate in the 127.12 three-year quality assurance pilot project established in 127.13 section 256B.095 from the requirements of Minnesota Rules, part 127.14 4665, upon approval by the federal government of a waiver of 127.15 federal certification requirements for ICFs/MR. The 127.16 commissioners of health and human services shall apply for any 127.17 necessary waivers as soon as practicable and shall submit the 127.18 concept paper to the federal government by June 1, 1998. 127.19 Sec. 36. Minnesota Statutes 1996, section 256B.41, 127.20 subdivision 1, is amended to read: 127.21 Subdivision 1. [AUTHORITY.] The commissioner shall 127.22 establish, by rule, procedures for determining rates for care of 127.23 residents of nursing facilities which qualify as vendors of 127.24 medical assistance, and for implementing the provisions of this 127.25 section and sections 256B.421, 256B.431, 256B.432, 256B.433, 127.26 256B.47, 256B.48, 256B.50, and 256B.502. The procedures shall 127.27be based on methods and standards that the commissioner finds127.28are adequate to provide for the costs that must be incurred for127.29the care of residents in efficiently and economically operated127.30nursing facilities and shallspecify the costs that are 127.31 allowable for establishing payment rates through medical 127.32 assistance. 127.33 Sec. 37. Minnesota Statutes 1996, section 256B.431, 127.34 subdivision 2b, is amended to read: 127.35 Subd. 2b. [OPERATING COSTS, AFTER JULY 1, 1985.] (a) For 127.36 rate years beginning on or after July 1, 1985, the commissioner 128.1 shall establish procedures for determining per diem 128.2 reimbursement for operating costs. 128.3 (b) The commissioner shall contract with an econometric 128.4 firm with recognized expertise in and access to national 128.5 economic change indices that can be applied to the appropriate 128.6 cost categories when determining the operating cost payment rate. 128.7 (c) The commissioner shall analyze and evaluate each 128.8 nursing facility's cost report of allowable operating costs 128.9 incurred by the nursing facility during the reporting year 128.10 immediately preceding the rate year for which the payment rate 128.11 becomes effective. 128.12 (d) The commissioner shall establish limits on actual 128.13 allowable historical operating cost per diems based on cost 128.14 reports of allowable operating costs for the reporting year that 128.15 begins October 1, 1983, taking into consideration relevant 128.16 factors including resident needs, geographic location, and size 128.17 of the nursing facility, and the costs that must be incurred for128.18the care of residents in an efficiently and economically128.19operated nursing facility. In developing the geographic groups 128.20 for purposes of reimbursement under this section, the 128.21 commissioner shall ensure that nursing facilities in any county 128.22 contiguous to the Minneapolis-St. Paul seven-county metropolitan 128.23 area are included in the same geographic group. The limits 128.24 established by the commissioner shall not be less, in the 128.25 aggregate, than the 60th percentile of total actual allowable 128.26 historical operating cost per diems for each group of nursing 128.27 facilities established under subdivision 1 based on cost reports 128.28 of allowable operating costs in the previous reporting year. 128.29 For rate years beginning on or after July 1, 1989, facilities 128.30 located in geographic group I as described in Minnesota Rules, 128.31 part 9549.0052, on January 1, 1989, may choose to have the 128.32 commissioner apply either the care related limits or the other 128.33 operating cost limits calculated for facilities located in 128.34 geographic group II, or both, if either of the limits calculated 128.35 for the group II facilities is higher. The efficiency incentive 128.36 for geographic group I nursing facilities must be calculated 129.1 based on geographic group I limits. The phase-in must be 129.2 established utilizing the chosen limits. For purposes of these 129.3 exceptions to the geographic grouping requirements, the 129.4 definitions in Minnesota Rules, parts 9549.0050 to 9549.0059 129.5 (Emergency), and 9549.0010 to 9549.0080, apply. The limits 129.6 established under this paragraph remain in effect until the 129.7 commissioner establishes a new base period. Until the new base 129.8 period is established, the commissioner shall adjust the limits 129.9 annually using the appropriate economic change indices 129.10 established in paragraph (e). In determining allowable 129.11 historical operating cost per diems for purposes of setting 129.12 limits and nursing facility payment rates, the commissioner 129.13 shall divide the allowable historical operating costs by the 129.14 actual number of resident days, except that where a nursing 129.15 facility is occupied at less than 90 percent of licensed 129.16 capacity days, the commissioner may establish procedures to 129.17 adjust the computation of the per diem to an imputed occupancy 129.18 level at or below 90 percent. The commissioner shall establish 129.19 efficiency incentives as appropriate. The commissioner may 129.20 establish efficiency incentives for different operating cost 129.21 categories. The commissioner shall consider establishing 129.22 efficiency incentives in care related cost categories. The 129.23 commissioner may combine one or more operating cost categories 129.24 and may use different methods for calculating payment rates for 129.25 each operating cost category or combination of operating cost 129.26 categories. For the rate year beginning on July 1, 1985, the 129.27 commissioner shall: 129.28 (1) allow nursing facilities that have an average length of 129.29 stay of 180 days or less in their skilled nursing level of care, 129.30 125 percent of the care related limit and 105 percent of the 129.31 other operating cost limit established by rule; and 129.32 (2) exempt nursing facilities licensed on July 1, 1983, by 129.33 the commissioner to provide residential services for the 129.34 physically handicapped under Minnesota Rules, parts 9570.2000 to 129.35 9570.3600, from the care related limits and allow 105 percent of 129.36 the other operating cost limit established by rule. 130.1 For the purpose of calculating the other operating cost 130.2 efficiency incentive for nursing facilities referred to in 130.3 clause (1) or (2), the commissioner shall use the other 130.4 operating cost limit established by rule before application of 130.5 the 105 percent. 130.6 (e) The commissioner shall establish a composite index or 130.7 indices by determining the appropriate economic change 130.8 indicators to be applied to specific operating cost categories 130.9 or combination of operating cost categories. 130.10 (f) Each nursing facility shall receive an operating cost 130.11 payment rate equal to the sum of the nursing facility's 130.12 operating cost payment rates for each operating cost category. 130.13 The operating cost payment rate for an operating cost category 130.14 shall be the lesser of the nursing facility's historical 130.15 operating cost in the category increased by the appropriate 130.16 index established in paragraph (e) for the operating cost 130.17 category plus an efficiency incentive established pursuant to 130.18 paragraph (d) or the limit for the operating cost category 130.19 increased by the same index. If a nursing facility's actual 130.20 historic operating costs are greater than the prospective 130.21 payment rate for that rate year, there shall be no retroactive 130.22 cost settle-up. In establishing payment rates for one or more 130.23 operating cost categories, the commissioner may establish 130.24 separate rates for different classes of residents based on their 130.25 relative care needs. 130.26 (g) The commissioner shall include the reported actual real 130.27 estate tax liability or payments in lieu of real estate tax of 130.28 each nursing facility as an operating cost of that nursing 130.29 facility. Allowable costs under this subdivision for payments 130.30 made by a nonprofit nursing facility that are in lieu of real 130.31 estate taxes shall not exceed the amount which the nursing 130.32 facility would have paid to a city or township and county for 130.33 fire, police, sanitation services, and road maintenance costs 130.34 had real estate taxes been levied on that property for those 130.35 purposes. For rate years beginning on or after July 1, 1987, 130.36 the reported actual real estate tax liability or payments in 131.1 lieu of real estate tax of nursing facilities shall be adjusted 131.2 to include an amount equal to one-half of the dollar change in 131.3 real estate taxes from the prior year. The commissioner shall 131.4 include a reported actual special assessment, and reported 131.5 actual license fees required by the Minnesota department of 131.6 health, for each nursing facility as an operating cost of that 131.7 nursing facility. For rate years beginning on or after July 1, 131.8 1989, the commissioner shall include a nursing facility's 131.9 reported public employee retirement act contribution for the 131.10 reporting year as apportioned to the care-related operating cost 131.11 categories and other operating cost categories multiplied by the 131.12 appropriate composite index or indices established pursuant to 131.13 paragraph (e) as costs under this paragraph. Total adjusted 131.14 real estate tax liability, payments in lieu of real estate tax, 131.15 actual special assessments paid, the indexed public employee 131.16 retirement act contribution, and license fees paid as required 131.17 by the Minnesota department of health, for each nursing facility 131.18 (1) shall be divided by actual resident days in order to compute 131.19 the operating cost payment rate for this operating cost 131.20 category, (2) shall not be used to compute the care-related 131.21 operating cost limits or other operating cost limits established 131.22 by the commissioner, and (3) shall not be increased by the 131.23 composite index or indices established pursuant to paragraph 131.24 (e), unless otherwise indicated in this paragraph. 131.25 (h) For rate years beginning on or after July 1, 1987, the 131.26 commissioner shall adjust the rates of a nursing facility that 131.27 meets the criteria for the special dietary needs of its 131.28 residents and the requirements in section 31.651. The 131.29 adjustment for raw food cost shall be the difference between the 131.30 nursing facility's allowable historical raw food cost per diem 131.31 and 115 percent of the median historical allowable raw food cost 131.32 per diem of the corresponding geographic group. 131.33 The rate adjustment shall be reduced by the applicable 131.34 phase-in percentage as provided under subdivision 2h. 131.35(i) For the cost report year ending September 30, 1996, and131.36for all subsequent reporting years, certified nursing facilities132.1must identify, differentiate, and record resident day statistics132.2for residents in case mix classification A who, on or after July132.31, 1996, meet the modified level of care criteria in section132.4144.0721. The resident day statistics shall be separated into132.5case mix classification A-1 for any resident day meeting the132.6high-function class A level of care criteria and case mix132.7classification A-2 for other case mix class A resident days.132.8 Sec. 38. Minnesota Statutes 1996, section 256B.501, 132.9 subdivision 2, is amended to read: 132.10 Subd. 2. [AUTHORITY.] The commissioner shall establish 132.11 procedures and rules for determining rates for care of residents 132.12 of intermediate care facilities for persons with mental 132.13 retardation or related conditions which qualify as providers of 132.14 medical assistance and waivered services.Approved rates shall132.15be established on the basis of methods and standards that the132.16commissioner finds adequate to provide for the costs that must132.17be incurred for the quality care of residents in efficiently and132.18economically operated facilities and services.The procedures 132.19 shall specify the costs that are allowable for payment through 132.20 medical assistance. The commissioner may use experts from 132.21 outside the department in the establishment of the procedures. 132.22 Sec. 39. Minnesota Statutes 1997 Supplement, section 132.23 256B.69, subdivision 2, is amended to read: 132.24 Subd. 2. [DEFINITIONS.] For the purposes of this section, 132.25 the following terms have the meanings given. 132.26 (a) "Commissioner" means the commissioner of human services. 132.27 For the remainder of this section, the commissioner's 132.28 responsibilities for methods and policies for implementing the 132.29 project will be proposed by the project advisory committees and 132.30 approved by the commissioner. 132.31 (b) "Demonstration provider" means a health maintenance 132.32 organizationor, community integrated service network, or 132.33 accountable provider network authorized and operating under 132.34 chapter 62Dor, 62N, or 62T that participates in the 132.35 demonstration project according to criteria, standards, methods, 132.36 and other requirements established for the project and approved 133.1 by the commissioner. Notwithstanding the above, Itasca county 133.2 may continue to participate as a demonstration provider until 133.3 July 1, 2000. 133.4 (c) "Eligible individuals" means those persons eligible for 133.5 medical assistance benefits as defined in sections 256B.055, 133.6 256B.056, and 256B.06. 133.7 (d) "Limitation of choice" means suspending freedom of 133.8 choice while allowing eligible individuals to choose among the 133.9 demonstration providers. 133.10 (e) This paragraph supersedes paragraph (c) as long as the 133.11 Minnesota health care reform waiver remains in effect. When the 133.12 waiver expires, this paragraph expires and the commissioner of 133.13 human services shall publish a notice in the State Register and 133.14 notify the revisor of statutes. "Eligible individuals" means 133.15 those persons eligible for medical assistance benefits as 133.16 defined in sections 256B.055, 256B.056, and 256B.06. 133.17 Notwithstanding sections 256B.055, 256B.056, and 256B.06, an 133.18 individual who becomes ineligible for the program because of 133.19 failure to submit income reports or recertification forms in a 133.20 timely manner, shall remain enrolled in the prepaid health plan 133.21 and shall remain eligible to receive medical assistance coverage 133.22 through the last day of the month following the month in which 133.23 the enrollee became ineligible for the medical assistance 133.24 program. 133.25 Sec. 40. Minnesota Statutes 1997 Supplement, section 133.26 256B.69, subdivision 3a, is amended to read: 133.27 Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when 133.28 implementing the general assistance medical care, or medical 133.29 assistance prepayment program within a county, must include the 133.30 county board in the process of development, approval, and 133.31 issuance of the request for proposals to provide services to 133.32 eligible individuals within the proposed county. County boards 133.33 must be given reasonable opportunity to make recommendations 133.34 regarding the development, issuance, review of responses, and 133.35 changes needed in the request for proposals. The commissioner 133.36 must provide county boards the opportunity to review each 134.1 proposal based on the identification of community needs under 134.2 chapters 145A and 256E and county advocacy activities. If a 134.3 county board finds that a proposal does not address certain 134.4 community needs, the county board and commissioner shall 134.5 continue efforts for improving the proposal and network prior to 134.6 the approval of the contract. The county board shall make 134.7 recommendations regarding the approval of local networks and 134.8 their operations to ensure adequate availability and access to 134.9 covered services. The provider or health plan must respond 134.10 directly to county advocates and the state prepaid medical 134.11 assistance ombudsperson regarding service delivery and must be 134.12 accountable to the state regarding contracts with medical 134.13 assistance and general assistance medical care funds. The 134.14 county board may recommend a maximum number of participating 134.15 health plans after considering the size of the enrolling 134.16 population; ensuring adequate access and capacity; considering 134.17 the client and county administrative complexity; and considering 134.18 the need to promote the viability of locally developed health 134.19 plans. The county board or a single entity representing a group 134.20 of county boards and the commissioner shall mutually select 134.21 health plans for participation at the time of initial 134.22 implementation of the prepaid medical assistance program in that 134.23 county or group of counties and at the time of contract renewal. 134.24 The commissioner shall also seek input for contract requirements 134.25 from the county or single entity representing a group of county 134.26 boards at each contract renewal and incorporate those 134.27 recommendations into the contract negotiation process. The 134.28 commissioner, in conjunction with the county board, shall 134.29 actively seek to develop a mutually agreeable timetable prior to 134.30 the development of the request for proposal, but counties must 134.31 agree to initial enrollment beginning on or before January 1, 134.32 1999, in either the prepaid medical assistance and general 134.33 assistance medical care programs or county-based purchasing 134.34 under section 256B.692. At least 90 days before enrollment in 134.35 the medical assistance and general assistance medical care 134.36 prepaid programs begins in a county in which the prepaid 135.1 programs have not been established, the commissioner shall 135.2 provide a report to the chairs of senate and house committees 135.3 having jurisdiction over state health care programs which 135.4 verifies that the commissioner complied with the requirements 135.5 for county involvement that are specified in this subdivision. 135.6 (b) The commissioner shall seek a federal waiver to allow a 135.7 fee-for-service plan option to MinnesotaCare enrollees. The 135.8 commissioner shall develop an increase of the premium fees 135.9 required under section 256L.06 up to 20 percent of the premium 135.10 fees for the enrollees who elect the fee-for-service option. 135.11 Prior to implementation, the commissioner shall submit this fee 135.12 schedule to the chair and ranking minority member of the senate 135.13 health care committee, the senate health care and family 135.14 services funding division, the house of representatives health 135.15 and human services committee, and the house of representatives 135.16 health and human services finance division. 135.17 (c) At the option of the county board, the board may 135.18 develop contract requirements related to the achievement of 135.19 local public health goals to meet the health needs of medical 135.20 assistance and general assistance medical care enrollees. These 135.21 requirements must be reasonably related to the performance of 135.22 health plan functions and within the scope of the medical 135.23 assistance and general assistance medical care benefit sets. If 135.24 the county board and the commissioner mutually agree to such 135.25 requirements, the department shall include such requirements in 135.26 all health plan contracts governing the prepaid medical 135.27 assistance and general assistance medical care programs in that 135.28 county at initial implementation of the program in that county 135.29 and at the time of contract renewal. The county board may 135.30 participate in the enforcement of the contract provisions 135.31 related to local public health goals. 135.32 (d) For counties in which prepaid medical assistance and 135.33 general assistance medical care programs have not been 135.34 established, the commissioner shall not implement those programs 135.35 if a county board submits acceptable and timely preliminary and 135.36 final proposals under section 256B.692, until county-based 136.1 purchasing is no longer operational in that county. For 136.2 counties in which prepaid medical assistance and general 136.3 assistance medical care programs are in existence on or after 136.4 September 1, 1997, the commissioner must terminate contracts 136.5 with health plans according to section 256B.692, subdivision 5, 136.6 if the county board submits and the commissioner accepts 136.7 preliminary and final proposals according to that subdivision. 136.8 The commissioner is not required to terminate contracts that 136.9 begin on or after September 1, 1997, according to section 136.10 256B.692 until two years have elapsed from the date of initial 136.11 enrollment. 136.12 (e) In the event that a county board or a single entity 136.13 representing a group of county boards and the commissioner 136.14 cannot reach agreement regarding: (i) the selection of 136.15 participating health plans in that county; (ii) contract 136.16 requirements; or (iii) implementation and enforcement of county 136.17 requirements including provisions regarding local public health 136.18 goals, the commissioner shall resolve all disputes after taking 136.19 into account the recommendations of a three-person mediation 136.20 panel. The panel shall be composed of one designee of the 136.21 president of the association of Minnesota counties, one designee 136.22 of the commissioner of human services, and one designee of the 136.23 commissioner of health. 136.24 (f) If a county which elects to implement county-based 136.25 purchasing ceases to implement county-based purchasing, it is 136.26 prohibited from assuming the responsibility of county-based 136.27 purchasing for a period of five years from the date it 136.28 discontinues purchasing. 136.29 (g) Notwithstanding the requirement in this subdivision 136.30 that a county must agree to initial enrollment on or before 136.31 January 1, 1999, the commissioner shall grant a delay of up to 136.32 nine months in the implementation of the county-based purchasing 136.33 authorized in section 256B.692 if the county or group of 136.34 counties has submitted a preliminary proposal for county-based 136.35 purchasing by September 1, 1997, has not already implemented the 136.36 prepaid medical assistance program before January 1, 1998, and 137.1 has submitted a written request for the delay to the 137.2 commissioner by July 1, 1998. In order for the delay to be 137.3 continued, the county or group of counties must also submit to 137.4 the commissioner the following information by December 1, 1998. 137.5 The information must: 137.6 (1) identify the proposed date of implementation, not later 137.7 than October 1, 1999; 137.8 (2) include copies of the county board resolutions which 137.9 demonstrate the continued commitment to the implementation of 137.10 county-based purchasing by the proposed date. County board 137.11 authorization may remain contingent on the submission of a final 137.12 proposal which meets the requirements of section 256B.692, 137.13 subdivision 5, paragraph (b); 137.14 (3) demonstrate the establishment of a governance structure 137.15 between the participating counties and describe how the 137.16 fiduciary responsibilities of county-based purchasing will be 137.17 allocated between the counties, if more than one county is 137.18 involved in the proposal; 137.19 (4) describe how the risk of a deficit will be managed in 137.20 the event expenditures are greater than total capitation 137.21 payments. This description must identify how any of the 137.22 following strategies will be used: 137.23 (i) risk contracts with licensed health plans; 137.24 (ii) risk arrangements with providers who are not licensed 137.25 health plans; 137.26 (iii) risk arrangements with other licensed insurance 137.27 entities; and 137.28 (iv) funding from other county resources; 137.29 (5) include, if county-based purchasing will not contract 137.30 with licensed health plans or provider networks, letters of 137.31 interest from local providers in at least the categories of 137.32 hospital, physician, mental health, and pharmacy which express 137.33 interest in contracting for services. These letters must 137.34 recognize any risk transfer identified in clause (4), item (ii); 137.35 and 137.36 (6) describe the options being considered to obtain the 138.1 administrative services required in section 256B.692, 138.2 subdivision 3, clauses (3) and (5). 138.3 (h) For counties which receive a delay under this 138.4 subdivision, the final proposals required under section 138.5 256B.692, subdivision 5, paragraph (b), must be submitted at 138.6 least six months prior to the requested implementation date. 138.7 Authority to implement county-based purchasing remains 138.8 contingent on approval of the final proposal as required under 138.9 section 256B.692. 138.10 Sec. 41. Minnesota Statutes 1996, section 256B.69, is 138.11 amended by adding a subdivision to read: 138.12 Subd. 25. [EXEMPTION FROM ENROLLMENT.] (a) Beginning on or 138.13 after January 1, 1999, for American Indian recipients of medical 138.14 assistance who live on or near a reservation, as defined in Code 138.15 of Federal Regulations, title 42, section 36.22(a)(6), and who 138.16 are required to enroll with a demonstration provider under 138.17 subdivision 4, medical assistance shall cover health care 138.18 services provided at American Indian health services facilities 138.19 and facilities operated by a tribe or tribal organization under 138.20 funding authorized by United States Code, title 25, sections 138.21 450f to 450n, or title III of the Indian Self-Determination and 138.22 Education Assistance Act, Public Law Number 93-638, if those 138.23 services would otherwise be covered under section 256B.0625. 138.24 Payments for services provided under this subdivision shall be 138.25 made on a fee-for-service basis, and may, at the option of the 138.26 tribe or tribal organization, be made in accordance with rates 138.27 authorized under sections 256.959, subdivision 16, and 138.28 256B.0625, subdivision 34. Implementation of this purchasing 138.29 model is contingent on federal approval. 138.30 (b) For purposes of this subdivision, "American Indian" has 138.31 the meaning given to persons to whom services will be provided 138.32 for in Code of Federal Regulations, title 42, section 36.12. 138.33 (c) This subdivision also applies to American Indian 138.34 recipients of general assistance medical care and to the prepaid 138.35 general assistance medical care program under section 256D.03, 138.36 subdivision 4, paragraph (d). 139.1 (d) The commissioner of human services, in consultation 139.2 with the tribal governments, shall develop a plan for tribes to 139.3 assist in the enrollment process for American Indian recipients 139.4 enrolled in the prepaid medical assistance program under this 139.5 section or the prepaid general assistance program under section 139.6 256D.03, subdivision 4, paragraph (d). This plan also shall 139.7 address how tribes will be included in ensuring the coordination 139.8 of care for American Indian recipients between Indian health 139.9 service or tribal providers and other providers. 139.10 Sec. 42. Minnesota Statutes 1997 Supplement, section 139.11 256B.692, subdivision 2, is amended to read: 139.12 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] 139.13 Notwithstanding chapters 62D and 62N, a county that elects to 139.14 purchase medical assistance and general assistance medical care 139.15 in return for a fixed sum without regard to the frequency or 139.16 extent of services furnished to any particular enrollee is not 139.17 required to obtain a certificate of authority under chapter 62D 139.18 or 62N. A county that elects to purchase medical assistance and 139.19 general assistance medical care services under this section must 139.20 satisfy the commissioner of health that the requirements of 139.21 chapter 62D, applicable to health maintenance organizations, or 139.22 chapter 62N, applicable to community integrated service 139.23 networks, will be met. A county must also assure the 139.24 commissioner of health that the requirements ofsectionsections 139.25 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all 139.26 applicable provisions of chapter 62Q, including sections 62Q.07; 139.27 62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 139.28 62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 139.29 62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 139.30 will be met. All enforcement and rulemaking powers available 139.31 under chapters 62Dand, 62J, 62M, 62N, and 62Q are hereby 139.32 granted to the commissioner of health with respect to counties 139.33 that purchase medical assistance and general assistance medical 139.34 care services under this section. 139.35 Sec. 43. Minnesota Statutes 1997 Supplement, section 139.36 256B.692, subdivision 5, is amended to read: 140.1 Subd. 5. [COUNTY PROPOSALS.] (a) On or before September 1, 140.2 1997, a county board that wishes to purchase or provide health 140.3 care under this section must submit a preliminary proposal that 140.4 substantially demonstrates the county's ability to meet all the 140.5 requirements of this section in response to criteria for 140.6 proposals issued by the department on or before July 1, 1997. 140.7 Counties submitting preliminary proposals must establish a local 140.8 planning process that involves input from medical assistance and 140.9 general assistance medical care recipients, recipient advocates, 140.10 providers and representatives of local school districts, labor, 140.11 and tribal government to advise on the development of a final 140.12 proposal and its implementation. 140.13 (b) The county board must submit a final proposal on or 140.14 before July 1, 1998, that demonstrates the ability to meet all 140.15 the requirements of this section, including beginning enrollment 140.16 on January 1, 1999, unless a delay has been granted under 140.17 section 256B.69, subdivision 3a, paragraph (g). 140.18 (c) After January 1, 1999, for a county in which the 140.19 prepaid medical assistance program is in existence, the county 140.20 board must submit a preliminary proposal at least 15 months 140.21 prior to termination of health plan contracts in that county and 140.22 a final proposal six months prior to the health plan contract 140.23 termination date in order to begin enrollment after the 140.24 termination. Nothing in this section shall impede or delay 140.25 implementation or continuation of the prepaid medical assistance 140.26 and general assistance medical care programs in counties for 140.27 which the board does not submit a proposal, or submits a 140.28 proposal that is not in compliance with this section. 140.29 (d) The commissioner is not required to terminate contracts 140.30 for the prepaid medical assistance and prepaid general 140.31 assistance medical care programs that begin on or after 140.32 September 1, 1997, in a county for which a county board has 140.33 submitted a proposal under this paragraph, until two years have 140.34 elapsed from the date of initial enrollment in the prepaid 140.35 medical assistance and prepaid general assistance medical care 140.36 programs. 141.1 Sec. 44. Minnesota Statutes 1997 Supplement, section 141.2 256B.77, subdivision 3, is amended to read: 141.3 Subd. 3. [ASSURANCES TO THE COMMISSIONER OF HEALTH.] A 141.4 county authority that elects to participate in a demonstration 141.5 project for people with disabilities under this section is not 141.6 required to obtain a certificate of authority under chapter 62D 141.7 or 62N. A county authority that elects to participate in a 141.8 demonstration project for people with disabilities under this 141.9 section must assure the commissioner of health that the 141.10 requirements of chapters 62D and 62N, and section 256B.692, 141.11 subdivision 2, are met. All enforcement and rulemaking powers 141.12 available under chapters 62Dand, 62J, 62M, 62N, and 62Q are 141.13 granted to the commissioner of health with respect to the county 141.14 authorities that contract with the commissioner to purchase 141.15 services in a demonstration project for people with disabilities 141.16 under this section. 141.17 Sec. 45. Minnesota Statutes 1997 Supplement, section 141.18 256B.77, subdivision 7a, is amended to read: 141.19 Subd. 7a. [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 141.20 for the demonstration project as provided in this subdivision. 141.21 (b) "Eligible individuals" means those persons living in 141.22 the demonstration site who are eligible for medical assistance 141.23 and are disabled based on a disability determination under 141.24 section 256B.055, subdivisions 7 and 12, or who are eligible for 141.25 medical assistance and have been diagnosed as having: 141.26 (1) serious and persistent mental illness as defined in 141.27 section 245.462, subdivision 20; 141.28 (2) severe emotional disturbance as defined in section 141.29 245.487, subdivision 6; or 141.30 (3) mental retardation, or being a mentally retarded person 141.31 as defined in section 252A.02, or a related condition as defined 141.32 in section 252.27, subdivision 1a. 141.33 Other individuals may be included at the option of the county 141.34 authority based on agreement with the commissioner. 141.35 (c) Eligible individuals residing on a federally recognized 141.36 Indian reservation may be excluded from participation in the 142.1 demonstration project at the discretion of the tribal government 142.2 based on agreement with the commissioner, in consultation with 142.3 the county authority. 142.4 (d) Eligible individuals include individuals in excluded 142.5 time status, as defined in chapter 256G. Enrollees in excluded 142.6 time at the time of enrollment shall remain in excluded time 142.7 status as long as they live in the demonstration site and shall 142.8 be eligible for 90 days after placement outside the 142.9 demonstration site if they move to excluded time status in a 142.10 county within Minnesota other than their county of financial 142.11 responsibility. 142.12 (e) A person who is a sexual psychopathic personality as 142.13 defined in section 253B.02, subdivision 18a, or a sexually 142.14 dangerous person as defined in section 253B.02, subdivision 18b, 142.15 is excluded from enrollment in the demonstration project. 142.16 Sec. 46. Minnesota Statutes 1997 Supplement, section 142.17 256B.77, subdivision 10, is amended to read: 142.18 Subd. 10. [CAPITATION PAYMENT.] (a) The commissioner shall 142.19 pay a capitation payment to the county authority and, when 142.20 applicable under subdivision 6, paragraph (a), to the service 142.21 delivery organization for each medical assistance eligible 142.22 enrollee. The commissioner shall develop capitation payment 142.23 rates for the initial contract period for each demonstration 142.24 site in consultation with an independent actuary, to ensure that 142.25 the cost of services under the demonstration project does not 142.26 exceed the estimated cost for medical assistance services for 142.27 the covered population under the fee-for-service system for the 142.28 demonstration period. For each year of the demonstration 142.29 project, the capitation payment rate shall be based on 96 142.30 percent of the projected per person costs that would otherwise 142.31 have been paid under medical assistance fee-for-service during 142.32 each of those years. Rates shall be adjusted within the limits 142.33 of the available risk adjustment technology, as mandated by 142.34 section 62Q.03. In addition, the commissioner shall implement 142.35 appropriate risk and savings sharing provisions with county 142.36 administrative entities and, when applicable under subdivision 143.1 6, paragraph (a), service delivery organizations within the 143.2 projected budget limits. Capitation rates shall be adjusted, at 143.3 least annually, to include any rate increases and payments for 143.4 expanded or newly covered services for eligible individuals. 143.5 The initial demonstration project rate shall include an amount 143.6 in addition to the fee-for-service payments to adjust for 143.7 underutilization of dental services. Any savings beyond those 143.8 allowed for the county authority, county administrative entity, 143.9 or service delivery organization shall be first used to meet the 143.10 unmet needs of eligible individuals. Payments to providers 143.11 participating in the project are exempt from the requirements of 143.12 sections 256.966 and 256B.03, subdivision 2. 143.13 (b) The commissioner shall monitor and evaluate annually 143.14 the effect of the discount on consumers, the county authority, 143.15 and providers of disability services. Findings shall be 143.16 reported and recommendations made, as appropriate, to ensure 143.17 that the discount effect does not adversely affect the ability 143.18 of the county administrative entity or providers of services to 143.19 provide appropriate services to eligible individuals, and does 143.20 not result in cost shifting of eligible individuals to the 143.21 county authority. 143.22 Sec. 47. Minnesota Statutes 1997 Supplement, section 143.23 256B.77, subdivision 12, is amended to read: 143.24 Subd. 12. [SERVICE COORDINATION.] (a) For purposes of this 143.25 section, "service coordinator" means an individual selected by 143.26 the enrollee or the enrollee's legal representative and 143.27 authorized by the county administrative entity or service 143.28 delivery organization to work in partnership with the enrollee 143.29 to develop, coordinate, and in some instances, provide supports 143.30 and services identified in the personal support plan. Service 143.31 coordinators may only provide services and supports if the 143.32 enrollee is informed of potential conflicts of interest, is 143.33 given alternatives, and gives informed consent. Eligible 143.34 service coordinators are individuals age 18 or older who meet 143.35 the qualifications as described in paragraph (b). Enrollees, 143.36 their legal representatives, or their advocates are eligible to 144.1 be service coordinators if they have the capabilities to perform 144.2 the activities and functions outlined in paragraph (b). 144.3 Providers licensed under chapter 245A to provide residential 144.4 services, or providers who are providing residential services 144.5 covered under the group residential housing program may not act 144.6 as service coordinator for enrollees for whom they provide 144.7 residential services. This does not apply to providers of 144.8 short-term detoxification services. Each county administrative 144.9 entity or service delivery organization may develop further 144.10 criteria for eligible vendors of service coordination during the 144.11 demonstration period and shall determine whom it contracts with 144.12 or employs to provide service coordination. County 144.13 administrative entities and service delivery organizations may 144.14 pay enrollees or their advocates or legal representatives for 144.15 service coordination activities. 144.16 (b) The service coordinator shall act as a facilitator, 144.17 working in partnership with the enrollee to ensure that their 144.18 needs are identified and addressed. The level of involvement of 144.19 the service coordinator shall depend on the needs and desires of 144.20 the enrollee. The service coordinator shall have the knowledge, 144.21 skills, and abilities to, and is responsible for: 144.22 (1) arranging for an initial assessment, and periodic 144.23 reassessment as necessary, of supports and services based on the 144.24 enrollee's strengths, needs, choices, and preferences in life 144.25 domain areas; 144.26 (2) developing and updating the personal support plan based 144.27 on relevant ongoing assessment; 144.28 (3) arranging for and coordinating the provisions of 144.29 supports and services, including knowledgeable and skilled 144.30 specialty services and prevention and early intervention 144.31 services, within the limitations negotiated with the county 144.32 administrative entity or service delivery organization; 144.33 (4) assisting the enrollee and the enrollee's legal 144.34 representative, if any, to maximize informed choice of and 144.35 control over services and supports and to exercise the 144.36 enrollee's rights and advocate on behalf of the enrollee; 145.1 (5) monitoring the progress toward achieving the enrollee's 145.2 outcomes in order to evaluate and adjust the timeliness and 145.3 adequacy of the implementation of the personal support plan; 145.4 (6) facilitating meetings and effectively collaborating 145.5 with a variety of agencies and persons, including attending 145.6 individual family service plan and individual education plan 145.7 meetings when requested by the enrollee or the enrollee's legal 145.8 representative; 145.9 (7) soliciting and analyzing relevant information; 145.10 (8) communicating effectively with the enrollee and with 145.11 other individuals participating in the enrollee's plan; 145.12 (9) educating and communicating effectively with the 145.13 enrollee about good health care practices and risk to the 145.14 enrollee's health with certain behaviors; 145.15 (10) having knowledge of basic enrollee protection 145.16 requirements, including data privacy; 145.17 (11) informing, educating, and assisting the enrollee in 145.18 identifying available service providers and accessing needed 145.19 resources and services beyond the limitations of the medical 145.20 assistance benefit set covered services; and 145.21 (12) providing other services as identified in the personal 145.22 support plan. 145.23 (c) For the demonstration project, the qualifications and 145.24 standards for service coordination in this section shall replace 145.25 comparable existing provisions of existing statutes and rules 145.26 governing case management for eligible individuals. 145.27 (d) The provisions of this subdivision apply only to the 145.28 demonstration sitesthat begin implementation on July 1,145.291998designated by the commissioner under subdivision 5. All 145.30 other demonstration sites must comply with laws and rules 145.31 governing case management services for eligible individuals in 145.32 effect when the site begins the demonstration project. 145.33 Sec. 48. Minnesota Statutes 1996, section 256D.03, 145.34 subdivision 4, is amended to read: 145.35 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 145.36 For a person who is eligible under subdivision 3, paragraph (a), 146.1 clause (3), general assistance medical care covers, except as 146.2 provided in paragraph (c): 146.3 (1) inpatient hospital services; 146.4 (2) outpatient hospital services; 146.5 (3) services provided by Medicare certified rehabilitation 146.6 agencies; 146.7 (4) prescription drugs and other products recommended 146.8 through the process established in section 256B.0625, 146.9 subdivision 13; 146.10 (5) equipment necessary to administer insulin and 146.11 diagnostic supplies and equipment for diabetics to monitor blood 146.12 sugar level; 146.13 (6) eyeglasses and eye examinations provided by a physician 146.14 or optometrist; 146.15 (7) hearing aids; 146.16 (8) prosthetic devices; 146.17 (9) laboratory and X-ray services; 146.18 (10) physician's services; 146.19 (11) medical transportation; 146.20 (12) chiropractic services as covered under the medical 146.21 assistance program; 146.22 (13) podiatric services; 146.23 (14) dental services; 146.24 (15) outpatient services provided by a mental health center 146.25 or clinic that is under contract with the county board and is 146.26 established under section 245.62; 146.27 (16) day treatment services for mental illness provided 146.28 under contract with the county board; 146.29 (17) prescribed medications for persons who have been 146.30 diagnosed as mentally ill as necessary to prevent more 146.31 restrictive institutionalization; 146.32 (18)case management services for a person with serious and146.33persistent mental illness who would be eligible for medical146.34assistance except that the person resides in an institution for146.35mental diseases;146.36(19)psychological services, medical supplies and 147.1 equipment, and Medicare premiums, coinsurance and deductible 147.2 payments; 147.3(20)(19) medical equipment not specifically listed in this 147.4 paragraph when the use of the equipment will prevent the need 147.5 for costlier services that are reimbursable under this 147.6 subdivision; 147.7(21)(20) services performed by a certified pediatric nurse 147.8 practitioner, a certified family nurse practitioner, a certified 147.9 adult nurse practitioner, a certified obstetric/gynecological 147.10 nurse practitioner, or a certified geriatric nurse practitioner 147.11 in independent practice, if the services are otherwise covered 147.12 under this chapter as a physician service, and if the service is 147.13 within the scope of practice of the nurse practitioner's license 147.14 as a registered nurse, as defined in section 148.171; and 147.15(22)(21) services of a certified public health nurse or a 147.16 registered nurse practicing in a public health nursing clinic 147.17 that is a department of, or that operates under the direct 147.18 authority of, a unit of government, if the service is within the 147.19 scope of practice of the public health nurse's license as a 147.20 registered nurse, as defined in section 148.171. 147.21 (b) Except as provided in paragraph (c), for a recipient 147.22 who is eligible under subdivision 3, paragraph (a), clause (1) 147.23 or (2), general assistance medical care covers the services 147.24 listed in paragraph (a) with the exception of special 147.25 transportation services. 147.26 (c) Gender reassignment surgery and related services are 147.27 not covered services under this subdivision unless the 147.28 individual began receiving gender reassignment services prior to 147.29 July 1, 1995. 147.30 (d) In order to contain costs, the commissioner of human 147.31 services shall select vendors of medical care who can provide 147.32 the most economical care consistent with high medical standards 147.33 and shall where possible contract with organizations on a 147.34 prepaid capitation basis to provide these services. The 147.35 commissioner shall consider proposals by counties and vendors 147.36 for prepaid health plans, competitive bidding programs, block 148.1 grants, or other vendor payment mechanisms designed to provide 148.2 services in an economical manner or to control utilization, with 148.3 safeguards to ensure that necessary services are provided. 148.4 Before implementing prepaid programs in counties with a county 148.5 operated or affiliated public teaching hospital or a hospital or 148.6 clinic operated by the University of Minnesota, the commissioner 148.7 shall consider the risks the prepaid program creates for the 148.8 hospital and allow the county or hospital the opportunity to 148.9 participate in the program in a manner that reflects the risk of 148.10 adverse selection and the nature of the patients served by the 148.11 hospital, provided the terms of participation in the program are 148.12 competitive with the terms of other participants considering the 148.13 nature of the population served. Payment for services provided 148.14 pursuant to this subdivision shall be as provided to medical 148.15 assistance vendors of these services under sections 256B.02, 148.16 subdivision 8, and 256B.0625. For payments made during fiscal 148.17 year 1990 and later years, the commissioner shall consult with 148.18 an independent actuary in establishing prepayment rates, but 148.19 shall retain final control over the rate methodology. 148.20 Notwithstanding the provisions of subdivision 3, an individual 148.21 who becomes ineligible for general assistance medical care 148.22 because of failure to submit income reports or recertification 148.23 forms in a timely manner, shall remain enrolled in the prepaid 148.24 health plan and shall remain eligible for general assistance 148.25 medical care coverage through the last day of the month in which 148.26 the enrollee became ineligible for general assistance medical 148.27 care. 148.28 (e) The commissioner of human services may reduce payments 148.29 provided under sections 256D.01 to 256D.21 and 261.23 in order 148.30 to remain within the amount appropriated for general assistance 148.31 medical care, within the following restrictions.: 148.32 (i) For the period July 1, 1985 to December 31, 1985, 148.33 reductions below the cost per service unit allowable under 148.34 section 256.966, are permitted only as follows: payments for 148.35 inpatient and outpatient hospital care provided in response to a 148.36 primary diagnosis of chemical dependency or mental illness may 149.1 be reduced no more than 30 percent; payments for all other 149.2 inpatient hospital care may be reduced no more than 20 percent. 149.3 Reductions below the payments allowable under general assistance 149.4 medical care for the remaining general assistance medical care 149.5 services allowable under this subdivision may be reduced no more 149.6 than ten percent. 149.7 (ii) For the period January 1, 1986 to December 31, 1986, 149.8 reductions below the cost per service unit allowable under 149.9 section 256.966 are permitted only as follows: payments for 149.10 inpatient and outpatient hospital care provided in response to a 149.11 primary diagnosis of chemical dependency or mental illness may 149.12 be reduced no more than 20 percent; payments for all other 149.13 inpatient hospital care may be reduced no more than 15 percent. 149.14 Reductions below the payments allowable under general assistance 149.15 medical care for the remaining general assistance medical care 149.16 services allowable under this subdivision may be reduced no more 149.17 than five percent. 149.18 (iii) For the period January 1, 1987 to June 30, 1987, 149.19 reductions below the cost per service unit allowable under 149.20 section 256.966 are permitted only as follows: payments for 149.21 inpatient and outpatient hospital care provided in response to a 149.22 primary diagnosis of chemical dependency or mental illness may 149.23 be reduced no more than 15 percent; payments for all other 149.24 inpatient hospital care may be reduced no more than ten 149.25 percent. Reductions below the payments allowable under medical 149.26 assistance for the remaining general assistance medical care 149.27 services allowable under this subdivision may be reduced no more 149.28 than five percent. 149.29 (iv) For the period July 1, 1987 to June 30, 1988, 149.30 reductions below the cost per service unit allowable under 149.31 section 256.966 are permitted only as follows: payments for 149.32 inpatient and outpatient hospital care provided in response to a 149.33 primary diagnosis of chemical dependency or mental illness may 149.34 be reduced no more than 15 percent; payments for all other 149.35 inpatient hospital care may be reduced no more than five percent. 149.36 Reductions below the payments allowable under medical assistance 150.1 for the remaining general assistance medical care services 150.2 allowable under this subdivision may be reduced no more than 150.3 five percent. 150.4 (v) For the period July 1, 1988 to June 30, 1989, 150.5 reductions below the cost per service unit allowable under 150.6 section 256.966 are permitted only as follows: payments for 150.7 inpatient and outpatient hospital care provided in response to a 150.8 primary diagnosis of chemical dependency or mental illness may 150.9 be reduced no more than 15 percent; payments for all other 150.10 inpatient hospital care may not be reduced. Reductions below 150.11 the payments allowable under medical assistance for the 150.12 remaining general assistance medical care services allowable 150.13 under this subdivision may be reduced no more than five percent. 150.14 (f) There shall be no copayment required of any recipient 150.15 of benefits for any services provided under this subdivision. A 150.16 hospital receiving a reduced payment as a result of this section 150.17 may apply the unpaid balance toward satisfaction of the 150.18 hospital's bad debts. 150.19(f)(g) Any county may, from its own resources, provide 150.20 medical payments for which state payments are not made. 150.21(g)(h) Chemical dependency services that are reimbursed 150.22 under chapter 254B must not be reimbursed under general 150.23 assistance medical care. 150.24(h)(i) The maximum payment for new vendors enrolled in the 150.25 general assistance medical care program after the base year 150.26 shall be determined from the average usual and customary charge 150.27 of the same vendor type enrolled in the base year. 150.28(i)(j) The conditions of payment for services under this 150.29 subdivision are the same as the conditions specified in rules 150.30 adopted under chapter 256B governing the medical assistance 150.31 program, unless otherwise provided by statute or rule. 150.32 Sec. 49. Minnesota Statutes 1996, section 256D.03, is 150.33 amended by adding a subdivision to read: 150.34 Subd. 9. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 150.35 services rendered on or after July 1, 1999, general assistance 150.36 medical care payments for ambulance services shall be increased 151.1 by ten percent. 151.2 Sec. 50. Minnesota Statutes 1996, section 256D.03, is 151.3 amended by adding a subdivision to read: 151.4 Subd. 10. [INFORMATION PROVIDED IN SEVERAL 151.5 LANGUAGES.] Upon request, the commissioner shall provide 151.6 applications and other information regarding general assistance 151.7 medical care, including all notices and disclosures provided to 151.8 applicants and recipients, in English, Spanish, Vietnamese, and 151.9 Hmong. Reasonable effort must be made to provide this 151.10 information to other non-English-speaking applicants and 151.11 recipients. 151.12 Sec. 51. Laws 1997, chapter 203, article 4, section 64, is 151.13 amended to read: 151.14 Sec. 64. [STUDY OF ELDERLY WAIVER EXPANSION.] 151.15 The commissioner of human services shall appoint a task 151.16 force that includes representatives of counties, health plans, 151.17 consumers, and legislators to study the impact of the expansion 151.18 of the elderly waiver program under section 4 and to make 151.19 recommendations for any changes in law necessary to facilitate 151.20 an efficient and equitable relationship between the elderly 151.21 waiver program and the Minnesota senior health options project. 151.22 Based on the results of the task force study, the commissioner 151.23 may seek any federal waivers needed to improve the relationship 151.24 between the elderly waiver and the Minnesota senior health 151.25 options project. The commissioner shall report the results of 151.26 the task force study to the legislature byJanuary 15, 1998July 151.27 1, 2000. 151.28 Sec. 52. [ELIMINATION OF CASE MIX SCORES.] 151.29 It is the intent of the legislature to repeal the unneeded, 151.30 unused, and costly requirement that persons with mental 151.31 retardation be assessed by case mix scores for the following 151.32 reasons: the scores are incomplete measures of a person's 151.33 needs, the scores are exempt from the rate setting process at 151.34 least to October 1, 1999, and the department of human services 151.35 has no plans to use the instrument in a managed care/capitated 151.36 payment arrangement. 152.1 Sec. 53. [OFFSET OF HMO SURCHARGE.] 152.2 Beginning October 1, 1998, and ending December 31, 1998, 152.3 the commissioner of human services shall offset monthly charges 152.4 for the health maintenance organization surcharge by the monthly 152.5 amount the health maintenance organization overpaid from August 152.6 1, 1997, to September 30, 1998, due to taxation of Medicare 152.7 revenues prohibited by Minnesota Statutes, section 256.9657, 152.8 subdivision 3. 152.9 Sec. 54. [MR/RC WAIVER PROPOSAL.] 152.10 By November 15, 1998, the commissioner of human services 152.11 shall provide to the chairs of the house health and human 152.12 services finance division and the senate health and family 152.13 security finance division a detailed budget proposal for 152.14 providing services under the home and community-based waiver for 152.15 persons with mental retardation or related conditions to those 152.16 individuals who are screened and waiting for services. 152.17 Sec. 55. [HIV HEALTH CARE ACCESS STUDY.] 152.18 The commissioner of human services shall study, in 152.19 consultation with the commissioner of health and a task force of 152.20 affected community stakeholders, the impact of positive patient 152.21 responses to new HIV treatment on re-entry to the workplace, 152.22 including, but not limited to, addressing continued access to 152.23 health care and disability benefits. The commissioner shall 152.24 submit a report on the study with recommendations to the 152.25 legislature by January 15, 1999. 152.26 Sec. 56. [MENTAL HEALTH REPORT.] 152.27 (a) By December 1, 1998, the commissioner of human services 152.28 shall report to the legislature on recommendations to maximize 152.29 federal funding for mental health services for children and 152.30 adults. In developing the recommendations, the commissioner 152.31 shall seek advice from a children's and adults' mental health 152.32 services stakeholders advisory group including representatives 152.33 of state and county government, private and state-operated 152.34 mental health providers, mental health consumers, family 152.35 members, and advocates. 152.36 (b) The report shall include a proposal developed in 153.1 conjunction with the counties that does not shift caseload 153.2 growth to counties after July 1, 1999, and recommendations on 153.3 whether the state should directly participate in medical 153.4 assistance mental health case management by funding a portion of 153.5 the nonfederal share of Medicaid. 153.6 Sec. 57. [AFFILIATION OF THE HEALTH-RELATED OMBUDSMAN AND 153.7 ADVOCACY SERVICES.] 153.8 The ombudsman for mental health and mental retardation, the 153.9 ombudsman for older Minnesotans, the Minnesota managed care/PMAP 153.10 ombudsman, and the office of health care consumer assistance, 153.11 advocacy, and information shall enter into an interagency 153.12 agreement to create a formal affiliation of the health-related 153.13 ombudsman and advocacy services. 153.14 Sec. 58. [CONSUMER PRICE INDEX REPORT.] 153.15 By January 15, 1999, and each year thereafter, the 153.16 commissioner of human services shall report to the chair of the 153.17 senate health and family security budget division and the chair 153.18 of the house health and human services budget division on the 153.19 cost of increasing the income standard under Minnesota Statutes, 153.20 section 256B.056, subdivision 4, and the provider rates under 153.21 Minnesota Statutes, section 256B.038, by an amount equal to the 153.22 percentage increase in the Consumer Price Index for all urban 153.23 consumers for the previous calendar year. 153.24 Sec. 59. [REPEALER.] 153.25 Minnesota Statutes 1996, section 144.0721, subdivision 3a; 153.26 and Minnesota Statutes 1997 Supplement, sections 144.0721, 153.27 subdivision 3; and 256B.0913, subdivision 15, are repealed. 153.28 Minnesota Statutes 1996, section 256B.501, subdivision 3g, is 153.29 repealed effective October 1, 2000. 153.30 Sec. 60. [EFFECTIVE DATES.] 153.31 (a) Section 6 is effective retroactive to August 1, 1997. 153.32 (b) Sections 14 and 19 are effective retroactive to July 1, 153.33 1997. 153.34 (c) Sections 9, 12, 22, 48, and 50 are effective January 1, 153.35 1999. 153.36 (d) Section 27 is effective for changes in eligibility that 154.1 occur on or after July 1, 1998. 154.2 (e) Sections 40 and 43 are effective the day following 154.3 final enactment. 154.4 ARTICLE 5 154.5 MINNESOTACARE 154.6 Section 1. Minnesota Statutes 1997 Supplement, section 154.7 60A.15, subdivision 1, is amended to read: 154.8 Subdivision 1. [DOMESTIC AND FOREIGN COMPANIES.] (a) On or 154.9 before April 1, June 1, and December 1 of each year, every 154.10 domestic and foreign company, including town and farmers' mutual 154.11 insurance companies, domestic mutual insurance companies, marine 154.12 insurance companies, health maintenance organizations, community 154.13 integrated service networks, and nonprofit health service plan 154.14 corporations, shall pay to the commissioner of revenue 154.15 installments equal to one-third of the insurer's total estimated 154.16 tax for the current year. Except as provided in paragraphs (d), 154.17 (e), (h), and (i), installments must be based on a sum equal to 154.18 two percent of the premiums described in paragraph (b). 154.19 (b) Installments under paragraph (a), (d), or (e) are 154.20 percentages of gross premiums less return premiums on all direct 154.21 business received by the insurer in this state, or by its agents 154.22 for it, in cash or otherwise, during such year. 154.23 (c) Failure of a company to make payments of at least 154.24 one-third of either (1) the total tax paid during the previous 154.25 calendar year or (2) 80 percent of the actual tax for the 154.26 current calendar year shall subject the company to the penalty 154.27 and interest provided in this section, unless the total tax for 154.28 the current tax year is $500 or less. 154.29 (d) For health maintenance organizations, nonprofit health 154.30 service plan corporations, and community integrated service 154.31 networks, the installments must be based on an amount determined 154.32 under paragraph (h) or (i). 154.33 (e) For purposes of computing installments for town and 154.34 farmers' mutual insurance companies and for mutual property 154.35 casualty companies with total assets on December 31, 1989, of 154.36 $1,600,000,000 or less, the following rates apply: 155.1 (1) for all life insurance, two percent; 155.2 (2) for town and farmers' mutual insurance companies and 155.3 for mutual property and casualty companies with total assets of 155.4 $5,000,000 or less, on all other coverages, one percent; and 155.5 (3) for mutual property and casualty companies with total 155.6 assets on December 31, 1989, of $1,600,000,000 or less, on all 155.7 other coverages, 1.26 percent. 155.8 (f) If the aggregate amount of premium tax payments under 155.9 this section and the fire marshal tax payments under section 155.10 299F.21 made during a calendar year is equal to or exceeds 155.11 $120,000, all tax payments in the subsequent calendar year must 155.12 be paid by means of a funds transfer as defined in section 155.13 336.4A-104, paragraph (a). The funds transfer payment date, as 155.14 defined in section 336.4A-401, must be on or before the date the 155.15 payment is due. If the date the payment is due is not a funds 155.16 transfer business day, as defined in section 336.4A-105, 155.17 paragraph (a), clause (4), the payment date must be on or before 155.18 the funds transfer business day next following the date the 155.19 payment is due. 155.20 (g) Premiums under medical assistance, general assistance 155.21 medical care, the MinnesotaCare program, and the Minnesota 155.22 comprehensive health insurance plan and all payments, revenues, 155.23 and reimbursements received from the federal government for 155.24 Medicare-related coverage as defined in section 62A.31, 155.25 subdivision 3, paragraph (e), are not subject to tax under this 155.26 section. 155.27 (h) For calendar years 1998 and 1999, the installments for 155.28 health maintenance organizations, community integrated service 155.29 networks, and nonprofit health service plan corporations must be 155.30 based on an amount equal to one percent of premiums described 155.31 under paragraph (b). Health maintenance organizations, 155.32 community integrated service networks, and nonprofit health 155.33 service plan corporations that have met the cost containment 155.34 goals established under section 62J.04 in the individual and 155.35 small employer market for calendar year 1996 are exempt from 155.36 payment of the tax imposed under this section for premiums paid 156.1 after March 30, 1997, and before April 1, 1998. Health 156.2 maintenance organizations, community integrated service 156.3 networks, and nonprofit health service plan corporations that 156.4 have met the cost containment goals established under section 156.5 62J.04 in the individual and small employer market for calendar 156.6 year 1997 are exempt from payment of the tax imposed under this 156.7 section for premiums paid after March 30, 1998, and before April 156.8 1, 1999. 156.9 (i) For calendar years after 1999, the commissioner of 156.10 finance shall determine the balance of the health care access 156.11 fund on September 1 of each year beginning September 1, 1999. 156.12 If the commissioner determines that there is no structural 156.13 deficit for the next fiscal year, no tax shall be imposed under 156.14 paragraph (d) for the following calendar year. If the 156.15 commissioner determines that there will be a structural deficit 156.16 in the fund for the following fiscal year, then the 156.17 commissioner, in consultation with the commissioner of revenue, 156.18 shall determine the amount needed to eliminate the structural 156.19 deficit and a tax shall be imposed under paragraph (d) for the 156.20 following calendar year. The commissioner shall determine the 156.21 rate of the tax as either one-quarter of one percent, one-half 156.22 of one percent, three-quarters of one percent, or one percent of 156.23 premiums described in paragraph (b), whichever is the lowest of 156.24 those rates that the commissioner determines will produce 156.25 sufficient revenue to eliminate the projected structural 156.26 deficit. The commissioner of finance shall publish in the State 156.27 Register by October 1 of each year the amount of tax to be 156.28 imposed for the following calendar year. In determining the 156.29 structural balance of the health care access fund for fiscal 156.30 years 2000 and 2001, the commissioner shall disregard the 156.31 transfer amount from the health care access fund to the general 156.32 fund for expenditures associated with the services provided to 156.33 pregnant women and children under the age of two enrolled in the 156.34 MinnesotaCare program. 156.35 (j) In approving the premium rates as required in sections 156.36 62L.08, subdivision 8, and 62A.65, subdivision 3, the 157.1 commissioners of health and commerce shall ensure that any 157.2 exemption from the tax as described in paragraphs (h) and (i) is 157.3 reflected in the premium rate. 157.4 Sec. 2. Minnesota Statutes 1997 Supplement, section 157.5 256B.04, subdivision 18, is amended to read: 157.6 Subd. 18. [APPLICATIONS FOR MEDICAL ASSISTANCE.] The state 157.7 agency may take applications for medical assistance and conduct 157.8 eligibility determinations for MinnesotaCare enrolleeswho are157.9required to apply for medical assistance according to section157.10256L.03, subdivision 3, paragraph (b). 157.11 Sec. 3. Minnesota Statutes 1996, section 256B.057, is 157.12 amended by adding a subdivision to read: 157.13 Subd. 7. [WAIVER OF MAINTENANCE OF EFFORT 157.14 REQUIREMENT.] Unless a federal waiver of the maintenance of 157.15 effort requirement of section 2105(d) of title XXI of the 157.16 Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 157.17 at Large, volume 111, page 251, is granted by the federal 157.18 Department of Health and Human Services by September 30, 1998, 157.19 eligibility for children under age 21 must be determined without 157.20 regard to asset standards established in section 256B.056, 157.21 subdivision 3. The commissioner of human services shall publish 157.22 a notice in the State Register upon receipt of a federal waiver. 157.23 Sec. 4. Minnesota Statutes 1997 Supplement, section 157.24 256D.03, subdivision 3, is amended to read: 157.25 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 157.26 (a) General assistance medical care may be paid for any person 157.27 who is not eligible for medical assistance under chapter 256B, 157.28 including eligibility for medical assistance based on a 157.29 spenddown of excess income according to section 256B.056, 157.30 subdivision 5, or MinnesotaCare as defined in clause(4)(5), 157.31 except as provided in paragraph (b); and: 157.32 (1) who is receiving assistance under section 256D.05, 157.33 except for families with children who are eligible under 157.34 Minnesota family investment program-statewide (MFIP-S), who is 157.35 having a payment made on the person's behalf under sections 157.36 256I.01 to 256I.06, or who resides in group residential housing 158.1 as defined in chapter 256I and can meet a spenddown using the 158.2 cost of remedial services received through group residential 158.3 housing; or 158.4 (2)(i) who is a resident of Minnesota; and whose equity in 158.5 assets is not in excess of $1,000 per assistance unit. Exempt 158.6 assets, the reduction of excess assets, and the waiver of excess 158.7 assets must conform to the medical assistance program in chapter 158.8 256B, with the following exception: the maximum amount of 158.9 undistributed funds in a trust that could be distributed to or 158.10 on behalf of the beneficiary by the trustee, assuming the full 158.11 exercise of the trustee's discretion under the terms of the 158.12 trust, must be applied toward the asset maximum; and 158.13 (ii) who has countable income not in excess of the 158.14 assistance standards established in section 256B.056, 158.15 subdivision 4, or whose excess income is spent down according to 158.16 section 256B.056, subdivision 5, using a six-month budget 158.17 period. The method for calculating earned income disregards and 158.18 deductions for a person who resides with a dependent child under 158.19 age 21 shall follow section 256B.056, subdivision 1a. However, 158.20 if a disregard of $30 and one-third of the remainder has been 158.21 applied to the wage earner's income, the disregard shall not be 158.22 applied again until the wage earner's income has not been 158.23 considered in an eligibility determination for general 158.24 assistance, general assistance medical care, medical assistance, 158.25 or MFIP-S for 12 consecutive months. The earned income and work 158.26 expense deductions for a person who does not reside with a 158.27 dependent child under age 21 shall be the same as the method 158.28 used to determine eligibility for a person under section 158.29 256D.06, subdivision 1, except the disregard of the first $50 of 158.30 earned income is not allowed; or 158.31 (3) who would be eligible for medical assistance except 158.32 that the person resides in a facility that is determined by the 158.33 commissioner or the federal Health Care Financing Administration 158.34 to be an institution for mental diseases.; 158.35 (4) who is receiving care and rehabilitation services from 158.36 a nonprofit center established to serve victims of torture. 159.1 These individuals are eligible for general assistance medical 159.2 care only for the period during which they are receiving 159.3 services from the center. During this period of eligibility, 159.4 individuals eligible under this clause shall not be required to 159.5 participate in prepaid general assistance medical care; or 159.6(4)(5) beginningJuly 1, 1998January 1, 2000, applicants 159.7 or recipients who meet all eligibility requirements of 159.8 MinnesotaCare as defined in sections 256L.01 to 256L.16, and are: 159.9 (i) adults with dependent children under 21 whose gross 159.10 family income is equal to or less than 275 percent of the 159.11 federal poverty guidelines; or 159.12 (ii) adults without children with earned income and whose 159.13 family gross income is between 75 percent of the federal poverty 159.14 guidelines and the amount set by section 256L.04, subdivision 7, 159.15 shall be terminated from general assistance medical care upon 159.16 enrollment in MinnesotaCare. 159.17 (b) For services rendered on or after July 1, 1997, 159.18 eligibility is limited to one month prior to application if the 159.19 person is determined eligible in the prior month. A 159.20 redetermination of eligibility must occur every 12 months. 159.21 BeginningJuly 1, 1998January 1, 2000, Minnesota health care 159.22 program applications completed by recipients and applicants who 159.23 are persons described in paragraph (a), clause(4)(5), may be 159.24 returned to the county agency to be forwarded to the department 159.25 of human services or sent directly to the department of human 159.26 services for enrollment in MinnesotaCare. If all other 159.27 eligibility requirements of this subdivision are met, 159.28 eligibility for general assistance medical care shall be 159.29 available in any month during which a MinnesotaCare eligibility 159.30 determination and enrollment are pending. Upon notification of 159.31 eligibility for MinnesotaCare, notice of termination for 159.32 eligibility for general assistance medical care shall be sent to 159.33 an applicant or recipient. If all other eligibility 159.34 requirements of this subdivision are met, eligibility for 159.35 general assistance medical care shall be available until 159.36 enrollment in MinnesotaCare subject to the provisions of 160.1 paragraph (d). 160.2 (c) The date of an initial Minnesota health care program 160.3 application necessary to begin a determination of eligibility 160.4 shall be the date the applicant has provided a name, address, 160.5 and social security number, signed and dated, to the county 160.6 agency or the department of human services. If the applicant is 160.7 unable to provide an initial application when health care is 160.8 delivered due to a medical condition or disability, a health 160.9 care provider may act on the person's behalf to complete the 160.10 initial application. The applicant must complete the remainder 160.11 of the application and provide necessary verification before 160.12 eligibility can be determined. The county agency must assist 160.13 the applicant in obtaining verification if necessary. 160.14 (d) County agencies are authorized to use all automated 160.15 databases containing information regarding recipients' or 160.16 applicants' income in order to determine eligibility for general 160.17 assistance medical care or MinnesotaCare. Such use shall be 160.18 considered sufficient in order to determine eligibility and 160.19 premium payments by the county agency. 160.20 (e) General assistance medical care is not available for a 160.21 person in a correctional facility unless the person is detained 160.22 by law for less than one year in a county correctional or 160.23 detention facility as a person accused or convicted of a crime, 160.24 or admitted as an inpatient to a hospital on a criminal hold 160.25 order, and the person is a recipient of general assistance 160.26 medical care at the time the person is detained by law or 160.27 admitted on a criminal hold order and as long as the person 160.28 continues to meet other eligibility requirements of this 160.29 subdivision. 160.30 (f) General assistance medical care is not available for 160.31 applicants or recipients who do not cooperate with the county 160.32 agency to meet the requirements of medical assistance. General 160.33 assistance medical care is limited to payment of emergency 160.34 services only for applicants or recipients as described in 160.35 paragraph (a), clause(4)(5), whose MinnesotaCare coverage is 160.36 denied or terminated for nonpayment of premiums as required by 161.1 sections 256L.06to 256L.08and 256L.07. 161.2 (g) In determining the amount of assets of an individual, 161.3 there shall be included any asset or interest in an asset, 161.4 including an asset excluded under paragraph (a), that was given 161.5 away, sold, or disposed of for less than fair market value 161.6 within the 60 months preceding application for general 161.7 assistance medical care or during the period of eligibility. 161.8 Any transfer described in this paragraph shall be presumed to 161.9 have been for the purpose of establishing eligibility for 161.10 general assistance medical care, unless the individual furnishes 161.11 convincing evidence to establish that the transaction was 161.12 exclusively for another purpose. For purposes of this 161.13 paragraph, the value of the asset or interest shall be the fair 161.14 market value at the time it was given away, sold, or disposed 161.15 of, less the amount of compensation received. For any 161.16 uncompensated transfer, the number of months of ineligibility, 161.17 including partial months, shall be calculated by dividing the 161.18 uncompensated transfer amount by the average monthly per person 161.19 payment made by the medical assistance program to skilled 161.20 nursing facilities for the previous calendar year. The 161.21 individual shall remain ineligible until this fixed period has 161.22 expired. The period of ineligibility may exceed 30 months, and 161.23 a reapplication for benefits after 30 months from the date of 161.24 the transfer shall not result in eligibility unless and until 161.25 the period of ineligibility has expired. The period of 161.26 ineligibility begins in the month the transfer was reported to 161.27 the county agency, or if the transfer was not reported, the 161.28 month in which the county agency discovered the transfer, 161.29 whichever comes first. For applicants, the period of 161.30 ineligibility begins on the date of the first approved 161.31 application. 161.32 (h) When determining eligibility for any state benefits 161.33 under this subdivision, the income and resources of all 161.34 noncitizens shall be deemed to include their sponsor's income 161.35 and resources as defined in the Personal Responsibility and Work 161.36 Opportunity Reconciliation Act of 1996, title IV, Public Law 162.1 Number 104-193, sections 421 and 422, and subsequently set out 162.2 in federal rules. 162.3 (i) (1) An undocumented noncitizen or a nonimmigrant is 162.4 ineligible for general assistance medical care other than 162.5 emergency services. For purposes of this subdivision, a 162.6 nonimmigrant is an individual in one or more of the classes 162.7 listed in United States Code, title 8, section 1101(a)(15), and 162.8 an undocumented noncitizen is an individual who resides in the 162.9 United States without the approval or acquiescence of the 162.10 Immigration and Naturalization Service. 162.11(j)(2) This paragraph does not apply to a child under age 162.12 18, to a Cuban or Haitian entrant as defined in Public Law 162.13 Number 96-422, section 501(e)(1) or (2)(a), or to a noncitizen 162.14 who is aged, blind, or disabled as defined in Code of Federal 162.15 Regulations, title 42, sections 435.520, 435.530, 435.531, 162.16 435.540, and 435.541, or to an individual eligible for general 162.17 assistance medical care under paragraph (a), clause (4), who 162.18 cooperates with the Immigration and Naturalization Service to 162.19 pursue any applicable immigration status, including citizenship, 162.20 that would qualify the individual for medical assistance with 162.21 federal financial participation. 162.22(k)(3) For purposes ofparagraphs (f) and (i)this 162.23 paragraph, "emergency services" has the meaning given in Code of 162.24 Federal Regulations, title 42, section 440.255(b)(1), except 162.25 that it also means services rendered because of suspected or 162.26 actual pesticide poisoning. 162.27(l)(j) Notwithstanding any other provision of law, a 162.28 noncitizen who is ineligible for medical assistance due to the 162.29 deeming of a sponsor's income and resources, is ineligible for 162.30 general assistance medical care. 162.31 Sec. 5. Minnesota Statutes 1997 Supplement, section 162.32 256L.01, is amended to read: 162.33 256L.01 [DEFINITIONS.] 162.34 Subdivision 1. [SCOPE.] For purposes of sections 256L.01 162.35 to256L.10256L.18, the following terms shall have the meanings 162.36 given them. 163.1 Subd. 1a. [CHILD.] "Child" means an individual under 21 163.2 years of age, including the unborn child of a pregnant woman, an 163.3 emancipated minor, and an emancipated minor's spouse. 163.4 Subd. 2. [COMMISSIONER.] "Commissioner" means the 163.5 commissioner of human services. 163.6 Subd. 3. [ELIGIBLE PROVIDERS.] "Eligible providers" means 163.7 those health care providers who provide covered health services 163.8 to medical assistance recipients under rules established by the 163.9 commissioner for that program. 163.10 Subd. 3a. [FAMILY WITH CHILDREN.] (a) "Family with 163.11 children" means: 163.12 (1) parents, their children, and dependent siblings 163.13 residing in the same household; or 163.14 (2) grandparents, foster parents, relative caretakers as 163.15 defined in the medical assistance program, or legal guardians; 163.16 their wards who are children; and dependent siblings residing in 163.17 the same household. 163.18 (b) The term includes children and dependent siblings who 163.19 are temporarily absent from the household in settings such as 163.20 schools, camps, or visitation with noncustodial parents. 163.21 (c) For purposes of this subdivision, a dependent sibling 163.22 means an unmarried child who is a full-time student under the 163.23 age of 25 years who is financially dependent upon a parent, 163.24 grandparent, foster parent, relative caretaker, or legal 163.25 guardian. Proof of school enrollment is required. 163.26 Subd. 4. [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] "Gross 163.27 individual or gross family income" for farm and nonfarm 163.28 self-employed means income calculated using as the baseline the 163.29 adjusted gross income reported on the applicant's federal income 163.30 tax form for the previous year and adding back in reported 163.31 depreciation, carryover loss, and net operating loss amounts 163.32 that apply to the business in which the family is currently 163.33 engaged. Applicants shall report the most recent financial 163.34 situation of the family if it has changed from the period of 163.35 time covered by the federal income tax form. The report may be 163.36 in the form of percentage increase or decrease. 164.1 Subd. 5. [INCOME.] "Income" has the meaning given for 164.2 earned and unearned income for families and children in the 164.3 medical assistance program, according to the state's aid to 164.4 families with dependent children plan in effect as of July 16, 164.5 1996. The definition does not include medical assistance income 164.6 methodologies and deeming requirements. The earned income of 164.7 full-time and part-time students under age 19 is not counted as 164.8 income. Public assistance payments and supplemental security 164.9 income are not excluded income. 164.10 Sec. 6. Minnesota Statutes 1997 Supplement, section 164.11 256L.02, subdivision 2, is amended to read: 164.12 Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall 164.13 establish an office for the state administration of this plan. 164.14 The plan shall be used to provide covered health services for 164.15 eligible persons. Payment for these services shall be made to 164.16 all eligible providers. The commissioner shall adopt rules to 164.17 administer the MinnesotaCare program. The commissioner shall 164.18 establish marketing efforts to encourage potentially eligible 164.19 persons to receive information about the program and about other 164.20 medical care programs administered or supervised by the 164.21 department of human services. A toll-free telephone number must 164.22 be used to provide information about medical programs and to 164.23 promote access to the covered services. 164.24 Upon request, the commissioner shall provide applications 164.25 and other information regarding the MinnesotaCare program, 164.26 including all notices and disclosures provided to applicants and 164.27 enrollees, in English, Spanish, Vietnamese, and Hmong. 164.28 Reasonable efforts must be made to provide this information to 164.29 other non-English-speaking applicants and enrollees. 164.30 Sec. 7. Minnesota Statutes 1997 Supplement, section 164.31 256L.02, subdivision 3, is amended to read: 164.32 Subd. 3. [FINANCIAL MANAGEMENT.] (a) The commissioner 164.33 shall manage spending for the MinnesotaCare program in a manner 164.34 that maintains a minimum reserve in accordance with section 164.35 16A.76. As part of each state revenue and expenditure forecast, 164.36 the commissioner must makea quarterlyan assessment of the 165.1 expected expenditures for the covered services for the remainder 165.2 of the current biennium and for the following biennium. The 165.3 estimated expenditure, including the reserve requirements 165.4 described in section 16A.76, shall be compared to an estimate of 165.5 the revenues that will bedepositedavailable in the health care 165.6 access fund. Based on this comparison, and after consulting 165.7 with the chairs of the house ways and means committee and the 165.8 senate finance committee, and the legislative commission on 165.9 health care access, the commissioner shall, as necessary, make 165.10 the adjustments specified in paragraph (b) to ensure that 165.11 expenditures remain within the limits of available revenues for 165.12 the remainder of the current biennium and for the following 165.13 biennium. The commissioner shall not hire additional staff 165.14 using appropriations from the health care access fund until the 165.15 commissioner of finance makes a determination that the 165.16 adjustments implemented under paragraph (b) are sufficient to 165.17 allow MinnesotaCare expenditures to remain within the limits of 165.18 available revenues for the remainder of the current biennium and 165.19 for the following biennium. 165.20 (b) The adjustments the commissioner shall use must be 165.21 implemented in this order: first, stop enrollment of single 165.22 adults and households without children; second, upon 45 days' 165.23 notice, stop coverage of single adults and households without 165.24 children already enrolled in the MinnesotaCare program; third, 165.25 upon 90 days' notice, decrease the premium subsidy amounts by 165.26 ten percent for families with gross annual income above 200 165.27 percent of the federal poverty guidelines; fourth, upon 90 days' 165.28 notice, decrease the premium subsidy amounts by ten percent for 165.29 families with gross annual income at or below 200 percent; and 165.30 fifth, require applicants to be uninsured for at least six 165.31 months prior to eligibility in the MinnesotaCare program. If 165.32 these measures are insufficient to limit the expenditures to the 165.33 estimated amount of revenue, the commissioner shall further 165.34 limit enrollment or decrease premium subsidies. 165.35 Sec. 8. Minnesota Statutes 1997 Supplement, section 165.36 256L.03, subdivision 1, is amended to read: 166.1 Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health 166.2 services" means the health services reimbursed under chapter 166.3 256B, with the exception of inpatient hospital services, special 166.4 education services, private duty nursing services, adult dental 166.5 care services other than preventive services, orthodontic 166.6 services, nonemergency medical transportation services, personal 166.7 care assistant and case management services, nursing home or 166.8 intermediate care facilities services, inpatient mental health 166.9 services, and chemical dependency services. Effective July 1, 166.10 1998, adult dental care for nonpreventive services with the 166.11 exception of orthodontic services is available to persons who 166.12 qualify under section 256L.04, subdivisions 1 to 7,or 256L.13,166.13 with family gross income equal to or less than 175 percent of 166.14 the federal poverty guidelines. Outpatient mental health 166.15 services covered under the MinnesotaCare program are limited to 166.16 diagnostic assessments, psychological testing, explanation of 166.17 findings, medication management by a physician, day treatment, 166.18 partial hospitalization, and individual, family, and group 166.19 psychotherapy. 166.20 No public funds shall be used for coverage of abortion 166.21 under MinnesotaCare except where the life of the female would be 166.22 endangered or substantial and irreversible impairment of a major 166.23 bodily function would result if the fetus were carried to term; 166.24 or where the pregnancy is the result of rape or incest. 166.25 Covered health services shall be expanded as provided in 166.26 this section. 166.27 Sec. 9. Minnesota Statutes 1997 Supplement, section 166.28 256L.03, is amended by adding a subdivision to read: 166.29 Subd. 1a. [COVERED SERVICES FOR PREGNANT WOMEN AND 166.30 CHILDREN UNDER MINNESOTACARE HEALTH CARE REFORM 166.31 WAIVER.] Children and pregnant women are eligible for coverage 166.32 of all services that are eligible for reimbursement under the 166.33 medical assistance program according to chapter 256B. Pregnant 166.34 women and children are exempt from the provisions of subdivision 166.35 5, regarding copayments. Pregnant women and children who are 166.36 lawfully residing in the United States but who are not 167.1 "qualified noncitizens" under title IV of the Personal 167.2 Responsibility and Work Opportunity Reconciliation Act of 1996, 167.3 Public Law Number 104-193, Statutes at Large, volume 110, page 167.4 2105, are eligible for coverage of all services provided under 167.5 the medical assistance program according to chapter 256B. 167.6 Sec. 10. Minnesota Statutes 1997 Supplement, section 167.7 256L.03, is amended by adding a subdivision to read: 167.8 Subd. 1b. [PREGNANT WOMEN; ELIGIBILITY FOR FULL MEDICAL 167.9 ASSISTANCE SERVICES.] A woman who is enrolled in MinnesotaCare 167.10 when her pregnancy is diagnosed is eligible for coverage of all 167.11 services provided under the medical assistance program according 167.12 to chapter 256B retroactive to the date the pregnancy is 167.13 medically diagnosed. Copayments totaling $30 or more, paid 167.14 after the date the pregnancy is diagnosed, shall be refunded. 167.15 Sec. 11. Minnesota Statutes 1997 Supplement, section 167.16 256L.03, subdivision 3, is amended to read: 167.17 Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a)Beginning July167.181, 1993,Covered health services shall include inpatient 167.19 hospital services, including inpatient hospital mental health 167.20 services and inpatient hospital and residential chemical 167.21 dependency treatment, subject to those limitations necessary to 167.22 coordinate the provision of these services with eligibility 167.23 under the medical assistance spenddown. Prior to July 1, 1997, 167.24 the inpatient hospital benefit for adult enrollees is subject to 167.25 an annual benefit limit of $10,000.Effective July 1, 1997,The 167.26 inpatient hospital benefit for adult enrollees who qualify under 167.27 section 256L.04, subdivision 7, or who qualify under section 167.28 256L.04, subdivisions 1to 6and 2,or 256L.13with family gross 167.29 income that exceeds 175 percent of the federal poverty 167.30 guidelines and who are not pregnant, is subject to an annual 167.31 limit of $10,000. 167.32 (b)Enrollees who qualify under section 256L.04,167.33subdivision 7, or who qualify under section 256L.04,167.34subdivisions 1 to 6, or 256L.13 with family gross income that167.35exceeds 175 percent of the federal poverty guidelines and who167.36are not pregnant, and are determined by the commissioner to have168.1a basis of eligibility for medical assistance shall apply for168.2and cooperate with the requirements of medical assistance by the168.3last day of the third month following admission to an inpatient168.4hospital. If an enrollee fails to apply for medical assistance168.5within this time period, the enrollee and the enrollee's family168.6shall be disenrolled from the plan and they may not reenroll168.7until 12 calendar months have elapsed. Enrollees and enrollees'168.8families disenrolled for not applying for or not cooperating168.9with medical assistance may not reenroll.168.10(c)Admissions for inpatient hospital services paid for 168.11 under section 256L.11, subdivision 3, must be certified as 168.12 medically necessary in accordance with Minnesota Rules, parts 168.13 9505.0500 to 9505.0540, except as provided in clauses (1) and 168.14 (2): 168.15 (1) all admissions must be certified, except those 168.16 authorized under rules established under section 254A.03, 168.17 subdivision 3, or approved under Medicare; and 168.18 (2) payment under section 256L.11, subdivision 3, shall be 168.19 reduced by five percent for admissions for which certification 168.20 is requested more than 30 days after the day of admission. The 168.21 hospital may not seek payment from the enrollee for the amount 168.22 of the payment reduction under this clause. 168.23(d) Any enrollee or family member of an enrollee who has168.24previously been permanently disenrolled from MinnesotaCare for168.25not applying for and cooperating with medical assistance shall168.26be eligible to reenroll if 12 calendar months have elapsed since168.27the date of disenrollment.168.28 Sec. 12. Minnesota Statutes 1997 Supplement, section 168.29 256L.03, is amended by adding a subdivision to read: 168.30 Subd. 3a. [INTERPRETER SERVICES.] Covered services include 168.31 sign and spoken language interpreter services that assist an 168.32 enrollee in obtaining covered health care services. 168.33 Sec. 13. Minnesota Statutes 1997 Supplement, section 168.34 256L.03, subdivision 4, is amended to read: 168.35 Subd. 4. [COORDINATION WITH MEDICAL ASSISTANCE.] The 168.36 commissioner shall coordinate the provision of hospital 169.1 inpatient services under the MinnesotaCare program with enrollee 169.2 eligibility under the medical assistance spenddown, and shall169.3apply to the secretary of health and human services for any169.4necessary federal waivers or approvals. 169.5 Sec. 14. Minnesota Statutes 1997 Supplement, section 169.6 256L.03, subdivision 5, is amended to read: 169.7 Subd. 5. [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 169.8 benefit plan shall include the following copayments and 169.9 coinsurance requirements: 169.10 (1) ten percent of the paid charges for inpatient hospital 169.11 services for adult enrolleesnot eligible for medical169.12assistance, subject to an annual inpatient out-of-pocket maximum 169.13 of $1,000 per individual and $3,000 per family; 169.14 (2) $3 per prescription for adult enrollees; 169.15 (3) $25 for eyeglasses for adult enrollees; and 169.16 (4) effective July 1, 1998, 50 percent of the 169.17 fee-for-service rate for adult dental care services other than 169.18 preventive care services for persons eligible under section 169.19 256L.04, subdivisions 1 to 7,or 256L.13,with income equal to 169.20 or less than 175 percent of the federal poverty guidelines. 169.21Prior to July 1, 1997, enrollees who are not eligible for169.22medical assistance with or without a spenddown shall be169.23financially responsible for the coinsurance amount and amounts169.24which exceed the $10,000 benefit limit.Effective July 1, 1997, 169.25 adult enrolleeswho qualify under section 256L.04, subdivision169.267, or who qualify under section 256L.04, subdivisions 1 to 6, or169.27256L.13with family gross income that exceeds 175 percent of the 169.28 federal poverty guidelines and who are not pregnant, and who are169.29not eligible for medical assistance with or without a spenddown,169.30 shall be financially responsible for the coinsurance amount and 169.31 amounts which exceed the $10,000 inpatient hospital benefit 169.32 limit. 169.33 When a MinnesotaCare enrollee becomes a member of a prepaid 169.34 health plan, or changes from one prepaid health plan to another 169.35 during a calendar year, any charges submitted towards the 169.36 $10,000 annual inpatient benefit limit, and any out-of-pocket 170.1 expenses incurred by the enrollee for inpatient services, that 170.2 were submitted or incurred prior to enrollment, or prior to the 170.3 change in health plans, shall be disregarded. 170.4 Sec. 15. Minnesota Statutes 1997 Supplement, section 170.5 256L.04, subdivision 1, is amended to read: 170.6 Subdivision 1. [CHILDREN; EXPANSION AND CONTINUATION OF170.7ELIGIBILITYFAMILIES WITH CHILDREN.] (a)[CHILDREN.] Prior to170.8October 1, 1992, "eligible persons" means children who are one170.9year of age or older but less than 18 years of age who have170.10gross family incomes that are equal to or less than 185 percent170.11of the federal poverty guidelines and who are not eligible for170.12medical assistance without a spenddown under chapter 256B and170.13who are not otherwise insured for the covered services. The170.14period of eligibility extends from the first day of the month in170.15which the child's first birthday occurs to the last day of the170.16month in which the child becomes 18 years old.Families with 170.17 children with family income equal to or less than 275 percent of 170.18 the federal poverty guidelines for the applicable family size 170.19 shall be eligible for MinnesotaCare according to this section. 170.20 All other provisions of sections 256L.01 to 256L.18, including 170.21 the insurance-related barriers to enrollment under section 170.22 256L.07, shall apply unless otherwise specified. 170.23 (b)[EXPANSION OF ELIGIBILITY.] Eligibility for170.24MinnesotaCare shall be expanded as provided in subdivisions 3 to170.257, except children who meet the criteria in this subdivision170.26shall continue to be enrolled pursuant to this subdivision. The170.27enrollment requirements in this paragraph apply to enrollment170.28under subdivisions 1 to 7.Parents who enroll in the 170.29 MinnesotaCare program must also enroll their children and 170.30 dependent siblings, if the children and their dependent siblings 170.31 are eligible. Children and dependent siblings may be enrolled 170.32 separately without enrollment by parents. However, if one 170.33 parent in the household enrolls, both parents must enroll, 170.34 unless other insurance is available. If one child from a family 170.35 is enrolled, all children must be enrolled, unless other 170.36 insurance is available. If one spouse in a household enrolls, 171.1 the other spouse in the household must also enroll, unless other 171.2 insurance is available. Families cannot choose to enroll only 171.3 certain uninsured members.For purposes of this section, a171.4"dependent sibling" means an unmarried child who is a full-time171.5student under the age of 25 years who is financially dependent171.6upon a parent. Proof of school enrollment will be required.171.7(c) [CONTINUATION OF ELIGIBILITY.] Individuals who171.8initially enroll in the MinnesotaCare program under the171.9eligibility criteria in subdivisions 3 to 7 remain eligible for171.10the MinnesotaCare program, regardless of age, place of171.11residence, or the presence or absence of children in the same171.12household, as long as all other eligibility criteria are met and171.13residence in Minnesota and continuous enrollment in the171.14MinnesotaCare program or medical assistance are maintained. In171.15order for either parent or either spouse in a household to171.16remain enrolled, both must remain enrolled, unless other171.17insurance is available.171.18 Sec. 16. Minnesota Statutes 1997 Supplement, section 171.19 256L.04, subdivision 2, is amended to read: 171.20 Subd. 2. [COOPERATION IN ESTABLISHING THIRD PARTY 171.21 LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 171.22 eligible for MinnesotaCare, individuals and families must 171.23 cooperate with the state agency to identify potentially liable 171.24 third party payers and assist the state in obtaining third party 171.25 payments. "Cooperation" includes, but is not limited to, 171.26 identifying any third party who may be liable for care and 171.27 services provided under MinnesotaCare to the enrollee, providing 171.28 relevant information to assist the state in pursuing a 171.29 potentially liable third party, and completing forms necessary 171.30 to recover third party payments. 171.31 (b) A parent, guardian, or child enrolled in the 171.32 MinnesotaCare program must cooperate with the department of 171.33 human services and the local agency in establishing the 171.34 paternity of an enrolled child and in obtaining medical care 171.35 support and payments for the child and any other person for whom 171.36 the person can legally assign rights, in accordance with 172.1 applicable laws and rules governing the medical assistance 172.2 program. A child shall not be ineligible for or disenrolled 172.3 from the MinnesotaCare program solely because the child's parent 172.4 or guardian fails to cooperate in establishing paternity or 172.5 obtaining medical support. 172.6 Sec. 17. Minnesota Statutes 1997 Supplement, section 172.7 256L.04, subdivision 7, is amended to read: 172.8 Subd. 7. [ADDITION OFSINGLE ADULTS AND HOUSEHOLDS WITH NO 172.9 CHILDREN.](a) Beginning October 1, 1994, the definition of172.10"eligible persons" is expanded to include all individuals and172.11households with no children who have gross family incomes that172.12are equal to or less than 125 percent of the federal poverty172.13guidelines and who are not eligible for medical assistance172.14without a spenddown under chapter 256B.172.15(b) Beginning July 1, 1997,The definition of eligible 172.16 personsis expanded to includeincludes all individuals and 172.17 households with no children who have gross family incomes that 172.18 are equal to or less than 175 percent of the federal poverty 172.19 guidelinesand who are not eligible for medical assistance172.20without a spenddown under chapter 256B. 172.21(c) All eligible persons under paragraphs (a) and (b) are172.22eligible for coverage through the MinnesotaCare program but must172.23pay a premium as determined under sections 256L.07 and 256L.08.172.24Individuals and families whose income is greater than the limits172.25established under section 256L.08 may not enroll in the172.26MinnesotaCare program.172.27 Sec. 18. Minnesota Statutes 1997 Supplement, section 172.28 256L.04, is amended by adding a subdivision to read: 172.29 Subd. 7a. [INELIGIBILITY.] Applicants whose income is 172.30 greater than the limits established under this section may not 172.31 enroll in the MinnesotaCare program. 172.32 Sec. 19. Minnesota Statutes 1997 Supplement, section 172.33 256L.04, subdivision 8, is amended to read: 172.34 Subd. 8. [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 172.35 ASSISTANCE.] (a) Individuals whoapply for MinnesotaCarereceive 172.36 supplemental security income or retirement, survivors, or 173.1 disability benefits due to a disability, or other 173.2 disability-based pension, who qualify under section 256L.04, 173.3 subdivision 7, but who are potentially eligible for medical 173.4 assistance without a spenddown shall be allowed to enroll in 173.5 MinnesotaCare for a period of 60 days, so long as the applicant 173.6 meets all other conditions of eligibility. The commissioner 173.7 shall identify and refer the applications of such individuals to 173.8 their county social service agency. The county and the 173.9 commissioner shall cooperate to ensure that the individuals 173.10 obtain medical assistance coverage for any months for which they 173.11 are eligible. 173.12 (b) The enrollee must cooperate with the county social 173.13 service agency in determining medical assistance eligibility 173.14 within the 60-day enrollment period. Enrollees who do notapply173.15for andcooperate with medical assistance within the 60-day 173.16 enrollment period, and their other family members,shall be 173.17 disenrolled from the plan within one calendar month. Persons 173.18 disenrolled for nonapplication for medical assistance may not 173.19 reenroll until they have obtained a medical assistance 173.20 eligibility determinationfor the family member or members who173.21were referred to the county agency. Persons disenrolled for 173.22 noncooperation with medical assistance may not reenroll until 173.23 they have cooperated with the county agency and have obtained a 173.24 medical assistance eligibility determination. 173.25 (c) Beginning January 1, 2000, counties that choose to 173.26 become MinnesotaCare enrollment sites shall consider 173.27 MinnesotaCare applications of individuals described in paragraph 173.28 (a) to also be applications for medical assistance and shall 173.29 first determine whether medical assistance eligibility exists. 173.30 Adults with children with family income under 175 percent of the 173.31 federal poverty guidelines for the applicable family size, 173.32 pregnant women, and children who qualify under subdivision 1 who 173.33 are potentially eligible for medical assistance without a 173.34 spenddown may choose to enroll in either MinnesotaCare or 173.35 medical assistance. 173.36 (d) The commissioner shall redetermine provider payments 174.1 made under MinnesotaCare to the appropriate medical assistance 174.2 payments for those enrollees who subsequently become eligible 174.3 for medical assistance. 174.4 Sec. 20. Minnesota Statutes 1997 Supplement, section 174.5 256L.04, subdivision 9, is amended to read: 174.6 Subd. 9. [GENERAL ASSISTANCE MEDICAL CARE.] A person 174.7 cannot have coverage under both MinnesotaCare and general 174.8 assistance medical care in the same month. Eligibility for 174.9 MinnesotaCare cannot be replaced by eligibility for general 174.10 assistance medical care, and eligibility for general assistance 174.11 medical care cannot be replaced by eligibility for MinnesotaCare. 174.12 Sec. 21. Minnesota Statutes 1997 Supplement, section 174.13 256L.04, subdivision 10, is amended to read: 174.14 Subd. 10. [SPONSOR'S INCOME AND RESOURCES DEEMED 174.15 AVAILABLE; DOCUMENTATION.] When determining eligibility for any 174.16 federal or state benefits under sections 256L.01 to256L.16174.17 256L.18, the income and resources of all noncitizens whose 174.18 sponsor signed an affidavit of support as defined under United 174.19 States Code, title 8, section 1183a, shall be deemed to include 174.20 their sponsors' income and resources as defined in the Personal 174.21 Responsibility and Work Opportunity Reconciliation Act of 1996, 174.22 title IV, Public Law Number 104-193, sections 421 and 422, and 174.23 subsequently set out in federal rules. To be eligible for the 174.24 program, noncitizens must provide documentation of their 174.25 immigration status. 174.26 Sec. 22. Minnesota Statutes 1997 Supplement, section 174.27 256L.04, is amended by adding a subdivision to read: 174.28 Subd. 12. [PERSONS IN DETENTION.] An applicant residing in 174.29 a correctional or detention facility is not eligible for 174.30 MinnesotaCare. An enrollee residing in a correctional or 174.31 detention facility is not eligible at renewal of eligibility 174.32 under section 256L.05, subdivision 3b. 174.33 Sec. 23. Minnesota Statutes 1997 Supplement, section 174.34 256L.04, is amended by adding a subdivision to read: 174.35 Subd. 13. [FAMILIES WITH GRANDPARENTS, RELATIVE 174.36 CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] In families 175.1 that include a grandparent, relative caretaker as defined in the 175.2 medical assistance program, foster parent, or legal guardian, 175.3 the grandparent, relative caretaker, foster parent, or legal 175.4 guardian may apply as a family or may apply separately for the 175.5 children. If the caretaker applies separately for the children, 175.6 only the children's income is counted. If the grandparent, 175.7 relative caretaker, foster parent, or legal guardian applies 175.8 with the family, their income is included in the gross family 175.9 income for determining eligibility and premium amount. 175.10 Sec. 24. Minnesota Statutes 1997 Supplement, section 175.11 256L.05, is amended by adding a subdivision to read: 175.12 Subd. 1a. [PERSON AUTHORIZED TO APPLY ON APPLICANT'S 175.13 BEHALF.] A family member who is age 18 or over or who is an 175.14 authorized representative, as defined in the medical assistance 175.15 program, may apply on an applicant's behalf. 175.16 Sec. 25. Minnesota Statutes 1997 Supplement, section 175.17 256L.05, subdivision 2, is amended to read: 175.18 Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall 175.19 use individuals' social security numbers as identifiers for 175.20 purposes of administering the plan and conduct data matches to 175.21 verify income. Applicants shall submit evidence of individual 175.22 and family income, earned and unearned,includingsuch as the 175.23 most recent income tax return, wage slips, or other 175.24 documentation that is determined by the commissioner as 175.25 necessary to verify income eligibility. The commissioner shall 175.26 perform random audits to verify reported income and 175.27 eligibility. The commissioner may execute data sharing 175.28 arrangements with the department of revenue and any other 175.29 governmental agency in order to perform income verification 175.30 related to eligibility and premium payment under the 175.31 MinnesotaCare program. 175.32 Sec. 26. Minnesota Statutes 1997 Supplement, section 175.33 256L.05, subdivision 3, is amended to read: 175.34 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] The effective date 175.35 of coverage is the first day of the month following the month in 175.36 which eligibility is approved and the first premium payment has 176.1 been received. As provided in section 256B.057, coverage for 176.2 newborns is automatic from the date of birth and must be 176.3 coordinated with other health coverage. The effective date of 176.4 coverage foreligible newborns oreligible newly adoptive 176.5 children added to a family receiving covered health services is 176.6 the date of entry into the family. The effective date of 176.7 coverage for other new recipients added to the family receiving 176.8 covered health services is the first day of the month following 176.9 the month in which eligibility is approvedand the first premium176.10payment has been receivedor at renewal, whichever the family 176.11 receiving covered health services prefers. All eligibility 176.12 criteria must be met by the family at the time the new family 176.13 member is added. The income of the new family member is 176.14 included with the family's gross income and the adjusted premium 176.15 begins in the month the new family member is added. The premium 176.16 must be received eight working days prior to the end of the 176.17 month for coverage to begin the following month. Benefits are 176.18 not available until the day following discharge if an enrollee 176.19 is hospitalized on the first day of coverage. Notwithstanding 176.20 any other law to the contrary, benefits under sections 256L.01 176.21 to256L.10256L.18 are secondary to a plan of insurance or 176.22 benefit program under which an eligible person may have coverage 176.23 and the commissioner shall use cost avoidance techniques to 176.24 ensure coordination of any other health coverage for eligible 176.25 persons. The commissioner shall identify eligible persons who 176.26 may have coverage or benefits under other plans of insurance or 176.27 who become eligible for medical assistance. 176.28 Sec. 27. Minnesota Statutes 1997 Supplement, section 176.29 256L.05, is amended by adding a subdivision to read: 176.30 Subd. 3a. [RENEWAL OF ELIGIBILITY.] An enrollee's 176.31 eligibility must be renewed every 12 months. The 12-month 176.32 period begins in the month after the month the application is 176.33 approved. Individuals who initially enroll in the MinnesotaCare 176.34 program under section 256L.04, subdivision 1 or 7, remain 176.35 eligible for the MinnesotaCare program regardless of age, place 176.36 of residence, or the presence or absence of children in the same 177.1 household, as long as all other eligibility criteria are met, 177.2 and residence in Minnesota and continuous enrollment in the 177.3 MinnesotaCare program are maintained. 177.4 Sec. 28. Minnesota Statutes 1997 Supplement, section 177.5 256L.05, is amended by adding a subdivision to read: 177.6 Subd. 3b. [REAPPLICATION.] Families and individuals must 177.7 reapply after a lapse in coverage of one calendar month or more 177.8 and must meet all eligibility criteria. 177.9 Sec. 29. Minnesota Statutes 1997 Supplement, section 177.10 256L.05, subdivision 4, is amended to read: 177.11 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 177.12 human services shall determine an applicant's eligibility for 177.13 MinnesotaCare no more than 30 days from the date that the 177.14 application is received by the department of human services. 177.15 Beginning January 1, 2000, this requirement also applies to 177.16 local county human services agencies that determine eligibility 177.17 for MinnesotaCare. To prevent processing delays, applicants 177.18 who, from the information provided on the application, appear to 177.19 meet eligibility requirements shall be enrolled. The enrollee 177.20 must provide all required verifications within 30 days of 177.21 enrollment or coverage from the program shall be terminated. 177.22 Enrollees who are determined to be ineligible when verifications 177.23 are provided shall be disenrolled from the program. 177.24 Sec. 30. Minnesota Statutes 1997 Supplement, section 177.25 256L.06, subdivision 3, is amended to read: 177.26 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 177.27 Premiums are dedicated to the commissioner for MinnesotaCare. 177.28The commissioner shall make an annual redetermination of177.29continued eligibility and identify people who may become177.30eligible for medical assistance.177.31 (b) The commissioner shall develop and implement procedures 177.32 to: (1) require enrollees to report changes in income; (2) 177.33 adjust sliding scale premium payments, based upon changes in 177.34 enrollee income; and (3) disenroll enrollees from MinnesotaCare 177.35 for failure to pay required premiums. Failure to pay includes 177.36 payment with a dishonored check. The commissioner may demand a 178.1 guaranteed form of payment as the only means to replace a 178.2 dishonored check. 178.3 (c) Premiums are calculated on a calendar month basis and 178.4 may be paid on a monthly, quarterly, or annual basis, with the 178.5 first payment due upon notice from the commissioner of the 178.6 premium amount required. Premium payment is required before 178.7 enrollment is complete and to maintain eligibility in 178.8 MinnesotaCare. 178.9 (d) Nonpayment of the premium will result in disenrollment 178.10 from the plan within one calendar month after the due date. 178.11 Persons disenrolled for nonpayment or who voluntarily terminate 178.12 coverage from the program may not reenroll until four calendar 178.13 months have elapsed. Persons disenrolled for nonpayment or who 178.14 voluntarily terminate coverage from the program may not reenroll 178.15 for four calendar months unless the person demonstrates good 178.16 cause for nonpayment. Good cause does not exist if a person 178.17 chooses to pay other family expenses instead of the premium. 178.18 The commissioner shall define good cause in rule. 178.19 Sec. 31. Minnesota Statutes 1997 Supplement, section 178.20 256L.07, is amended to read: 178.21 256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON 178.22 SLIDING SCALE.] 178.23 Subdivision 1. [GENERAL REQUIREMENTS.]Families and178.24individuals who enroll on or after October 1, 1992, are eligible178.25for subsidized premium payments based on a sliding scale under178.26section 256L.08 only if the family or individual meets the178.27requirements in subdivisions 2 and 3. Children already enrolled178.28in the children's health plan as of September 30, 1992, eligible178.29under section 256L.04, subdivision 1, paragraph (a), children178.30who enroll in the MinnesotaCare program after September 30,178.311992, pursuant to Laws 1992, chapter 549, article 4, section 17,178.32and children who enroll under section 256L.04, subdivision 6,178.33are eligible for subsidized premium payments without meeting178.34these requirements, as long as they maintain continuous coverage178.35in the MinnesotaCare plan or medical assistance.(a) Children 178.36 enrolled in the original children's health plan as of September 179.1 30, 1992, children who enrolled in the MinnesotaCare program 179.2 after September 30, 1992, pursuant to Laws 1992, chapter 549, 179.3 article 4, section 17, and children who have family gross 179.4 incomes that are equal to or less than 150 percent of the 179.5 federal poverty guidelines are eligible for subsidized premium 179.6 payments without meeting the requirements of subdivision 2, as 179.7 long as they maintain continuous coverage in the MinnesotaCare 179.8 program or medical assistance. 179.9 (b) Families and individuals who initially enrolled in 179.10 MinnesotaCare under section 256L.04,andsubdivision 1 or 7, 179.11 whose income increases abovethe limits established in section179.12256L.08275 percent of the federal poverty guidelines, may 179.13 continue enrollment and pay the full cost of coverage. 179.14 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 179.15 COVERAGE.] (a) To be eligible for subsidized premium payments 179.16 based on a sliding scale, a family or individual must not have 179.17 access to subsidized health coverage through an employer, and179.18must not have had access to subsidized health coverage through179.19an employer for the 18 months prior to application for179.20subsidized coverage under the MinnesotaCare program. The179.21requirement that the family or individual must not have had179.22access to employer-subsidized coverage during the previous 18179.23months does not apply if: (1) employer-subsidized coverage was179.24lost due to the death of an employee or divorce; (2)179.25employer-subsidized coverage was lost because an individual179.26became ineligible for coverage as a child or dependent; or (3)179.27employer-subsidized coverage was lost for reasons that would not179.28disqualify the individual for unemployment benefits under179.29section 268.09 and the family or individual has not had access179.30to employer-subsidized coverage since the loss of coverage. If179.31employer-subsidized coverage was lost for reasons that179.32disqualify an individual for unemployment benefits under section179.33268.09, children of that individual are exempt from the179.34requirement of no access to employer subsidized coverage for the179.3518 months prior to application, as long as the children have not179.36had access to employer subsidized coverage since the180.1disqualifying event. The requirement that the. A family or 180.2 individualmust not have had access to employer-subsidized180.3coverage during the previous 18 months does apply ifwhose 180.4 employer-subsidized coverage is lost due to an employer 180.5 terminating health care coverage as an employee benefit during 180.6 the previous 18 months is not eligible. 180.7 (b) For purposes of this requirement, subsidized health 180.8 coverage means health coverage for which the employer pays at 180.9 least 50 percent of the cost of coverage for the employee,180.10excluding dependent coverageor dependent, or a higher 180.11 percentage as specified by the commissioner. Children are 180.12 eligible for employer-subsidized coverage through either parent, 180.13 including the noncustodial parent. The commissioner must treat 180.14 employer contributions to Internal Revenue Code Section 125 180.15 plans and any other employer benefits intended to pay health 180.16 care costs as qualified employer subsidies toward the cost of 180.17 health coverage for employees for purposes of this subdivision. 180.18 Subd. 3. [PERIOD UNINSUREDOTHER HEALTH COVERAGE.]To be180.19eligible for subsidized premium payments based on a sliding180.20scale,(a) Families and individualsinitiallyenrolled in the 180.21 MinnesotaCare programunder section 256L.04, subdivisions 5 and180.227,must havehadno health coverage while enrolled or for at 180.23 least four months prior to application and renewal. Children 180.24 enrolled in the original children's health plan and children in 180.25 families with income equal to or less than 150 percent of the 180.26 federal poverty guidelines, who has other health insurance, is 180.27 eligible if the other health coverage meets the requirements of 180.28 Minnesota Rules, part 9506.0020, subpart 3, item B. The 180.29 commissioner may change this eligibility criterion for sliding 180.30 scale premiums in order to remain within the limits of available 180.31 appropriations. The requirement ofat least four months ofno 180.32 health coverageprior to application for the MinnesotaCare180.33programdoes not apply to:newborns. 180.34(1) families, children, and individuals who apply for the180.35MinnesotaCare program upon termination from or as required by180.36the medical assistance program, general assistance medical care181.1program, or coverage under a regional demonstration project for181.2the uninsured funded under section 256B.73, the Hennepin county181.3assured care program, or the Group Health, Inc., community181.4health plan;181.5(2) families and individuals initially enrolled under181.6section 256L.04, subdivisions 1, paragraph (a), and 3;181.7(3) children enrolled pursuant to Laws 1992, chapter 549,181.8article 4, section 17; or181.9(4) individuals currently serving or who have served in the181.10military reserves, and dependents of these individuals, if these181.11individuals: (i) reapply for MinnesotaCare coverage after a181.12period of active military service during which they had been181.13covered by the Civilian Health and Medical Program of the181.14Uniformed Services (CHAMPUS); (ii) were covered under181.15MinnesotaCare immediately prior to obtaining coverage under181.16CHAMPUS; and (iii) have maintained continuous coverage.181.17 (b) For purposes of this section, medical assistance, 181.18 general assistance medical care, and civilian health and medical 181.19 program of the uniformed service, CHAMPUS, are not considered 181.20 insurance or health coverage. 181.21 (c) For purposes of this section, Medicare part A or B 181.22 coverage under title XVIII of the Social Security Act, United 181.23 States Code, title 42, sections 1395c to 1395w-4, is considered 181.24 health coverage. An applicant or enrollee may not refuse 181.25 Medicare coverage to establish eligibility for MinnesotaCare. 181.26 Sec. 32. Minnesota Statutes 1997 Supplement, section 181.27 256L.09, subdivision 2, is amended to read: 181.28 Subd. 2. [RESIDENCY REQUIREMENT.] (a)Prior to July 1,181.291997, to be eligible for health coverage under the MinnesotaCare181.30program, families and individuals must be permanent residents of181.31Minnesota.181.32(b) Effective July 1, 1997,To be eligible for health 181.33 coverage under the MinnesotaCare program, adults without 181.34 children must be permanent residents of Minnesota. 181.35(c) Effective July 1, 1997,(b) To be eligible for health 181.36 coverage under the MinnesotaCare program, pregnant women, 182.1 families, and children must meet the residency requirements as 182.2 provided by Code of Federal Regulations, title 42, section 182.3 435.403, except that the provisions of section 256B.056, 182.4 subdivision 1, shall apply upon receipt of federal approval. 182.5 Sec. 33. Minnesota Statutes 1997 Supplement, section 182.6 256L.09, subdivision 4, is amended to read: 182.7 Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 182.8 purposes of this section, a permanent Minnesota resident is a 182.9 person who has demonstrated, through persuasive and objective 182.10 evidence, that the person is domiciled in the state and intends 182.11 to live in the state permanently. 182.12 (b) To be eligible as a permanent resident,all applicants182.13 an applicant must demonstrate the requisite intent to live in 182.14 the state permanently by: 182.15 (1) showing that the applicant maintains a residence at a 182.16 verified address other than a place of public accommodation, 182.17 through the use of evidence of residence described in section 182.18 256D.02, subdivision 12a, clause (1); 182.19 (2) demonstrating that the applicant has been continuously 182.20 domiciled in the state for no less than 180 days immediately 182.21 before the application; and 182.22 (3) signing an affidavit declaring that (A) the applicant 182.23 currently resides in the state and intends to reside in the 182.24 state permanently; and (B) the applicant did not come to the 182.25 state for the primary purpose of obtaining medical coverage or 182.26 treatment. 182.27 (c) A person who is temporarily absent from the state does 182.28 not lose eligibility for MinnesotaCare. "Temporarily absent 182.29 from the state" means the person is out of the state for a 182.30 temporary purpose and intends to return when the purpose of the 182.31 absence has been accomplished. A person is not temporarily 182.32 absent from the state if another state has determined that the 182.33 person is a resident for any purpose. If temporarily absent 182.34 from the state, the person must follow the requirements of the 182.35 health plan in which he or she is enrolled to receive services. 182.36 Sec. 34. Minnesota Statutes 1997 Supplement, section 183.1 256L.09, subdivision 6, is amended to read: 183.2 Subd. 6. [12-MONTH PREEXISTING EXCLUSION.] If the 180-day 183.3 requirement in subdivision 4, paragraph (b), clause (2), is 183.4 determined by a court to be unconstitutional, the commissioner 183.5 of human services shall impose a 12-month preexisting condition 183.6 exclusion on coverage for persons who have been domiciled in the 183.7 state for less than 180 days. 183.8 Sec. 35. Minnesota Statutes 1997 Supplement, section 183.9 256L.11, subdivision 6, is amended to read: 183.10 Subd. 6. [ENROLLEES 18 OR OLDER.] Payment by the 183.11 MinnesotaCare program for inpatient hospital services provided 183.12 to MinnesotaCare enrollees eligible under section 256L.04, 183.13 subdivision 7, or who qualify under section 256L.04, 183.14 subdivisions 1to 6and 2,or 256L.13with family gross income 183.15 that exceeds 175 percent of the federal poverty guidelines and 183.16 who are not pregnant, who are 18 years old or older on the date 183.17 of admission to the inpatient hospital must be in accordance 183.18 with paragraphs (a) and (b). Payment for adults who are not 183.19 pregnant and are eligible under section 256L.04, subdivisions 183.20 1to 6and 2,or 256L.13,and whose incomes are equal to or less 183.21 than 175 percent of the federal poverty guidelines, shall be as 183.22 provided for under paragraph (c). 183.23 (a) If the medical assistance rate minus any copayment 183.24 required under section 256L.03, subdivision 4, is less than or 183.25 equal to the amount remaining in the enrollee's benefit limit 183.26 under section 256L.03, subdivision 3, payment must be the 183.27 medical assistance rate minus any copayment required under 183.28 section 256L.03, subdivision 4. The hospital must not seek 183.29 payment from the enrollee in addition to the copayment. The 183.30 MinnesotaCare payment plus the copayment must be treated as 183.31 payment in full. 183.32 (b) If the medical assistance rate minus any copayment 183.33 required under section 256L.03, subdivision 4, is greater than 183.34 the amount remaining in the enrollee's benefit limit under 183.35 section 256L.03, subdivision 3, payment must be the lesser of: 183.36 (1) the amount remaining in the enrollee's benefit limit; 184.1 or 184.2 (2) charges submitted for the inpatient hospital services 184.3 less any copayment established under section 256L.03, 184.4 subdivision 4. 184.5 The hospital may seek payment from the enrollee for the 184.6 amount by which usual and customary charges exceed the payment 184.7 under this paragraph. If payment is reduced under section 184.8 256L.03, subdivision 3, paragraph(c)(b), the hospital may not 184.9 seek payment from the enrollee for the amount of the reduction. 184.10 (c) For admissions occurring during the period of July 1, 184.11 1997, through June 30, 1998, for adults who are not pregnant and 184.12 are eligible under section 256L.04, subdivisions 1to 6and 184.13 2,or 256L.13,and whose incomes are equal to or less than 175 184.14 percent of the federal poverty guidelines, the commissioner 184.15 shall pay hospitals directly, up to the medical assistance 184.16 payment rate, for inpatient hospital benefits in excess of the 184.17 $10,000 annual inpatient benefit limit. 184.18 Sec. 36. Minnesota Statutes 1997 Supplement, section 184.19 256L.12, subdivision 5, is amended to read: 184.20 Subd. 5. [ELIGIBILITY FOR OTHER STATE PROGRAMS.] 184.21 MinnesotaCare enrollees who become eligible for medical 184.22 assistance or general assistance medical care will remain in the 184.23 same managed care plan if the managed care plan has a contract 184.24 for that population. Effective January 1, 1998, MinnesotaCare 184.25 enrollees who were formerly eligible for general assistance 184.26 medical care pursuant to section 256D.03, subdivision 3, within 184.27 six months of MinnesotaCare enrollment and were enrolled in a 184.28 prepaid health plan pursuant to section 256D.03, subdivision 4, 184.29 paragraph (d), must remain in the same managed care plan if the 184.30 managed care plan has a contract for that population.Contracts184.31between the department of human services and managed care plans184.32must include MinnesotaCare, and medical assistance and may, at184.33the option of the commissioner of human services, also include184.34general assistance medical care.Managed care plans must 184.35 participate in the MinnesotaCare and general assistance medical 184.36 care programs under a contract with the department of human 185.1 services in service areas where they participate in the medical 185.2 assistance program. 185.3 Sec. 37. Minnesota Statutes 1997 Supplement, section 185.4 256L.15, is amended to read: 185.5 256L.15 [PREMIUMS.] 185.6 Subdivision 1. [PREMIUM DETERMINATION.] Familiesandwith 185.7 childrenenrolled according to sections 256L.13 to 256L.16and 185.8 individuals shall pay a premium determined according to a 185.9 sliding fee based on the cost of coverage as a percentage of the 185.10 family's gross family income. Pregnant women and children under 185.11 age two are exempt from the provisions of section 256L.06, 185.12 subdivision 3, paragraph (b), clause (3), requiring 185.13 disenrollment for failure to pay premiums. For pregnant women, 185.14 this exemption continues until the first day of the month 185.15 following the 60th day postpartum. Women who remain enrolled 185.16 during pregnancy or the postpartum period, despite nonpayment of 185.17 premiums, shall be disenrolled on the first of the month 185.18 following the 60th day postpartum for the penalty period that 185.19 otherwise applies under section 256L.06, unless they begin 185.20 paying premiums. 185.21 Subd. 1a. [PAYMENT OPTIONS.] The commissioner may offer 185.22 the following payment options to an enrollee: 185.23 (1) payment by check; 185.24 (2) payment by credit card; 185.25 (3) payment by recurring automatic checking withdrawal; 185.26 (4) payment by one-time electronic transfer of funds; 185.27 (5) payment by wage withholding with the consent of the 185.28 employer and the employee; or 185.29 (6) payment by using state tax refund payments. 185.30 At application or reapplication, a MinnesotaCare applicant 185.31 or enrollee may authorize the commissioner to use the Revenue 185.32 Recapture Act in chapter 270A to collect funds from the 185.33 applicant's or enrollee's state income tax refund for the 185.34 purposes of meeting all or part of the applicant's or enrollee's 185.35 MinnesotaCare premium obligation for the forthcoming year. The 185.36 applicant or enrollee may authorize the commissioner to apply 186.1 for the state working family tax credit on behalf of the 186.2 applicant or enrollee. The setoff due under this subdivision 186.3 shall not be subject to the $10 fee under section 270A.07, 186.4 subdivision 1. 186.5 Subd. 1b. [PAYMENTS NONREFUNDABLE.] MinnesotaCare premiums 186.6 are not refundable. 186.7 Subd. 2. [SLIDING SCALE TO DETERMINE PERCENTAGE OF GROSS 186.8 INDIVIDUAL OR FAMILY INCOME.] The commissioner shall establish a 186.9 sliding fee scale to determine the percentage of 186.10 gross individual or family income that households at different 186.11 income levels must pay to obtain coverage through the 186.12 MinnesotaCare program. The sliding fee scale must be based on 186.13 the enrollee's gross individual or family income during the 186.14 previous four months. The sliding fee scale begins with a 186.15 premium of 1.5 percent of gross individual or family income for 186.16 individuals or families with incomes below the limits for the 186.17 medical assistance program for families and children and 186.18 proceeds through the following evenly spaced steps: 1.8, 2.3, 186.19 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. These percentages are 186.20 matched to evenly spaced income steps ranging from the medical 186.21 assistance income limit for families and children to 275 percent 186.22 of the federal poverty guidelines for the applicable family 186.23 size. An adult without children whose income is equal to or 186.24 less than 175 percent of the federal poverty guidelines shall 186.25 pay premiums according to the sliding fee scale. When an 186.26 enrollee's income exceeds 275 percent of the federal poverty 186.27 guidelines, the enrollee must pay the full cost of coverage as 186.28 required under section 256L.07, subdivision 1. The sliding fee 186.29 scale and percentages are not subject to the provisions of 186.30 chapter 14. If a family or individual reports increased income 186.31 after enrollment, premiums shall not be adjusted until 186.32 eligibility renewal. 186.33 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 186.34 of $48 is required for all childrenwho are eligible according186.35to section 256L.13, subdivision 4in families with income at or 186.36 less than 150 percent of federal poverty guidelines. 187.1 Sec. 38. Minnesota Statutes 1997 Supplement, section 187.2 256L.17, is amended by adding a subdivision to read: 187.3 Subd. 6. [WAIVER OF MAINTENANCE OF EFFORT 187.4 REQUIREMENT.] Unless a federal waiver of the maintenance of 187.5 effort requirements of section 2105(d) of title XXI of the 187.6 Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 187.7 at Large, volume 111, page 251, is granted by the federal 187.8 Department of Health and Human Services by September 30, 1998, 187.9 this section does not apply to children. The commissioner shall 187.10 publish a notice in the State Register upon receipt of a federal 187.11 waiver. 187.12 Sec. 39. Minnesota Statutes 1997 Supplement, section 187.13 270A.03, subdivision 5, is amended to read: 187.14 Subd. 5. [DEBT.] "Debt" means a legal obligation of a 187.15 natural person to pay a fixed and certain amount of money, which 187.16 equals or exceeds $25 and which is due and payable to a claimant 187.17 agency. The term includes criminal fines imposed under section 187.18 609.10 or 609.125 and restitution. A debt may arise under a 187.19 contractual or statutory obligation, a court order, or other 187.20 legal obligation, but need not have been reduced to judgment. 187.21 A debt includes any legal obligation of a current recipient 187.22 of assistance which is based on overpayment of an assistance 187.23 grant where that payment is based on a client waiver or an 187.24 administrative or judicial finding of an intentional program 187.25 violation; or where the debt is owed to a program wherein the 187.26 debtor is not a client at the time notification is provided to 187.27 initiate recovery under this chapter and the debtor is not a 187.28 current recipient of food stamps, transitional child care, or 187.29 transitional medical assistance. 187.30 A debt does not include any legal obligation to pay a 187.31 claimant agency for medical care, including hospitalization if 187.32 the income of the debtor at the time when the medical care was 187.33 rendered does not exceed the following amount: 187.34 (1) for an unmarried debtor, an income of $6,400 or less; 187.35 (2) for a debtor with one dependent, an income of $8,200 or 187.36 less; 188.1 (3) for a debtor with two dependents, an income of $9,700 188.2 or less; 188.3 (4) for a debtor with three dependents, an income of 188.4 $11,000 or less; 188.5 (5) for a debtor with four dependents, an income of $11,600 188.6 or less; and 188.7 (6) for a debtor with five or more dependents, an income of 188.8 $12,100 or less. 188.9 The income amounts in this subdivision shall be adjusted 188.10 for inflation for debts incurred in calendar years 1991 and 188.11 thereafter. The dollar amount of each income level that applied 188.12 to debts incurred in the prior year shall be increased in the 188.13 same manner as provided in section 290.06, subdivision 2d, for 188.14 the expansion of the tax rate brackets. 188.15 Debt also includes an agreement to pay a MinnesotaCare 188.16 premium, regardless of the dollar amount of the premium 188.17 authorized under section 256L.15, subdivision 1a. 188.18 Sec. 40. Laws 1997, chapter 225, article 2, section 64, is 188.19 amended to read: 188.20 Sec. 64. [EFFECTIVE DATE.] 188.21 Section 8 is effective for payments made for MinnesotaCare 188.22 services on or after July 1, 1996. Section 23 is effective the 188.23 day following final enactment. Section 46 is effective January 188.24 1, 1998, and applies to high deductible health plans issued or 188.25 renewed on or after that date. 188.26 Sec. 41. [FEDERAL EARNED INCOME TAX CREDIT.] 188.27 The commissioner of human services shall seek a federal 188.28 waiver from the appropriate federal agency to allow the state to 188.29 use the federal earned income tax credit for payment of state 188.30 subsidized health care premiums. 188.31 Sec. 42. [INPATIENT HOSPITAL COPAYMENT.] 188.32 If federal approval of a waiver to obtain federal Medicaid 188.33 funding for coverage provided to parents enrolled in the 188.34 MinnesotaCare program is contingent upon not applying the 188.35 inpatient hospital services copayment under section 256L.03, 188.36 subdivision 5, clause (1), the inpatient hospital services 189.1 copayment shall not be applied to enrollees for whom the state 189.2 receives federal Medicaid funding. 189.3 Sec. 43. [AUTHORIZATION TO SUBMIT PLANS AND REQUESTS FOR 189.4 WAIVERS TO OBTAIN FEDERAL FUNDS UNDER TITLE XXI.] 189.5 (a) The commissioner of human services is authorized to 189.6 claim enhanced federal matching funds available under sections 189.7 2105(a)(2) and 2110 of the Balanced Budget Act of 1997, Public 189.8 Law Number 105-33, for any and all state or local expenditures 189.9 eligible as child health assistance for targeted low-income 189.10 children and health service initiatives for low-income 189.11 children. If required by federal law or regulation, the 189.12 commissioner is authorized to establish accounts, make 189.13 appropriate payments, and receive reimbursement from any and all 189.14 state and local entities providing child health assistance or 189.15 health services for low-income children in order to obtain 189.16 federal matching funds. Federal matching funds received under 189.17 this section shall be deposited in the health care access fund. 189.18 (b) The commissioner of human services shall submit to the 189.19 health care financing administration all necessary plans or 189.20 requests for waivers in order to obtain enhanced matching funds 189.21 under the state children's health insurance program for 189.22 expenditures made under the MinnesotaCare program. The 189.23 commissioner shall report to the 1999 legislature all changes to 189.24 the MinnesotaCare program that may be required in order to 189.25 receive enhanced matching funds. 189.26 Sec. 44. [REVISOR'S INSTRUCTION.] 189.27 In each section of Minnesota Statutes referred to in column 189.28 A, the revisor of statutes shall delete the reference in column 189.29 B and insert the reference in column C. 189.30 Column A Column B Column C 189.31 256B.057, subd. 1a 256L.08 256L.15 189.32 256B.0645 256L.14 256L.03, subd. 1a 189.33 256L.16 256L.14 256L.03, subd. 1a 189.34 Sec. 45. [REPEALER.] 189.35 Minnesota Statutes 1997 Supplement, sections 256B.057, 189.36 subdivision 1a; 256L.04, subdivisions 3, 4, 5, and 6; 256L.06, 190.1 subdivisions 1 and 2; 256L.08; 256L.09, subdivision 3; 256L.13; 190.2 and 256L.14, are repealed. 190.3 Sec. 46. [EFFECTIVE DATE.] 190.4 Sections 2, 4 to 11, 13 to 37, 39, 44, and 45 are effective 190.5 January 1, 1999. Sections 3 and 38 are effective September 30, 190.6 1998. Sections 12, 40, 41, 42, and 43 are effective the day 190.7 following final enactment. 190.8 ARTICLE 6 190.9 WELFARE REFORM 190.10 Section 1. Minnesota Statutes 1996, section 119B.24, is 190.11 amended to read: 190.12 119B.24 [DUTIES OF COMMISSIONER.] 190.13 In addition to the powers and duties already conferred by 190.14 law, the commissioner of children, families, and learning shall: 190.15 (1) by September 1, 1998, and every five years thereafter, 190.16 survey and report on all components of the child care system, 190.17 including, but not limited to, availability of licensed child 190.18 care slots, the number of children in various kinds of child 190.19 care settings, staff wages, rate of staff turnover, 190.20 qualifications of child care workers, cost of child care by type 190.21 of service and ages of children, and child care availability 190.22 through school systems; 190.23 (2) by September 1, 1998, and every five years thereafter, 190.24 survey and report on the extent to which existing child care 190.25 services fulfill the need for child care, giving particular 190.26 attention to the need for part-time care and for care of 190.27 infants, sick children, children with special needs, low-income 190.28 children, toddlers, and school-age children; 190.29 (3) administer the child care fund, including the sliding 190.30 fee program authorized under sections 119B.01 to 119B.16; 190.31 (4) monitor the child care resource and referral programs 190.32 established under section 119B.19; and 190.33 (5) encourage child care providers to participate in a 190.34 nationally recognized accreditation system for early childhood 190.35 programs. The commissioner shall reimburse licensed child care 190.36 providers for one-half of the direct cost of accreditation fees, 191.1 upon successful completion of accreditation. 191.2 The commissioner may enter into contractual agreements with 191.3 a federally recognized Indian tribe with a reservation in 191.4 Minnesota to carry out any of the responsibilities of county 191.5 human service agencies to the extent necessary for the tribe to 191.6 operate a child care assistance program under the supervision of 191.7 the commissioner. 191.8 Funding to support services under section 119B.03 may be 191.9 transferred to the federally recognized Indian tribe with a 191.10 reservation in Minnesota from allocations available to counties 191.11 in which reservation boundaries lie. When funding is 191.12 transferred, the amount shall be commensurate to estimates of 191.13 the proportion of reservation residents to the total population 191.14 of county residents with characteristics identified in section 191.15 119B.03. 191.16 Sec. 2. Minnesota Statutes 1996, section 245A.03, is 191.17 amended by adding a subdivision to read: 191.18 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 191.19 clause (2), does not apply to: 191.20 (1) a child care provider who as an applicant for licensure 191.21 or as a license holder has received a license denial under 191.22 section 245A.05, a fine under section 245A.06, or a sanction 191.23 under section 245A.07 from the commissioner that has not been 191.24 reversed on appeal; or 191.25 (2) a child care provider, or a child care provider who has 191.26 a household member who, as a result of a licensing process, has 191.27 a disqualification under this chapter that has not been set 191.28 aside by the commissioner. 191.29 Sec. 3. Minnesota Statutes 1996, section 245A.14, 191.30 subdivision 4, is amended to read: 191.31 Subd. 4. [SPECIAL FAMILY DAY CARE HOMES.] (a) 191.32 Nonresidential child care programs serving 14 or fewer children 191.33 that are conducted at a location other than the license holder's 191.34 own residence shall be licensed under this section and the rules 191.35 governing family day care or group family day care if: 191.36(a)(1) the license holder is the primary provider of care;192.1(b)and the nonresidential child care program is conducted 192.2 in a dwelling that is located on a residential lot;andor 192.3(c) the license holder complies with all other requirements192.4of sections 245A.01 to 245A.15 and the rules governing family192.5day care or group family day care.192.6 (2) the license holder is an employer who may or may not be 192.7 the primary provider of care, and the purpose for the child care 192.8 program is to provide child care services to children of the 192.9 license holder's employees. 192.10 (b) Notwithstanding section 245A.16, subdivision 1, the 192.11 commissioner shall not delegate the authority to licensing 192.12 facilities under this section to county agencies or other 192.13 private agencies. 192.14 Sec. 4. Minnesota Statutes 1997 Supplement, section 192.15 245B.06, subdivision 2, is amended to read: 192.16 Subd. 2. [RISK MANAGEMENT PLAN.] The license holder must 192.17 develop and document in writing a risk management plan that 192.18 incorporates the individual abuse prevention plan as required in 192.19chapter 245Csection 245A.65. License holders jointly providing 192.20 services to a consumer shall coordinate and use the resulting 192.21 assessment of risk areas for the development of this plan. Upon 192.22 initiation of services, the license holder will have in place an 192.23 initial risk management plan that identifies areas in which the 192.24 consumer is vulnerable, including health, safety, and 192.25 environmental issues and the supports the provider will have in 192.26 place to protect the consumer and to minimize these risks. The 192.27 plan must be changed based on the needs of the individual 192.28 consumer and reviewed at least annually. 192.29 Sec. 5. Minnesota Statutes 1997 Supplement, section 192.30 256.01, subdivision 2, is amended to read: 192.31 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 192.32 section 241.021, subdivision 2, the commissioner of human 192.33 services shall: 192.34 (1) Administer and supervise all forms of public assistance 192.35 provided for by state law and other welfare activities or 192.36 services as are vested in the commissioner. Administration and 193.1 supervision of human services activities or services includes, 193.2 but is not limited to, assuring timely and accurate distribution 193.3 of benefits, completeness of service, and quality program 193.4 management. In addition to administering and supervising human 193.5 services activities vested by law in the department, the 193.6 commissioner shall have the authority to: 193.7 (a) require county agency participation in training and 193.8 technical assistance programs to promote compliance with 193.9 statutes, rules, federal laws, regulations, and policies 193.10 governing human services; 193.11 (b) monitor, on an ongoing basis, the performance of county 193.12 agencies in the operation and administration of human services, 193.13 enforce compliance with statutes, rules, federal laws, 193.14 regulations, and policies governing welfare services and promote 193.15 excellence of administration and program operation; 193.16 (c) develop a quality control program or other monitoring 193.17 program to review county performance and accuracy of benefit 193.18 determinations; 193.19 (d) require county agencies to make an adjustment to the 193.20 public assistance benefits issued to any individual consistent 193.21 with federal law and regulation and state law and rule and to 193.22 issue or recover benefits as appropriate; 193.23 (e) delay or deny payment of all or part of the state and 193.24 federal share of benefits and administrative reimbursement 193.25 according to the procedures set forth in section 256.017;and193.26 (f) make contracts with and grants to public and private 193.27 agencies and organizations, both profit and nonprofit, and 193.28 individuals, using appropriated funds; and 193.29 (g) enter into contractual agreements with federally 193.30 recognized Indian tribes with a reservation in Minnesota to the 193.31 extent necessary for the tribe to operate a federally approved 193.32 family assistance program or any other program under the 193.33 supervision of the commissioner. The commissioner may establish 193.34 necessary accounts for the purposes of receiving and disbursing 193.35 funds as necessary for the operation of the programs. 193.36 (2) Inform county agencies, on a timely basis, of changes 194.1 in statute, rule, federal law, regulation, and policy necessary 194.2 to county agency administration of the programs. 194.3 (3) Administer and supervise all child welfare activities; 194.4 promote the enforcement of laws protecting handicapped, 194.5 dependent, neglected and delinquent children, and children born 194.6 to mothers who were not married to the children's fathers at the 194.7 times of the conception nor at the births of the children; 194.8 license and supervise child-caring and child-placing agencies 194.9 and institutions; supervise the care of children in boarding and 194.10 foster homes or in private institutions; and generally perform 194.11 all functions relating to the field of child welfare now vested 194.12 in the state board of control. 194.13 (4) Administer and supervise all noninstitutional service 194.14 to handicapped persons, including those who are visually 194.15 impaired, hearing impaired, or physically impaired or otherwise 194.16 handicapped. The commissioner may provide and contract for the 194.17 care and treatment of qualified indigent children in facilities 194.18 other than those located and available at state hospitals when 194.19 it is not feasible to provide the service in state hospitals. 194.20 (5) Assist and actively cooperate with other departments, 194.21 agencies and institutions, local, state, and federal, by 194.22 performing services in conformity with the purposes of Laws 194.23 1939, chapter 431. 194.24 (6) Act as the agent of and cooperate with the federal 194.25 government in matters of mutual concern relative to and in 194.26 conformity with the provisions of Laws 1939, chapter 431, 194.27 including the administration of any federal funds granted to the 194.28 state to aid in the performance of any functions of the 194.29 commissioner as specified in Laws 1939, chapter 431, and 194.30 including the promulgation of rules making uniformly available 194.31 medical care benefits to all recipients of public assistance, at 194.32 such times as the federal government increases its participation 194.33 in assistance expenditures for medical care to recipients of 194.34 public assistance, the cost thereof to be borne in the same 194.35 proportion as are grants of aid to said recipients. 194.36 (7) Establish and maintain any administrative units 195.1 reasonably necessary for the performance of administrative 195.2 functions common to all divisions of the department. 195.3 (8) Act as designated guardian of both the estate and the 195.4 person of all the wards of the state of Minnesota, whether by 195.5 operation of law or by an order of court, without any further 195.6 act or proceeding whatever, except as to persons committed as 195.7 mentally retarded. For children under the guardianship of the 195.8 commissioner whose interests would be best served by adoptive 195.9 placement, the commissioner may contract with a licensed 195.10 child-placing agency to provide adoption services. A contract 195.11 with a licensed child-placing agency must be designed to 195.12 supplement existing county efforts and may not replace existing 195.13 county programs, unless the replacement is agreed to by the 195.14 county board and the appropriate exclusive bargaining 195.15 representative or the commissioner has evidence that child 195.16 placements of the county continue to be substantially below that 195.17 of other counties. 195.18 (9) Act as coordinating referral and informational center 195.19 on requests for service for newly arrived immigrants coming to 195.20 Minnesota. 195.21 (10) The specific enumeration of powers and duties as 195.22 hereinabove set forth shall in no way be construed to be a 195.23 limitation upon the general transfer of powers herein contained. 195.24 (11) Establish county, regional, or statewide schedules of 195.25 maximum fees and charges which may be paid by county agencies 195.26 for medical, dental, surgical, hospital, nursing and nursing 195.27 home care and medicine and medical supplies under all programs 195.28 of medical care provided by the state and for congregate living 195.29 care under the income maintenance programs. 195.30 (12) Have the authority to conduct and administer 195.31 experimental projects to test methods and procedures of 195.32 administering assistance and services to recipients or potential 195.33 recipients of public welfare. To carry out such experimental 195.34 projects, it is further provided that the commissioner of human 195.35 services is authorized to waive the enforcement of existing 195.36 specific statutory program requirements, rules, and standards in 196.1 one or more counties. The order establishing the waiver shall 196.2 provide alternative methods and procedures of administration, 196.3 shall not be in conflict with the basic purposes, coverage, or 196.4 benefits provided by law, and in no event shall the duration of 196.5 a project exceed four years. It is further provided that no 196.6 order establishing an experimental project as authorized by the 196.7 provisions of this section shall become effective until the 196.8 following conditions have been met: 196.9 (a) The secretary of health, education, and welfare of the 196.10 United States has agreed, for the same project, to waive state 196.11 plan requirements relative to statewide uniformity. 196.12 (b) A comprehensive plan, including estimated project 196.13 costs, shall be approved by the legislative advisory commission 196.14 and filed with the commissioner of administration. 196.15 (13) According to federal requirements, establish 196.16 procedures to be followed by local welfare boards in creating 196.17 citizen advisory committees, including procedures for selection 196.18 of committee members. 196.19 (14) Allocate federal fiscal disallowances or sanctions 196.20 which are based on quality control error rates for the aid to 196.21 families with dependent children, Minnesota family investment 196.22 program-statewide, medical assistance, or food stamp program in 196.23 the following manner: 196.24 (a) One-half of the total amount of the disallowance shall 196.25 be borne by the county boards responsible for administering the 196.26 programs. For the medical assistance, MFIP-S, and AFDC 196.27 programs, disallowances shall be shared by each county board in 196.28 the same proportion as that county's expenditures for the 196.29 sanctioned program are to the total of all counties' 196.30 expenditures for the AFDC, MFIP-S, and medical assistance 196.31 programs. For the food stamp program, sanctions shall be shared 196.32 by each county board, with 50 percent of the sanction being 196.33 distributed to each county in the same proportion as that 196.34 county's administrative costs for food stamps are to the total 196.35 of all food stamp administrative costs for all counties, and 50 196.36 percent of the sanctions being distributed to each county in the 197.1 same proportion as that county's value of food stamp benefits 197.2 issued are to the total of all benefits issued for all 197.3 counties. Each county shall pay its share of the disallowance 197.4 to the state of Minnesota. When a county fails to pay the 197.5 amount due hereunder, the commissioner may deduct the amount 197.6 from reimbursement otherwise due the county, or the attorney 197.7 general, upon the request of the commissioner, may institute 197.8 civil action to recover the amount due. 197.9 (b) Notwithstanding the provisions of paragraph (a), if the 197.10 disallowance results from knowing noncompliance by one or more 197.11 counties with a specific program instruction, and that knowing 197.12 noncompliance is a matter of official county board record, the 197.13 commissioner may require payment or recover from the county or 197.14 counties, in the manner prescribed in paragraph (a), an amount 197.15 equal to the portion of the total disallowance which resulted 197.16 from the noncompliance, and may distribute the balance of the 197.17 disallowance according to paragraph (a). 197.18 (15) Develop and implement special projects that maximize 197.19 reimbursements and result in the recovery of money to the 197.20 state. For the purpose of recovering state money, the 197.21 commissioner may enter into contracts with third parties. Any 197.22 recoveries that result from projects or contracts entered into 197.23 under this paragraph shall be deposited in the state treasury 197.24 and credited to a special account until the balance in the 197.25 account reaches $1,000,000. When the balance in the account 197.26 exceeds $1,000,000, the excess shall be transferred and credited 197.27 to the general fund. All money in the account is appropriated 197.28 to the commissioner for the purposes of this paragraph. 197.29 (16) Have the authority to make direct payments to 197.30 facilities providing shelter to women and their children 197.31 according to section 256D.05, subdivision 3. Upon the written 197.32 request of a shelter facility that has been denied payments 197.33 under section 256D.05, subdivision 3, the commissioner shall 197.34 review all relevant evidence and make a determination within 30 197.35 days of the request for review regarding issuance of direct 197.36 payments to the shelter facility. Failure to act within 30 days 198.1 shall be considered a determination not to issue direct payments. 198.2 (17) Have the authority to establish and enforce the 198.3 following county reporting requirements: 198.4 (a) The commissioner shall establish fiscal and statistical 198.5 reporting requirements necessary to account for the expenditure 198.6 of funds allocated to counties for human services programs. 198.7 When establishing financial and statistical reporting 198.8 requirements, the commissioner shall evaluate all reports, in 198.9 consultation with the counties, to determine if the reports can 198.10 be simplified or the number of reports can be reduced. 198.11 (b) The county board shall submit monthly or quarterly 198.12 reports to the department as required by the commissioner. 198.13 Monthly reports are due no later than 15 working days after the 198.14 end of the month. Quarterly reports are due no later than 30 198.15 calendar days after the end of the quarter, unless the 198.16 commissioner determines that the deadline must be shortened to 198.17 20 calendar days to avoid jeopardizing compliance with federal 198.18 deadlines or risking a loss of federal funding. Only reports 198.19 that are complete, legible, and in the required format shall be 198.20 accepted by the commissioner. 198.21 (c) If the required reports are not received by the 198.22 deadlines established in clause (b), the commissioner may delay 198.23 payments and withhold funds from the county board until the next 198.24 reporting period. When the report is needed to account for the 198.25 use of federal funds and the late report results in a reduction 198.26 in federal funding, the commissioner shall withhold from the 198.27 county boards with late reports an amount equal to the reduction 198.28 in federal funding until full federal funding is received. 198.29 (d) A county board that submits reports that are late, 198.30 illegible, incomplete, or not in the required format for two out 198.31 of three consecutive reporting periods is considered 198.32 noncompliant. When a county board is found to be noncompliant, 198.33 the commissioner shall notify the county board of the reason the 198.34 county board is considered noncompliant and request that the 198.35 county board develop a corrective action plan stating how the 198.36 county board plans to correct the problem. The corrective 199.1 action plan must be submitted to the commissioner within 45 days 199.2 after the date the county board received notice of noncompliance. 199.3 (e) The final deadline for fiscal reports or amendments to 199.4 fiscal reports is one year after the date the report was 199.5 originally due. If the commissioner does not receive a report 199.6 by the final deadline, the county board forfeits the funding 199.7 associated with the report for that reporting period and the 199.8 county board must repay any funds associated with the report 199.9 received for that reporting period. 199.10 (f) The commissioner may not delay payments, withhold 199.11 funds, or require repayment under paragraph (c) or (e) if the 199.12 county demonstrates that the commissioner failed to provide 199.13 appropriate forms, guidelines, and technical assistance to 199.14 enable the county to comply with the requirements. If the 199.15 county board disagrees with an action taken by the commissioner 199.16 under paragraph (c) or (e), the county board may appeal the 199.17 action according to sections 14.57 to 14.69. 199.18 (g) Counties subject to withholding of funds under 199.19 paragraph (c) or forfeiture or repayment of funds under 199.20 paragraph (e) shall not reduce or withhold benefits or services 199.21 to clients to cover costs incurred due to actions taken by the 199.22 commissioner under paragraph (c) or (e). 199.23 (18) Allocate federal fiscal disallowances or sanctions for 199.24 audit exceptions when federal fiscal disallowances or sanctions 199.25 are based on a statewide random sample for the foster care 199.26 program under title IV-E of the Social Security Act, United 199.27 States Code, title 42, in direct proportion to each county's 199.28 title IV-E foster care maintenance claim for that period. 199.29 (19) Be responsible for ensuring the detection, prevention, 199.30 investigation, and resolution of fraudulent activities or 199.31 behavior by applicants, recipients, and other participants in 199.32 the human services programs administered by the department. 199.33 (20) Require county agencies to identify overpayments, 199.34 establish claims, and utilize all available and cost-beneficial 199.35 methodologies to collect and recover these overpayments in the 199.36 human services programs administered by the department. 200.1 (21) Have the authority to administer a drug rebate program 200.2 for drugs purchased pursuant to the senior citizen drug program 200.3 established under section 256.955 after the beneficiary's 200.4 satisfaction of any deductible established in the program. The 200.5 commissioner shall require a rebate agreement from all 200.6 manufacturers of covered drugs as defined in section 256B.0625, 200.7 subdivision 13. For each drug, the amount of the rebate shall 200.8 be equal to the basic rebate as defined for purposes of the 200.9 federal rebate program in United States Code, title 42, section 200.10 1396r-8(c)(1). This basic rebate shall be applied to 200.11 single-source and multiple-source drugs. The manufacturers must 200.12 provide full payment within 30 days of receipt of the state 200.13 invoice for the rebate within the terms and conditions used for 200.14 the federal rebate program established pursuant to section 1927 200.15 of title XIX of the Social Security Act. The manufacturers must 200.16 provide the commissioner with any information necessary to 200.17 verify the rebate determined per drug. The rebate program shall 200.18 utilize the terms and conditions used for the federal rebate 200.19 program established pursuant to section 1927 of title XIX of the 200.20 Social Security Act. 200.21 Sec. 6. Minnesota Statutes 1996, section 256.014, 200.22 subdivision 1, is amended to read: 200.23 Subdivision 1. [ESTABLISHMENT OF SYSTEMS.] The 200.24 commissioner of human services shall establish and enhance 200.25 computer systems necessary for the efficient operation of the 200.26 programs the commissioner supervises, including: 200.27 (1) management and administration of the food stamp and 200.28 income maintenance programs, including the electronic 200.29 distribution of benefits; 200.30 (2) management and administration of the child support 200.31 enforcement program; and 200.32 (3) administration of medical assistance and general 200.33 assistance medical care. 200.34 The commissioner shall distribute the nonfederal share of 200.35 the costs of operating and maintaining the systems to the 200.36 commissioner and to the counties participating in the system in 201.1 a manner that reflects actual system usage, except that the 201.2 nonfederal share of the costs of the MAXIS computer system and 201.3 child support enforcement systems shall be borne entirely by the 201.4 commissioner. Development costs must not be assessed against 201.5 county agencies. 201.6 The commissioner may enter into contractual agreements with 201.7 federally recognized Indian tribes with a reservation in 201.8 Minnesota to participate in state-operated computer systems 201.9 related to the management and administration of the food stamp, 201.10 income maintenance, child support enforcement, and medical 201.11 assistance and general assistance medical care programs to the 201.12 extent necessary for the tribe to operate a federally approved 201.13 family assistance program or any other program under the 201.14 supervision of the commissioner. 201.15 Sec. 7. Minnesota Statutes 1997 Supplement, section 201.16 256.031, subdivision 6, is amended to read: 201.17 Subd. 6. [END OF FIELD TRIALS.] (a) Upon agreement with 201.18 the federal government, the field trials of the Minnesota family 201.19 investment plan will end June 30, 1998. 201.20 (b) Families in the comparison group under subdivision 3, 201.21 paragraph (d), clause (i), receiving aid to families with 201.22 dependent children under sections 256.72 to 256.87, and STRIDE 201.23 services under section 256.736 will continue in those programs 201.24 until June 30, 1998. After June 30, 1998, families who cease 201.25 receiving assistance under the Minnesota family investment plan 201.26 and comparison group families who cease receiving assistance 201.27 under AFDC and STRIDE who are eligible for the Minnesota family 201.28 investment program-statewide (MFIP-S), medical assistance, 201.29 general assistance medical care, or the food stamp program shall 201.30 be placed with their consent on the programs for which they are 201.31 eligible. 201.32 (c) Families who cease receiving assistance under the MFIP 201.33 and comparison families who cease receiving assistance under 201.34 AFDC and STRIDE who are ineligible for MFIP-S due to increased 201.35 income from employment, or increased child or spousal support or 201.36 a combination of employment income and child or spousal support, 202.1 will be eligible for extended medical assistance under section 202.2 256B.0635. For the purpose of determining receipt of extended 202.3 medical assistance, receipt of AFDC and MFIP will be the same as 202.4 receipt of MFIP-S. 202.5 Sec. 8. Minnesota Statutes 1997 Supplement, section 202.6 256.9864, is amended to read: 202.7 256.9864 [REPORTS BY RECIPIENT.] 202.8 (a) An assistance unit with a recent work history or with 202.9 earned income shall report monthly to the county agency on 202.10 income received and other circumstances affecting eligibility or 202.11 assistance amounts. All other assistance units shall report on 202.12 income and other circumstances affecting eligibility and 202.13 assistance amounts, as specified by the state agency. 202.14 (b) An assistance unit required to submit a report on the 202.15 form designated by the commissioner and within ten days of the 202.16 due date or the date of the significant change, whichever is 202.17 later, or otherwise report significant changes which would 202.18 affect eligibility or assistance amounts, is considered to have 202.19 continued its application for assistance effective the date the 202.20 required report is received by the county agency, if a complete 202.21 report is received within a calendar month in which assistance 202.22 was received, except that no assistance shall be paid for the202.23period beginning with the end of the month in which the report202.24was due and ending with the date the report was received by the202.25county agency. 202.26 Sec. 9. Minnesota Statutes 1997 Supplement, section 202.27 256B.062, is amended to read: 202.28 256B.062 [CONTINUED ELIGIBILITY.] 202.29 Medical assistance may be paid for persons who received aid 202.30 to families with dependent children in at least three of the six 202.31 months preceding the month in which the person became ineligible 202.32 for aid to families with dependent children, if the 202.33 ineligibility was due to an increase in hours of employment or 202.34 employment income or due to the loss of an earned income 202.35 disregard. A person who is eligible for extended medical 202.36 assistance is entitled to six months of assistance without 203.1 reapplication, unless the assistance unit ceases to include a 203.2 dependent child. For a person under 21 years of age, medical 203.3 assistance may not be discontinued within the six-month period 203.4 of extended eligibility until it has been determined that the 203.5 person is not otherwise eligible for medical assistance. 203.6 Medical assistance may be continued for an additional six months 203.7 if the person meets all requirements for the additional six 203.8 months, according to Title XIX of the Social Security Act, as 203.9 amended by section 303 of the Family Support Act of 1988, Public 203.10 Law Number 100-485. This section is repealed effectiveMarch 31203.11 July 1, 1998. 203.12 Sec. 10. Minnesota Statutes 1997 Supplement, section 203.13 256D.05, subdivision 8, is amended to read: 203.14 Subd. 8. [CITIZENSHIP.] (a) Effective July 1, 1997, 203.15 citizenship requirements for applicants and recipients under 203.16 sections 256D.01 to 256D.03, subdivision 2, and 256D.04 to 203.17 256D.21 shall be determined the same as under section 256J.11,203.18except that legal noncitizens who are applicants or recipients203.19must have been residents of Minnesota on March 1, 1997. Legal203.20noncitizens who arrive in Minnesota after March 1, 1997, and203.21become elderly or disabled after that date, and are otherwise203.22eligible for general assistance can receive benefits under this203.23section. The income and assets of sponsors of noncitizens shall 203.24 be deemed available to general assistance applicants and 203.25 recipients according to the Personal Responsibility and Work 203.26 Opportunity Reconciliation Act of 1996, Public Law Number 203.27 104-193, title IV, sections 421 and 422, and subsequently set 203.28 out in federal rules. 203.29 (b) As a condition of eligibility, each legal adult 203.30 noncitizen in the assistance unit who has resided in the country 203.31 for four years or more and who is under 70 years of age must: 203.32 (1) be enrolled in a literacy class, English as a second 203.33 language class, or a citizen class; 203.34 (2) be applying for admission to a literacy class, English 203.35 as a second language class, and is on a waiting list; 203.36 (3) be in the process of applying for a waiver from the 204.1 Immigration and Naturalization Service of the English language 204.2 or civics requirements of the citizenship test; 204.3 (4) have submitted an application for citizenship to the 204.4 Immigration and Naturalization Service and is waiting for a 204.5 testing date or a subsequent swearing in ceremony; or 204.6 (5) have been denied citizenship due to a failure to pass 204.7 the test after two attempts or because of an inability to 204.8 understand the rights and responsibilities of becoming a United 204.9 States citizen, as documented by the Immigration and 204.10 Naturalization Service or the county. 204.11 If the county social service agency determines that a legal 204.12 noncitizen subject to the requirements of this subdivision will 204.13 require more than one year of English language training, then 204.14 the requirements of clause (1) or (2) shall be imposed after the 204.15 legal noncitizen has resided in the country for three years. 204.16 Individuals who reside in a facility licensed under chapter 204.17 144A, 144D, 245A, or 256I are exempt from the requirements of 204.18 this section. 204.19 Sec. 11. Minnesota Statutes 1996, section 256D.051, is 204.20 amended by adding a subdivision to read: 204.21 Subd. 19. [WAIVER OF SERVICE COST REIMBURSEMENT LIMIT FOR 204.22 PARTICIPANTS WITH SIGNIFICANT BARRIERS TO EMPLOYMENT.] To the 204.23 extent of available resources, the commissioner may waive the 204.24 $400 service cost limit specified in subdivision 6 for county 204.25 agencies that propose to provide enhanced services under the 204.26 food stamp employment and training program for hard-to-employ 204.27 individuals. A "hard-to-employ individual" is defined as: 204.28 (1) a recipient of general assistance under chapter 256D; 204.29 or 204.30 (2) an individual with at least two of the following three 204.31 barriers to employment: 204.32 (i) the individual has not completed secondary school or 204.33 obtained a certificate of general equivalency, and has low 204.34 skills in reading or mathematics; 204.35 (ii) the individual requires substance abuse treatment for 204.36 employment; and 205.1 (iii) the individual has a poor work history. 205.2 To obtain a waiver, the county agency must submit a waiver 205.3 request to the commissioner. The request must specify: 205.4 (1) the number of hard-to-employ individuals the agency 205.5 plans to serve; and 205.6 (2) the nature of the enhanced employment and training 205.7 services the agency will provide. 205.8 Sec. 12. [256D.053] [MINNESOTA FOOD ASSISTANCE PROGRAM.] 205.9 Subdivision 1. [PROGRAM ESTABLISHED.] For the period of 205.10 July 1, 1998, to June 30, 1999, the Minnesota food assistance 205.11 program is established to provide food assistance to legal 205.12 noncitizens residing in this state who are ineligible to 205.13 participate in the federal Food Stamp Program solely due to the 205.14 provisions of section 402 or 403 of Public Law Number 104-193, 205.15 as authorized by Title VII of the 1997 Emergency Supplemental 205.16 Appropriations Act, Public Law Number 105-18. 205.17 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 205.18 the Minnesota food assistance program, all of the following 205.19 conditions must be met: 205.20 (1) the applicant must meet the initial and ongoing 205.21 eligibility requirements for the federal Food Stamp Program, 205.22 except for the applicant's ineligible immigration status; 205.23 (2) the applicant must be either a qualified noncitizen as 205.24 defined in section 256J.08, subdivision 73, or a noncitizen 205.25 otherwise residing lawfully in the United States; 205.26 (3) the applicant must be a resident of the state; and 205.27 (4) the applicant must not be receiving assistance under 205.28 the MFIP-S or the work first program. 205.29 Subd. 3. [PROGRAM ADMINISTRATION.] (a) The rules for the 205.30 Minnesota food assistance program shall follow exactly the 205.31 regulations for the federal Food Stamp Program, except for the 205.32 provisions pertaining to immigration status under sections 402 205.33 or 403 of Public Law Number 104-193. 205.34 (b) The county agency shall use the income, budgeting, and 205.35 benefit allotment regulations of the federal Food Stamp Program 205.36 to calculate an eligible recipient's monthly Minnesota food 206.1 assistance program benefit. Until September 30, 1998, eligible 206.2 recipients under this subdivision shall receive the average per 206.3 person food stamp issuance in Minnesota in the fiscal year 206.4 ending June 30, 1997. Beginning October 1, 1998, eligible 206.5 recipients shall receive the same level of benefits as those 206.6 provided by the federal Food Stamp Program to similarly situated 206.7 citizen recipients. The monthly Minnesota food assistance 206.8 program benefits shall not exceed an amount equal to the amount 206.9 of federal Food Stamp Program benefits the household would 206.10 receive if all members of the household were eligible for the 206.11 federal Food Stamp Program. 206.12 (c) Minnesota food assistance program benefits must be 206.13 disregarded as income in all programs that do not count food 206.14 stamps as income. 206.15 (d) The county agency must redetermine a Minnesota food 206.16 assistance program recipient's eligibility for the federal Food 206.17 Stamp Program when the agency receives information that the 206.18 recipient's legal immigration status has changed in such a way 206.19 that would make the recipient potentially eligible for the 206.20 federal Food Stamp Program. 206.21 (e) Until October 1, 1998, the commissioner may provide 206.22 benefits under this section in cash. 206.23 Subd. 4. [STATE PLAN REQUIRED.] The commissioner shall 206.24 submit a state plan to the secretary of agriculture to allow the 206.25 commissioner to purchase federal Food Stamp Program benefits for 206.26 each Minnesota food assistance program recipient who is 206.27 ineligible to participate in the federal Food Stamp Program 206.28 solely due to the provisions of section 402 or 403 of Public Law 206.29 Number 104-193, as authorized by Title VII of the 1997 Emergency 206.30 Supplemental Appropriations Act, Public Law Number 105-18. The 206.31 commissioner shall enter into a contract as necessary with the 206.32 secretary to use the existing federal Food Stamp Program 206.33 benefits delivery system for the purposes of administering the 206.34 Minnesota food assistance program under this section. 206.35 Sec. 13. Minnesota Statutes 1996, section 256D.46, 206.36 subdivision 2, is amended to read: 207.1 Subd. 2. [INCOME AND RESOURCE TEST.] All income and 207.2 resources available to the recipient must be considered in 207.3 determining the recipient's ability to meet the emergency need. 207.4 Property that can be liquidated in time to resolve the emergency 207.5 and income,(excludingMinnesota supplemental aid issued for207.6current month's need)an amount equal to the Minnesota 207.7 supplemental aid standard of assistance, that is normally 207.8 disregarded or excluded under the Minnesota supplemental aid 207.9 program must be considered available to meet the emergency need. 207.10 Sec. 14. Minnesota Statutes 1997 Supplement, section 207.11 256J.02, subdivision 4, is amended to read: 207.12 Subd. 4. [AUTHORITY TO TRANSFER.] Subject to limitations 207.13 of title I of Public Law Number 104-193, the Personal 207.14 Responsibility and Work Opportunity Reconciliation Act of 207.15 1996, as amended, the legislature may transfer money from the 207.16 TANF block grant to the child care fund under chapter 119B, or 207.17 the Title XX block grant under section 256E.07. 207.18 Sec. 15. Minnesota Statutes 1997 Supplement, section 207.19 256J.03, is amended to read: 207.20 256J.03 [TANF RESERVE ACCOUNT.] 207.21 Subdivision 1. TheMinnesota family investment207.22program-statewide/TANFTANF reserve account is created in the 207.23 state treasury. Funds retained or deposited in the TANF reserve 207.24 shall include: (1) funds designated by the legislatureand; (2) 207.25 unexpended state funds resulting from the acceleration of TANF 207.26 expenditures under subdivision 2; (3) earnings available from 207.27 the federal TANF block grant appropriated to the commissioner 207.28 but not expended in the biennium beginning July 1, 1997, shall207.29be retained; and (4) TANF funds available in fiscal years 1998, 207.30 1999, 2000, and 2001 that are not spent or not budgeted to be 207.31 spent in those years. 207.32 Funds deposited in the reserve accounttomust be expended 207.33 for the Minnesota family investment program-statewidein fiscal207.34year 2000 and subsequent fiscal yearsand directly related state 207.35 programs for the purposes in subdivision 3. 207.36 Subd. 2. [AUTHORIZATION TO ACCELERATE EXPENDITURE OF TANF 208.1 FUNDS.] The commissioner may expend federal TANF block grant 208.2 funds in excess of appropriated levels for the purpose of 208.3 accelerating federal funding of the MFIP program. By the end of 208.4 the fiscal year in which the additional federal expenditures are 208.5 made, the commissioner must deposit into the reserve account an 208.6 amount of unexpended state funds appropriated for assistance to 208.7 families grants, AFDC, and MFIP equal to the additional federal 208.8 expenditures. Reserve funds may be spent as TANF appropriations 208.9 if insufficient TANF funds are available because of acceleration. 208.10 Subd. 3. [ALLOWED TRANSFER PURPOSE.] Funds from the 208.11 reserve account may be used for the following purposes: 208.12 (1) unanticipated TANF block grant maintenance of effort 208.13 shortfalls; 208.14 (2) MFIP cost increases due to reduced federal revenues and 208.15 federal law changes; 208.16 (3) one-half of the MFIP general fund cost increase in 208.17 fiscal year 2000 and subsequent fiscal years due to caseload 208.18 increases over fiscal year 1999; and 208.19 (4) transfers allowed under section 256J.02, subdivision 4. 208.20 Sec. 16. Minnesota Statutes 1997 Supplement, section 208.21 256J.08, subdivision 11, is amended to read: 208.22 Subd. 11. [CAREGIVER.] "Caregiver" means a minor child's 208.23 natural or adoptive parent or parents and stepparent who live in 208.24 the home with the minor child. For purposes of determining 208.25 eligibility for this program, caregiver also means any of the 208.26 following individuals, if adults, who live with and provide care 208.27 and support to a minor child when the minor child's natural or 208.28 adoptive parent or parents or stepparents do not reside in the 208.29 same home: legalcustodianscustodian or guardian, grandfather, 208.30 grandmother, brother, sister,stepfather, stepmother,208.31 stepbrother, stepsister, uncle, aunt, first cousin, nephew, 208.32 niece, person of preceding generation as denoted by prefixes of 208.33 "great," "great-great," or "great-great-great," or a spouse of 208.34 any person named in the above groups even after the marriage 208.35 ends by death or divorce. 208.36 Sec. 17. Minnesota Statutes 1997 Supplement, section 209.1 256J.08, is amended by adding a subdivision to read: 209.2 Subd. 24a. [DISQUALIFIED.] "Disqualified" means being 209.3 ineligible to receive MFIP-S due to noncooperation with program 209.4 requirements. Except for persons whose disqualification is 209.5 based on fraud, a disqualified person can take action to correct 209.6 the reason for ineligibility. 209.7 Sec. 18. Minnesota Statutes 1997 Supplement, section 209.8 256J.08, subdivision 26, is amended to read: 209.9 Subd. 26. [EARNED INCOME.] "Earned income" means cash or 209.10 in-kind income earned through the receipt of wages, salary, 209.11 commissions, profit from employment activities, net profit from 209.12 self-employment activities, payments made by an employer for 209.13 regularly accrued vacation or sick leave, and any other profit 209.14 from activity earned through effort or labor. The income must 209.15 be in return for, or as a result of, legal activity. 209.16 Sec. 19. Minnesota Statutes 1997 Supplement, section 209.17 256J.08, subdivision 28, is amended to read: 209.18 Subd. 28. [EMERGENCY.] "Emergency" means a situation or a 209.19 set of circumstances that causes or threatens to cause 209.20 destitution to aminor childfamily with a child under age 21. 209.21 Sec. 20. Minnesota Statutes 1997 Supplement, section 209.22 256J.08, subdivision 40, is amended to read: 209.23 Subd. 40. [GROSS EARNED INCOME.] "Gross earned income" 209.24 means earned income from employment before mandatory and 209.25 voluntary payroll deductions. Gross earned income includes 209.26 salaries, wages, tips, gratuities, commissions, incentive 209.27 payments from work or training programs, payments made by an 209.28 employer for regularly accrued vacation or sick leave, and 209.29 profits from other activity earned by an individual's effort or 209.30 labor. Gross earned income includes uniform and meal allowances 209.31 if federal income tax is deducted from the allowance. Gross 209.32 earned income includes flexible work benefits received from an 209.33 employer if the employee has the option of receiving the benefit 209.34 or benefits in cash. For self-employment, gross earned income 209.35 is the nonexcluded income minus expenses for the business. 209.36 Sec. 21. Minnesota Statutes 1997 Supplement, section 210.1 256J.08, is amended by adding a subdivision to read: 210.2 Subd. 50a. [INTERSTATE TRANSITIONAL STANDARD.] "Interstate 210.3 transitional standard" means a combination of the cash 210.4 assistance a family with no other income would have received in 210.5 the state of previous residence and the Minnesota food portion 210.6 for the appropriate size family. 210.7 Sec. 22. Minnesota Statutes 1997 Supplement, section 210.8 256J.08, is amended by adding a subdivision to read: 210.9 Subd. 51a. [LEGAL CUSTODIAN.] "Legal custodian" means any 210.10 person who is under a legal obligation to provide care for a 210.11 minor and who is in fact providing care for a minor. For an 210.12 Indian child, "custodian" means any Indian person who has legal 210.13 custody of an Indian child under tribal law or custom, under 210.14 state law, or to whom temporary physical care, custody, and 210.15 control has been transferred by the parent of the child, as 210.16 provided in section 257.351, subdivision 8. 210.17 Sec. 23. Minnesota Statutes 1997 Supplement, section 210.18 256J.08, subdivision 60, is amended to read: 210.19 Subd. 60. [MINOR CHILD.] "Minor child" means a child who 210.20 is living in the same home of a parent or other caregiver, is 210.21 not the parent of a child in the home, and is either less than 210.22 18 years of age or is under the age of 19 years and isregularly210.23attending asa full-time studentand is expected to complete a210.24high school orin a secondary school or pursuing a full-time 210.25 secondary level course of vocational or technical training 210.26 designed to fit students for gainful employmentbefore reaching210.27age 19. 210.28 Sec. 24. Minnesota Statutes 1997 Supplement, section 210.29 256J.08, is amended by adding a subdivision to read: 210.30 Subd. 61a. [NONCUSTODIAL PARENT.] "Noncustodial parent" 210.31 means a minor child's parent who does not live in the same home 210.32 as the child. 210.33 Sec. 25. Minnesota Statutes 1997 Supplement, section 210.34 256J.08, subdivision 68, is amended to read: 210.35 Subd. 68. [PERSONAL PROPERTY.] "Personal property" means 210.36 an item of value that is not real property, including the value 211.1 of a contract for deed held by a seller, assets held in trust on 211.2 behalf of members of an assistance unit,cash surrender value of211.3life insurance,value of a prepaid burial, savings account, 211.4 value of stocks and bonds, and value of retirement accounts. 211.5 Sec. 26. Minnesota Statutes 1997 Supplement, section 211.6 256J.08, subdivision 73, is amended to read: 211.7 Subd. 73. [QUALIFIED NONCITIZEN.] "Qualified noncitizen" 211.8 means a person: 211.9 (1) who was lawfully admitted for permanent residence 211.10 pursuant to United States Code, title 8; 211.11 (2) who was admitted to the United States as a refugee 211.12 pursuant to United States Code, title 8; section 1157; 211.13 (3) whose deportation is being withheld pursuant to United 211.14 States Code, title 8, section 1253(h); 211.15 (4) who was paroled for a period of at least one year 211.16 pursuant to United States Code, title 8, section 1182(d)(5); 211.17 (5) who was granted conditional entry pursuant to United 211.18 State Code, title 8, section 1153(a)(7); 211.19 (6) who was granted asylum pursuant to United States Code, 211.20 title 8, section 1158;or211.21 (7) determined to be a battered noncitizen by the United 211.22 States Attorney General according to the Illegal Immigration 211.23 Reform and Immigrant Responsibility Act of 1996, Title V of the 211.24 Omnibus Consolidated Appropriations Bill, Public Law Number 211.25 104-208; or 211.26 (8) who was admitted as a Cuban or Haitian entrant. 211.27 Sec. 27. Minnesota Statutes 1997 Supplement, section 211.28 256J.08, is amended by adding a subdivision to read: 211.29 Subd. 82a. [SHELTER COSTS.] "Shelter costs" means rent, 211.30 manufactured home lot rental costs, or monthly principal, 211.31 interest, insurance premiums, and property taxes due for 211.32 mortgages or contracts for deed. 211.33 Sec. 28. Minnesota Statutes 1997 Supplement, section 211.34 256J.08, subdivision 83, is amended to read: 211.35 Subd. 83. [SIGNIFICANT CHANGE.] "Significant change" means 211.36 a decline in gross income of3536 percent or more from the 212.1 income used to determine the grant for the current month. 212.2 Sec. 29. Minnesota Statutes 1997 Supplement, section 212.3 256J.09, subdivision 6, is amended to read: 212.4 Subd. 6. [INVALID REASON FOR DELAY.] A county agency must 212.5 not delay a decision on eligibility or delay issuing the 212.6 assistance payment except to establish state residence as 212.7 provided in section 256J.12 by: 212.8 (1) treating the 30-day processing period as a waiting 212.9 period; 212.10 (2) delaying approval or issuance of the assistance payment 212.11 pending the decision of the county board; or 212.12 (3) awaiting the result of a referral to a county agency in 212.13 another county when the county receiving the application does 212.14 not believe it is the county of financial responsibility. 212.15 Sec. 30. Minnesota Statutes 1997 Supplement, section 212.16 256J.09, subdivision 9, is amended to read: 212.17 Subd. 9. [ADDENDUM TO AN EXISTING APPLICATION.] (a) An 212.18 addendum to an existing application must be used to add persons 212.19 to an assistance unit regardless of whether the persons being 212.20 added are required to be in the assistance unit. When a person 212.21 is added by addendum to an assistance unit, eligibility for that 212.22 person begins on the first of the month the addendum was filed 212.23 except as provided in section 256J.74, subdivision 2, clause (1). 212.24 (b) An overpayment must be determined when a change in 212.25 household composition is not reported within the deadlines in 212.26 section 256J.30, subdivision 9. Any overpayment must be 212.27 calculated from the month of the change including the needs, 212.28 income, and assets of any individual who is required to be 212.29 included in the assistance unit under section 256J.24, 212.30 subdivision 2. Individuals not included in the assistance unit 212.31 who are identified in section 256J.37, subdivisions 1 to 2, must 212.32 have their income and assets considered when determining the 212.33 amount of the overpayment. 212.34 Sec. 31. Minnesota Statutes 1997 Supplement, section 212.35 256J.11, subdivision 2, as amended by Laws 1997, Third Special 212.36 Session chapter 1, is amended to read: 213.1 Subd. 2. [NONCITIZENS; FOOD PORTION.] (a) For the period 213.2 September 1, 1997, to October 31, 1997, noncitizens who do not 213.3 meet one of the exemptions in section 412 of the Personal 213.4 Responsibility and Work Opportunity Reconciliation Act of 1996, 213.5 but were residing in this state as of July 1, 1997, are eligible 213.6 for the 6/10 of the average value of food stamps for the same 213.7 family size and composition until MFIP-S is operative in the 213.8 noncitizen's county of financial responsibility and thereafter, 213.9 the 6/10 of the food portion of MFIP-S. However, federal food 213.10 stamp dollars cannot be used to fund the food portion of MFIP-S 213.11 benefits for an individual under this subdivision. 213.12 (b) For the period November 1, 1997, to June 30,19981999, 213.13 noncitizens who do not meet one of the exemptions in section 412 213.14 of the Personal Responsibility and Work Opportunity 213.15 Reconciliation Act of 1996,but were residing in this state as213.16of July 1, 1997,and are receiving cash assistance under the 213.17 AFDC, family general assistance, MFIP or MFIP-S programs are 213.18 eligible for the average value of food stamps for the same 213.19 family size and composition until MFIP-S is operative in the 213.20 noncitizen's county of financial responsibility and thereafter, 213.21 the food portion of MFIP-S. However, federal food stamp dollars 213.22 cannot be used to fund the food portion of MFIP-S benefits for 213.23 an individual under this subdivision. The assistance provided 213.24 under this subdivision, which is designated as a supplement to 213.25 replace lost benefits under the federal food stamp program, must 213.26 be disregarded as income in all programs that do not count food 213.27 stamps as income where the commissioner has the authority to 213.28 make the income disregard determination for the program. 213.29 (c) The commissioner shall submit a state plan to the 213.30 secretary of agriculture to allow the commissioner to purchase 213.31 federal Food Stamp Program benefits in an amount equal to the 213.32 MFIP-S food portion for each legal noncitizen receiving MFIP-S 213.33 assistance who is ineligible to participate in the federal Food 213.34 Stamp Program solely due to the provisions of section 402 or 403 213.35 of Public Law Number 104-193, as authorized by Title VII of the 213.36 1997 Emergency Supplemental Appropriations Act, Public Law 214.1 Number 105-18. The commissioner shall enter into a contract as 214.2 necessary with the secretary to use the existing federal Food 214.3 Stamp Program benefits delivery system for the purposes of 214.4 administering the food portion of MFIP-S under this subdivision. 214.5 Sec. 32. Minnesota Statutes 1997 Supplement, section 214.6 256J.12, is amended to read: 214.7 256J.12 [MINNESOTA RESIDENCE.] 214.8 Subdivision 1. [SIMPLE RESIDENCY.] To be eligible for AFDC 214.9 or MFIP-S, whichever is in effect,a familyan assistance unit 214.10 must have established residency in this state which means 214.11 thefamilyassistance unit is present in the state and intends 214.12 to remain here. A person who lives in this state and who 214.13 entered this state with a job commitment or to seek employment 214.14 in this state, whether or not that person is currently employed, 214.15 meets the criteria in this subdivision. 214.16 Subd. 1a. [30-DAY RESIDENCY REQUIREMENT.]A familyAn 214.17 assistance unit is considered to have established residency in 214.18 this state only when a child or caregiver has resided in this 214.19 state for at least 30 days with the intention of making the 214.20 person's home here and not for any temporary purpose. The birth 214.21 of a child in Minnesota to a member of the assistance unit does 214.22 not automatically meet the 30-day residency requirement for the 214.23 members of the assistance unit. Time spent in a shelter for 214.24 battered women shall count toward satisfying the 30-day 214.25 residency requirement. 214.26 Subd. 2. [EXCEPTIONS.] (a) A county shall waive the 30-day 214.27 residency requirement where unusual hardship would result from 214.28 denial of assistance. 214.29 (b) For purposes of this section, unusual hardship meansa214.30familyan assistance unit: 214.31 (1) is without alternative shelter; or 214.32 (2) is without available resources for food. 214.33 (c) For purposes of this subdivision, the following 214.34 definitions apply (1) "metropolitan statistical area" is as 214.35 defined by the U.S. Census Bureau; (2) "alternative shelter" 214.36 includes any shelter that is located within the metropolitan 215.1 statistical area containing the county and for which the family 215.2 is eligible, provided thefamilyassistance unit does not have 215.3 to travel more than 20 miles to reach the shelter and has access 215.4 to transportation to the shelter. Clause (2) does not apply to 215.5 counties in the Minneapolis-St. Paul metropolitan statistical 215.6 area. 215.7 (d) Applicants meet the residency requirement if they once 215.8 resided in Minnesota and: 215.9 (1) joined the United States armed services, returned to 215.10 Minnesota within 30 days of leaving the armed services, and 215.11 intend to remain in Minnesota; or 215.12 (2) left to attend school in another state, paid 215.13 nonresident tuition or Minnesota tuition rates under a 215.14 reciprocity agreement, and returned to Minnesota within 30 days 215.15 of graduation with the intent to remain in Minnesota. 215.16 (e) The 30-day residence requirement is met when: 215.17 (1) a minor child or a minor caregiver moves from another 215.18 state to the residence of a relative caregiver; 215.19 (2) the minor caregiver applies for and receives family 215.20 cash assistance; 215.21 (3) the relative caregiver chooses not to be part of the 215.22 MFIP-S assistance unit; and 215.23 (4) the relative caregiver has resided in Minnesota for at 215.24 least 30 days prior to the date the assistance unit applies for 215.25 cash assistance. 215.26 (f) Ineligible mandatory unit members who have resided in 215.27 Minnesota for 12 months immediately before the date of 215.28 application meet eligibility for the Minnesota payment standard 215.29 for the other assistance unit members. 215.30 Subd. 2a. [MIGRANT WORKERS.] Migrant workers, as defined 215.31 in section 256J.08, and their immediate families are exempt from 215.32 the requirements of subdivisions 1 and 1a, provided the migrant 215.33 worker provides verification that the migrant family worked in 215.34 this state within the last 12 months and earned at least $1,000 215.35 in gross wages during the time the migrant worker worked in this 215.36 state. 216.1 Subd. 3. [PAYMENT PLAN FOR NEW RESIDENTS.] Assistance paid 216.2 to an eligiblefamilyassistance unit in which all members have 216.3 resided in this state for fewer than 12 consecutive calendar 216.4 months immediately preceding the date of application shall be at 216.5 the standard and in the form specified in section 256J.43. 216.6 Subd. 4. [SEVERABILITY CLAUSE.] If any subdivision in this 216.7 section is enjoined from implementation or found 216.8 unconstitutional by any court of competent jurisdiction, the 216.9 remaining subdivisions shall remain valid and shall be given 216.10 full effect. 216.11 Sec. 33. Minnesota Statutes 1997 Supplement, section 216.12 256J.14, is amended to read: 216.13 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 216.14 (a) The definitions in this paragraph only apply to this 216.15 subdivision. 216.16 (1) "Household of a parent, legal guardian, or other adult 216.17 relative" means the place of residence of: 216.18 (i) a natural or adoptive parent; 216.19 (ii) a legal guardian according to appointment or 216.20 acceptance under section 260.242, 525.615, or 525.6165, and 216.21 related laws;or216.22 (iii) a caregiver as defined in section 256J.08, 216.23 subdivision 11; or 216.24 (iv) an appropriate adult relative designated by a county 216.25 agency. 216.26 (2) "Adult-supervised supportive living arrangement" means 216.27 a private family setting which assumes responsibility for the 216.28 care and control of the minor parent and minor child, or other 216.29 living arrangement, not including a public institution, licensed 216.30 by the commissioner of human services which ensures that the 216.31 minor parent receives adult supervision and supportive services, 216.32 such as counseling, guidance, independent living skills 216.33 training, or supervision. 216.34 (b) A minor parent and the minor child who is in the care 216.35 of the minor parent must reside in the household of a parent, 216.36 legal guardian, otherappropriateadult relative,or other217.1caregiver,or in an adult-supervised supportive living 217.2 arrangement in order to receive MFIP-S unless: 217.3 (1) the minor parent has no living parent, other 217.4appropriateadult relative, or legal guardian whose whereabouts 217.5 is known; 217.6 (2) no living parent, otherappropriateadult relative, or 217.7 legal guardian of the minor parent allows the minor parent to 217.8 live in the parent's,appropriateother adult relative's, or 217.9 legal guardian's home; 217.10 (3) the minor parent lived apart from the minor parent's 217.11 own parent or legal guardian for a period of at least one year 217.12 before either the birth of the minor child or the minor parent's 217.13 application for MFIP-S; 217.14 (4) the physical or emotional health or safety of the minor 217.15 parent or minor child would be jeopardized if the minor parent 217.16 and the minor child resided in the same residence with the minor 217.17 parent's parent, otherappropriateadult relative, or legal 217.18 guardian; or 217.19 (5) an adult supervised supportive living arrangement is 217.20 not available for the minor parent andthe dependentchild in 217.21 the county in which the minor parent and child currentlyresides217.22 reside. If an adult supervised supportive living arrangement 217.23 becomes available within the county, the minor parent and child 217.24 must reside in that arrangement. 217.25 (c) Minor applicants must be informed orally and in writing 217.26 about the eligibility requirements and their rights and 217.27 obligations under the MFIP-S program. The county must advise 217.28 the minor of the possible exemptions and specifically ask 217.29 whether one or more of these exemptions is applicable. If the 217.30 minor alleges one or more of these exemptions, then the county 217.31 must assist the minor in obtaining the necessary verifications 217.32 to determine whether or not these exemptions apply. 217.33 (d) If the county worker has reason to suspect that the 217.34 physical or emotional health or safety of the minor parent or 217.35 minor child would be jeopardized if they resided with the minor 217.36 parent's parent, other adult relative, or legal guardian, then 218.1 the county worker must make a referral to child protective 218.2 services to determine if paragraph (b), clause (4), applies. A 218.3 new determination by the county worker is not necessary if one 218.4 has been made within the last six months, unless there has been 218.5 a significant change in circumstances which justifies a new 218.6 referral and determination. 218.7 (e) If a minor parent is not living with a parentor, legal 218.8 guardian, or other adult relative due to paragraph (b), clause 218.9 (1), (2), or (4), the minor parent must reside, when possible, 218.10 in a living arrangement that meets the standards of paragraph 218.11 (a), clause (2). 218.12 (f) When a minor parent and minor child live withanothera 218.13 parent, other adult relative, legal guardian, or in an 218.14 adult-supervised supportive living arrangement, MFIP-S must be 218.15 paid, when possible, in the form of a protective payment on 218.16 behalf of the minor parent and minor childin accordance with218.17 according to section 256J.39, subdivisions 2 to 4. 218.18 Sec. 34. Minnesota Statutes 1997 Supplement, section 218.19 256J.15, subdivision 2, is amended to read: 218.20 Subd. 2. [ELIGIBILITY DURING LABOR DISPUTES.]To receive218.21assistance under MFIP-S, a member of an assistance unit who is218.22on strike must have been an MFIP-S participant on the day before218.23the strike, or have been eligible for MFIP-S on the day before218.24the strike.218.25The county agency must count the striker's prestrike218.26earnings as current earnings. When a member of an assistance218.27unit who is not in the bargaining unit that voted for the strike218.28does not cross the picket line for fear of personal injury, the218.29assistance unit member is not a striker. Except for a member of218.30an assistance unit who is not in the bargaining unit that voted218.31for the strike and who does not cross the picket line for fear218.32of personal injury, a significant change cannot be invoked as a218.33result of a labor dispute.To receive assistance when a member 218.34 of an assistance unit is on strike, or when an individual 218.35 identified in section 256J.37, subdivisions 1 to 2, whose income 218.36 and assets must be considered when determining eligibility for 219.1 the unit is on strike, the assistance unit must have been 219.2 receiving or been eligible for MFIP-S on the day before the 219.3 strike. The county agency must count the striker's prestrike 219.4 earnings as current earnings. A significant change cannot be 219.5 invoked when a member of an assistance unit, or an individual 219.6 identified in section 256J.37, subdivisions 1 to 2, is on 219.7 strike. A member of an assistance unit, or an individual 219.8 identified in section 256J.37, subdivisions 1 and 2, is not 219.9 considered a striker when that person is not in the bargaining 219.10 unit that voted for the strike and does not cross the picket 219.11 line for fear of personal injury. 219.12 Sec. 35. Minnesota Statutes 1997 Supplement, section 219.13 256J.20, subdivision 2, is amended to read: 219.14 Subd. 2. [REAL PROPERTY LIMITATIONS.] Ownership of real 219.15 property by an applicant or participant is subject to the 219.16 limitations in paragraphs (a) and (b). 219.17 (a) A county agency shall exclude the homestead of an 219.18 applicant or participant according to clauses (1) to(4)(5): 219.19 (1) an applicant or participant who is purchasing real 219.20 property through a contract for deed and using that property as 219.21 a home is considered the owner of real property; 219.22 (2) the total amount of land that can be excluded under 219.23 this subdivision is limited to surrounding property which is not 219.24 separated from the home by intervening property owned by 219.25 others. Additional property must be assessed as to its legal 219.26 and actual availability according to subdivision 1; 219.27 (3) when real property that has been used as a home by a 219.28 participant is sold, the county agency must treat the cash 219.29 proceeds from the sale as excluded property for six months when 219.30 the participant intends to reinvest the proceeds in another home 219.31 and maintains those proceeds, unused for other purposes, in a 219.32 separate account;and219.33 (4) when the homestead is jointly owned, but the client 219.34 does not reside in it because of legal separation, pending 219.35 divorce, or battering or abuse by the spouse or partner, the 219.36 homestead is excluded; and 220.1 (5) the homestead shall continue to be excluded if it is 220.2 temporarily unoccupied due to employment, illness, or a 220.3 county-approved employability plan. The education, training, or 220.4 job search must be within the state, but can be outside the 220.5 immediate geographic area. A homestead temporarily unoccupied 220.6 because it is not habitable due to a casualty or natural 220.7 disaster is excluded. The homestead is excluded during periods 220.8 only if the client intends to return to it. 220.9 (b) The equity value of real property that is not excluded 220.10 under paragraph (a) and which is legally available must be 220.11 applied against the limits in subdivision 3. When the equity 220.12 value of the real property exceeds the limits under subdivision 220.13 3, the applicant or participant may qualify to receive 220.14 assistance when the applicant or participant continues to make a 220.15 good faith effort to sell the property and signs a legally 220.16 binding agreement to repay the amount of assistance, less child 220.17 support collected by the agency. Repayment must be made within 220.18 five working days after the property is sold. Repayment to the 220.19 county agency must be in the amount of assistance received or 220.20 the proceeds of the sale, whichever is less. 220.21 Sec. 36. Minnesota Statutes 1997 Supplement, section 220.22 256J.20, subdivision 3, is amended to read: 220.23 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 220.24 MFIP-S, the equity value of all nonexcluded real and personal 220.25 property of the assistance unit must not exceed $2,000 for 220.26 applicants and $5,000 for ongoingrecipientsparticipants. The 220.27 value of assets in clauses (1) to (18) must be excluded when 220.28 determining the equity value of real and personal property: 220.29 (1) a licensedvehiclesvehicle up to atotal marketloan 220.30 value of less than or equal to $7,500. The county agency shall 220.31 apply any excessmarketloan value as if it were equity value to 220.32 the asset limit described in this section. If the assistance 220.33 unit owns more than one licensed vehicle, the county agency 220.34 shall determine the vehicle with the highestmarketloan value 220.35 and count only themarketloan value over $7,500. The county 220.36 agency shall count themarketloan value of all other vehicles 221.1 and apply this amount as if it were equity value to the asset 221.2 limit described in this section. The value of special equipment 221.3 for a handicapped member of the assistance unit is excluded. To 221.4 establish themarketloan value of vehicles, a county agency 221.5 must use the N.A.D.A. Official Used Car Guide, Midwest Edition, 221.6 for newer model cars.The N.A.D.A. Official Used Car Guide,221.7Midwest Edition, is incorporated by reference.When a vehicle 221.8 is not listed in the guidebook, or when the applicant or 221.9 participant disputes the loan value listed in the guidebook as 221.10 unreasonable given the condition of the particular vehicle, the 221.11 county agency may require the applicant or participantto221.12 document the loan value by securing a written statement from a 221.13 motor vehicle dealer licensed under section 168.27, stating the 221.14 amount that the dealer would pay to purchase the vehicle. The 221.15 county agency shall reimburse the applicant or participant for 221.16 the cost of a written statement that documents a lower loan 221.17 value. If the loan value exceeds $7,500, the county agency 221.18 shall determine the equity value of the vehicle and exclude a 221.19 vehicle with a total equity value of less than or equal to 221.20 $7,500. "Equity value" is equal to loan value minus any 221.21 outstanding encumbrances; 221.22 (2) the value of life insurance policies for members of the 221.23 assistance unit; 221.24 (3) one burial plot per member of an assistance unit; 221.25 (4) the value of personal property needed to produce earned 221.26 income, including tools, implements, farm animals, inventory, 221.27 business loans, business checking and savings accounts used at 221.28 least annually and used exclusively for the operation of a 221.29 self-employment business, and any motor vehicles if the vehicles 221.30 are essential for the self-employment business; 221.31 (5) the value of personal property not otherwise specified 221.32 which is commonly used by household members in day-to-day living 221.33 such as clothing, necessary household furniture, equipment, and 221.34 other basic maintenance items essential for daily living; 221.35 (6) the value of real and personal property owned by a 221.36 recipient of Supplemental Security Income or Minnesota 222.1 supplemental aid; 222.2 (7) the value of corrective payments, but only for the 222.3 month in which the payment is received and for the following 222.4 month; 222.5 (8) a mobile home used by an applicant or participant as 222.6 the applicant's or participant's home; 222.7 (9) money in a separate escrow account that is needed to 222.8 pay real estate taxes or insurance and that is used for this 222.9 purpose; 222.10 (10) money held in escrow to cover employee FICA, employee 222.11 tax withholding, sales tax withholding, employee worker 222.12 compensation, business insurance, property rental, property 222.13 taxes, and other costs that are paid at least annually, but less 222.14 often than monthly; 222.15 (11) monthly assistanceand, emergency assistance, and 222.16 diversionary payments for the current month's needs; 222.17 (12) the value of school loans, grants, or scholarships for 222.18 the period they are intended to cover; 222.19 (13) payments listed in section 256J.21, subdivision 2, 222.20 clause (9), which are held in escrow for a period not to exceed 222.21 three months to replace or repair personal or real property; 222.22 (14) income received in a budget month through the end of 222.23 thebudgetpayment month; 222.24 (15) savings from earned income of a minor child or a minor 222.25 parent that are set aside in a separate account designated 222.26 specifically for future education or employment costs; 222.27 (16) the federal earned incometaxcreditand, Minnesota 222.28 working family credit, state and federal income tax refunds, 222.29 state homeowners' credit, and state renters' credit in the month 222.30 received and the following month; 222.31 (17) payments excluded under federal law as long as those 222.32 payments are held in a separate account from any nonexcluded 222.33 funds; and 222.34 (18) money received by a participant of the corps to career 222.35 program under section 84.0887, subdivision 2, paragraph (b), as 222.36 a postservice benefit under the federal Americorps Act. 223.1 Sec. 37. Minnesota Statutes 1997 Supplement, section 223.2 256J.21, is amended to read: 223.3 256J.21 [INCOME LIMITATIONS.] 223.4 Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP-S 223.5 eligibility, the county agency must evaluate income received by 223.6 members of an assistance unit, or by other persons whose income 223.7 is considered available to the assistance unit, and only count 223.8 income that is available to the member of the assistance unit. 223.9 Income is available if the individual has legal access to the 223.10 income. All payments, unless specifically excluded in 223.11 subdivision 2, must be counted as income. 223.12 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 223.13 excluded in determining a family's available income: 223.14 (1) payments for basic care, difficulty of care, and 223.15 clothing allowances received for providing family foster care to 223.16 children or adults under Minnesota Rules, parts 9545.0010 to 223.17 9545.0260 and 9555.5050 to 9555.6265, and payments received and 223.18 used for care and maintenance of a third-party beneficiary who 223.19 is not a household member; 223.20 (2) reimbursements for employment training received through 223.21 the Job Training Partnership Act, United States Code, title 29, 223.22 chapter 19, sections 1501 to 1792b; 223.23 (3) reimbursement for out-of-pocket expenses incurred while 223.24 performing volunteer services, jury duty, or employment; 223.25 (4) all educational assistance, except the county agency 223.26 must count graduate student teaching assistantships, 223.27 fellowships, and other similar paid work as earned income and, 223.28 after allowing deductions for any unmet and necessary 223.29 educational expenses, shall count scholarships or grants awarded 223.30 to graduate students that do not require teaching or research as 223.31 unearned income; 223.32 (5) loans, regardless of purpose, from public or private 223.33 lending institutions, governmental lending institutions, or 223.34 governmental agencies; 223.35 (6) loans from private individuals, regardless of purpose, 223.36 provided an applicant or participant documents that the lender 224.1 expects repayment; 224.2 (7)(i) stateand federalincome tax refunds; and 224.3 (ii) federal income tax refunds; 224.4 (8)state and(i) federal earned income credits; 224.5 (ii) Minnesota working family credits; 224.6 (iii) state homeowners' credits; 224.7 (iv) state renters' credits; and 224.8 (v) federal or state tax rebates; 224.9 (9) funds received for reimbursement, replacement, or 224.10 rebate of personal or real property when these payments are made 224.11 by public agencies, awarded by a court, solicited through public 224.12 appeal, or made as a grant by a federal agency, state or local 224.13 government, or disaster assistance organizations, subsequent to 224.14 a presidential declaration of disaster; 224.15 (10) the portion of an insurance settlement that is used to 224.16 pay medical, funeral, and burial expenses, or to repair or 224.17 replace insured property; 224.18 (11) reimbursements for medical expenses that cannot be 224.19 paid by medical assistance; 224.20 (12) payments by a vocational rehabilitation program 224.21 administered by the state under chapter 268A, except those 224.22 payments that are for current living expenses; 224.23 (13) in-kind income, including any payments directly made 224.24 by a third party to a provider of goods and services; 224.25 (14) assistance payments to correct underpayments, but only 224.26 for the month in which the payment is received; 224.27 (15) emergency assistance payments; 224.28 (16) funeral and cemetery payments as provided by section 224.29 256.935; 224.30 (17) nonrecurring cash gifts of $30 or less, not exceeding 224.31 $30 per participant in a calendar month; 224.32 (18) any form of energy assistance payment made through 224.33 Public Law Number 97-35, Low-Income Home Energy Assistance Act 224.34 of 1981, payments made directly to energy providers by other 224.35 public and private agencies, and any form of credit or rebate 224.36 payment issued by energy providers; 225.1 (19) Supplemental Security Income, including retroactive 225.2 payments; 225.3 (20) Minnesota supplemental aid, including retroactive 225.4 payments; 225.5 (21) proceeds from the sale of real or personal property; 225.6 (22) adoption assistance payments under section 259.67; 225.7 (23) state-funded family subsidy program payments made 225.8 under section 252.32 to help families care for children with 225.9 mental retardation or related conditions; 225.10 (24) interest payments and dividends from property that is 225.11 not excluded from and that does not exceed the asset limit; 225.12 (25) rent rebates; 225.13 (26) income earned by a minor caregiver or minor child who 225.14 is at least a half-time student in an approved secondary 225.15 education program; 225.16 (27) income earned by a caregiver under age 20 who is at 225.17 least a half-time student in an approved secondary education 225.18 program; 225.19 (28) MFIP-S child care payments under section 119B.05; 225.20 (29) all other payments made through MFIP-S to support a 225.21 caregiver's pursuit of greater self-support; 225.22 (30) income a participant receives related to shared living 225.23 expenses; 225.24 (31) reverse mortgages; 225.25 (32) benefits provided by the Child Nutrition Act of 1966, 225.26 United States Code, title 42, chapter 13A, sections 1771 to 225.27 1790; 225.28 (33) benefits provided by the women, infants, and children 225.29 (WIC) nutrition program, United States Code, title 42, chapter 225.30 13A, section 1786; 225.31 (34) benefits from the National School Lunch Act, United 225.32 States Code, title 42, chapter 13, sections 1751 to 1769e; 225.33 (35) relocation assistance for displaced persons under the 225.34 Uniform Relocation Assistance and Real Property Acquisition 225.35 Policies Act of 1970, United States Code, title 42, chapter 61, 225.36 subchapter II, section 4636, or the National Housing Act, United 226.1 States Code, title 12, chapter 13, sections 1701 to 1750jj; 226.2 (36) benefits from the Trade Act of 1974, United States 226.3 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 226.4 (37) war reparations payments to Japanese Americans and 226.5 Aleuts under United States Code, title 50, sections 1989 to 226.6 1989d; 226.7 (38) payments to veterans or their dependents as a result 226.8 of legal settlements regarding Agent Orange or other chemical 226.9 exposure under Public Law Number 101-239, section 10405, 226.10 paragraph (a)(2)(E); 226.11 (39) income that is otherwise specifically excluded from 226.12 the MFIP-S program consideration in federal law, state law, or 226.13 federal regulation; 226.14 (40) security and utility deposit refunds; 226.15 (41) American Indian tribal land settlements excluded under 226.16 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 226.17 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 226.18 reservations and payments to members of the White Earth Band, 226.19 under United States Code, title 25, chapter 9, section 331, and 226.20 chapter 16, section 1407; 226.21 (42) all income of the minor parent's parent and stepparent 226.22 when determining the grant for the minor parent in households 226.23 that include a minor parent living with a parent or stepparent 226.24 on MFIP-S with otherdependentchildren; and 226.25 (43) income of the minor parent's parent and stepparent 226.26 equal to 200 percent of the federal poverty guideline for a 226.27 family size not including the minor parent and the minor 226.28 parent's child in households that include a minor parent living 226.29 with a parent or stepparent not on MFIP-S when determining the 226.30 grant for the minor parent. The remainder of income is deemed 226.31 as specified in section 256J.37, subdivision11b; 226.32 (44) payments made to children eligible for relative 226.33 custody assistance under section 257.85; 226.34 (45) vendor payments for goods and services made on behalf 226.35 of a client unless the client has the option of receiving the 226.36 payment in cash; and 227.1 (46) the principal portion of a contract for deed payment. 227.2 Subd. 3. [INITIAL INCOME TEST.] The county agency shall 227.3 determine initial eligibility by considering all earned and 227.4 unearned income that is not excluded under subdivision 2. To be 227.5 eligible for MFIP-S, the assistance unit's countable income 227.6 minus the disregards in paragraphs (a) and (b) must be below the 227.7 transitional standard of assistance according to section 256J.24 227.8 for that size assistance unit. 227.9 (a) The initial eligibility determination must disregard 227.10 the following items: 227.11 (1) the employment disregard is 18 percent of the gross 227.12 earned income whether or not the member is working full time or 227.13 part time; 227.14 (2) dependent care costs must be deducted from gross earned 227.15 income for the actual amount paid for dependent care up tothea 227.16 maximumdisregard allowedof $200 per month for each child less 227.17 than two years of age, and $175 per month for each child two 227.18 years of age and older under this chapter and chapter 119B;and227.19 (3) all payments made according to a court order 227.20 for spousal support or the support of children not living in the 227.21 assistance unit's household shall be disregarded from the income 227.22 of the person with the legal obligation to pay support, provided 227.23 that, if there has been a change in the financial circumstances 227.24 of the person with the legal obligation to pay support since the 227.25 support order was entered, the person with the legal obligation 227.26 to pay support has petitioned for a modification of the support 227.27 order; and 227.28 (4) an allocation for the unmet need of an ineligible 227.29 spouse or an ineligible child under the age of 21 for whom the 227.30 caregiver is financially responsible and who lives with the 227.31 caregiver according to section 256J.36. 227.32 (b) Notwithstanding paragraph (a), when determining initial 227.33 eligibility forapplicants who haveapplicant units when at 227.34 least one member has received AFDC, family general assistance, 227.35 MFIP, MFIP-R, work first, or MFIP-S in this state within four 227.36 months of the most recent application for MFIP-S, the employment 228.1 disregard for all unit members is 36 percent of the gross earned 228.2 income. 228.3 After initial eligibility is established, the assistance 228.4 payment calculation is based on the monthly income test. 228.5 Subd. 4. [MONTHLY INCOME TEST AND DETERMINATION OF 228.6 ASSISTANCE PAYMENT.] The county agency shall determine ongoing 228.7 eligibility and the assistance payment amount according to the 228.8 monthly income test. To be eligible for MFIP-S, the result of 228.9 the computations in paragraphs (a) to (e) must be at least $1. 228.10 (a) Apply a 36 percent income disregard to gross earnings 228.11 and subtract this amount from the family wage level. If the 228.12 difference is equal to or greater than the transitional 228.13 standard, the assistance payment is equal to the transitional 228.14 standard. If the difference is less than the transitional 228.15 standard, the assistance payment is equal to the difference. 228.16 The employment disregard in this paragraph must be deducted 228.17 every month there is earned income. 228.18 (b) All payments made according to a court order 228.19 for spousal support or the support of children not living in the 228.20 assistance unit's household must be disregarded from the income 228.21 of the person with the legal obligation to pay support, provided 228.22 that, if there has been a change in the financial circumstances 228.23 of the person with the legal obligation to pay support since the 228.24 support order was entered, the person with the legal obligation 228.25 to pay support has petitioned for a modification of the court 228.26 order. 228.27 (c) An allocation for the unmet need of an ineligible 228.28 spouse or an ineligible child under the age of 21 for whom the 228.29 caregiver is financially responsible and who lives with the 228.30 caregiver according to section 256J.36. 228.31 (d) Subtract unearned income dollar for dollar from the 228.32 transitional standard to determine the assistance payment amount. 228.33(d)(e) When income is both earned and unearned, the amount 228.34 of the assistance payment must be determined by first treating 228.35 gross earned income as specified in paragraph (a). After 228.36 determining the amount of the assistance payment under paragraph 229.1 (a), unearned income must be subtracted from that amount dollar 229.2 for dollar to determine the assistance payment amount. 229.3(e)(f) When the monthly income is greater than the 229.4 transitional or family wage level standard after applicable 229.5 deductions and the income will only exceed the standard for one 229.6 month, the county agency must suspend the assistance payment for 229.7 the payment month. 229.8 Subd. 5. [DISTRIBUTION OF INCOME.] The income of all 229.9 members of the assistance unit must be counted. Income may also 229.10 be deemed from ineligible persons to the assistance unit. 229.11 Income must be attributed to the person who earns it or to the 229.12 assistance unit according to paragraphs (a) to (c). 229.13 (a) Funds distributed from a trust, whether from the 229.14 principal holdings or sale of trust property or from the 229.15 interest and other earnings of the trust holdings, must be 229.16 considered income when the income is legally available to an 229.17 applicant or participant. Trusts are presumed legally available 229.18 unless an applicant or participant can document that the trust 229.19 is not legally available. 229.20 (b) Income from jointly owned property must be divided 229.21 equally among property owners unless the terms of ownership 229.22 provide for a different distribution. 229.23 (c) Deductions are not allowed from the gross income of a 229.24 financially responsible household member or by the members of an 229.25 assistance unit to meet a current or prior debt. 229.26 Sec. 38. Minnesota Statutes 1997 Supplement, section 229.27 256J.24, subdivision 1, is amended to read: 229.28 Subdivision 1. [MFIP-S ASSISTANCE UNIT.] An MFIP-S 229.29 assistance unit is either a group of individuals with at least 229.30 one minor child who live together whose needs, assets, and 229.31 income are considered together and who receive MFIP-S 229.32 assistance, or a pregnant woman and her spouse whoreceives229.33 receive MFIP-S assistance. 229.34 Individuals identified in subdivision 2 must be included in 229.35 the MFIP-S assistance unit. Individuals identified in 229.36 subdivision 3must be excluded from the assistance unitare 230.1 ineligible to receive MFIP-S. Individuals identified in 230.2 subdivision 4 may be included in the assistance unit at their 230.3 option. Individuals not included in the assistance unit who are 230.4 identified in section 256J.37,subdivisionsubdivisions 1orto 230.5 2, must have their income and assets considered when determining 230.6 eligibility and benefits for an MFIP-S assistance unit. All 230.7 assistance unit members, whether mandatory or elective, who live 230.8 together and for whom one caregiver or two caregivers apply must 230.9 be included in a single assistance unit. 230.10 Sec. 39. Minnesota Statutes 1997 Supplement, section 230.11 256J.24, subdivision 2, is amended to read: 230.12 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 230.13 for minor caregivers and their children whoaremust be in a 230.14 separate assistance unit from the other persons in the 230.15 household, when the following individuals live together, they 230.16 must be included in the assistance unit: 230.17 (1) a minor child, including a pregnant minor; 230.18 (2) the minor child's siblings, half-siblings, and 230.19 step-siblings;and230.20 (3) the minor child's natural, adoptive parents, and 230.21 stepparents; and 230.22 (4) the spouse of a pregnant woman. 230.23 Sec. 40. Minnesota Statutes 1997 Supplement, section 230.24 256J.24, subdivision 3, is amended to read: 230.25 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 230.26 ASSISTANCE UNIT.] The following individualsmust be excluded230.27from an assistance unitwho are part of the assistance unit 230.28 determined under subdivision 2 are ineligible to receive MFIP-S: 230.29 (1) individuals receiving Supplemental Security Income or 230.30 Minnesota supplemental aid; 230.31 (2) individuals living at home while performing 230.32 court-imposed, unpaid community service work due to a criminal 230.33 conviction; 230.34 (3) individuals disqualified from the food stamp program or 230.35 MFIP-S, until the disqualification ends; 230.36 (4) children on whose behalf federal, state, or local 231.1 foster care paymentsunder title IV-E of the Social Security Act231.2 are made, except as provided insectionsections 256J.13, 231.3 subdivision 2, and 256J.74, subdivision 2; and 231.4 (5) children receiving ongoing monthly adoption assistance 231.5 payments under section269.67259.67. 231.6 The exclusion of a person under this subdivision does not 231.7 alter the mandatory assistance unit composition. 231.8 Sec. 41. Minnesota Statutes 1997 Supplement, section 231.9 256J.24, subdivision 4, is amended to read: 231.10 Subd. 4. [INDIVIDUALS WHO MAY ELECT TO BE INCLUDED IN THE 231.11 ASSISTANCE UNIT.] (a) The minor child's eligible caregiver may 231.12 choose to be in the assistance unit, if the caregiver is not 231.13 required to be in the assistance unit under subdivision 2. If 231.14 the relative caregiver chooses to be in the assistance unit, 231.15 that person's spouse must also be in the unit. 231.16 (b) Any minor child not related as a sibling, stepsibling, 231.17 or adopted sibling to the minor child in the unit, but for whom 231.18 there is an eligible caregiver may elect to be in the unit. 231.19 (c) A foster care provider of a minor child who is 231.20 receiving federal, state, or local foster care maintenance 231.21 payments may elect to receive MFIP-S if the provider meets the 231.22 definition of caregiver under section 256J.08, subdivision 11. 231.23 If the provider chooses to receive MFIP-S, the spouse of the 231.24 provider must also be included in the assistance unit with the 231.25 provider. The provider and spouse are eligible for assistance 231.26 even though the only minor child living in the provider's home 231.27 is receiving foster care maintenance payments. 231.28 (d) The adult caregiver or caregivers of a minor parent are 231.29 eligible to be a separate assistance unit from the minor parent 231.30 and the minor parent's child when: 231.31 (1) the adult caregiver or caregivers have no other minor 231.32 children in the household; 231.33 (2) the minor parent and the minor parent's child are 231.34 living together with the adult caregiver or caregivers; and 231.35 (3) the minor parent and the minor parent's child receive 231.36 MFIP-S or would be eligible to receive MFIP-S if they were not 232.1 receiving SSI benefits. 232.2 Sec. 42. Minnesota Statutes 1997 Supplement, section 232.3 256J.24, is amended by adding a subdivision to read: 232.4 Subd. 5a. [FOOD PORTION OF MFIP-S TRANSITIONAL 232.5 STANDARD.] The commissioner shall increase the food portion of 232.6 the MFIP-S transitional standard by October 1 each year 232.7 beginning October 1998 to reflect the cost-of-living adjustments 232.8 to the Food Stamp Program. The commissioner shall annually 232.9 publish in the State Register the transitional standard for an 232.10 assistance unit of sizes 1 to 10. 232.11 Sec. 43. Minnesota Statutes 1997 Supplement, section 232.12 256J.26, subdivision 1, is amended to read: 232.13 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 232.14 Applicants orrecipientsparticipants who have been convicted of 232.15 a drug offense after July 1, 1997, may, if otherwise eligible, 232.16 receive AFDC or MFIP-S benefits subject to the following 232.17 conditions: 232.18 (1) Benefits for the entire assistance unit must be paid in 232.19 vendor form for shelter and utilities during any time the 232.20 applicant is part of the assistance unit;. 232.21 (2) The convicted applicant orrecipientparticipant shall 232.22 be subject to random drug testing as a condition of continued 232.23 eligibility andis subject to sanctions under section 256J.46232.24 following any positive test for an illegal controlled substance,232.25except that the grant must continue to be vendor paid under232.26clause (1).232.27For purposes of this subdivision, section 256J.46 is232.28effective July 1, 1997.232.29This subdivision also applies to persons who receive food232.30stamps under section 115 of the Personal Responsibility and Work232.31Opportunity Reconciliation Act of 1996.is subject to the 232.32 following sanctions: 232.33 (i) for failing a drug test the first time, the 232.34 participant's grant shall be reduced by ten percent of the 232.35 MFIP-S transitional standard or the interstate transitional 232.36 standard, whichever is applicable, prior to making vendor 233.1 payments for shelter and utility costs; or 233.2 (ii) for failing a drug test more than once, the residual 233.3 amount of the participant's grant after making vendor payments 233.4 for shelter and utility costs, if any, must be reduced by an 233.5 amount equal to 30 percent of the MFIP-S transitional standard 233.6 or the interstate transitional standard, whichever is applicable. 233.7 (b) Applicants or participants who have been convicted of a 233.8 drug offense after July 1, 1997, may, if otherwise eligible, 233.9 receive food stamps if the convicted applicant or participant is 233.10 subject to random drug testing as a condition of continued 233.11 eligibility. Following a positive test for an illegal 233.12 controlled substance, the applicant is subject to the following 233.13 sanctions: 233.14 (1) for failing a drug test the first time, food stamps 233.15 shall be reduced by ten percent of the applicable food stamp 233.16 allotment; and 233.17 (2) for failing a drug test more than once, food stamps 233.18 shall be reduced by an amount equal to 30 percent of the 233.19 applicable food stamp allotment. 233.20(b)(c) For the purposes of this subdivision, "drug offense" 233.21 means a conviction that occurred after July 1, 1997, of sections 233.22 152.021 to 152.025, 152.0261, or 152.096. Drug offense also 233.23 means a conviction in another jurisdiction of the possession, 233.24 use, or distribution of a controlled substance, or conspiracy to 233.25 commit any of these offenses, if the offense occurred after July 233.26 1, 1997, and the conviction is a felony offense in that 233.27 jurisdiction, or in the case of New Jersey, a high misdemeanor. 233.28 Sec. 44. Minnesota Statutes 1997 Supplement, section 233.29 256J.26, subdivision 2, is amended to read: 233.30 Subd. 2. [PAROLE VIOLATORS.] An individual violating a 233.31 condition of probation or parole or supervised release imposed 233.32 under federal law or the law of any state isineligible to233.33receivedisqualified from receiving AFDC or MFIP-S. 233.34 Sec. 45. Minnesota Statutes 1997 Supplement, section 233.35 256J.26, subdivision 3, is amended to read: 233.36 Subd. 3. [FLEEING FELONS.] An individual who is fleeing to 234.1 avoid prosecution, or custody, or confinement after conviction 234.2 for a crime that is a felony under the laws of the jurisdiction 234.3 from which the individual flees, or in the case of New Jersey, 234.4 is a high misdemeanor, isineligible to receivedisqualified 234.5 from receiving AFDC or MFIP-S. 234.6 Sec. 46. Minnesota Statutes 1997 Supplement, section 234.7 256J.26, subdivision 4, is amended to read: 234.8 Subd. 4. [DENIAL OF ASSISTANCE FOR TEN YEARS TO A PERSON 234.9 FOUND TO HAVE FRAUDULENTLY MISREPRESENTED RESIDENCY.] An 234.10 individual who is convicted in federal or state court of having 234.11 made a fraudulent statement or representation with respect to 234.12 the place of residence of the individual in order to receive 234.13 assistance simultaneously from two or more states isineligible234.14to receivedisqualified from receiving AFDC or MFIP-S for ten 234.15 years beginning on the date of the conviction. 234.16 Sec. 47. Minnesota Statutes 1997 Supplement, section 234.17 256J.28, subdivision 1, is amended to read: 234.18 Subdivision 1. [EXPEDITED ISSUANCE OF FOOD STAMP 234.19 ASSISTANCE.] The following households are entitled to expedited 234.20 issuance of food stamp assistance: 234.21 (1) households with less than $150 in monthly gross income 234.22 provided their liquid assets do not exceed $100; 234.23 (2) migrant or seasonal farm worker households who are 234.24 destitute as defined in Code of Federal Regulations, title 7, 234.25 subtitle B, chapter 2, subchapter C, part 273, section 273.10, 234.26 paragraph (e)(3), provided their liquid assets do not exceed 234.27 $100; and 234.28 (3) eligible households whose combined monthly gross income 234.29 and liquid resources are less than the household's monthly rent 234.30 or mortgage and utilities. 234.31The benefits issued through expedited issuance of food234.32stamp assistance must be deducted from the amount of the full234.33monthly MFIP-S assistance payment and a supplemental payment for234.34the difference must be issued.For any month an individual 234.35 receives expedited Food Stamp Program benefits, the individual 234.36 is not eligible for the MFIP-S food portion of assistance. 235.1 Sec. 48. Minnesota Statutes 1997 Supplement, section 235.2 256J.28, subdivision 2, is amended to read: 235.3 Subd. 2. [FOOD STAMPS FOR HOUSEHOLD MEMBERS NOT IN THE 235.4 ASSISTANCE UNIT.] (a) For household members who purchase and 235.5 prepare food with the MFIP-S assistance unit but are not part of 235.6 the assistance unit, the county agency must determine a separate 235.7 food stamp benefit based on regulations agreed upon with the 235.8 United States Department of Agriculture. 235.9(b) This subdivision does not apply to optional members who235.10have chosen not to be in the assistance unit.235.11(c)(b) Fair hearing requirements for persons who receive 235.12 food stamps under this subdivision are governed by section 235.13 256.045, and Code of Federal Regulations, title 7, subtitle B, 235.14 chapter II, part 273, section 273.15. 235.15 Sec. 49. Minnesota Statutes 1997 Supplement, section 235.16 256J.28, is amended by adding a subdivision to read: 235.17 Subd. 5. [FOOD STAMPS FOR PERSONS RESIDING IN A BATTERED 235.18 WOMAN'S SHELTER.] Members of an MFIP-S assistance unit residing 235.19 in a battered woman's shelter may receive food stamps or the 235.20 food portion twice in a month if the unit that initially 235.21 received the food stamps or food portion included the alleged 235.22 abuser. 235.23 Sec. 50. Minnesota Statutes 1997 Supplement, section 235.24 256J.30, subdivision 10, is amended to read: 235.25 Subd. 10. [COOPERATION WITH HEALTH CARE BENEFITS.] (a) The 235.26 caregiver of a minor child must cooperate with the county agency 235.27 to identify and provide information to assist the county agency 235.28 in pursuing third-party liability for medical services. 235.29 (b) A caregiver must assign to the department any rights to 235.30 health insurance policy benefits the caregiver has during the 235.31 period of MFIP-S eligibility. 235.32 (c) A caregiver must identify any third party who may be 235.33 liable for care and services available under the medical 235.34 assistance program on behalf of the applicant or participant and 235.35 all other assistance unit members. 235.36 (d) When a participant refuses to identify any third party 236.1 who may be liable for care and services, the recipient must be 236.2 sanctioned as provided in section 256J.46, subdivision 1. The 236.3 recipient is also ineligible for medical assistancefor a236.4minimum of one month anduntil the recipient cooperates with the 236.5 requirements of this subdivision. 236.6 Sec. 51. Minnesota Statutes 1997 Supplement, section 236.7 256J.30, subdivision 11, is amended to read: 236.8 Subd. 11. [REQUIREMENT TO ASSIGN SUPPORT AND MAINTENANCE 236.9 RIGHTS.]To be eligibleAn assistance unit is ineligible for 236.10 MFIP-S,unless the caregivermust assignassigns all rights to 236.11 child support and spousal maintenance benefits according 236.12 tosections 256.74, subdivision 5, andsection 256.741, if236.13enacted. 236.14 Sec. 52. Minnesota Statutes 1997 Supplement, section 236.15 256J.31, subdivision 5, is amended to read: 236.16 Subd. 5. [MAILING OF NOTICE.] The notice of adverse action 236.17 shall be issued according to paragraphs (a) to (c). 236.18 (a) A county agency shall mail a notice of adverse action 236.19 at least ten days before the effective date of the adverse 236.20 action, except as provided in paragraphs (b) and (c). 236.21 (b) A county agency must mail a notice of adverse action at 236.22 least five days before the effective date of the adverse action 236.23 when the county agency has factual information that requires an 236.24 action to reduce, suspend, or terminate assistance based on 236.25 probable fraud. 236.26 (c) A county agency shall mail a notice of adverse action 236.27 before or on the effective date of the adverse action when the 236.28 county agency: 236.29 (1) receives the caregiver's signed monthly MFIP-S 236.30 household report form that includes information that requires 236.31 payment reduction, suspension, or termination; 236.32 (2) is informed of the death of a participant or the payee; 236.33 (3) receives a signed statement from the caregiver that 236.34 assistance is no longer wanted; 236.35 (4) receives a signed statement from the caregiver that 236.36 provides information that requires the termination or reduction 237.1 of assistance; 237.2 (5) verifies that a member of the assistance unit is absent 237.3 from the home and does not meet temporary absence provisions in 237.4 section 256J.13; 237.5 (6) verifies that a member of the assistance unit has 237.6 entered a regional treatment center or a licensed residential 237.7 facility for medical or psychological treatment or 237.8 rehabilitation; 237.9 (7) verifies that a member of an assistance unit has been 237.10 placed in foster care, and the provisions of section 256J.13, 237.11 subdivision 2, paragraph(b)(c), clause (2), do not apply; 237.12 (8) verifies that a member of an assistance unit has been 237.13 approved to receive assistance by another state; or 237.14 (9) cannot locate a caregiver. 237.15 Sec. 53. Minnesota Statutes 1997 Supplement, section 237.16 256J.31, subdivision 10, is amended to read: 237.17 Subd. 10. [PROTECTION FROM GARNISHMENT.] MFIP-S grants or 237.18 earnings of a caregiverwhile participating in full or part-time237.19employment or trainingshall be protected from garnishment. 237.20 This protection for earnings shall extend for a period of six 237.21 months from the date of termination from MFIP-S. 237.22 Sec. 54. Minnesota Statutes 1997 Supplement, section 237.23 256J.32, subdivision 4, is amended to read: 237.24 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 237.25 verify the following at application: 237.26 (1) identity of adults; 237.27 (2) presence of the minor child in the home, if 237.28 questionable; 237.29 (3) relationship of a minor child to caregivers in the 237.30 assistance unit; 237.31 (4) age, if necessary to determine MFIP-S eligibility; 237.32 (5) immigration status; 237.33 (6) social security numberin accordance withaccording to 237.34 the requirements of section 256J.30, subdivision 12; 237.35 (7) income; 237.36 (8) self-employment expenses used as a deduction; 238.1 (9) source and purpose of deposits and withdrawals from 238.2 business accounts; 238.3 (10) spousal support and child support payments made to 238.4 persons outside the household; 238.5 (11) real property; 238.6 (12) vehicles; 238.7 (13) checking and savings accounts; 238.8 (14) savings certificates, savings bonds, stocks, and 238.9 individual retirement accounts; 238.10 (15) pregnancy, if related to eligibility; 238.11 (16) inconsistent information, if related to eligibility; 238.12 (17) medical insurance; 238.13 (18) anticipated graduation date of an 18-year-old; 238.14 (19) burial accounts; 238.15 (20) school attendance, if related to eligibility;and238.16 (21) residence; 238.17 (22) a claim of domestic violence if used as a basis for a 238.18 deferral or exemption from the 60-month time limit in section 238.19 256J.42 or employment and training services requirements in 238.20 section 256J.56; and 238.21 (23) disability if used as an exemption from employment and 238.22 training services requirements under section 256J.56. 238.23 Sec. 55. Minnesota Statutes 1997 Supplement, section 238.24 256J.32, subdivision 6, is amended to read: 238.25 Subd. 6. [RECERTIFICATION.] The county agency shall 238.26 recertify eligibility in an annual face-to-face interview with 238.27 the participant and verify the following: 238.28 (1) presence of the minor child in the home, if 238.29 questionable; 238.30 (2) income, unless excluded, including self-employment 238.31 expenses used as a deduction or deposits or withdrawals from 238.32 business accounts; 238.33 (3) assets when the value is within $200 of the asset 238.34 limit; and 238.35 (4) inconsistent information, if related to eligibility. 238.36 Sec. 56. Minnesota Statutes 1997 Supplement, section 239.1 256J.32, is amended by adding a subdivision to read: 239.2 Subd. 7. [NOTICE TO UNDOCUMENTED PERSONS; RELEASE OF 239.3 PRIVATE DATA.] County agencies in consultation with the 239.4 commissioner of human services shall provide notification to 239.5 undocumented persons regarding the release of personal data to 239.6 the Immigration and Naturalization Service and develop protocol 239.7 regarding the release or sharing of data about undocumented 239.8 persons with the Immigration and Naturalization Service as 239.9 required under sections 404, 434, and 411A of the Personal 239.10 Responsibility and Work Opportunity Reconciliation Act of 1996. 239.11 Sec. 57. Minnesota Statutes 1997 Supplement, section 239.12 256J.33, subdivision 1, is amended to read: 239.13 Subdivision 1. [DETERMINATION OF ELIGIBILITY.] A county 239.14 agency must determine MFIP-S eligibility prospectively for a 239.15 payment month based on retrospectively assessing income and the 239.16 county agency's best estimate of the circumstances that will 239.17 exist in the payment month. 239.18 Except as described in section 256J.34, subdivision 1, when 239.19 prospective eligibility exists, a county agency must calculate 239.20 the amount of the assistance payment using retrospective 239.21 budgeting. To determine MFIP-S eligibility and the assistance 239.22 payment amount, a county agency must apply countable income, 239.23 described in section 256J.37, subdivisions 3 to 10, received by 239.24 members of an assistance unit or by other persons whose income 239.25 is counted for the assistance unit, described under sections 239.26 256J.21 and 256J.37, subdivisions 1andto 2. 239.27 This income must be applied to the transitional standard or 239.28 family wage standard subject to this section and sections 239.29 256J.34 to 256J.36. Income received in a calendar month and not 239.30 otherwise excluded under section 256J.21, subdivision 2, must be 239.31 applied to the needs of an assistance unit. 239.32 Sec. 58. Minnesota Statutes 1997 Supplement, section 239.33 256J.33, subdivision 4, is amended to read: 239.34 Subd. 4. [MONTHLY INCOME TEST.] A county agency must apply 239.35 the monthly income test retrospectively for each month of MFIP-S 239.36 eligibility. An assistance unit is not eligible when the 240.1 countable income equals or exceeds the transitional standard or 240.2 the family wage level for the assistance unit. The income 240.3 applied against the monthly income test must include: 240.4 (1) gross earned income from employment, prior to mandatory 240.5 payroll deductions, voluntary payroll deductions, wage 240.6 authorizations, and after the disregards in section 256J.21, 240.7 subdivision34, and the allocations in section 256J.36, unless 240.8 the employment income is specifically excluded under section 240.9 256J.21, subdivision 2; 240.10 (2) gross earned income from self-employment less 240.11 deductions for self-employment expenses in section 256J.37, 240.12 subdivision 5, but prior to any reductions for personal or 240.13 business state and federal income taxes, personal FICA, personal 240.14 health and life insurance, and after the disregards in section 240.15 256J.21, subdivision34, and the allocations in section 240.16 256J.36; 240.17 (3) unearned income after deductions for allowable expenses 240.18 in section 256J.37, subdivision 9, and allocations in section 240.19 256J.36, unless the income has been specifically excluded in 240.20 section 256J.21, subdivision 2; 240.21 (4) gross earned income from employment as determined under 240.22 clause (1) which is received by a member of an assistance unit 240.23 who is a minor child or minor caregiver and less than a 240.24 half-time student; 240.25 (5) child support and spousal support received or 240.26 anticipated to be received by an assistance unit; 240.27 (6) the income of a parent when that parent is not included 240.28 in the assistance unit; 240.29 (7) the income of an eligible relative and spouse who seek 240.30 to be included in the assistance unit; and 240.31 (8) the unearned income of a minor child included in the 240.32 assistance unit. 240.33 Sec. 59. Minnesota Statutes 1997 Supplement, section 240.34 256J.35, is amended to read: 240.35 256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 240.36 Except as provided in paragraphs (a) to(c)(d), the amount 241.1 of an assistance payment is equal to the difference between the 241.2 transitional standard or the Minnesota family wage level in 241.3 section 256J.24, whichever is less, and countable income. 241.4 (a) When MFIP-S eligibility exists for the month of 241.5 application, the amount of the assistance payment for the month 241.6 of application must be prorated from the date of application or 241.7 the date all other eligibility factors are met for that 241.8 applicant, whichever is later. This provision applies when an 241.9 applicant loses at least one day of MFIP-S eligibility. 241.10 (b) MFIP-S overpayments to an assistance unit must be 241.11 recouped according to section 256J.38, subdivision 4. 241.12 (c) An initial assistance payment must not be made to an 241.13 applicant who is not eligible on the date payment is made. 241.14 (d) An individual whose needs have been otherwise provided 241.15 for in another state, in whole or in part by county, state, or 241.16 federal dollars during a month, is ineligible to receive MFIP-S 241.17 for the month. 241.18 Sec. 60. Minnesota Statutes 1997 Supplement, section 241.19 256J.36, is amended to read: 241.20 256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 241.21 MEMBERS.] 241.22 Except as prohibited in paragraphs (a) and (b), an 241.23 allocation of income is allowed from the caregiver's income to 241.24 meet the unmet need of an ineligible spouse or an ineligible 241.25 child under the age of 21 for whom the caregiver is financially 241.26 responsible who also lives with the caregiver.An allocation is241.27allowed from the caregiver's income to meet the need of an241.28ineligible or excluded person.That allocation is allowed in an 241.29 amount up to the difference between the MFIP-Sfamily allowance241.30 transitional standard for the assistance unit when thatexcluded241.31orineligible person is included in the assistance unit and the 241.32 MFIP-S family allowance for the assistance unit when 241.33 theexcluded orineligible person is not included in the 241.34 assistance unit. These allocations must be deducted from the 241.35 caregiver's counted earnings and from unearned income subject to 241.36 paragraphs (a) and (b). 242.1 (a) Income of a minor child in the assistance unit must not 242.2 be allocated to meet the need ofaan ineligible personwho is242.3not a member of the assistance unit, including the child's 242.4 parent, even when that parent is the payee of the child's income. 242.5 (b) Income ofan assistance unita caregiver must not be 242.6 allocated to meet the needs of a disqualified personineligible242.7for failure to cooperate with program requirements including242.8child support requirements, a person ineligible due to fraud, or242.9a relative caregiver and the caregiver's spouse who opt out of242.10the assistance unit. 242.11 Sec. 61. Minnesota Statutes 1997 Supplement, section 242.12 256J.37, subdivision 1, is amended to read: 242.13 Subdivision 1. [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 242.14 MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 242.15 the income of ineligible household members must be deemed after 242.16 allowing the following disregards: 242.17 (1) the first 18 percent of theexcludedineligible family 242.18 member's gross earned income; 242.19 (2) amounts the ineligible person actually paid to 242.20 individuals not living in the same household but whom the 242.21 ineligible person claims or could claim as dependents for 242.22 determining federal personal income tax liability; 242.23 (3)child or spousal support paid to a person who lives242.24outside of the householdall payments made by the ineligible 242.25 person according to a court order for spousal support or the 242.26 support of children not living in the assistance unit's 242.27 household, provided that, if there has been a change in the 242.28 financial circumstances of the ineligible person since the 242.29 support order was entered, the ineligible person has petitioned 242.30 for a modification of the support order; and 242.31 (4) an amount for the needs of the ineligible person and 242.32 other persons who live in the household but are not included in 242.33 the assistance unit and are or could be claimed by an ineligible 242.34 person as dependents for determining federal personal income tax 242.35 liability. This amount is equal to the difference between the 242.36 MFIP-Sneedtransitional standard when theexcludedineligible 243.1 person is included in the assistance unit and the MFIP-Sneed243.2 transitional standard when theexcludedineligible person is not 243.3 included in the assistance unit. 243.4 Sec. 62. Minnesota Statutes 1997 Supplement, section 243.5 256J.37, is amended by adding a subdivision to read: 243.6 Subd. 1a. [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 243.7 income of disqualified members must be deemed after allowing the 243.8 following disregards: 243.9 (1) the first 18 percent of the disqualified member's gross 243.10 earned income; 243.11 (2) amounts the disqualified member actually paid to 243.12 individuals not living in the same household but whom the 243.13 disqualified member claims or could claim as dependents for 243.14 determining federal personal income tax liability; 243.15 (3) all payments made by the disqualified member according 243.16 to a court order for spousal support or the support of children 243.17 or a spouse not living in the assistance unit's household, 243.18 provided that, if there has been a change in the financial 243.19 circumstances of the disqualified member's legal obligation to 243.20 pay support since the support order was entered, the 243.21 disqualified member has petitioned for a modification of the 243.22 support order; and 243.23 (4) an amount for the needs of other persons who live in 243.24 the household but are not included in the assistance unit and 243.25 are or could be claimed by the disqualified member as dependents 243.26 for determining federal personal income tax liability. This 243.27 amount is equal to the difference between the MFIP-S 243.28 transitional standard when the ineligible person is included in 243.29 the assistance unit and the MFIP-S transitional standard when 243.30 the ineligible person is not included in the assistance unit. 243.31 An amount shall not be allowed for the needs of a disqualified 243.32 member. 243.33 Sec. 63. Minnesota Statutes 1997 Supplement, section 243.34 256J.37, is amended by adding a subdivision to read: 243.35 Subd. 1b. [DEEMED INCOME FROM PARENTS OF MINOR 243.36 CAREGIVERS.] In households where minor caregivers live with a 244.1 parent or parents who do not receive MFIP-S, the income of the 244.2 parents must be deemed after allowing the following disregards: 244.3 (1) income of the parents equal to 200 percent of the 244.4 federal poverty guideline for a family size not including the 244.5 minor parent and the minor parent's child in the household 244.6 according to section 256J.21, subdivision 2, clause (43); 244.7 (2) 18 percent of the parent's gross earned income; 244.8 (3) amounts the parents actually paid to individuals not 244.9 living in the same household but whom the parents claim or could 244.10 claim as dependents for determining federal personal income tax 244.11 liability; and 244.12 (4) all payments made by parents according to a court order 244.13 for spousal support or the support of children or spouse not 244.14 living in the parent's household, provided that, if there has 244.15 been a change in the financial circumstances of the parent's 244.16 legal obligation to pay support since the support order was 244.17 entered, the parents have petitioned for a modification of the 244.18 support order. 244.19 Sec. 64. Minnesota Statutes 1997 Supplement, section 244.20 256J.37, subdivision 2, is amended to read: 244.21 Subd. 2. [DEEMED INCOME AND ASSETS OF SPONSOR OF 244.22 NONCITIZENS.]All income and assets of a sponsor, or sponsor's244.23spouse, who executed an affidavit of support for a noncitizen244.24must be deemed to be unearned income of the noncitizen as244.25specified in the Personal Responsibility and Work Opportunity244.26Reconciliation Act of 1996, title IV, Public Law Number 104-193,244.27sections 421 and 422, and subsequently set out in federal244.28rules.If a noncitizen applies for or receives MFIP-S, the 244.29 county must deem the income and assets of the noncitizen's 244.30 sponsor and the sponsor's spouse who have signed an affidavit of 244.31 support for the noncitizen as specified in Public Law Number 244.32 104-193, title IV, sections 421 and 422, the Personal 244.33 Responsibility and Work Opportunity Reconciliation Act of 1996. 244.34 The income of a sponsor and the sponsor's spouse is considered 244.35 unearned income of the noncitizen. The assets of a sponsor and 244.36 the sponsor's spouse are considered available assets of the 245.1 noncitizen. 245.2 Sec. 65. Minnesota Statutes 1997 Supplement, section 245.3 256J.37, subdivision 9, is amended to read: 245.4 Subd. 9. [UNEARNED INCOME.] (a) The county agency must 245.5 apply unearned income, including housing subsidies as in245.6paragraph (b),to the transitional standard. When determining 245.7 the amount of unearned income, the county agency must deduct the 245.8 costs necessary to secure payments of unearned income. These 245.9 costs include legal fees, medical fees, and mandatory deductions 245.10 such as federal and state income taxes. 245.11 (b) Effective July 1,19981999, the county agency shall 245.12 count $100 of the value of public and assisted rental subsidies 245.13 provided through the Department of Housing and Urban Development 245.14 (HUD) as unearned income. The full amount of the subsidy must 245.15 be counted as unearned income when the subsidy is less than $100. 245.16 Sec. 66. Minnesota Statutes 1997 Supplement, section 245.17 256J.38, subdivision 1, is amended to read: 245.18 Subdivision 1. [SCOPE OF OVERPAYMENT.] When a participant 245.19 or former participant receives an overpayment due to agency, 245.20 client, or ATM error, or due to assistance received while an 245.21 appeal is pending and the participant or former participant is 245.22 determined ineligible for assistance or for less assistance than 245.23 was received, the county agency must recoup or recover the 245.24 overpaymentunderusing theconditions of this245.25section.following methods: 245.26 (1) reconstruct each affected budget month and 245.27 corresponding payment month; 245.28 (2) use the policies and procedures that were in effect for 245.29 the payment month; and 245.30 (3) do not allow employment disregards in section 256J.21, 245.31 subdivision 3 or 4, in the calculation of the overpayment when 245.32 the unit has not reported within two calendar months following 245.33 the end of the month in which the income was received. 245.34 Sec. 67. Minnesota Statutes 1997 Supplement, section 245.35 256J.39, subdivision 2, is amended to read: 245.36 Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 246.1 paying assistance directly to a participant may be used when: 246.2 (1) a county agency determines that a vendor payment is the 246.3 most effective way to resolve an emergency situation pertaining 246.4 to basic needs; 246.5 (2) a caregiver makes a written request to the county 246.6 agency asking that part or all of the assistance payment be 246.7 issued by protective or vendor payments for shelter and utility 246.8 service only. The caregiver may withdraw this request in 246.9 writing at any time; 246.10 (3)a caregiver has exhibited a continuing pattern of246.11mismanaging funds as determined by the county agency;246.12(4)the vendor payment is part of a sanction under section 246.13 256J.46, subdivision 2;or246.14(5)(4) the vendor payment is required under section 246.15256J.24256J.26 or 256J.43; 246.16 (5) protective payments are required for minor parents 246.17 under section 256J.14; or 246.18 (6) a caregiver has exhibited a continuing pattern of 246.19 mismanaging funds as determined by the county agency. 246.20 The director of a county agency must approve a proposal for 246.21 protective or vendor payment for money mismanagement when there 246.22 is a pattern of mismanagement under clause (6). During the time 246.23 a protective or vendor payment is being made, the county agency 246.24 must provide services designed to alleviate the causes of the 246.25 mismanagement. 246.26 The continuing need for and method of payment must be 246.27 documented and reviewed every 12 months. The director of a 246.28 county agency must approve the continuation of protective or 246.29 vendor payments. when it appears that the need for protective or 246.30 vendor payments will continue or is likely to continue beyond 246.31 two years because the county agency's efforts have not resulted 246.32 in sufficiently improved use of assistance on behalf of the 246.33 minor child, judicial appointment of a legal guardian or other 246.34 legal representative must be sought by the county agency. 246.35 Sec. 68. Minnesota Statutes 1997 Supplement, section 246.36 256J.395, is amended to read: 247.1 256J.395 [VENDOR PAYMENT OFRENTSHELTER COSTS AND 247.2 UTILITIES.] 247.3 Subdivision 1. [VENDOR PAYMENT.] (a) Effective July 1, 247.4 1997, when a county is required to provide assistance to 247.5 arecipientparticipant in vendor form forrentshelter costs 247.6 and utilities under this chapter, or chapter 256, 256D, or 256K, 247.7 the cost of utilities for a given family may be assumed to be: 247.8 (1) the average of the actual monthly cost of utilities for 247.9 that family for the prior 12 months at the family's current 247.10 residence, if applicable; 247.11 (2) the monthly plan amount, if any, set by the local 247.12 utilities for that family at the family's current residence; or 247.13 (3) the estimated monthly utility costs for the dwelling in 247.14 which the family currently resides. 247.15 (b) For purposes of this section, "utility" means any of 247.16 the following: municipal water and sewer service; electric, 247.17 gas, or heating fuel service; or wood, if that is the heating 247.18 source. 247.19 (c) In any instance where a vendor payment for rent is 247.20 directed to a landlord not legally entitled to the payment, the 247.21 county social services agency shall immediately institute 247.22 proceedings to collect the amount of the vendored rent payment, 247.23 which shall be considered a debt under section 270A.03, 247.24 subdivision 5. 247.25 Subd. 2. [VENDOR PAYMENT NOTIFICATION.] (a) When a county 247.26 agency is required to provide assistance to a participant in 247.27 vendor payment form for shelter costs or utilities under 247.28 subdivision 1, and the participant does not give the agency the 247.29 information needed to pay the vendor, the county agency shall 247.30 notify the participant of the intent to terminate assistance by 247.31 mail at least ten days before the effective date of the adverse 247.32 action. 247.33 (b) The notice of action shall include a request for 247.34 information about: 247.35 (1) the amount of the participant's shelter costs or 247.36 utilities; 248.1 (2) the due date of the shelter costs or utilities; and 248.2 (3) the name and address of the landlord, contract for deed 248.3 holder, mortgage company, and utility vendor. 248.4 (c) If the participant fails to provide the requested 248.5 information by the effective date of the adverse action, the 248.6 county must terminate the MFIP-S grant. If the applicant or 248.7 participant verifies they do not have shelter costs or utility 248.8 obligations, the county shall not terminate assistance if the 248.9 assistance unit is otherwise eligible. 248.10 Sec. 69. Minnesota Statutes 1997 Supplement, section 248.11 256J.42, is amended to read: 248.12 256J.42 [60-MONTH TIME LIMIT.] 248.13 Subdivision 1. [TIME LIMIT.] (a) Except for the exemptions 248.14 in this section and in section 256J.11, subdivision 2, an 248.15 assistance unit in which any adult caregiver has received 60 248.16 months of cash assistance funded in whole or in part by the TANF 248.17 block grant in this or any other state or United States 248.18 territory, MFIP-S, AFDC, or family general assistance, funded in 248.19 whole or in part by state appropriations, is ineligible to 248.20 receive MFIP-S. Any cash assistance funded with TANF dollars in 248.21 this or any other state or United States territory, or MFIP-S 248.22 assistance funded in whole or in part by state appropriations, 248.23 that was received by the unit on or after the date TANF was 248.24 implemented, including any assistance received in states or 248.25 United States territories of prior residence, counts toward the 248.26 60-month limitation. The 60-month limit applies to a minor who 248.27 is the head of a household or who is married to the head of a 248.28 household except under subdivision 5. The 60-month time period 248.29 does not need to be consecutive months for this provision to 248.30 apply. 248.31 (b) Months before July 1998 in which individuals receive 248.32 assistance as part of an MFIP, MFIP-R, or MFIP or MFIP-R 248.33 comparison group family under sections 256.031 to 256.0361 or 248.34 sections 256.047 to 256.048 are not included in the 60-month 248.35 time limit. 248.36Subd. 2. [ASSISTANCE FROM ANOTHER STATE.] An individual249.1whose needs have been otherwise provided for in another state,249.2in whole or in part by the TANF block grant during a month, is249.3ineligible to receive MFIP-S for the month.249.4 Subd. 3. [ADULTS LIVING ON AN INDIAN RESERVATION.] In 249.5 determining the number of months for which an adult has received 249.6 assistance under MFIP-S, the county agency must disregard any 249.7 month during which the adult lived on an Indian reservation if,249.8 during the month:249.9(1) at least 1,000 individuals were living on the249.10reservation; and249.11(2)at least 50 percent of the adults living on the 249.12 reservation wereunemployednot employed. 249.13 Subd. 4. [VICTIMS OF DOMESTIC VIOLENCE.] Any cash 249.14 assistance received by an assistance unit in a month when a 249.15 caregiver is complying with a safety plan under the MFIP-S 249.16 employment and training component does not count toward the 249.17 60-month limitation on assistance. 249.18 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 249.19 assistance received by an assistance unit does not count toward 249.20 the 60-month limit on assistance during a month in which 249.21 theparentalcaregiver is in the category in section 256J.56, 249.22 clause (1). The exemption applies for the period of time the 249.23 caregiver belongs to one of the categories specified in this 249.24 subdivision. 249.25 (b) From July 1, 1997, until the date MFIP-S is operative 249.26 in the caregiver's county of financial responsibility, any cash 249.27 assistance received by a caregiver who is complying with 249.28 sections 256.73, subdivision 5a, and 256.736, if applicable, 249.29 does not count toward the 60-month limit on assistance. 249.30 Thereafter, any cash assistance received by a minor caregiver 249.31 who is complying with the requirements of sections 256J.14 and 249.32 256J.54, if applicable, does not count towards the 60-month 249.33 limit on assistance. 249.34 (c) The receipt of diversionary assistance or emergency 249.35 assistance does not count toward the 60-month limit. 249.36 (d) Any cash assistance received by an 18- or 19-year-old 250.1 caregiver who is complying with the requirements of section 250.2 256J.54 does not count toward the 60-month limit. 250.3 Sec. 70. Minnesota Statutes 1997 Supplement, section 250.4 256J.43, is amended to read: 250.5 256J.43 [INTERSTATE PAYMENT STANDARDS.] 250.6 Subdivision 1. [PAYMENT.] (a) Effective July 1, 1997, the 250.7 amount of assistance paid to an eligiblefamilyunit in which 250.8 all members have resided in this state for fewer than 12 250.9 consecutive calendar months immediately preceding the date of 250.10 application shall be the lesser of either thepaymentinterstate 250.11 transitional standard that would have been received by 250.12 thefamilyassistance unit from the state of immediate prior 250.13 residence, or the amount calculated in accordance with AFDC or 250.14 MFIP-S standards. The lesser payment must continue until 250.15 thefamilyassistance unit meets the 12-month requirement. An 250.16 assistance unit that has not resided in Minnesota for 12 months 250.17 from the date of application is not exempt from the interstate 250.18 payment provisions solely because a child is born in Minnesota 250.19 to a member of the assistance unit. Payment must be calculated 250.20 by applying this state's budgeting policies, and the unit's net 250.21 income must be deducted from the payment standard in the other 250.22 state or in this state, whichever is lower. Payment shall be 250.23 made in vendor form forrentshelter and utilities, up to the 250.24 limit of the grant amount, and residual amounts, if any, shall 250.25 be paid directly to the assistance unit. 250.26 (b) During the first 12 monthsa familyan assistance unit 250.27 resides in this state, the number of months that afamilyunit 250.28 is eligible to receive AFDC or MFIP-S benefits is limited to the 250.29 number of months thefamilyassistance unit would have been 250.30 eligible to receive similar benefits in the state of immediate 250.31 prior residence. 250.32 (c) This policy applies whether or not thefamily250.33 assistance unit received similar benefits while residing in the 250.34 state of previous residence. 250.35 (d) Whena familyan assistance unit moves to this state 250.36 from another state where thefamilyassistance unit has 251.1 exhausted that state's time limit for receiving benefits under 251.2 that state's TANF program, thefamilyunit will not be eligible 251.3 to receive any AFDC or MFIP-S benefits in this state for 12 251.4 months from the date thefamilyassistance unit moves here. 251.5 (e) For the purposes of this section, "state of immediate 251.6 prior residence" means: 251.7 (1) the state in which the applicant declares the applicant 251.8 spent the most time in the 30 days prior to moving to this 251.9 state; or 251.10 (2) the state in which an applicant who is a migrant worker 251.11 maintains a home. 251.12 (f) The commissioner shall annually verify and update all 251.13 other states' payment standards as they are to be in effect in 251.14 July of each year. 251.15 (g) Applicants must provide verification of their state of 251.16 immediate prior residence, in the form of tax statements, a 251.17 driver's license, automobile registration, rent receipts, or 251.18 other forms of verification approved by the commissioner. 251.19 (h) Migrant workers, as defined in section 256J.08, and 251.20 their immediate families are exempt from this section, provided 251.21 the migrant worker provides verification that the migrant family 251.22 worked in this state within the last 12 months and earned at 251.23 least $1,000 in gross wages during the time the migrant worker 251.24 worked in this state. 251.25 Subd. 2. [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 251.26 assistance unit that has met the requirements of section 251.27 256J.12, the number of months that the assistance unit receives 251.28 benefits under the interstate payment standards in this section 251.29 is not affected by an absence from Minnesota for fewer than 30 251.30 consecutive days. 251.31 (b) For an assistance unit that has met the requirements of 251.32 section 256J.12, the number of months that the assistance unit 251.33 receives benefits under the interstate payment standards in this 251.34 section is not affected by an absence from Minnesota for more 251.35 than 30 consecutive days but fewer than 90 consecutive days, 251.36 provided the assistance unit continues to maintain a residence 252.1 in Minnesota during the period of absence. 252.2 Subd. 3. [EXCEPTIONS TO THE INTERSTATE PAYMENT 252.3 POLICY.] Applicants who lived in another state in the 12 months 252.4 previous to application for assistance are exempt from the 252.5 interstate payment policy for the months that a member of the 252.6 unit: 252.7 (1) served in the United States armed services, provided 252.8 the person returned to Minnesota within 30 days of leaving the 252.9 armed forces, and intends to remain in Minnesota; 252.10 (2) attended school in another state, paid nonresident 252.11 tuition or Minnesota tuition rates under a reciprocity 252.12 agreement, provided the person left Minnesota specifically to 252.13 attend school and returned to Minnesota within 30 days of 252.14 graduation with the intent to remain in Minnesota; or 252.15 (3) meets the following criteria: 252.16 (i) a minor child or a minor caregiver moves from another 252.17 state to the residence of a relative caregiver; 252.18 (ii) the minor caregiver applies for and receives family 252.19 cash assistance; 252.20 (iii) the relative caregiver chooses not to be part of the 252.21 MFIP-S assistance unit; and 252.22 (iv) the relative caregiver has resided in Minnesota for at 252.23 least 12 months from the date the assistance unit applies for 252.24 cash assistance. 252.25 Subd. 4. [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 252.26 mandatory unit members who have resided in Minnesota for 12 252.27 months immediately before the date of application meet 252.28 eligibility for the Minnesota payment standard for the other 252.29 assistance unit members. 252.30 Sec. 71. Minnesota Statutes 1997 Supplement, section 252.31 256J.45, subdivision 1, is amended to read: 252.32 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 252.33 county agency must provide each MFIP-S caregiver with a 252.34 face-to-face orientation. The caregiver must attend the 252.35 orientation. The county agency must inform the caregiver that 252.36 failure to attend the orientation is considereda firstan 253.1 occurrence of noncompliance with program requirements, and will 253.2 result in the imposition of a sanction under section 253.3 256J.46. If the client complies with the orientation 253.4 requirement prior to the effective date of the sanction, the 253.5 orientation sanction shall be lifted. 253.6 Sec. 72. Minnesota Statutes 1997 Supplement, section 253.7 256J.45, subdivision 2, is amended to read: 253.8 Subd. 2. [GENERAL INFORMATION.] The MFIP-S orientation 253.9 must consist of a presentation that informs caregivers of: 253.10 (1) the necessity to obtain immediate employment; 253.11 (2) the work incentives under MFIP-S; 253.12 (3) the requirement to comply with the employment plan and 253.13 other requirements of the employment and training services 253.14 component of MFIP-S; 253.15 (4) the consequences for failing to comply with the 253.16 employment plan and other program requirements; 253.17 (5) the rights, responsibilities, and obligations of 253.18 participants; 253.19 (6) the types and locations of child care services 253.20 available through the county agency; 253.21 (7) the availability and the benefits of the early 253.22 childhood health and developmental screening under sections 253.23 123.701 to 123.74; 253.24 (8) the caregiver's eligibility for transition year child 253.25 care assistance under section 119B.05; 253.26 (9) the caregiver's eligibility for extended medical 253.27 assistance when the caregiver loses eligibility for MFIP-S due 253.28 to increased earnings or increased child or spousal support;and253.29 (10) the caregiver's option to choose an employment and 253.30 training provider and information about each provider, including 253.31 but not limited to, services offered, program components, job 253.32 placement rates, job placement wages, and job retention rates; 253.33 (11) the caregiver's option to request approval of an 253.34 education and training plan pursuant to section 256J.52; and 253.35 (12) the work study programs available under the higher 253.36 educational system. 254.1 Sec. 73. Minnesota Statutes 1997 Supplement, section 254.2 256J.45, is amended by adding a subdivision to read: 254.3 Subd. 3. [GOOD CAUSE EXEMPTIONS FOR NOT ATTENDING 254.4 ORIENTATION.] (a) The county agency shall not impose the 254.5 sanction under section 256J.46 if it determines that the 254.6 participant has good cause for failing to attend orientation. 254.7 Good cause exists when: 254.8 (1) appropriate child care is not available; 254.9 (2) the participant is ill or injured; 254.10 (3) a family member is ill and needs care by the 254.11 participant that prevents the participant from attending 254.12 orientation; 254.13 (4) the caregiver is unable to secure necessary 254.14 transportation; 254.15 (5) the caregiver is in an emergency situation that 254.16 prevents orientation attendance; 254.17 (6) the orientation conflicts with the caregiver's work, 254.18 training, or school schedule; or 254.19 (7) the caregiver documents other verifiable impediments to 254.20 orientation attendance beyond the caregiver's control. 254.21 (b) Counties must work with clients to provide child care 254.22 and transportation necessary to ensure a caregiver has every 254.23 opportunity to attend orientation. 254.24 Sec. 74. Minnesota Statutes 1997 Supplement, section 254.25 256J.46, subdivision 1, is amended to read: 254.26 Subdivision 1. [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 254.27 WITH PROGRAM REQUIREMENTS.] (a) The following participants are 254.28 subject to a sanction under this subdivision: 254.29 (1) a participant who fails without good cause to comply 254.30 with the requirements of this chapter, and who is not subject to 254.31 a sanction under subdivision 2, shall be subject to a sanction254.32as provided in this subdivision; and 254.33 (2) a participant who has not complied with the orientation 254.34 requirement before the effective date of the sanction. 254.35 A sanction under this subdivision becomes effective ten 254.36 days after the required notice is given. For purposes of this 255.1 subdivision, each month that a participant fails to comply with 255.2 a requirement of this chapter shall be considered a separate 255.3 occurrence of noncompliance. A participant who has had one or 255.4 more sanctions imposed must remain in compliance with the 255.5 provisions of this chapter for six months in order for a 255.6 subsequent occurrence of noncompliance to be considered a first 255.7 occurrence. 255.8 (b) Sanctions for noncompliance shall be imposed as follows: 255.9 (1) For the first occurrence of noncompliance by a 255.10 participant in a single-parent household or by one participant 255.11 in a two-parent household, theparticipant'sfamily's grant 255.12 shall be reduced by ten percent of theapplicableMFIP-S 255.13 transitional standard or the interstate transitional standard 255.14 for an assistance unit of the same size, whichever is 255.15 applicable, with the residual paid to the participant. The 255.16 reduction in the grant amount must be in effect for a minimum of 255.17 one month and shall be removed in the month following the month 255.18 that the participant returns to compliance or in the month 255.19 following the minimum one-month sanction, whichever is later. 255.20 (2) For a second or subsequent occurrence of noncompliance, 255.21 or when both participants in a two-parent household are out of 255.22 compliance at the same time, theparticipant's rentfamily's 255.23 shelter costs shall be vendor paid up to the amount of the cash 255.24 portion of the MFIP-S grant for which the participant's 255.25 assistance unit is eligible. At county option, 255.26 theparticipant'sfamily's utilities may also be vendor paid up 255.27 to the amount of the cash portion of the MFIP-S grant remaining 255.28 after vendor payment of theparticipant's rentfamily's shelter 255.29 costs.The vendor payment of rent and, if in effect, utilities,255.30must be in effect for six months from the date that a sanction255.31is imposed under this clause.The residual amount of the grant 255.32 after vendor payment, if any, must be reduced by an amount equal 255.33 to 30 percent of theapplicableMFIP-S transitional standard, or 255.34 the interstate transitional standard for an assistance unit of 255.35 the same size, whichever is applicable, before the residual is 255.36 paid to theparticipantfamily. The reduction in the grant 256.1 amount must be in effect for a minimum of one month and shall be 256.2 removed in the month following the month thatthea participant 256.3 in a one-parent household returns to compliance or in the month 256.4 following the minimum one-month sanction, whichever is later. 256.5 In a two-parent household, the grant reduction shall be removed 256.6 in the month following the month both participants return to 256.7 compliance or in the month following the minimum one-month 256.8 sanction, whichever is later. The vendor payment of 256.9rentshelter costs and, if applicable, utilities shall be 256.10 removed six months after the month in which the 256.11 participantreturnsor participants return to compliance. 256.12 (c) No later than during the second month that a sanction 256.13 under paragraph (b), clause (2), is in effect due to 256.14 noncompliance with employment services, the participant's case 256.15 file must be reviewed to determine if: 256.16 (i) the continued noncompliance can be explained and 256.17 mitigated by providing a needed preemployment activity, as 256.18 defined in section 256J.49, subdivision 13, clause (16); 256.19 (ii) the participant qualifies for a good cause exception 256.20 under section 256J.57; or 256.21 (iii) the participant qualifies for an exemption under 256.22 section 256J.56. 256.23 If the lack of an identified activity can explain the 256.24 noncompliance, the county must work with the participant to 256.25 provide the identified activity, and the county must restore the 256.26 participant's grant amount to the full amount for which the 256.27 assistance unit is eligible. The grant must be restored 256.28 retroactively to the first day of the month in which the 256.29 participant was found to lack preemployment activities or to 256.30 qualify for an exemption or good cause exception. 256.31 If the participant is found to qualify for a good cause 256.32 exception or an exemption, the county must restore the 256.33 participant's grant to the full amount for which the assistance 256.34 unit is eligible.If the participant's grant is restored under256.35this paragraph, the vendor payment of rent and if applicable,256.36utilities, shall be removed six months after the month in which257.1the sanction was imposed and the county must consider a257.2subsequent occurrence of noncompliance to be a first occurrence.257.3 Sec. 75. Minnesota Statutes 1997 Supplement, section 257.4 256J.46, subdivision 2, is amended to read: 257.5 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 257.6 REQUIREMENTS.] The grant of an MFIP-S caregiver who refuses to 257.7 cooperate, as determined by the child support enforcement 257.8 agency, with support requirements under section 256.741, if 257.9 enacted, shall be subject to sanction as specified in this 257.10 subdivision. The assistance unit's grant must be reduced by 25 257.11 percent of the applicable transitional standard. The residual 257.12 amount of the grant, if any, must be paid to the caregiver. A 257.13 sanction under this subdivision becomes effective ten days after 257.14 the required notice is given. The sanction must be in effect 257.15 for a minimum of one month and shall be removed only when the 257.16 caregiver cooperates with the support requirements or in the 257.17 month following the minimum one-month sanction, whichever is 257.18 later. Each month that an MFIP-S caregiver fails to comply with 257.19 the requirements of section 256.741 must be considered a 257.20 separate occurrence of noncompliance. An MFIP-S caregiver who 257.21 has had one or more sanctions imposed must remain in compliance 257.22 with the requirements of section 256.741 for six months in order 257.23 for a subsequent sanction to be considered a first occurrence. 257.24 Sec. 76. Minnesota Statutes 1997 Supplement, section 257.25 256J.46, subdivision 2a, is amended to read: 257.26 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 257.27 provisions of subdivisions 1 and 2, for a participant subject to 257.28 a sanction for refusal to comply with child support requirements 257.29 under subdivision 2 and subject to a concurrent sanction for 257.30 refusal to cooperate with other program requirements under 257.31 subdivision 1, sanctions shall be imposed in the manner 257.32 prescribed in this subdivision. 257.33 A participant who has had one or more sanctions imposed 257.34 under this subdivision must remain in compliance with the 257.35 provisions of this chapter for six months in order for a 257.36 subsequent occurrence of noncompliance to be considered a first 258.1 occurrence. Any vendor payment ofrentshelter costs or 258.2 utilities under this subdivision must remain in effect for six 258.3 months after the month in which the participant is no longer 258.4 subject to sanction under subdivision 1. 258.5 (b) If the participant was subject to sanction for: 258.6 (i) noncompliance under subdivision 1 before being subject 258.7 to sanction for noncooperation under subdivision 2; or 258.8 (ii) noncooperation under subdivision 2 before being 258.9 subject to sanction for noncompliance under subdivision 1; 258.10 the participant shall be sanctioned as provided in subdivision 258.11 1, paragraph (b), clause (2), and the requirement that the 258.12 county conduct a review as specified in subdivision 1, paragraph 258.13 (c), remains in effect. 258.14 (c) A participant who first becomes subject to sanction 258.15 under both subdivisions 1 and 2 in the same month is subject to 258.16 sanction as follows: 258.17 (i) in the first month of noncompliance and noncooperation, 258.18 the participant's grant must be reduced by 25 percent of the 258.19 applicable transitional standard, with any residual amount paid 258.20 to the participant; 258.21 (ii) in the second and subsequent months of noncompliance 258.22 and noncooperation, the participant shall be sanctioned as 258.23 provided in subdivision 1, paragraph (b), clause (2). 258.24 The requirement that the county conduct a review as 258.25 specified in subdivision 1, paragraph (c), remains in effect. 258.26 (d) A participant remains subject to sanction under 258.27 subdivision 2 if the participant: 258.28 (i) returns to compliance and is no longer subject to 258.29 sanction under subdivision 1; or 258.30 (ii) has the sanction under subdivision 1, paragraph (b), 258.31 removed upon completion of the review under subdivision 1, 258.32 paragraph (c). 258.33 A participant remains subject to sanction under subdivision 258.34 1, paragraph (b), if the participant cooperates and is no longer 258.35 subject to sanction under subdivision 2. 258.36 Sec. 77. Minnesota Statutes 1997 Supplement, section 259.1 256J.47, subdivision 4, is amended to read: 259.2 Subd. 4. [INELIGIBILITY FOR MFIP-S; EMERGENCY ASSISTANCE; 259.3 AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of diversionary 259.4 assistance, the family is ineligible for MFIP-S, emergency 259.5 assistance, and emergency general assistance for a period of 259.6 time. To determine the period of ineligibility, the county 259.7 shall use the following formula: regardless of household 259.8 changes, the county agency must calculate the number of days of 259.9 ineligibility by dividing the diversionary assistance issued by 259.10 the transitional standard a family of the same size and 259.11 composition would have received under MFIP-S, or if applicable 259.12 the interstate transitional standard, multiplied by 30, 259.13 truncating the result. The ineligibility period begins the date 259.14 the diversionary assistance is issued. 259.15 Sec. 78. Minnesota Statutes 1997 Supplement, section 259.16 256J.48, subdivision 2, is amended to read: 259.17 Subd. 2. [ELIGIBILITY.] Notwithstanding other eligibility 259.18 provisions of this chapter, any family without resources 259.19 immediately available to meet emergency needs identified in 259.20 subdivision 3 shall be eligible for an emergency grant under the 259.21 following conditions: 259.22 (1) a family member has resided in this state for at least 259.23 30 days; 259.24 (2) the family is without resources immediately available 259.25 to meet emergency needs; 259.26 (3) assistance is necessary to avoid destitution or provide 259.27 emergency shelter arrangements;and259.28 (4) the family's destitution or need for shelter or 259.29 utilities did not arise because the child or relative caregiver 259.30 refused without good cause under section 256J.57 to accept 259.31 employment or training for employment in this state or another 259.32 state; and 259.33 (5) at least one child or pregnant woman in the emergency 259.34 assistance unit meets MFIP-S citizenship requirements in section 259.35 256J.11. 259.36 Sec. 79. Minnesota Statutes 1997 Supplement, section 260.1 256J.48, is amended by adding a subdivision to read: 260.2 Subd. 2a. [MIGRANT WORKER ELIGIBILITY.] Notwithstanding 260.3 other eligibility provisions of this chapter, migrant workers, 260.4 as defined in section 256J.08, and their immediate families, who 260.5 meet the eligibility requirements in subdivision 2, except the 260.6 30-day residency requirement, are eligible for emergency 260.7 assistance, if the migrant worker provides verification to the 260.8 county agency that the migrant worker worked in this state 260.9 within the last 12 months and earned at least $1,000 in gross 260.10 wages during the time the migrant worker worked in this state. 260.11 Sec. 80. Minnesota Statutes 1997 Supplement, section 260.12 256J.48, subdivision 3, is amended to read: 260.13 Subd. 3. [EMERGENCY NEEDS.] Emergency needs are limited to 260.14 the following: 260.15 (a) [RENT.] A county agency may deny assistance to prevent 260.16 eviction from rented or leased shelter of an otherwise eligible 260.17 applicant when the county agency determines that an applicant's 260.18 anticipated income will not cover continued payment for shelter, 260.19 subject to conditions in clauses (1) to (3): 260.20 (1) a county agency must not deny assistance when an 260.21 applicant can document that the applicant is unable to locate 260.22 habitable shelter, unless the county agency can document that 260.23 one or more habitable shelters are available in the community 260.24 that will result in at least a 20 percent reduction in monthly 260.25 expense for shelter and that this shelter will be cost-effective 260.26 for the applicant; 260.27 (2) when no alternative shelter can be identified by either 260.28 the applicant or the county agency, the county agency shall not 260.29 deny assistance because anticipated income will not cover rental 260.30 obligation; and 260.31 (3) when cost-effective alternative shelter is identified, 260.32 the county agency shall issue assistance for moving expenses as 260.33 provided in paragraph(d)(e). 260.34 (b) [DEFINITIONS.] For purposes of paragraph (a), the 260.35 following definitions apply (1) "metropolitan statistical area" 260.36 is as defined by the United States Census Bureau; (2) 261.1 "alternative shelter" includes any shelter that is located 261.2 within the metropolitan statistical area containing the county 261.3 and for which the applicant is eligible, provided the applicant 261.4 does not have to travel more than 20 miles to reach the shelter 261.5 and has access to transportation to the shelter. Clause (2) 261.6 does not apply to counties in the Minneapolis-St. Paul 261.7 metropolitan statistical area. 261.8 (c) [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 261.9 agency shall issue assistance for mortgage or contract for deed 261.10 arrearages on behalf of an otherwise eligible applicant 261.11 according to clauses (1) to (4): 261.12 (1) assistance for arrearages must be issued only when a 261.13 home is owned, occupied, and maintained by the applicant; 261.14 (2) assistance for arrearages must be issued only when no 261.15 subsequent foreclosure action is expected within the 12 months 261.16 following the issuance; 261.17 (3) assistance for arrearages must be issued only when an 261.18 applicant has been refused refinancing through a bank or other 261.19 lending institution and the amount payable, when combined with 261.20 any payments made by the applicant, will be accepted by the 261.21 creditor as full payment of the arrearage; 261.22 (4) costs paid by a family which are counted toward the 261.23 payment requirements in this clause are: principle and interest 261.24 payments on mortgages or contracts for deed, balloon payments, 261.25 homeowner's insurance payments, manufactured home lot rental 261.26 payments, and tax or special assessment payments related to the 261.27 homestead. Costs which are not counted include closing costs 261.28 related to the sale or purchase of real property. 261.29 To be eligible for assistance for costs specified in clause 261.30 (4) which are outstanding at the time of foreclosure, an 261.31 applicant must have paid at least 40 percent of the family's 261.32 gross income toward these costs in the month of application and 261.33 the 11-month period immediately preceding the month of 261.34 application. 261.35 When an applicant is eligible under clause (4), a county 261.36 agency shall issue assistance up to a maximum of four times the 262.1 MFIP-S transitional standard for a comparable assistance unit. 262.2 (d) [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 262.3 issue assistance for damage or utility deposits when necessary 262.4 to alleviate the emergency. The county may require that 262.5 assistance paid in the form of a damage depositor a utility262.6deposit, less any amount retained by the landlord to remedy a 262.7 tenant's default in payment of rent or other funds due to the 262.8 landlord under a rental agreement, or to restore the premises to 262.9 the condition at the commencement of the tenancy, ordinary wear 262.10 and tear excepted, be returned to the county when the individual 262.11 vacates the premises or be paid to the recipient's new landlord 262.12 as a vendor payment. The county may require that assistance 262.13 paid in the form of a utility deposit less any amount retained 262.14 to satisfy outstanding utility costs be returned to the county 262.15 when the person vacates the premises, or be paid for the 262.16 person's new housing unit as a vendor payment. The vendor 262.17 payment of returned funds shall not be considered a new use of 262.18 emergency assistance. 262.19 (e) [MOVING EXPENSES.] A county agency shall issue 262.20 assistance for expenses incurred when a family must move to a 262.21 different shelter according to clauses (1) to (4): 262.22 (1) moving expenses include the cost to transport personal 262.23 property belonging to a family, the cost for utility connection, 262.24 and the cost for securing different shelter; 262.25 (2) moving expenses must be paid only when the county 262.26 agency determines that a move is cost-effective; 262.27 (3) moving expenses must be paid at the request of an 262.28 applicant, but only when destitution or threatened destitution 262.29 exists; and 262.30 (4) moving expenses must be paid when a county agency 262.31 denies assistance to prevent an eviction because the county 262.32 agency has determined that an applicant's anticipated income 262.33 will not cover continued shelter obligation in paragraph (a). 262.34 (f) [HOME REPAIRS.] A county agency shall pay for repairs 262.35 to the roof, foundation, wiring, heating system, chimney, and 262.36 water and sewer system of a home that is owned and lived in by 263.1 an applicant. 263.2 The applicant shall document, and the county agency shall 263.3 verify the need for and method of repair. 263.4 The payment must be cost-effective in relation to the 263.5 overall condition of the home and in relation to the cost and 263.6 availability of alternative housing. 263.7 (g) [UTILITY COSTS.] Assistance for utility costs must be 263.8 made when an otherwise eligible family has had a termination or 263.9 is threatened with a termination of municipal water and sewer 263.10 service, electric, gas or heating fuel service, or lacks wood 263.11 when that is the heating source, subject to the conditions in 263.12 clauses (1) and (2): 263.13 (1) a county agency must not issue assistance unless the 263.14 county agency receives confirmation from the utility provider 263.15 that assistance combined with payment by the applicant will 263.16 continue or restore the utility; and 263.17 (2) a county agency shall not issue assistance for utility 263.18 costs unless a family paid at least eight percent of the 263.19 family's gross income toward utility costs due during the 263.20 preceding 12 months. 263.21 Clauses (1) and (2) must not be construed to prevent the 263.22 issuance of assistance when a county agency must take immediate 263.23 and temporary action necessary to protect the life or health of 263.24 a child. 263.25 (h) [SPECIAL DIETS.] Effective January 1, 1998, a county 263.26 shall pay for special diets or dietary items for MFIP-S 263.27 participants. Persons receiving emergency assistance funds for 263.28 special diets or dietary items are also eligible to receive 263.29 emergency assistance for shelter and utility emergencies, if 263.30 otherwise eligible. The need for special diets or dietary items 263.31 must be prescribed by a licensed physician. Costs for special 263.32 diets shall be determined as percentages of the allotment for a 263.33 one-person household under the Thrifty Food Plan as defined by 263.34 the United States Department of Agriculture. The types of diets 263.35 and the percentages of the Thrifty Food Plan that are covered 263.36 are as follows: 264.1 (1) high protein diet, at least 80 grams daily, 25 percent 264.2 of Thrifty Food Plan; 264.3 (2) controlled protein diet, 40 to 60 grams and requires 264.4 special products, 100 percent of Thrifty Food Plan; 264.5 (3) controlled protein diet, less than 40 grams and 264.6 requires special products, 125 percent of Thrifty Food Plan; 264.7 (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 264.8 (5) high residue diet, 20 percent of Thrifty Food Plan; 264.9 (6) pregnancy and lactation diet, 35 percent of Thrifty 264.10 Food Plan; 264.11 (7) gluten-free diet, 25 percent of Thrifty Food Plan; 264.12 (8) lactose-free diet, 25 percent of Thrifty Food Plan; 264.13 (9) antidumping diet, 15 percent of Thrifty Food Plan; 264.14 (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 264.15 (11) ketogenic diet, 25 percent of Thrifty Food Plan. 264.16 Sec. 81. Minnesota Statutes 1997 Supplement, section 264.17 256J.49, subdivision 4, is amended to read: 264.18 Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 264.19 "Employment and training service provider" means: 264.20 (1) a public, private, or nonprofit employment and training 264.21 agency certified by the commissioner of economic security under 264.22 sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 264.23 is approved under section 256J.51 and is included in the county 264.24 plan submitted under section 256J.50, subdivision 7;or264.25 (2) a public, private, or nonprofit agency that is not 264.26 certified by the commissioner under clause (1), but with which a 264.27 county has contracted to provide employment and training 264.28 services and which is included in the county's plan submitted 264.29 under section 256J.50, subdivision 7; or 264.30 (3) a county agency, if the countyis certified under264.31clause (1)has opted to provide employment and training services 264.32 and the county has indicated that fact in the plan submitted 264.33 under section 256J.50, subdivision 7. 264.34 Notwithstanding section 268.871, an employment and training 264.35 services provider meeting this definition may deliver employment 264.36 and training services under this chapter. 265.1 Sec. 82. Minnesota Statutes 1997 Supplement, section 265.2 256J.50, subdivision 5, is amended to read: 265.3 Subd. 5. [PARTICIPATION REQUIREMENTS FOR SINGLE-PARENT AND 265.4 TWO-PARENT CASES.] (a) A county must establish a uniform 265.5 schedule for requiring participation by single parents. 265.6 Mandatory participation must be required within six months of 265.7 eligibility for cash assistance. For two-parent cases, 265.8 participation is required concurrent with the receipt of MFIP-S 265.9 cash assistance. 265.10 (b) Beginning January 1, 1998, with the exception of 265.11 caregivers required to attend high school under the provisions 265.12 of section 256J.54, subdivision 5, MFIP caregivers, upon 265.13 completion of the secondary assessment, must develop an 265.14 employment plan and participate in work activities. 265.15 (c) In single-parent families with no children under six 265.16 years of age, the job counselor and the caregiver must develop 265.17 an employment plan that includes 20 to 35 hours per week of work 265.18 activities for the period January 1, 1998, to September 30, 265.19 1998; 25 to 35 hours of work activities per week in federal 265.20 fiscal year 1999; and 30 to 35 hours per week of work activities 265.21 in federal fiscal year 2000 and thereafter. 265.22 (d) In single-parent families with a child under six years 265.23 of age, the job counselor and the caregiver must develop an 265.24 employment plan that includes 20 to 35 hours per week of work 265.25 activities. 265.26 (e) In two-parent families, the job counselor and the 265.27 caregivers must develop employment plans. 265.28 (f) Notwithstanding paragraphs (c) to (e), an MFIP 265.29 caregiver who is meeting the hourly work participation 265.30 requirements under the Personal Responsibility and Work 265.31 Opportunity Reconciliation Act of 1996 through employment and is 265.32 enrolled in training or education that meets the requirements of 265.33 section 256J.53, subdivision 2, concurrent with employment, 265.34 cannot be required to work additional hours under this section. 265.35 Sec. 83. Minnesota Statutes 1997 Supplement, section 265.36 256J.50, is amended by adding a subdivision to read: 266.1 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OF DOMESTIC 266.2 VIOLENCE.] County agencies and their contractors must provide 266.3 universal notification to all applicants and recipients of 266.4 MFIP-S that: 266.5 (1) referrals to counseling and supportive services are 266.6 available for victims of domestic violence; 266.7 (2) nonpermanent resident battered individuals married to 266.8 United States citizens or permanent residents may be eligible to 266.9 petition for permanent residency under the Violence Against 266.10 Women Act, and that referrals to appropriate legal services are 266.11 available; 266.12 (3) victims of domestic violence are exempt from the 266.13 60-month limit on assistance while the individual is complying 266.14 with an approved safety plan, as defined in section 256J.49, 266.15 subdivision 11; and 266.16 (4) victims of domestic violence may choose to be exempt or 266.17 deferred from work requirements for up to 12 months while the 266.18 individual is complying with an approved safety plan as defined 266.19 in section 256J.49, subdivision 11. 266.20 Notification must be in writing and orally at the time of 266.21 application and recertification, when the individual is referred 266.22 to the title IV-D child support agency, and at the beginning of 266.23 any job training or work placement assistance program. 266.24 Sec. 84. Minnesota Statutes 1997 Supplement, section 266.25 256J.52, subdivision 4, is amended to read: 266.26 Subd. 4. [SECONDARY ASSESSMENT.] (a) The job counselor 266.27 must conduct a secondary assessment for those participants who: 266.28 (1) in the judgment of the job counselor, have barriers to 266.29 obtaining employment that will not be overcome with a job search 266.30 support plan under subdivision 3; 266.31 (2) have completed eight weeks of job search under 266.32 subdivision 3 without obtaining suitable employment;or266.33 (3) have not received a secondary assessment, are working 266.34 at least 20 hours per week, and the participant, job counselor, 266.35 or county agency requests a secondary assessment; or 266.36 (4) have an existing plan or are already involved in 267.1 training or education activities under section 256J.55, 267.2 subdivision 5. 267.3 (b) In the secondary assessment the job counselor must 267.4 evaluate the participant's skills and prior work experience, 267.5 family circumstances, interests and abilities, need for 267.6 preemployment activities, supportive or educational services, 267.7 and the extent of any barriers to employment. The job counselor 267.8 must use the information gathered through the secondary 267.9 assessment to develop an employment plan under subdivision 5. 267.10 (c) The provider shall make available to participants 267.11 information regarding additional vendors or resources which 267.12 provide employment and training services that may be available 267.13 to the participant under a plan developed under this section. 267.14 The information must include a brief summary of services 267.15 provided and related performance indicators. Performance 267.16 indicators must include, but are not limited to, the average 267.17 time to complete program offerings, placement rates, entry and 267.18 average wages, and retention rates. To be included in the 267.19 information given to participants, a vendor or resource must 267.20 provide counties with relevant information in the format 267.21 required by the county. 267.22 Sec. 85. Minnesota Statutes 1997 Supplement, section 267.23 256J.54, subdivision 2, is amended to read: 267.24 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 267.25 PLAN.] For caregivers who are under age 18 without a high school 267.26 diploma or its equivalent, the assessment under subdivision 1 267.27 and the employment plan under subdivision 3 must be completed by 267.28 the social services agency under section 257.33. For caregivers 267.29 who are age 18 or 19 without a high school diploma or its 267.30 equivalent, the assessment under subdivision 1 and the 267.31 employment plan under subdivision 3 must be completed by the job 267.32 counselor. The social services agency or the job counselor 267.33 shall consult with representatives of educational agencies that 267.34 are required to assist in developing educational plans under 267.35 section 126.235. 267.36 Sec. 86. Minnesota Statutes 1997 Supplement, section 268.1 256J.54, subdivision 3, is amended to read: 268.2 Subd. 3. [EDUCATIONAL OPTION DEVELOPED.] If the job 268.3 counselor or county social services agency identifies an 268.4 appropriate educational option for a caregiver under the age of 268.5 20 without a high school diploma or its equivalent,itthe job 268.6 counselor or agency must develop an employment plan which 268.7 reflects the identified option. The plan must specify that 268.8 participation in an educational activity is required, what 268.9 school or educational program is most appropriate, the services 268.10 that will be provided, the activities the caregiver will take 268.11 part in, including child care and supportive services, the 268.12 consequences to the caregiver for failing to participate or 268.13 comply with the specified requirements, and the right to appeal 268.14 any adverse action. The employment plan must, to the extent 268.15 possible, reflect the preferences of the caregiver. 268.16 Sec. 87. Minnesota Statutes 1997 Supplement, section 268.17 256J.54, subdivision 4, is amended to read: 268.18 Subd. 4. [NO APPROPRIATE EDUCATIONAL OPTION.] If the job 268.19 counselor determines that there is no appropriate educational 268.20 option for a caregiver who is age 18 or 19 without a high school 268.21 diploma or its equivalent, the job counselor must develop an 268.22 employment plan, as defined in section 256J.49, subdivision 5, 268.23 for the caregiver. If the county social services agency 268.24 determines that school attendance is not appropriate for a 268.25 caregiver under age 18 without a high school diploma or its 268.26 equivalent, the county agency shall refer the caregiver to 268.27 social services for services as provided in section 257.33. 268.28 Sec. 88. Minnesota Statutes 1997 Supplement, section 268.29 256J.54, subdivision 5, is amended to read: 268.30 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 268.31 the provisions of section 256J.56, minor parents, or 18- or 268.32 19-year-old parents without a high school diploma or its 268.33 equivalent must attend school unless: 268.34 (1) transportation services needed to enable the caregiver 268.35 to attend school are not available; 268.36 (2) appropriate child care services needed to enable the 269.1 caregiver to attend school are not available; 269.2 (3) the caregiver is ill or incapacitated seriously enough 269.3 to prevent attendance at school; or 269.4 (4) the caregiver is needed in the home because of the 269.5 illness or incapacity of another member of the household. This 269.6 includes a caregiver of a child who is younger than six weeks of 269.7 age. 269.8 (b) The caregiver must be enrolled in a secondary school 269.9 and meeting the school's attendance requirements. The county, 269.10 social service agency, or job counselor must verify that the 269.11 caregiver is meeting the school's attendance requirements at 269.12 least once per quarter. An enrolled caregiver is considered to 269.13 be meeting the attendance requirements when the school is not in 269.14 regular session, including during holiday and summer breaks. 269.15 Sec. 89. Minnesota Statutes 1997 Supplement, section 269.16 256J.55, subdivision 5, is amended to read: 269.17 Subd. 5. [OPTION TO UTILIZE EXISTING PLAN.] With job 269.18 counselor approval, if a participant is already complying with a 269.19 job search support or employment plan that was developed for a 269.20 different program or is already involved in education or 269.21 training activities, the participant may utilize that plan and 269.22 that program's services, subject to the requirements of 269.23 subdivision 3, to be in compliance with sections 256J.52 to 269.24 256J.57 so long as the plan meets, or is modified to meet, the 269.25 requirements of those sections. 269.26 Sec. 90. Minnesota Statutes 1997 Supplement, section 269.27 256J.56, is amended to read: 269.28 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 269.29 EXEMPTIONS.] 269.30 An MFIP-S caregiver is exempt from the requirements of 269.31 sections 256J.52 to 256J.55 if the caregiver belongs to any of 269.32 the following groups: 269.33 (1) individuals who are age 60 or older; 269.34 (2) individuals who are suffering from a professionally 269.35 certified permanent or temporary illness, injury, or incapacity 269.36 which is expected to continue for more than 30 days and which 270.1 prevents the person from obtaining or retaining employment. 270.2 Persons in this category with a temporary illness, injury, or 270.3 incapacity must be reevaluated at least quarterly; 270.4 (3) caregivers whose presence in the home is required 270.5 because of the professionally certified illness or incapacity of 270.6 another member in the assistance unit, a relative in the 270.7 household, or a foster child in the household; 270.8 (4) women who are pregnant, if the pregnancy has resulted 270.9 in a professionally certified incapacity that prevents the woman 270.10 from obtaining or retaining employment; 270.11 (5) caregivers of a child under the age of one year who 270.12 personally provide full-time care for the child. This exemption 270.13 may be used for only 12 months in a lifetime. In two-parent 270.14 households, only one parent or other relative may qualify for 270.15 this exemption; 270.16 (6) individuals who are single parents or one parent in a 270.17 two-parent family employed at least40 hours per week or at270.18least 30 hours per week and engaged in job search for at least270.19an additional ten35 hours per week; 270.20 (7) individuals experiencing a personal or family crisis 270.21 that makes them incapable of participating in the program, as 270.22 determined by the county agency. If the participant does not 270.23 agree with the county agency's determination, the participant 270.24 may seek professional certification, as defined in section 270.25 256J.08, that the participant is incapable of participating in 270.26 the program. 270.27 Persons in this exemption category must be reevaluated 270.28 every 60 days; or 270.29 (8) second parents in two-parent families, provided the270.30second parent isemployed for 20 or more hours per week provided 270.31 the first parent is employed at least 35 hours per week. 270.32 A caregiver who is exempt under clause (5) must enroll in 270.33 and attend an early childhood and family education class, a 270.34 parenting class, or some similar activity, if available, during 270.35 the period of time the caregiver is exempt under this section. 270.36 Notwithstanding section 256J.46, failure to attend the required 271.1 activity shall not result in the imposition of a sanction. 271.2 Sec. 91. Minnesota Statutes 1997 Supplement, section 271.3 256J.57, subdivision 1, is amended to read: 271.4 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 271.5 county agency shall not impose the sanction under section 271.6 256J.46 if it determines that the participant has good cause for 271.7 failing to comply with the requirements ofsection 256J.45 or271.8 sections 256J.52 to 256J.55. Good cause exists when: 271.9 (1) appropriate child care is not available; 271.10 (2) the job does not meet the definition of suitable 271.11 employment; 271.12 (3) the participant is ill or injured; 271.13 (4) afamilymember of the assistance unit, a relative in 271.14 the household, or a foster child in the household is ill and 271.15 needs care by the participant that prevents the participant from 271.16 complying with the job search support plan or employment plan; 271.17 (5) the parental caregiver is unable to secure necessary 271.18 transportation; 271.19 (6) the parental caregiver is in an emergency situation 271.20 that prevents compliance with the job search support plan or 271.21 employment plan; 271.22 (7) the schedule of compliance with the job search support 271.23 plan or employment plan conflicts with judicial proceedings; 271.24 (8) the parental caregiver is already participating in 271.25 acceptable work activities; 271.26 (9) the employment plan requires an educational program for 271.27 a caregiver under age 20, but the educational program is not 271.28 available; 271.29 (10) activities identified in the job search support plan 271.30 or employment plan are not available; 271.31 (11) the parental caregiver is willing to accept suitable 271.32 employment, but suitable employment is not available; or 271.33 (12) the parental caregiver documents other verifiable 271.34 impediments to compliance with the job search support plan or 271.35 employment plan beyond the parental caregiver's control. 271.36 Sec. 92. Minnesota Statutes 1997 Supplement, section 272.1 256J.645, subdivision 3, is amended to read: 272.2 Subd. 3. [FUNDING.] If the commissioner and an Indian 272.3 tribe are parties to an agreement under this subdivision, the 272.4 agreement may annually provide to the Indian tribe the funding 272.5 amount in clause (1) or (2): 272.6 (1) if the Indian tribe operated a tribal STRIDE program 272.7 during state fiscal year 1997, the amount to be provided is the 272.8 amount the Indian tribe received from the state for operation of 272.9 its tribal STRIDE program in state fiscal year 1997, except that 272.10 the amount provided for a fiscal year may increase or decrease 272.11 in the same proportion that the total amount of state and 272.12 federal funds available for MFIP-S employment and training 272.13 services increased or decreased that fiscal year; or 272.14 (2) if the Indian tribe did not operate a tribal STRIDE 272.15 program during state fiscal year 1997, the commissioner may 272.16 provide to the Indian tribe for the first year of operations the 272.17 amount determined by multiplying the state allocation for MFIP-S 272.18 employment and training services to each county agency in the 272.19 Indian tribe's service delivery area by the percentage of MFIP-S 272.20 recipients in that county who were members of the Indian tribe 272.21 during the previous state fiscal year. The resulting amount 272.22 shall also be the amount that the commissioner may provide to 272.23 the Indian tribe annually thereafter through an agreement under 272.24 this subdivision, except that the amount provided for a fiscal 272.25 year may increase or decrease in the same proportion that the 272.26 total amount of state and federal funds available for MFIP-S 272.27 employment and training services increased or decreased that 272.28 fiscal year. 272.29 Sec. 93. Minnesota Statutes 1997 Supplement, section 272.30 256J.74, subdivision 2, is amended to read: 272.31 Subd. 2. [CONCURRENT ELIGIBILITY, LIMITATIONS.] A county 272.32 agency must not count an applicant or participant as a member of 272.33 more than one assistance unit in a given payment month, except 272.34 as provided in clauses (1) and (2). 272.35 (1) A participant who is a member of an assistance unit in 272.36 this state is eligible to be included in a second assistance 273.1 unitinthe first full monththatafter the month the 273.2 participantleaves the first assistance unit and lives with273.3ajoins the secondassistanceunit. 273.4 (2) An applicant whose needs are met through foster care 273.5 that is reimbursed under title IV-E of the Social Security Act 273.6 for the first part of an application month is eligible to 273.7 receive assistance for the remaining part of the month in which 273.8 the applicant returns home. Title IV-E payments and adoption 273.9 assistance payments must be considered prorated payments rather 273.10 than a duplication of MFIP-S need. 273.11 Sec. 94. Minnesota Statutes 1997 Supplement, section 273.12 256J.74, is amended by adding a subdivision to read: 273.13 Subd. 5. [FOOD STAMPS.] For any month an individual 273.14 receives Food Stamp Program benefits, the individual is not 273.15 eligible for the MFIP-S food portion of assistance, except under 273.16 section 256J.28, subdivision 5. 273.17 Sec. 95. [256J.77] [AGING OF CASH BENEFITS.] 273.18 Cash benefits under chapters 256D, 256J, and 256K by 273.19 warrants or electronic benefit transfer that have not been 273.20 accessed within 90 days of issuance shall be canceled. Cash 273.21 benefits may be replaced after they are canceled, for up to one 273.22 year after the date of issuance, if failure to do so would place 273.23 the client or family at risk. For purposes of this section, 273.24 "accessed" means cashing a warrant or making at least one 273.25 withdrawal from benefits deposited in an electronic benefit 273.26 account. 273.27 Sec. 96. Minnesota Statutes 1997 Supplement, section 273.28 256K.03, subdivision 5, is amended to read: 273.29 Subd. 5. [EXEMPTION CATEGORIES.] (a) The applicant will be 273.30 exempt from the job search requirements and development of a job 273.31 search plan and an employability development plan under 273.32 subdivisions 3, 4, and 8 if the applicant belongs to any of the 273.33 following groups: 273.34 (1)caregivers under age 20 who have not completed a high273.35school education and are attending high school on a full-time273.36basis;274.1(2)individuals who are age 60 or older; 274.2(3)(2) individuals who are suffering from a professionally 274.3 certified permanent or temporary illness, injury, or incapacity 274.4 which is expected to continue for more than 30 days and which 274.5 prevents the person from obtaining or retaining employment. 274.6 Persons in this category with a temporary illness, injury, or 274.7 incapacity must be reevaluated at least quarterly; 274.8(4)(3) caregivers whose presence in the home is needed 274.9 because of the professionally certified illness or incapacity of 274.10 another member in the assistance unit, a relative in the 274.11 household, or a foster child in the household; 274.12(5)(4) women who are pregnant, ifitthe pregnancy has 274.13been medically verifiedresulted in a professionally certified 274.14 incapacity thatthe child is expected to be born within the next274.15six monthsprevents the woman from obtaining and retaining 274.16 employment; 274.17(6)(5) caregiversor other caregiver relativesof a child 274.18 under the age ofthreeone year who personally provide full-time 274.19 care for the child. This exemption may be used for only 12 274.20 months in a lifetime. In two-parent households, only one parent 274.21 or other relative may qualify for this exemption; 274.22(7)(6) individuals who are single parents or one parent in 274.23 a two-parent family employed at least3035 hours per week; 274.24(8) individuals for whom participation would require a274.25round trip commuting time by available transportation of more274.26than two hours, excluding transporting of children for child274.27care;274.28(9) individuals for whom lack of proficiency in English is274.29a barrier to employment, provided such individuals are274.30participating in an intensive program which lasts no longer than274.31six months and is designed to remedy their language deficiency;274.32(10) individuals who, because of advanced age or lack of274.33ability, are incapable of gaining proficiency in English, as274.34determined by the county social worker, shall continue to be274.35exempt under this subdivision and are not subject to the274.36requirement that they be participating in a language program;275.1(11)(7) individualsunder such duress that they are275.2incapable of participating in the program, as determined by the275.3county social workerexperiencing a personal or family crisis 275.4 that makes them incapable of participating in the program, as 275.5 determined by the county agency. If the participant does not 275.6 agree with the county agency's determination, the participant 275.7 may seek professional certification, as defined in section 275.8 256J.08, that the participant is incapable of participating in 275.9 the program. Persons in this exemption category must be 275.10 reevaluated every 60 days; or 275.11(12) individuals in need of refresher courses for purposes275.12of obtaining professional certification or licensure.275.13(b) In a two-parent family, only one caregiver may be275.14exempted under paragraph (a), clauses (4) and (6).275.15 (8) second parents in two-parent families employed for 20 275.16 or more hours per week provided the first parent is employed at 275.17 least 35 hours per week. 275.18 (b) A caregiver who is exempt under clause (5) must enroll 275.19 in and attend an early childhood and family education class, a 275.20 parenting class, or some similar activity, if available, during 275.21 the period of time the caregiver is exempt under this section. 275.22 Notwithstanding section 256J.46, failure to attend the required 275.23 activity shall not result in the imposition of a sanction. 275.24 Sec. 97. Laws 1997, chapter 203, article 9, section 21, is 275.25 amended to read: 275.26 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMSUNSPENT 275.27 STATE MONEY.] 275.28(a) Beginning July 1, 1999, the following persons will be275.29ineligible for general assistance and general assistance medical275.30care under Minnesota Statutes, chapter 256D, group residential275.31housing under Minnesota Statutes, chapter 256I, and MFIP-S275.32assistance under Minnesota Statutes, chapter 256J, funded with275.33state money:275.34(1) persons who are terminated from or denied Supplemental275.35Security Income due to the 1996 changes in the federal law275.36making persons whose alcohol or drug addiction is a material276.1factor contributing to the person's disability ineligible for276.2Supplemental Security Income, and are eligible for general276.3assistance under Minnesota Statutes, section 256D.05,276.4subdivision 1, paragraph (a), clause (17), general assistance276.5medical care under Minnesota Statutes, chapter 256D, or group276.6residential housing under Minnesota Statutes, chapter 256I;276.7(2) legal noncitizens who are ineligible for Supplemental276.8Security Income due to the 1996 changes in federal law making276.9certain noncitizens ineligible for these programs due to their276.10noncitizen status; and276.11(3) legal noncitizens who are eligible for MFIP-S276.12assistance, either the cash assistance portion or the food276.13assistance portion, funded entirely with state money.276.14(b)State money that remains unspenton June 30, 1999, due 276.15 to changes in federal law enacted after May 12, 1997, that 276.16 reduce state spending for legal noncitizens or for persons whose 276.17 alcohol or drug addiction is a material factor contributing to 276.18 the person's disability, or enacted after February 1, 1998, that 276.19 reduce state spending for food benefits for legal noncitizens 276.20 shall not cancel and shall be deposited in the TANF reserve 276.21 account. 276.22 Sec. 98. Laws 1997, chapter 248, section 46, as amended by 276.23 Laws 1997, First Special Session chapter 5, section 10, is 276.24 amended to read: 276.25 Sec. 46. [UNLICENSED CHILD CARE PROVIDERS; INTERIM 276.26 EXPANSION.] 276.27 (a) Notwithstanding Minnesota Statutes, section 245A.03, 276.28 subdivision 2, clause (2), until June 30, 1999, nonresidential 276.29 child care programs or services that are provided by an 276.30 unrelated individual to persons from two or three other 276.31 unrelated families are excluded from the licensure provisions of 276.32 Minnesota Statutes, chapter 245A, provided that: 276.33 (1) the individual provides services at any one time to no 276.34 more than four children who are unrelated to the individual; 276.35 (2) no more than two of the children are under two years of 276.36 age; and 277.1 (3) the total number of children being cared for at any one 277.2 time does not exceed five. 277.3 (b) Paragraph (a), clauses (1) to (3), do not apply to: 277.4 (1) nonresidential programs that are provided by an 277.5 unrelated individual to persons from a single related family.; 277.6 (2) a child care provider whose child care services meet 277.7 the criteria in paragraph (a), clauses (1) to (3), but who 277.8 chooses to apply for licensure; 277.9 (3) a child care provider who, as an applicant for 277.10 licensure or as a license holder, has received a license denial 277.11 under Minnesota Statutes, section 245A.05, a fine under 277.12 Minnesota Statutes, section 245A.06, or a sanction under 277.13 Minnesota Statutes, section 245A.07 from the commissioner that 277.14 has not been reversed on appeal; or 277.15 (4) a child care provider, or a child care provider who has 277.16 a household member who, as a result of a licensing process, has 277.17 a disqualification under Minnesota Statutes, chapter 245A, that 277.18 has not been set aside by the commissioner. 277.19 Sec. 99. [REPEALER.] 277.20 (a) Minnesota Statutes 1997 Supplement, section 256J.28, 277.21 subdivision 4, is repealed effective January 1, 1998. 277.22 (b) Minnesota Statutes 1997 Supplement, sections 256J.25; 277.23 and 256J.76; Laws 1997, chapter 85, article 1, sections 61 and 277.24 71, and article 3, section 55, are repealed. 277.25 (c) Minnesota Statutes 1996, sections 256.031, subdivisions 277.26 1, 2, 3, and 4; 256.032; 256.033, subdivisions 2, 3, 4, 5, and 277.27 6; 256.034; 256.035; 256.036; 256.0361; 256.047; 256.0475; 277.28 256.048; and 256.049; and Minnesota Statutes 1997 Supplement, 277.29 sections 256.031, subdivisions 5 and 6; 256.033, subdivisions 1 277.30 and 1a; 256B.062; 256J.32, subdivision 5; and 256J.34, 277.31 subdivision 5, are repealed effective July 1, 1998. 277.32 (d) Minnesota Rules (Exempt), parts 9500.9100; 9500.9110; 277.33 9500.9120; 9500.9130; 9500.9140; 9500.9150; 9500.9160; 277.34 9500.9170; 9500.9180; 9500.9190; 9500.9200; 9500.9210; and 277.35 9500.9220, are repealed effective July 1, 1998. 277.36 Sec. 100. [EFFECTIVE DATE.] 278.1 Sections 1, 2, 5, 6, 79, and 96 are effective the day 278.2 following final enactment. 278.3 ARTICLE 7 278.4 REGIONAL TREATMENT CENTERS 278.5 Section 1. [CONVEYANCE OF STATE LAND; ANOKA COUNTY.] 278.6 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 278.7 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 278.8 subdivision 3, or any other law to the contrary, the 278.9 commissioner of administration may convey all, or any part of, 278.10 the land and associated buildings described in subdivision 3 to 278.11 Anoka county after the commissioner of human services declares 278.12 said property surplus to its needs. 278.13 Subd. 2. [FORM.] (a) The conveyance shall be in a form 278.14 approved by the attorney general. 278.15 (b) The conveyance is subject to a scenic easement, as 278.16 defined in Minnesota Statutes, section 103F.311, subdivision 6, 278.17 to be under the custodial control of the commissioner of natural 278.18 resources, on that portion of the conveyed land that is 278.19 designated for inclusion in the wild and scenic river system 278.20 under Minnesota Statutes, section 103F.325. The scenic easement 278.21 shall allow for continued use of the structures located within 278.22 the easement and for development of a walking path within the 278.23 easement. 278.24 (c) The conveyance shall restrict use of the land to 278.25 governmental, including recreational, purposes and shall provide 278.26 that ownership of any portion of the land that ceases to be used 278.27 for such purposes shall revert to the state of Minnesota. 278.28 (d) The commissioner of administration may convey any part 278.29 of the property described in subdivision 3 any time after the 278.30 land is declared surplus by the commissioner of human services 278.31 and the execution and recording of the scenic easement under 278.32 paragraph (b) has been completed. 278.33 (e) Notwithstanding any law, regulation, or ordinance to 278.34 the contrary, the instrument of conveyance to Anoka county may 278.35 be recorded in the office of the Anoka county recorder without 278.36 compliance with any subdivision requirement. 279.1 Subd. 3. [LAND DESCRIPTION.] Subject to right-of-way for 279.2 Grant Street, Northview Lane, Garfield Street, 5th Avenue, and 279.3 state trunk highway No. 288, also known as 4th Avenue, the land 279.4 to be conveyed may include all, or part of, that which is 279.5 described as follows: 279.6 (1) all that part of Government Lots 3 and 4 and that part 279.7 of the Southeast Quarter of the Southwest Quarter, all in 279.8 Section 31, Township 32 North, Range 24 West, Anoka county, 279.9 Minnesota, described as follows: 279.10 Beginning at the southwest corner of said Southeast Quarter 279.11 of the Southwest Quarter of Section 31; thence North 13 279.12 degrees 16 minutes 11 seconds East, assumed bearing, 473.34 279.13 feet; thence North 07 degrees 54 minutes 43 seconds East 279.14 186.87 feet; thence North 14 degrees 08 minutes 33 seconds 279.15 West 154.77 feet; thence North 62 degrees 46 minutes 44 279.16 seconds West 526.92 feet; thence North 25 degrees 45 279.17 minutes 30 seconds East 74.43 feet; thence northerly 88.30 279.18 feet along a tangential curve concave to the west having a 279.19 radius of 186.15 feet and a central angle of 27 degrees 10 279.20 minutes 50 seconds; thence North 01 degrees 25 minutes 20 279.21 seconds West, tangent to said curve, 140.53 feet; thence 279.22 North 71 degrees 56 minutes 34 seconds West to the 279.23 southeasterly shoreline of the Rum river; thence 279.24 southwesterly along said shoreline to the south line of 279.25 said Government Lot 4; thence easterly along said south 279.26 line to the point of beginning. For the purpose of this 279.27 description the south line of said Southeast Quarter of the 279.28 Southwest Quarter of Section 31 has an assumed bearing of 279.29 North 89 degrees 08 minutes 19 seconds East; 279.30 (2) Government Lot 1, Section 6, Township 31 North, Range 279.31 24 West, Anoka county, Minnesota; EXCEPT that part platted as 279.32 Grant Properties, Anoka county, Minnesota; ALSO EXCEPT that part 279.33 lying southerly of the westerly extension of the south line of 279.34 Block 6, Woodbury's Addition to the city of Anoka, Anoka county, 279.35 Minnesota, and lying westerly of the west line of said plat of 279.36 Grant Properties, said line also being the centerline of 4th 280.1 Avenue; 280.2 (3) all that part of said Block 6, Woodbury's Addition to 280.3 the city of Anoka lying westerly of Northview 1st Addition, 280.4 Anoka county, Minnesota; 280.5 (4) all that part of said Northview 1st Addition lying 280.6 westerly of the east line of Lots 11 through 20, Block 1, 280.7 inclusive, thereof; and 280.8 (5) all that part of the Northeast Quarter of the Northwest 280.9 Quarter of said Section 6, Township 31 North, Range 24 West, 280.10 Anoka county, Minnesota, lying northerly of the centerline of 280.11 Grant Street as defined by said plat of Grant Properties and 280.12 lying westerly of said east line of Lots 11 through 20, Block 1, 280.13 inclusive, Northview 1st Addition and said line's extension 280.14 north and south. 280.15 Subd. 4. [DETERMINATION.] The commissioner of human 280.16 services has determined that the land described in subdivision 3 280.17 will no longer be needed for the Anoka metro regional treatment 280.18 center upon the completion of the state facilities currently 280.19 under construction and the completion of renovation work to 280.20 state buildings that are not located on the land described in 280.21 subdivision 3. The state's land and building management 280.22 interests may best be served by conveying all, or part of, the 280.23 land and associated buildings located on the land described in 280.24 subdivision 3. 280.25 Sec. 2. [CONVEYANCE OF STATE LAND; CROW WING COUNTY.] 280.26 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 280.27 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 280.28 subdivision 3, or any other law to the contrary, the 280.29 commissioner of administration may convey all, or any part of, 280.30 the land and the state building located on the land described in 280.31 subdivision 3, to Crow Wing county after the commissioner of 280.32 human services declares the property surplus to its needs. 280.33 Subd. 2. [FORM.] (a) The conveyance shall be in a form 280.34 approved by the attorney general. 280.35 (b) The conveyance shall restrict use of the land to county 280.36 governmental purposes, including community corrections programs, 281.1 and shall provide that ownership of any portion of the land or 281.2 building that ceases to be used for such purposes shall revert 281.3 to the state of Minnesota. 281.4 Subd. 3. [LAND DESCRIPTION.] That part of the Northeast 281.5 Quarter (NE l/4) of Section 30, Township 45 North, Range 30 281.6 West, Crow Wing county, Minnesota, described as follows: 281.7 Commencing at the southeast corner of said Northeast 281.8 quarter; thence North 00 degrees 46 minutes 05 seconds 281.9 West, bearing based on the Crow Wing county Coordinate 281.10 Database NAD 83/94, 1520.06 feet along the east line of 281.11 said Northeast quarter to the point of beginning; thence 281.12 continue North 00 degrees 46 minutes 05 seconds West 634.14 281.13 feet along said east line of the Northeast quarter; thence 281.14 South 89 degrees 13 minutes 20 seconds West 550.00 feet; 281.15 thence South 18 degrees 57 minutes 23 seconds East 115.59 281.16 feet; thence South 42 degrees 44 minutes 39 seconds East 281.17 692.37 feet; thence South 62 degrees 46 minutes 19 seconds 281.18 East 20.24 feet; thence North 89 degrees 13 minutes 55 281.19 seconds East 33.00 feet to the point of beginning. 281.20 Containing 4.69 acres, more or less. Subject to the 281.21 right-of-way of the Township road along the east side 281.22 thereof, subject to other easements, reservations, and 281.23 restrictions of record, if any. 281.24 Subd. 4. [DETERMINATION.] The commissioner of human 281.25 services has determined that the land, and the building on this 281.26 land, described in subdivision 3 will not be needed for future 281.27 operations of the Brainerd regional human services center.