Minnesota Legislature
SF 3346
1st Unofficial 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; changing provisions for 1.3 health insurance, health programs, and health 1.4 professions; providing for recording and providing of 1.5 abortion data; prohibiting partial-birth abortions; 1.6 changing provisions in long-term care, MA, GAMC, 1.7 MinnesotaCare, welfare provisions, Work First 1.8 assistance programs, child support licensing, and 1.9 tribal child care assistance; providing for the 1.10 conveyance of state land; providing for criminal 1.11 penalties; appropriating money; amending Minnesota 1.12 Statutes 1996, sections 62A.65, subdivision 5; 1.13 62D.042, subdivision 2; 62E.16; 144.701, subdivisions 1.14 1, 2, and 4; 144.702, subdivisions 1, 2, and 8; 1.15 144.9501, subdivisions 1, 17, 18, 20, 23, 30, 32, and 1.16 by adding subdivisions; 144.9502, subdivisions 3, 4, 1.17 and 9; 144.9503, subdivisions 4, 6, and 7; 144.9504, 1.18 subdivisions 1, 3, 4, 5, 6, 7, 8, 9, and 10; 144.9505, 1.19 subdivisions 1, 4, and 5; 144.9506, subdivision 2; 1.20 144.9507, subdivisions 2, 3, and 4; 144.9508, 1.21 subdivisions 1, 3, 4, and by adding a subdivision; 1.22 144.9509, subdivision 2; 144.99, subdivision 1; 1.23 144A.04, subdivision 5; 144A.09, subdivision 1; 1.24 144A.44, subdivision 2; 145.411, by adding a 1.25 subdivision; 145A.15, subdivision 2; 148.66; 148.67; 1.26 148.70; 148.705; 148.71; 148.72, subdivisions 1, 2, 1.27 and 4; 148.73; 148.74; 148.75; 148.76; 148.78; 214.01, 1.28 subdivision 2; 214.03; 245.462, subdivisions 4 and 8; 1.29 245.4871, subdivision 4; 245A.03, by adding 1.30 subdivisions; 245A.14, subdivision 4; 254A.17, 1.31 subdivision 1, and by adding a subdivision; 256.014, 1.32 subdivision 1; 256.969, subdivisions 16, 17, and by 1.33 adding a subdivision; 256B.03, subdivision 3; 1.34 256B.055, by adding a subdivision; 256B.057, 1.35 subdivision 3a, and by adding subdivisions; 256B.0625, 1.36 subdivisions 20, 34, 38, and by adding a subdivision; 1.37 256B.0911, subdivision 4; 256B.41, subdivision 1; 1.38 256B.431, subdivisions 2b, 2i, 11, and by adding 1.39 subdivisions; 256B.501, subdivision 2; 256B.69, by 1.40 adding a subdivision; 256D.03, subdivision 4, and by 1.41 adding a subdivision; 256D.051, by adding a 1.42 subdivision; 256D.46, subdivision 2; 268.88; and 1.43 268.92, subdivision 4; Minnesota Statutes 1997 1.44 Supplement, sections 60A.15, subdivision 1; 62D.11, 1.45 subdivision 1; 62J.69, subdivisions 1, 2, and by 1.46 adding a subdivision; 62J.70, subdivision 3; 62J.71, 2.1 subdivisions 1, 3, and 4; 62J.72, subdivision 1; 2.2 62Q.105, subdivision 1; 62Q.30; 103I.208, subdivision 2.3 2; 119B.01, subdivision 16; 119B.02; 144.1494, 2.4 subdivision 1; 144.9504, subdivision 2; 144.9506, 2.5 subdivision 1; 144A.071, subdivision 4a; 144A.46, 2.6 subdivision 2; 144A.4605, subdivision 4; 171.29, 2.7 subdivision 2; 214.32, subdivision 1; 256.01, 2.8 subdivision 2; 256.031, subdivision 6; 256.741, by 2.9 adding a subdivision; 256.9657, subdivision 3; 2.10 256.9685, subdivision 1; 256.9864; 256B.04, 2.11 subdivision 18; 256B.06, subdivision 4; 256B.062; 2.12 256B.0625, subdivision 31a; 256B.0627, subdivisions 5 2.13 and 8; 256B.0635, by adding a subdivision; 256B.0645; 2.14 256B.0911, subdivisions 2 and 7; 256B.0915, 2.15 subdivision 1d; 256B.0951, by adding a subdivision; 2.16 256B.431, subdivisions 3f and 26; 256B.69, 2.17 subdivisions 2 and 3a; 256B.692, subdivisions 2 and 5; 2.18 256B.77, subdivisions 3, 7a, 10, and 12; 256D.03, 2.19 subdivision 3; 256D.05, subdivision 8; 256F.05, 2.20 subdivision 8; 256J.02, subdivision 4; 256J.03; 2.21 256J.08, subdivisions 11, 26, 28, 40, 60, 68, 73, 83, 2.22 and by adding subdivisions; 256J.09, subdivisions 6 2.23 and 9; 256J.11, subdivision 2, as amended; 256J.12; 2.24 256J.14; 256J.15, subdivision 2; 256J.20, subdivisions 2.25 2 and 3; 256J.21; 256J.24, subdivisions 1, 2, 3, 4, 2.26 and by adding subdivisions; 256J.26, subdivisions 1, 2.27 2, 3, and 4; 256J.28, subdivisions 1, 2, and by adding 2.28 a subdivision; 256J.30, subdivisions 10 and 11; 2.29 256J.31, subdivisions 5, 10, and by adding a 2.30 subdivision; 256J.32, subdivisions 4, 6, and by adding 2.31 a subdivision; 256J.33, subdivisions 1 and 4; 256J.35; 2.32 256J.36; 256J.37, subdivisions 1, 2, 9, and by adding 2.33 subdivisions; 256J.38, subdivision 1; 256J.39, 2.34 subdivision 2; 256J.395; 256J.42; 256J.43; 256J.44, by 2.35 adding a subdivision; 256J.45, subdivisions 1, 2, and 2.36 by adding a subdivision; 256J.46, subdivisions 1 and 2.37 2; 256J.47, subdivision 4; 256J.48, subdivisions 2 and 2.38 3; 256J.50, subdivision 5, and by adding a 2.39 subdivision; 256J.515; 256J.52, subdivisions 2, 3, 4, 2.40 and by adding subdivisions; 256J.54, subdivisions 2, 2.41 3, 4, and 5; 256J.55, subdivision 5; 256J.56; 256J.57, 2.42 subdivision 1; 256J.74, subdivision 2, and by adding a 2.43 subdivision; 256K.03, subdivision 5; 256L.01; 256L.02, 2.44 subdivision 3, and by adding a subdivision; 256L.03, 2.45 subdivisions 1, 3, 4, 5, and by adding subdivisions; 2.46 256L.04, subdivisions 1, 2, 7, 8, 9, 10, and by adding 2.47 subdivisions; 256L.05, subdivisions 2, 3, 4, and by 2.48 adding subdivisions; 256L.06, subdivision 3; 256L.07, 2.49 subdivisions 2 and 3; 256L.09, subdivisions 2, 4, and 2.50 6; 256L.11, subdivision 6; 256L.12, subdivision 5; 2.51 256L.15; and 256L.17, by adding a subdivision; Laws 2.52 1997, chapter 195, section 5; chapter 203, article 1, 2.53 section 2, subdivisions 5 and 12; article 4, section 2.54 64; chapter 207, section 7; chapter 225, article 2, 2.55 section 64; chapter 248, section 46, as amended; 2.56 proposing coding for new law in Minnesota Statutes, 2.57 chapters 62J; 62Q; 144; 145; 148; 256; 256B; 256D; 2.58 256J; and 256L; proposing coding for new law as 2.59 Minnesota Statutes, chapter 256M; repealing Minnesota 2.60 Statutes 1996, sections 144.0721, subdivision 3a; 2.61 144.491; 144.9501, subdivisions 12, 14, and 16; 2.62 144.9503, subdivisions 5, 8, and 9; 256.031, as 2.63 amended; 256.032; 256.033, as amended; 256.034; 2.64 256.035; 256.036; 256.0361; 256.047; 256.0475; 2.65 256.048; and 256.049; Minnesota Statutes 1997 2.66 Supplement, sections 62D.042, subdivision 3; 144.0721, 2.67 subdivision 3; 256B.057, subdivision 1a; 256B.062; 2.68 256B.0913, subdivision 15; 256J.25; 256J.28, 2.69 subdivision 4; 256J.32, subdivision 5; 256J.34, 2.70 subdivision 5; 256L.04, subdivisions 3, 4, 5, and 6; 2.71 256L.06, subdivisions 1 and 2; 256L.08; 256L.09, 3.1 subdivision 3; 256L.13; 256L.14; and 256L.15, 3.2 subdivision 3; Laws 1997, chapter 85, article 1, 3.3 sections 61 and 71; article 3, section 55; Minnesota 3.4 Rules (exempt), parts 2740.1600, subpart 1; and 3.5 9500.9100 to 9500.9220. 3.6 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.7 ARTICLE 1 3.8 APPROPRIATIONS 3.9 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 3.10 The sums in the columns headed "APPROPRIATIONS" are 3.11 appropriated or reductions from appropriations from the general 3.12 fund, or another named fund, to the agencies and for the 3.13 purposes specified to be available for the fiscal years 3.14 indicated for each purpose. 3.15 SUMMARY BY FUND 3.16 1998 1999 3.17 General $ (118,953,000)$ (122,813,000) 3.18 State Government Special 3.19 Revenue Fund 113,000 90,000 3.20 Special Revenue Fund -0- 400,000 3.21 Health Care Access 6,616,000 (1,161,000) 3.22 APPROPRIATIONS 3.23 Available for the Year 3.24 Ending June 30 3.25 1998 1999 3.26 Sec. 2. COMMISSIONER OF HUMAN SERVICES 3.27 Subdivision 1. Total 3.28 Appropriation (112,337,000) (142,747,000) 3.29 Summary by Fund 3.30 1998 1999 3.31 General (118,953,000) (141,721,000) 3.32 Special Revenue 3.33 Fund -0- 400,000 3.34 Health Care Access 6,616,000 (1,420,000) 3.35 Subd. 2. Children's Grants 3.36 General -0- 1,665,000 3.37 [TECHNICAL ASSISTANCE FOR CRISIS 3.38 NURSERIES.] Of this appropriation, 3.39 $200,000 in fiscal year 1999 is from 3.40 the general fund for the commissioner 3.41 to contract for technical assistance 3.42 with counties that are interested in 3.43 developing a crisis nursery program. 3.44 The technical assistance must be 3.45 designed to assist interested counties 4.1 in building capacity to develop and 4.2 maintain a crisis nursery program in 4.3 the county. The grant amount to a 4.4 county must range from $10,000 to 4.5 $20,000. To be eligible to receive a 4.6 grant under this program, the county 4.7 must not have an existing crisis 4.8 nursery program and must not be a 4.9 metropolitan county, as that term is 4.10 defined in Minnesota Statutes 1996, 4.11 section 473.121. This appropriation 4.12 shall not become part of the base for 4.13 the 2000-2001 biennial budget. 4.14 [PRIMARY SUPPORT TO IMPLEMENT THE 4.15 INDIAN FAMILY PRESERVATION ACT.] For 4.16 fiscal year 1998, $100,000 of federal 4.17 funds are transferred from the state's 4.18 federal TANF block grant and added to 4.19 the state's allocation of federal Title 4.20 XX block grant funds. Notwithstanding 4.21 the provisions of Minnesota Statutes 4.22 1997 Supplement, section 256E.07, the 4.23 commissioner shall use $100,000 of the 4.24 state's Title XX block grant funds for 4.25 a grant under Minnesota Statutes, 4.26 section 257.3571, subdivision 1, to an 4.27 Indian organization licensed as an 4.28 adoption agency. The grant must be 4.29 used to provide primary support for 4.30 implementation of the Minnesota Indian 4.31 Family Preservation Act and compliance 4.32 with the Indian Child Welfare Act. 4.33 This appropriation must be used 4.34 according to the requirements of the 4.35 amendments to section 404(d)(3)(B) of 4.36 Part A of Title IV of the Social 4.37 Security Act in Public Law Number 4.38 104-193. This appropriation is 4.39 available until June 30, 1999. 4.40 [ADOPTION ASSISTANCE CARRYFORWARD.] Of 4.41 the appropriation in Laws 1997, chapter 4.42 203, section 2, subdivision 3, for 4.43 children's grants for fiscal year 1998, 4.44 $600,000 of the amount appropriated for 4.45 the adoption assistance program is 4.46 available for the same purpose in 4.47 fiscal year 1999. The amount carried 4.48 forward shall become part of the base 4.49 for the adoption assistance program in 4.50 the 2000-2001 biennial budget. 4.51 [FAMILY PRESERVATION PROGRAM FUNDING.] 4.52 $10,000,000 is transferred in fiscal 4.53 year 1999 from the state's federal TANF 4.54 block grant to the state's federal 4.55 Title XX block grant. Notwithstanding 4.56 the provisions of Minnesota Statutes 4.57 1997 Supplement, section 256E.07, in 4.58 fiscal year 1999 the commissioner shall 4.59 transfer $10,000,000 of the state's 4.60 Title XX block grant funds to the 4.61 family preservation program under 4.62 Minnesota Statutes, chapter 256F. Of 4.63 the total amount transferred, the 4.64 commissioner shall allocate $8,800,000 4.65 to counties for the purposes of the 4.66 child protection assessments or 4.67 investigations community collaboration 4.68 pilot program under Minnesota Statutes, 5.1 section 626.5560. The commissioner 5.2 shall allocate $750,000 to counties for 5.3 the concurrent permanency planning 5.4 pilot program under Minnesota Statutes, 5.5 section 257.0711. The commissioner 5.6 shall transfer $200,000 to the 5.7 commissioner of health for the program 5.8 under Minnesota Statutes, section 5.9 145A.15, that funds home visiting 5.10 projects. The commissioner may retain 5.11 up to $250,000 of the total amount 5.12 transferred to conduct evaluations of 5.13 these pilot programs. The 5.14 commissioners shall ensure that money 5.15 allocated to counties under this 5.16 provision must be used in accordance 5.17 with the requirements of the amendments 5.18 to section 404(d)(3)(B) of Part A of 5.19 Title IV of the Social Security Act in 5.20 Public Law Number 104-193. This is a 5.21 one-time appropriation that shall not 5.22 be added to the base for the family 5.23 preservation program for the 2000-2001 5.24 biennial budget. 5.25 Subd. 3. Children's Services 5.26 Management 5.27 General -0- -0- 5.28 Special Revenue Fund -0- 400,000 5.29 Subd. 4. Basic Health Care 5.30 Grants 5.31 General (74,679,000) (90,243,000) 5.32 Health Care Access 6,808,000 (4,278,000) 5.33 The amounts that may be spent from this 5.34 appropriation for each purpose are as 5.35 follows: 5.36 (a) MinnesotaCare Grants 5.37 Health Care Access 6,808,000 (4,278,000) 5.38 (b) MA Basic Health Care Grants; 5.39 Families and Children 5.40 General (23,231,000) (38,644,000) 5.41 Of this appropriation, $100,000 in 5.42 fiscal year 1999 is from the general 5.43 fund to the commissioner for the 5.44 post-kidney transplant drug program. 5.45 This appropriation shall not cancel, 5.46 but is available until expended. 5.47 [JANUARY 1, 1999 PROVIDER RATE INCREASE 5.48 FOR CERTAIN SERVICES.] (a) Effective 5.49 for services rendered on or after 5.50 January 1, 1999, the commissioner shall 5.51 increase reimbursement or allocation 5.52 rates by five percent, and county 5.53 boards shall adjust provider contracts 5.54 as needed, for mental health services 5.55 provided by community mental health 5.56 centers under Minnesota Statutes, 5.57 sections 245.62 and 256B.0625, 5.58 subdivision 5, and for community 6.1 support services for deaf and 6.2 hard-of-hearing adults with mental 6.3 illness who use or wish to use sign 6.4 language as their primary means of 6.5 communication. The commissioner shall 6.6 also increase prepaid medical 6.7 assistance program capitation rates as 6.8 appropriate to reflect the rate 6.9 increases in this provision. Section 6.10 10, sunset of uncodified language, does 6.11 not apply to this provision. 6.12 (b) It is the intention of the 6.13 legislature that the compensation 6.14 packages of staff within each service 6.15 be increased by five percent. 6.16 (c) MA Basic Health Care Grants; 6.17 Elderly and Disabled 6.18 General (23,819,000) (41,964,000) 6.19 [REGION 10 COMMISSION CARRYOVER 6.20 AUTHORITY.] Any unspent portion of the 6.21 appropriation to the commissioner of 6.22 human services in Laws 1997, chapter 6.23 203, article 1, section 2, subdivision 6.24 9, for the region 10 quality assurance 6.25 commission for fiscal year 1998 shall 6.26 not cancel but shall be available for 6.27 the commission for fiscal year 1999. 6.28 [DD CRISIS INTERVENTION PROJECT.] Of 6.29 this appropriation, $150,000 in fiscal 6.30 year 1999 is from the general fund to 6.31 the commissioner for start-up operating 6.32 and training costs for the action, 6.33 support, and prevention project of 6.34 southeastern Minnesota. This 6.35 appropriation is to provide crisis 6.36 intervention through community-based 6.37 services in the private sector to 6.38 persons with developmental disabilities 6.39 under Laws 1995, chapter 207, article 6.40 3, section 22. 6.41 [PRESCRIPTION DRUG BENEFIT.] (a) If, by 6.42 September 15, 1998, federal approval is 6.43 obtained to provide a prescription drug 6.44 benefit for qualified Medicare 6.45 beneficiaries at no less than 100 6.46 percent of the federal poverty 6.47 guidelines and service-limited Medicare 6.48 beneficiaries under Minnesota Statutes, 6.49 section 256B.057, subdivision 3a, at no 6.50 less than 120 percent of federal 6.51 poverty guidelines, the commissioner of 6.52 human services shall not implement the 6.53 senior citizen drug program under 6.54 Minnesota Statutes, section 256.955, 6.55 but shall implement a drug benefit in 6.56 accordance with the approved waiver. 6.57 Upon approval of this waiver, the total 6.58 appropriation for the senior citizen 6.59 drug program under Laws 1997, chapter 6.60 225, article 7, section 2, shall be 6.61 transferred to the medical assistance 6.62 account to fund the federally approved 6.63 coverage for eligible persons for 6.64 fiscal year 1999. 7.1 (b) The commissioner may seek approval 7.2 for a higher copayment for eligible 7.3 persons above 100 percent of the 7.4 federal poverty guidelines. 7.5 (c) The commissioner shall report by 7.6 October 15, 1998, to the chairs of the 7.7 health and human services policy and 7.8 fiscal committees of the house and 7.9 senate whether the waiver referred to 7.10 in paragraph (a) has been approved and 7.11 will be implemented or whether the 7.12 state senior citizen drug program will 7.13 be implemented. 7.14 (d) If the commissioner does not 7.15 receive federal waiver approval at or 7.16 above the level of eligibility defined 7.17 in paragraph (a), the commissioner 7.18 shall implement the program under 7.19 Minnesota Statutes, section 256.955. 7.20 (d) General Assistance 7.21 Medical Care 7.22 General (27,629,000) (9,635,000) 7.23 Subd. 5. Basic Health Care 7.24 Management 7.25 General -0- 261,000 7.26 Health Care Access (192,000) 1,774,000 7.27 The amounts that may be spent from this 7.28 appropriation for each purpose are as 7.29 follows: 7.30 (a) Health Care Policy 7.31 Administration 7.32 General -0- 173,000 7.33 Health Care Access (192,000) 37,000 7.34 [DELAY IN TRANSFERRING GAMC CLIENTS.] 7.35 Due to delaying the transfer of GAMC 7.36 clients to MinnesotaCare until January 7.37 1, 2000, $192,000 in fiscal year 1998 7.38 health care access fund administrative 7.39 funds, appropriated in Laws 1997, 7.40 chapter 225, article 7, section 2, 7.41 subdivision 1, are canceled. 7.42 [MINNESOTACARE OUTREACH.] Unexpended 7.43 money in fiscal year 1998 for 7.44 MinnesotaCare outreach activities 7.45 appropriated in Laws 1997, chapter 225, 7.46 article 7, section 2, subdivision 1, 7.47 does not cancel, but is available for 7.48 those purposes in fiscal year 1999. 7.49 [HEALTH CARE MANUAL PRODUCTION COSTS.] 7.50 For the biennium ending June 30, 1999, 7.51 the money difference between the cost 7.52 of producing and distributing the 7.53 department of human services health 7.54 care manual, and the fees paid by 7.55 individuals and private entities on 7.56 January 1, 1998, is appropriated to the 7.57 commissioner to defray manual 8.1 production and distribution costs. The 8.2 commissioner must provide the health 8.3 care manual to government agencies and 8.4 nonprofit agencies serving the legal 8.5 and social service needs of clients at 8.6 no cost to those agencies. 8.7 (b) Health Care Operations 8.8 General -0- 88,000 8.9 Health Care Access -0- 1,737,000 8.10 Subd. 6. State-Operated 8.11 Services 8.12 General -0- 700,000 8.13 The amounts that may be spent from this 8.14 appropriation for each purpose are as 8.15 follows: 8.16 RTC Facilities 8.17 General -0- 700,000 8.18 [LEAVE LIABILITIES.] The accrued leave 8.19 liabilities of state employees 8.20 transferred to state-operated community 8.21 services programs may be paid from the 8.22 appropriation for state-operated 8.23 services in Laws 1997, chapter 203, 8.24 article 1, section 2, subdivision 7, 8.25 paragraph (a). Funds set aside for 8.26 this purpose shall not exceed the 8.27 amount of the actual leave liability 8.28 calculated as of June 30, 1999, and 8.29 shall be available until expended. 8.30 This provision is effective the day 8.31 following final enactment. 8.32 Subd. 7. Continuing Care and 8.33 Community Support Grants 8.34 General (35,100,000) (24,527,000) 8.35 The amounts that may be spent from this 8.36 appropriation for each purpose are as 8.37 follows: 8.38 (a) Community Services Block 8.39 Grant 8.40 General 130,000 -0- 8.41 [WILKIN COUNTY.] Of this appropriation, 8.42 $130,000 for fiscal year 1998 is to 8.43 reimburse Wilkin county for 8.44 flood-related human services and public 8.45 health costs which cannot be reimbursed 8.46 through any other source. 8.47 (b) Mental Health Grants 8.48 General 300,000 2,144,000 8.49 [CHILDREN'S MENTAL HEALTH SERVICES.] 8.50 (a) Of this appropriation, $200,000 in 8.51 fiscal year 1999 is from the general 8.52 fund for the commissioner to award 8.53 grants to counties that have a 9.1 relatively low net tax capacity to 9.2 provide children's mental health 9.3 services to children and families 9.4 residing outside of a metropolitan 9.5 statistical area, as that term is 9.6 defined by the United States Census 9.7 Bureau. Funds shall be used to provide 9.8 services according to an individual 9.9 family community support plan as 9.10 described in Minnesota Statutes, 9.11 section 245.4881, subdivision 4. The 9.12 plan must be developed using a process 9.13 that enhances consumer empowerment. 9.14 Counties with an approved children's 9.15 mental health collaborative may 9.16 integrate funds appropriated for fiscal 9.17 years 1998 and 1999 with existing funds 9.18 to meet the needs identified in the 9.19 child's individual family community 9.20 support plan. 9.21 (b) In awarding grants to counties 9.22 under this provision, the commissioner 9.23 shall follow the process established in 9.24 Minnesota Statutes, section 245.4886, 9.25 subdivision 2. The commissioner shall 9.26 give priority for funding to counties 9.27 that continued to spend for mental 9.28 health services specified in Minnesota 9.29 Statutes, sections 245.461 to 245.486 9.30 and 245.487 to 245.4888, according to 9.31 generally accepted accounting 9.32 principles, in an amount equal to the 9.33 total expenditures shown in the 9.34 county's approved 1987 CSSA plan for 9.35 services to persons with mental illness 9.36 plus the comparable figure for 9.37 facilities licensed under Minnesota 9.38 Rules, chapter 9545, for target 9.39 populations other than mental illness 9.40 in the county's approved 1989 CSSA 9.41 plan. The commissioner shall ensure 9.42 that grant funds are not used to 9.43 replace existing funds. 9.44 [PLANNING GRANT FOR PROSTITUTION 9.45 RECOVERY CENTER.] Of this 9.46 appropriation, $50,000 in fiscal year 9.47 1999 is from the general fund to the 9.48 commissioner for a planning grant to 9.49 enable an organization to develop a 9.50 long-term treatment program for women 9.51 escaping systems of prostitution. 9.52 [COMPULSIVE GAMBLING CARRYFORWARD.] 9.53 Unexpended funds appropriated to the 9.54 commissioner for compulsive gambling 9.55 programs for fiscal year 1998 do not 9.56 cancel but are available for these 9.57 purposes for fiscal year 1999. 9.58 [FLOOD COSTS.] Of this appropriation, 9.59 $300,000 in fiscal year 1998 and 9.60 $1,000,000 in fiscal year 1999 is from 9.61 the general fund to the commissioner 9.62 for the purpose of continuing 9.63 initiatives funded by Federal Emergency 9.64 Management Agency (FEMA) mental health 9.65 care grants beyond April 15, 1998. 9.66 This appropriation is available until 9.67 June 30, 1999. This provision is 10.1 effective April 15, 1998, if FEMA does 10.2 not extend these mental health care 10.3 grants beyond April 15, 1998. 10.4 (c) Deaf and Hard-of-hearing 10.5 Grants 10.6 General -0- 81,000 10.7 [SERVICES TO DEAF PERSONS WITH MENTAL 10.8 ILLNESS.] Of this appropriation, 10.9 $65,000 in fiscal year 1999 is from the 10.10 general fund to the commissioner for a 10.11 grant to a nonprofit agency that 10.12 currently serves deaf and 10.13 hard-of-hearing adults with mental 10.14 illness through residential programs 10.15 and supported housing outreach 10.16 activities. The grant must be used to 10.17 continue or maintain community support 10.18 services for deaf and hard-of-hearing 10.19 adults with mental illness who use or 10.20 wish to use sign language as their 10.21 primary means of communication. This 10.22 appropriation is in addition to the 10.23 appropriation in Laws 1997, chapter 10.24 203, article 1, section 2, subdivision 10.25 8, paragraph (d), for a grant to this 10.26 nonprofit agency. 10.27 (d) DD Community Support Grants 10.28 General -0- 41,000 10.29 (e) Aging and Adult 10.30 Services 10.31 General -0- 100,000 10.32 (f) Medical Assistance Long-term 10.33 Care Waivers and Home Care 10.34 General (8,463,000) (13,096,000) 10.35 [JANUARY 1, 1999, PROVIDER RATE 10.36 INCREASE.] (a) Effective for services 10.37 rendered on or after January 1, 1999, 10.38 the commissioner shall increase 10.39 reimbursement or allocation rates by 10.40 1.25 percent, and county boards shall 10.41 adjust provider contracts as needed, 10.42 for home and community-based waiver 10.43 services for persons with mental 10.44 retardation or related conditions under 10.45 Minnesota Statutes, section 256B.501; 10.46 home and community-based waiver 10.47 services for the elderly under 10.48 Minnesota Statutes, section 256B.0915; 10.49 nursing services and home health 10.50 services under Minnesota Statutes, 10.51 section 256B.0625, subdivision 6a; 10.52 personal care services and nursing 10.53 supervision of personal care services 10.54 under Minnesota Statutes, section 10.55 256B.0625, subdivision 19a; private 10.56 duty nursing services under Minnesota 10.57 Statutes, section 256B.0625, 10.58 subdivision 7; day training and 10.59 habilitation services for adults with 10.60 mental retardation or related 10.61 conditions under Minnesota Statutes, 11.1 sections 252.40 to 252.47; physical 11.2 therapy services under Minnesota 11.3 Statutes, sections 256B.0625, 11.4 subdivision 8, and 256D.03, subdivision 11.5 4; occupational therapy services under 11.6 Minnesota Statutes, sections 256B.0625, 11.7 subdivision 8a, and 256D.03, 11.8 subdivision 4; speech-language therapy 11.9 services under Minnesota Statutes, 11.10 section 256D.03, subdivision 4, and 11.11 Minnesota Rules, part 9505.0390; 11.12 respiratory therapy services under 11.13 Minnesota Statutes, section 256D.03, 11.14 subdivision 4, and Minnesota Rules, 11.15 part 9505.0295; family community 11.16 support grants under Minnesota Rules, 11.17 parts 9535.1700 to 9535.1760; and 11.18 semi-independent living services under 11.19 Minnesota Statutes, section 252.275, 11.20 including SILS funding under county 11.21 social services grants formerly funded 11.22 under Minnesota Statutes, chapter 11.23 256I. The commissioner shall also 11.24 increase prepaid medical assistance 11.25 program capitation rates as appropriate 11.26 to reflect the rate increases in this 11.27 provision. Section 10, sunset of 11.28 uncodified language, does not apply to 11.29 this provision. 11.30 (b) It is the intention of the 11.31 legislature that the compensation 11.32 packages of staff within each service 11.33 be increased by 1.25 percent. 11.34 (g) Medical Assistance Long-term 11.35 Care Facilities 11.36 General (18,272,000) (19,117,000) 11.37 [ICF/MR DISALLOWANCES.] Of this 11.38 appropriation, $65,000 in fiscal year 11.39 1999 is from the general fund to the 11.40 commissioner for the purpose of 11.41 reimbursing a 12-bed ICF/MR in Stearns 11.42 county and a 12-bed ICF/MR in Sherburne 11.43 county for disallowances resulting from 11.44 field audit findings. The commissioner 11.45 shall exempt these facilities from the 11.46 provisions of Minnesota Statutes, 11.47 section 256B.501, subdivision 5b, 11.48 paragraph (d), clause (6), for the rate 11.49 years beginning October 1, 1997, and 11.50 October 1, 1998. Section 10, sunset of 11.51 uncodified language, does not apply to 11.52 this provision. 11.53 [NURSING HOME MORATORIUM EXCEPTIONS.] 11.54 Base level funding for medical 11.55 assistance long-term care facilities is 11.56 increased by $255,000 in fiscal year 11.57 2000 and by $278,000 in fiscal year 11.58 2001 for the additional medical 11.59 assistance costs of the nursing home 11.60 moratorium exceptions under Minnesota 11.61 Statutes 1997 Supplement, section 11.62 144A.071, subdivision 4a, paragraphs 11.63 (w) and (x). Notwithstanding the 11.64 provisions of section 10, sunset of 11.65 uncodified language, this provision 11.66 shall not expire. 12.1 [ICFs/MR AND NURSING FACILITY 12.2 FLOOD-RELATED REPORTING.] For the 12.3 reporting year ending December 31, 12.4 1997, for ICFs/MR that temporarily 12.5 admitted victims of the flood of 1997, 12.6 the resident days related to those 12.7 temporary placements (persons not 12.8 formally admitted which continued to be 12.9 billed under the evacuated facility's 12.10 provider number) shall not be counted 12.11 in the cost report submitted to 12.12 calculate October 1, 1998, rates, and 12.13 the additional expenditures shall be 12.14 considered nonallowable. 12.15 For the reporting year ending September 12.16 30, 1997, for nursing facilities that 12.17 temporarily admitted victims of the 12.18 flood of 1997, the resident days 12.19 related to those temporary placements 12.20 (persons not formally admitted which 12.21 continued to be billed under the 12.22 evacuated facility's provider number) 12.23 shall not be counted in the cost report 12.24 submitted to calculate July 1, 1998, 12.25 rates, and the additional expenditures 12.26 shall be considered nonallowable. 12.27 (h) Alternative Care Grants 12.28 General -0- 21,666,000 12.29 (i) Group Residential Housing 12.30 General (8,795,000) (9,447,000) 12.31 (j) Chemical Dependency 12.32 Entitlement Grants 12.33 General -0- (7,498,000) 12.34 (k) Chemical Dependency 12.35 Nonentitlement Grants 12.36 General -0- 400,000 12.37 [MATCHING GRANT FOR YOUTH ALCOHOL 12.38 TREATMENT.] Of this appropriation, 12.39 $400,000 in fiscal year 1999 is from 12.40 the general fund for the commissioner 12.41 to provide a grant to the board of 12.42 directors of the Minnesota Indian 12.43 Primary Residential Treatment Center, 12.44 Inc., to build a youth alcohol 12.45 treatment wing at the Mash-Ka-Wisen 12.46 Treatment Center. This appropriation 12.47 is available only if matched by a 12.48 $1,500,000 federal grant and a $100,000 12.49 grant from state Indian bands. 12.50 [MATCHING GRANT FOR PROJECT TURNABOUT.] 12.51 If money is appropriated in fiscal year 12.52 1999 to the commissioner from the 12.53 lottery prize fund, the money shall be 12.54 used to provide a grant for capital 12.55 improvements to Project Turnabout in 12.56 Granite Falls. A local match is 12.57 required before the commissioner may 12.58 release this appropriation to the 12.59 facility. The facility shall receive 12.60 state funds equal to the amount of 13.1 local matching funds provided, up to 13.2 the limit of this appropriation. 13.3 Subd. 8. Economic Support Grants 13.4 General (9,174,000) (29,413,000) 13.5 The amounts that may be spent from this 13.6 appropriation for each purpose are as 13.7 follows: 13.8 (a) Assistance to Families 13.9 Grants 13.10 General -0- (20,343,000) 13.11 [TRANSFER OF STATE MONEY FROM TANF 13.12 RESERVE.] For fiscal year 1999, 13.13 $10,220,000 is appropriated from the 13.14 state money in the TANF reserve to the 13.15 commissioner for the purposes of 13.16 funding the families-first distribution 13.17 of child support arrearages under 13.18 Minnesota Statutes, section 256.741, 13.19 subdivision 2a; the Minnesota food 13.20 assistance program under Minnesota 13.21 Statutes, section 256D.053; and the 13.22 MFIP-S noncitizen food portion under 13.23 Minnesota Statutes, section 256J.11, 13.24 subdivision 2. 13.25 [TRANSFER OF FEDERAL TANF FUNDS TO 13.26 CHILD CARE DEVELOPMENT FUND.] $406,000 13.27 is transferred in fiscal year 1999 from 13.28 the state's federal TANF block grant to 13.29 the state's child care development 13.30 fund, and is appropriated to the 13.31 commissioner of children, families, and 13.32 learning for the purposes of Minnesota 13.33 Statutes, section 119B.05. 13.34 (b) General Assistance 13.35 General (6,933,000) (6,321,000) 13.36 (c) Minnesota Supplemental 13.37 Aid 13.38 General (2,241,000) (2,749,000) 13.39 Subd. 9. Economic Support 13.40 Management 13.41 General -0- 35,000 13.42 Health Care Access -0- 1,084,000 13.43 [ASSESSMENT OF AFFORDABLE HOUSING 13.44 SUPPLY.] The commissioner of human 13.45 services shall assess the statewide 13.46 supply of affordable housing for all 13.47 MFIP-S and GA recipients, and report to 13.48 the legislature by January 15, 1999, on 13.49 the results of this assessment. 13.50 The amounts that may be spent from this 13.51 appropriation for each purpose are as 13.52 follows: 13.53 Economic Support 13.54 Operations 14.1 General -0- 35,000 14.2 Health Care Access -0- 1,084,000 14.3 Sec. 3. COMMISSIONER OF HEALTH 14.4 Subdivision 1. Total 14.5 Appropriation -0- 18,896,000 14.6 Summary by Fund 14.7 General -0- 18,896,000 14.8 State Government Special 14.9 Revenue -0- 7,000 14.10 Health Care 14.11 Access -0- 259,000 14.12 Subd. 2. Health Systems and 14.13 Special Populations -0- 13,759,000 14.14 Summary by Fund 14.15 General -0- 13,500,000 14.16 Health Care 14.17 Access -0- 259,000 14.18 [FETAL ALCOHOL SYNDROME.] (a) Of this 14.19 appropriation, $3,500,000 in fiscal 14.20 year 1999 is from the general fund to 14.21 the commissioner for the fetal alcohol 14.22 syndrome/fetal alcohol effect (FAS/FAE) 14.23 initiatives specified in paragraphs (b) 14.24 to (k). 14.25 (b) Of the amount in paragraph (a), 14.26 $100,000 is transferred to the 14.27 commissioner of children, families, and 14.28 learning for school-based pilot 14.29 programs to identify and implement 14.30 effective educational strategies for 14.31 individuals with FAS/FAE. 14.32 (c) Of the amount in paragraph (a), 14.33 $600,000 is for the public awareness 14.34 campaign under Minnesota Statutes, 14.35 section 145.9266, subdivision 1. 14.36 (d) Of the amount in paragraph (a), 14.37 $300,000 is to develop a statewide 14.38 network of regional FAS diagnostic 14.39 clinics under Minnesota Statutes, 14.40 section 145.9266, subdivision 2. 14.41 (e) Of the amount in paragraph (a), 14.42 $150,000 is for professional training 14.43 about FAS under Minnesota Statutes, 14.44 section 145.9266, subdivision 3. 14.45 (f) Of the amount in paragraph (a), 14.46 $200,000 is for the fetal alcohol 14.47 coordinating board under Minnesota 14.48 Statutes, section 145.9266, subdivision 14.49 6. 14.50 (g) Of the amount in paragraph (a), 14.51 $500,000 is transferred to the 14.52 commissioner of human services to 15.1 expand the maternal and child health 15.2 social service programs under Minnesota 15.3 Statutes, section 254A.17, subdivision 15.4 1. 15.5 (h) Of the amount in paragraph (a), 15.6 $200,000 is for the commissioner to 15.7 study the extent of fetal alcohol 15.8 syndrome in the state. 15.9 (i) Of the amount in paragraph (a), 15.10 $300,000 is transferred to the 15.11 commissioner of human services for the 15.12 intervention and advocacy program under 15.13 Minnesota Statutes, section 254A.17, 15.14 subdivision 1b. 15.15 (j) Of the amount in paragraph (a), 15.16 $700,000 is for the FAS community grant 15.17 program under Minnesota Statutes, 15.18 section 145.9266, subdivision 4. 15.19 (k) Of the amount in paragraph (a), 15.20 $450,000 is transferred to the 15.21 commissioner of human services to 15.22 expand treatment services and halfway 15.23 houses for pregnant women and women 15.24 with children who abuse alcohol during 15.25 pregnancy. 15.26 [RURAL PHYSICIAN LOAN FORGIVENESS 15.27 BUDGET REQUEST.] The budget request for 15.28 the rural physician loan forgiveness 15.29 program in the 2000-2001 biennial 15.30 budget shall detail the amount of funds 15.31 carried forward and obligations 15.32 canceled. 15.33 [GRANTS FROM HEALTH CARE ACCESS FUND.] 15.34 Of any grants made from the health care 15.35 access fund to the commissioner of 15.36 health for purposes of Minnesota 15.37 Statutes, section 145.925, priority 15.38 shall be given for grants to entities 15.39 providing natural family planning 15.40 services that did not receive funding 15.41 under Minnesota Statutes, section 15.42 145.925, in fiscal year 1998. 15.43 Subd. 3. Health Protection -0- 5,130,000 15.44 Summary by Fund 15.45 General -0- 5,130,000 15.46 State Government 15.47 Special Revenue -0- 7,000 15.48 [OCCUPATIONAL RESPIRATORY DISEASE 15.49 INFORMATION SYSTEM.] Of the general 15.50 fund appropriation, $300,000 in fiscal 15.51 year 1999 is to design an occupational 15.52 respiratory disease information 15.53 system. This appropriation is 15.54 available until expended. This 15.55 appropriation is added to the base for 15.56 the 2000-2001 biennial budget. 15.57 [INFECTION CONTROL.] Of the general 15.58 fund appropriation, $300,000 in fiscal 15.59 year 1999 is for infection control 16.1 activities, including training and 16.2 technical assistance of health care 16.3 personnel to prevent and control 16.4 disease outbreaks, and for hospital and 16.5 public health laboratory testing and 16.6 other activities to monitor trends in 16.7 drug-resistant infections. Start-up 16.8 costs shall not become part of the base 16.9 for the 2000-2001 biennial budget. 16.10 [CANCER SCREENING.] Of the general fund 16.11 appropriation, $989,000 in fiscal year 16.12 1999 is for increased cancer screening 16.13 and diagnostic services for women, 16.14 particularly underserved women, and to 16.15 improve cancer screening rates for the 16.16 general population. Of this amount, at 16.17 least $665,000 is for grants to support 16.18 local boards of health in providing 16.19 outreach and coordination and to 16.20 reimburse health care providers for 16.21 screening and diagnostic tests, and up 16.22 to $324,000 is for technical 16.23 assistance, consultation, and outreach. 16.24 [SEXUALLY TRANSMITTED DISEASE 16.25 PREVENTION INITIATIVES.] (a) Of this 16.26 appropriation, $300,000 in fiscal year 16.27 1999 is from the general fund to the 16.28 commissioner for the sexually 16.29 transmitted disease prevention 16.30 initiatives specified in paragraphs (b) 16.31 to (d). 16.32 (b) $100,000 is for the commissioner, 16.33 in consultation with the HIV/STD 16.34 prevention task force and the 16.35 commissioner of children, families, and 16.36 learning, to conduct a statewide 16.37 assessment of need and capacity to 16.38 prevent and treat sexually transmitted 16.39 diseases and to prepare a comprehensive 16.40 plan for how to prevent and treat 16.41 sexually transmitted diseases, 16.42 including strategies for reducing 16.43 infection and for increasing access to 16.44 treatment. This appropriation shall 16.45 not become part of the base level 16.46 funding for this activity for the 16.47 2000-2001 biennial budget. 16.48 (c) $100,000 is for the commissioner to 16.49 conduct research on the prevalence of 16.50 sexually transmitted diseases among 16.51 populations at highest risk for 16.52 infection. The research may be done in 16.53 collaboration with the University of 16.54 Minnesota and nonprofit community 16.55 health clinics. This appropriation 16.56 shall not become part of the base level 16.57 funding for this activity for the 16.58 2000-2001 biennial budget. 16.59 (d) $100,000 is for the commissioner to 16.60 conduct laboratory screenings for 16.61 sexually transmitted diseases and to 16.62 overcome barriers to diagnostic 16.63 screening and treatment services, 16.64 particularly in populations at highest 16.65 risk for acquiring a sexually 16.66 transmitted disease. 17.1 Sec. 4. HEALTH-RELATED BOARDS 17.2 Subdivision 1. Total 17.3 Appropriation 113,000 83,000 17.4 The appropriations in this section are 17.5 from the state government special 17.6 revenue fund. 17.7 Subd. 2. Board of Medical 17.8 Practice 80,000 (110,000) 17.9 This appropriation is added to the 17.10 appropriation in Laws 1997, chapter 17.11 203, article 1, section 5, subdivision 17.12 6, and is for the health professional 17.13 services activity. 17.14 Subd. 3. Board of Physical 17.15 Therapy -0- 160,000 17.16 Subd. 4. Board of 17.17 Veterinary Medicine 33,000 33,000 17.18 This appropriation is added to the 17.19 appropriation in Laws 1997, chapter 17.20 203, article 1, section 5, subdivision 17.21 14, and is for national examination 17.22 costs. 17.23 Sec. 5. EMERGENCY MEDICAL 17.24 SERVICES BOARD 17.25 General -0- 78,000 17.26 [EMERGENCY MEDICAL SERVICES 17.27 COMMUNICATIONS NEEDS ASSESSMENT.] (a) 17.28 Of this appropriation, $78,000 in 17.29 fiscal year 1999 is from the general 17.30 fund to the board to conduct an 17.31 emergency medical services needs 17.32 assessment for areas outside the 17.33 seven-county metropolitan area. The 17.34 assessment shall determine the current 17.35 status of and need for emergency 17.36 medical services communications 17.37 equipment. All regional emergency 17.38 medical services programs designated by 17.39 the board under Minnesota Statutes 1997 17.40 Supplement, section 144E.50, shall 17.41 cooperate in the preparation of the 17.42 assessment. 17.43 (b) The appropriation for this project 17.44 shall be distributed through the 17.45 emergency medical services system fund 17.46 under Minnesota Statutes, section 17.47 144E.50, through a request-for-proposal 17.48 process. The board must select a 17.49 regional EMS program that receives at 17.50 least 20 percent of its funding from 17.51 nonstate sources to conduct the 17.52 assessment. The request for proposals 17.53 must be issued by August 1, 1998. 17.54 (c) A final report with recommendations 17.55 shall be presented to the board and the 17.56 legislature by July 1, 1999. 17.57 (d) This appropriation shall not become 17.58 part of base level funding for the 18.1 2000-2001 biennium. 18.2 Sec. 6. OMBUDSMAN FOR MENTAL 18.3 HEALTH AND MENTAL RETARDATION 18.4 General -0- 200,000 18.5 Sec. 7. Laws 1997, chapter 203, article 1, section 2, 18.6 subdivision 5, is amended to read: 18.7 Subd. 5. Basic Health Care Grants 18.8 Summary by Fund 18.9 General 834,098,000 938,504,000 18.10 The amounts that may be spent from this 18.11 appropriation for each purpose are as 18.12 follows: 18.13 (a) MA Basic Health Care Grants- 18.14 Families and Children 18.15 General 322,970,000 367,726,000 18.16[NOTICE ON CHANGES IN ASSET TEST.] The18.17commissioner shall provide a notice by18.18July 15, 1997, to all recipients18.19affected by the changes in this act in18.20asset standards for families with18.21children notifying them:18.22(1) what asset limits will apply to18.23them;18.24(2) when the new limits will apply;18.25(3) what options they have to spenddown18.26assets; and18.27(4) what options they have to enroll in18.28MinnesotaCare, including an explanation18.29of the MinnesotaCare premium structure.18.30 (b) MA Basic Health Care Grants- 18.31 Elderly & Disabled 18.32 General 337,659,000 400,408,000 18.33 [PUBLIC HEALTH NURSE ASSESSMENT.] The 18.34 reimbursement for public health nurse 18.35 visits relating to the provision of 18.36 personal care services under Minnesota 18.37 Statutes, sections 256B.0625, 18.38 subdivision 19a, and 256B.0627, is 18.39 $204.36 for the initial assessment 18.40 visit and $102.18 for each reassessment 18.41 visit. 18.42 [SURCHARGE COMPLIANCE.] In the event 18.43 that federal financial participation in 18.44 the Minnesota medical assistance 18.45 program is reduced as a result of a 18.46 determination that Minnesota is out of 18.47 compliance with Public Law Number 18.48 102-234 or its implementing regulations 18.49 or with any other federal law designed 18.50 to restrict provider tax programs or 18.51 intergovernmental transfers, the 18.52 commissioner shall appeal the 19.1 determination to the fullest extent 19.2 permitted by law and may ratably reduce 19.3 all medical assistance and general 19.4 assistance medical care payments to 19.5 providers other than the state of 19.6 Minnesota in order to eliminate any 19.7 shortfall resulting from the reduced 19.8 federal funding. Any amount later 19.9 recovered through the appeals process 19.10 shall be used to reimburse providers 19.11 for any ratable reductions taken. 19.12 [BLOOD PRODUCTS LITIGATION.] To the 19.13 extent permitted by federal law, 19.14 Minnesota Statutes, sections 256.015, 19.15 256B.042, 256B.056, and 256B.15 are 19.16 waived as necessary for the limited 19.17 purpose of resolving the state's claims 19.18 in connection with In re Factor VIII or 19.19 IX Concentrate Blood Products 19.20 Litigation, MDL-986, No. 93-C7452 19.21 (N.D.III.). 19.22 [DISTRIBUTION TO MEDICAL ASSISTANCE 19.23 PROVIDERS.] (a) Of the amount 19.24 appropriated to the medical assistance 19.25 account in fiscal year 1998, $5,000,000 19.26 plus the federal financial 19.27 participation amount shall be 19.28 distributed to medical assistance 19.29 providers according to the distribution 19.30 methodology of the medical education 19.31 research trust fund established under 19.32 Minnesota Statutes, section 62J.69. 19.33 (b) In fiscal year 1999, the prepaid 19.34 medical assistance and prepaid general 19.35 assistance medical care capitation rate 19.36 reduction amounts under Minnesota 19.37 Statutes, section 256B.69, subdivision 19.38 5c, and the federal financial 19.39 participation amount associated with 19.40 the medical assistance reduction, shall 19.41 be distributed to medical assistance 19.42 providers according to the distribution 19.43 methodology of the trust fund. 19.44[AUGMENTATIVE AND ALTERNATIVE19.45COMMUNICATION SYSTEMS.] Augmentative19.46and alternative communication systems19.47and related components that are prior19.48authorized by the department through19.49pass through vendors during the period19.50from January 1, 1997, until the19.51augmentative and alternative19.52communication system purchasing program19.53or other alternatives are operational19.54shall be paid under the medical19.55assistance program at the actual price19.56charged the pass through vendor plus 2019.57percent to cover administrative costs19.58of prior authorization and billing and19.59shipping charges.19.60 (c) General Assistance Medical Care 19.61 General 173,469,000 170,370,000 19.62 [HEALTH CARE ACCESS TRANSFERS TO 19.63 GENERAL FUND.] Funds shall be 19.64 transferred from the health care access 20.1 fund to the general fund in an amount 20.2 equal to the projected savings to 20.3 general assistance medical care (GAMC) 20.4 that would result from the transition 20.5 of GAMC parents and adults without 20.6 children to MinnesotaCare. Based on 20.7 this projection, for state fiscal year 20.8 1998, the amount transferred from the 20.9 health care access fund to the general 20.10 fund shall be $13,700,000. The amount 20.11 of transfer, if any, necessary for 20.12 state fiscal year 1999 shall be 20.13determined on a pro rata20.14basis$2,659,000. 20.15 [TUBERCULOSIS COST OF CARE.] Of the 20.16 general fund appropriation, $89,000 for 20.17 the biennium is for the cost of care 20.18 that is required to be paid by the 20.19 commissioner under Minnesota Statutes, 20.20 section 144.4872, to diagnose or treat 20.21 tuberculosis carriers. 20.22 Sec. 8. Laws 1997, chapter 203, article 1, section 2, 20.23 subdivision 12, is amended to read: 20.24 Subd. 12. Federal TANF Funds 20.25 [FEDERAL TANF FUNDS.] (a) Federal 20.26 Temporary Assistance for Needy Families 20.27 block grant funds authorized under 20.28 title I of Public Law Number 104-193, 20.29 the Personal Responsibility and Work 20.30 Opportunity Reconciliation Act of 1996, 20.31 are appropriated to the commissioner in 20.32 amounts up to$276,741,000$240,936,000 20.33 in fiscal year 1998 20.34 and$265,795,000$272,083,000 in fiscal 20.35 year 1999. Additional TANF funds may 20.36 be expended, but only to the extent 20.37 that an equal amount of state funds 20.38 have been transferred to the TANF 20.39 reserve under Minnesota Statutes 1997 20.40 Supplement, section 256J.03. 20.41 (b) The commissioner may use TANF 20.42 reserve funds to offset any future 20.43 reductions in the amount of the state's 20.44 allocation of federal TANF block grant 20.45 funds. 20.46 Sec. 9. [CARRYOVER LIMITATION.] 20.47 The appropriations in this article which are allowed to be 20.48 carried forward from fiscal year 1998 to fiscal year 1999 shall 20.49 not become part of the base level funding for the 2000-2001 20.50 biennial budget, unless specifically directed by the legislature. 20.51 Sec. 10. [SUNSET OF UNCODIFIED LANGUAGE.] 20.52 All uncodified language contained in this article expires 20.53 on June 30, 1999, unless a different expiration date is 20.54 specified. 20.55 Sec. 11. [EFFECTIVE DATE.] 21.1 The amendments to Laws 1997, chapter 203, article 1, 21.2 section 2, subdivision 12, in section 8 are effective the day 21.3 following final enactment. 21.4 ARTICLE 2 21.5 HEALTH DEPARTMENT AND HEALTH PROFESSIONALS 21.6 Section 1. Minnesota Statutes 1997 Supplement, section 21.7 62D.11, subdivision 1, is amended to read: 21.8 Subdivision 1. [ENROLLEE COMPLAINT SYSTEM.] Every health 21.9 maintenance organization shall establish and maintain a 21.10 complaint system, as required under section 62Q.105 to provide 21.11 reasonable procedures for the resolution of written complaints 21.12 initiated by or on behalf of enrollees concerning the provision 21.13 of health care services. "Provision of health services" 21.14 includes, but is not limited to, questions of the scope of 21.15 coverage, quality of care, and administrative operations. The 21.16 health maintenance organization must inform enrollees that they 21.17 may choose to usealternative dispute resolutionarbitration to 21.18 appeal a health maintenance organization's internal appeal 21.19 decision. The health maintenance organization must also inform 21.20 enrollees that they have the right to use arbitration to appeal 21.21 a health maintenance organization's internal appeal decision not 21.22 to certify an admission, procedure, service, or extension of 21.23 stay under section 62M.06. If an enrollee chooses to usean21.24alternative dispute resolution processarbitration, the health 21.25 maintenance organization must participate. 21.26 Sec. 2. Minnesota Statutes 1997 Supplement, section 21.27 62J.70, subdivision 3, is amended to read: 21.28 Subd. 3. [HEALTH PLAN COMPANY.] "Health plan company" 21.29 means a health plan company as defined in section 62Q.01, 21.30 subdivision 4, the medical assistance program, the MinnesotaCare 21.31 program, the general assistance medical care program, the state 21.32 employee group insurance program, the public employees insurance 21.33 program under section 43A.316, and coverage provided by 21.34 political subdivisions under section 471.617. 21.35 Sec. 3. Minnesota Statutes 1997 Supplement, section 21.36 62J.71, subdivision 1, is amended to read: 22.1 Subdivision 1. [PROHIBITED AGREEMENTS AND DIRECTIVES.] The 22.2 following types of agreements and directives are contrary to 22.3 state public policy, are prohibited under this section, and are 22.4 null and void: 22.5 (1) any agreement or directive that prohibits a health care 22.6 provider from communicating with an enrollee with respect to the 22.7 enrollee's health status, health care, or treatment options, if 22.8 the health care provider is acting in good faith and within the 22.9 provider's scope of practice as defined by law; 22.10 (2) any agreement or directive that prohibits a health care 22.11 provider from making a recommendation regarding the suitability 22.12 or desirability of a health plan company, health insurer, or 22.13 health coverage plan for an enrollee, unless the provider has a 22.14 financial conflict of interest in the enrollee's choice of 22.15 health plan company, health insurer, or health coverage plan; 22.16 (3) any agreement or directive that prohibits a provider 22.17 from providing testimony, supporting or opposing legislation, or 22.18 making any other contact with state or federal legislators or 22.19 legislative staff or with state and federal executive branch 22.20 officers or staff; 22.21 (4) any agreement or directive that prohibits a health care 22.22 provider from disclosing accurate information about whether 22.23 services or treatment will be paid for by a patient's health 22.24 plan company or health insurer or health coverage plan; and 22.25 (5) any agreement or directive that prohibits a health care 22.26 provider from informing an enrollee about the nature of the 22.27 reimbursement methodology used by an enrollee's health plan 22.28 company, health insurer, or health coverage plan to pay the 22.29 provider. 22.30 Sec. 4. Minnesota Statutes 1997 Supplement, section 22.31 62J.71, subdivision 3, is amended to read: 22.32 Subd. 3. [RETALIATION PROHIBITED.] No person, health plan 22.33 company, or other organization may take retaliatory action 22.34 against a health care provider solely on the grounds that the 22.35 provider: 22.36 (1) refused to enter into an agreement or provide services 23.1 or information in a manner that is prohibited under this section 23.2 or took any of the actions listed in subdivision 1; 23.3 (2) disclosed accurate information about whether a health 23.4 care service or treatment is covered by an enrollee's health 23.5 plan company, health insurer, or health coverage plan;or23.6 (3) discussed diagnostic, treatment, or referral options 23.7 that are not covered or are limited by the enrollee's health 23.8 plan company, health insurer, or health coverage plan; 23.9 (4) criticized coverage of the enrollee's health plan 23.10 company, health insurer, or health coverage plan; or 23.11 (5) expressed personal disagreement with a decision made by 23.12 a person, organization, or health care provider regarding 23.13 treatment or coverage provided to a patient of the provider, or 23.14 assisted or advocated for the patient in seeking reconsideration 23.15 of such a decision, provided the health care provider makes it 23.16 clear that the provider is acting in a personal capacity and not 23.17 as a representative of or on behalf of the entity that made the 23.18 decision. 23.19 Sec. 5. Minnesota Statutes 1997 Supplement, section 23.20 62J.71, subdivision 4, is amended to read: 23.21 Subd. 4. [EXCLUSION.] (a) Nothing in this section 23.22 prohibitsa health planan entity that is subject to this 23.23 section from taking action against a provider if thehealth plan23.24 entity has evidence that the provider's actions are illegal, 23.25 constitute medical malpractice, or are contrary to accepted 23.26 medical practices. 23.27 (b) Nothing in this section prohibits a contract provision 23.28 or directive that requires any contracting party to keep 23.29 confidential or to not use or disclose the specific amounts paid 23.30 to a provider, provider fee schedules, provider salaries, and 23.31 other similar provider-specific proprietary information of a 23.32 specifichealth plan or health plan companyentity that is 23.33 subject to this section. 23.34 Sec. 6. Minnesota Statutes 1997 Supplement, section 23.35 62J.72, subdivision 1, is amended to read: 23.36 Subdivision 1. [WRITTEN DISCLOSURE.] (a) A health plan 24.1 company, as defined under section 62J.70, subdivision 3, a 24.2 health care network cooperative as defined under section 62R.04, 24.3 subdivision 3, and a health care provider as defined under 24.4 section 62J.70, subdivision 2, shall, during open enrollment, 24.5 upon enrollment, and annually thereafter, provide enrollees with 24.6 a description of the general nature of the reimbursement 24.7 methodologies used by the health plan company, health insurer, 24.8 or health coverage plan to pay providers. The description must 24.9 explain clearly any aspect of the reimbursement methodology that 24.10 in any way may tend to make it advantageous for the health care 24.11 provider to minimize or restrict the health care provided to 24.12 enrollees. This description may be incorporated into the member 24.13 handbook, subscriber contract, certificate of coverage, or other 24.14 written enrollee communication. The general reimbursement 24.15 methodology shall be made available to employers at the time of 24.16 open enrollment. 24.17 (b) Health plan companies, health care network 24.18 cooperatives, and providers must, upon request, provide an 24.19 enrollee with specific information regarding the reimbursement 24.20 methodology, including, but not limited to, the following 24.21 information: 24.22 (1) a concise written description of the provider payment 24.23 plan, including any incentive plan applicable to the enrollee; 24.24 (2) a written description of any incentive to the provider 24.25 relating to the provision of health care services to enrollees, 24.26 including any compensation arrangement that is dependent on the 24.27 amount of health coverage or health care services provided to 24.28 the enrollee, or the number of referrals to or utilization of 24.29 specialists; and 24.30 (3) a written description of any incentive plan that 24.31 involves the transfer of financial risk to the health care 24.32 provider. 24.33 (c) The disclosure statement describing the general nature 24.34 of the reimbursement methodologies must comply with the 24.35 Readability of Insurance Policies Act in chapter 72C.24.36Notwithstanding any other law to the contrary, the disclosure25.1statement may voluntarily be filed with the commissioner for25.2approvaland must be filed with and approved by the commissioner 25.3 prior to its use. 25.4 (d) A disclosure statement that hasvoluntarilybeen filed 25.5 with the commissioner for approval underchapter 72C or25.6voluntarily filed with the commissioner for approval for25.7purposes other than pursuant to chapter 72Cparagraph (c) is 25.8 deemed approved 30 days after the date of filing, unless 25.9 approved or disapproved by the commissioner on or before the end 25.10 of that 30-day period. 25.11 (e) The disclosure statement describing the general nature 25.12 of the reimbursement methodologies must be provided upon request 25.13 in English, Spanish, Vietnamese, and Hmong. In addition, 25.14 reasonable efforts must be made to provide information contained 25.15 in the disclosure statement to other non-English-speaking 25.16 enrollees. 25.17 (f) Health plan companies and providers may enter into 25.18 agreements to determine how to respond to enrollee requests 25.19 received by either the provider or the health plan 25.20 company. Health plan companies may also enter into agreements 25.21 to determine how to respond to enrollee requests. This 25.22 subdivision does not require disclosure of specific amounts paid 25.23 to a provider, provider fee schedules, provider salaries, or 25.24 other proprietary information of a specific health plan company 25.25 or health insurer or health coverage plan or provider. 25.26 Sec. 7. [62J.77] [DEFINITIONS.] 25.27 Subdivision 1. [APPLICABILITY.] For purposes of sections 25.28 62J.77 to 62J.80, the terms defined in this section have the 25.29 meanings given them. 25.30 Subd. 2. [ENROLLEE.] "Enrollee" means a natural person 25.31 covered by a health plan company, health insurance, or health 25.32 coverage plan and includes an insured, policyholder, subscriber, 25.33 contract holder, member, covered person, or certificate holder. 25.34 Subd. 3. [PATIENT.] "Patient" means a former, current, or 25.35 prospective patient of a health care provider. 25.36 Sec. 8. [62J.78] [ESTABLISHMENT; ORGANIZATION.] 26.1 Subdivision 1. [GENERAL.] The office of health care 26.2 consumer assistance, advocacy, and information is established to 26.3 provide assistance, advocacy, and information to all health care 26.4 consumers within the state. The office shall have no regulatory 26.5 power or authority and shall not provide legal representation in 26.6 a court of law. 26.7 Subd. 2. [EXECUTIVE DIRECTOR.] An executive director shall 26.8 be appointed by the governor, in consultation with the consumer 26.9 advisory board, for a three-year term and may be removed only 26.10 for just cause. The executive director must be selected without 26.11 regard to political affiliation and must be a person who has 26.12 knowledge and experience concerning the needs and rights of 26.13 health care consumers and must be qualified to analyze questions 26.14 of law, administrative functions, and public policy. No person 26.15 may serve as executive director while holding another public 26.16 office. The director shall serve in the unclassified service. 26.17 Subd. 3. [STAFF.] The executive director shall appoint at 26.18 least nine consumer advocates to discharge the responsibilities 26.19 and duties of the office. The executive director and full-time 26.20 staff shall be included in the Minnesota state retirement 26.21 association. 26.22 Subd. 4. [DELEGATION.] The executive director may delegate 26.23 to staff any of the authority or duties of the director, except 26.24 the duty of formally making recommendations to the legislature. 26.25 Subd. 5. [TRAINING.] The executive director shall ensure 26.26 that the consumer advocates are adequately trained. 26.27 Subd. 6. [STATEWIDE ADVOCACY.] The executive director 26.28 shall assign a consumer advocate to represent each regional 26.29 coordinating board's geographic area. 26.30 Subd. 7. [FINANCIAL INTEREST.] The executive director and 26.31 staff must not have any direct personal financial interest in 26.32 the health care system, except as an individual consumer of 26.33 health care services. 26.34 Subd. 8. [ADMINISTRATION.] The office of the ombudsman for 26.35 mental health and mental retardation shall coordinate and share 26.36 administrative services with the office of health care consumer 27.1 assistance, advocacy, and information. To the extent practical, 27.2 all ombudsman offices with health care responsibilities shall 27.3 have their telephone systems linked in order to facilitate 27.4 immediate referrals. 27.5 Sec. 9. [62J.79] [DUTIES AND POWERS OF THE OFFICE OF 27.6 HEALTH CARE CONSUMER ASSISTANCE, ADVOCACY, AND INFORMATION.] 27.7 Subdivision 1. [DUTIES.] (a) The executive director shall 27.8 provide information and assistance to all health care consumers 27.9 by: 27.10 (1) assisting patients and enrollees in understanding and 27.11 asserting their contractual and legal rights, including the 27.12 rights under an alternative dispute resolution process. This 27.13 assistance may include advocacy for enrollees in administrative 27.14 proceedings or other formal or informal dispute resolution 27.15 processes; 27.16 (2) assisting enrollees in obtaining health care referrals 27.17 under their health plan company, health insurance, or health 27.18 coverage plan; 27.19 (3) assisting patients and enrollees in accessing the 27.20 services of governmental agencies, regulatory boards, and other 27.21 state consumer assistance programs, ombudsman, or advocacy 27.22 services whenever appropriate so that the patient or enrollee 27.23 can take full advantage of existing mechanisms for resolving 27.24 complaints; 27.25 (4) referring patients and enrollees to governmental 27.26 agencies and regulatory boards for the investigation of health 27.27 care complaints and for enforcement action; 27.28 (5) educating and training enrollees about their health 27.29 plan company, health insurance, or health coverage plan in order 27.30 to enable them to assert their rights and to understand their 27.31 responsibilities; 27.32 (6) assisting enrollees in receiving a timely resolution of 27.33 their complaints; 27.34 (7) monitoring health care complaints addressed by the 27.35 office to identify specific complaint patterns or areas of 27.36 potential improvement; 28.1 (8) recommending to health plan companies ways to identify 28.2 and remove any barriers that might delay or impede the health 28.3 plan company's effort to resolve consumer complaints; and 28.4 (9) in performing the duties specified in clauses (1) to 28.5 (8), taking into consideration the special situations of 28.6 patients and enrollees who have unique culturally defined needs. 28.7 (b) The executive director shall prioritize the duties 28.8 listed in this subdivision within the appropriations allocated. 28.9 Subd. 2. [COMMUNICATION.] The executive director shall 28.10 meet at least six times per year with the consumer advisory 28.11 board. The executive director shall share all public 28.12 information obtained by the office of health care consumer 28.13 assistance, advocacy, and information with the consumer advisory 28.14 board in order to assist the consumer advisory board in its role 28.15 of advising the commissioners of health and commerce and the 28.16 legislature in accordance with section 62J.75. 28.17 Subd. 3. [REPORTS.] Beginning January 15, 1999, the 28.18 executive director, on at least a quarterly basis, shall provide 28.19 data from the health care complaints addressed by the office to 28.20 the commissioners of health and commerce, the consumer advisory 28.21 board, the Minnesota council of health plans, the Insurance 28.22 Federation of Minnesota, and the information clearinghouse. 28.23 Beginning January 15, 1999, the executive director must make an 28.24 annual written report to the legislature regarding activities of 28.25 the office, including recommendations on improving health care 28.26 consumer assistance and complaint resolution processes. 28.27 Sec. 10. [62J.80] [RETALIATION.] 28.28 A health plan company or health care provider shall not 28.29 retaliate or take adverse action against an enrollee or patient 28.30 who, in good faith, makes a complaint against a health plan 28.31 company or health care provider. If retaliation is suspected, 28.32 the executive director may report it to the appropriate 28.33 regulatory authority. 28.34 Sec. 11. Minnesota Statutes 1997 Supplement, section 28.35 62Q.105, subdivision 1, is amended to read: 28.36 Subdivision 1. [ESTABLISHMENT.] Each health plan company 29.1 shall establish and make available to enrollees, by July 1,199829.2 1999, an informal complaint resolution process that meets the 29.3 requirements of this section. A health plan company must make 29.4 reasonable efforts to resolve enrollee complaints, and must 29.5 inform complainants in writing of the company's decision within 29.6 30 days of receiving the complaint. The complaint resolution 29.7 process must treat the complaint and information related to it 29.8 as required under sections 72A.49 to 72A.505. 29.9 Sec. 12. [62Q.107] [PROHIBITED PROVISION; EFFECT OF DENIAL 29.10 OF CLAIM.] 29.11 No health plan, including the coverages described in 29.12 section 62A.011, subdivision 3, clauses (7) and (10), may 29.13 specify a standard of review upon which a court may review 29.14 denial of a claim or of any other decision made by a health plan 29.15 company with respect to an enrollee. This section prohibits 29.16 limiting court review to a determination of whether the health 29.17 plan company's decision is arbitrary and capricious, an abuse of 29.18 discretion, or any other standard less favorable to the enrollee 29.19 than a preponderance of the evidence. 29.20 Sec. 13. Minnesota Statutes 1997 Supplement, section 29.21 62Q.30, is amended to read: 29.22 62Q.30 [EXPEDITED FACT FINDING AND DISPUTE RESOLUTION 29.23 PROCESS.] 29.24 The commissioner shall establish an expedited fact finding 29.25 and dispute resolution process to assist enrollees of health 29.26 plan companies with contested treatment, coverage, and service 29.27 issues to be in effect July 1,19981999. If the disputed issue 29.28 relates to whether a service is appropriate and necessary, the 29.29 commissioner shall issue an order only after consulting with 29.30 appropriate experts knowledgeable, trained, and practicing in 29.31 the area in dispute, reviewing pertinent literature, and 29.32 considering the availability of satisfactory alternatives. The 29.33 commissioner shall take steps including but not limited to 29.34 fining, suspending, or revoking the license of a health plan 29.35 company that is the subject of repeated orders by the 29.36 commissioner that suggests a pattern of inappropriate 30.1 underutilization. 30.2 Sec. 14. Minnesota Statutes 1997 Supplement, section 30.3 103I.208, subdivision 2, is amended to read: 30.4 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 30.5 property owner is: 30.6 (1) for a well that is not in use under a maintenance 30.7 permit, $100 annually; 30.8 (2) for construction of a monitoring well, $120, which 30.9 includes the state core function fee; 30.10 (3) for a monitoring well that is unsealed under a 30.11 maintenance permit, $100 annually; 30.12 (4) for monitoring wells used as a leak detection device at 30.13 a single motor fuel retail outletor, a single petroleum bulk 30.14 storage site excluding tank farms, or a single agricultural 30.15 chemical facility site, the construction permit fee is $120, 30.16 which includes the state core function fee, per site regardless 30.17 of the number of wells constructed on the site, and the annual 30.18 fee for a maintenance permit for unsealed monitoring wells is 30.19 $100 per site regardless of the number of monitoring wells 30.20 located on site; 30.21 (5) for a groundwater thermal exchange device, in addition 30.22 to the notification fee for wells, $120, which includes the 30.23 state core function fee; 30.24 (6) for a vertical heat exchanger, $120; 30.25 (7) for a dewatering well that is unsealed under a 30.26 maintenance permit, $100 annually for each well, except a 30.27 dewatering project comprising more than five wells shall be 30.28 issued a single permit for $500 annually for wells recorded on 30.29 the permit; and 30.30 (8) for excavating holes for the purpose of installing 30.31 elevator shafts, $120 for each hole. 30.32 Sec. 15. Minnesota Statutes 1997 Supplement, section 30.33 144.1494, subdivision 1, is amended to read: 30.34 Subdivision 1. [CREATION OF ACCOUNT.] A rural physician 30.35 education account is established in the health care access 30.36 fund. The commissioner shall use money from the account to 31.1 establish a loan forgiveness program for medical residents 31.2 agreeing to practice in designated rural areas, as defined by 31.3 the commissioner. Appropriations made to this account do not 31.4 cancel and are available until expended, except that at the end 31.5 of each biennium the commissioner shall cancel to the health 31.6 care access fund any remaining unobligated balance in this 31.7 account. 31.8 Sec. 16. Minnesota Statutes 1996, section 144.701, 31.9 subdivision 1, is amended to read: 31.10 Subdivision 1. [CONSUMER INFORMATION.] The commissioner of 31.11 health shall ensure that the total costs, total 31.12 revenues, overall utilization, and total services of each 31.13 hospital and each outpatient surgical center are reported to the 31.14 public in a form understandable to consumers. 31.15 Sec. 17. Minnesota Statutes 1996, section 144.701, 31.16 subdivision 2, is amended to read: 31.17 Subd. 2. [DATA FOR POLICY MAKING.] The commissioner of 31.18 health shall compile relevant financial and accounting, 31.19 utilization, and services data concerning hospitals and 31.20 outpatient surgical centers in order to have statistical 31.21 information available for legislative policy making. 31.22 Sec. 18. Minnesota Statutes 1996, section 144.701, 31.23 subdivision 4, is amended to read: 31.24 Subd. 4. [FILING FEES.] Each report which is required to 31.25 be submitted to the commissioner of health under sections 31.26 144.695 to 144.703 and which is not submitted to a voluntary, 31.27 nonprofit reporting organization in accordance with section 31.28 144.702 shall be accompanied by a filing fee in an amount 31.29 prescribed by rule of the commissioner of health.Fees received31.30pursuant to this subdivision shall be deposited in the general31.31fund of the state treasury.Upon the withdrawal of approval of 31.32 a reporting organization, or the decision of the commissioner to 31.33 not renew a reporting organization, fees collected under section 31.34 144.702 shall be submitted to the commissionerand deposited in31.35the general fund. Fees received under this subdivision shall be 31.36 deposited in a revolving fund and are appropriated to the 32.1 commissioner of health for the purposes of sections 144.695 to 32.2 144.703. The commissioner shall report the termination or 32.3 nonrenewal of the voluntary reporting organization to the chair 32.4 of the health and human services subdivision of the 32.5 appropriations committee of the house of representatives, to the 32.6 chair of the health and human services division of the finance 32.7 committee of the senate, and the commissioner of finance. 32.8 Sec. 19. Minnesota Statutes 1996, section 144.702, 32.9 subdivision 1, is amended to read: 32.10 Subdivision 1. [REPORTING THROUGH A REPORTING 32.11 ORGANIZATION.] A hospital or outpatient surgical center may 32.12 agree to submit its financial, utilization, and services reports 32.13 to a voluntary, nonprofit reporting organization whose reporting 32.14 procedures have been approved by the commissioner of health in 32.15 accordance with this section. Each report submitted to the 32.16 voluntary, nonprofit reporting organization under this section 32.17 shall be accompanied by a filing fee. 32.18 Sec. 20. Minnesota Statutes 1996, section 144.702, 32.19 subdivision 2, is amended to read: 32.20 Subd. 2. [APPROVAL OF ORGANIZATION'S REPORTING 32.21 PROCEDURES.] The commissioner of health may approve voluntary 32.22 reporting procedures consistent with written operating 32.23 requirements for the voluntary, nonprofit reporting organization 32.24 which shall be established annually by the commissioner. These 32.25 written operating requirements shall specify reports, analyses, 32.26 and other deliverables to be produced by the voluntary, 32.27 nonprofit reporting organization, and the dates on which those 32.28 deliverables must be submitted to the commissioner. These 32.29 written operating requirements shall specify deliverable dates 32.30 sufficient to enable the commissioner of health to process and 32.31 report health care cost information system data to the 32.32 commissioner of human services by August 15 of each year. The 32.33 commissioner of health shall, by rule, prescribe standards for 32.34 submission of data by hospitals and outpatient surgical centers 32.35 to the voluntary, nonprofit reporting organization or to the 32.36 commissioner. These standards shall provide for: 33.1 (a) The filing of appropriate financial, utilization, and 33.2 services information with the reporting organization; 33.3 (b) Adequate analysis and verification of that financial, 33.4 utilization, and services information; and 33.5 (c) Timely publication of the costs, revenues, and rates of 33.6 individual hospitals and outpatient surgical centers prior to 33.7 the effective date of any proposed rate increase. The 33.8 commissioner of health shall annually review the procedures 33.9 approved pursuant to this subdivision. 33.10 Sec. 21. Minnesota Statutes 1996, section 144.702, 33.11 subdivision 8, is amended to read: 33.12 Subd. 8. [TERMINATION OR NONRENEWAL OF REPORTING 33.13 ORGANIZATION.] The commissioner may withdraw approval of any 33.14 voluntary, nonprofit reporting organization for failure on the 33.15 part of the voluntary, nonprofit reporting organization to 33.16 comply with the written operating requirements under subdivision 33.17 2. Upon the effective date of the withdrawal, all funds 33.18 collected by the voluntary, nonprofit reporting organization 33.19 undersection 144.701,subdivision41, but not expended shall 33.20 be deposited inthe general funda revolving fund and are 33.21 appropriated to the commissioner of health for the purposes of 33.22 sections 144.695 to 144.703. 33.23 The commissioner may choose not to renew approval of a 33.24 voluntary, nonprofit reporting organization if the organization 33.25 has failed to perform its obligations satisfactorily under the 33.26 written operating requirements under subdivision 2. 33.27 Sec. 22. [144.7022] [ADMINISTRATIVE PENALTY ORDERS FOR 33.28 REPORTING ORGANIZATIONS.] 33.29 Subdivision 1. [AUTHORIZATION.] The commissioner may issue 33.30 an order to the voluntary, nonprofit reporting organization 33.31 requiring violations to be corrected and administratively 33.32 assessing monetary penalties for violations of sections 144.695 33.33 to 144.703 or rules, written operating requirements, orders, 33.34 stipulation agreements, settlements, or compliance agreements 33.35 adopted, enforced, or issued by the commissioner. 33.36 Subd. 2. [CONTENTS OF ORDER.] An order assessing an 34.1 administrative penalty under this section must include: 34.2 (1) a concise statement of the facts alleged to constitute 34.3 a violation; 34.4 (2) a reference to the section of law, rule, written 34.5 operating requirement, order, stipulation agreement, settlement, 34.6 or compliance agreement that has been violated; 34.7 (3) a statement of the amount of the administrative penalty 34.8 to be imposed and the factors upon which the penalty is based; 34.9 (4) a statement of the corrective actions necessary to 34.10 correct the violation; and 34.11 (5) a statement of the right to request a hearing pursuant 34.12 to sections 14.57 to 14.62. 34.13 Subd. 3. [CONCURRENT CORRECTIVE ORDER.] The commissioner 34.14 may issue an order assessing an administrative penalty and 34.15 requiring the violations cited in the order to be corrected 34.16 within 30 calendar days from the date the order is received. 34.17 Before the 31st day after the order was received, the voluntary, 34.18 nonprofit reporting organization that is subject to the order 34.19 shall provide the commissioner with information demonstrating 34.20 that the violation has been corrected or that a corrective plan, 34.21 acceptable to the commissioner, has been developed. The 34.22 commissioner shall determine whether the violation has been 34.23 corrected and notify the voluntary, nonprofit reporting 34.24 organization of the commissioner's determination. 34.25 Subd. 4. [PENALTY.] If the commissioner determines that 34.26 the violation has been corrected or an acceptable corrective 34.27 plan has been developed, the penalty may be forgiven, except 34.28 where there are repeated or serious violations, the commissioner 34.29 may issue an order with a penalty that will not be forgiven 34.30 after corrective action is taken. Unless there is a request for 34.31 review of the order under subdivision 6 before the penalty is 34.32 due, the penalty is due and payable: 34.33 (1) on the 31st calendar day after the order was received, 34.34 if the voluntary, nonprofit reporting organization fails to 34.35 provide information to the commissioner showing that the 34.36 violation has been corrected or that appropriate steps have been 35.1 taken toward correcting the violation; 35.2 (2) on the 20th day after the voluntary, nonprofit 35.3 reporting organization receives the commissioner's determination 35.4 that the information provided is not sufficient to show that 35.5 either the violation has been corrected or that appropriate 35.6 steps have been taken toward correcting the violation; or 35.7 (3) on the 31st day after the order was received where the 35.8 penalty is for repeated or serious violations and according to 35.9 the order issued, the penalty will not be forgiven after 35.10 corrective action is taken. 35.11 All penalties due under this section are payable to the 35.12 treasurer, state of Minnesota, and shall be deposited in the 35.13 general fund. 35.14 Subd. 5. [AMOUNT OF PENALTY; CONSIDERATIONS.] (a) The 35.15 maximum amount for an administrative penalty is $5,000 for each 35.16 specific violation identified in an inspection, investigation, 35.17 or compliance review, up to an annual maximum total for all 35.18 violations of ten percent of the fees collected by the 35.19 voluntary, nonprofit reporting organization under section 35.20 144.702, subdivision 1. The annual total is based upon the 35.21 reporting year. 35.22 (b) In determining the amount of the administrative 35.23 penalty, the commissioner shall consider the following: 35.24 (1) the willfulness of the violation; 35.25 (2) the gravity of the violation; 35.26 (3) the history of past violations; 35.27 (4) the number of violations; 35.28 (5) the economic benefit gained by the person allowing or 35.29 committing the violation; and 35.30 (6) other factors as justice may require, if the 35.31 commissioner specifically identifies the additional factors in 35.32 the commissioner's order. 35.33 (c) In determining the amount of a penalty for a violation 35.34 committed after an initial violation, the commissioner shall 35.35 also consider: 35.36 (1) the similarity of the most recent previous violation 36.1 and the current violation; 36.2 (2) the time elapsed since the last violation; and 36.3 (3) the response of the voluntary, nonprofit reporting 36.4 organization to the most recent previous violation. 36.5 Subd. 6. [REQUEST FOR HEARING; HEARING; AND FINAL 36.6 ORDER.] A request for hearing must be in writing, delivered to 36.7 the commissioner by certified mail within 20 calendar days after 36.8 the receipt of the order, and specifically state the reasons for 36.9 seeking review of the order. The commissioner must initiate a 36.10 hearing within 30 calendar days from the date of receipt of the 36.11 written request for hearing. The hearing shall be conducted 36.12 pursuant to the contested case procedures in sections 14.57 to 36.13 14.62. No earlier than ten calendar days after and within 30 36.14 calendar days of receipt of the presiding administrative law 36.15 judge's report, the commissioner shall, based on all relevant 36.16 facts, issue a final order modifying, vacating, or making the 36.17 original order permanent. If, within 20 calendar days of 36.18 receipt of the original order, the voluntary, nonprofit 36.19 reporting organization fails to request a hearing in writing, 36.20 the order becomes the final order of the commissioner. 36.21 Subd. 7. [REVIEW OF FINAL ORDER AND PAYMENT OF 36.22 PENALTY.] Once the commissioner issues a final order, any 36.23 penalty due under that order shall be paid within 30 calendar 36.24 days after the date of the final order, unless review of the 36.25 final order is requested. The final order of the commissioner 36.26 may be appealed in the manner prescribed in sections 14.63 to 36.27 14.69. If the final order is reviewed and upheld, the penalty 36.28 shall be paid 30 calendar days after the date of the decision of 36.29 the reviewing court. Failure to request an administrative 36.30 hearing pursuant to subdivision 6 shall constitute a waiver of 36.31 the right to further agency or judicial review of the final 36.32 order. 36.33 Subd. 8. [REINSPECTIONS AND EFFECT OF NONCOMPLIANCE.] If 36.34 upon reinspection, or in the determination of the commissioner, 36.35 it is found that any deficiency specified in the order has not 36.36 been corrected or an acceptable corrective plan has not been 37.1 developed, the voluntary, nonprofit reporting organization is in 37.2 noncompliance. The commissioner shall issue a notice of 37.3 noncompliance and may impose any additional remedy available 37.4 under sections 144.695 to 144.703. 37.5 Subd. 9. [ENFORCEMENT.] The attorney general may proceed 37.6 on behalf of the commissioner to enforce penalties that are due 37.7 and payable under this section in any manner provided by law for 37.8 the collection of debts. 37.9 Subd. 10. [TERMINATION OR NONRENEWAL OF REPORTING 37.10 ORGANIZATION.] The commissioner may withdraw or not renew 37.11 approval of any voluntary, nonprofit reporting organization for 37.12 failure on the part of the voluntary, nonprofit reporting 37.13 organization to pay penalties owed under this section. 37.14 Subd. 11. [CUMULATIVE REMEDY.] The authority of the 37.15 commissioner to issue an administrative penalty order is in 37.16 addition to other lawfully available remedies. 37.17 Subd. 12. [MEDIATION.] In addition to review under 37.18 subdivision 6, the commissioner is authorized to enter into 37.19 mediation concerning an order issued under this section if the 37.20 commissioner and the voluntary, nonprofit reporting organization 37.21 agree to mediation. 37.22 Sec. 23. Minnesota Statutes 1996, section 144.9501, 37.23 subdivision 1, is amended to read: 37.24 Subdivision 1. [CITATION.] Sections 144.9501 to 144.9509 37.25 may be cited as the "childhoodLead Poisoning Prevention Act." 37.26 Sec. 24. Minnesota Statutes 1996, section 144.9501, is 37.27 amended by adding a subdivision to read: 37.28 Subd. 4a. [ASSESSING AGENCY.] "Assessing agency" means the 37.29 commissioner or a board of health with authority and 37.30 responsibility to conduct lead risk assessments in response to 37.31 reports of children or pregnant women with elevated blood lead 37.32 levels. 37.33 Sec. 25. Minnesota Statutes 1996, section 144.9501, is 37.34 amended by adding a subdivision to read: 37.35 Subd. 6b. [CLEARANCE INSPECTION.] "Clearance inspection" 37.36 means a visual identification of deteriorated paint and bare 38.1 soil and a resampling and analysis of interior dust lead 38.2 concentrations in a residence to ensure that the lead standards 38.3 established in rules adopted under section 144.9508 are not 38.4 exceeded. 38.5 Sec. 26. Minnesota Statutes 1996, section 144.9501, 38.6 subdivision 17, is amended to read: 38.7 Subd. 17. [LEAD HAZARD REDUCTION.] "Lead hazard reduction" 38.8 means action undertakenin response to a lead orderto make a 38.9 residence, child care facility, school, or playground lead-safe 38.10 by complying with the lead standards and methods adopted under 38.11 section 144.9508, by: 38.12 (1) a property owner orlead contractor complyingpersons 38.13 hired by the property owner to comply with a lead order issued 38.14 under section 144.9504;or38.15 (2) a swab team service provided in response to a lead 38.16 order issued under section 144.9504; or 38.17 (3) a renter residing at a rental property or one or more 38.18 volunteers to comply with a lead order issued under section 38.19 144.9504. 38.20 Sec. 27. Minnesota Statutes 1996, section 144.9501, is 38.21 amended by adding a subdivision to read: 38.22 Subd. 17a. [LEAD HAZARD SCREEN.] "Lead hazard screen" 38.23 means visual identification of the existence and location of any 38.24 deteriorated paint, collection and analysis of dust samples, and 38.25 visual identification of the existence and location of bare soil. 38.26 Sec. 28. Minnesota Statutes 1996, section 144.9501, 38.27 subdivision 18, is amended to read: 38.28 Subd. 18. [LEAD INSPECTION.] "Lead inspection" means a 38.29qualitative orquantitativeanalytical inspection of a residence38.30for deteriorated paint or bare soil and the collection of38.31samples of deteriorated paint, bare soil, dust, or drinking38.32water for analysis to determine if the lead concentrations in38.33the samples exceed standards adopted under section 144.9508.38.34Lead inspection includes the clearance inspection after the38.35completion of a lead ordermeasurement of the lead content of 38.36 paint and a visual identification of the existence and location 39.1 of bare soil. 39.2 Sec. 29. Minnesota Statutes 1996, section 144.9501, 39.3 subdivision 20, is amended to read: 39.4 Subd. 20. [LEAD ORDER.] "Lead order" means a legal 39.5 instrument to compel a property owner to engage in lead hazard 39.6 reduction according to the specifications given by the 39.7inspectingassessing agency. 39.8 Sec. 30. Minnesota Statutes 1996, section 144.9501, is 39.9 amended by adding a subdivision to read: 39.10 Subd. 20a. [LEAD PROJECT DESIGNER.] "Lead project designer" 39.11 means an individual who is responsible for planning the 39.12 site-specific performance of lead abatement or lead hazard 39.13 reduction and who has been licensed by the commissioner under 39.14 section 144.9505. 39.15 Sec. 31. Minnesota Statutes 1996, section 144.9501, is 39.16 amended by adding a subdivision to read: 39.17 Subd. 20b. [LEAD RISK ASSESSMENT.] "Lead risk assessment" 39.18 means a quantitative measurement of the lead content of paint, 39.19 interior dust, and bare soil to determine compliance with the 39.20 standards established under section 144.9508. 39.21 Sec. 32. Minnesota Statutes 1996, section 144.9501, is 39.22 amended by adding a subdivision to read: 39.23 Subd. 20c. [LEAD RISK ASSESSOR.] "Lead risk assessor" 39.24 means an individual who performs lead risk assessments or lead 39.25 inspections and who has been licensed by the commissioner under 39.26 section 144.9506. 39.27 Sec. 33. Minnesota Statutes 1996, section 144.9501, is 39.28 amended by adding a subdivision to read: 39.29 Subd. 22a. [LEAD SUPERVISOR.] "Lead supervisor" means an 39.30 individual who is responsible for the on-site performance of 39.31 lead abatement or lead hazard reduction and who has been 39.32 licensed by the commissioner under section 144.9505. 39.33 Sec. 34. Minnesota Statutes 1996, section 144.9501, 39.34 subdivision 23, is amended to read: 39.35 Subd. 23. [LEAD WORKER.] "Lead worker" meansany person39.36who is certifiedan individual who performs lead abatement or 40.1 lead hazard reduction and who has been licensed by the 40.2 commissioner under section 144.9505. 40.3 Sec. 35. Minnesota Statutes 1996, section 144.9501, is 40.4 amended by adding a subdivision to read: 40.5 Subd. 25a. [PLAY AREA.] "Play area" means any established 40.6 area where children play, or on residential property, any 40.7 established area where children play or bare soil is accessible 40.8 to children. 40.9 Sec. 36. Minnesota Statutes 1996, section 144.9501, is 40.10 amended by adding a subdivision to read: 40.11 Subd. 28a. [STANDARD.] "Standard" means a quantitative 40.12 assessment of lead in any environmental media or consumer 40.13 product or a work practice or method that reduces the likelihood 40.14 of lead exposure. 40.15 Sec. 37. Minnesota Statutes 1996, section 144.9501, 40.16 subdivision 30, is amended to read: 40.17 Subd. 30. [SWAB TEAM WORKER.] "Swab team worker" meansa40.18person who is certifiedan individual who performs swab team 40.19 services and who has been licensed by the commissioner as a lead 40.20 worker under section 144.9505. 40.21 Sec. 38. Minnesota Statutes 1996, section 144.9501, 40.22 subdivision 32, is amended to read: 40.23 Subd. 32. [VOLUNTARY LEAD HAZARD REDUCTION.] "Voluntary 40.24 lead hazard reduction" meansaction undertaken by a property40.25owner with the intention to engage in lead hazard reduction or40.26abatementlead hazard reduction activities defined in 40.27 subdivision 17, but not undertaken in response to the issuance 40.28 of a lead order. 40.29 Sec. 39. Minnesota Statutes 1996, section 144.9502, 40.30 subdivision 3, is amended to read: 40.31 Subd. 3. [REPORTS OF BLOOD LEAD ANALYSIS REQUIRED.] (a) 40.32 Every hospital, medical clinic, medical laboratory,orother 40.33 facility, or individual performing blood lead analysis shall 40.34 report the results after the analysis of each specimen analyzed, 40.35 for both capillary and venous specimens, and epidemiologic 40.36 information required in this section to the commissioner of 41.1 health, within the time frames set forth in clauses (1) and (2): 41.2 (1) within two working days by telephone, fax, or 41.3 electronic transmission, with written or electronic confirmation 41.4 within one month, for a venous blood lead level equal to or 41.5 greater than 15 micrograms of lead per deciliter of whole blood; 41.6 or 41.7 (2) within one month in writing or by electronic 41.8 transmission, foraany capillary result or for a venous blood 41.9 lead level less than 15 micrograms of lead per deciliter of 41.10 whole blood. 41.11 (b) If a blood lead analysis is performed outside of 41.12 Minnesota and the facility performing the analysis does not 41.13 report the blood lead analysis results and epidemiological 41.14 information required in this section to the commissioner, the 41.15 provider who collected the blood specimen must satisfy the 41.16 reporting requirements of this section. For purposes of this 41.17 section, "provider" has the meaning given in section 62D.02, 41.18 subdivision 9. 41.19 (c) The commissioner shall coordinate with hospitals, 41.20 medical clinics, medical laboratories, and other facilities 41.21 performing blood lead analysis to develop a universal reporting 41.22 form and mechanism. 41.23The reporting requirements of this subdivision shall expire41.24on December 31, 1997. Beginning January 1, 1998, every41.25hospital, medical clinic, medical laboratory, or other facility41.26performing blood lead analysis shall report the results within41.27two working days by telephone, fax, or electronic transmission,41.28with written or electronic confirmation within one month, for41.29capillary or venous blood lead level equal to the level for41.30which reporting is recommended by the Center for Disease Control.41.31 Sec. 40. Minnesota Statutes 1996, section 144.9502, 41.32 subdivision 4, is amended to read: 41.33 Subd. 4. [BLOOD LEAD ANALYSES AND EPIDEMIOLOGIC 41.34 INFORMATION.] The blood lead analysis reports required in this 41.35 section must specify: 41.36 (1) whether the specimen was collected as a capillary or 42.1 venous sample; 42.2 (2) the date the sample was collected; 42.3 (3) the results of the blood lead analysis; 42.4 (4) the date the sample was analyzed; 42.5 (5) the method of analysis used; 42.6 (6) the full name, address, and phone number of the 42.7 laboratory performing the analysis; 42.8 (7) the full name, address, and phone number of the 42.9 physician or facility requesting the analysis; 42.10 (8) the full name, address, and phone number of the person 42.11 with theelevatedblood lead level, and the person's birthdate, 42.12 gender, and race. 42.13 Sec. 41. Minnesota Statutes 1996, section 144.9502, 42.14 subdivision 9, is amended to read: 42.15 Subd. 9. [CLASSIFICATION OF DATA.] Notwithstanding any law 42.16 to the contrary, including section 13.05, subdivision 9, data 42.17 collected by the commissioner of health about persons with 42.18elevatedblood lead levels, including analytic results from 42.19 samples of paint, soil, dust, and drinking water taken from the 42.20 individual's home and immediate property, shall be private and 42.21 may only be used by the commissioner of health, the commissioner 42.22 of labor and industry, authorized agents of Indian tribes, and 42.23 authorized employees of local boards of health for the purposes 42.24 set forth in this section. 42.25 Sec. 42. Minnesota Statutes 1996, section 144.9503, 42.26 subdivision 4, is amended to read: 42.27 Subd. 4. [SWAB TEAM SERVICES.] Primary prevention must 42.28 include the use of swab team services in census tracts 42.29 identified at high risk for toxic lead exposure as identified by 42.30 the commissioner under this section. The swab team services may 42.31 be provided based onvisual inspectionslead hazard screens 42.32 whenever possible and must at least include lead 42.33 hazardmanagementreduction for deteriorated interior lead-based 42.34 paint, bare soil, and dust. 42.35 Sec. 43. Minnesota Statutes 1996, section 144.9503, 42.36 subdivision 6, is amended to read: 43.1 Subd. 6. [VOLUNTARY LEAD ABATEMENT OR LEAD HAZARD 43.2 REDUCTION.] The commissioner shall monitor the lead abatement or 43.3 lead hazard reduction methods adopted under section 144.9508 in 43.4 cases of voluntary lead abatement or lead hazard reduction. All 43.5contractorspersons hired to do voluntary lead abatement or lead 43.6 hazard reduction must be licensedlead contractorsby the 43.7 commissioner under section 144.9505 or 144.9506. Renters and 43.8 volunteers performing lead abatement or lead hazard reduction 43.9 must be trained and licensed as lead supervisors or lead 43.10 workers. If a property owner does notuse a lead contractor43.11 hire a person for voluntary lead abatement or lead hazard 43.12 reduction, the property owner shall provide the commissioner 43.13 with a work plan for lead abatement or lead hazard reduction at 43.14 least ten working days before beginning the lead abatement or 43.15 lead hazard reduction. The work plan must include the details 43.16 required in section 144.9505, and notice as to when 43.17 lead abatement or lead hazard reduction activities will begin. 43.18 Within the limits of appropriations, the commissioner shall 43.19 review work plans and shall approve or disapprove them as to 43.20 compliance with the requirements in section 144.9505. No 43.21 penalty shall be assessed against a property owner for 43.22 discontinuing voluntary lead hazard reduction before completion 43.23 of the work plan, provided that the property owner discontinues 43.24 theplanlead hazard reduction in a manner that leaves the 43.25 property in a condition no more hazardous than its condition 43.26 before the work plan implementation. 43.27 Sec. 44. Minnesota Statutes 1996, section 144.9503, 43.28 subdivision 7, is amended to read: 43.29 Subd. 7. [LEAD-SAFE INFORMATIONAL DIRECTIVES.] (a) By July 43.30 1, 1995, and amended and updated as necessary, the commissioner 43.31 shall develop in cooperation with the commissioner of 43.32 administration provisions and procedures to define 43.33 lead-safe informational directives for residential remodeling, 43.34 renovation, installation, and rehabilitation activities that are 43.35 not lead hazard reduction, but may disrupt lead-based paint 43.36 surfaces. 44.1 (b) The provisions and procedures shall define lead-safe 44.2 directives for nonlead hazard reduction activities including 44.3 preparation, cleanup, and disposal procedures. The directives 44.4 shall be based on the different levels and types of work 44.5 involved and the potential for lead hazards. The directives 44.6 shall address activities including painting; remodeling; 44.7 weatherization; installation of cable, wire, plumbing, and gas; 44.8 and replacement of doors and windows. The commissioners of 44.9 health and administration shall consult with representatives of 44.10 builders, weatherization providers, nonprofit rehabilitation 44.11 organizations, each of the affected trades, and housing and 44.12 redevelopment authorities in developing the directives and 44.13 procedures. This group shall also make recommendations for 44.14 consumer and contractor education and training. The 44.15 commissioner of health shall report to the legislature by 44.16 February 15, 1996, regarding development of the provisions 44.17 required under thissubdivisionparagraph. 44.18 (c) By January 1, 1999, the commissioner, in cooperation 44.19 with interested and informed persons and using the meeting 44.20 structure and format developed in paragraph (b), shall develop 44.21 lead-safe informational directives on the following topics: 44.22 (1) maintaining floors, walls, and ceilings; 44.23 (2) maintaining and repairing porches; 44.24 (3) conducting a risk evaluation for lead; and 44.25 (4) prohibited practices when working with lead. 44.26 The commissioner shall report to the legislature by January 1, 44.27 1999, regarding development of the provisions required under 44.28 this paragraph. 44.29 Sec. 45. Minnesota Statutes 1996, section 144.9504, 44.30 subdivision 1, is amended to read: 44.31 Subdivision 1. [JURISDICTION.] (a) A board of health 44.32 serving cities of the first class must conduct leadinspections44.33 risk assessments for purposes of secondary prevention, according 44.34 to the provisions of this section. A board of health not 44.35 serving cities of the first class must conduct leadinspections44.36 risk assessments for the purposes of secondary prevention, 45.1 unless theycertifycertified in writing to the commissioner by 45.2 January 1, 1996, that theydesiredesired to relinquish these 45.3 duties back to the commissioner. At the discretion of the 45.4 commissioner, a board of health may relinquish the authority and 45.5 duty to perform lead risk assessments for secondary prevention 45.6 by so certifying in writing to the commissioner by December 31, 45.7 1999. At the discretion of the commissioner, a board of health 45.8 may, upon written request to the commissioner, resume these 45.9 duties. 45.10 (b)InspectionsLead risk assessments must be conducted by 45.11 a board of health serving a city of the first class. The 45.12 commissioner must conduct leadinspectionsrisk assessments in 45.13 any area not including cities of the first class where a board 45.14 of health has relinquished to the commissioner the 45.15 responsibility for leadinspectionsrisk assessments. The 45.16 commissioner shall coordinate with the board of health to ensure 45.17 that the requirements of this section are met. 45.18 (c) The commissioner may assist boards of health by 45.19 providing technical expertise, equipment, and personnel to 45.20 boards of health. The commissioner may provide laboratory or 45.21 field lead-testing equipment to a board of health or may 45.22 reimburse a board of health for direct costs associated with 45.23 leadinspectionsrisk assessments. 45.24 (d) The commissioner shall enforce the rules under section 45.25 144.9508 in cases of voluntary lead hazard reduction. 45.26 Sec. 46. Minnesota Statutes 1997 Supplement, section 45.27 144.9504, subdivision 2, is amended to read: 45.28 Subd. 2. [LEADINSPECTIONRISK ASSESSMENT.] (a) 45.29 Aninspectingassessing agency shall conduct a leadinspection45.30 risk assessment of a residence according to the venous blood 45.31 lead level and time frame set forth in clauses (1) to (5) for 45.32 purposes of secondary prevention: 45.33 (1) within 48 hours of a child or pregnant female in the 45.34 residence being identified to the agency as having a venous 45.35 blood lead level equal to or greater than 70 micrograms of lead 45.36 per deciliter of whole blood; 46.1 (2) within five working days of a child or pregnant female 46.2 in the residence being identified to the agency as having a 46.3 venous blood lead level equal to or greater than 45 micrograms 46.4 of lead per deciliter of whole blood; 46.5 (3) within ten working days of a child in the residence 46.6 being identified to the agency as having a venous blood lead 46.7 level equal to or greater than 20 micrograms of lead per 46.8 deciliter of whole blood; 46.9 (4) within ten working days of a child in the residence 46.10 being identified to the agency as having a venous blood lead 46.11 level that persists in the range of 15 to 19 micrograms of lead 46.12 per deciliter of whole blood for 90 days after initial 46.13 identification; or 46.14 (5) within ten working days of a pregnant female in the 46.15 residence being identified to the agency as having a venous 46.16 blood lead level equal to or greater than ten micrograms of lead 46.17 per deciliter of whole blood. 46.18 (b) Within the limits of available state and federal 46.19 appropriations, aninspectingassessing agency may also conduct 46.20 a leadinspectionrisk assessment for children with any elevated 46.21 blood lead level. 46.22 (c) In a building with two or more dwelling units, an 46.23inspectingassessing agency shall inspect the individual unit in 46.24 which the conditions of this section are met and shall also 46.25 inspect all common areas. If a child visits one or more other 46.26 sites such as another residence, or a residential or commercial 46.27 child care facility, playground, or school, theinspecting46.28 assessing agency shall also inspect the other sites. 46.29 Theinspectingassessing agency shall have one additional day 46.30 added to the time frame set forth in this subdivision to 46.31 complete the leadinspectionrisk assessment for each additional 46.32 site. 46.33 (d) Within the limits of appropriations, theinspecting46.34 assessing agency shall identify the known addresses for the 46.35 previous 12 months of the child or pregnant female with venous 46.36 blood lead levels of at least 20 micrograms per deciliter for 47.1 the child or at least ten micrograms per deciliter for the 47.2 pregnant female; notify the property owners, landlords, and 47.3 tenants at those addresses that an elevated blood lead level was 47.4 found in a person who resided at the property; and give them a 47.5 copy of the leadinspectionrisk assessment guide. The 47.6inspectingassessing agency shall provide the notice required by 47.7 this subdivision without identifying the child or pregnant 47.8 female with the elevated blood lead level. Theinspecting47.9 assessing agency is not required to obtain the consent of the 47.10 child's parent or guardian or the consent of the pregnant female 47.11 for purposes of this subdivision. This information shall be 47.12 classified as private data on individuals as defined under 47.13 section 13.02, subdivision 12. 47.14 (e) Theinspectingassessing agency shall conduct the lead 47.15inspectionrisk assessment according to rules adopted by the 47.16 commissioner under section 144.9508. Aninspectingassessing 47.17 agency shall have leadinspectionsrisk assessments performed by 47.18 leadinspectorsrisk assessors licensed by the commissioner 47.19 according to rules adopted under section 144.9508. If a 47.20 property owner refuses to allowan inspectiona lead risk 47.21 assessment, theinspectingassessing agency shall begin legal 47.22 proceedings to gain entry to the property and the time frame for 47.23 conducting a leadinspectionrisk assessment set forth in this 47.24 subdivision no longer applies.An inspectorA lead risk 47.25 assessor orinspectingassessing agency may observe the 47.26 performance of lead hazard reduction in progress and shall 47.27 enforce the provisions of this section under section 144.9509. 47.28 Deteriorated painted surfaces, bare soil, and dust, and drinking47.29watermust be tested with appropriate analytical equipment to 47.30 determine the lead content, except that deteriorated painted 47.31 surfaces or bare soil need not be tested if the property owner 47.32 agrees to engage in lead hazard reduction on those 47.33 surfaces. The lead content of drinking water must be measured 47.34 if a probable source of lead exposure is not identified by 47.35 measurement of lead in paint, bare soil, or dust. Within a 47.36 standard metropolitan statistical area, an assessing agency may 48.1 order lead hazard reduction of bare soil without measuring the 48.2 lead content of the bare soil if the property is in a census 48.3 tract in which soil sampling has been performed according to 48.4 rules established by the commissioner and at least 25 percent of 48.5 the soil samples contain lead concentrations above the standard 48.6 in section 144.9508. 48.7 (f) A leadinspectorrisk assessor shall notify the 48.8 commissioner and the board of health of all violations of lead 48.9 standards under section 144.9508, that are identified in a 48.10 leadinspectionrisk assessment conducted under this section. 48.11 (g) Eachinspectingassessing agency shall establish an 48.12 administrative appeal procedure which allows a property owner to 48.13 contest the nature and conditions of any lead order issued by 48.14 theinspectingassessing agency.InspectingAssessing agencies 48.15 must consider appeals that propose lower cost methods that make 48.16 the residence lead safe. 48.17 (h) Sections 144.9501 to 144.9509 neither authorize nor 48.18 prohibit aninspectingassessing agency from charging a property 48.19 owner for the cost of a leadinspectionrisk assessment. 48.20 Sec. 47. Minnesota Statutes 1996, section 144.9504, 48.21 subdivision 3, is amended to read: 48.22 Subd. 3. [LEAD EDUCATION STRATEGY.] At the time of a 48.23 leadinspectionrisk assessment or following a lead order, the 48.24inspectingassessing agency shall ensure that a family will 48.25 receive a visit at their residence by a swab team worker or 48.26 public health professional, such as a nurse, sanitarian, public 48.27 health educator, or other public health professional. The swab 48.28 team worker or public health professional shall inform the 48.29 property owner, landlord, and the tenant of the health-related 48.30 aspects of lead exposure; nutrition; safety measures to minimize 48.31 exposure; methods to be followed before, during, and after the 48.32 lead hazard reduction process; and community, legal, and housing 48.33 resources. If a family moves to a temporary residence during 48.34 the lead hazard reduction process, lead education services 48.35 should be provided at the temporary residence whenever feasible. 48.36 Sec. 48. Minnesota Statutes 1996, section 144.9504, 49.1 subdivision 4, is amended to read: 49.2 Subd. 4. [LEADINSPECTIONRISK ASSESSMENT GUIDES.] (a) The 49.3 commissioner of health shall develop or purchase leadinspection49.4 risk assessment guides that enable parents and other caregivers 49.5 to assess the possible lead sources present and that suggest 49.6 lead hazard reduction actions. The guide must provide 49.7 information on lead hazard reduction and disposal methods, 49.8 sources of equipment, and telephone numbers for additional 49.9 information to enable the persons to either selecta lead49.10contractorpersons licensed by the commissioner under section 49.11 144.9505 or 144.9506 to perform lead hazard reduction or perform 49.12 the lead hazard reduction themselves. The guides must explain: 49.13 (1) the requirements of this section and rules adopted 49.14 under section 144.9508; 49.15 (2) information on the administrative appeal procedures 49.16 required under this section; 49.17 (3) summary information on lead-safe directives; 49.18 (4) be understandable at an eighth grade reading level; and 49.19 (5) be translated for use by non-English-speaking persons. 49.20 (b) Aninspectingassessing agency shall provide the lead 49.21inspectionrisk assessment guides at no cost to: 49.22 (1) parents and other caregivers of children who are 49.23 identified as having blood lead levels of at least ten 49.24 micrograms of lead per deciliter of whole blood; 49.25 (2) all property owners who are issued housing code or lead 49.26 orders requiring lead hazard reduction of lead sources and all 49.27 occupants of those properties; and 49.28 (3) occupants of residences adjacent to the inspected 49.29 property. 49.30 (c) Aninspectingassessing agency shall provide the lead 49.31inspectionrisk assessment guides on request to owners or 49.32 occupants of residential property, builders, contractors, 49.33 inspectors, and the public within the jurisdiction of 49.34 theinspectingassessing agency. 49.35 Sec. 49. Minnesota Statutes 1996, section 144.9504, 49.36 subdivision 5, is amended to read: 50.1 Subd. 5. [LEAD ORDERS.] Aninspectingassessing agency, 50.2 after conducting a leadinspectionrisk assessment, shall order 50.3 a property owner to perform lead hazard reduction on all lead 50.4 sources that exceed a standard adopted according to section 50.5 144.9508. If leadinspectionsrisk assessments and lead orders 50.6 are conducted at times when weather or soil conditions do not 50.7 permit the leadinspectionrisk assessment or lead hazard 50.8 reduction, external surfaces and soil lead shall be inspected, 50.9 and lead orders complied with, if necessary, at the first 50.10 opportunity that weather and soil conditions allow. If the 50.11 paint standard under section 144.9508 is violated, but the paint 50.12 is intact, theinspectingassessing agency shall not order the 50.13 paint to be removed unless the intact paint is a known source of 50.14 actual lead exposure to a specific person. Before the 50.15inspectingassessing agency may order the intact paint to be 50.16 removed, a reasonable effort must be made to protect the child 50.17 and preserve the intact paint by the use of guards or other 50.18 protective devices and methods. Whenever windows and doors or 50.19 other components covered with deteriorated lead-based paint have 50.20 sound substrate or are not rotting, those components should be 50.21 repaired, sent out for stripping or be planed down to remove 50.22 deteriorated lead-based paint or covered with protective guards 50.23 instead of being replaced, provided that such an activity is the 50.24 least cost method. However, a property owner who has been 50.25 ordered to perform lead hazard reduction may choose any method 50.26 to address deteriorated lead-based paint on windows, doors, or 50.27 other components, provided that the method is approved in rules 50.28 adopted under section 144.9508 and that it is appropriate to the 50.29 specific property. Lead orders must require that any source of 50.30 damage, such as leaking roofs, plumbing, and windows, be 50.31 repaired or replaced, as needed, to prevent damage to 50.32 lead-containing interior surfaces. Theinspectingassessing 50.33 agency is not required to pay for lead hazard reduction. Lead 50.34 orders must be issued within 30 days of receiving the blood lead 50.35 level analysis. Theinspectingassessing agency shall enforce 50.36 the lead orders issued to a property owner under this section. 51.1 A copy of the lead order must be forwarded to the commissioner. 51.2 Sec. 50. Minnesota Statutes 1996, section 144.9504, 51.3 subdivision 6, is amended to read: 51.4 Subd. 6. [SWAB TEAM SERVICES.] After a leadinspection51.5 risk assessment or after issuing lead orders, theinspecting51.6 assessing agency, within the limits of appropriations and 51.7 availability, shall offer the property owner the services of a 51.8 swab team free of charge and, if accepted, shall send a swab 51.9 team within ten working days to the residence to perform swab 51.10 team services as defined in section 144.9501. If theinspecting51.11 assessing agency provides swab team services after a 51.12 leadinspectionrisk assessment, but before the issuance of a 51.13 lead order, swab team services do not need to be repeated after 51.14 the issuance of the lead order if the swab team services 51.15 fulfilled the lead order. Swab team services are not considered 51.16 completed until the clearance inspection required under this 51.17 section shows that the property is lead safe. 51.18 Sec. 51. Minnesota Statutes 1996, section 144.9504, 51.19 subdivision 7, is amended to read: 51.20 Subd. 7. [RELOCATION OF RESIDENTS.] (a) Within the limits 51.21 of appropriations, theinspectingassessing agency shall ensure 51.22 that residents are relocated from rooms or dwellings during a 51.23 lead hazard reduction process that generates leaded dust, such 51.24 as removal or disruption of lead-based paint or plaster that 51.25 contains lead. Residents shall not remain in rooms or dwellings 51.26 where the lead hazard reduction process is occurring. An 51.27inspectingassessing agency is not required to pay for 51.28 relocation unless state or federal funding is available for this 51.29 purpose. Theinspectingassessing agency shall make an effort 51.30 to assist the resident in locating resources that will provide 51.31 assistance with relocation costs. Residents shall be allowed to 51.32 return to the residence or dwelling after completion of the lead 51.33 hazard reduction process. Aninspectingassessing agency shall 51.34 use grant funds under section 144.9507 if available, in 51.35 cooperation with local housing agencies, to pay for moving costs 51.36 and rent for a temporary residence for any low-income resident 52.1 temporarily relocated during lead hazard reduction. For 52.2 purposes of this section, "low-income resident" means any 52.3 resident whose gross household income is at or below 185 percent 52.4 of federal poverty level. 52.5 (b) A resident of rental property who is notified by an 52.6inspectingassessing agency to vacate the premises during lead 52.7 hazard reduction, notwithstanding any rental agreement or lease 52.8 provisions: 52.9 (1) shall not be required to pay rent due the landlord for 52.10 the period of time the tenant vacates the premises due to lead 52.11 hazard reduction; 52.12 (2) may elect to immediately terminate the tenancy 52.13 effective on the date the tenant vacates the premises due to 52.14 lead hazard reduction; and 52.15 (3) shall not, if the tenancy is terminated, be liable for 52.16 any further rent or other charges due under the terms of the 52.17 tenancy. 52.18 (c) A landlord of rental property whose tenants vacate the 52.19 premises during lead hazard reduction shall: 52.20 (1) allow a tenant to return to the dwelling unit after 52.21 lead hazard reduction and clearance inspection, required under 52.22 this section, is completed, unless the tenant has elected to 52.23 terminate the tenancy as provided for in paragraph (b); and 52.24 (2) return any security deposit due under section 504.20 52.25 within five days of the date the tenant vacates the unit, to any 52.26 tenant who terminates tenancy as provided for in paragraph (b). 52.27 Sec. 52. Minnesota Statutes 1996, section 144.9504, 52.28 subdivision 8, is amended to read: 52.29 Subd. 8. [PROPERTY OWNER RESPONSIBILITY.] Property owners 52.30 shall comply with lead orders issued under this section within 52.31 60 days or be subject to enforcement actions as provided under 52.32 section 144.9509. For orders or portions of orders concerning 52.33 external lead hazards, property owners shall comply within 60 52.34 days, or as soon thereafter as weather permits. If the property 52.35 owner does notuse a lead contractorhire a person licensed by 52.36 the commissioner under section 144.9505 for compliance with the 53.1 lead orders, the property owner shall submit a work plan to 53.2 theinspectingassessing agency within 30 days after receiving 53.3 the orders. The work plan must include the details required in 53.4 section 144.9505 as to how the property owner intends to comply 53.5 with the lead orders and notice as to when lead hazard reduction 53.6 activities will begin. Within the limits of appropriations, the 53.7 commissioner shall review plans and shall approve or disapprove 53.8 them as to compliance with the requirements in section 144.9505, 53.9 subdivision 5. Renters and volunteers performing lead abatement 53.10 or lead hazard reduction must be trained and licensed as lead 53.11 supervisors or lead workers under section 144.9505. 53.12 Sec. 53. Minnesota Statutes 1996, section 144.9504, 53.13 subdivision 9, is amended to read: 53.14 Subd. 9. [CLEARANCE INSPECTION.] After completion of swab 53.15 team services and compliance with the lead orders by the 53.16 property owner, including any repairs ordered by a local housing 53.17 or building inspector, theinspectingassessing agency shall 53.18 conduct a clearance inspection byvisually inspecting the53.19residence forvisual identification of deteriorated paint and 53.20 bare soil and retest the dust lead concentration in the 53.21 residence to assure that violations of the lead standards under 53.22 section 144.9508 no longer exist. Theinspectingassessing 53.23 agency is not required to test a dwelling unit after lead hazard 53.24 reduction that was not ordered by theinspectingassessing 53.25 agency. 53.26 Sec. 54. Minnesota Statutes 1996, section 144.9504, 53.27 subdivision 10, is amended to read: 53.28 Subd. 10. [CASE CLOSURE.] A leadinspectionrisk 53.29 assessment is completed and the responsibility of theinspecting53.30 assessing agency ends when all of the following conditions are 53.31 met: 53.32 (1) lead orders are written on all known sources of 53.33 violations of lead standards under section 144.9508; 53.34 (2) compliance with all lead orders has been completed; and 53.35 (3) clearance inspections demonstrate that no deteriorated 53.36 lead paint, bare soil, or lead dust levels exist that exceed the 54.1 standards adopted under section 144.9508. 54.2 Sec. 55. Minnesota Statutes 1996, section 144.9505, 54.3 subdivision 1, is amended to read: 54.4 Subdivision 1. [LICENSING AND CERTIFICATION.] (a)Lead54.5contractorsA person shall, before performing abatement or lead 54.6 hazard reduction or providing planning services for lead 54.7 abatement or lead hazard reduction, obtain a license from the 54.8 commissioner as a lead supervisor, lead worker, or lead project 54.9 designer.Workers for lead contractors shall obtain54.10certification from the commissioner.The commissioner shall 54.11 specify training and testing requirements for licensure and 54.12 certification as required in section 144.9508 and shall charge a 54.13 fee for the cost of issuing a license or certificate and for 54.14 training provided by the commissioner.Fees collected under54.15this section shall be set in amounts to be determined by the54.16commissioner to cover but not exceed the costs of adopting rules54.17under section 144.9508, the costs of licensure, certification,54.18and training, and the costs of enforcing licenses and54.19certificates under this section.License fees shall be 54.20 nonrefundable and must be submitted with each application in the 54.21 amount of $50 for each lead supervisor, lead worker, or lead 54.22 inspector and $100 for each lead project designer, lead risk 54.23 assessor, or certified firm. All fees received shall be paid 54.24 into the state treasury and credited to the lead abatement 54.25 licensing and certification account and are appropriated to the 54.26 commissioner to cover costs incurred under this section and 54.27 section 144.9508. 54.28 (b)ContractorsPersons shall not advertise or otherwise 54.29 present themselves as leadcontractorssupervisors, lead 54.30 workers, or lead project designers unless they havelead54.31contractorlicenses issued by thedepartment of health54.32 commissioner under section 144.9505. 54.33 Sec. 56. Minnesota Statutes 1996, section 144.9505, 54.34 subdivision 4, is amended to read: 54.35 Subd. 4. [NOTICE OF LEAD ABATEMENT OR LEAD HAZARD 54.36 REDUCTION WORK.] (a) At least five working days before starting 55.1 work at each lead abatement or lead hazard reduction worksite, 55.2 the person performing the lead abatement or lead hazard 55.3 reduction work shall give written notice and an approved work 55.4 plan as required in this section to the commissioner and the 55.5 appropriate board of health. Within the limits of 55.6 appropriations, the commissioner shall review plans and shall 55.7 approve or disapprove them as to compliance with the 55.8 requirements in subdivision 5. 55.9 (b) This provision does not apply to swab team workers 55.10 performing work under an order of aninspectingassessing agency. 55.11 Sec. 57. Minnesota Statutes 1996, section 144.9505, 55.12 subdivision 5, is amended to read: 55.13 Subd. 5. [ABATEMENT OR LEAD HAZARD REDUCTION WORK PLANS.] 55.14 (a) Alead contractorperson who performs lead abatement or lead 55.15 hazard reduction shall present a lead abatement or lead hazard 55.16 reduction work plan to the property owner with each bid or 55.17 estimate for lead abatement or lead hazard reduction work. 55.18 The work plan does not replace or supersede more stringent 55.19 contractual agreements. A written lead abatement or lead hazard 55.20 reduction work plan must be prepared which describes the 55.21 equipment and procedures to be used throughout the lead 55.22 abatement or lead hazard reduction work project. At a minimum, 55.23 the work plan must describe: 55.24 (1) the building area and building components to be worked 55.25 on; 55.26 (2) the amount of lead-containing material to be removed, 55.27 encapsulated, or enclosed; 55.28 (3) the schedule to be followed for each work stage; 55.29 (4) the workers' personal protection equipment and 55.30 clothing; 55.31 (5) the dust suppression and debris containment methods; 55.32 (6) the lead abatement or lead hazard reduction methods to 55.33 be used on each building component; 55.34 (7) cleaning methods; 55.35 (8) temporary, on-site waste storage, if any; and 55.36 (9) the methods for transporting waste material and its 56.1 destination. 56.2 (b)A lead contractorThe work plan shall itemize the costs 56.3 for each item listed in paragraph (a) and for any other expenses 56.4 associated with the lead abatement or lead hazard reduction work 56.5 and shallpresent these costsbe presented to the property owner 56.6 with any bid or estimate for lead abatement or lead hazard 56.7 reduction work. 56.8 (c)A lead contractorThe person performing the lead 56.9 abatement or lead hazard reduction shall keep a copy of the work 56.10 plan readily available at the worksite for the duration of the 56.11 project and present it to theinspectingassessing agency on 56.12 demand. 56.13 (d)A lead contractorThe person performing the lead 56.14 abatement or lead hazard reduction shall keep a copy of the work 56.15 plan on record for one year after completion of the project and 56.16 shall present it to theinspectingassessing agency on demand. 56.17 (e) This provision does not apply to swab team workers 56.18 performing work under an order of aninspectingassessing agency 56.19 or providing services at no cost to a property owner with 56.20 funding under a state or federal grant. 56.21 Sec. 58. Minnesota Statutes 1997 Supplement, section 56.22 144.9506, subdivision 1, is amended to read: 56.23 Subdivision 1. [LICENSE REQUIRED.] (a) Alead56.24inspectorperson shall obtain a license as a lead inspector or a 56.25 lead risk assessor before performing lead inspections, lead 56.26 hazard screens, or lead risk assessments and shall renew 56.27 itannuallyas required in rules adopted under section 144.9508. 56.28 The commissioner shall charge a fee and requireannualrefresher 56.29 training, as specified in this section. A lead inspector or 56.30 lead risk assessor shall have the lead inspector's license or 56.31 lead risk assessor's license readily available at all times 56.32 atana lead inspection site or lead risk assessment site and 56.33 make it available, on request, forinspectionexamination by the 56.34inspectingassessing agency with jurisdiction over the site. A 56.35 license shall not be transferred. License fees shall be 56.36 nonrefundable and must be submitted with each application in the 57.1 amount of $50 for each lead inspector and $100 for each lead 57.2 risk assessor. 57.3 (b) Individuals shall not advertise or otherwise present 57.4 themselves as lead inspectors or lead risk assessors unless 57.5 licensed by the commissioner. 57.6 (c) An individual may use sodium rhodizonate to test paint 57.7 for the presence of lead without obtaining a lead inspector or 57.8 lead risk assessor license, but must not represent the test as a 57.9 lead inspection or lead risk assessment. 57.10 Sec. 59. Minnesota Statutes 1996, section 144.9506, 57.11 subdivision 2, is amended to read: 57.12 Subd. 2. [LICENSE APPLICATION.] An application for a 57.13 license or license renewal shall be on a form provided by the 57.14 commissioner and shall include: 57.15 (1) a$50nonrefundable fee, in a form approved by the 57.16 commissioner; and 57.17 (2) evidence that the applicant has successfully completed 57.18 a lead inspector training course approved under this section or 57.19 from another state with which the commissioner has established 57.20 reciprocity. The fee required in this section is waived for 57.21 federal, state, or local government employees within Minnesota. 57.22 Sec. 60. Minnesota Statutes 1996, section 144.9507, 57.23 subdivision 2, is amended to read: 57.24 Subd. 2. [LEADINSPECTIONRISK ASSESSMENT CONTRACTS.] The 57.25 commissioner shall, within available federal or state 57.26 appropriations, contract with boards of health to conduct 57.27 leadinspectionsrisk assessments to determine sources of lead 57.28 contamination and to issue and enforce lead orders according to 57.29 section 144.9504. 57.30 Sec. 61. Minnesota Statutes 1996, section 144.9507, 57.31 subdivision 3, is amended to read: 57.32 Subd. 3. [TEMPORARY LEAD-SAFE HOUSING CONTRACTS.] The 57.33 commissioner shall, within the limits of available 57.34 appropriations, contract with boards of health for temporary 57.35 housing, to be used in meeting relocation requirements in 57.36 section 144.9504, and award grants to boards of health for the 58.1 purposes of paying housing and relocation costs under section 58.2 144.9504. The commissioner may use up to 15 percent of the 58.3 available appropriations to provide temporary lead-safe housing 58.4 in areas of the state in which the commissioner has the duty 58.5 under section 144.9504 to perform secondary prevention. 58.6 Sec. 62. Minnesota Statutes 1996, section 144.9507, 58.7 subdivision 4, is amended to read: 58.8 Subd. 4. [LEAD CLEANUP EQUIPMENT AND MATERIALGRANTS TO 58.9 NONPROFIT ORGANIZATIONS.] (a) The commissioner shall, within the 58.10 limits of available state or federal appropriations, provide 58.11 funds for lead cleanup equipment and materials under a grant 58.12 program to nonprofit community-based organizations in areas at 58.13 high risk for toxic lead exposure, as provided for in section 58.14 144.9503. 58.15 (b) Nonprofit community-based organizations in areas at 58.16 high risk for toxic lead exposure may apply for grants from the 58.17 commissioner to purchase lead cleanup equipment and materials 58.18 and to pay for training for staff and volunteers for lead 58.19 licensure under sections 144.9505 and 144.9506. 58.20 (c) For purposes of this section, lead cleanup equipment 58.21 and materials means high efficiency particle accumulator (HEPA) 58.22 and wet vacuum cleaners, wash water filters, mops, buckets, 58.23 hoses, sponges, protective clothing, drop cloths, wet scraping 58.24 equipment, secure containers, dust and particle containment 58.25 material, and other cleanup and containment materials to remove 58.26 loose paint and plaster, patch plaster, control household dust, 58.27 wax floors, clean carpets and sidewalks, and cover bare soil. 58.28 (d) The grantee's staff and volunteers may make lead 58.29 cleanup equipment and materials available to residents and 58.30 property owners and instruct them on the proper use of the 58.31 equipment. Lead cleanup equipment and materials must be made 58.32 available to low-income households, as defined by federal 58.33 guidelines, on a priority basis at no fee. Other households may 58.34 be charged on a sliding fee scale. 58.35 (e) The grantee shall not charge a fee for services 58.36 performed using the equipment or materials. 59.1 (f) Any funds appropriated for purposes of this subdivision 59.2 that are not awarded, due to a lack of acceptable proposals for 59.3 the full amount appropriated, may be used for any purpose 59.4 authorized in this section. 59.5 Sec. 63. Minnesota Statutes 1996, section 144.9508, 59.6 subdivision 1, is amended to read: 59.7 Subdivision 1. [SAMPLING AND ANALYSIS.] The commissioner 59.8 shall adopt, by rule,visual inspection and sampling and59.9analysismethods for: 59.10 (1) lead inspectionsunder section 144.9504, lead hazard 59.11 screens, lead risk assessments, and clearance inspections; 59.12 (2) environmental surveys of lead in paint, soil, dust, and 59.13 drinking water to determine census tracts that are areas at high 59.14 risk for toxic lead exposure; 59.15 (3) soil sampling for soil used as replacement soil;and59.16 (4) drinking water sampling, which shall be done in 59.17 accordance with lab certification requirements and analytical 59.18 techniques specified by Code of Federal Regulations, title 40, 59.19 section 141.89; and 59.20 (5) sampling to determine whether at least 25 percent of 59.21 the soil samples collected from a census tract within a standard 59.22 metropolitan statistical area contain lead in concentrations 59.23 that exceed 100 parts per million. 59.24 Sec. 64. Minnesota Statutes 1996, section 144.9508, is 59.25 amended by adding a subdivision to read: 59.26 Subd. 2a. [LEAD STANDARDS FOR EXTERIOR SURFACES AND STREET 59.27 DUST.] The commissioner may, by rule, establish lead standards 59.28 for exterior horizontal surfaces, concrete or other impervious 59.29 surfaces, and street dust on residential property to protect the 59.30 public health and the environment. 59.31 Sec. 65. Minnesota Statutes 1996, section 144.9508, 59.32 subdivision 3, is amended to read: 59.33 Subd. 3. [LEAD CONTRACTORS AND WORKERSLICENSURE AND 59.34 CERTIFICATION.] The commissioner shall adopt rules to license 59.35 leadcontractors and to certifysupervisors, lead workersof59.36lead contractors who perform lead abatement or lead hazard60.1reduction, lead project designers, lead inspectors, and lead 60.2 risk assessors. The commissioner shall also adopt rules 60.3 requiring certification of firms that perform lead abatement, 60.4 lead hazard reduction, lead hazard screens, or lead risk 60.5 assessments. The commissioner shall require periodic renewal of 60.6 licenses and certificates and shall establish the renewal 60.7 periods. 60.8 Sec. 66. Minnesota Statutes 1996, section 144.9508, 60.9 subdivision 4, is amended to read: 60.10 Subd. 4. [LEAD TRAINING COURSE.] The commissioner shall 60.11 establish by rule a permit fee to be paid by a training course 60.12 provider on application for a training course permit or renewal 60.13 period for each lead-related training course required for 60.14 certification or licensure. The commissioner shall establish 60.15 criteria in rules for the content and presentation of training 60.16 courses intended to qualify trainees for licensure under 60.17 subdivision 3. Training course permit fees shall be 60.18 nonrefundable and must be submitted with each application in the 60.19 amount of $500 for an initial training course, $250 for renewal 60.20 of a permit for an initial training course, $250 for a refresher 60.21 training course, and $125 for renewal of a permit of a refresher 60.22 training course. 60.23 Sec. 67. Minnesota Statutes 1996, section 144.9509, 60.24 subdivision 2, is amended to read: 60.25 Subd. 2. [DISCRIMINATION.] A person who discriminates 60.26 against or otherwise sanctions an employee who complains to or 60.27 cooperates with theinspectingassessing agency in administering 60.28 sections 144.9501 to 144.9509 is guilty of a petty misdemeanor. 60.29 Sec. 68. [144.9511] [LEAD-SAFE PROPERTY CERTIFICATION.] 60.30 Subdivision 1. [LEAD-SAFE PROPERTY CERTIFICATION PROGRAM 60.31 ESTABLISHED.] (a) The commissioner shall establish, within the 60.32 limits of available appropriations, a voluntary lead-safe 60.33 property certification program for residential properties. This 60.34 program shall involve an initial property certification process, 60.35 a property condition report, and a lead-safe property 60.36 certification booklet. 61.1 (b) The commissioner shall establish an initial property 61.2 certification process composed of the following: 61.3 (1) a lead hazard screen, which shall include a visual 61.4 evaluation of a residential property for both deteriorated paint 61.5 and bare soil; and 61.6 (2) a quantitative measure of lead in dust within the 61.7 structure and in common areas as determined by rule adopted 61.8 under authority of section 144.9508. 61.9 (c) The commissioner shall establish forms and checklists 61.10 for conducting a property condition report. A property 61.11 condition report is an evaluation of property components, 61.12 without regard to aesthetic considerations, to determine whether 61.13 any of the following conditions are likely to occur within one 61.14 year of the report: 61.15 (1) paint will become chipped, flaked, or cracked; 61.16 (2) structural defects in the roof, windows, or plumbing 61.17 will fail and cause paint to deteriorate; 61.18 (3) window wells or window troughs will not be cleanable 61.19 and washable; 61.20 (4) windows will generate dust due to friction; 61.21 (5) cabinet, room, and threshold doors will rub against 61.22 casings or have repeated contact with painted surfaces; 61.23 (6) floors will not be smooth and cleanable and carpeted 61.24 floors will not be cleanable; 61.25 (7) soil will not remain covered; 61.26 (8) bare soil in vegetable and flower gardens will not (i) 61.27 be inaccessible to children or (ii) be tested to determine if it 61.28 is below the soil standard under section 144.9508; 61.29 (9) parking areas will not remain covered by an impervious 61.30 surface or gravel; 61.31 (10) covered soil will erode, particularly in play areas; 61.32 and 61.33 (11) gutters and down spouts will not function correctly. 61.34 (d) The commissioner shall develop a lead-safe property 61.35 certification booklet that contains the following: 61.36 (1) information on how property owners and their 62.1 maintenance personnel can perform essential maintenance 62.2 practices to correct any of the property component conditions 62.3 listed in paragraph (c) that may occur; 62.4 (2) the lead-safe work practices fact sheets created under 62.5 section 144.9503, subdivision 7; 62.6 (3) forms, checklists, and copies of recommended lead-safe 62.7 property certification certificates; and 62.8 (4) an educational sheet for landlords to give to tenants 62.9 on the importance of having tenants inform property owners or 62.10 designated maintenance staff of one or more of the conditions 62.11 listed in paragraph (c). 62.12 Subd. 2. [CONDITIONS FOR CERTIFICATION.] A property shall 62.13 be certified as lead-safe only if the following conditions are 62.14 met: 62.15 (1) the property passes the initial certification process 62.16 in subdivision 1; 62.17 (2) the property owner agrees in writing to perform 62.18 essential maintenance practices; 62.19 (3) the property owner agrees in writing to use lead-safe 62.20 work practices, as provided for under section 144.9503, 62.21 subdivision 7; 62.22 (4) the property owner performs essential maintenance as 62.23 the need arises or uses maintenance personnel who have completed 62.24 a United States Environmental Protection Agency- or Minnesota 62.25 department of health-approved maintenance training program or 62.26 course to perform essential maintenance; 62.27 (5) the lead-safe property certification booklet is 62.28 distributed to the property owner, maintenance personnel, and 62.29 tenants at the completion of the initial certification process; 62.30 and 62.31 (6) a copy of the lead-safe property certificate is filed 62.32 with the commissioner along with a $5 filing fee. 62.33 Subd. 3. [LEAD STANDARDS.] Lead standards used in this 62.34 section shall be those approved by the commissioner under 62.35 section 144.9508. 62.36 Subd. 4. [LEAD RISK ASSESSORS.] Lead-safe property 63.1 certifications shall only be performed by lead risk assessors 63.2 licensed by the commissioner under section 144.9506. 63.3 Subd. 5. [EXPIRATION.] Lead-safe property certificates are 63.4 valid for one year. 63.5 Subd. 6. [LIST OF CERTIFIED PROPERTIES.] Within the limits 63.6 of available appropriations, the commissioner shall maintain a 63.7 list of all properties certified as lead-safe under this section 63.8 and make it freely available to the public. 63.9 Subd. 7. [REAPPLICATION.] Properties failing the initial 63.10 property certification may reapply for a lead-safe property 63.11 certification by having a new initial certification process 63.12 performed and by correcting any condition listed by the licensed 63.13 lead risk assessor in the property condition report. Properties 63.14 that fail the initial property certification process must have 63.15 the condition corrected by the property owner, by trained 63.16 maintenance staff, or by a contractor with personnel licensed 63.17 for lead hazard reduction or lead abatement work by the 63.18 commissioner under section 144.9505, in order to have the 63.19 property certified. 63.20 Sec. 69. Minnesota Statutes 1996, section 144.99, 63.21 subdivision 1, is amended to read: 63.22 Subdivision 1. [REMEDIES AVAILABLE.] The provisions of 63.23 chapters 103I and 157 and sections 115.71 to 115.77; 144.12, 63.24 subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), 63.25 (14), and (15); 144.121; 144.1222; 144.35; 144.381 to 144.385; 63.26 144.411 to 144.417;144.491;144.495; 144.71 to 144.74; 144.9501 63.27 to 144.9509; 144.992; 326.37 to 326.45; 326.57 to 326.785; 63.28 327.10 to 327.131; and 327.14 to 327.28 and all rules, orders, 63.29 stipulation agreements, settlements, compliance agreements, 63.30 licenses, registrations, certificates, and permits adopted or 63.31 issued by the department or under any other law now in force or 63.32 later enacted for the preservation of public health may, in 63.33 addition to provisions in other statutes, be enforced under this 63.34 section. 63.35 Sec. 70. Minnesota Statutes 1996, section 144A.44, 63.36 subdivision 2, is amended to read: 64.1 Subd. 2. [INTERPRETATION AND ENFORCEMENT OF RIGHTS.] These 64.2 rights are established for the benefit of persons who receive 64.3 home care services. "Home care services" means home care 64.4 services as defined in section 144A.43, subdivision 3. A home 64.5 care provider may not require a person to surrender these rights 64.6 as a condition of receiving services. A guardian or conservator 64.7 or, when there is no guardian or conservator, a designated 64.8 person, may seek to enforce these rights. This statement of 64.9 rights does not replace or diminish other rights and liberties 64.10 that may exist relative to persons receiving home care services, 64.11 persons providing home care services, or providers licensed 64.12 under Laws 1987, chapter 378. A copy of these rights must be 64.13 provided to an individual at the time home care services are 64.14 initiated. The copy shall also contain the address and phone 64.15 number of the office of health facility complaints and the 64.16 office of the ombudsman for older Minnesotans and a brief 64.17 statement describing how to file a complaint withthat office64.18 these offices. Information about how to contact the office of 64.19 the ombudsman for older Minnesotans shall be included in notices 64.20 of change in client fees and in notices where home care 64.21 providers initiate transfer or discontinuation of services. 64.22 Sec. 71. Minnesota Statutes 1997 Supplement, section 64.23 144A.46, subdivision 2, is amended to read: 64.24 Subd. 2. [EXEMPTIONS.] The following individuals or 64.25 organizations are exempt from the requirement to obtain a home 64.26 care provider license: 64.27 (1) a person who is licensed as a registered nurse under 64.28 sections 148.171 to 148.285 and who independently provides 64.29 nursing services in the home without any contractual or 64.30 employment relationship to a home care provider or other 64.31 organization; 64.32 (2) a personal care assistant who provides services to only 64.33 one individual under the medical assistance program as 64.34 authorized under sections 256B.0625, subdivision 19, and 64.35 256B.04, subdivision 16; 64.36 (3) a person or organization that exclusively offers, 65.1 provides, or arranges for personal care assistant services to 65.2 only one individual under the medical assistance program as 65.3 authorized under sections 256B.0625, subdivision 19, and 65.4 256B.04, subdivision 16; 65.5 (4) a person who isregisteredlicensed under sections 65.6 148.65 to 148.78 and who independently provides physical therapy 65.7 services in the home without any contractual or employment 65.8 relationship to a home care provider or other organization; 65.9 (5) a provider that is licensed by the commissioner of 65.10 human services to provide semi-independent living services under 65.11 Minnesota Rules, parts 9525.0500 to 9525.0660 when providing 65.12 home care services to a person with a developmental disability; 65.13 (6) a provider that is licensed by the commissioner of 65.14 human services to provide home and community-based services 65.15 under Minnesota Rules, parts 9525.2000 to 9525.2140 when 65.16 providing home care services to a person with a developmental 65.17 disability; 65.18 (7) a person or organization that provides only home 65.19 management services, if the person or organization is registered 65.20 under section 144A.461; or 65.21 (8) a person who is licensed as a social worker under 65.22 sections 148B.18 to 148B.289 and who provides social work 65.23 services in the home independently and not through any 65.24 contractual or employment relationship with a home care provider 65.25 or other organization. 65.26 An exemption under this subdivision does not excuse the 65.27 individual from complying with applicable provisions of the home 65.28 care bill of rights. 65.29 Sec. 72. Minnesota Statutes 1997 Supplement, section 65.30 144A.4605, subdivision 4, is amended to read: 65.31 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 65.32 establishment registered under chapter 144D that is required to 65.33 obtain a home care license must obtain an assisted living home 65.34 care license according to this section or a class A or class E 65.35 license according to rule. A housing with services 65.36 establishment that obtains a class E license under this 66.1 subdivision remains subject to the payment limitations in 66.2 sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915, 66.3 subdivision 3, paragraph (g). 66.4 (b) A board and lodging establishment registered for 66.5 special services as of December 31, 1996, and also registered as 66.6 a housing with services establishment under chapter 144D, must 66.7 deliver home care services according to sections 144A.43 to 66.8 144A.49, and may apply for a waiver from requirements under 66.9 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 66.10 licensed agency under the standards of section 157.17. Such 66.11 waivers as may be granted by the department will expire upon 66.12 promulgation of home care rules implementing section 144A.4605. 66.13 (c) An adult foster care provider licensed by the 66.14 department of human services and registered under chapter 144D 66.15 may continue to provide health-related services under its foster 66.16 care license until the promulgation of home care rules 66.17 implementing this section. 66.18 Sec. 73. Minnesota Statutes 1996, section 145.411, is 66.19 amended by adding a subdivision to read: 66.20 Subd. 6. [COMMISSIONER.] "Commissioner" means the 66.21 commissioner of health. 66.22 Sec. 74. [145.4131] [RECORDING AND REPORTING ABORTION 66.23 DATA.] 66.24 Subdivision 1. [FORMS.] (a) Within 90 days of the 66.25 effective date of this section, the commissioner shall prepare a 66.26 reporting form for physicians performing abortions. A copy of 66.27 this section shall be attached to the form. A physician 66.28 performing an abortion shall obtain a form from the commissioner. 66.29 (b) The form shall require the following information: 66.30 (1) the number of abortions performed by the physician in 66.31 the previous calendar year, reported by month; 66.32 (2) the method used for each abortion; 66.33 (3) the approximate gestational age of each child subject 66.34 to abortion, expressed in one of the following increments: 66.35 (i) less than nine weeks; 66.36 (ii) nine to ten weeks; 67.1 (iii) 11 to 12 weeks; 67.2 (iv) 13 to 15 weeks; 67.3 (v) 16 to 20 weeks; 67.4 (vi) 21 to 24 weeks; 67.5 (vii) 25 to 30 weeks; 67.6 (viii) 31 to 36 weeks; or 67.7 (ix) 37 weeks to term; 67.8 (4) the age of the mother on whom the abortion was 67.9 performed at the time the abortion was performed; 67.10 (5) the specific reason for the abortion, including, but 67.11 not limited to, the following: 67.12 (i) the pregnancy was a result of rape; 67.13 (ii) the pregnancy was a result of incest; 67.14 (iii) the mother cannot afford the child; 67.15 (iv) the mother does not want the child; 67.16 (v) the mother's emotional health is at stake; 67.17 (vi) the mother will suffer substantial and irreversible 67.18 impairment of a major bodily function if the pregnancy 67.19 continues; or 67.20 (vii) other; 67.21 (6) the number of prior induced abortions; 67.22 (7) the number of prior spontaneous abortions; 67.23 (8) whether the abortion was paid for by: 67.24 (i) private insurance; 67.25 (ii) a public health plan; or 67.26 (iii) another form of payment; 67.27 (9) whether coverage was under: 67.28 (i) a fee-for-service insurance company; 67.29 (ii) a managed care company; or 67.30 (iii) another type of health carrier; 67.31 (10) complications, if any, for each abortion and for the 67.32 aftermath of each abortion. Space for a description of any 67.33 complications shall be available on the form; 67.34 (11) the fee collected for each abortion; 67.35 (12) the type of anesthetic used, if any, for each 67.36 abortion; 68.1 (13) the method used to dispose of fetal tissue and 68.2 remains; 68.3 (14) the medical specialty of the physician performing the 68.4 abortion; and 68.5 (15) whether the physician performing the abortion has had 68.6 a physician's license suspended or revoked or has had other 68.7 professional sanctions in this or another state. 68.8 Subd. 2. [SUBMISSION.] A physician performing an abortion 68.9 shall complete and submit the form to the commissioner no later 68.10 than April 1 for abortions performed in the previous calendar 68.11 year. 68.12 Subd. 3. [ADDITIONAL REPORTING.] Nothing in this section 68.13 shall be construed to preclude the voluntary or required 68.14 submission of other reports or forms regarding abortions. 68.15 Sec. 75. [145.4132] [RECORDING AND REPORTING ABORTION 68.16 COMPLICATION DATA.] 68.17 Subdivision 1. [FORMS.] (a) Within 90 days of the 68.18 effective date of this section, the commissioner shall prepare 68.19 an abortion complication reporting form for all physicians 68.20 licensed and practicing in the state. A copy of this section 68.21 shall be attached to the form. 68.22 (b) The board of medical practice shall ensure that the 68.23 abortion complication reporting form is distributed: 68.24 (1) to all physicians licensed to practice in the state, 68.25 within 120 days after the effective date of this section and by 68.26 December 1 of each subsequent year; and 68.27 (2) to a physician who is newly licensed to practice in the 68.28 state, at the same time as official notification to the 68.29 physician that the physician is so licensed. 68.30 Subd. 2. [REQUIRED REPORTING.] A physician licensed and 68.31 practicing in the state who encounters an illness or injury that 68.32 is related to an induced abortion shall complete and submit an 68.33 abortion complication reporting form to the commissioner. 68.34 Subd. 3. [SUBMISSION.] A physician required to submit an 68.35 abortion complication reporting form to the commissioner shall 68.36 do so as soon as practicable after the encounter with the 69.1 abortion related illness or injury, but in no case more than 60 69.2 days after the encounter. 69.3 Subd. 4. [ADDITIONAL REPORTING.] Nothing in this section 69.4 shall be construed to preclude the voluntary or required 69.5 submission of other reports or forms regarding abortion 69.6 complications. 69.7 Sec. 76. [145.4133] [REPORTING OUT-OF-STATE ABORTIONS.] 69.8 The commissioner of human services shall report to the 69.9 commissioner by April 1 each year the following information 69.10 regarding abortions paid for with state funds and performed out 69.11 of state in the previous calendar year: 69.12 (1) the total number of abortions performed out of state 69.13 and partially or fully paid for with state funds through the 69.14 medical assistance, general assistance medical care, or 69.15 MinnesotaCare program, or any other program; 69.16 (2) the total amount of state funds used to pay for the 69.17 abortions and expenses incidental to the abortions; and 69.18 (3) the gestational age of each unborn child at the time of 69.19 abortion. 69.20 Sec. 77. [145.4134] [COMMISSIONER'S PUBLIC REPORT.] 69.21 (a) By July 1 of each year, the commissioner shall issue a 69.22 public report providing statistics for the previous calendar 69.23 year compiled from the data submitted under sections 145.4131 to 69.24 145.4133. Each report shall provide the statistics for all 69.25 previous calendar years, adjusted to reflect any additional 69.26 information from late or corrected reports. The commissioner 69.27 shall ensure that none of the information included in the public 69.28 reports can reasonably lead to identification of an individual 69.29 having performed or having had an abortion. All data included 69.30 on the forms under sections 145.4131 to 145.4133 must be 69.31 included in the public report. The commissioner shall submit 69.32 the report to the senate health care committee and the house 69.33 health and human services committee. 69.34 (b) The commissioner may, by rules adopted under chapter 69.35 14, alter the submission dates established under sections 69.36 145.4131 to 145.4133 for administrative convenience, fiscal 70.1 savings, or other valid reason, provided that physicians and the 70.2 commissioner of health submit the required information once each 70.3 year and the commissioner issues a report once each year. 70.4 Sec. 78. [145.4135] [ENFORCEMENT; PENALTIES.] 70.5 (a) A physician who fails to submit the required forms 70.6 under sections 145.4131 and 145.4132 within 30 days following 70.7 the due date is subject to a late fee of $500 for each 30-day 70.8 period, or portion thereof, that the forms are overdue. A 70.9 physician required to report under this section who does not 70.10 submit a report, or submits only an incomplete report, more than 70.11 one year following the due date, may be fined and, in an action 70.12 brought by the commissioner, be directed by a court of competent 70.13 jurisdiction to submit a complete report within a period stated 70.14 by court order or be subject to sanctions for civil contempt. 70.15 (b) If the commissioner fails to issue the public report 70.16 required under this section, or fails in any way to enforce this 70.17 section, a group of ten or more citizens of the state may seek 70.18 an injunction in a court of competent jurisdiction against the 70.19 commissioner requiring that a complete report be issued within a 70.20 period stated by court order or requiring that enforcement 70.21 action be taken. Failure to abide by an injunction shall 70.22 subject the commissioner to sanctions for civil contempt. 70.23 (c) A physician who knowingly or recklessly submits a false 70.24 report under this section is guilty of a misdemeanor. 70.25 (d) The commissioner may take reasonable steps to ensure 70.26 compliance with sections 145.4131 to 145.4133 and to verify data 70.27 provided, including but not limited to, inspection of places 70.28 where abortions are performed in accordance with chapter 14. 70.29 Sec. 79. [145.4136] [SEVERABILITY.] 70.30 If any one or more provision, section, subdivision, 70.31 sentence, clause, phrase, or word in sections 145.4131 to 70.32 145.4135, or the application thereof to any person or 70.33 circumstance is found to be unconstitutional, the same is hereby 70.34 declared to be severable and the balance of sections 145.4131 to 70.35 145.4135 shall remain effective notwithstanding such 70.36 unconstitutionality. The legislature hereby declares that it 71.1 would have passed sections 145.4131 to 145.4135, and each 71.2 provision, section, subdivision, sentence, clause, phrase, or 71.3 word thereof, irrespective of the fact that any one or more 71.4 provision, section, subdivision, sentence, clause, phrase, or 71.5 word be declared unconstitutional. 71.6 Sec. 80. [145.4201] [PARTIAL-BIRTH ABORTION; DEFINITIONS.] 71.7 Subdivision 1. [TERMS.] As used in sections 145.4201 to 71.8 145.4206, the terms defined in this section have the meanings 71.9 given them. 71.10 Subd. 2. [ABORTION.] "Abortion" means the use of any means 71.11 to intentionally terminate the pregnancy of a female known to be 71.12 pregnant with knowledge that the termination with those means 71.13 will, with reasonable likelihood, cause the death of the fetus. 71.14 Subd. 3. [FETUS AND INFANT.] "Fetus" and "infant" are used 71.15 interchangeably to refer to the biological offspring of human 71.16 parents. 71.17 Subd. 4. [PARTIAL-BIRTH ABORTION.] "Partial-birth abortion" 71.18 means an abortion in which the person performing the abortion 71.19 partially vaginally delivers a living fetus before killing the 71.20 fetus and completing the delivery. 71.21 Sec. 81. [145.4202] [PARTIAL-BIRTH ABORTIONS PROHIBITED.] 71.22 No person shall knowingly perform a partial-birth abortion. 71.23 Sec. 82. [145.4203] [LIFE OF THE MOTHER EXCEPTION.] 71.24 The prohibition under section 145.4202 shall not apply to a 71.25 partial-birth abortion that is necessary to save the life of the 71.26 mother because her life is endangered by a physical disorder, 71.27 physical illness, or physical injury, including a 71.28 life-endangering condition caused by or arising from the 71.29 pregnancy itself, provided that no other medical procedure would 71.30 suffice for that purpose. 71.31 Sec. 83. [145.4204] [CIVIL REMEDIES.] 71.32 Subdivision 1. [STANDING.] The woman upon whom a 71.33 partial-birth abortion has been performed in violation of 71.34 section 145.4202, the father of the fetus or infant, and the 71.35 maternal grandparents of the fetus or infant if the mother has 71.36 not attained the age of 18 years at the time of the abortion, 72.1 may obtain appropriate relief in a civil action, unless the 72.2 pregnancy resulted from the plaintiff's criminal conduct or the 72.3 plaintiff consented to the abortion. 72.4 Subd. 2. [TYPE OF RELIEF.] Relief shall include: 72.5 (1) money damages for all injuries, psychological and 72.6 physical, occasioned by the violation of sections 145.4201 to 72.7 145.4206; and 72.8 (2) statutory damages equal to three times the cost of the 72.9 partial-birth abortion. 72.10 Subd. 3. [ATTORNEY'S FEE.] If judgment is rendered in 72.11 favor of the plaintiff in an action described in this section, 72.12 the court shall also render judgment for a reasonable attorney's 72.13 fee in favor of the plaintiff against the defendant. If the 72.14 judgment is rendered in favor of the defendant and the court 72.15 finds that the plaintiff's suit was frivolous and brought in bad 72.16 faith, the court shall also render judgment for a reasonable 72.17 attorney's fee in favor of the defendant against the plaintiff. 72.18 Sec. 84. [145.4205] [CRIMINAL PENALTY.] 72.19 Subdivision 1. [FELONY.] A person who performs a 72.20 partial-birth abortion in knowing or reckless violation of 72.21 sections 145.4201 to 145.4206 is guilty of a felony and may be 72.22 sentenced to imprisonment for not more than 15 years or to 72.23 payment of a fine of not more than $50,000. 72.24 Subd. 2. [PROSECUTION OF MOTHER PROHIBITED.] A woman upon 72.25 whom a partial-birth abortion is performed may not be prosecuted 72.26 under this section for violating sections 145.4201 to 145.4206, 72.27 or any provision thereof, or for conspiracy to violate sections 72.28 145.4201 to 145.4206, or any provision thereof. 72.29 Sec. 85. [145.4206] [SEVERABILITY.] 72.30 (a) If any provision, word, phrase, or clause of section 72.31 145.4203, or the application thereof to any person or 72.32 circumstance is found to be unconstitutional, the same is hereby 72.33 declared to be inseverable. 72.34 (b) If any provision, section, subdivision, sentence, 72.35 clause, phrase, or word in section 145.4201, 145.4202, 145.4204, 72.36 145.4205, or 145.4206 or the application thereof to any person 73.1 or circumstance is found to be unconstitutional, the same is 73.2 hereby declared to be severable and the balance of sections 73.3 145.4201 to 145.4206 shall remain effective notwithstanding such 73.4 unconstitutionality. The legislature hereby declares that it 73.5 would have passed sections 145.4201 to 145.4206, and each 73.6 provision, section, subdivision, sentence, clause, phrase, or 73.7 word thereto, with the exception of section 145.4203, 73.8 irrespective of the fact that a provision, section, subdivision, 73.9 sentence, clause, phrase, or word be declared unconstitutional. 73.10 Sec. 86. [145.9266] [FETAL ALCOHOL SYNDROME.] 73.11 Subdivision 1. [PUBLIC AWARENESS.] The commissioner of 73.12 health shall design and implement an ongoing statewide campaign 73.13 to raise public awareness about fetal alcohol syndrome and other 73.14 effects of prenatal alcohol exposure. The campaign shall 73.15 include messages directed to the general population as well as 73.16 culturally specific and community-based messages. A toll-free 73.17 resource and referral telephone line shall be included in the 73.18 messages. The commissioner of health shall conduct an 73.19 evaluation to determine the effectiveness of the campaign. 73.20 Subd. 2. [STATEWIDE NETWORK OF FAS DIAGNOSTIC CLINICS.] A 73.21 statewide network of regional fetal alcohol syndrome diagnostic 73.22 clinics shall be developed between the department of health and 73.23 the University of Minnesota. This collaboration shall be based 73.24 on a statewide needs assessment and shall include involvement 73.25 from consumers, providers, and payors. By the end of calendar 73.26 year 1998, a plan shall be developed for the clinic network, and 73.27 shall include a comprehensive evaluation component. Sites shall 73.28 be established in calendar year 1999. The commissioner shall 73.29 not access or collect individually identifiable data for the 73.30 statewide network of regional fetal alcohol syndrome diagnostic 73.31 clinics. Data collected at the clinics shall be maintained 73.32 according to applicable data privacy laws, including section 73.33 144.335. 73.34 Subd. 3. [PROFESSIONAL TRAINING ABOUT FAS.] (a) The 73.35 commissioner of health, in collaboration with the board of 73.36 medical practice, the board of nursing, and other professional 74.1 boards and state agencies, shall develop curricula and materials 74.2 about fetal alcohol syndrome for professional training of health 74.3 care providers, social service providers, educators, and 74.4 judicial and corrections systems professionals. The training 74.5 and curricula shall increase knowledge and develop practical 74.6 skills of professionals to help them address the needs of 74.7 at-risk pregnant women and the needs of individuals affected by 74.8 fetal alcohol syndrome or fetal alcohol effects and their 74.9 families. 74.10 (b) Training for health care providers shall focus on skill 74.11 building for screening, counseling, referral, and follow-up for 74.12 women using or at risk of using alcohol while pregnant. 74.13 Training for health care professionals shall include methods for 74.14 diagnosis and evaluation of fetal alcohol syndrome and fetal 74.15 alcohol effects. Training for education, judicial, and 74.16 corrections professionals shall involve effective education 74.17 strategies, methods to identify the behaviors and learning 74.18 styles of children with alcohol-related birth defects, and 74.19 methods to identify available referral and community resources. 74.20 (c) Training for social service providers shall focus on 74.21 resources for assessing, referring, and treating at-risk 74.22 pregnant women, changes in the mandatory reporting and 74.23 commitment laws, and resources for affected children and their 74.24 families. 74.25 Subd. 4. [FAS COMMUNITY GRANT PROGRAM.] The commissioner 74.26 of health shall administer a grant program to provide money to 74.27 community organizations and coalitions to collaborate on fetal 74.28 alcohol syndrome prevention and intervention strategies and 74.29 activities. The commissioner shall disburse grant money through 74.30 a request for proposal process or sole-source distribution where 74.31 appropriate, and shall include at least one grant award for 74.32 transitional skills and services for individuals with fetal 74.33 alcohol syndrome or fetal alcohol effects. 74.34 Subd. 5. [SCHOOL PILOT PROGRAMS.] (a) The commissioner of 74.35 children, families, and learning shall award up to four grants 74.36 to schools for pilot programs to identify and implement 75.1 effective educational strategies for individuals with fetal 75.2 alcohol syndrome and other alcohol-related birth defects. 75.3 (b) One grant shall be awarded in each of the following age 75.4 categories: 75.5 (1) birth to three years; 75.6 (2) three to five years; 75.7 (3) six to 12 years; and 75.8 (4) 13 to 18 years. 75.9 (c) Grant proposals must include an evaluation plan, 75.10 demonstrate evidence of a collaborative or multisystem approach, 75.11 provide parent education and support, and show evidence of a 75.12 child- and family-focused approach consistent with 75.13 research-based educational practices and other guidelines 75.14 developed by the department of children, families, and learning. 75.15 (d) Children participating in the pilot program sites may 75.16 be identified through child find activities or a diagnostic 75.17 clinic. No identification activity may be undertaken without 75.18 the consent of a child's parent or guardian. 75.19 Subd. 6. [FETAL ALCOHOL COORDINATING BOARD; DUTIES.] (a) 75.20 The fetal alcohol coordinating board consists of: 75.21 (1) the commissioners of health, human services, 75.22 corrections, public safety, economic security, and children, 75.23 families, and learning; 75.24 (2) the director of the office of strategic and long-range 75.25 planning; 75.26 (3) the chair of the maternal and child health advisory 75.27 task force established by section 145.881, or the chair's 75.28 designee; 75.29 (4) a representative of the University of Minnesota 75.30 academic health center, appointed by the provost; 75.31 (5) five members from the general public appointed by the 75.32 governor, one of whom must be a family member of an individual 75.33 with fetal alcohol syndrome or fetal alcohol effect; and 75.34 (6) one member from the judiciary appointed by the chief 75.35 justice of the supreme court. 75.36 Terms, compensation, removal, and filling of vacancies of 76.1 appointed members are governed by section 15.0575. The board 76.2 shall elect a chair from its membership to serve a one-year 76.3 term. The commissioner of health shall provide staff and 76.4 consultant support for the board. Support must be provided 76.5 based on an annual budget and work plan developed by the board. 76.6 The board shall contract with the department of health for 76.7 necessary administrative services. Administrative services 76.8 include personnel, budget, payroll, and contract 76.9 administration. The board shall adopt an annual budget and work 76.10 program. 76.11 (b) Board duties include: 76.12 (1) reviewing programs of state agencies that involve fetal 76.13 alcohol syndrome and coordinating those that are 76.14 interdepartmental in nature; 76.15 (2) providing an integrated and comprehensive approach to 76.16 fetal alcohol syndrome prevention and intervention strategies 76.17 both at a local and statewide level; 76.18 (3) approving on an annual basis the statewide public 76.19 awareness campaign as designed and implemented by the 76.20 commissioner of health under subdivision 1; 76.21 (4) reviewing fetal alcohol syndrome community grants 76.22 administered by the commissioner of health under subdivision 4; 76.23 and 76.24 (5) submitting a report to the governor on January 15 of 76.25 each odd-numbered year summarizing board operations, activities, 76.26 findings, and recommendations, and fetal alcohol syndrome 76.27 activities throughout the state. 76.28 (c) The board expires on January 1, 2001. 76.29 Subd. 7. [FEDERAL FUNDS; CONTRACTS; DONATIONS.] The fetal 76.30 alcohol coordinating board may apply for, receive, and disburse 76.31 federal funds made available to the state by federal law or 76.32 rules adopted for any purpose related to the powers and duties 76.33 of the board. The board shall comply with any requirements of 76.34 federal law, rules, and regulations in order to apply for, 76.35 receive, and disburse funds. The board may contract with or 76.36 provide grants to public and private nonprofit entities. The 77.1 board may accept donations or grants from any public or private 77.2 entity. Money received by the board must be deposited in a 77.3 separate account in the state treasury and invested by the state 77.4 board of investment. The amount deposited, including investment 77.5 earnings, is appropriated to the board to carry out its duties. 77.6 Money deposited in the state treasury shall not cancel. 77.7 Sec. 87. Minnesota Statutes 1996, section 145A.15, 77.8 subdivision 2, is amended to read: 77.9 Subd. 2. [GRANT RECIPIENTS.] (a) The commissioner is 77.10 authorized to award grants to programs that meet the 77.11 requirements of subdivision 3 and include a strong child abuse 77.12 and neglect prevention focus for families in need of services. 77.13 Priority will be given to families considered to be in need of 77.14 additional services. These families include, but are not 77.15 limited to, families with: 77.16 (1) adolescent parents; 77.17 (2) a history of alcohol and other drug abuse; 77.18 (3) a history of child abuse, domestic abuse, or other 77.19 types of violence in the family of origin; 77.20 (4) a history of domestic abuse, rape, or other forms of 77.21 victimization; 77.22 (5) reduced cognitive functioning; 77.23 (6) a lack of knowledge of child growth and development 77.24 stages; 77.25 (7) low resiliency to adversities and environmental 77.26 stresses; or 77.27 (8) lack of sufficient financial resources to meet their 77.28 needs. 77.29 (b) Grants made under this section shall be used to fund 77.30 existing home visiting programs and to establish new programs. 77.31 The commissioner shall award grants to home visiting programs 77.32 that meet the program requirements in subdivision 3, regardless 77.33 of the number of years an existing program has received grant 77.34 funds in the past. 77.35 Sec. 88. Minnesota Statutes 1996, section 148.66, is 77.36 amended to read: 78.1 148.66 [STATE BOARD OFMEDICAL PRACTICEPHYSICAL THERAPY, 78.2 DUTIES.] 78.3 The state board ofmedical practice, as now or hereafter78.4constituted, hereinafter termed "the board," in the manner78.5hereinafter provided,physical therapy established under section 78.6 148.67 shall administerthe provisions of this lawsections 78.7 148.65 to 148.78. As used in sections 148.65 to 148.78, "board" 78.8 means the state board of physical therapy. 78.9 The board shall: 78.10 (1) adopt rules necessary to administer and enforce 78.11 sections 148.65 to 148.78; 78.12 (2) administer, coordinate, and enforce sections 148.65 to 78.13 148.78; 78.14 (3) evaluate the qualifications of applicants; 78.15 (4) issue subpoenas, examine witnesses, and administer 78.16 oaths; 78.17 (5) conduct hearings and keep records and minutes necessary 78.18 to the orderly administration of sections 148.65 to 148.78; 78.19 (6) investigate persons engaging in practices that violate 78.20 sections 148.65 to 148.78; and 78.21 (7) adopt rules under chapter 14 prescribing a code of 78.22 ethics for licensees. 78.23 Sec. 89. Minnesota Statutes 1996, section 148.67, is 78.24 amended to read: 78.25 148.67 [STATE BOARD OF PHYSICAL THERAPYCOUNCIL; MEMBERSHIP 78.26 APPOINTMENTS, VACANCIES, REMOVALS.] 78.27 Subdivision 1. [BOARD OF PHYSICAL THERAPY APPOINTED.] The 78.28board of medical practicegovernor shall appoint a state board 78.29 of physical therapycouncil in carrying out the provisions of78.30this lawto administer sections 148.65 to 148.78, regarding the 78.31 qualifications and examination of physical therapists. 78.32 Thecouncilboard shall consist ofsevennine members, citizens 78.33 and residents of the state of Minnesota, composed ofthreefive 78.34 physical therapists,twoone licensed and registereddoctors78.35 doctor of medicineand surgery, one being a professor or78.36associate or assistant professor from a program in physical79.1therapy approved by the board of medical practice, one aide or79.2assistant to a physical therapist and one public member. The79.3council shall expire, and the terms, compensation and removal of79.4members shall be as provided in section 15.059., one physical 79.5 therapy assistant and two public members. The five physical 79.6 therapist members must be licensed physical therapists in this 79.7 state. Each of the five physical therapist members must have at 79.8 least five years experience in physical therapy practice, 79.9 physical therapy administration, or physical therapy education. 79.10 The five years experience must immediately precede appointment. 79.11 Membership terms, compensation of members, removal of members, 79.12 filling of membership vacancies, and fiscal year and reporting 79.13 requirements shall be as provided in sections 214.07 to 214.09. 79.14 The provision of staff, administrative services, and office 79.15 space; the review and processing of complaints; the setting of 79.16 board fees; and other provisions relating to board operations 79.17 shall be as provided in chapter 214. Each member of the board 79.18 shall file with the secretary of state the constitutional oath 79.19 of office before beginning the term of office. 79.20 Subd. 2. [REPLACEMENT OF PHYSICAL THERAPISTS AND PHYSICIAN 79.21 MEMBERS.] When a member's term expires and the member is a 79.22 licensed physical therapist, the governor may appoint a licensed 79.23 physical therapist from a list submitted by the Minnesota 79.24 chapter of the American Physical Therapy Association. When a 79.25 member who is a licensed physical therapist leaves the board 79.26 before the member's term expires, the governor may appoint a 79.27 member for the remainder of the term from a list submitted by 79.28 the Minnesota chapter of the American Physical Therapy 79.29 Association. When a member who is a physician leaves the board 79.30 before the member's term expires, the governor may appoint a 79.31 member for the remainder of the term from lists submitted by the 79.32 state board of medical practice or the Minnesota Medical 79.33 Association. 79.34 Sec. 90. [148.691] [OFFICERS; EXECUTIVE DIRECTOR.] 79.35 Subdivision 1. [OFFICERS OF THE BOARD.] The board shall 79.36 elect from its members a president, a vice-president, and a 80.1 secretary-treasurer. Each shall serve for one year or until a 80.2 successor is elected and qualifies. The board shall appoint and 80.3 employ an executive secretary. A majority of the board, 80.4 including one officer, constitutes a quorum at a meeting. 80.5 Subd. 2. [BOARD AUTHORITY TO HIRE.] The board may employ 80.6 persons needed to carry out its work. 80.7 Sec. 91. Minnesota Statutes 1996, section 148.70, is 80.8 amended to read: 80.9 148.70 [APPLICANTS, QUALIFICATIONS.] 80.10It shall be the duty ofThe board ofmedical practice with80.11the advice and assistance of the physical therapy council to80.12pass uponphysical therapy must: 80.13 (1) establish the qualifications of applicants for 80.14registration,licensing and continuing education requirements 80.15 forreregistration,relicensing; 80.16 (2) provide for and conduct all examinations following 80.17 satisfactory completion of all didactic requirements,; 80.18 (3) determine the applicants who successfully pass the 80.19 examination,; and 80.20 (4) dulyregister such applicantslicense an applicant 80.21 after the applicant has presented evidence satisfactory to the 80.22 board that the applicant has completedaan accredited physical 80.23 therapy educational program of education or continuing education 80.24 approved by the board. 80.25 The passing score for examinations taken after July 1, 80.26 1995, shall be based on objective, numerical standards, as 80.27 established by a nationally recognized board approved testing 80.28 service. 80.29 Sec. 92. Minnesota Statutes 1996, section 148.705, is 80.30 amended to read: 80.31 148.705 [APPLICATION.] 80.32 An applicant forregistrationlicensing as a physical 80.33 therapist shall file a written application on forms provided by 80.34 the board together with a fee in the amount set by the board, no80.35portion of which shall be returned. No portion of the fee is 80.36 refundable. 81.1 An approved program for physical therapists shall include 81.2 the following: 81.3(a)(1) a minimum of 60 academic semester credits or its 81.4 equivalent from an accredited college, including courses in the 81.5 biological and physical sciences; and 81.6(b)(2) an accredited course in physical therapy education 81.7 which has provided adequate instruction in the basic sciences, 81.8 clinical sciences, and physical therapy theory and procedures, 81.9 as determined by the board. In determining whether or not a 81.10 course in physical therapy is approved, the board may take into 81.11 consideration the accreditation of such schools by the 81.12 appropriate council of the American Medical Association, the 81.13 American Physical Therapy Association, or the Canadian Medical 81.14 Association. 81.15 Sec. 93. Minnesota Statutes 1996, section 148.71, is 81.16 amended to read: 81.17 148.71 [REGISTRATIONLICENSING.] 81.18 Subdivision 1. [QUALIFIED APPLICANT.] The state board 81.19 ofmedical practicephysical therapy shallregisterlicense as a 81.20 physical therapist and shall furnish acertificate of81.21registrationlicense toeachan applicant who successfully 81.22 passes an examination provided for in sections 148.65 to 148.78 81.23 forregistrationlicensing as a physical therapist and who is 81.24 otherwise qualified as requiredhereinin sections 148.65 to 81.25 148.78. 81.26 Subd. 2. [TEMPORARY PERMIT.] (a) The board may, upon 81.27 payment of a fee set by the board, issue a temporary permit to 81.28 practice physical therapy under supervision to a physical 81.29 therapist who is a graduate of an approved school of physical 81.30 therapy and qualified for admission to examination for 81.31registrationlicensing as a physical therapist. A temporary 81.32 permit to practice physical therapy under supervision may be 81.33 issued only once and cannot be renewed. It expires 90 days 81.34 after the next examination forregistrationlicensing given by 81.35 the board or on the date on which the board, after examination 81.36 of the applicant, grants or denies the applicant aregistration82.1 license to practice, whichever occurs first. A temporary permit 82.2 expires on the first day the board begins its next examination 82.3 forregistrationlicense after the permit is issued if the 82.4 holder does not submit to examination on that date. The holder 82.5 of a temporary permit to practice physical therapy under 82.6 supervision may practice physical therapy as defined in section 82.7 148.65 if the entire practice is under the supervision of a 82.8 person holding a validregistrationlicense to practice physical 82.9 therapy in this state. The supervision shall be direct, 82.10 immediate, and on premises. 82.11 (b) A physical therapist from another state who is licensed 82.12 or otherwise registered in good standing as a physical therapist 82.13 by that state and meets the requirements forregistration82.14 licensing under section 148.72 does not require supervision to 82.15 practice physical therapy while holding a temporary permit in 82.16 this state. The temporary permit remains valid only until the 82.17 meeting of the board at which the application forregistration82.18 licensing is considered. 82.19 Subd. 3. [FOREIGN-TRAINED PHYSICAL THERAPISTS; TEMPORARY 82.20 PERMITS.] (a) The board of medical practice may issue a 82.21 temporary permit to a foreign-trained physical therapist who: 82.22 (1) is enrolled in a supervised physical therapy 82.23 traineeship that meets the requirements under paragraph (b); 82.24 (2) has completed a physical therapy education program 82.25 equivalent to that under section 148.705 and Minnesota Rules, 82.26 part 5601.0800, subpart 2; 82.27 (3) has achieved a score of at least 550 on the test of 82.28 English as a foreign language or a score of at least 85 on the 82.29 Minnesota battery test; and 82.30 (4) has paid a nonrefundable fee set by the board. 82.31 A foreign-trained physical therapist must have the 82.32 temporary permit before beginning a traineeship. 82.33 (b) A supervised physical therapy traineeship must: 82.34 (1) be at least six months; 82.35 (2) be at a board-approved facility; 82.36 (3) provide a broad base of clinical experience to the 83.1 foreign-trained physical therapist including a variety of 83.2 physical agents, therapeutic exercises, evaluation procedures, 83.3 and patient diagnoses; 83.4 (4) be supervised by a physical therapist who has at least 83.5 three years of clinical experience and isregisteredlicensed 83.6 under subdivision 1; and 83.7 (5) be approved by the board before the foreign-trained 83.8 physical therapist begins the traineeship. 83.9 (c) A temporary permit is effective on the first day of a 83.10 traineeship and expires 90 days after the next examination for 83.11registrationlicensing given by the board following successful 83.12 completion of the traineeship or on the date on which the board, 83.13 after examination of the applicant, grants or denies the 83.14 applicant aregistrationlicense to practice, whichever occurs 83.15 first. 83.16 (d) A foreign-trained physical therapist must successfully 83.17 complete a traineeship to beregisteredlicensed as a physical 83.18 therapist under subdivision 1. The traineeship may be waived 83.19 for a foreign-trained physical therapist who is licensed or 83.20 otherwise registered in good standing in another state and has 83.21 successfully practiced physical therapy in that state under the 83.22 supervision of a licensed or registered physical therapist for 83.23 at least six months at a facility that meets the requirements 83.24 under paragraph (b), clauses (2) and (3). 83.25 (e) A temporary permit will not be issued to a 83.26 foreign-trained applicant who has been issued a temporary permit 83.27 for longer than six months in any other state. 83.28 Sec. 94. Minnesota Statutes 1996, section 148.72, 83.29 subdivision 1, is amended to read: 83.30 Subdivision 1. [ISSUANCE OFREGISTRATIONLICENSE WITHOUT 83.31 EXAMINATION.] On payment to the board of a fee in the amount set 83.32 by the board and on submission of a written application on forms 83.33 provided by the board, the board shall issueregistrationa 83.34 license without examination to a person who is licensed or 83.35 otherwise registered as a physical therapist by another state of 83.36 the United States of America, its possessions, or the District 84.1 of Columbia, if the board determines that the requirements for 84.2licensurelicensing or registration in the state, possession, or 84.3 District are equal to, or greater than, the requirementsset84.4forthin sections 148.65 to 148.78. 84.5 Sec. 95. Minnesota Statutes 1996, section 148.72, 84.6 subdivision 2, is amended to read: 84.7 Subd. 2. [CERTIFICATE OF REGISTRATIONLICENSE.] The board 84.8 may issue acertificate of registration to a physical therapist84.9 license without examination to an applicant who presents 84.10 evidence satisfactory to the board of having passed an 84.11 examination recognized by the board, if the board determines the 84.12 standards of the other state or foreign country aredetermined84.13by the board to be as high asequal to those of this state.At84.14the time of making anUpon application, the applicant shall pay 84.15 to the board a fee in the amount set by the board,. No portion 84.16 ofwhich shall be returnedthe fee is refundable. 84.17 Sec. 96. Minnesota Statutes 1996, section 148.72, 84.18 subdivision 4, is amended to read: 84.19 Subd. 4. [ISSUANCE OFREGISTRATIONLICENSE AFTER 84.20 EXAMINATION.] The board shall issue acertificate of84.21registrationlicense toeachan applicant who passes the 84.22 examinationin accordance withaccording to standards 84.23 established by the board and who is not disqualified to 84.24 receiveregistrationa license underthe provisions ofsection 84.25 148.75. 84.26 Sec. 97. Minnesota Statutes 1996, section 148.73, is 84.27 amended to read: 84.28 148.73 [RENEWALS.] 84.29 Everyregisteredlicensed physical therapist shall, during 84.30 each January, apply to the board for an extension 84.31 ofregistrationa license and pay a fee in the amount set by the 84.32 board. The extension ofregistrationthe license is contingent 84.33 upon demonstration that the continuing education requirements 84.34 set by the board under section 148.70 have been satisfied. 84.35 Sec. 98. Minnesota Statutes 1996, section 148.74, is 84.36 amended to read: 85.1 148.74 [RULES.] 85.2 The boardis authorized tomay adopt rulesas may be85.3necessaryneeded to carry outthe purposes ofsections 148.65 to 85.4 148.78. Thesecretarysecretary-treasurer of the board shall 85.5 keep a record of proceedings under these sections and a register 85.6 of all personsregisteredlicensed under it. The register shall 85.7 show the name, address, date and number ofregistrationthe 85.8 license, and the renewalthereofof the license. Any other 85.9 interested person in the state may obtain a copy ofsuchthe 85.10 list on request to the board uponpayment ofpaying an amountas85.11may befixed by the board, which. The amount shall not exceed 85.12 the cost of the listsofurnished. The board shall provide 85.13 blanks, books, certificates, and stationery and assistanceas is85.14 necessaryfor the transaction of theto transact business of the 85.15 boardand the physical therapy council hereunder, and. All 85.16 money received by the board under sections 148.65 to 148.78 85.17 shall be paid into the state treasury as provided for by law. 85.18 The board shall set by rule the amounts of the application fee 85.19 and the annualregistrationlicensing fee. The fees collected 85.20 by the board must be sufficient to cover the costs of 85.21 administering sections 148.65 to 148.78. 85.22 Sec. 99. Minnesota Statutes 1996, section 148.75, is 85.23 amended to read: 85.24 148.75 [CERTIFICATESLICENSES; DENIAL, SUSPENSION, 85.25 REVOCATION.] 85.26 (a) The state board ofmedical practicephysical therapy 85.27 may refuse to grantregistrationa license to any physical 85.28 therapist, or may suspend or revoke theregistrationlicense of 85.29 any physical therapist for any of the following grounds: 85.30(a)(1) using drugs or intoxicating liquors to an extent 85.31 which affects professional competence; 85.32(b) been convicted(2) conviction of a felony; 85.33(c)(3) conviction for violating any state or federal 85.34 narcotic law; 85.35(d) procuring, aiding or abetting a criminal abortion;85.36(e) registration(4) obtaining a license orattempted86.1registrationattempting to obtain a license by fraud or 86.2 deception; 86.3(f)(5) conduct unbecoming a personregisteredlicensed as 86.4 a physical therapist or conduct detrimental to the best 86.5 interests of the public; 86.6(g)(6) gross negligence in the practice of physical 86.7 therapy as a physical therapist; 86.8(h)(7) treating human ailments by physical therapy after 86.9 an initial 30-day period of patient admittance to treatment has 86.10 lapsed, except by the order or referral of a person licensed in 86.11 this statetoin the practice of medicine as defined in section 86.12 147.081, the practice of chiropractic as defined in section 86.13 148.01, the practice of podiatry as defined in section 153.01, 86.14 or the practice of dentistry as defined in section 150A.05 and 86.15 whose license is in good standing; or when a previous diagnosis 86.16 exists indicating an ongoing condition warranting physical 86.17 therapy treatment, subject to periodic review defined by board 86.18 ofmedical practicephysical therapy rule; 86.19(i)(8) treating human ailments, without referral, by 86.20 physical therapy treatment without first having practiced one 86.21 year under a physician's orders as verified by the board's 86.22 records; 86.23(j) failure(9) failing to consult with the patient's 86.24 health care provider who prescribed the physical therapy 86.25 treatment if the treatment is altered by the physical therapist 86.26 from the original written order. The provision does not include 86.27 written ordersspecifying ordersto "evaluate and treat"; 86.28(k)(10) treating human ailments other than by physical 86.29 therapy unless duly licensed or registered to do so under the 86.30 laws of this state; 86.31(l)(11) inappropriate delegation to a physical therapist 86.32 assistant or inappropriate task assignment to an aide or 86.33 inadequate supervision of either level of supportive personnel; 86.34(m) treating human ailments other than by performing86.35physical therapy procedures unless duly licensed or registered86.36to do so under the laws of this state;87.1(n)(12) practicing as a physical therapist performing 87.2 medical diagnosis, the practice of medicine as defined in 87.3 section 147.081, or the practice of chiropractic as defined in 87.4 section 148.01; 87.5(o) failure(13) failing to comply with a reasonable 87.6 request to obtain appropriate clearance for mental or physical 87.7 conditionswhichthat would interfere with the ability to 87.8 practice physical therapy, andwhichthat may be potentially 87.9 harmful to patients; 87.10(p)(14) dividing fees with, or paying or promising to pay 87.11 a commission or part of the fee to, any person who contacts the 87.12 physical therapist for consultation or sends patients to the 87.13 physical therapist for treatment; 87.14(q)(15) engaging in an incentive payment arrangement, 87.15 other than that prohibited by clause(p)(14), that tends to 87.16 promote physical therapyoverutilizationoveruse,wherebythat 87.17 allows the referring person or person who controls the 87.18 availability of physical therapy services to a clientprofitsto 87.19 profit unreasonably as a result of patient treatment; 87.20(r)(16) practicing physical therapy and failing to refer 87.21 to a licensed health care professionalanya patient whose 87.22 medical condition at the time of evaluation has been determined 87.23 by the physical therapist to be beyond the scope of practice of 87.24 a physical therapist; and 87.25(s) failure(17) failing to report to the board other 87.26registeredlicensed physical therapists who violate this section. 87.27 (b) Acertificate of registrationlicense to practice as a 87.28 physical therapist is suspended if (1) a guardian of the person 87.29 of the physical therapist is appointed by order of a court 87.30 pursuant to sections 525.54 to 525.61, for reasons other than 87.31 the minority of the physical therapist; or (2) the physical 87.32 therapist is committed by order of a court pursuant to chapter 87.33 253B. Thecertificate of registrationlicense remains suspended 87.34 until the physical therapist is restored to capacity by a court 87.35 and, upon petition by the physical therapist, the suspension is 87.36 terminated by the board ofmedical practicephysical therapy 88.1 after a hearing. 88.2 Sec. 100. Minnesota Statutes 1996, section 148.76, is 88.3 amended to read: 88.4 148.76 [PROHIBITED CONDUCT.] 88.5 Subdivision 1. No person shall: 88.6(a)(1) use the title of physical therapist without a 88.7certificate of registrationlicense as a physical therapist 88.8 issuedpursuant to the provisions ofunder sections 148.65 to 88.9 148.78; 88.10(b)(2) in any manner hold out as a physical therapist, or 88.11 use in connection with the person's name the words or letters 88.12 Physical Therapist, Physiotherapist, Physical Therapy 88.13 Technician, Registered Physical Therapist, Licensed Physical 88.14 Therapist, P.T., P.T.T., R.P.T., L.P.T., or any letters, words, 88.15 abbreviations or insignia indicating or implying that the person 88.16 is a physical therapist, without acertificate of88.17registrationlicense as a physical therapist issuedpursuant to88.18the provisions ofunder sections 148.65 to 148.78. To do so is 88.19 a gross misdemeanor; 88.20(c)(3) employ fraud or deception in applying for or 88.21 securing acertificate of registrationlicense as a physical 88.22 therapist. 88.23 Nothingcontainedin sections 148.65 to 148.78shall88.24prohibit anyprohibits a person licensed or registered in this 88.25 state under another law from carrying out the therapy or 88.26 practice for which the person is duly licensed or registered. 88.27 Subd. 2. No physical therapist shall: 88.28(a)(1) treat human ailments by physical therapy after an 88.29 initial 30-day period of patient admittance to treatment has 88.30 lapsed, except by the order or referral of a person licensed in 88.31 this state to practice medicine as defined in section 147.081, 88.32 the practice of chiropractic as defined in section 148.01, the 88.33 practice of podiatry as defined in section 153.01, or the 88.34 practice of dentistry as defined in section 150A.05 and whose 88.35 license is in good standing; or when a previous diagnosis exists 88.36 indicating an ongoing condition warranting physical therapy 89.1 treatment, subject to periodic review defined by board of 89.2medical practicephysical therapy rule; 89.3(b)(2) treat human ailments by physical therapy treatment 89.4 without first having practiced one year under a physician's 89.5 orders as verified by the board's records; 89.6(c) utilize(3) use any chiropractic manipulative technique 89.7 whose end is the chiropractic adjustment of an abnormal 89.8 articulation of the body; and 89.9(d)(4) treat human ailments other than by physical therapy 89.10 unless duly licensed or registered to do so under the laws of 89.11 this state. 89.12 Sec. 101. Minnesota Statutes 1996, section 148.78, is 89.13 amended to read: 89.14 148.78 [PROSECUTION, ALLEGATIONS.] 89.15 In the prosecution of any person for violation of sections 89.16 148.65 to 148.78 as specified in section 148.76, it shall not be 89.17 necessary to allege or prove want of a validcertificate of89.18registrationlicense as a physical therapist, but shall be a 89.19 matter of defense to be established by the accused. 89.20 Sec. 102. Minnesota Statutes 1996, section 214.01, 89.21 subdivision 2, is amended to read: 89.22 Subd. 2. [HEALTH-RELATED LICENSING BOARD.] "Health-related 89.23 licensing board" means the board of examiners of nursing home 89.24 administrators established pursuant to section 144A.19, the 89.25 board of medical practice created pursuant to section 147.01, 89.26 the board of nursing created pursuant to section 148.181, the 89.27 board of chiropractic examiners established pursuant to section 89.28 148.02, the board of optometry established pursuant to section 89.29 148.52, the board of physical therapy established pursuant to 89.30 section 148.67, the board of psychology established pursuant to 89.31 section 148.90, the board of social work pursuant to section 89.32 148B.19, the board of marriage and family therapy pursuant to 89.33 section 148B.30, the office of mental health practice 89.34 established pursuant to section 148B.61, the alcohol and drug 89.35 counselors licensing advisory council established pursuant to 89.36 section 148C.02, the board of dietetics and nutrition practice 90.1 established under section 148.622, the board of dentistry 90.2 established pursuant to section 150A.02, the board of pharmacy 90.3 established pursuant to section 151.02, the board of podiatric 90.4 medicine established pursuant to section 153.02, and the board 90.5 of veterinary medicine, established pursuant to section 156.01. 90.6 Sec. 103. Minnesota Statutes 1996, section 214.03, is 90.7 amended to read: 90.8 214.03 [STANDARDIZED TESTS.] 90.9 Subdivision 1. [STANDARDIZED TESTS USED.] All state 90.10 examining and licensing boards, other than the state board of 90.11 law examiners, the state board of professional responsibility or 90.12 any other board established by the supreme court to regulate the 90.13 practice of law and judicial functions, shall use national 90.14 standardized tests for the objective, nonpractical portion of 90.15 any examination given to prospective licensees to the extent 90.16 that such national standardized tests are appropriate, except 90.17 when the subject matter of the examination relates to the 90.18 application of Minnesota law to the profession or calling being 90.19 licensed. 90.20 Subd. 2. [HEALTH-RELATED BOARDS; SPECIAL ACCOUNT.] There 90.21 is established an account in the special revenue fund where a 90.22 health-related licensing board may deposit applicants' payments 90.23 for national or regional standardized tests. Money in the 90.24 account is appropriated to each board that has deposited monies 90.25 into the account, in an amount equal to the amount deposited by 90.26 the board, to pay for the use of national or regional 90.27 standardized tests. 90.28 Sec. 104. Minnesota Statutes 1997 Supplement, section 90.29 214.32, subdivision 1, is amended to read: 90.30 Subdivision 1. [MANAGEMENT.] (a) A health professionals 90.31 services program committee is established, consisting of one 90.32 person appointed by each participating board, with each 90.33 participating board having one vote. The committee shall 90.34 designate one board to provide administrative management of the 90.35 program, set the program budget and the pro rata share of 90.36 program expenses to be borne by each participating board, 91.1 provide guidance on the general operation of the program, 91.2 including hiring of program personnel, and ensure that the 91.3 program's direction is in accord with its authority. No more 91.4 than half plus one of the members of the committee may be of one 91.5 gender. If the participating boards change which board is 91.6 designated to provide administrative management of the program, 91.7 any appropriation remaining for the program shall transfer to 91.8 the newly designated board on the effective date of the change. 91.9 The participating boards must inform the appropriate legislative 91.10 committees and the commissioner of finance of any change in the 91.11 administrative management of the program, and the amount of any 91.12 appropriation transferred under this provision. 91.13 (b) The designated board, upon recommendation of the health 91.14 professional services program committee, shall hire the program 91.15 manager and employees and pay expenses of the program from funds 91.16 appropriated for that purpose. The designated board may apply 91.17 for grants to pay program expenses and may enter into contracts 91.18 on behalf of the program to carry out the purposes of the 91.19 program. The participating boards shall enter into written 91.20 agreements with the designated board. 91.21 (c) An advisory committee is established to advise the 91.22 program committee consisting of: 91.23 (1) one member appointed by each of the following: the 91.24 Minnesota Academy of Physician Assistants, the Minnesota Dental 91.25 Association, the Minnesota Chiropractic Association, the 91.26 Minnesota Licensed Practical Nurse Association, the Minnesota 91.27 Medical Association, the Minnesota Nurses Association, and the 91.28 Minnesota Podiatric Medicine Association; 91.29 (2) one member appointed by each of the professional 91.30 associations of the other professions regulated by a 91.31 participating board not specified in clause (1); and 91.32 (3) two public members, as defined by section 214.02. 91.33 Members of the advisory committee shall be appointed for two 91.34 years and members may be reappointed. 91.35 No more than half plus one of the members of the committee 91.36 may be of one gender. 92.1 The advisory committee expires June 30, 2001. 92.2 Sec. 105. Minnesota Statutes 1996, section 254A.17, 92.3 subdivision 1, is amended to read: 92.4 Subdivision 1. [MATERNAL AND CHILD SERVICE PROGRAMS.] (a) 92.5 The commissioner shall fund maternal and child health and social 92.6 service programs designed to improve the health and functioning 92.7 of children born to mothers using alcohol and controlled 92.8 substances. Comprehensive programs shall include immediate and 92.9 ongoing intervention, treatment, and coordination of medical, 92.10 educational, and social services through a child's preschool 92.11 years. Programs shall also include research and evaluation to 92.12 identify methods most effective in improving outcomes among this 92.13 high-risk population. The commissioner shall ensure that the 92.14 programs are available on a statewide basis to the extent 92.15 possible with available funds. 92.16 (b) The commissioner of human services shall develop models 92.17 for the treatment of children ages 6 to 12 who are in need of 92.18 chemical dependency treatment. The commissioner shall fund at 92.19 least two pilot projects with qualified providers to provide 92.20 nonresidential treatment for children in this age group. Model 92.21 programs must include a component to monitor and evaluate 92.22 treatment outcomes. 92.23 Sec. 106. Minnesota Statutes 1996, section 254A.17, is 92.24 amended by adding a subdivision to read: 92.25 Subd. 1b. [INTERVENTION AND ADVOCACY PROGRAM.] Within the 92.26 limits of money available, the commissioner of human services 92.27 shall fund voluntary hospital-based outreach programs targeted 92.28 at women who deliver children affected by prenatal alcohol or 92.29 drug use. The program shall help women obtain treatment, stay 92.30 in recovery, and plan any future pregnancies. An advocate shall 92.31 be assigned to each woman in the program to provide guidance and 92.32 advice with respect to treatment programs, child safety and 92.33 parenting, housing, family planning, and any other personal 92.34 issues that are barriers to remaining free of chemical 92.35 dependence. The commissioner shall develop an evaluation 92.36 component and provide centralized coordination of the evaluation 93.1 process. 93.2 Sec. 107. Minnesota Statutes 1997 Supplement, section 93.3 256B.692, subdivision 2, is amended to read: 93.4 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] 93.5 Notwithstanding chapters 62D and 62N, a county that elects to 93.6 purchase medical assistance and general assistance medical care 93.7 in return for a fixed sum without regard to the frequency or 93.8 extent of services furnished to any particular enrollee is not 93.9 required to obtain a certificate of authority under chapter 62D 93.10 or 62N. A county that elects to purchase medical assistance and 93.11 general assistance medical care services under this section must 93.12 satisfy the commissioner of health that the requirements of 93.13 chapter 62D, applicable to health maintenance organizations, or 93.14 chapter 62N, applicable to community integrated service 93.15 networks, will be met. A county must also assure the 93.16 commissioner of health that the requirements ofsectionsections 93.17 62J.041; 62J.48; 62J.71 to 62J.73; all applicable provisions of 93.18 chapter 62Q, including sections 62Q.07; 62Q.075; 62Q.105; 93.19 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 62Q.14; 62Q.145; 93.20 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 62Q.47; 62Q.50; 93.21 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 will be met. All 93.22 enforcement and rulemaking powers available under chapters 62D, 93.23 62J, and 62N are hereby granted to the commissioner of health 93.24 with respect to counties that purchase medical assistance and 93.25 general assistance medical care services under this section. 93.26 Sec. 108. Minnesota Statutes 1996, section 268.92, 93.27 subdivision 4, is amended to read: 93.28 Subd. 4. [LEADCONTRACTORSSUPERVISOR OR CERTIFIED FIRM.] 93.29 (a) Eligible organizations and leadcontractorssupervisors or 93.30 certified firms may participate in the swab team program. An 93.31 eligible organization receiving a grant under this section must 93.32 assure that all participating leadcontractorssupervisors or 93.33 certified firms are licensed and that all swab team workers are 93.34 certified by the department of health under section 144.9505. 93.35 Eligible organizations and leadcontractorssupervisors or 93.36 certified firms may distinguish between interior and exterior 94.1 services in assigning duties and may participate in the program 94.2 by: 94.3 (1) providing on-the-job training for swab team workers; 94.4 (2) providing swab team services to meet the requirements 94.5 of sections 144.9503, subdivision 4, and 144.9504, subdivision 94.6 6; 94.7 (3) providing a removal and replacement component using 94.8 skilled craft workers under subdivision 7; 94.9 (4) providing lead testing according to subdivision 7a; 94.10 (5) providing lead dust cleaning supplies, as described in 94.11 section144.9503144.9507, subdivision54, 94.12 paragraph(b)(c), to residents; or 94.13 (6) having a swab team worker instruct residents and 94.14 property owners on appropriate lead control techniques, 94.15 including the lead-safe directives developed by the commissioner 94.16 of health. 94.17 (b) Participating leadcontractorssupervisors or certified 94.18 firms must: 94.19 (1) demonstrate proof of workers' compensation and general 94.20 liability insurance coverage; 94.21 (2) be knowledgeable about lead abatement requirements 94.22 established by the Department of Housing and Urban Development 94.23 and the Occupational Safety and Health Administration and lead 94.24 hazard reduction requirements and lead-safe directives of the 94.25 commissioner of health; 94.26 (3) demonstrate experience with on-the-job training 94.27 programs; 94.28 (4) demonstrate an ability to recruit employees from areas 94.29 at high risk for toxic lead exposure; and 94.30 (5) demonstrate experience in working with low-income 94.31 clients. 94.32 Sec. 109. [COMPLAINT PROCESS STUDY.] 94.33 The complaint process work group established by the 94.34 commissioners of health and commerce as required under Laws 94.35 1997, chapter 237, section 20, shall continue to meet to develop 94.36 a complaint resolution process for health plan companies to make 95.1 available to enrollees as required under Minnesota Statutes, 95.2 sections 62Q.105, 62Q.11, and 62Q.30. The commissioners of 95.3 health and commerce shall submit a progress report to the 95.4 legislative commission on health care access by September 15, 95.5 1998, and shall submit final recommendations to the legislature, 95.6 including draft legislation on developing such a process by 95.7 November 15, 1998. The recommendations must also include, in 95.8 consultation with the work group, a permanent method of 95.9 financing the office of health care consumer assistance, 95.10 advocacy, and information. 95.11 Sec. 110. [RESIDENTIAL HOSPICE ADVISORY TASK FORCE.] 95.12 The commissioner of health shall convene an advisory task 95.13 force to study issues related to the building codes and safety 95.14 standards that residential hospice facilities must meet for 95.15 licensure and to make recommendations on changes to these 95.16 standards. Task force membership shall include representatives 95.17 of residential hospices, pediatric residential hospices, the 95.18 Minnesota hospice organization, the Minnesota department of 95.19 health, and other interested parties. The task force is 95.20 governed by Minnesota Statutes, section 15.059, subdivision 6. 95.21 The task force shall submit recommendations and any draft 95.22 legislation to the legislature by January 15, 1999. 95.23 Sec. 111. [TEMPORARY LICENSURE WAIVER FOR DIETITIANS.] 95.24 Until October 31, 1998, the board of dietetics and 95.25 nutrition practice may waive the requirements for licensure as a 95.26 dietitian established in Minnesota Statutes, section 148.624, 95.27 subdivision 1, clause (1), and may issue a license to an 95.28 applicant who meets the qualifications for licensure specified 95.29 in Minnesota Statutes, section 148.627, subdivision 1. A waiver 95.30 may be granted in cases in which unusual or extraordinary 95.31 job-related circumstances prevented an applicant from applying 95.32 for licensure during the transition period specified in 95.33 Minnesota Statutes, section 148.627, subdivision 1. An 95.34 applicant must request a waiver in writing and must explain the 95.35 circumstances that prevented the applicant from applying for 95.36 licensure during the transition period. 96.1 Sec. 112. [ADVICE AND RECOMMENDATIONS.] 96.2 The commissioners of health and commerce shall convene an 96.3 ad hoc advisory panel of selected representatives of health plan 96.4 companies, purchasers, and provider groups engaged in the 96.5 practice of health care in Minnesota, and interested 96.6 legislators. This advisory panel shall meet and assist the 96.7 commissioners in developing measures to prevent discrimination 96.8 against providers and provider groups in managed care in 96.9 Minnesota and clarify the requirements of Minnesota Statutes, 96.10 section 62Q.23, paragraph (c). Any such measures shall be 96.11 reported to the legislature prior to November 15, 1998. 96.12 Sec. 113. [AGREEMENT AUTHORIZED.] 96.13 In order to have a comprehensive program to protect the 96.14 public from radiation hazards, the governor may enter into an 96.15 agreement with the United States Nuclear Regulatory Commission, 96.16 under the Atomic Energy Act of 1954, United States Code, title 96.17 42, section 2021, paragraph (b). The agreement may allow the 96.18 state to assume regulation over nonpower plant radiation hazards 96.19 including certain by-product, source, and special nuclear 96.20 materials not sufficient to form a critical mass. 96.21 Sec. 114. [HEALTH DEPARTMENT DESIGNATED LEAD.] 96.22 The department of health is designated as the lead agency 96.23 to pursue an agreement on behalf of the governor, and for any 96.24 assumption of specified licensing and regulatory authority from 96.25 the Nuclear Regulatory Commission under an agreement. The 96.26 department may enter into negotiations with the Nuclear 96.27 Regulatory Commission for that purpose. The commissioner of 96.28 health shall establish an advisory group to assist the 96.29 department in preparing the state to meet the requirements for 96.30 achieving an agreement. 96.31 Sec. 115. [RULES.] 96.32 The department of health may adopt rules for the state 96.33 assumption of regulation under an agreement under this act, 96.34 including the licensing and regulation of by-product, source, 96.35 and special nuclear material not sufficient to form a critical 96.36 mass. 97.1 Sec. 116. [TRANSITION.] 97.2 A person who, on the effective date of an agreement under 97.3 this act, possesses a Nuclear Regulatory Commission license that 97.4 is subject to the agreement shall be deemed to possess a similar 97.5 license issued by the department of health. Licenses shall 97.6 expire on the expiration date specified in the federal license. 97.7 Sec. 117. [STUDY OF EXTENT OF FETAL ALCOHOL SYNDROME.] 97.8 The commissioner of health shall conduct a study of the 97.9 incidence and prevalence of fetal alcohol syndrome in Minnesota. 97.10 The commissioner shall not collect individually identifiable 97.11 data for this study. 97.12 Sec. 118. [INITIAL APPOINTMENTS TO BOARD.] 97.13 Notwithstanding Minnesota Statutes, section 148.67, the 97.14 first physical therapist members appointed to the board may be 97.15 registered physical therapists. 97.16 Sec. 119. [SUNSET.] 97.17 An agreement entered into before August 2, 2002, shall 97.18 remain in effect until terminated or suspended under the Atomic 97.19 Energy Act of 1954, United States Code, title 42, section 2021, 97.20 paragraph (j). The governor may not enter into an initial 97.21 agreement with the Nuclear Regulatory Commission after August 1, 97.22 2002. If an agreement is not entered into, any rules adopted 97.23 under this act are repealed on that date. 97.24 Sec. 120. [REPEALER.] 97.25 Minnesota Statutes 1996, sections 144.491; 144.9501, 97.26 subdivisions 12, 14, and 16; and 144.9503, subdivisions 5, 8, 97.27 and 9, are repealed. 97.28 Sec. 121. [EFFECTIVE DATES.] 97.29 Sections 23 to 37, 39 to 58, 60 to 69, 103 (214.03), 104 97.30 (214.32, subdivision 1), 111 (temporary licensure), 112 (advice 97.31 and recommendations), and 120 (Repealer) are effective the day 97.32 following final enactment. 97.33 Sections 1 and 7 to 10 are effective January 1, 1999, and 97.34 apply to coverage issued, renewed, or continued as defined in 97.35 section 60A.02, subdivision 2a, on or after that date. 97.36 ARTICLE 3 98.1 LONG-TERM CARE 98.2 Section 1. Minnesota Statutes 1996, section 144A.04, 98.3 subdivision 5, is amended to read: 98.4 Subd. 5. [ADMINISTRATORS.] Except as otherwise provided by 98.5 this subdivision, a nursing home must have a full time licensed 98.6 nursing home administrator serving the facility. In any nursing 98.7 home of less than2531 beds, the director of nursing services 98.8 may also serve as the licensed nursing home administrator. Two 98.9 nursing homes under common ownership having a total of 150 beds 98.10 or less and located within 75 miles of each other may share the 98.11 services of a licensed administrator if the administrator 98.12 divides full-time work week between the two facilities in 98.13 proportion to the number of beds in each facility. Every 98.14 nursing home shall have a person-in-charge on the premises at 98.15 all times in the absence of the licensed administrator. The 98.16 name of the person in charge must be posted in a conspicuous 98.17 place in the facility. The commissioner of health shall by rule 98.18 promulgate minimum education and experience requirements for 98.19 persons-in-charge, and may promulgate rules specifying the times 98.20 of day during which a licensed administrator must be on the 98.21 nursing home's premises. In the absence of rules adopted by the 98.22 commissioner governing the division of an administrator's time 98.23 between two nursing homes, the administrator shall designate and 98.24 post the times the administrator will be on site in each home on 98.25 a regular basis. A nursing home may employ as its administrator 98.26 the administrator of a hospital licensed pursuant to sections 98.27 144.50 to 144.56 if the individual is licensed as a nursing home 98.28 administrator pursuant to section 144A.20 and the nursing home 98.29 and hospital have a combined total of 150 beds or less and are 98.30 located within one mile of each other. A nonproprietary 98.31 retirement home having fewer than 15 licensed nursing home beds 98.32 may share the services of a licensed administrator with a 98.33 nonproprietary nursing home, having fewer than 150 licensed 98.34 nursing home beds, that is located within 25 miles of the 98.35 retirement home. A nursing home which is located in a facility 98.36 licensed as a hospital pursuant to sections 144.50 to 144.56, 99.1 may employ as its administrator the administrator of the 99.2 hospital if the individual meets minimum education and long term 99.3 care experience criteria set by rule of the commissioner of 99.4 health. 99.5 Sec. 2. Minnesota Statutes 1997 Supplement, section 99.6 144A.071, subdivision 4a, is amended to read: 99.7 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 99.8 best interest of the state to ensure that nursing homes and 99.9 boarding care homes continue to meet the physical plant 99.10 licensing and certification requirements by permitting certain 99.11 construction projects. Facilities should be maintained in 99.12 condition to satisfy the physical and emotional needs of 99.13 residents while allowing the state to maintain control over 99.14 nursing home expenditure growth. 99.15 The commissioner of health in coordination with the 99.16 commissioner of human services, may approve the renovation, 99.17 replacement, upgrading, or relocation of a nursing home or 99.18 boarding care home, under the following conditions: 99.19 (a) to license or certify beds in a new facility 99.20 constructed to replace a facility or to make repairs in an 99.21 existing facility that was destroyed or damaged after June 30, 99.22 1987, by fire, lightning, or other hazard provided: 99.23 (i) destruction was not caused by the intentional act of or 99.24 at the direction of a controlling person of the facility; 99.25 (ii) at the time the facility was destroyed or damaged the 99.26 controlling persons of the facility maintained insurance 99.27 coverage for the type of hazard that occurred in an amount that 99.28 a reasonable person would conclude was adequate; 99.29 (iii) the net proceeds from an insurance settlement for the 99.30 damages caused by the hazard are applied to the cost of the new 99.31 facility or repairs; 99.32 (iv) the new facility is constructed on the same site as 99.33 the destroyed facility or on another site subject to the 99.34 restrictions in section 144A.073, subdivision 5; 99.35 (v) the number of licensed and certified beds in the new 99.36 facility does not exceed the number of licensed and certified 100.1 beds in the destroyed facility; and 100.2 (vi) the commissioner determines that the replacement beds 100.3 are needed to prevent an inadequate supply of beds. 100.4 Project construction costs incurred for repairs authorized under 100.5 this clause shall not be considered in the dollar threshold 100.6 amount defined in subdivision 2; 100.7 (b) to license or certify beds that are moved from one 100.8 location to another within a nursing home facility, provided the 100.9 total costs of remodeling performed in conjunction with the 100.10 relocation of beds does not exceed $750,000; 100.11 (c) to license or certify beds in a project recommended for 100.12 approval under section 144A.073; 100.13 (d) to license or certify beds that are moved from an 100.14 existing state nursing home to a different state facility, 100.15 provided there is no net increase in the number of state nursing 100.16 home beds; 100.17 (e) to certify and license as nursing home beds boarding 100.18 care beds in a certified boarding care facility if the beds meet 100.19 the standards for nursing home licensure, or in a facility that 100.20 was granted an exception to the moratorium under section 100.21 144A.073, and if the cost of any remodeling of the facility does 100.22 not exceed $750,000. If boarding care beds are licensed as 100.23 nursing home beds, the number of boarding care beds in the 100.24 facility must not increase beyond the number remaining at the 100.25 time of the upgrade in licensure. The provisions contained in 100.26 section 144A.073 regarding the upgrading of the facilities do 100.27 not apply to facilities that satisfy these requirements; 100.28 (f) to license and certify up to 40 beds transferred from 100.29 an existing facility owned and operated by the Amherst H. Wilder 100.30 Foundation in the city of St. Paul to a new unit at the same 100.31 location as the existing facility that will serve persons with 100.32 Alzheimer's disease and other related disorders. The transfer 100.33 of beds may occur gradually or in stages, provided the total 100.34 number of beds transferred does not exceed 40. At the time of 100.35 licensure and certification of a bed or beds in the new unit, 100.36 the commissioner of health shall delicense and decertify the 101.1 same number of beds in the existing facility. As a condition of 101.2 receiving a license or certification under this clause, the 101.3 facility must make a written commitment to the commissioner of 101.4 human services that it will not seek to receive an increase in 101.5 its property-related payment rate as a result of the transfers 101.6 allowed under this paragraph; 101.7 (g) to license and certify nursing home beds to replace 101.8 currently licensed and certified boarding care beds which may be 101.9 located either in a remodeled or renovated boarding care or 101.10 nursing home facility or in a remodeled, renovated, newly 101.11 constructed, or replacement nursing home facility within the 101.12 identifiable complex of health care facilities in which the 101.13 currently licensed boarding care beds are presently located, 101.14 provided that the number of boarding care beds in the facility 101.15 or complex are decreased by the number to be licensed as nursing 101.16 home beds and further provided that, if the total costs of new 101.17 construction, replacement, remodeling, or renovation exceed ten 101.18 percent of the appraised value of the facility or $200,000, 101.19 whichever is less, the facility makes a written commitment to 101.20 the commissioner of human services that it will not seek to 101.21 receive an increase in its property-related payment rate by 101.22 reason of the new construction, replacement, remodeling, or 101.23 renovation. The provisions contained in section 144A.073 101.24 regarding the upgrading of facilities do not apply to facilities 101.25 that satisfy these requirements; 101.26 (h) to license as a nursing home and certify as a nursing 101.27 facility a facility that is licensed as a boarding care facility 101.28 but not certified under the medical assistance program, but only 101.29 if the commissioner of human services certifies to the 101.30 commissioner of health that licensing the facility as a nursing 101.31 home and certifying the facility as a nursing facility will 101.32 result in a net annual savings to the state general fund of 101.33 $200,000 or more; 101.34 (i) to certify, after September 30, 1992, and prior to July 101.35 1, 1993, existing nursing home beds in a facility that was 101.36 licensed and in operation prior to January 1, 1992; 102.1 (j) to license and certify new nursing home beds to replace 102.2 beds in a facilitycondemnedacquired by the Minneapolis 102.3 community development agency as part ofan economic102.4 redevelopmentplanactivities in a city of the first class, 102.5 provided the new facility is located withinone milethree miles 102.6 of the site of the old facility. Operating and property costs 102.7 for the new facility must be determined and allowed 102.8 underexisting reimbursement rulessection 256B.431 or 256B.434; 102.9 (k) to license and certify up to 20 new nursing home beds 102.10 in a community-operated hospital and attached convalescent and 102.11 nursing care facility with 40 beds on April 21, 1991, that 102.12 suspended operation of the hospital in April 1986. The 102.13 commissioner of human services shall provide the facility with 102.14 the same per diem property-related payment rate for each 102.15 additional licensed and certified bed as it will receive for its 102.16 existing 40 beds; 102.17 (l) to license or certify beds in renovation, replacement, 102.18 or upgrading projects as defined in section 144A.073, 102.19 subdivision 1, so long as the cumulative total costs of the 102.20 facility's remodeling projects do not exceed $750,000; 102.21 (m) to license and certify beds that are moved from one 102.22 location to another for the purposes of converting up to five 102.23 four-bed wards to single or double occupancy rooms in a nursing 102.24 home that, as of January 1, 1993, was county-owned and had a 102.25 licensed capacity of 115 beds; 102.26 (n) to allow a facility that on April 16, 1993, was a 102.27 106-bed licensed and certified nursing facility located in 102.28 Minneapolis to layaway all of its licensed and certified nursing 102.29 home beds. These beds may be relicensed and recertified in a 102.30 newly-constructed teaching nursing home facility affiliated with 102.31 a teaching hospital upon approval by the legislature. The 102.32 proposal must be developed in consultation with the interagency 102.33 committee on long-term care planning. The beds on layaway 102.34 status shall have the same status as voluntarily delicensed and 102.35 decertified beds, except that beds on layaway status remain 102.36 subject to the surcharge in section 256.9657. This layaway 103.1 provision expires July 1, 1998; 103.2 (o) to allow a project which will be completed in 103.3 conjunction with an approved moratorium exception project for a 103.4 nursing home in southern Cass county and which is directly 103.5 related to that portion of the facility that must be repaired, 103.6 renovated, or replaced, to correct an emergency plumbing problem 103.7 for which a state correction order has been issued and which 103.8 must be corrected by August 31, 1993; 103.9 (p) to allow a facility that on April 16, 1993, was a 103.10 368-bed licensed and certified nursing facility located in 103.11 Minneapolis to layaway, upon 30 days prior written notice to the 103.12 commissioner, up to 30 of the facility's licensed and certified 103.13 beds by converting three-bed wards to single or double 103.14 occupancy. Beds on layaway status shall have the same status as 103.15 voluntarily delicensed and decertified beds except that beds on 103.16 layaway status remain subject to the surcharge in section 103.17 256.9657, remain subject to the license application and renewal 103.18 fees under section 144A.07 and shall be subject to a $100 per 103.19 bed reactivation fee. In addition, at any time within three 103.20 years of the effective date of the layaway, the beds on layaway 103.21 status may be: 103.22 (1) relicensed and recertified upon relocation and 103.23 reactivation of some or all of the beds to an existing licensed 103.24 and certified facility or facilities located in Pine River, 103.25 Brainerd, or International Falls; provided that the total 103.26 project construction costs related to the relocation of beds 103.27 from layaway status for any facility receiving relocated beds 103.28 may not exceed the dollar threshold provided in subdivision 2 103.29 unless the construction project has been approved through the 103.30 moratorium exception process under section 144A.073; 103.31 (2) relicensed and recertified, upon reactivation of some 103.32 or all of the beds within the facility which placed the beds in 103.33 layaway status, if the commissioner has determined a need for 103.34 the reactivation of the beds on layaway status. 103.35 The property-related payment rate of a facility placing 103.36 beds on layaway status must be adjusted by the incremental 104.1 change in its rental per diem after recalculating the rental per 104.2 diem as provided in section 256B.431, subdivision 3a, paragraph 104.3 (d). The property-related payment rate for a facility 104.4 relicensing and recertifying beds from layaway status must be 104.5 adjusted by the incremental change in its rental per diem after 104.6 recalculating its rental per diem using the number of beds after 104.7 the relicensing to establish the facility's capacity day 104.8 divisor, which shall be effective the first day of the month 104.9 following the month in which the relicensing and recertification 104.10 became effective. Any beds remaining on layaway status more 104.11 than three years after the date the layaway status became 104.12 effective must be removed from layaway status and immediately 104.13 delicensed and decertified; 104.14 (q) to license and certify beds in a renovation and 104.15 remodeling project to convert 12 four-bed wards into 24 two-bed 104.16 rooms, expand space, and add improvements in a nursing home 104.17 that, as of January 1, 1994, met the following conditions: the 104.18 nursing home was located in Ramsey county; had a licensed 104.19 capacity of 154 beds; and had been ranked among the top 15 104.20 applicants by the 1993 moratorium exceptions advisory review 104.21 panel. The total project construction cost estimate for this 104.22 project must not exceed the cost estimate submitted in 104.23 connection with the 1993 moratorium exception process; 104.24 (r) to license and certify up to 117 beds that are 104.25 relocated from a licensed and certified 138-bed nursing facility 104.26 located in St. Paul to a hospital with 130 licensed hospital 104.27 beds located in South St. Paul, provided that the nursing 104.28 facility and hospital are owned by the same or a related 104.29 organization and that prior to the date the relocation is 104.30 completed the hospital ceases operation of its inpatient 104.31 hospital services at that hospital. After relocation, the 104.32 nursing facility's status under section 256B.431, subdivision 104.33 2j, shall be the same as it was prior to relocation. The 104.34 nursing facility's property-related payment rate resulting from 104.35 the project authorized in this paragraph shall become effective 104.36 no earlier than April 1, 1996. For purposes of calculating the 105.1 incremental change in the facility's rental per diem resulting 105.2 from this project, the allowable appraised value of the nursing 105.3 facility portion of the existing health care facility physical 105.4 plant prior to the renovation and relocation may not exceed 105.5 $2,490,000; 105.6 (s) to license and certify two beds in a facility to 105.7 replace beds that were voluntarily delicensed and decertified on 105.8 June 28, 1991; 105.9 (t) to allow 16 licensed and certified beds located on July 105.10 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 105.11 facility in Minneapolis, notwithstanding the licensure and 105.12 certification after July 1, 1995, of the Minneapolis facility as 105.13 a 147-bed nursing home facility after completion of a 105.14 construction project approved in 1993 under section 144A.073, to 105.15 be laid away upon 30 days' prior written notice to the 105.16 commissioner. Beds on layaway status shall have the same status 105.17 as voluntarily delicensed or decertified beds except that they 105.18 shall remain subject to the surcharge in section 256.9657. The 105.19 16 beds on layaway status may be relicensed as nursing home beds 105.20 and recertified at any time within five years of the effective 105.21 date of the layaway upon relocation of some or all of the beds 105.22 to a licensed and certified facility located in Watertown, 105.23 provided that the total project construction costs related to 105.24 the relocation of beds from layaway status for the Watertown 105.25 facility may not exceed the dollar threshold provided in 105.26 subdivision 2 unless the construction project has been approved 105.27 through the moratorium exception process under section 144A.073. 105.28 The property-related payment rate of the facility placing 105.29 beds on layaway status must be adjusted by the incremental 105.30 change in its rental per diem after recalculating the rental per 105.31 diem as provided in section 256B.431, subdivision 3a, paragraph 105.32 (d). The property-related payment rate for the facility 105.33 relicensing and recertifying beds from layaway status must be 105.34 adjusted by the incremental change in its rental per diem after 105.35 recalculating its rental per diem using the number of beds after 105.36 the relicensing to establish the facility's capacity day 106.1 divisor, which shall be effective the first day of the month 106.2 following the month in which the relicensing and recertification 106.3 became effective. Any beds remaining on layaway status more 106.4 than five years after the date the layaway status became 106.5 effective must be removed from layaway status and immediately 106.6 delicensed and decertified; 106.7 (u) to license and certify beds that are moved within an 106.8 existing area of a facility or to a newly constructed addition 106.9 which is built for the purpose of eliminating three- and 106.10 four-bed rooms and adding space for dining, lounge areas, 106.11 bathing rooms, and ancillary service areas in a nursing home 106.12 that, as of January 1, 1995, was located in Fridley and had a 106.13 licensed capacity of 129 beds; 106.14 (v) to relocate 36 beds in Crow Wing county and four beds 106.15 from Hennepin county to a 160-bed facility in Crow Wing county, 106.16 provided all the affected beds are under common ownership; 106.17 (w) to license and certify a total replacement project of 106.18 up to 49 beds located in Norman county that are relocated from a 106.19 nursing home destroyed by flood and whose residents were 106.20 relocated to other nursing homes. The operating cost payment 106.21 rates for the new nursing facility shall be determined based on 106.22 the interim and settle-up payment provisions of Minnesota Rules, 106.23 part 9549.0057, and the reimbursement provisions of section 106.24 256B.431, except that subdivision 26, paragraphs (a) and (b), 106.25 shall not apply until the second rate year after the settle-up 106.26 cost report is filed. Property-related reimbursement rates 106.27 shall be determined under section 256B.431, taking into account 106.28 any federal or state flood-related loans or grants provided to 106.29 the facility; 106.30 (x) to license and certify a total replacement project of 106.31 up to 129 beds located in Polk county that are relocated from a 106.32 nursing home destroyed by flood and whose residents were 106.33 relocated to other nursing homes. The operating cost payment 106.34 rates for the new nursing facility shall be determined based on 106.35 the interim and settle-up payment provisions of Minnesota Rules, 106.36 part 9549.0057, and the reimbursement provisions of section 107.1 256B.431, except that subdivision 26, paragraphs (a) and (b), 107.2 shall not apply until the second rate year after the settle-up 107.3 cost report is filed. Property-related reimbursement rates 107.4 shall be determined under section 256B.431, taking into account 107.5 any federal or state flood-related loans or grants provided to 107.6 the facility;or107.7 (y) to license and certify beds in a renovation and 107.8 remodeling project to convert 13 three-bed wards into 13 two-bed 107.9 rooms and 13 single-bed rooms, expand space, and add 107.10 improvements in a nursing home that, as of January 1, 1994, met 107.11 the following conditions: the nursing home was located in 107.12 Ramsey county, was not owned by a hospital corporation, had a 107.13 licensed capacity of 64 beds, and had been ranked among the top 107.14 15 applicants by the 1993 moratorium exceptions advisory review 107.15 panel. The total project construction cost estimate for this 107.16 project must not exceed the cost estimate submitted in 107.17 connection with the 1993 moratorium exception process.; 107.18 (z) to allow a 285-bed nursing facility in St. Paul that 107.19 provides for the special dietary needs of its residents under 107.20 the requirements in section 31.651 to undertake a construction 107.21 project that will improve some of the existing structures, 107.22 create new buildings, and reduce the licensed and certified beds 107.23 to 150; or 107.24 (aa) to allow the commissioner of human services to license 107.25 an additional 36 beds to provide residential services for the 107.26 physically handicapped under Minnesota Rules, parts 9570.2000 to 107.27 9570.3400, in a 198-bed nursing home located in Red Wing, 107.28 provided that the total number of licensed and certified beds at 107.29 the facility does not increase. 107.30 Sec. 3. Minnesota Statutes 1996, section 144A.09, 107.31 subdivision 1, is amended to read: 107.32 Subdivision 1. [SPIRITUAL MEANS FOR HEALING.]No rule107.33establishedSections 144A.04, subdivision 5, and 144A.18 to 107.34 144A.27, and rules adopted under sections 144A.01 to 144A.16 107.35 other than a rule relating to sanitation and safety of premises, 107.36 to cleanliness of operation, or to physical equipmentshalldo 108.1 not apply to a nursing home conducted by and for the adherents 108.2 of any recognized church or religious denomination for the 108.3 purpose of providing care and treatment for those who select and 108.4 depend upon spiritual means through prayer alone, in lieu of 108.5 medical care, for healing. 108.6 Sec. 4. Minnesota Statutes 1997 Supplement, section 108.7 256B.0951, is amended by adding a subdivision to read: 108.8 Subd. 7. [WAIVER OF RULES.] The commissioner of health may 108.9 exempt residents of intermediate care facilities for persons 108.10 with mental retardation (ICFs/MR) who participate in the 108.11 three-year quality assurance pilot project established in 108.12 section 256B.095 from the requirements of Minnesota Rules, 108.13 chapter 4665, upon approval by the federal government of a 108.14 waiver of federal certification requirements for ICFs/MR. The 108.15 commissioners of health and human services shall apply for any 108.16 necessary waivers as soon as practicable and shall submit the 108.17 concept paper to the federal government by June 1, 1998. 108.18 Sec. 5. Minnesota Statutes 1996, section 256B.431, 108.19 subdivision 2i, is amended to read: 108.20 Subd. 2i. [OPERATING COSTS AFTER JULY 1, 1988.] (a) 108.21 [OTHER OPERATING COST LIMITS.] For the rate year beginning July 108.22 1, 1988, the commissioner shall increase the other operating 108.23 cost limits established in Minnesota Rules, part 9549.0055, 108.24 subpart 2, item E, to 110 percent of the median of the array of 108.25 allowable historical other operating cost per diems and index 108.26 these limits as in Minnesota Rules, part 9549.0056, subparts 3 108.27 and 4. The limits must be established in accordance with 108.28 subdivision 2b, paragraph (d). For rate years beginning on or 108.29 after July 1, 1989, the adjusted other operating cost limits 108.30 must be indexed as in Minnesota Rules, part 9549.0056, subparts 108.31 3 and 4. For the rate period beginning October 1, 1992, and for 108.32 rate years beginning after June 30, 1993, the amount of the 108.33 surcharge under section 256.9657, subdivision 1, shall be 108.34 included in the plant operations and maintenance operating cost 108.35 category. The surcharge shall be an allowable cost for the 108.36 purpose of establishing the payment rate. 109.1 (b) [CARE-RELATED OPERATING COST LIMITS.] For the rate 109.2 year beginning July 1, 1988, the commissioner shall increase the 109.3 care-related operating cost limits established in Minnesota 109.4 Rules, part 9549.0055, subpart 2, items A and B, to 125 percent 109.5 of the median of the array of the allowable historical case mix 109.6 operating cost standardized per diems and the allowable 109.7 historical other care-related operating cost per diems and index 109.8 those limits as in Minnesota Rules, part 9549.0056, subparts 1 109.9 and 2. The limits must be established in accordance with 109.10 subdivision 2b, paragraph (d). For rate years beginning on or 109.11 after July 1, 1989, the adjusted care-related limits must be 109.12 indexed as in Minnesota Rules, part 9549.0056, subparts 1 and 2. 109.13 (c) [SALARY ADJUSTMENT PER DIEM.]For the rate period109.14 Effective October 1,19881998, to June 30,19902000, the 109.15 commissioner, within the limits of available appropriations, 109.16 shalladd the appropriatemake available the salary adjustment 109.17 per diem calculated in clause (1) or (2) to the total operating 109.18 cost payment rate of each nursing facility reimbursed under this 109.19 section or section 256B.434. The salary adjustment per diem for 109.20 each nursing facility must be determined as follows: 109.21 (1) for each nursing facility that reports salaries for 109.22 registered nurses, licensed practical nurses, and aides, 109.23 orderlies and attendants separately, the commissioner shall 109.24 determine the salary adjustment per diem by multiplying the 109.25 total salaries, payroll taxes, and fringe benefits allowed in 109.26 each operating cost category, except management fees and 109.27 administrator and central office salaries and the related 109.28 payroll taxes and fringe benefits, by3.55 percent and then 109.29 dividing the resulting amount by the nursing facility's actual 109.30 resident days; and 109.31 (2) for each nursing facility that does not report salaries 109.32 for registered nurses, licensed practical nurses, aides, 109.33 orderlies, and attendants separately, the salary adjustment per 109.34 diem is the weighted average salary adjustment per diem increase 109.35 determined under clause (1). 109.36Each nursing facility that receives a salary adjustment per110.1diem pursuant to this subdivision shall adjust nursing facility110.2employee salaries by a minimum of the amount determined in110.3clause (1) or (2). The commissioner shall review allowable110.4salary costs, including payroll taxes and fringe benefits, for110.5the reporting year ending September 30, 1989, to determine110.6whether or not each nursing facility complied with this110.7requirement. The commissioner shall report the extent to which110.8each nursing facility complied with the legislative commission110.9on long-term care by August 1, 1990.110.10 (3) A nursing facility may apply for the salary adjustment 110.11 per diem calculated under clauses (1) and (2). The application 110.12 must be made to the commissioner and contain a plan by which the 110.13 nursing facility will distribute the salary adjustment to 110.14 employees of the nursing facility. For nursing facilities in 110.15 which the employees are represented by an exclusive bargaining 110.16 representative, an agreement negotiated and agreed to by the 110.17 employer and the exclusive bargaining representative, after July 110.18 1, 1998, may constitute the plan for the salary distribution. 110.19 The commissioner shall review the plan to ensure that the salary 110.20 adjustment per diem is used solely to increase the compensation 110.21 of nursing home facility employees. 110.22 (d) [NEW BASE YEAR.] The commissioner shall establish new 110.23 base years for both the reporting year ending September 30, 110.24 1989, and the reporting year ending September 30, 1990. In 110.25 establishing new base years, the commissioner must take into 110.26 account: 110.27 (1) statutory changes made in geographic groups; 110.28 (2) redefinitions of cost categories; and 110.29 (3) reclassification, pass-through, or exemption of certain 110.30 costs such as public employee retirement act contributions. 110.31 (e) [NEW BASE YEAR.] The commissioner shall establish a 110.32 new base year for the reporting years ending September 30, 1991, 110.33 and September 30, 1992. In establishing a new base year, the 110.34 commissioner must take into account: 110.35 (1) statutory changes made in geographic groups; 110.36 (2) redefinitions of cost categories; and 111.1 (3) reclassification, pass-through, or exemption of certain 111.2 costs. 111.3 Sec. 6. Minnesota Statutes 1996, section 256B.431, is 111.4 amended by adding a subdivision to read: 111.5 Subd. 2s. [NONALLOWABLE COST.] Costs incurred for any 111.6 activities which are directed at or are intended to influence or 111.7 dissuade employees in the exercise of their legal rights to 111.8 freely engage in the process of selecting an exclusive 111.9 representative for the purpose of collective bargaining with 111.10 their employer shall not be allowable for purposes of setting 111.11 payment rates. 111.12 Sec. 7. Minnesota Statutes 1997 Supplement, section 111.13 256B.431, subdivision 3f, is amended to read: 111.14 Subd. 3f. [PROPERTY COSTS AFTER JULY 1, 1988.] (a) [ 111.15 INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 111.16 1988, the replacement-cost-new per bed limit must be $32,571 per 111.17 licensed bed in multiple bedrooms and $48,857 per licensed bed 111.18 in a single bedroom. For the rate year beginning July 1, 1989, 111.19 the replacement-cost-new per bed limit for a single bedroom must 111.20 be $49,907 adjusted according to Minnesota Rules, part 111.21 9549.0060, subpart 4, item A, subitem (1). Beginning January 1, 111.22 1990, the replacement-cost-new per bed limits must be adjusted 111.23 annually as specified in Minnesota Rules, part 9549.0060, 111.24 subpart 4, item A, subitem (1). Beginning January 1, 1991, the 111.25 replacement-cost-new per bed limits will be adjusted annually as 111.26 specified in Minnesota Rules, part 9549.0060, subpart 4, item A, 111.27 subitem (1), except that the index utilized will be the Bureau 111.28 of the Census: Composite fixed-weighted price index as 111.29 published in the C30 Report, Value of New Construction Put in 111.30 Place. 111.31 (b) [RENTAL FACTOR.] For the rate year beginning July 1, 111.32 1988, the commissioner shall increase the rental factor as 111.33 established in Minnesota Rules, part 9549.0060, subpart 8, item 111.34 A, by 6.2 percent rounded to the nearest 100th percent for the 111.35 purpose of reimbursing nursing facilities for soft costs and 111.36 entrepreneurial profits not included in the cost valuation 112.1 services used by the state's contracted appraisers. For rate 112.2 years beginning on or after July 1, 1989, the rental factor is 112.3 the amount determined under this paragraph for the rate year 112.4 beginning July 1, 1988. 112.5 (c) [OCCUPANCY FACTOR.] For rate years beginning on or 112.6 after July 1, 1988, in order to determine property-related 112.7 payment rates under Minnesota Rules, part 9549.0060, for all 112.8 nursing facilities except those whose average length of stay in 112.9 a skilled level of care within a nursing facility is 180 days or 112.10 less, the commissioner shall use 95 percent of capacity days. 112.11 For a nursing facility whose average length of stay in a skilled 112.12 level of care within a nursing facility is 180 days or less, the 112.13 commissioner shall use the greater of resident days or 80 112.14 percent of capacity days but in no event shall the divisor 112.15 exceed 95 percent of capacity days. 112.16 (d) [EQUIPMENT ALLOWANCE.] For rate years beginning on 112.17 July 1, 1988, and July 1, 1989, the commissioner shall add ten 112.18 cents per resident per day to each nursing facility's 112.19 property-related payment rate. The ten-cent property-related 112.20 payment rate increase is not cumulative from rate year to rate 112.21 year. For the rate year beginning July 1, 1990, the 112.22 commissioner shall increase each nursing facility's equipment 112.23 allowance as established in Minnesota Rules, part 9549.0060, 112.24 subpart 10, by ten cents per resident per day. For rate years 112.25 beginning on or after July 1, 1991, the adjusted equipment 112.26 allowance must be adjusted annually for inflation as in 112.27 Minnesota Rules, part 9549.0060, subpart 10, item E. For the 112.28 rate period beginning October 1, 1992, the equipment allowance 112.29 for each nursing facility shall be increased by 28 percent. For 112.30 rate years beginning after June 30, 1993, the allowance must be 112.31 adjusted annually for inflation. 112.32 (e) [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND 112.33 INTEREST EXPENSE.] For rate years beginning on or after July 1, 112.34 1990, Minnesota Rules, part 9549.0060, subpart 5, item E, shall 112.35 not apply to outstanding related organization debt incurred 112.36 prior to May 23, 1983, provided that the debt was an allowable 113.1 debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the 113.2 debt is subject to repayment through annual principal payments, 113.3 and the nursing facility demonstrates to the commissioner's 113.4 satisfaction that the interest rate on the debt was less than 113.5 market interest rates for similar arms-length transactions at 113.6 the time the debt was incurred. If the debt was incurred due to 113.7 a sale between family members, the nursing facility must also 113.8 demonstrate that the seller no longer participates in the 113.9 management or operation of the nursing facility. Debts meeting 113.10 the conditions of this paragraph are subject to all other 113.11 provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. 113.12 (f) [BUILDING CAPITAL ALLOWANCE FOR NURSING FACILITIES 113.13 WITH OPERATING LEASES.] For rate years beginning on or after 113.14 July 1, 1990, a nursing facility with operating lease costs 113.15 incurred for the nursing facility's buildings shall receive its 113.16 building capital allowance computed in accordance with Minnesota 113.17 Rules, part 9549.0060, subpart 8. If an operating lease 113.18 provides that the lessee's rent is adjusted to recognize 113.19 improvements made by the lessor and related debt, the costs for 113.20 capital improvements and related debt shall be allowed in the 113.21 computation of the lessee's building capital allowance, provided 113.22 that reimbursement for these costs under an operating lease 113.23 shall not exceed the rate otherwise paid. 113.24 Sec. 8. Minnesota Statutes 1996, section 256B.431, 113.25 subdivision 11, is amended to read: 113.26 Subd. 11. [SPECIAL PROPERTY RATE SETTING PROCEDURES FOR 113.27 CERTAIN NURSING FACILITIES.] (a) Notwithstanding Minnesota 113.28 Rules, part 9549.0060, subpart 13, item H, to the contrary, for 113.29 the rate year beginning July 1, 1990, a nursing facility leased 113.30 prior to January 1, 1986, and currently subject to adverse 113.31 licensure action under section 144A.04, subdivision 4, paragraph 113.32 (a), or section 144A.11, subdivision 2, and whose ownership 113.33 changes prior to July 1, 1990, shall be allowed a 113.34 property-related payment equal to the lesser of its current 113.35 lease obligation divided by its capacity days as determined in 113.36 Minnesota Rules, part 9549.0060, subpart 11, as modified by 114.1 subdivision 3f, paragraph (c), or the frozen property-related 114.2 payment rate in effect for the rate year beginning July 1, 114.3 1989. For rate years beginning on or after July 1, 1991, the 114.4 property-related payment rate shall be its rental rate computed 114.5 using the previous owner's allowable principal and interest 114.6 expense as allowed by the department prior to that prior owner's 114.7 sale and lease-back transaction of December 1985. 114.8 (b) Notwithstanding other provisions of applicable law, a 114.9 nursing facility licensed for 122 beds on January 1, 1998, and 114.10 located in Columbia Heights shall have its property-related 114.11 payment rate set under this subdivision. The commissioner shall 114.12 make a rate adjustment by adding $2.41 to the facility's July 1, 114.13 1997, property-related payment rate. The adjusted 114.14 property-related payment rate shall be effective for rate years 114.15 beginning on or after July 1, 1998. The adjustment in this 114.16 paragraph shall remain in effect so long as the facility's rates 114.17 are set under this section. If the facility participates in the 114.18 alternative payment system under section 256B.434, the 114.19 adjustment in this paragraph shall be included in the facility's 114.20 contract payment rate. If historical rates or property costs 114.21 recognized under this section become the basis for future 114.22 medical assistance payments to the facility under a managed 114.23 care, capitation, or other alternative payment system, the 114.24 adjustment in this paragraph shall be included in the 114.25 computation of the facility's payments. 114.26 Sec. 9. Minnesota Statutes 1997 Supplement, section 114.27 256B.431, subdivision 26, is amended to read: 114.28 Subd. 26. [CHANGES TO NURSING FACILITY REIMBURSEMENT 114.29 BEGINNING JULY 1, 1997.] The nursing facility reimbursement 114.30 changes in paragraphs (a) to (f) shall apply in the sequence 114.31 specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 114.32 this section, beginning July 1, 1997. 114.33 (a) For rate years beginning on or after July 1, 1997, the 114.34 commissioner shall limit a nursing facility's allowable 114.35 operating per diem for each case mix category for each rate year. 114.36 The commissioner shall group nursing facilities into two groups, 115.1 freestanding and nonfreestanding, within each geographic group, 115.2 using their operating cost per diem for the case mix A 115.3 classification. A nonfreestanding nursing facility is a nursing 115.4 facility whose other operating cost per diem is subject to the 115.5 hospital attached, short length of stay, or the rule 80 limits. 115.6 All other nursing facilities shall be considered freestanding 115.7 nursing facilities. The commissioner shall then array all 115.8 nursing facilities in each grouping by their allowable case mix 115.9 A operating cost per diem. In calculating a nursing facility's 115.10 operating cost per diem for this purpose, the commissioner shall 115.11 exclude the raw food cost per diem related to providing special 115.12 diets that are based on religious beliefs, as determined in 115.13 subdivision 2b, paragraph (h). For those nursing facilities in 115.14 each grouping whose case mix A operating cost per diem: 115.15 (1) is at or below the median of the array, the 115.16 commissioner shall limit the nursing facility's allowable 115.17 operating cost per diem for each case mix category to the lesser 115.18 of the prior reporting year's allowable operating cost per diem 115.19 as specified in Laws 1996, chapter 451, article 3, section 11, 115.20 paragraph (h), plus the inflation factor as established in 115.21 paragraph (d), clause (2), increased by two percentage points, 115.22 or the current reporting year's corresponding allowable 115.23 operating cost per diem; or 115.24 (2) is above the median of the array, the commissioner 115.25 shall limit the nursing facility's allowable operating cost per 115.26 diem for each case mix category to the lesser of the prior 115.27 reporting year's allowable operating cost per diem as specified 115.28 in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 115.29 plus the inflation factor as established in paragraph (d), 115.30 clause (2), increased by one percentage point, or the current 115.31 reporting year's corresponding allowable operating cost per diem. 115.32 For purposes of paragraph (a), for rate years beginning on 115.33 or after July 1, 1998, if a nursing facility reports on its cost 115.34 report a reduction in cost due to a refund or credit, the 115.35 commissioner shall increase that facility's spend-up limit for 115.36 the rate year following the current rate year by the amount of 116.1 the cost reduction divided by its resident days for the 116.2 reporting year preceding the rate year in which the adjustment 116.3 is to be made. 116.4 (b) For rate years beginning on or after July 1, 1997, the 116.5 commissioner shall limit the allowable operating cost per diem 116.6 for high cost nursing facilities. After application of the 116.7 limits in paragraph (a) to each nursing facility's operating 116.8 cost per diem, the commissioner shall group nursing facilities 116.9 into two groups, freestanding or nonfreestanding, within each 116.10 geographic group. A nonfreestanding nursing facility is a 116.11 nursing facility whose other operating cost per diem are subject 116.12 to hospital attached, short length of stay, or rule 80 limits. 116.13 All other nursing facilities shall be considered freestanding 116.14 nursing facilities. The commissioner shall then array all 116.15 nursing facilities within each grouping by their allowable case 116.16 mix A operating cost per diem. In calculating a nursing 116.17 facility's operating cost per diem for this purpose, the 116.18 commissioner shall exclude the raw food cost per diem related to 116.19 providing special diets that are based on religious beliefs, as 116.20 determined in subdivision 2b, paragraph (h). For those nursing 116.21 facilities in each grouping whose case mix A operating cost per 116.22 diem exceeds 1.0 standard deviation above the median, the 116.23 commissioner shall reduce their allowable operating cost per 116.24 diem by three percent. For those nursing facilities in each 116.25 grouping whose case mix A operating cost per diem exceeds 0.5 116.26 standard deviation above the median but is less than or equal to 116.27 1.0 standard deviation above the median, the commissioner shall 116.28 reduce their allowable operating cost per diem by two percent. 116.29 However, in no case shall a nursing facility's operating cost 116.30 per diem be reduced below its grouping's limit established at 116.31 0.5 standard deviations above the median. 116.32 (c) For rate years beginning on or after July 1, 1997, the 116.33 commissioner shall determine a nursing facility's efficiency 116.34 incentive by first computing the allowable difference, which is 116.35 the lesser of $4.50 or the amount by which the facility's other 116.36 operating cost limit exceeds its nonadjusted other operating 117.1 cost per diem for that rate year. The commissioner shall 117.2 compute the efficiency incentive by: 117.3 (1) subtracting the allowable difference from $4.50 and 117.4 dividing the result by $4.50; 117.5 (2) multiplying 0.20 by the ratio resulting from clause 117.6 (1), and then; 117.7 (3) adding 0.50 to the result from clause (2); and 117.8 (4) multiplying the result from clause (3) times the 117.9 allowable difference. 117.10 The nursing facility's efficiency incentive payment shall 117.11 be the lesser of $2.25 or the product obtained in clause (4). 117.12 (d) For rate years beginning on or after July 1, 1997, the 117.13 forecasted price index for a nursing facility's allowable 117.14 operating cost per diem shall be determined under clauses (1) 117.15 and (2) using the change in the Consumer Price Index-All Items 117.16 (United States city average) (CPI-U) as forecasted by Data 117.17 Resources, Inc. The commissioner shall use the indices as 117.18 forecasted in the fourth quarter of the calendar year preceding 117.19 the rate year, subject to subdivision 2l, paragraph (c). 117.20 (1) The CPI-U forecasted index for allowable operating cost 117.21 per diem shall be based on the 21-month period from the midpoint 117.22 of the nursing facility's reporting year to the midpoint of the 117.23 rate year following the reporting year. 117.24 (2) For rate years beginning on or after July 1, 1997, the 117.25 forecasted index for operating cost limits referred to in 117.26 subdivision 21, paragraph (b), shall be based on the CPI-U for 117.27 the 12-month period between the midpoints of the two reporting 117.28 years preceding the rate year. 117.29 (e) After applying these provisions for the respective rate 117.30 years, the commissioner shall index these allowable operating 117.31 cost per diem by the inflation factor provided for in paragraph 117.32 (d), clause (1), and add the nursing facility's efficiency 117.33 incentive as computed in paragraph (c). 117.34 (f) For rate years beginning on or after July 1, 1997, the 117.35 total operating cost payment rates for a nursing facility shall 117.36 be the greater of the total operating cost payment rates 118.1 determined under this section or the total operating cost 118.2 payment rates in effect on June 30, 1997, subject to rate 118.3 adjustments due to field audit or rate appeal resolution. This 118.4 provision shall not apply to subsequent field audit adjustments 118.5 of the nursing facility's operating cost rates for rate years 118.6 beginning on or after July 1, 1997. 118.7 (g) For the rate years beginning on July 1, 1997,andJuly 118.8 1, 1998, and July 1, 1999, a nursing facility licensed for 40 118.9 beds effective May 1, 1992, with a subsequent increase of 20 118.10 Medicare/Medicaid certified beds, effective January 26, 1993, in 118.11 accordance with an increase in licensure is exempt from 118.12 paragraphs (a) and (b). 118.13 (h) For a nursing facility whose construction project was 118.14 authorized according to section 144A.073, subdivision 5, 118.15 paragraph (g), the operating cost payment rates for the third 118.16 location shall be determined based on Minnesota Rules, part 118.17 9549.0057. Paragraphs (a) and (b) shall not apply until the 118.18 second rate year after the settle-up cost report is filed. 118.19 Notwithstanding subdivision 2b, paragraph (g), real estate taxes 118.20 and special assessments payable by the third location, a 118.21 501(c)(3) nonprofit corporation, shall be included in the 118.22 payment rates determined under this subdivision for all 118.23 subsequent rate years. 118.24 (i) For the rate year beginning July 1, 1997, the 118.25 commissioner shall compute the payment rate for a nursing 118.26 facility licensed for 94 beds on September 30, 1996, that 118.27 applied in October 1993 for approval of a total replacement 118.28 under the moratorium exception process in section 144A.073, and 118.29 completed the approved replacement in June 1995, with other 118.30 operating cost spend-up limit under paragraph (a), increased by 118.31 $3.98, and after computing the facility's payment rate according 118.32 to this section, the commissioner shall make a one-year positive 118.33 rate adjustment of $3.19 for operating costs related to the 118.34 newly constructed total replacement, without application of 118.35 paragraphs (a) and (b). The facility's per diem, before the 118.36 $3.19 adjustment, shall be used as the prior reporting year's 119.1 allowable operating cost per diem for payment rate calculation 119.2 for the rate year beginning July 1, 1998. A facility described 119.3 in this paragraph is exempt from paragraph (b) for the rate 119.4 years beginning July 1, 1997, and July 1, 1998. 119.5 (j) For the purpose of applying the limit stated in 119.6 paragraph (a), a nursing facility in Kandiyohi county licensed 119.7 for 86 beds that was granted hospital-attached status on 119.8 December 1, 1994, shall have the prior year's allowable 119.9 care-related per diem increased by $3.207 and the prior year's 119.10 other operating cost per diem increased by $4.777 before adding 119.11 the inflation in paragraph (d), clause (2), for the rate year 119.12 beginning on July 1, 1997. 119.13 (k) For the purpose of applying the limit stated in 119.14 paragraph (a), a 117 bed nursing facility located in Pine county 119.15 shall have the prior year's allowable other operating cost per 119.16 diem increased by $1.50 before adding the inflation in paragraph 119.17 (d), clause (2), for the rate year beginning on July 1, 1997. 119.18 (l) For the purpose of applying the limit under paragraph 119.19 (a), a nursing facility in Hibbing licensed for 192 beds shall 119.20 have the prior year's allowable other operating cost per diem 119.21 increased by $2.67 before adding the inflation in paragraph (d), 119.22 clause (2), for the rate year beginning July 1, 1997. 119.23 (m) For the purpose of applying the limit stated in 119.24 paragraph (a), a nursing facility in Hennepin county licensed 119.25 for 181 beds on September 30, 1996, shall have the prior year's 119.26 allowable care-related per diem increased by $1.455 and the 119.27 prior year's other operating cost per diem increased by $0.439 119.28 before adding the inflation in paragraph (d), clause (2), for 119.29 the rate year beginning on July 1, 1998. 119.30 (n) For the purpose of applying the limit stated in 119.31 paragraph (a), a nursing facility in Hennepin county licensed 119.32 for 161 beds on September 30, 1996, shall have the prior year's 119.33 allowable care-related per diem increased by $1.154 and the 119.34 prior year's other operating cost per diem increased by $0.256 119.35 before adding the inflation in paragraph (d), clause (2), for 119.36 the rate year beginning on July 1, 1998. 120.1 (o) For the purpose of applying the limit stated in 120.2 paragraph (a), a nursing facility in Ramsey county licensed for 120.3 176 beds on September 30, 1996, shall have the prior year's 120.4 allowable care-related per diem increased by $0.803 and the 120.5 prior year's other operating cost per diem increased by $0.272 120.6 before adding the inflation in paragraph (d), clause (2), for 120.7 the rate year beginning on July 1, 1998. 120.8 (p) For the purpose of applying the limit stated in 120.9 paragraph (a), a nursing facility in Brown county licensed for 120.10 86 beds on September 30, 1996, shall have the prior year's 120.11 allowable care-related per diem increased by $0.850 and the 120.12 prior year's other operating cost per diem increased by $0.275 120.13 before adding the inflation in paragraph (d), clause (2), for 120.14 the rate year beginning on July 1, 1998. 120.15 (q) For the rate year beginning July 1, 1998, the 120.16 commissioner shall compute the payment rate for a nursing 120.17 facility, which was licensed for 110 beds on May 1, 1997, was 120.18 granted approval in January 1994 for a replacement and 120.19 remodeling project under the moratorium exception process in 120.20 section 144A.073, and completed the approved replacement and 120.21 remodeling project on March 14, 1997, by increasing the other 120.22 operating cost spend-up limit under paragraph (a) by $1.64. 120.23 After computing the facility's payment rate for the rate year 120.24 beginning July 1, 1998, according to this section, the 120.25 commissioner shall make a one-year positive rate adjustment of 120.26 48 cents for increased real estate taxes resulting from 120.27 completion of the moratorium exception project, without 120.28 application of paragraphs (a) and (b). 120.29 Sec. 10. Minnesota Statutes 1996, section 256B.431, is 120.30 amended by adding a subdivision to read: 120.31 Subd. 27. [RULE 80 LIMITED EXEMPTION.] For the rate year 120.32 beginning July 1, 1998, the commissioner shall compute the 120.33 payment rate for a nursing facility exempted from care-related 120.34 limits under subdivision 2b, paragraph (d), clause (2), with a 120.35 minimum of three-quarters of its beds licensed to provide 120.36 residential services for the physically handicapped under 121.1 Minnesota Rules, parts 9570.2000 to 9570.3400, with the care 121.2 related spend-up limit under subdivision 26, paragraph (a), 121.3 increased by $13.21 for the rate year beginning July 1, 1998, 121.4 without application of subdivision 26, paragraph (b). For rate 121.5 years beginning on or after July 1, 1999, the commissioner shall 121.6 exclude that amount in calculating the facility's operating cost 121.7 per diem for purposes of applying subdivision 26, paragraph (b). 121.8 Sec. 11. [256B.435] [NURSING FACILITY REIMBURSEMENT SYSTEM 121.9 EFFECTIVE JULY 1, 2000.] 121.10 Subdivision 1. [IN GENERAL.] Effective July 1, 2000, the 121.11 commissioner shall implement a performance-based contracting 121.12 system to replace the current method of setting operating cost 121.13 payment rates under sections 256B.431 and 256B.434 and Minnesota 121.14 Rules, parts 9549.0010 to 9549.0080. A nursing facility in 121.15 operation on May 1, 1998, with payment rates not established 121.16 under section 256B.431 or 256B.434 on that date, is ineligible 121.17 for this performance-based contracting system. In determining 121.18 prospective payment rates of nursing facility services, the 121.19 commissioner shall distinguish between operating costs and 121.20 property-related costs. The operating cost portion of the 121.21 payment rates shall be indexed annually by an inflation factor 121.22 as specified in subdivision 3, and in accordance with section 121.23 256B.431, subdivision 21, paragraph (c). Property related 121.24 payment rates, including real estate taxes and special 121.25 assessments, shall be determined under section 256B.431 or 121.26 256B.434. 121.27 Subd. 2. [CONTRACT PROVISIONS.] (a) The performance-based 121.28 contract with each nursing facility must include provisions that: 121.29 (1) apply the resident case mix assessment provisions of 121.30 Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 121.31 another assessment system, with the goal of moving to a single 121.32 assessment system; 121.33 (2) monitor resident outcomes through various methods, such 121.34 as quality indicators based on the minimum data set and other 121.35 utilization and performance measures; 121.36 (3) require the establishment and use of a continuous 122.1 quality improvement process that integrates information from 122.2 quality indicators and regular resident and family satisfaction 122.3 interviews; 122.4 (4) require annual reporting of facility statistical 122.5 information, including resident days by case mix category, 122.6 productive nursing hours, wages and benefits, and raw food costs 122.7 for use by the commissioner in the development of facility 122.8 profiles that include trends in payment and service utilization; 122.9 (5) require from each nursing facility an annual certified 122.10 audited financial statement consisting of a balance sheet, 122.11 income and expense statements, and an opinion from either a 122.12 licensed or certified public accountant, if a certified audit 122.13 was prepared, or unaudited financial statements if no certified 122.14 audit was prepared; and 122.15 (6) establish additional requirements and penalties for 122.16 nursing facilities not meeting the standards set forth in the 122.17 performance-based contract. 122.18 (b) The commissioner may develop additional incentive-based 122.19 payments for achieving outcomes specified in each contract. The 122.20 specified facility-specific outcomes must be measurable and 122.21 approved by the commissioner. 122.22 (c) The commissioner may also contract with nursing 122.23 facilities in other ways through requests for proposals, 122.24 including contracts on a risk or nonrisk basis, with nursing 122.25 facilities or consortia of nursing facilities, to provide 122.26 comprehensive long-term care coverage on a premium or capitated 122.27 basis. 122.28 Subd. 3. [PAYMENT RATE PROVISIONS.] (a) For rate years 122.29 beginning on or after July 1, 2000, the commissioner shall 122.30 determine operating cost payment rates for each licensed and 122.31 certified nursing facility by indexing its operating cost 122.32 payment rates in effect on June 30, 2000, for inflation. The 122.33 inflation factor to be used must be based on the change in the 122.34 Consumer Price Index-All Items, United States city average 122.35 (CPI-U) as forecasted by Data Resources, Inc. in the fourth 122.36 quarter preceding the rate year. The CPI-U forecasted index for 123.1 operating cost payment rates shall be based on the 12-month 123.2 period from the midpoint of the nursing facility's prior rate 123.3 year to the midpoint of the rate year for which the operating 123.4 payment rate is being determined. 123.5 (b) Beginning July 1, 2000, each nursing facility subject 123.6 to a performance-based contract under this section shall choose 123.7 one of two methods of payment for property related costs: 123.8 (1) the method established in section 256B.434; or 123.9 (2) the method established in section 256B.431. 123.10 Once the nursing facility has made the election in paragraph 123.11 (b), that election shall remain in effect for at least four 123.12 years or until an alternative property payment system is 123.13 developed. 123.14 Sec. 12. [256B.5011] [ICF/MR REIMBURSEMENT SYSTEM 123.15 EFFECTIVE OCTOBER 1, 2000.] 123.16 Subdivision 1. [PERFORMANCE-BASED CONTRACTING SYSTEM.] (a) 123.17 Effective October 1, 2000, the commissioner shall implement a 123.18 performance-based contracting system to replace the current 123.19 method of setting total cost payment rates under section 123.20 256B.501 and Minnesota Rules, parts 9553.0010 to 9553.0080. In 123.21 determining prospective payment rates of intermediate care 123.22 facilities for persons with mental retardation or related 123.23 conditions, the commissioner shall index each facility's total 123.24 payment rate by an inflation factor as described in subdivision 123.25 3. The commissioner of finance shall include annual inflation 123.26 adjustments in operating costs for intermediate care facilities 123.27 for persons with mental retardation and related conditions as a 123.28 budget change request in each biennial detailed expenditure 123.29 budget submitted to the legislature under section 16A.11. 123.30 Subd. 2. [CONTRACT PROVISIONS.] The performance-based 123.31 contract with each intermediate care facility must include 123.32 provisions for: 123.33 (1) modifying payments when significant changes occur in 123.34 the needs of the consumers; 123.35 (2) monitoring service quality using performance indicators 123.36 that measure consumer outcomes; 124.1 (3) the establishment and use of continuous quality 124.2 improvement processes using the results attained through service 124.3 quality monitoring; 124.4 (4) the annual reporting of facility statistical 124.5 information on all supervisory personnel, direct care personnel, 124.6 specialized support personnel, hours, wages and benefits, 124.7 staff-to-consumer ratios, and staffing patterns; 124.8 (5) annual aggregate facility financial information or an 124.9 annual certified audited financial statement, including a 124.10 balance sheet and income and expense statements for each 124.11 facility, if a certified audit was prepared; and 124.12 (6) additional requirements and penalties for intermediate 124.13 care facilities not meeting the standards set forth in the 124.14 performance-based contract. 124.15 Subd. 3. [PAYMENT RATE PROVISIONS.] For rate years 124.16 beginning on or after October 1, 2000, the commissioner shall 124.17 determine the total payment rate for each licensed and certified 124.18 intermediate care facility by indexing the total payment rate in 124.19 effect on September 30, 2000, for inflation. The inflation 124.20 factor to be used must be based on the change in the Consumer 124.21 Price Index-All Items, United States city average (CPI-U) as 124.22 forecasted by Data Resources, Inc. in the first quarter of the 124.23 calendar year during which the rate year begins. The CPI-U 124.24 forecasted index for total payment rates shall be based on the 124.25 12-month period from the midpoint of the ICFs/MR prior rate year 124.26 to the midpoint of the rate year for which the operating payment 124.27 rate is being determined. 124.28 Sec. 13. [RECOMMENDATIONS TO IMPLEMENT NEW REIMBURSEMENT 124.29 SYSTEM.] 124.30 (a) By January 15, 1999, the commissioner shall make 124.31 recommendations to the chairs of the health and human services 124.32 policy and fiscal committees on the repeal of specific statutes 124.33 and rules as well as any other additional recommendations 124.34 related to implementation of sections 11 and 12. 124.35 (b) In developing recommendations for nursing facility 124.36 reimbursement, the commissioner shall consider making each 125.1 nursing facility's total payment rates, both operating and 125.2 property rate components, prospective. The commissioner shall 125.3 involve nursing facility industry and consumer representatives 125.4 in the development of these recommendations. 125.5 (c) In making recommendations for ICF/MR reimbursement, the 125.6 commissioner may consider methods of establishing payment rates 125.7 that take into account individual client costs and needs, 125.8 include provisions to establish links between performance 125.9 indicators and reimbursement and other performance incentives, 125.10 and allow local control over resources necessary for local 125.11 agencies to set rates and contract with ICF/MR facilities. In 125.12 addition, the commissioner may establish methods that provide 125.13 information to consumers regarding service quality as measured 125.14 by performance indicators. The commissioner shall involve 125.15 ICF/MR industry and consumer representatives in the development 125.16 of these recommendations. 125.17 Sec. 14. [APPROVAL EXTENDED.] 125.18 Minnesota Statutes, section 144A.073, subdivision 3, 125.19 notwithstanding, the commissioner of health shall grant an 125.20 additional 18 months of approval for a proposed exception to the 125.21 nursing home licensure and certification moratorium, if the 125.22 proposal is to replace a 96-bed nursing home facility in Carlton 125.23 county and if initial approval for the proposal was granted in 125.24 November 1996. 125.25 Sec. 15. [EFFECTIVE DATE.] 125.26 Sections 4 (256B.0951, subd. 7), 9 (256B.431, subd. 26), 125.27 and 14 (approval extended) are effective the day following final 125.28 enactment. 125.29 ARTICLE 4 125.30 HEALTH CARE PROGRAMS, INCLUDING MA AND GAMC 125.31 Section 1. Minnesota Statutes 1997 Supplement, section 125.32 62J.69, subdivision 1, is amended to read: 125.33 Subdivision 1. [DEFINITIONS.] For purposes of this 125.34 section, the following definitions apply: 125.35 (a) "Medical education" means the accredited clinical 125.36 training of physicians (medical students and residents), doctor 126.1 of pharmacy practitioners, dentists, advanced practice nurses 126.2 (clinical nurse specialist, certified registered nurse 126.3 anesthetists, nurse practitioners, and certified nurse 126.4 midwives), and physician assistants. 126.5 (b) "Clinical training" means accredited training for the 126.6 health care practitioners listed in paragraph (a) that is funded 126.7and was historically fundedin part byinpatientpatient care 126.8 revenues and that occurs inbotheither an inpatientandor 126.9 ambulatory patient caresettingstraining site. 126.10 (c) "Trainee" means students involved in an accredited 126.11 clinical training program for medical education as defined in 126.12 paragraph (a). 126.13 (d) "Eligible trainee" means a student involved in an 126.14 accredited training program for medical education as defined in 126.15 paragraph (a), which meets the definition of clinical training 126.16 in paragraph (b), who is in a training site that is located in 126.17 Minnesota and which has a medical assistance provider number. 126.18 (e) "Health care research" means approved clinical, 126.19 outcomes, and health services investigations that are funded by 126.20 patient out-of-pocket expenses or a third-party payer. 126.21(e)(f) "Commissioner" means the commissioner of health. 126.22(f)(g) "Teaching institutions" means any hospital, medical 126.23 center, clinic, or other organization that currently sponsors or 126.24 conducts accredited medical education programs or clinical 126.25 research in Minnesota. 126.26 (h) "Accredited training" means training provided by a 126.27 program that is accredited through an organization recognized by 126.28 the department of education or the health care financing 126.29 administration as the official accrediting body for that program. 126.30 (i) "Sponsoring institution" means a hospital, school, or 126.31 consortium located in Minnesota that sponsors and maintains 126.32 primary organizational and financial responsibility for an 126.33 accredited medical education program in Minnesota and which is 126.34 accountable to the accrediting body. 126.35 Sec. 2. Minnesota Statutes 1997 Supplement, section 126.36 62J.69, subdivision 2, is amended to read: 127.1 Subd. 2. [ALLOCATION AND FUNDING FOR MEDICAL EDUCATION AND 127.2 RESEARCH.] (a) The commissioner may establish a trust fund for 127.3 the purposes of funding medical education and research 127.4 activities in the state of Minnesota. 127.5 (b) By January 1, 1997, the commissioner may appoint an 127.6 advisory committee to provide advice and oversight on the 127.7 distribution of funds from the medical education and research 127.8 trust fund. If a committee is appointed, the commissioner 127.9 shall: (1) consider the interest of all stakeholders when 127.10 selecting committee members; (2) select members that represent 127.11 both urban and rural interest; and (3) select members that 127.12 include ambulatory care as well as inpatient perspectives. The 127.13 commissioner shall appoint to the advisory committee 127.14 representatives of the following groups: medical researchers, 127.15 public and private academic medical centers, managed care 127.16 organizations, Blue Cross and Blue Shield of Minnesota, 127.17 commercial carriers, Minnesota Medical Association, Minnesota 127.18 Nurses Association, medical product manufacturers, employers, 127.19 and other relevant stakeholders, including consumers. The 127.20 advisory committee is governed by section 15.059, for membership 127.21 terms and removal of members and will sunset on June 30, 1999. 127.22 (c) Eligible applicants for funds are accredited medical 127.23 education teaching institutions, consortia, and programs 127.24 operating in Minnesota. Applications must be submitted by the 127.25 sponsoring institution on behalf of the teaching program, and 127.26 must be received by September 30 of each year for distribution 127.27 in January of the following year. An application for funds must 127.28 include the following: 127.29 (1) the official name and address of the sponsoring 127.30 institution and the official name and address of the facility or 127.31programprograms on whose behalf the institution is applying for 127.32 funding; 127.33 (2) the name, title, and business address of those persons 127.34 responsible for administering the funds; 127.35 (3)the total number, type, and specialty orientation of127.36eligible Minnesota-based trainees infor each accredited medical 128.1 education program for which funds are being sought the type and 128.2 specialty orientation of trainees in the program, the name, 128.3 address, and medical assistance provider number of each training 128.4 site used in the program, the total number of trainees at each 128.5 site, and the total number of eligible trainees at each training 128.6 site; 128.7 (4) audited clinical training costs per trainee for each 128.8 medical education program where available or estimates of 128.9 clinical training costs based on audited financial data; 128.10 (5) a description of current sources of funding for medical 128.11 education costs including a description and dollar amount of all 128.12 state and federal financial support, including Medicare direct 128.13 and indirect payments; 128.14 (6) other revenue received for the purposes of clinical 128.15 training; and 128.16 (7)a statement identifying unfunded costs; and128.17(8)other supporting information the commissioner, with 128.18 advice from the advisory committee, determines is necessary for 128.19 the equitable distribution of funds. 128.20 (d) The commissioner shall distribute medical education 128.21 funds to all qualifying applicants based on the following basic 128.22 criteria: (1) total medical education funds available; (2) 128.23 total eligible trainees in each eligible education program; and 128.24 (3) the statewide average cost per trainee, by type of trainee, 128.25 in each medical education program. Funds distributed shall not 128.26 be used to displace current funding appropriations from federal 128.27 or state sources. Funds shall be distributed to the sponsoring 128.28 institutions indicating the amount to be paid to each of the 128.29 sponsor's medical education programs based on the criteria in 128.30 this paragraph. Sponsoring institutions which receive funds 128.31 from the trust fund must distribute approved funds to the 128.32 medical education program according to the commissioner's 128.33 approval letter. Further, programs must distribute funds among 128.34 the sites of trainingbased on the percentage of total program128.35training performed at each site.as specified in the 128.36 commissioner's approval letter. Any funds not distributed as 129.1 directed by the commissioner's approval letter shall be returned 129.2 to the medical education and research trust fund within 30 days 129.3 of a notice from the commissioner. The commissioner shall 129.4 distribute returned funds to the appropriate entities in 129.5 accordance with the commissioner's approval letter. 129.6 (e) Medical education programs receiving funds from the 129.7 trust fund must submitannual cost and program reportsa medical 129.8 education and research grant verification report (GVR) through 129.9 the sponsoring institution based on criteria established by the 129.10 commissioner. If the sponsoring institution fails to submit the 129.11 GVR by the stated deadline, or to request and meet the deadline 129.12 for an extension, the sponsoring institution is required to 129.13 return the full amount of the medical education and research 129.14 trust fund grant to the medical education and research trust 129.15 fund within 30 days of a notice from the commissioner. The 129.16 commissioner shall distribute returned funds to the appropriate 129.17 entities in accordance with the commissioner's approval letter. 129.18 The reports must include: 129.19 (1) the total number of eligible trainees in the program; 129.20 (2) the programs and residencies funded, the amounts of 129.21 trust fund payments to each program, and within each program, 129.22 thepercentagedollar amount distributed to each training site; 129.23 and 129.24 (3)the average cost per trainee and a detailed breakdown129.25of the components of those costs;129.26(4) other state or federal appropriations received for the129.27purposes of clinical training;129.28(5) other revenue received for the purposes of clinical129.29training; and129.30(6)other information the commissioner, with advice from 129.31 the advisory committee, deems appropriate to evaluate the 129.32 effectiveness of the use of funds for clinical training. 129.33 The commissioner, with advice from the advisory committee, 129.34 will provide an annual summary report to the legislature on 129.35 program implementation due February 15 of each year. 129.36 (f) The commissioner is authorized to distribute funds made 130.1 available through: 130.2 (1) voluntary contributions by employers or other entities; 130.3 (2) allocations for the department of human services to 130.4 support medical education and research; and 130.5 (3) other sources as identified and deemed appropriate by 130.6 the legislature for inclusion in the trust fund. 130.7 (g) The advisory committee shall continue to study and make 130.8 recommendations on: 130.9 (1) the funding of medical research consistent with work 130.10 currently mandated by the legislature and under way at the 130.11 department of health; and 130.12 (2) the costs and benefits associated with medical 130.13 education and research. 130.14 Sec. 3. Minnesota Statutes 1997 Supplement, section 130.15 62J.69, is amended by adding a subdivision to read: 130.16 Subd. 4. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 130.17 SERVICES.] (a) The amount transferred according to section 130.18 256B.69, subdivision 5c, shall be distributed to qualifying 130.19 applicants based on a distribution formula that reflects a 130.20 summation of two factors: 130.21 (1) an education factor, which is determined by the total 130.22 number of eligible trainees and the total statewide average 130.23 costs per trainee, by type of trainee, in each program; and 130.24 (2) a public program volume factor, which is determined by 130.25 the total volume of public program revenue received by each 130.26 training site as a percentage of all public program revenue 130.27 received by all training sites in the trust fund pool. 130.28 In this formula, the education factor shall be weighted at 130.29 50 percent and the public program volume factor shall be 130.30 weighted at 50 percent. 130.31 (b) Public program revenue for the formula in paragraph (a) 130.32 shall include revenue from medical assistance, prepaid medical 130.33 assistance, general assistance medical care, and prepaid general 130.34 assistance medical care. 130.35 (c) Training sites that receive no public program revenue 130.36 shall be ineligible for payments from the prepaid medical 131.1 assistance program transfer pool. 131.2 Sec. 4. Minnesota Statutes 1996, section 245.462, 131.3 subdivision 4, is amended to read: 131.4 Subd. 4. [CASE MANAGER.] "Case manager" means an 131.5 individual employed by the county or other entity authorized by 131.6 the county board to provide case management services specified 131.7 in section 245.4711. A case manager musthave a bachelor's131.8degree in one of the behavioral sciences or related fields from131.9an accredited college or university and have at least 2,000131.10hours of supervised experience in the delivery of services to131.11adults with mental illness, mustbe skilled in the process of 131.12 identifying and assessing a wide range of client needs,andmust 131.13 be knowledgeable about local community resources and how to use 131.14 those resources for the benefit of the client, and must meet the 131.15 qualifications for mental health practitioners in subdivision 131.16 17. The case manager shall meet in person with a mental health 131.17 professional at least once each month to obtain clinical 131.18 supervision of the case manager's activities. Case managers 131.19 with a bachelor's degree but without 2,000 hours of supervised 131.20 experience in the delivery of services to adults with mental 131.21 illness must complete 40 hours of training approved by the 131.22 commissioner of human services in case management skills and in 131.23 the characteristics and needs of adults with serious and 131.24 persistent mental illness and must receive clinical supervision 131.25 regarding individual service delivery from a mental health 131.26 professional at least once each week until the requirement of 131.27 2,000 hours of supervised experience is met. Case managers 131.28 without a bachelor's degree but with 6,000 hours of supervised 131.29 experience in the delivery of services to adults with mental 131.30 illness must complete 40 hours of training approved by the 131.31 commissioner of human services in case management skills and in 131.32 the characteristics and needs of adults with serious and 131.33 persistent mental illness. Clinical supervision must be 131.34 documented in the client record. 131.35 Until June 30, 1999,a refugeean immigrant who does not 131.36 have the qualifications specified in this subdivision may 132.1 provide case management services to adultrefugeesimmigrants 132.2 with serious and persistent mental illness who are members of 132.3 the same ethnic group as the case manager if the person: (1) is 132.4 actively pursuing credits toward the completion of a bachelor's 132.5 degree in one of the behavioral sciences or a related field from 132.6 an accredited college or university; (2) completes 40 hours of 132.7 training as specified in this subdivision; and (3) receives 132.8 clinical supervision at least once a week until the requirements 132.9 ofobtaining a bachelor's degree and 2,000 hours of supervised132.10experiencethis subdivision are met. 132.11 Sec. 5. Minnesota Statutes 1996, section 245.462, 132.12 subdivision 8, is amended to read: 132.13 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 132.14 treatment services," or "day treatment program" means a 132.15 structured program of treatment and care provided to an adult in 132.16 or by: (1) a hospital accredited by the joint commission on 132.17 accreditation of health organizations and licensed under 132.18 sections 144.50 to 144.55; (2) a community mental health center 132.19 under section 245.62; or (3) an entity that is under contract 132.20 with the county board to operate a program that meets the 132.21 requirements of section 245.4712, subdivision 2, and Minnesota 132.22 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 132.23 group psychotherapy and other intensive therapeutic services 132.24 that are provided at least one day a weekfor a minimum132.25three-hour time blockby a multidisciplinary staff under the 132.26 clinical supervision of a mental health professional. The 132.27 services are aimed at stabilizing the adult's mental health 132.28 status, providing mental health services, and developing and 132.29 improving the adult's independent living and socialization 132.30 skills. The goal of day treatment is to reduce or relieve 132.31 mental illness and to enable the adult to live in the 132.32 community. Day treatment services are not a part of inpatient 132.33 or residential treatment services. Day treatment services are 132.34 distinguished from day care by their structured therapeutic 132.35 program of psychotherapy services. The commissioner may limit 132.36 medical assistance reimbursement for day treatment to 15 hours 133.1 per week per person instead of the three hours per day per 133.2 person specified in Minnesota Rules, part 9505.0323, subpart 15. 133.3 Sec. 6. Minnesota Statutes 1996, section 245.4871, 133.4 subdivision 4, is amended to read: 133.5 Subd. 4. [CASE MANAGER.] (a) "Case manager" means an 133.6 individual employed by the county or other entity authorized by 133.7 the county board to provide case management services specified 133.8 in subdivision 3 for the child with severe emotional disturbance 133.9 and the child's family. A case manager must have experience and 133.10 training in working with children. 133.11 (b) A case manager must meet the qualifications for a 133.12 mental health practitioner in subdivision 26: 133.13 (1)have at least a bachelor's degree in one of the133.14behavioral sciences or a related field from an accredited133.15college or university;133.16(2) have at least 2,000 hours of supervised experience in133.17the delivery of mental health services to children;133.18(3)have experience and training in identifying and 133.19 assessing a wide range of children's needs; and 133.20(4)(2) be knowledgeable about local community resources 133.21 and how to use those resources for the benefit of children and 133.22 their families. 133.23 (c) The case manager may be a member of any professional 133.24 discipline that is part of the local system of care for children 133.25 established by the county board. 133.26 (d) The case manager must meet in person with a mental 133.27 health professional at least once each month to obtain clinical 133.28 supervision. 133.29 (e) Case managers with a bachelor's degree but without 133.30 2,000 hours of supervised experience in the delivery of mental 133.31 health services to children with emotional disturbance must: 133.32 (1) begin 40 hours of training approved by the commissioner 133.33 of human services in case management skills and in the 133.34 characteristics and needs of children with severe emotional 133.35 disturbance before beginning to provide case management 133.36 services; and 134.1 (2) receive clinical supervision regarding individual 134.2 service delivery from a mental health professional at least once 134.3 each week until the requirement of 2,000 hours of experience is 134.4 met. 134.5 (f) Clinical supervision must be documented in the child's 134.6 record. When the case manager is not a mental health 134.7 professional, the county board must provide or contract for 134.8 needed clinical supervision. 134.9 (g) The county board must ensure that the case manager has 134.10 the freedom to access and coordinate the services within the 134.11 local system of care that are needed by the child. 134.12 (h) Until June 30, 1999,a refugeean immigrant who does 134.13 not have the qualifications specified in this subdivision may 134.14 provide case management services to childrefugeesimmigrants 134.15 with severe emotional disturbance of the same ethnic group as 134.16 therefugeeimmigrant if the person: 134.17 (1) is actively pursuing credits toward the completion of a 134.18 bachelor's degree in one of the behavioral sciences or related 134.19 fields at an accredited college or university; 134.20 (2) completes 40 hours of training as specified in this 134.21 subdivision; and 134.22 (3) receives clinical supervision at least once a week 134.23 until the requirements ofobtaining a bachelor's degree and134.242,000 hours of supervised experiencethis subdivision are met. 134.25 (i) Case managers without a bachelor's degree but with 134.26 6,000 hours of supervised experience in the delivery of mental 134.27 health services to children with emotional disturbance must 134.28 begin 40 hours of training approved by the commissioner of human 134.29 services in case management skills and in the characteristics 134.30 and needs of children with severe emotional disturbance before 134.31 beginning to provide case management services. 134.32 Sec. 7. [256.9364] [POST-KIDNEY TRANSPLANT DRUG PROGRAM.] 134.33 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 134.34 services shall establish and administer a program to pay for 134.35 costs of drugs prescribed exclusively for post-kidney transplant 134.36 maintenance when those costs are not otherwise reimbursed by a 135.1 third-party payer. The commissioner may contract with a 135.2 nonprofit entity to administer this program. 135.3 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 135.4 the program, an applicant must satisfy the following 135.5 requirements: 135.6 (1) the applicant's family gross income must not exceed 275 135.7 percent of the federal poverty level; and 135.8 (2) the applicant must be a Minnesota resident who has 135.9 resided in Minnesota for at least 12 months. 135.10 An applicant shall not be excluded because the applicant 135.11 received the transplant outside the state of Minnesota, so long 135.12 as the other requirements are met. 135.13 Subd. 3. [PAYMENT AMOUNTS.] (a) The amount of the payments 135.14 made for each eligible recipient shall be based on the following: 135.15 (1) available funds; and 135.16 (2) the cost of the post-kidney transplant maintenance 135.17 drugs. 135.18 (b) The payment rate under this program must be no greater 135.19 than the medical assistance reimbursement rate for the 135.20 prescribed drug. 135.21 (c) Payments shall be made to or on behalf of an eligible 135.22 recipient for the cost of the post-kidney transplant maintenance 135.23 drugs that is not covered, reimbursed, or eligible for 135.24 reimbursement by any other third party or government entity, 135.25 including, but not limited to, private or group health 135.26 insurance, medical assistance, Medicare, the Veterans 135.27 Administration, the senior citizen drug program established 135.28 under section 256.955, or under any waiver arrangement received 135.29 by the state to provide a prescription drug benefit for 135.30 qualified Medicare beneficiaries or service-limited Medicare 135.31 beneficiaries. 135.32 (d) The commissioner may restrict or categorize payments to 135.33 meet the appropriation allocated for this program. 135.34 (e) Any cost of the post-kidney transplant maintenance 135.35 drugs that is not reimbursed under this program is the 135.36 responsibility of the program recipient. 136.1 Subd. 4. [DRUG FORMULARY.] The commissioner shall maintain 136.2 a drug formulary that includes all drugs eligible for 136.3 reimbursement by the program. The commissioner may use the drug 136.4 formulary established under section 256B.0625, subdivision 13. 136.5 The commissioner shall establish an internal review procedure 136.6 for updating the formulary that allows for the addition and 136.7 deletion of drugs to the formulary. The drug formulary must be 136.8 reviewed at least quarterly per fiscal year. 136.9 Subd. 5. [PRIVATE DONATIONS.] The commissioner may accept 136.10 funding from other public or private sources. 136.11 Subd. 6. [SUNSET.] This program expires on July 1, 2000. 136.12 Sec. 8. Minnesota Statutes 1997 Supplement, section 136.13 256.9657, subdivision 3, is amended to read: 136.14 Subd. 3. [HEALTH MAINTENANCE ORGANIZATION; COMMUNITY 136.15 INTEGRATED SERVICE NETWORK SURCHARGE.] (a) Effective October 1, 136.16 1992, each health maintenance organization with a certificate of 136.17 authority issued by the commissioner of health under chapter 62D 136.18 and each community integrated service network licensed by the 136.19 commissioner under chapter 62N shall pay to the commissioner of 136.20 human services a surcharge equal to six-tenths of one percent of 136.21 the total premium revenues of the health maintenance 136.22 organization or community integrated service network as reported 136.23 to the commissioner of health according to the schedule in 136.24 subdivision 4. 136.25 (b) For purposes of this subdivision, total premium revenue 136.26 means: 136.27 (1) premium revenue recognized on a prepaid basis from 136.28 individuals and groups for provision of a specified range of 136.29 health services over a defined period of time which is normally 136.30 one month, excluding premiums paid to a health maintenance 136.31 organization or community integrated service network from the 136.32 Federal Employees Health Benefit Program; 136.33 (2) premiums from Medicare wrap-around subscribers for 136.34 health benefits which supplement Medicare coverage; 136.35 (3) Medicare revenue, as a result of an arrangement between 136.36 a health maintenance organization or a community integrated 137.1 service network and the health care financing administration of 137.2 the federal Department of Health and Human Services, for 137.3 services to a Medicare beneficiary, excluding Medicare revenue 137.4 that states are prohibited from taxing under sections 4001 and 137.5 4002 of Public Law Number 105-33 received by a health 137.6 maintenance organization or community integrated service network 137.7 through risk sharing or Medicare Choice + contracts; and 137.8 (4) medical assistance revenue, as a result of an 137.9 arrangement between a health maintenance organization or 137.10 community integrated service network and a Medicaid state 137.11 agency, for services to a medical assistance beneficiary. 137.12 If advance payments are made under clause (1) or (2) to the 137.13 health maintenance organization or community integrated service 137.14 network for more than one reporting period, the portion of the 137.15 payment that has not yet been earned must be treated as a 137.16 liability. 137.17 (c) When a health maintenance organization or community 137.18 integrated service network merges or consolidates with or is 137.19 acquired by another health maintenance organization or community 137.20 integrated service network, the surviving corporation or the new 137.21 corporation shall be responsible for the annual surcharge 137.22 originally imposed on each of the entities or corporations 137.23 subject to the merger, consolidation, or acquisition, regardless 137.24 of whether one of the entities or corporations does not retain a 137.25 certificate of authority under chapter 62D or a license under 137.26 chapter 62N. 137.27 (d) Effective July 1 of each year, the surviving 137.28 corporation's or the new corporation's surcharge shall be based 137.29 on the revenues earned in the second previous calendar year by 137.30 all of the entities or corporations subject to the merger, 137.31 consolidation, or acquisition regardless of whether one of the 137.32 entities or corporations does not retain a certificate of 137.33 authority under chapter 62D or a license under chapter 62N until 137.34 the total premium revenues of the surviving corporation include 137.35 the total premium revenues of all the merged entities as 137.36 reported to the commissioner of health. 138.1 (e) When a health maintenance organization or community 138.2 integrated service network, which is subject to liability for 138.3 the surcharge under this chapter, transfers, assigns, sells, 138.4 leases, or disposes of all or substantially all of its property 138.5 or assets, liability for the surcharge imposed by this chapter 138.6 is imposed on the transferee, assignee, or buyer of the health 138.7 maintenance organization or community integrated service network. 138.8 (f) In the event a health maintenance organization or 138.9 community integrated service network converts its licensure to a 138.10 different type of entity subject to liability for the surcharge 138.11 under this chapter, but survives in the same or substantially 138.12 similar form, the surviving entity remains liable for the 138.13 surcharge regardless of whether one of the entities or 138.14 corporations does not retain a certificate of authority under 138.15 chapter 62D or a license under chapter 62N. 138.16 (g) The surcharge assessed to a health maintenance 138.17 organization or community integrated service network ends when 138.18 the entity ceases providing services for premiums and the 138.19 cessation is not connected with a merger, consolidation, 138.20 acquisition, or conversion. 138.21 Sec. 9. Minnesota Statutes 1997 Supplement, section 138.22 256.9685, subdivision 1, is amended to read: 138.23 Subdivision 1. [AUTHORITY.] The commissioner shall 138.24 establish procedures for determining medical assistance and 138.25 general assistance medical care payment rates under a 138.26 prospective payment system for inpatient hospital services in 138.27 hospitals that qualify as vendors of medical assistance. The 138.28 commissioner shall establish, by rule, procedures for 138.29 implementing this section and sections 256.9686, 256.969, and 138.30 256.9695.The medical assistance payment rates must be based on138.31methods and standards that the commissioner finds are adequate138.32to provide for the costs that must be incurred for the care of138.33recipients in efficiently and economically operated hospitals.138.34 Services must meet the requirements of section 256B.04, 138.35 subdivision 15, or 256D.03, subdivision 7, paragraph (b), to be 138.36 eligible for payment. 139.1 Sec. 10. Minnesota Statutes 1996, section 256.969, is 139.2 amended by adding a subdivision to read: 139.3 Subd. 9c. [COUNTY BILLING.] Hospitals that have a 139.4 disproportionate population adjustment greater than eight 139.5 percent shall be eligible for a special payment for 139.6 uncompensated care. These hospitals may bill a county of 139.7 residence for services provided to a resident of that county 139.8 provided: 139.9 (1) the patient is from a county other than that in which 139.10 the hospital resides; and 139.11 (2) the hospital has made a preliminary determination at 139.12 the delivery of service that the patient was indigent based on 139.13 current medical assistance guidelines. 139.14 Counties that are billed under this program must pay 139.15 eligible hospitals at the rates established under the medical 139.16 assistance program. If the county can establish eligibility for 139.17 medical assistance after the service has been delivered, the 139.18 state shall reimburse the county for any funds paid to the 139.19 eligible hospital. 139.20 Sec. 11. Minnesota Statutes 1996, section 256.969, 139.21 subdivision 16, is amended to read: 139.22 Subd. 16. [INDIAN HEALTH SERVICE FACILITIES.]Indian139.23health serviceFacilities of the Indian health service and 139.24 facilities operated by a tribe or tribal organization under 139.25 funding authorized by title III of the Indian Self-Determination 139.26 and Education Assistance Act, Public Law Number 93-638, or by 139.27 United States Code, title 25, chapter 14, subchapter II, 139.28 sections 450f to 450n, are exempt from the rate establishment 139.29 methods required by this section and shall bereimbursed at139.30charges as limited to the amount allowed under federal lawpaid 139.31 according to the rate published by the United States assistant 139.32 secretary for health under authority of United States Code, 139.33 title 42, sections 248A and 248B. 139.34 Sec. 12. Minnesota Statutes 1996, section 256.969, 139.35 subdivision 17, is amended to read: 139.36 Subd. 17. [OUT-OF-STATE HOSPITALS IN LOCAL TRADE AREAS.] 140.1 Out-of-state hospitals that are located within a Minnesota local 140.2 trade area and that have more than 20 admissions in the base 140.3 year shall have rates established using the same procedures and 140.4 methods that apply to Minnesota hospitals. For this subdivision 140.5 and subdivision 18, local trade area means a county contiguous 140.6 to Minnesota and located in a metropolitan statistical area as 140.7 determined by Medicare for October 1 prior to the most current 140.8 rebased rate year. Hospitals that are not required by law to 140.9 file information in a format necessary to establish rates shall 140.10 have rates established based on the commissioner's estimates of 140.11 the information. Relative values of the diagnostic categories 140.12 shall not be redetermined under this subdivision until required 140.13 by rule. Hospitals affected by this subdivision shall then be 140.14 included in determining relative values. However, hospitals 140.15 that have rates established based upon the commissioner's 140.16 estimates of information shall not be included in determining 140.17 relative values. This subdivision is effective for hospital 140.18 fiscal years beginning on or after July 1, 1988. A hospital 140.19 shall provide the information necessary to establish rates under 140.20 this subdivision at least 90 days before the start of the 140.21 hospital's fiscal year. 140.22 Sec. 13. Minnesota Statutes 1996, section 256B.03, 140.23 subdivision 3, is amended to read: 140.24 Subd. 3. [AMERICAN INDIAN HEALTH FUNDING.] (a) 140.25 Notwithstanding subdivision 1 and sections 256B.0625 and 140.26 256D.03, subdivision 4, paragraph(f)(i), the commissioner may 140.27 make payments to federally recognized Indian tribes with a 140.28 reservation in the state to provide medical assistance and 140.29 general assistance medical care to Indians, as defined under 140.30 federal law, who reside on or near the reservation. The 140.31 payments may be made in the form of a block grant or other 140.32 payment mechanism determined in consultation with the tribe. 140.33 Any alternative payment mechanism agreed upon by the tribes and 140.34 the commissioner under this subdivision is not dependent upon 140.35 county agreement but is intended to create a direct payment 140.36 mechanism between the state and the tribe for the administration 141.1 of the medical assistanceprogramand general assistance medical 141.2 care programs, and for covered services. 141.3 (b) A tribe that implements a purchasing model under this 141.4 subdivision shall report to the commissioner at least annually 141.5 on the operation of the model. The commissioner and the tribe 141.6 shall cooperatively determine the data elements, format, and 141.7 timetable for the report. 141.8 (c) For purposes of this subdivision, "Indian tribe" means 141.9 a tribe, band, or nation, or other organized group or community 141.10 of Indians that is recognized as eligible for the special 141.11 programs and services provided by the United States to Indians 141.12 because of their status as Indians and for which a reservation 141.13 exists as is consistent with Public Law Number 100-485, as 141.14 amended. 141.15 (d) Payments under this subdivision may not result in an 141.16 increase in expenditures that would not otherwise occur in the 141.17 medical assistance program under this chapter or the general 141.18 assistance medical care program under chapter 256D. 141.19 Sec. 14. Minnesota Statutes 1996, section 256B.055, is 141.20 amended by adding a subdivision to read: 141.21 Subd. 7a. [SPECIAL CATEGORY FOR DISABLED 141.22 CHILDREN.] Medical assistance may be paid for a person who is 141.23 under age 18 and who meets income and asset eligibility 141.24 requirements of the Supplemental Security Income program if the 141.25 person was receiving Supplemental Security Income payments on 141.26 the date of enactment of section 211(a) of Public Law Number 141.27 104-193, the Personal Responsibility and Work Opportunity Act of 141.28 1996, and the person would have continued to receive the 141.29 payments except for the change in the childhood disability 141.30 criteria in section 211(a) of Public Law Number 104-193. 141.31 Sec. 15. Minnesota Statutes 1996, section 256B.057, 141.32 subdivision 3a, is amended to read: 141.33 Subd. 3a. [ELIGIBILITY FOR PAYMENT OF MEDICARE PART B 141.34 PREMIUMS.] A person who would otherwise be eligible as a 141.35 qualified Medicare beneficiary under subdivision 3, except the 141.36 person's income is in excess of the limit, is eligible for 142.1 medical assistance reimbursement of Medicare Part B premiums if 142.2 the person's income is less than110120 percent of the official 142.3 federal poverty guidelines for the applicable family size.The142.4income limit shall increase to 120 percent of the official142.5federal poverty guidelines for the applicable family size on142.6January 1, 1995.142.7 Sec. 16. Minnesota Statutes 1996, section 256B.057, is 142.8 amended by adding a subdivision to read: 142.9 Subd. 3b. [QUALIFIED INDIVIDUALS.] Beginning July 1, 1998, 142.10 to the extent of the federal allocation to Minnesota, a person, 142.11 who would otherwise be eligible as a qualified Medicare 142.12 beneficiary under subdivision 3, except that the person's income 142.13 is in excess of the limit, is eligible as a qualified individual 142.14 according to the following criteria: 142.15 (1) if the person's income is greater than 120 percent, but 142.16 less than 135 percent of the official federal poverty guidelines 142.17 for the applicable family size, the person is eligible for 142.18 medical assistance reimbursement of Medicare Part B premiums; or 142.19 (2) if the person's income is greater than 135 percent but 142.20 less than 175 percent of the official federal poverty guidelines 142.21 for the applicable family size, the person is eligible for 142.22 medical assistance reimbursement of that portion of the Medicare 142.23 Part B premium attributable to an increase in Part B 142.24 expenditures which resulted from the shift of home care services 142.25 from Medicare Part A to Medicare Part B under section 4732 of 142.26 Public Law Number 105-33, the Balanced Budget Act of 1997. 142.27 The commissioner shall limit enrollment of qualifying 142.28 individuals under this subdivision according to the requirements 142.29 of section 4732 of Public Law Number 105-33. 142.30 Sec. 17. Minnesota Statutes 1997 Supplement, section 142.31 256B.06, subdivision 4, is amended to read: 142.32 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 142.33 medical assistance is limited to citizens of the United States, 142.34 qualified noncitizens as defined in this subdivision, and other 142.35 persons residing lawfully in the United States. 142.36 (b) "Qualified noncitizen" means a person who meets one of 143.1 the following immigration criteria: 143.2 (1) admitted for lawful permanent residence according to 143.3 United States Code, title 8; 143.4 (2) admitted to the United States as a refugee according to 143.5 United States Code, title 8, section 1157; 143.6 (3) granted asylum according to United States Code, title 143.7 8, section 1158; 143.8 (4) granted withholding of deportation according to United 143.9 States Code, title 8, section 1253(h); 143.10 (5) paroled for a period of at least one year according to 143.11 United States Code, title 8, section 1182(d)(5); 143.12 (6) granted conditional entrant status according to United 143.13 States Code, title 8, section 1153(a)(7);or143.14 (7) determined to be a battered noncitizen by the United 143.15 States Attorney General according to the Illegal Immigration 143.16 Reform and Immigrant Responsibility Act of 1996, title V of the 143.17 Omnibus Consolidated Appropriations Bill, Public Law Number 143.18 104-200; 143.19 (8) is a child of a noncitizen determined to be a battered 143.20 noncitizen by the United States Attorney General according to 143.21 the Illegal Immigration Reform and Immigrant Responsibility Act 143.22 of 1996, title V of the Omnibus Consolidated Appropriations 143.23 Bill, Public Law Number 104-200; or 143.24 (9) determined to be a Cuban or Haitian entrant as defined 143.25 in section 501(e) of Public Law Number 96-422, the Refugee 143.26 Education Assistance Act of 1980. 143.27 (c) All qualified noncitizens who were residing in the 143.28 United States before August 22, 1996, who otherwise meet the 143.29 eligibility requirements of chapter 256B, are eligible for 143.30 medical assistance with federal financial participation. 143.31 (d) All qualified noncitizens who entered the United States 143.32 on or after August 22, 1996, and who otherwise meet the 143.33 eligibility requirements of chapter 256B, are eligible for 143.34 medical assistance with federal financial participation through 143.35 November 30, 1996. 143.36 Beginning December 1, 1996, qualified noncitizens who 144.1 entered the United States on or after August 22, 1996, and who 144.2 otherwise meet the eligibility requirements of chapter 256B are 144.3 eligible for medical assistance with federal participation for 144.4 five years if they meet one of the following criteria: 144.5 (i) refugees admitted to the United States according to 144.6 United States Code, title 8, section 1157; 144.7 (ii) persons granted asylum according to United States 144.8 Code, title 8, section 1158; 144.9 (iii) persons granted withholding of deportation according 144.10 to United States Code, title 8, section 1253(h); 144.11 (iv) veterans of the United States Armed Forces with an 144.12 honorable discharge for a reason other than noncitizen status, 144.13 their spouses and unmarried minor dependent children; or 144.14 (v) persons on active duty in the United States Armed 144.15 Forces, other than for training, their spouses and unmarried 144.16 minor dependent children. 144.17 Beginning December 1, 1996, qualified noncitizens who do 144.18 not meet one of the criteria in items (i) to (v) are eligible 144.19 for medical assistance without federal financial participation 144.20 as described in paragraph (j). 144.21 (e) Noncitizens who are not qualified noncitizens as 144.22 defined in paragraph (b), who are lawfully residing in the 144.23 United States and who otherwise meet the eligibility 144.24 requirements of chapter 256B, are eligible for medical 144.25 assistance under clauses (1) to (3). These individuals must 144.26 cooperate with the Immigration and Naturalization Service to 144.27 pursue any applicable immigration status, including citizenship, 144.28 that would qualify them for medical assistance with federal 144.29 financial participation. 144.30 (1) Persons who were medical assistance recipients on 144.31 August 22, 1996, are eligible for medical assistance with 144.32 federal financial participation through December 31, 1996. 144.33 (2) Beginning January 1, 1997, persons described in clause 144.34 (1) are eligible for medical assistance without federal 144.35 financial participation as described in paragraph (j). 144.36 (3) Beginning December 1, 1996, persons residing in the 145.1 United States prior to August 22, 1996, who were not receiving 145.2 medical assistance and persons who arrived on or after August 145.3 22, 1996, are eligible for medical assistance without federal 145.4 financial participation as described in paragraph (j). 145.5 (f) Nonimmigrants who otherwise meet the eligibility 145.6 requirements of chapter 256B are eligible for the benefits as 145.7 provided in paragraphs (g) to (i). For purposes of this 145.8 subdivision, a "nonimmigrant" is a person in one of the classes 145.9 listed in United States Code, title 8, section 1101(a)(15). 145.10 (g) Payment shall also be made for care and services that 145.11 are furnished to noncitizens, regardless of immigration status, 145.12 who otherwise meet the eligibility requirements of chapter 256B, 145.13 if such care and services are necessary for the treatment of an 145.14 emergency medical condition, except for organ transplants and 145.15 related care and services and routine prenatal care. 145.16 (h) For purposes of this subdivision, the term "emergency 145.17 medical condition" means a medical condition that meets the 145.18 requirements of United States Code, title 42, section 1396b(v). 145.19 (i) Pregnant noncitizens who are undocumented or 145.20 nonimmigrants, who otherwise meet the eligibility requirements 145.21 of chapter 256B, are eligible for medical assistance payment 145.22 without federal financial participation for care and services 145.23 through the period of pregnancy, and 60 days postpartum, except 145.24 for labor and delivery. 145.25 (j) Qualified noncitizens as described in paragraph (d), 145.26 and all other noncitizens lawfully residing in the United States 145.27 as described in paragraph (e), who are ineligible for medical 145.28 assistance with federal financial participation and who 145.29 otherwise meet the eligibility requirements of chapter 256B and 145.30 of this paragraph, are eligible for medical assistance without 145.31 federal financial participation. Qualified noncitizens as 145.32 described in paragraph (d) are only eligible for medical 145.33 assistance without federal financial participation for five 145.34 years from their date of entry into the United States. 145.35 (k) The commissioner shall submit to the legislature by 145.36 December 31, 1998, a report on the number of recipients and cost 146.1 of coverage of care and services made according to paragraphs 146.2 (i) and (j). 146.3 Sec. 18. Minnesota Statutes 1996, section 256B.0625, is 146.4 amended by adding a subdivision to read: 146.5 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 146.6 services rendered on or after July 1, 1999, medical assistance 146.7 payments for ambulance services shall be increased by ten 146.8 percent. 146.9 Sec. 19. Minnesota Statutes 1996, section 256B.0625, 146.10 subdivision 20, is amended to read: 146.11 Subd. 20. [MENTALILLNESSHEALTH CASE MANAGEMENT.] (a) To 146.12 the extent authorized by rule of the state agency, medical 146.13 assistance covers case management services to persons with 146.14 serious and persistent mental illnessor subject to federal146.15approval,and children with severe emotional disturbance. 146.16 Services provided under this section must meet the relevant 146.17 standards in sections 245.461 to 245.4888, the Comprehensive 146.18 Adult and Children's Mental Health Acts, Minnesota Rules, parts 146.19 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10. 146.20 (b) Entities meeting program standards set out in rules 146.21 governing family community support services as defined in 146.22 section 245.4871, subdivision 17, are eligible for medical 146.23 assistance reimbursement for case management services for 146.24 children with severe emotional disturbance when these services 146.25 meet the program standards in Minnesota Rules, parts 9520.0900 146.26 to 9520.0926 and 9505.0322, excludingsubpart 6subparts 6 and 146.27 10. 146.28(b) In counties where fewer than 50 percent of children146.29estimated to be eligible under medical assistance to receive146.30case management services for children with severe emotional146.31disturbance actually receive these services in state fiscal year146.321995, community mental health centers serving those counties,146.33entities meeting program standards in Minnesota Rules, parts146.349520.0570 to 9520.0870, and other entities authorized by the146.35commissioner are eligible for medical assistance reimbursement146.36for case management services for children with severe emotional147.1disturbance when these services meet the program standards in147.2Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322,147.3excluding subpart 6.147.4 (c) Medical assistance and MinnesotaCare payment for mental 147.5 health case management shall be made on a monthly basis. In 147.6 order to receive payment for an eligible child, the provider 147.7 must document at least a face-to-face contact with the child, 147.8 the child's parents, or the child's legal representative. To 147.9 receive payment for an eligible adult, the provider must 147.10 document at least a face-to-face contact with the adult or the 147.11 adult's legal representative. 147.12 (d) Payment for mental health case management provided by 147.13 county or state staff shall be based on the monthly rate 147.14 methodology under section 256B.094, subdivision 6, paragraph 147.15 (b), with separate rates calculated for child welfare and mental 147.16 health, and within mental health, separate rates for children 147.17 and adults. 147.18 (e) Payment for mental health case management provided by 147.19 county-contracted vendors shall be based on a monthly rate 147.20 negotiated by the host county. The negotiated rate must not 147.21 exceed the rate charged by the vendor for the same service to 147.22 other payers. If the service is provided by a team of contracted 147.23 vendors, the county may negotiate a team rate with a vendor who 147.24 is a member of the team. The team shall determine how to 147.25 distribute the rate among its members. No reimbursement 147.26 received by contracted vendors shall be returned to the county, 147.27 except to reimburse the county for advance funding provided by 147.28 the county to the vendor. 147.29 (f) If the service is provided by a team which includes 147.30 contracted vendors and county or state staff, the costs for 147.31 county or state staff participation in the team shall be 147.32 included in the rate for county-provided services. In this 147.33 case, the contracted vendor and the county may each receive 147.34 separate payment for services provided by each entity in the 147.35 same month. In order to prevent duplication of services, the 147.36 county must document, in the recipient's file, the need for team 148.1 case management and a description of the roles of the team 148.2 members. 148.3 (g) The commissioner shall calculate the nonfederal share 148.4 of actual medical assistance and general assistance medical care 148.5 payments for each county, based on the higher of calendar year 148.6 1995 or 1996 by service date, trend that amount forward to 1999, 148.7 and transfer the result from medical assistance and general 148.8 assistance medical care to each county's mental health grants 148.9 under sections 245.4886 and 256E.12 for calendar year 1999. The 148.10 minimum amount added to each county's mental health grant shall 148.11 be $3,000 per year for children and $5,000 per year for adults. 148.12 The commissioner may reduce the statewide growth factor in order 148.13 to fund these minimums. The total amount transferred shall 148.14 become part of the base for future mental health grants for each 148.15 county. 148.16 (h) Any net increase in revenue to the county as a result 148.17 of the change in this section must be used to provide expanded 148.18 mental health services as defined in sections 245.461 to 148.19 245.4888, the Comprehensive Adult and Children's Mental Health 148.20 Acts, excluding inpatient and residential treatment. For 148.21 adults, increased revenue may also be used for services and 148.22 consumer supports which are part of adult mental health projects 148.23 approved under Laws 1997, chapter 203, article 7, section 25. 148.24 For children, increased revenue may also be used for respite 148.25 care and nonresidential individualized rehabilitation services 148.26 as defined in section 245.492, subdivisions 17 and 23. 148.27 "Increased revenue" has the meaning given in Minnesota Rules, 148.28 part 9520.0903, subpart 3. 148.29 (i) Notwithstanding section 256B.19, subdivision 1, the 148.30 nonfederal share of costs for mental health case management 148.31 shall be provided by the recipient's county of responsibility, 148.32 as defined in sections 256G.01 to 256G.12, from sources other 148.33 than federal funds or funds used to match other federal funds. 148.34 (j) The commissioner may suspend, reduce, or terminate the 148.35 reimbursement to a provider that does not meet the reporting or 148.36 other requirements of this section. The county of 149.1 responsibility, as defined in sections 256G.01 to 256G.12, is 149.2 responsible for any federal disallowances. The county may share 149.3 this responsibility with its contracted vendors. 149.4 (k) The commissioner shall set aside a portion of the 149.5 federal funds earned under this section to repay the special 149.6 revenue maximization account under section 256.01, subdivision 149.7 2, clause (15). The repayment is limited to: 149.8 (1) the costs of developing and implementing this section; 149.9 and 149.10 (2) programming the information systems. 149.11 (l) Notwithstanding section 256.025, subdivision 2, 149.12 payments to counties for case management expenditures under this 149.13 section shall only be made from federal earnings from services 149.14 provided under this section. Payments to contracted vendors 149.15 shall include both the federal earnings and the county share. 149.16 (m) Notwithstanding section 256B.041, county payments for 149.17 the cost of mental health case management services provided by 149.18 county or state staff shall not be made to the state treasurer. 149.19 For the purposes of mental health case management services 149.20 provided by county or state staff under this section, the 149.21 centralized disbursement of payments to counties under section 149.22 256B.041 consists only of federal earnings from services 149.23 provided under this section. 149.24 (n) Case management services under this subdivision do not 149.25 include therapy, treatment, legal, or outreach services. 149.26 (o) If the recipient is a resident of a nursing facility, 149.27 intermediate care facility, or hospital, and the recipient's 149.28 institutional care is paid by medical assistance, payment for 149.29 case management services under this subdivision is limited to 149.30 the last 30 days of the recipient's residency in that facility 149.31 and may not exceed more than two months in a calendar year. 149.32 (p) Payment for case management services under this 149.33 subdivision shall not duplicate payments made under other 149.34 program authorities for the same purpose. 149.35 (q) By July 1, 2000, the commissioner shall evaluate the 149.36 effectiveness of the changes required by this section, including 150.1 changes in number of persons receiving mental health case 150.2 management, changes in hours of service per person, and changes 150.3 in caseload size. 150.4 Sec. 20. Minnesota Statutes 1997 Supplement, section 150.5 256B.0625, subdivision 31a, is amended to read: 150.6 Subd. 31a. [AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 150.7 SYSTEMS.] (a) Medical assistance covers augmentative and 150.8 alternative communication systems consisting of electronic or 150.9 nonelectronic devices and the related components necessary to 150.10 enable a person with severe expressive communication limitations 150.11 to produce or transmit messages or symbols in a manner that 150.12 compensates for that disability. 150.13 (b)By January 1, 1998, the commissioner, in cooperation150.14with the commissioner of administration, shall establish an150.15augmentative and alternative communication system purchasing150.16program within a state agency or by contract with a qualified150.17private entity. The purpose of this service is to facilitate150.18ready availability of the augmentative and alternative150.19communication systems needed to meet the needs of persons with150.20severe expressive communication limitations in an efficient and150.21cost-effective manner. This program shall:150.22(1) coordinate purchase and rental of augmentative and150.23alternative communication systems;150.24(2) negotiate agreements with manufacturers and vendors for150.25purchase of components of these systems, for warranty coverage,150.26and for repair service;150.27(3) when efficient and cost-effective, maintain and150.28refurbish if needed, an inventory of components of augmentative150.29and alternative communication systems for short- or long-term150.30loan to recipients;150.31(4) facilitate training sessions for service providers,150.32consumers, and families on augmentative and alternative150.33communication systems; and150.34(5) develop a recycling program for used augmentative and150.35alternative communications systems to be reissued and used for150.36trials and short-term use, when appropriate.151.1The availability of components of augmentative and151.2alternative communication systems through this program is151.3subject to prior authorization requirements established under151.4subdivision 25The commissioner shall reimburse augmentative and 151.5 alternative communication manufacturers and vendors at the 151.6 manufacturer's suggested retail price for augmentative and 151.7 alternative communication systems and related components. The 151.8 commissioner shall separately reimburse providers for purchasing 151.9 and integrating individual communication systems which are 151.10 unavailable as a package from an augmentative and alternative 151.11 communication vendor. 151.12 (c) Reimbursement rates established by this purchasing 151.13 program are not subject to Minnesota Rules, part 9505.0445, item 151.14 S or T. 151.15 Sec. 21. Minnesota Statutes 1996, section 256B.0625, 151.16 subdivision 34, is amended to read: 151.17 Subd. 34. [AMERICAN INDIAN HEALTH SERVICES FACILITIES.] 151.18 Medical assistance payments toAmerican Indian health services151.19facilities for outpatient medical services billed after June 30,151.201990, must befacilities of the Indian health service and 151.21 facilities operated by a tribe or tribal organization under 151.22 funding authorized by United States Code, title 25, sections 151.23 450f to 450n, or title III of the Indian Self-Determination and 151.24 Education Assistance Act, Public Law Number 93-638, shall be at 151.25 the option of the facility in accordance with the rate published 151.26 by the United States Assistant Secretary for Health under the 151.27 authority of United States Code, title 42, sections 248(a) and 151.28 249(b). General assistance medical care payments to facilities 151.29 of the American Indian health services and facilities operated 151.30 by a tribe or tribal organization for the provision of 151.31 outpatient medical care services billed after June 30, 1990, 151.32 must be in accordance with the general assistance medical care 151.33 rates paid for the same services when provided in a facility 151.34 other thanan Americana facility of the Indian health 151.35 service or a facility operated by a tribe or tribal organization. 151.36 Sec. 22. Minnesota Statutes 1996, section 256B.0625, 152.1 subdivision 38, is amended to read: 152.2 Subd. 38. [PAYMENTS FOR MENTAL HEALTH SERVICES.] Payments 152.3 for mental health services covered under the medical assistance 152.4 program that are provided by masters-prepared mental health 152.5 professionals shall be 80 percent of the rate paid to 152.6 doctoral-prepared professionals. Payments for mental health 152.7 services covered under the medical assistance program that are 152.8 provided by masters-prepared mental health professionals 152.9 employed by community mental health centers shall be 100 percent 152.10 of the rate paid to doctoral-prepared professionals. For 152.11 purposes of reimbursement of mental health professionals under 152.12 the medical assistance program, all social workers who: 152.13 (1) have received a master's degree in social work from a 152.14 program accredited by the council on social work education; 152.15 (2) are licensed at the level of graduate social worker or 152.16 independent social worker; and 152.17 (3) are practicing clinical social work under appropriate 152.18 supervision, as defined by section 148B.18; meet all 152.19 requirements under Minnesota Rules, part 9505.0323, subpart 24, 152.20 and shall be paid accordingly. 152.21 Sec. 23. Minnesota Statutes 1997 Supplement, section 152.22 256B.0627, subdivision 5, is amended to read: 152.23 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 152.24 payments for home care services shall be limited according to 152.25 this subdivision. 152.26 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 152.27 recipient may receive the following home care services during a 152.28 calendar year: 152.29 (1) any initial assessment; 152.30 (2) up to two reassessments per year done to determine a 152.31 recipient's need for personal care services; and 152.32 (3) up to five skilled nurse visits. 152.33 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 152.34 services above the limits in paragraph (a) must receive the 152.35 commissioner's prior authorization, except when: 152.36 (1) the home care services were required to treat an 153.1 emergency medical condition that if not immediately treated 153.2 could cause a recipient serious physical or mental disability, 153.3 continuation of severe pain, or death. The provider must 153.4 request retroactive authorization no later than five working 153.5 days after giving the initial service. The provider must be 153.6 able to substantiate the emergency by documentation such as 153.7 reports, notes, and admission or discharge histories; 153.8 (2) the home care services were provided on or after the 153.9 date on which the recipient's eligibility began, but before the 153.10 date on which the recipient was notified that the case was 153.11 opened. Authorization will be considered if the request is 153.12 submitted by the provider within 20 working days of the date the 153.13 recipient was notified that the case was opened; 153.14 (3) a third-party payor for home care services has denied 153.15 or adjusted a payment. Authorization requests must be submitted 153.16 by the provider within 20 working days of the notice of denial 153.17 or adjustment. A copy of the notice must be included with the 153.18 request; 153.19 (4) the commissioner has determined that a county or state 153.20 human services agency has made an error; or 153.21 (5) the professional nurse determines an immediate need for 153.22 up to 40 skilled nursing or home health aide visits per calendar 153.23 year and submits a request for authorization within 20 working 153.24 days of the initial service date, and medical assistance is 153.25 determined to be the appropriate payer. 153.26 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 153.27 authorization will be evaluated according to the same criteria 153.28 applied to prior authorization requests. 153.29 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 153.30 section 256B.0627, subdivision 1, paragraph (a), shall be 153.31 conducted initially, and at least annually thereafter, in person 153.32 with the recipient and result in a completed service plan using 153.33 forms specified by the commissioner. Within 30 days of 153.34 recipient or responsible party request for home care services, 153.35 the assessment, the service plan, and other information 153.36 necessary to determine medical necessity such as diagnostic or 154.1 testing information, social or medical histories, and hospital 154.2 or facility discharge summaries shall be submitted to the 154.3 commissioner. For personal care services: 154.4 (1) The amount and type of service authorized based upon 154.5 the assessment and service plan will follow the recipient if the 154.6 recipient chooses to change providers. 154.7 (2) If the recipient's medical need changes, the 154.8 recipient's provider may assess the need for a change in service 154.9 authorization and request the change from the county public 154.10 health nurse. Within 30 days of the request, the public health 154.11 nurse will determine whether to request the change in services 154.12 based upon the provider assessment, or conduct a home visit to 154.13 assess the need and determine whether the change is appropriate. 154.14 (3) To continue to receive personal care serviceswhen the154.15recipient displays no significant change, the county public154.16health nurse has the option to review with the commissioner, or154.17the commissioner's designee, the service plan on record and154.18receive authorization for up to an additional 12 months at a154.19time for up to three years.after the first year, the recipient 154.20 or the responsible party, in conjunction with the public health 154.21 nurse, may complete a service update on forms developed by the 154.22 commissioner. The service update may substitute for the annual 154.23 reassessment described in subdivision 1. 154.24 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 154.25 commissioner's designee, shall review the assessment, the 154.26 service plan, and any additional information that is submitted. 154.27 The commissioner shall, within 30 days after receiving a 154.28 complete request, assessment, and service plan, authorize home 154.29 care services as follows: 154.30 (1) [HOME HEALTH SERVICES.] All home health services 154.31 provided by a licensed nurse or a home health aide must be prior 154.32 authorized by the commissioner or the commissioner's designee. 154.33 Prior authorization must be based on medical necessity and 154.34 cost-effectiveness when compared with other care options. When 154.35 home health services are used in combination with personal care 154.36 and private duty nursing, the cost of all home care services 155.1 shall be considered for cost-effectiveness. The commissioner 155.2 shall limit nurse and home health aide visits to no more than 155.3 one visit each per day. 155.4 (2) [PERSONAL CARE SERVICES.] (i) All personal care 155.5 services and registered nurse supervision must be prior 155.6 authorized by the commissioner or the commissioner's designee 155.7 except for the assessments established in paragraph (a). The 155.8 amount of personal care services authorized must be based on the 155.9 recipient's home care rating. A child may not be found to be 155.10 dependent in an activity of daily living if because of the 155.11 child's age an adult would either perform the activity for the 155.12 child or assist the child with the activity and the amount of 155.13 assistance needed is similar to the assistance appropriate for a 155.14 typical child of the same age. Based on medical necessity, the 155.15 commissioner may authorize: 155.16 (A) up to two times the average number of direct care hours 155.17 provided in nursing facilities for the recipient's comparable 155.18 case mix level; or 155.19 (B) up to three times the average number of direct care 155.20 hours provided in nursing facilities for recipients who have 155.21 complex medical needs or are dependent in at least seven 155.22 activities of daily living and need physical assistance with 155.23 eating or have a neurological diagnosis; or 155.24 (C) up to 60 percent of the average reimbursement rate, as 155.25 of July 1, 1991, for care provided in a regional treatment 155.26 center for recipients who have Level I behavior, plus any 155.27 inflation adjustment as provided by the legislature for personal 155.28 care service; or 155.29 (D) up to the amount the commissioner would pay, as of July 155.30 1, 1991, plus any inflation adjustment provided for home care 155.31 services, for care provided in a regional treatment center for 155.32 recipients referred to the commissioner by a regional treatment 155.33 center preadmission evaluation team. For purposes of this 155.34 clause, home care services means all services provided in the 155.35 home or community that would be included in the payment to a 155.36 regional treatment center; or 156.1 (E) up to the amount medical assistance would reimburse for 156.2 facility care for recipients referred to the commissioner by a 156.3 preadmission screening team established under section 256B.0911 156.4 or 256B.092; and 156.5 (F) a reasonable amount of time for the provision of 156.6 nursing supervision of personal care services. 156.7 (ii) The number of direct care hours shall be determined 156.8 according to the annual cost report submitted to the department 156.9 by nursing facilities. The average number of direct care hours, 156.10 as established by May 1, 1992, shall be calculated and 156.11 incorporated into the home care limits on July 1, 1992. These 156.12 limits shall be calculated to the nearest quarter hour. 156.13 (iii) The home care rating shall be determined by the 156.14 commissioner or the commissioner's designee based on information 156.15 submitted to the commissioner by the county public health nurse 156.16 on forms specified by the commissioner. The home care rating 156.17 shall be a combination of current assessment tools developed 156.18 under sections 256B.0911 and 256B.501 with an addition for 156.19 seizure activity that will assess the frequency and severity of 156.20 seizure activity and with adjustments, additions, and 156.21 clarifications that are necessary to reflect the needs and 156.22 conditions of recipients who need home care including children 156.23 and adults under 65 years of age. The commissioner shall 156.24 establish these forms and protocols under this section and shall 156.25 use an advisory group, including representatives of recipients, 156.26 providers, and counties, for consultation in establishing and 156.27 revising the forms and protocols. 156.28 (iv) A recipient shall qualify as having complex medical 156.29 needs if the care required is difficult to perform and because 156.30 of recipient's medical condition requires more time than 156.31 community-based standards allow or requires more skill than 156.32 would ordinarily be required and the recipient needs or has one 156.33 or more of the following: 156.34 (A) daily tube feedings; 156.35 (B) daily parenteral therapy; 156.36 (C) wound or decubiti care; 157.1 (D) postural drainage, percussion, nebulizer treatments, 157.2 suctioning, tracheotomy care, oxygen, mechanical ventilation; 157.3 (E) catheterization; 157.4 (F) ostomy care; 157.5 (G) quadriplegia; or 157.6 (H) other comparable medical conditions or treatments the 157.7 commissioner determines would otherwise require institutional 157.8 care. 157.9 (v) A recipient shall qualify as having Level I behavior if 157.10 there is reasonable supporting evidence that the recipient 157.11 exhibits, or that without supervision, observation, or 157.12 redirection would exhibit, one or more of the following 157.13 behaviors that cause, or have the potential to cause: 157.14 (A) injury to the recipient's own body; 157.15 (B) physical injury to other people; or 157.16 (C) destruction of property. 157.17 (vi) Time authorized for personal care relating to Level I 157.18 behavior in subclause (v), items (A) to (C), shall be based on 157.19 the predictability, frequency, and amount of intervention 157.20 required. 157.21 (vii) A recipient shall qualify as having Level II behavior 157.22 if the recipient exhibits on a daily basis one or more of the 157.23 following behaviors that interfere with the completion of 157.24 personal care services under subdivision 4, paragraph (a): 157.25 (A) unusual or repetitive habits; 157.26 (B) withdrawn behavior; or 157.27 (C) offensive behavior. 157.28 (viii) A recipient with a home care rating of Level II 157.29 behavior in subclause (vii), items (A) to (C), shall be rated as 157.30 comparable to a recipient with complex medical needs under 157.31 subclause (iv). If a recipient has both complex medical needs 157.32 and Level II behavior, the home care rating shall be the next 157.33 complex category up to the maximum rating under subclause (i), 157.34 item (B). 157.35 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 157.36 nursing services shall be prior authorized by the commissioner 158.1 or the commissioner's designee. Prior authorization for private 158.2 duty nursing services shall be based on medical necessity and 158.3 cost-effectiveness when compared with alternative care options. 158.4 The commissioner may authorize medically necessary private duty 158.5 nursing services in quarter-hour units when: 158.6 (i) the recipient requires more individual and continuous 158.7 care than can be provided during a nurse visit; or 158.8 (ii) the cares are outside of the scope of services that 158.9 can be provided by a home health aide or personal care assistant. 158.10 The commissioner may authorize: 158.11 (A) up to two times the average amount of direct care hours 158.12 provided in nursing facilities statewide for case mix 158.13 classification "K" as established by the annual cost report 158.14 submitted to the department by nursing facilities in May 1992; 158.15 (B) private duty nursing in combination with other home 158.16 care services up to the total cost allowed under clause (2); 158.17 (C) up to 16 hours per day if the recipient requires more 158.18 nursing than the maximum number of direct care hours as 158.19 established in item (A) and the recipient meets the hospital 158.20 admission criteria established under Minnesota Rules, parts 158.21 9505.0500 to 9505.0540. 158.22 The commissioner may authorize up to 16 hours per day of 158.23 medically necessary private duty nursing services or up to 24 158.24 hours per day of medically necessary private duty nursing 158.25 services until such time as the commissioner is able to make a 158.26 determination of eligibility for recipients who are 158.27 cooperatively applying for home care services under the 158.28 community alternative care program developed under section 158.29 256B.49, or until it is determined by the appropriate regulatory 158.30 agency that a health benefit plan is or is not required to pay 158.31 for appropriate medically necessary health care services. 158.32 Recipients or their representatives must cooperatively assist 158.33 the commissioner in obtaining this determination. Recipients 158.34 who are eligible for the community alternative care program may 158.35 not receive more hours of nursing under this section than would 158.36 otherwise be authorized under section 256B.49. 159.1 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 159.2 ventilator-dependent, the monthly medical assistance 159.3 authorization for home care services shall not exceed what the 159.4 commissioner would pay for care at the highest cost hospital 159.5 designated as a long-term hospital under the Medicare program. 159.6 For purposes of this clause, home care services means all 159.7 services provided in the home that would be included in the 159.8 payment for care at the long-term hospital. 159.9 "Ventilator-dependent" means an individual who receives 159.10 mechanical ventilation for life support at least six hours per 159.11 day and is expected to be or has been dependent for at least 30 159.12 consecutive days. 159.13 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 159.14 or the commissioner's designee shall determine the time period 159.15 for which a prior authorization shall be effective. If the 159.16 recipient continues to require home care services beyond the 159.17 duration of the prior authorization, the home care provider must 159.18 request a new prior authorization. Under no circumstances, 159.19 other than the exceptions in paragraph (b), shall a prior 159.20 authorization be valid prior to the date the commissioner 159.21 receives the request or for more than 12 months. A recipient 159.22 who appeals a reduction in previously authorized home care 159.23 services may continue previously authorized services, other than 159.24 temporary services under paragraph (h), pending an appeal under 159.25 section 256.045. The commissioner must provide a detailed 159.26 explanation of why the authorized services are reduced in amount 159.27 from those requested by the home care provider. 159.28 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 159.29 the commissioner's designee shall determine the medical 159.30 necessity of home care services, the level of caregiver 159.31 according to subdivision 2, and the institutional comparison 159.32 according to this subdivision, the cost-effectiveness of 159.33 services, and the amount, scope, and duration of home care 159.34 services reimbursable by medical assistance, based on the 159.35 assessment, primary payer coverage determination information as 159.36 required, the service plan, the recipient's age, the cost of 160.1 services, the recipient's medical condition, and diagnosis or 160.2 disability. The commissioner may publish additional criteria 160.3 for determining medical necessity according to section 256B.04. 160.4 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 160.5 The agency nurse, the independently enrolled private duty nurse, 160.6 or county public health nurse may request a temporary 160.7 authorization for home care services by telephone. The 160.8 commissioner may approve a temporary level of home care services 160.9 based on the assessment, and service or care plan information, 160.10 and primary payer coverage determination information as required. 160.11 Authorization for a temporary level of home care services 160.12 including nurse supervision is limited to the time specified by 160.13 the commissioner, but shall not exceed 45 days, unless extended 160.14 because the county public health nurse has not completed the 160.15 required assessment and service plan, or the commissioner's 160.16 determination has not been made. The level of services 160.17 authorized under this provision shall have no bearing on a 160.18 future prior authorization. 160.19 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 160.20 Home care services provided in an adult or child foster care 160.21 setting must receive prior authorization by the department 160.22 according to the limits established in paragraph (a). 160.23 The commissioner may not authorize: 160.24 (1) home care services that are the responsibility of the 160.25 foster care provider under the terms of the foster care 160.26 placement agreement and administrative rules. Requests for home 160.27 care services for recipients residing in a foster care setting 160.28 must include the foster care placement agreement and 160.29 determination of difficulty of care; 160.30 (2) personal care services when the foster care license 160.31 holder is also the personal care provider or personal care 160.32 assistant unless the recipient can direct the recipient's own 160.33 care, or case management is provided as required in section 160.34 256B.0625, subdivision 19a; 160.35 (3) personal care services when the responsible party is an 160.36 employee of, or under contract with, or has any direct or 161.1 indirect financial relationship with the personal care provider 161.2 or personal care assistant, unless case management is provided 161.3 as required in section 256B.0625, subdivision 19a; 161.4 (4) home care services when the number of foster care 161.5 residents is greater than four unless the county responsible for 161.6 the recipient's foster placement made the placement prior to 161.7 April 1, 1992, requests that home care services be provided, and 161.8 case management is provided as required in section 256B.0625, 161.9 subdivision 19a; or 161.10 (5) home care services when combined with foster care 161.11 payments, other than room and board payments that exceed the 161.12 total amount that public funds would pay for the recipient's 161.13 care in a medical institution. 161.14 Sec. 24. Minnesota Statutes 1997 Supplement, section 161.15 256B.0627, subdivision 8, is amended to read: 161.16 Subd. 8. [PERSONAL CARE ASSISTANT SERVICES; SHARED CARE.] 161.17 (a) Medical assistance payments for personal care assistance 161.18 shared care shall be limited according to this subdivision. 161.19 (b) Recipients of personal care assistant services may 161.20 share staff and the commissioner shall provide a rate system for 161.21 shared personal care assistant services. For two persons 161.22 sharing care, the ratesystemshall not exceed 1-1/2 times the 161.23 amount paid forproviding services toone person, andshall161.24increase incrementally by one-half the cost of serving a single161.25person, for each person served. A personal care assistant may161.26not serve more than three children in a single setting.for 161.27 three persons, the rate shall not exceed twice the rate for 161.28 serving a single individual. No more than three persons may 161.29 receive shared care from a personal care assistant in a single 161.30 setting. 161.31 (c) Shared care is the provision of personal care services 161.32 by a personal care assistant to two or three recipients at the 161.33 same time and in the same setting. For the purposes of this 161.34 subdivision, "setting" means: 161.35 (1) the home or foster care home of one of the individual 161.36 recipients; or 162.1 (2) a child care program in which all recipients served by 162.2 one personal care assistant are participating, which is licensed 162.3 under chapter 245A or operated by a local school district or 162.4 private school. 162.5 The provisions of this subdivision do not apply when a 162.6 personal care assistant is caring for multiple recipients in 162.7 more than one setting. 162.8 (d) The recipient or the recipient's responsible party, in 162.9 conjunction with the county public health nurse, shall determine: 162.10 (1) whether shared care is an appropriate option based on 162.11 the individual needs and preferences of the recipient; and 162.12 (2) the amount of shared care allocated as part of the 162.13 overall authorization of personal care services. 162.14 The recipient or the responsible party, in conjunction with 162.15 the supervising registered nurse, shall approve the setting, 162.16 grouping, and arrangement of shared care based on the individual 162.17 needs and preferences of the recipients. Decisions on the 162.18 selection of recipients to share care must be based on the ages 162.19 of the recipients, compatibility, and coordination of their care 162.20 needs. 162.21 (e) The following items must be considered by the recipient 162.22 or the responsible party and the supervising nurse, and 162.23 documented in the recipient's care plan: 162.24 (1) the additional qualifications needed by the personal 162.25 care assistant to provide care to several recipients in the same 162.26 setting; 162.27 (2) the additional training and supervision needed by the 162.28 personal care assistant to ensure that the needs of the 162.29 recipient are met appropriately and safely. The provider must 162.30 provide on-site supervision by a registered nurse within the 162.31 first 14 days of shared care, and monthly thereafter; 162.32 (3) the setting in which the shared care will be provided; 162.33 (4) the ongoing monitoring and evaluation of the 162.34 effectiveness and appropriateness of the service and process 162.35 used to make changes in service or setting; and 162.36 (5) a contingency plan which accounts for absence of the 163.1 recipient in a shared care setting due to illness or other 163.2 circumstances and staffing contingencies. 163.3 (f) The provider must offer the recipient or the 163.4 responsible party the option of shared or individual personal 163.5 care assistant care. The recipient or the responsible party can 163.6 withdraw from participating in a shared care arrangement at any 163.7 time. 163.8 (g) Notwithstanding provisions to the contrary, all other 163.9 statutory and regulatory provisions relating to personal care 163.10 services continue to be in effect. 163.11 Nothing in this subdivision shall be construed to reduce 163.12 the total number of hours authorized for an individual recipient. 163.13 Sec. 25. Minnesota Statutes 1997 Supplement, section 163.14 256B.0645, is amended to read: 163.15 256B.0645 [PROVIDER PAYMENTS; RETROACTIVE CHANGES IN 163.16 ELIGIBILITY.] 163.17 Payment to a provider for a health care service provided to 163.18 a general assistance medical care recipient who is later 163.19 determined eligible for medical assistance or MinnesotaCare 163.20 according to section 256L.14 for the period in which the health 163.21 care service was provided,shall be considered payment in full,163.22and shall notmay be adjusted due to the change in eligibility. 163.23 This sectionappliesdoes not apply toboth fee-for-service163.24payments andpayments made to health plans on a prepaid 163.25 capitated basis. 163.26 Sec. 26. Minnesota Statutes 1997 Supplement, section 163.27 256B.0911, subdivision 2, is amended to read: 163.28 Subd. 2. [PERSONS REQUIRED TO BE SCREENED; EXEMPTIONS.] 163.29 All applicants to Medicaid certified nursing facilities must be 163.30 screened prior to admission, regardless of income, assets, or 163.31 funding sources, except the following: 163.32 (1) patients who, having entered acute care facilities from 163.33 certified nursing facilities, are returning to a certified 163.34 nursing facility; 163.35 (2) residents transferred from other certified nursing 163.36 facilities located within the state of Minnesota; 164.1 (3) individuals who have a contractual right to have their 164.2 nursing facility care paid for indefinitely by the veteran's 164.3 administration; 164.4 (4) individuals who are enrolled in the Ebenezer/Group 164.5 Health social health maintenance organization project, or 164.6 enrolled in a demonstration project under section 256B.69, 164.7 subdivision188, at the time of application to a nursing home; 164.8 (5) individuals previously screened and currently being 164.9 served under the alternative care program or under a home and 164.10 community-based services waiver authorized under section 1915(c) 164.11 of the Social Security Act; or 164.12 (6) individuals who are admitted to a certified nursing 164.13 facility for a short-term stay, which, based upon a physician's 164.14 certification, is expected to be 14 days or less in duration, 164.15 and who have been screened and approved for nursing facility 164.16 admission within the previous six months. This exemption 164.17 applies only if the screener determines at the time of the 164.18 initial screening of the six-month period that it is appropriate 164.19 to use the nursing facility for short-term stays and that there 164.20 is an adequate plan of care for return to the home or 164.21 community-based setting. If a stay exceeds 14 days, the 164.22 individual must be referred no later than the first county 164.23 working day following the 14th resident day for a screening, 164.24 which must be completed within five working days of the 164.25 referral. Payment limitations in subdivision 7 will apply to an 164.26 individual found at screening to not meet the level of care 164.27 criteria for admission to a certified nursing facility. 164.28 Regardless of the exemptions in clauses (2) to (6), persons 164.29 who have a diagnosis or possible diagnosis of mental illness, 164.30 mental retardation, or a related condition must receive a 164.31 preadmission screening before admission unless the admission 164.32 prior to screening is authorized by the local mental health 164.33 authority or the local developmental disabilities case manager, 164.34 or unless authorized by the county agency according to Public 164.35 Law Number 101-508. 164.36 Before admission to a Medicaid certified nursing home or 165.1 boarding care home, all persons must be screened and approved 165.2 for admission through an assessment process. The nursing 165.3 facility is authorized to conduct case mix assessments which are 165.4 not conducted by the county public health nurse under Minnesota 165.5 Rules, part 9549.0059. The designated county agency is 165.6 responsible for distributing the quality assurance and review 165.7 form for all new applicants to nursing homes. 165.8 Other persons who are not applicants to nursing facilities 165.9 must be screened if a request is made for a screening. 165.10 Sec. 27. Minnesota Statutes 1996, section 256B.0911, 165.11 subdivision 4, is amended to read: 165.12 Subd. 4. [RESPONSIBILITIES OF THE COUNTY AND THE SCREENING 165.13 TEAM.] (a) The county shall: 165.14 (1) provide information and education to the general public 165.15 regarding availability of the preadmission screening program; 165.16 (2) accept referrals from individuals, families, human 165.17 service and health professionals, and hospital and nursing 165.18 facility personnel; 165.19 (3) assess the health, psychological, and social needs of 165.20 referred individuals and identify services needed to maintain 165.21 these persons in the least restrictive environments; 165.22 (4) determine if the individual screened needs nursing 165.23 facility level of care; 165.24 (5) assess specialized service needs based upon an 165.25 evaluation by: 165.26 (i) a qualified independent mental health professional for 165.27 persons with a primary or secondary diagnosis of a serious 165.28 mental illness; and 165.29 (ii) a qualified mental retardation professional for 165.30 persons with a primary or secondary diagnosis of mental 165.31 retardation or related conditions. For purposes of this clause, 165.32 a qualified mental retardation professional must meet the 165.33 standards for a qualified mental retardation professional in 165.34 Code of Federal Regulations, title 42, section 483.430; 165.35 (6) make recommendations for individuals screened regarding 165.36 cost-effective community services which are available to the 166.1 individual; 166.2 (7) make recommendations for individuals screened regarding 166.3 nursing home placement when there are no cost-effective 166.4 community services available; 166.5 (8) develop an individual's community care plan and provide 166.6 follow-up services as needed; and 166.7 (9) prepare and submit reports that may be required by the 166.8 commissioner of human services. 166.9 (b) The screener shall document that the most 166.10 cost-effective alternatives available were offered to the 166.11 individual or the individual's legal representative. For 166.12 purposes of this section, "cost-effective alternatives" means 166.13 community services and living arrangements that cost the same or 166.14 less than nursing facility care. 166.15 (c)Screeners shall adhere to the level of care criteria166.16for admission to a certified nursing facility established under166.17section 144.0721.166.18(d)For persons who are eligible for medical assistance or 166.19 who would be eligible within 180 days of admission to a nursing 166.20 facility and who are admitted to a nursing facility, the nursing 166.21 facility must include a screener or the case manager in the 166.22 discharge planning process for those individuals who the team 166.23 has determined have discharge potential. The screener or the 166.24 case manager must ensure a smooth transition and follow-up for 166.25 the individual's return to the community. 166.26 Screeners shall cooperate with other public and private 166.27 agencies in the community, in order to offer a variety of 166.28 cost-effective services to the disabled and elderly. The 166.29 screeners shall encourage the use of volunteers from families, 166.30 religious organizations, social clubs, and similar civic and 166.31 service organizations to provide services. 166.32 Sec. 28. Minnesota Statutes 1997 Supplement, section 166.33 256B.0911, subdivision 7, is amended to read: 166.34 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 166.35 (a) Medical assistance reimbursement for nursing facilities 166.36 shall be authorized for a medical assistance recipient only if a 167.1 preadmission screening has been conducted prior to admission or 167.2 the local county agency has authorized an exemption. Medical 167.3 assistance reimbursement for nursing facilities shall not be 167.4 provided for any recipient who the local screener has determined 167.5 does not meet the level of care criteria for nursing facility 167.6 placement or, if indicated, has not had a level II PASARR 167.7 evaluation completed unless an admission for a recipient with 167.8 mental illness is approved by the local mental health authority 167.9 or an admission for a recipient with mental retardation or 167.10 related condition is approved by the state mental retardation 167.11 authority.The county preadmission screening team may deny167.12certified nursing facility admission using the level of care167.13criteria established under section 144.0721 and deny medical167.14assistance reimbursement for certified nursing facility care.167.15Persons receiving care in a certified nursing facility or167.16certified boarding care home who are reassessed by the167.17commissioner of health according to section 144.0722 and167.18determined to no longer meet the level of care criteria for a167.19certified nursing facility or certified boarding care home may167.20no longer remain a resident in the certified nursing facility or167.21certified boarding care home and must be relocated to the167.22community if the persons were admitted on or after July 1, 1998.167.23 (b)Persons receiving services under section 256B.0913,167.24subdivisions 1 to 14, or 256B.0915 who are reassessed and found167.25to not meet the level of care criteria for admission to a167.26certified nursing facility or certified boarding care home may167.27no longer receive these services if persons were admitted to the167.28program on or after July 1, 1998.The commissioner shall make a 167.29 request to the health care financing administration for a waiver 167.30 allowing screening team approval of Medicaid payments for 167.31 certified nursing facility care. An individual has a choice and 167.32 makes the final decision between nursing facility placement and 167.33 community placement after the screening team's recommendation, 167.34 except as provided in paragraphs (b) and (c). 167.35 (c) The local county mental health authority or the state 167.36 mental retardation authority under Public Law Numbers 100-203 168.1 and 101-508 may prohibit admission to a nursing facility, if the 168.2 individual does not meet the nursing facility level of care 168.3 criteria or needs specialized services as defined in Public Law 168.4 Numbers 100-203 and 101-508. For purposes of this section, 168.5 "specialized services" for a person with mental retardation or a 168.6 related condition means "active treatment" as that term is 168.7 defined in Code of Federal Regulations, title 42, section 168.8 483.440(a)(1). 168.9 (d) Upon the receipt by the commissioner of approval by the 168.10 Secretary of Health and Human Services of the waiver requested 168.11 under paragraph (a), the local screener shall deny medical 168.12 assistance reimbursement for nursing facility care for an 168.13 individual whose long-term care needs can be met in a 168.14 community-based setting and whose cost of community-based home 168.15 care services is less than 75 percent of the average payment for 168.16 nursing facility care for that individual's case mix 168.17 classification, and who is either: 168.18 (i) a current medical assistance recipient being screened 168.19 for admission to a nursing facility; or 168.20 (ii) an individual who would be eligible for medical 168.21 assistance within 180 days of entering a nursing facility and 168.22 who meets a nursing facility level of care. 168.23 (e) Appeals from the screening team's recommendation or the 168.24 county agency's final decision shall be made according to 168.25 section 256.045, subdivision 3. 168.26 Sec. 29. Minnesota Statutes 1997 Supplement, section 168.27 256B.0915, subdivision 1d, is amended to read: 168.28 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 168.29 RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the 168.30 provisions of section 256B.056, the commissioner shall make the 168.31 following amendment to the medical assistance elderly waiver 168.32 program effective July 1,19971999, or upon federal approval, 168.33 whichever is later. 168.34 A recipient's maintenance needs will be an amount equal to 168.35 the Minnesota supplemental aid equivalent rate as defined in 168.36 section 256I.03, subdivision 5, plus the medical assistance 169.1 personal needs allowance as defined in section 256B.35, 169.2 subdivision 1, paragraph (a), when applying posteligibility 169.3 treatment of income rules to the gross income of elderly waiver 169.4 recipients, except for individuals whose income is in excess of 169.5 the special income standard according to Code of Federal 169.6 Regulations, title 42, section 435.236. Recipient maintenance 169.7 needs shall be adjusted under this provision each July 1. 169.8 (b) The commissioner of human services shall secure 169.9 approval of additional elderly waiver slots sufficient to serve 169.10 persons who will qualify under the revised income standard 169.11 described in paragraph (a) before implementing section 169.12 256B.0913, subdivision 16. 169.13 Sec. 30. Minnesota Statutes 1996, section 256B.41, 169.14 subdivision 1, is amended to read: 169.15 Subdivision 1. [AUTHORITY.] The commissioner shall 169.16 establish, by rule, procedures for determining rates for care of 169.17 residents of nursing facilities which qualify as vendors of 169.18 medical assistance, and for implementing the provisions of this 169.19 section and sections 256B.421, 256B.431, 256B.432, 256B.433, 169.20 256B.47, 256B.48, 256B.50, and 256B.502. The procedures shall 169.21be based on methods and standards that the commissioner finds169.22are adequate to provide for the costs that must be incurred for169.23the care of residents in efficiently and economically operated169.24nursing facilities and shallspecify the costs that are 169.25 allowable for establishing payment rates through medical 169.26 assistance. 169.27 Sec. 31. Minnesota Statutes 1996, section 256B.431, 169.28 subdivision 2b, is amended to read: 169.29 Subd. 2b. [OPERATING COSTS, AFTER JULY 1, 1985.] (a) For 169.30 rate years beginning on or after July 1, 1985, the commissioner 169.31 shall establish procedures for determining per diem 169.32 reimbursement for operating costs. 169.33 (b) The commissioner shall contract with an econometric 169.34 firm with recognized expertise in and access to national 169.35 economic change indices that can be applied to the appropriate 169.36 cost categories when determining the operating cost payment rate. 170.1 (c) The commissioner shall analyze and evaluate each 170.2 nursing facility's cost report of allowable operating costs 170.3 incurred by the nursing facility during the reporting year 170.4 immediately preceding the rate year for which the payment rate 170.5 becomes effective. 170.6 (d) The commissioner shall establish limits on actual 170.7 allowable historical operating cost per diems based on cost 170.8 reports of allowable operating costs for the reporting year that 170.9 begins October 1, 1983, taking into consideration relevant 170.10 factors including resident needs, geographic location, and size 170.11 of the nursing facility, and the costs that must be incurred for170.12the care of residents in an efficiently and economically170.13operated nursing facility. In developing the geographic groups 170.14 for purposes of reimbursement under this section, the 170.15 commissioner shall ensure that nursing facilities in any county 170.16 contiguous to the Minneapolis-St. Paul seven-county metropolitan 170.17 area are included in the same geographic group. The limits 170.18 established by the commissioner shall not be less, in the 170.19 aggregate, than the 60th percentile of total actual allowable 170.20 historical operating cost per diems for each group of nursing 170.21 facilities established under subdivision 1 based on cost reports 170.22 of allowable operating costs in the previous reporting year. 170.23 For rate years beginning on or after July 1, 1989, facilities 170.24 located in geographic group I as described in Minnesota Rules, 170.25 part 9549.0052, on January 1, 1989, may choose to have the 170.26 commissioner apply either the care related limits or the other 170.27 operating cost limits calculated for facilities located in 170.28 geographic group II, or both, if either of the limits calculated 170.29 for the group II facilities is higher. The efficiency incentive 170.30 for geographic group I nursing facilities must be calculated 170.31 based on geographic group I limits. The phase-in must be 170.32 established utilizing the chosen limits. For purposes of these 170.33 exceptions to the geographic grouping requirements, the 170.34 definitions in Minnesota Rules, parts 9549.0050 to 9549.0059 170.35 (Emergency), and 9549.0010 to 9549.0080, apply. The limits 170.36 established under this paragraph remain in effect until the 171.1 commissioner establishes a new base period. Until the new base 171.2 period is established, the commissioner shall adjust the limits 171.3 annually using the appropriate economic change indices 171.4 established in paragraph (e). In determining allowable 171.5 historical operating cost per diems for purposes of setting 171.6 limits and nursing facility payment rates, the commissioner 171.7 shall divide the allowable historical operating costs by the 171.8 actual number of resident days, except that where a nursing 171.9 facility is occupied at less than 90 percent of licensed 171.10 capacity days, the commissioner may establish procedures to 171.11 adjust the computation of the per diem to an imputed occupancy 171.12 level at or below 90 percent. The commissioner shall establish 171.13 efficiency incentives as appropriate. The commissioner may 171.14 establish efficiency incentives for different operating cost 171.15 categories. The commissioner shall consider establishing 171.16 efficiency incentives in care related cost categories. The 171.17 commissioner may combine one or more operating cost categories 171.18 and may use different methods for calculating payment rates for 171.19 each operating cost category or combination of operating cost 171.20 categories. For the rate year beginning on July 1, 1985, the 171.21 commissioner shall: 171.22 (1) allow nursing facilities that have an average length of 171.23 stay of 180 days or less in their skilled nursing level of care, 171.24 125 percent of the care related limit and 105 percent of the 171.25 other operating cost limit established by rule; and 171.26 (2) exempt nursing facilities licensed on July 1, 1983, by 171.27 the commissioner to provide residential services for the 171.28 physically handicapped under Minnesota Rules, parts 9570.2000 to 171.29 9570.3600, from the care related limits and allow 105 percent of 171.30 the other operating cost limit established by rule. 171.31 For the purpose of calculating the other operating cost 171.32 efficiency incentive for nursing facilities referred to in 171.33 clause (1) or (2), the commissioner shall use the other 171.34 operating cost limit established by rule before application of 171.35 the 105 percent. 171.36 (e) The commissioner shall establish a composite index or 172.1 indices by determining the appropriate economic change 172.2 indicators to be applied to specific operating cost categories 172.3 or combination of operating cost categories. 172.4 (f) Each nursing facility shall receive an operating cost 172.5 payment rate equal to the sum of the nursing facility's 172.6 operating cost payment rates for each operating cost category. 172.7 The operating cost payment rate for an operating cost category 172.8 shall be the lesser of the nursing facility's historical 172.9 operating cost in the category increased by the appropriate 172.10 index established in paragraph (e) for the operating cost 172.11 category plus an efficiency incentive established pursuant to 172.12 paragraph (d) or the limit for the operating cost category 172.13 increased by the same index. If a nursing facility's actual 172.14 historic operating costs are greater than the prospective 172.15 payment rate for that rate year, there shall be no retroactive 172.16 cost settle-up. In establishing payment rates for one or more 172.17 operating cost categories, the commissioner may establish 172.18 separate rates for different classes of residents based on their 172.19 relative care needs. 172.20 (g) The commissioner shall include the reported actual real 172.21 estate tax liability or payments in lieu of real estate tax of 172.22 each nursing facility as an operating cost of that nursing 172.23 facility. Allowable costs under this subdivision for payments 172.24 made by a nonprofit nursing facility that are in lieu of real 172.25 estate taxes shall not exceed the amount which the nursing 172.26 facility would have paid to a city or township and county for 172.27 fire, police, sanitation services, and road maintenance costs 172.28 had real estate taxes been levied on that property for those 172.29 purposes. For rate years beginning on or after July 1, 1987, 172.30 the reported actual real estate tax liability or payments in 172.31 lieu of real estate tax of nursing facilities shall be adjusted 172.32 to include an amount equal to one-half of the dollar change in 172.33 real estate taxes from the prior year. The commissioner shall 172.34 include a reported actual special assessment, and reported 172.35 actual license fees required by the Minnesota department of 172.36 health, for each nursing facility as an operating cost of that 173.1 nursing facility. For rate years beginning on or after July 1, 173.2 1989, the commissioner shall include a nursing facility's 173.3 reported public employee retirement act contribution for the 173.4 reporting year as apportioned to the care-related operating cost 173.5 categories and other operating cost categories multiplied by the 173.6 appropriate composite index or indices established pursuant to 173.7 paragraph (e) as costs under this paragraph. Total adjusted 173.8 real estate tax liability, payments in lieu of real estate tax, 173.9 actual special assessments paid, the indexed public employee 173.10 retirement act contribution, and license fees paid as required 173.11 by the Minnesota department of health, for each nursing facility 173.12 (1) shall be divided by actual resident days in order to compute 173.13 the operating cost payment rate for this operating cost 173.14 category, (2) shall not be used to compute the care-related 173.15 operating cost limits or other operating cost limits established 173.16 by the commissioner, and (3) shall not be increased by the 173.17 composite index or indices established pursuant to paragraph 173.18 (e), unless otherwise indicated in this paragraph. 173.19 (h) For rate years beginning on or after July 1, 1987, the 173.20 commissioner shall adjust the rates of a nursing facility that 173.21 meets the criteria for the special dietary needs of its 173.22 residents and the requirements in section 31.651. The 173.23 adjustment for raw food cost shall be the difference between the 173.24 nursing facility's allowable historical raw food cost per diem 173.25 and 115 percent of the median historical allowable raw food cost 173.26 per diem of the corresponding geographic group. 173.27 The rate adjustment shall be reduced by the applicable 173.28 phase-in percentage as provided under subdivision 2h. 173.29(i) For the cost report year ending September 30, 1996, and173.30for all subsequent reporting years, certified nursing facilities173.31must identify, differentiate, and record resident day statistics173.32for residents in case mix classification A who, on or after July173.331, 1996, meet the modified level of care criteria in section173.34144.0721. The resident day statistics shall be separated into173.35case mix classification A-1 for any resident day meeting the173.36high-function class A level of care criteria and case mix174.1classification A-2 for other case mix class A resident days.174.2 Sec. 32. Minnesota Statutes 1996, section 256B.431, is 174.3 amended by adding a subdivision to read: 174.4 Subd. 27. [SPEND-UP AND HIGH COST LIMITS INDEXED; NOT 174.5 REBASED.] (a) For rate years beginning on or after July 1, 1998, 174.6 the commissioner shall modify the determination of the spend-up 174.7 limits referred to in subdivision 26, paragraph (a), by indexing 174.8 each group's previous year's median value by the factor in 174.9 subdivision 26, paragraph (d), clause (2), plus one percentage 174.10 point. 174.11 (b) For rate years beginning on or after July 1, 1998, the 174.12 commissioner shall modify the determination of the high cost 174.13 limits referred to in subdivision 26, paragraph (b), by indexing 174.14 each group's previous year's high cost per diem limits at .5 and 174.15 one standard deviations above the median by the factor in 174.16 subdivision 26, paragraph (d), clause (2), plus one percentage 174.17 point. 174.18 Sec. 33. Minnesota Statutes 1996, section 256B.501, 174.19 subdivision 2, is amended to read: 174.20 Subd. 2. [AUTHORITY.] The commissioner shall establish 174.21 procedures and rules for determining rates for care of residents 174.22 of intermediate care facilities for persons with mental 174.23 retardation or related conditions which qualify as providers of 174.24 medical assistance and waivered services.Approved rates shall174.25be established on the basis of methods and standards that the174.26commissioner finds adequate to provide for the costs that must174.27be incurred for the quality care of residents in efficiently and174.28economically operated facilities and services.The procedures 174.29 shall specify the costs that are allowable for payment through 174.30 medical assistance. The commissioner may use experts from 174.31 outside the department in the establishment of the procedures. 174.32 Sec. 34. Minnesota Statutes 1997 Supplement, section 174.33 256B.69, subdivision 2, is amended to read: 174.34 Subd. 2. [DEFINITIONS.] For the purposes of this section, 174.35 the following terms have the meanings given. 174.36 (a) "Commissioner" means the commissioner of human services. 175.1 For the remainder of this section, the commissioner's 175.2 responsibilities for methods and policies for implementing the 175.3 project will be proposed by the project advisory committees and 175.4 approved by the commissioner. 175.5 (b) "Demonstration provider" means a health maintenance 175.6 organizationor, community integrated service network, or 175.7 accountable provider network authorized and operating under 175.8 chapter 62Dor, 62N, or 62T that participates in the 175.9 demonstration project according to criteria, standards, methods, 175.10 and other requirements established for the project and approved 175.11 by the commissioner. Notwithstanding the above, Itasca county 175.12 may continue to participate as a demonstration provider until 175.13 July 1, 2000. 175.14 (c) "Eligible individuals" means those persons eligible for 175.15 medical assistance benefits as defined in sections 256B.055, 175.16 256B.056, and 256B.06. 175.17 (d) "Limitation of choice" means suspending freedom of 175.18 choice while allowing eligible individuals to choose among the 175.19 demonstration providers. 175.20 (e) This paragraph supersedes paragraph (c) as long as the 175.21 Minnesota health care reform waiver remains in effect. When the 175.22 waiver expires, this paragraph expires and the commissioner of 175.23 human services shall publish a notice in the State Register and 175.24 notify the revisor of statutes. "Eligible individuals" means 175.25 those persons eligible for medical assistance benefits as 175.26 defined in sections 256B.055, 256B.056, and 256B.06. 175.27 Notwithstanding sections 256B.055, 256B.056, and 256B.06, an 175.28 individual who becomes ineligible for the program because of 175.29 failure to submit income reports or recertification forms in a 175.30 timely manner, shall remain enrolled in the prepaid health plan 175.31 and shall remain eligible to receive medical assistance coverage 175.32 through the last day of the month following the month in which 175.33 the enrollee became ineligible for the medical assistance 175.34 program. 175.35 Sec. 35. Minnesota Statutes 1997 Supplement, section 175.36 256B.69, subdivision 3a, is amended to read: 176.1 Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when 176.2 implementing the general assistance medical care, or medical 176.3 assistance prepayment program within a county, must include the 176.4 county board in the process of development, approval, and 176.5 issuance of the request for proposals to provide services to 176.6 eligible individuals within the proposed county. County boards 176.7 must be given reasonable opportunity to make recommendations 176.8 regarding the development, issuance, review of responses, and 176.9 changes needed in the request for proposals. The commissioner 176.10 must provide county boards the opportunity to review each 176.11 proposal based on the identification of community needs under 176.12 chapters 145A and 256E and county advocacy activities. If a 176.13 county board finds that a proposal does not address certain 176.14 community needs, the county board and commissioner shall 176.15 continue efforts for improving the proposal and network prior to 176.16 the approval of the contract. The county board shall make 176.17 recommendations regarding the approval of local networks and 176.18 their operations to ensure adequate availability and access to 176.19 covered services. The provider or health plan must respond 176.20 directly to county advocates and the state prepaid medical 176.21 assistance ombudsperson regarding service delivery and must be 176.22 accountable to the state regarding contracts with medical 176.23 assistance and general assistance medical care funds. The 176.24 county board may recommend a maximum number of participating 176.25 health plans after considering the size of the enrolling 176.26 population; ensuring adequate access and capacity; considering 176.27 the client and county administrative complexity; and considering 176.28 the need to promote the viability of locally developed health 176.29 plans. The county board or a single entity representing a group 176.30 of county boards and the commissioner shall mutually select 176.31 health plans for participation at the time of initial 176.32 implementation of the prepaid medical assistance program in that 176.33 county or group of counties and at the time of contract renewal. 176.34 The commissioner shall also seek input for contract requirements 176.35 from the county or single entity representing a group of county 176.36 boards at each contract renewal and incorporate those 177.1 recommendations into the contract negotiation process. The 177.2 commissioner, in conjunction with the county board, shall 177.3 actively seek to develop a mutually agreeable timetable prior to 177.4 the development of the request for proposal, but counties must 177.5 agree to initial enrollment beginning on or before January 1, 177.6 1999, in either the prepaid medical assistance and general 177.7 assistance medical care programs or county-based purchasing 177.8 under section 256B.692. At least 90 days before enrollment in 177.9 the medical assistance and general assistance medical care 177.10 prepaid programs begins in a county in which the prepaid 177.11 programs have not been established, the commissioner shall 177.12 provide a report to the chairs of senate and house committees 177.13 having jurisdiction over state health care programs which 177.14 verifies that the commissioner complied with the requirements 177.15 for county involvement that are specified in this subdivision. 177.16 (b) The commissioner shall seek a federal waiver to allow a 177.17 fee-for-service plan option to MinnesotaCare enrollees. The 177.18 commissioner shall develop an increase of the premium fees 177.19 required under section 256L.06 up to 20 percent of the premium 177.20 fees for the enrollees who elect the fee-for-service option. 177.21 Prior to implementation, the commissioner shall submit this fee 177.22 schedule to the chair and ranking minority member of the senate 177.23 health care committee, the senate health care and family 177.24 services funding division, the house of representatives health 177.25 and human services committee, and the house of representatives 177.26 health and human services finance division. 177.27 (c) At the option of the county board, the board may 177.28 develop contract requirements related to the achievement of 177.29 local public health goals to meet the health needs of medical 177.30 assistance and general assistance medical care enrollees. These 177.31 requirements must be reasonably related to the performance of 177.32 health plan functions and within the scope of the medical 177.33 assistance and general assistance medical care benefit sets. If 177.34 the county board and the commissioner mutually agree to such 177.35 requirements, the department shall include such requirements in 177.36 all health plan contracts governing the prepaid medical 178.1 assistance and general assistance medical care programs in that 178.2 county at initial implementation of the program in that county 178.3 and at the time of contract renewal. The county board may 178.4 participate in the enforcement of the contract provisions 178.5 related to local public health goals. 178.6 (d) For counties in which prepaid medical assistance and 178.7 general assistance medical care programs have not been 178.8 established, the commissioner shall not implement those programs 178.9 if a county board submits acceptable and timely preliminary and 178.10 final proposals under section 256B.692, until county-based 178.11 purchasing is no longer operational in that county. For 178.12 counties in which prepaid medical assistance and general 178.13 assistance medical care programs are in existence on or after 178.14 September 1, 1997, the commissioner must terminate contracts 178.15 with health plans according to section 256B.692, subdivision 5, 178.16 if the county board submits and the commissioner accepts 178.17 preliminary and final proposals according to that subdivision. 178.18 The commissioner is not required to terminate contracts that 178.19 begin on or after September 1, 1997, according to section 178.20 256B.692 until two years have elapsed from the date of initial 178.21 enrollment. 178.22 (e) In the event that a county board or a single entity 178.23 representing a group of county boards and the commissioner 178.24 cannot reach agreement regarding: (i) the selection of 178.25 participating health plans in that county; (ii) contract 178.26 requirements; or (iii) implementation and enforcement of county 178.27 requirements including provisions regarding local public health 178.28 goals, the commissioner shall resolve all disputes after taking 178.29 into account the recommendations of a three-person mediation 178.30 panel. The panel shall be composed of one designee of the 178.31 president of the association of Minnesota counties, one designee 178.32 of the commissioner of human services, and one designee of the 178.33 commissioner of health. 178.34 (f) If a county which elects to implement county-based 178.35 purchasing ceases to implement county-based purchasing, it is 178.36 prohibited from assuming the responsibility of county-based 179.1 purchasing for a period of five years from the date it 179.2 discontinues purchasing. 179.3 (g) Notwithstanding the requirement in paragraph (a) that a 179.4 county must agree to initial enrollment on or before January 1, 179.5 1999, the commissioner shall grant a delay of up to 12 months in 179.6 the implementation of the county-based purchasing authorized in 179.7 section 256B.692 if the county or group of counties has 179.8 submitted a preliminary proposal for county-based purchasing by 179.9 September 1, 1997, has not already implemented the prepaid 179.10 medical assistance program before January 1, 1998, and has 179.11 submitted a written request for the delay to the commissioner by 179.12 July 1, 1998. In order for the delay to be continued, the 179.13 county or group of counties must also submit to the commissioner 179.14 the following information by December 1, 1998: 179.15 (1) identify the proposed date of implementation, not later 179.16 than January 1, 2000; 179.17 (2) include copies of the county board resolutions which 179.18 demonstrate the continued commitment to the implementation of 179.19 county-based purchasing by the proposed date of implementation. 179.20 County board authorization may remain contingent on the 179.21 submission of a final proposal which meets the requirements of 179.22 section 256B.692, subdivision 5, paragraph (b); 179.23 (3) if more than one county is involved in the proposal, 179.24 demonstrate actions taken for the establishment of a governance 179.25 structure between the participating counties and describe how 179.26 the fiduciary responsibilities of county-based purchasing will 179.27 be allocated between the counties; 179.28 (4) describe actions taken to identify how the risk of a 179.29 deficit will be managed in the event expenditures are greater 179.30 than total capitation payments. This description must identify 179.31 how any of the following strategies will be assessed: 179.32 (i) risk contracts with licensed health plans; 179.33 (ii) risk arrangements with providers who are not licensed 179.34 health plans; 179.35 (iii) risk arrangements with other licensed insurance 179.36 entities; and 180.1 (iv) funding from other county resources; 180.2 (5) include, if county-based purchasing will not contract 180.3 with licensed health plans or provider networks, letters of 180.4 interest from local providers in at least the categories of 180.5 hospital, physician, mental health, and pharmacy which express 180.6 interest in contracting for services; and 180.7 (6) describe the options being considered to obtain the 180.8 administrative services required in section 256B.692, 180.9 subdivision 3, clauses (3) and (5). 180.10 For counties which receive a delay under this subdivision, 180.11 the final proposals required under section 256B.692, subdivision 180.12 5, paragraph (b), must be submitted at least six months prior to 180.13 the requested implementation date. Authority to implement 180.14 county-based purchasing remains contingent on approval of the 180.15 final proposal as required under section 256B.692. 180.16 Sec. 36. Minnesota Statutes 1996, section 256B.69, is 180.17 amended by adding a subdivision to read: 180.18 Subd. 25. [AMERICAN INDIAN RECIPIENTS.] (a) Beginning on 180.19 or after January 1, 1999, for American Indian recipients of 180.20 medical assistance who are required to enroll with a 180.21 demonstration provider under subdivision 4 or in a county-based 180.22 purchasing entity, if applicable, under section 256B.692, 180.23 medical assistance shall cover health care services provided at 180.24 Indian health services facilities and facilities operated by a 180.25 tribe or tribal organization under funding authorized by United 180.26 States Code, title 25, sections 450f to 450n, or title III of 180.27 the Indian Self-Determination and Education Assistance Act, 180.28 Public Law Number 93-638, if those services would otherwise be 180.29 covered under section 256B.0625. Payments for services provided 180.30 under this subdivision shall be made on a fee-for-service basis, 180.31 and may, at the option of the tribe or tribal organization, be 180.32 made in accordance with rates authorized under sections 256.969, 180.33 subdivision 16, and 256B.0625, subdivision 34. Implementation 180.34 of this subdivision is contingent on federal approval. 180.35 (b) The commissioner of human services, in consultation 180.36 with the tribal governments, shall develop a plan for tribes to 181.1 assist in the enrollment process for American Indian recipients 181.2 enrolled in the prepaid medical assistance program under this 181.3 section or the prepaid general assistance medical care program 181.4 under section 256D.03, subdivision 4, paragraph (d). This plan 181.5 also shall address how tribes will be included in ensuring the 181.6 coordination of care for American Indian recipients between 181.7 Indian health service or tribal providers and other providers. 181.8 (c) For purposes of this subdivision, "American Indian" has 181.9 the meaning given to persons to whom services will be provided 181.10 for in Code of Federal Regulations, title 42, section 36.12. 181.11 (d) This subdivision also applies to American Indian 181.12 recipients of general assistance medical care and to the prepaid 181.13 general assistance medical care program under section 256D.03, 181.14 subdivision 4, paragraph (d). 181.15 Sec. 37. Minnesota Statutes 1997 Supplement, section 181.16 256B.692, subdivision 2, is amended to read: 181.17 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] 181.18 Notwithstanding chapters 62D and 62N, a county that elects to 181.19 purchase medical assistance and general assistance medical care 181.20 in return for a fixed sum without regard to the frequency or 181.21 extent of services furnished to any particular enrollee is not 181.22 required to obtain a certificate of authority under chapter 62D 181.23 or 62N. A county that elects to purchase medical assistance and 181.24 general assistance medical care services under this section must 181.25 satisfy the commissioner of health that the requirements of 181.26 chapter 62D, applicable to health maintenance organizations, or 181.27 chapter 62N, applicable to community integrated service 181.28 networks, will be met. A county must also assure the 181.29 commissioner of health that the requirements ofsectionsections 181.30 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all 181.31 applicable provisions of chapter 62Q, including sections 62Q.07; 181.32 62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 181.33 62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 181.34 62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 181.35 will be met. All enforcement and rulemaking powers available 181.36 under chapters 62Dand, 62J, 62M, 62N, and 62Q are hereby 182.1 granted to the commissioner of health with respect to counties 182.2 that purchase medical assistance and general assistance medical 182.3 care services under this section. 182.4 Sec. 38. Minnesota Statutes 1997 Supplement, section 182.5 256B.692, subdivision 5, is amended to read: 182.6 Subd. 5. [COUNTY PROPOSALS.] (a) On or before September 1, 182.7 1997, a county board that wishes to purchase or provide health 182.8 care under this section must submit a preliminary proposal that 182.9 substantially demonstrates the county's ability to meet all the 182.10 requirements of this section in response to criteria for 182.11 proposals issued by the department on or before July 1, 1997. 182.12 Counties submitting preliminary proposals must establish a local 182.13 planning process that involves input from medical assistance and 182.14 general assistance medical care recipients, recipient advocates, 182.15 providers and representatives of local school districts, labor, 182.16 and tribal government to advise on the development of a final 182.17 proposal and its implementation. 182.18 (b) The county board must submit a final proposal on or 182.19 before July 1, 1998, that demonstrates the ability to meet all 182.20 the requirements of this section, including beginning enrollment 182.21 on January 1, 1999, unless a delay has been granted under 182.22 section 256B.69, subdivision 3a, paragraph (g). 182.23 (c) After January 1, 1999, for a county in which the 182.24 prepaid medical assistance program is in existence, the county 182.25 board must submit a preliminary proposal at least 15 months 182.26 prior to termination of health plan contracts in that county and 182.27 a final proposal six months prior to the health plan contract 182.28 termination date in order to begin enrollment after the 182.29 termination. Nothing in this section shall impede or delay 182.30 implementation or continuation of the prepaid medical assistance 182.31 and general assistance medical care programs in counties for 182.32 which the board does not submit a proposal, or submits a 182.33 proposal that is not in compliance with this section. 182.34 (d) The commissioner is not required to terminate contracts 182.35 for the prepaid medical assistance and prepaid general 182.36 assistance medical care programs that begin on or after 183.1 September 1, 1997, in a county for which a county board has 183.2 submitted a proposal under this paragraph, until two years have 183.3 elapsed from the date of initial enrollment in the prepaid 183.4 medical assistance and prepaid general assistance medical care 183.5 programs. 183.6 Sec. 39. Minnesota Statutes 1997 Supplement, section 183.7 256B.77, subdivision 3, is amended to read: 183.8 Subd. 3. [ASSURANCES TO THE COMMISSIONER OF HEALTH.] A 183.9 county authority that elects to participate in a demonstration 183.10 project for people with disabilities under this section is not 183.11 required to obtain a certificate of authority under chapter 62D 183.12 or 62N. A county authority that elects to participate in a 183.13 demonstration project for people with disabilities under this 183.14 section must assure the commissioner of health that the 183.15 requirements of chapters 62Dand, 62N, and section 256B.692, 183.16 subdivision 2, are met. All enforcement and rulemaking powers 183.17 available under chapters 62Dand, 62J, 62M, 62N, and 62Q are 183.18 granted to the commissioner of health with respect to the county 183.19 authorities that contract with the commissioner to purchase 183.20 services in a demonstration project for people with disabilities 183.21 under this section. 183.22 Sec. 40. Minnesota Statutes 1997 Supplement, section 183.23 256B.77, subdivision 7a, is amended to read: 183.24 Subd. 7a. [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 183.25 for the demonstration project as provided in this subdivision. 183.26 (b) "Eligible individuals" means those persons living in 183.27 the demonstration site who are eligible for medical assistance 183.28 and are disabled based on a disability determination under 183.29 section 256B.055, subdivisions 7 and 12, or who are eligible for 183.30 medical assistance and have been diagnosed as having: 183.31 (1) serious and persistent mental illness as defined in 183.32 section 245.462, subdivision 20; 183.33 (2) severe emotional disturbance as defined in section 183.34 245.487, subdivision 6; or 183.35 (3) mental retardation, or being a mentally retarded person 183.36 as defined in section 252A.02, or a related condition as defined 184.1 in section 252.27, subdivision 1a. 184.2 Other individuals may be included at the option of the county 184.3 authority based on agreement with the commissioner. 184.4 (c) Eligible individuals residing on a federally recognized 184.5 Indian reservation may be excluded from participation in the 184.6 demonstration project at the discretion of the tribal government 184.7 based on agreement with the commissioner, in consultation with 184.8 the county authority. 184.9 (d) Eligible individuals include individuals in excluded 184.10 time status, as defined in chapter 256G. Enrollees in excluded 184.11 time at the time of enrollment shall remain in excluded time 184.12 status as long as they live in the demonstration site and shall 184.13 be eligible for 90 days after placement outside the 184.14 demonstration site if they move to excluded time status in a 184.15 county within Minnesota other than their county of financial 184.16 responsibility. 184.17 (e) A person who is a sexual psychopathic personality as 184.18 defined in section 253B.02, subdivision 18a, or a sexually 184.19 dangerous person as defined in section 253B.02, subdivision 18b, 184.20 is excluded from enrollment in the demonstration project. 184.21 Sec. 41. Minnesota Statutes 1997 Supplement, section 184.22 256B.77, subdivision 10, is amended to read: 184.23 Subd. 10. [CAPITATION PAYMENT.] (a) The commissioner shall 184.24 pay a capitation payment to the county authority and, when 184.25 applicable under subdivision 6, paragraph (a), to the service 184.26 delivery organization for each medical assistance eligible 184.27 enrollee. The commissioner shall develop capitation payment 184.28 rates for the initial contract period for each demonstration 184.29 site in consultation with an independent actuary, to ensure that 184.30 the cost of services under the demonstration project does not 184.31 exceed the estimated cost for medical assistance services for 184.32 the covered population under the fee-for-service system for the 184.33 demonstration period. For each year of the demonstration 184.34 project, the capitation payment rate shall be based on 96 184.35 percent of the projected per person costs that would otherwise 184.36 have been paid under medical assistance fee-for-service during 185.1 each of those years. Rates shall be adjusted within the limits 185.2 of the available risk adjustment technology, as mandated by 185.3 section 62Q.03. In addition, the commissioner shall implement 185.4 appropriate risk and savings sharing provisions with county 185.5 administrative entities and, when applicable under subdivision 185.6 6, paragraph (a), service delivery organizations within the 185.7 projected budget limits. Capitation rates shall be adjusted at 185.8 least annually to include any rate increases and payments for 185.9 expanded or newly covered services for eligible individuals. 185.10 The initial demonstration project rate shall include an amount 185.11 in addition to the fee for service payments to adjust for 185.12 underutilization of dental services. Any savings beyond those 185.13 allowed for the county authority, county administrative entity, 185.14 or service delivery organization shall be first used to meet the 185.15 unmet needs of eligible individuals. Payments to providers 185.16 participating in the project are exempt from the requirements of 185.17 sections 256.966 and 256B.03, subdivision 2. 185.18 (b) The commissioner shall monitor and evaluate annually 185.19 the effect of the discount on consumers, the county authority, 185.20 and providers of disability services. Findings shall be 185.21 reported and recommendations made, as appropriate, to ensure 185.22 that the discount effect does not adversely affect the ability 185.23 of the county administrative entity or providers of services to 185.24 provide appropriate services to eligible individuals, and does 185.25 not result in cost shifting of eligible individuals to the 185.26 county authority. 185.27 Sec. 42. Minnesota Statutes 1997 Supplement, section 185.28 256B.77, subdivision 12, is amended to read: 185.29 Subd. 12. [SERVICE COORDINATION.] (a) For purposes of this 185.30 section, "service coordinator" means an individual selected by 185.31 the enrollee or the enrollee's legal representative and 185.32 authorized by the county administrative entity or service 185.33 delivery organization to work in partnership with the enrollee 185.34 to develop, coordinate, and in some instances, provide supports 185.35 and services identified in the personal support plan. Service 185.36 coordinators may only provide services and supports if the 186.1 enrollee is informed of potential conflicts of interest, is 186.2 given alternatives, and gives informed consent. Eligible 186.3 service coordinators are individuals age 18 or older who meet 186.4 the qualifications as described in paragraph (b). Enrollees, 186.5 their legal representatives, or their advocates are eligible to 186.6 be service coordinators if they have the capabilities to perform 186.7 the activities and functions outlined in paragraph (b). 186.8 Providers licensed under chapter 245A to provide residential 186.9 services, or providers who are providing residential services 186.10 covered under the group residential housing program may not act 186.11 as service coordinator for enrollees for whom they provide 186.12 residential services. This does not apply to providers of 186.13 short-term detoxification services. Each county administrative 186.14 entity or service delivery organization may develop further 186.15 criteria for eligible vendors of service coordination during the 186.16 demonstration period and shall determine whom it contracts with 186.17 or employs to provide service coordination. County 186.18 administrative entities and service delivery organizations may 186.19 pay enrollees or their advocates or legal representatives for 186.20 service coordination activities. 186.21 (b) The service coordinator shall act as a facilitator, 186.22 working in partnership with the enrollee to ensure that their 186.23 needs are identified and addressed. The level of involvement of 186.24 the service coordinator shall depend on the needs and desires of 186.25 the enrollee. The service coordinator shall have the knowledge, 186.26 skills, and abilities to, and is responsible for: 186.27 (1) arranging for an initial assessment, and periodic 186.28 reassessment as necessary, of supports and services based on the 186.29 enrollee's strengths, needs, choices, and preferences in life 186.30 domain areas; 186.31 (2) developing and updating the personal support plan based 186.32 on relevant ongoing assessment; 186.33 (3) arranging for and coordinating the provisions of 186.34 supports and services, including knowledgeable and skilled 186.35 specialty services and prevention and early intervention 186.36 services, within the limitations negotiated with the county 187.1 administrative entity or service delivery organization; 187.2 (4) assisting the enrollee and the enrollee's legal 187.3 representative, if any, to maximize informed choice of and 187.4 control over services and supports and to exercise the 187.5 enrollee's rights and advocate on behalf of the enrollee; 187.6 (5) monitoring the progress toward achieving the enrollee's 187.7 outcomes in order to evaluate and adjust the timeliness and 187.8 adequacy of the implementation of the personal support plan; 187.9 (6) facilitating meetings and effectively collaborating 187.10 with a variety of agencies and persons, including attending 187.11 individual family service plan and individual education plan 187.12 meetings when requested by the enrollee or the enrollee's legal 187.13 representative; 187.14 (7) soliciting and analyzing relevant information; 187.15 (8) communicating effectively with the enrollee and with 187.16 other individuals participating in the enrollee's plan; 187.17 (9) educating and communicating effectively with the 187.18 enrollee about good health care practices and risk to the 187.19 enrollee's health with certain behaviors; 187.20 (10) having knowledge of basic enrollee protection 187.21 requirements, including data privacy; 187.22 (11) informing, educating, and assisting the enrollee in 187.23 identifying available service providers and accessing needed 187.24 resources and services beyond the limitations of the medical 187.25 assistance benefit set covered services; and 187.26 (12) providing other services as identified in the personal 187.27 support plan. 187.28 (c) For the demonstration project, the qualifications and 187.29 standards for service coordination in this section shall replace 187.30 comparable existing provisions of existing statutes and rules 187.31 governing case management for eligible individuals. 187.32 (d) The provisions of this subdivision apply only to the 187.33 demonstration sitesthat begin implementation on July 1, 1998187.34 designated by the commissioner under subdivision 5. 187.35 All other demonstration sites must comply with laws and 187.36 rules governing case management services for eligible 188.1 individuals in effect when the site begins the demonstration 188.2 project. 188.3 Sec. 43. Minnesota Statutes 1997 Supplement, section 188.4 256D.03, subdivision 3, is amended to read: 188.5 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 188.6 (a) General assistance medical care may be paid for any person 188.7 who is not eligible for medical assistance under chapter 256B, 188.8 including eligibility for medical assistance based on a 188.9 spenddown of excess income according to section 256B.056, 188.10 subdivision 5, or MinnesotaCare as defined in clause(4)(5), 188.11 except as provided in paragraph (b); and: 188.12 (1) who is receiving assistance under section 256D.05, 188.13 except for families with children who are eligible under 188.14 Minnesota family investment program-statewide (MFIP-S), who is 188.15 having a payment made on the person's behalf under sections 188.16 256I.01 to 256I.06, or who resides in group residential housing 188.17 as defined in chapter 256I and can meet a spenddown using the 188.18 cost of remedial services received through group residential 188.19 housing; or 188.20 (2)(i) who is a resident of Minnesota; and whose equity in 188.21 assets is not in excess of $1,000 per assistance unit. Exempt 188.22 assets, the reduction of excess assets, and the waiver of excess 188.23 assets must conform to the medical assistance program in chapter 188.24 256B, with the following exception: the maximum amount of 188.25 undistributed funds in a trust that could be distributed to or 188.26 on behalf of the beneficiary by the trustee, assuming the full 188.27 exercise of the trustee's discretion under the terms of the 188.28 trust, must be applied toward the asset maximum; and 188.29 (ii) who has countable income not in excess of the 188.30 assistance standards established in section 256B.056, 188.31 subdivision 4, or whose excess income is spent down according to 188.32 section 256B.056, subdivision 5, using a six-month budget 188.33 period. The method for calculating earned income disregards and 188.34 deductions for a person who resides with a dependent child under 188.35 age 21 shall follow section 256B.056, subdivision 1a. However, 188.36 if a disregard of $30 and one-third of the remainder has been 189.1 applied to the wage earner's income, the disregard shall not be 189.2 applied again until the wage earner's income has not been 189.3 considered in an eligibility determination for general 189.4 assistance, general assistance medical care, medical assistance, 189.5 or MFIP-S for 12 consecutive months. The earned income and work 189.6 expense deductions for a person who does not reside with a 189.7 dependent child under age 21 shall be the same as the method 189.8 used to determine eligibility for a person under section 189.9 256D.06, subdivision 1, except the disregard of the first $50 of 189.10 earned income is not allowed;or189.11 (3) who would be eligible for medical assistance except 189.12 that the person resides in a facility that is determined by the 189.13 commissioner or the federal Health Care Financing Administration 189.14 to be an institution for mental diseases; or 189.15 (4) who is receiving care and rehabilitation services from 189.16 a nonprofit center established to serve victims of torture. 189.17 These individuals are eligible for general assistance medical 189.18 care only for the period during which they are receiving 189.19 services from the center. During this period of eligibility, 189.20 individuals eligible under this clause shall not be required to 189.21 participate in prepaid general assistance medical care. 189.22(4)(5) Beginning July 1, 1998, applicants or recipients 189.23 who meet all eligibility requirements of MinnesotaCare as 189.24 defined in sections 256L.01 to 256L.16, and are: 189.25 (i) adults with dependent children under 21 whose gross 189.26 family income is equal to or less than 275 percent of the 189.27 federal poverty guidelines; or 189.28 (ii) adults without children with earned income and whose 189.29 family gross income is between 75 percent of the federal poverty 189.30 guidelines and the amount set by section 256L.04, subdivision 7, 189.31 shall be terminated from general assistance medical care upon 189.32 enrollment in MinnesotaCare. 189.33 (b) For services rendered on or after July 1, 1997, 189.34 eligibility is limited to one month prior to application if the 189.35 person is determined eligible in the prior month. A 189.36 redetermination of eligibility must occur every 12 months. 190.1 Beginning July 1, 1998, Minnesota health care program 190.2 applications completed by recipients and applicants who are 190.3 persons described in paragraph (a), clause(4)(5), may be 190.4 returned to the county agency to be forwarded to the department 190.5 of human services or sent directly to the department of human 190.6 services for enrollment in MinnesotaCare. If all other 190.7 eligibility requirements of this subdivision are met, 190.8 eligibility for general assistance medical care shall be 190.9 available in any month during which a MinnesotaCare eligibility 190.10 determination and enrollment are pending. Upon notification of 190.11 eligibility for MinnesotaCare, notice of termination for 190.12 eligibility for general assistance medical care shall be sent to 190.13 an applicant or recipient. If all other eligibility 190.14 requirements of this subdivision are met, eligibility for 190.15 general assistance medical care shall be available until 190.16 enrollment in MinnesotaCare subject to the provisions of 190.17 paragraph (d). 190.18 (c) The date of an initial Minnesota health care program 190.19 application necessary to begin a determination of eligibility 190.20 shall be the date the applicant has provided a name, address, 190.21 and social security number, signed and dated, to the county 190.22 agency or the department of human services. If the applicant is 190.23 unable to provide an initial application when health care is 190.24 delivered due to a medical condition or disability, a health 190.25 care provider may act on the person's behalf to complete the 190.26 initial application. The applicant must complete the remainder 190.27 of the application and provide necessary verification before 190.28 eligibility can be determined. The county agency must assist 190.29 the applicant in obtaining verification if necessary. 190.30 (d) County agencies are authorized to use all automated 190.31 databases containing information regarding recipients' or 190.32 applicants' income in order to determine eligibility for general 190.33 assistance medical care or MinnesotaCare. Such use shall be 190.34 considered sufficient in order to determine eligibility and 190.35 premium payments by the county agency. 190.36 (e) General assistance medical care is not available for a 191.1 person in a correctional facility unless the person is detained 191.2 by law for less than one year in a county correctional or 191.3 detention facility as a person accused or convicted of a crime, 191.4 or admitted as an inpatient to a hospital on a criminal hold 191.5 order, and the person is a recipient of general assistance 191.6 medical care at the time the person is detained by law or 191.7 admitted on a criminal hold order and as long as the person 191.8 continues to meet other eligibility requirements of this 191.9 subdivision. 191.10 (f) General assistance medical care is not available for 191.11 applicants or recipients who do not cooperate with the county 191.12 agency to meet the requirements of medical assistance. General 191.13 assistance medical care is limited to payment of emergency 191.14 services only for applicants or recipients as described in 191.15 paragraph (a), clause(4)(5), whose MinnesotaCare coverage is 191.16 denied or terminated for nonpayment of premiums as required by 191.17 sections 256L.06 to 256L.08. 191.18 (g) In determining the amount of assets of an individual, 191.19 there shall be included any asset or interest in an asset, 191.20 including an asset excluded under paragraph (a), that was given 191.21 away, sold, or disposed of for less than fair market value 191.22 within the 60 months preceding application for general 191.23 assistance medical care or during the period of eligibility. 191.24 Any transfer described in this paragraph shall be presumed to 191.25 have been for the purpose of establishing eligibility for 191.26 general assistance medical care, unless the individual furnishes 191.27 convincing evidence to establish that the transaction was 191.28 exclusively for another purpose. For purposes of this 191.29 paragraph, the value of the asset or interest shall be the fair 191.30 market value at the time it was given away, sold, or disposed 191.31 of, less the amount of compensation received. For any 191.32 uncompensated transfer, the number of months of ineligibility, 191.33 including partial months, shall be calculated by dividing the 191.34 uncompensated transfer amount by the average monthly per person 191.35 payment made by the medical assistance program to skilled 191.36 nursing facilities for the previous calendar year. The 192.1 individual shall remain ineligible until this fixed period has 192.2 expired. The period of ineligibility may exceed 30 months, and 192.3 a reapplication for benefits after 30 months from the date of 192.4 the transfer shall not result in eligibility unless and until 192.5 the period of ineligibility has expired. The period of 192.6 ineligibility begins in the month the transfer was reported to 192.7 the county agency, or if the transfer was not reported, the 192.8 month in which the county agency discovered the transfer, 192.9 whichever comes first. For applicants, the period of 192.10 ineligibility begins on the date of the first approved 192.11 application. 192.12 (h) When determining eligibility for any state benefits 192.13 under this subdivision, the income and resources of all 192.14 noncitizens shall be deemed to include their sponsor's income 192.15 and resources as defined in the Personal Responsibility and Work 192.16 Opportunity Reconciliation Act of 1996, title IV, Public Law 192.17 Number 104-193, sections 421 and 422, and subsequently set out 192.18 in federal rules. 192.19 (i)(1) An undocumented noncitizen or a nonimmigrant is 192.20 ineligible for general assistance medical care other than 192.21 emergency services. For purposes of this subdivision, a 192.22 nonimmigrant is an individual in one or more of the classes 192.23 listed in United States Code, title 8, section 1101(a)(15), and 192.24 an undocumented noncitizen is an individual who resides in the 192.25 United States without the approval or acquiescence of the 192.26 Immigration and Naturalization Service. 192.27(j)(2) This paragraph does not apply to a child under age 192.28 18, to a Cuban or Haitian entrant as defined in Public Law 192.29 Number 96-422, section 501(e)(1) or (2)(a), or to a noncitizen 192.30 who is aged, blind, or disabled as defined in Code of Federal 192.31 Regulations, title 42, sections 435.520, 435.530, 435.531, 192.32 435.540, and 435.541, or to an individual eligible for general 192.33 assistance medical care under paragraph (a), clause (4), who 192.34 cooperates with the Immigration and Naturalization Service to 192.35 pursue any applicable immigration status, including citizenship, 192.36 that would qualify the individual for medical assistance with 193.1 federal financial participation. 193.2(k)(3) For purposes ofparagraphs (f) and (i)this 193.3 paragraph, "emergency services" has the meaning given in Code of 193.4 Federal Regulations, title 42, section 440.255(b)(1), except 193.5 that it also means services rendered because of suspected or 193.6 actual pesticide poisoning. 193.7(l)(j) Notwithstanding any other provision of law, a 193.8 noncitizen who is ineligible for medical assistance due to the 193.9 deeming of a sponsor's income and resources, is ineligible for 193.10 general assistance medical care. 193.11 Sec. 44. Minnesota Statutes 1996, section 256D.03, 193.12 subdivision 4, is amended to read: 193.13 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 193.14 For a person who is eligible under subdivision 3, paragraph (a), 193.15 clause (3), general assistance medical care covers, except as 193.16 provided in paragraph (c): 193.17 (1) inpatient hospital services; 193.18 (2) outpatient hospital services; 193.19 (3) services provided by Medicare certified rehabilitation 193.20 agencies; 193.21 (4) prescription drugs and other products recommended 193.22 through the process established in section 256B.0625, 193.23 subdivision 13; 193.24 (5) equipment necessary to administer insulin and 193.25 diagnostic supplies and equipment for diabetics to monitor blood 193.26 sugar level; 193.27 (6) eyeglasses and eye examinations provided by a physician 193.28 or optometrist; 193.29 (7) hearing aids; 193.30 (8) prosthetic devices; 193.31 (9) laboratory and X-ray services; 193.32 (10) physician's services; 193.33 (11) medical transportation; 193.34 (12) chiropractic services as covered under the medical 193.35 assistance program; 193.36 (13) podiatric services; 194.1 (14) dental services; 194.2 (15) outpatient services provided by a mental health center 194.3 or clinic that is under contract with the county board and is 194.4 established under section 245.62; 194.5 (16) day treatment services for mental illness provided 194.6 under contract with the county board; 194.7 (17) prescribed medications for persons who have been 194.8 diagnosed as mentally ill as necessary to prevent more 194.9 restrictive institutionalization; 194.10 (18)case management services for a person with serious and194.11persistent mental illness who would be eligible for medical194.12assistance except that the person resides in an institution for194.13mental diseases;194.14(19)psychological services, medical supplies and 194.15 equipment, and Medicare premiums, coinsurance and deductible 194.16 payments; 194.17(20)(19) medical equipment not specifically listed in this 194.18 paragraph when the use of the equipment will prevent the need 194.19 for costlier services that are reimbursable under this 194.20 subdivision; 194.21(21)(20) services performed by a certified pediatric nurse 194.22 practitioner, a certified family nurse practitioner, a certified 194.23 adult nurse practitioner, a certified obstetric/gynecological 194.24 nurse practitioner, or a certified geriatric nurse practitioner 194.25 in independent practice, if the services are otherwise covered 194.26 under this chapter as a physician service, and if the service is 194.27 within the scope of practice of the nurse practitioner's license 194.28 as a registered nurse, as defined in section 148.171; and 194.29(22)(21) services of a certified public health nurse or a 194.30 registered nurse practicing in a public health nursing clinic 194.31 that is a department of, or that operates under the direct 194.32 authority of, a unit of government, if the service is within the 194.33 scope of practice of the public health nurse's license as a 194.34 registered nurse, as defined in section 148.171. 194.35 (b) Except as provided in paragraph (c), for a recipient 194.36 who is eligible under subdivision 3, paragraph (a), clause (1) 195.1 or (2), general assistance medical care covers the services 195.2 listed in paragraph (a) with the exception of special 195.3 transportation services. 195.4 (c) Gender reassignment surgery and related services are 195.5 not covered services under this subdivision unless the 195.6 individual began receiving gender reassignment services prior to 195.7 July 1, 1995. 195.8 (d) In order to contain costs, the commissioner of human 195.9 services shall select vendors of medical care who can provide 195.10 the most economical care consistent with high medical standards 195.11 and shall where possible contract with organizations on a 195.12 prepaid capitation basis to provide these services. The 195.13 commissioner shall consider proposals by counties and vendors 195.14 for prepaid health plans, competitive bidding programs, block 195.15 grants, or other vendor payment mechanisms designed to provide 195.16 services in an economical manner or to control utilization, with 195.17 safeguards to ensure that necessary services are provided. 195.18 Before implementing prepaid programs in counties with a county 195.19 operated or affiliated public teaching hospital or a hospital or 195.20 clinic operated by the University of Minnesota, the commissioner 195.21 shall consider the risks the prepaid program creates for the 195.22 hospital and allow the county or hospital the opportunity to 195.23 participate in the program in a manner that reflects the risk of 195.24 adverse selection and the nature of the patients served by the 195.25 hospital, provided the terms of participation in the program are 195.26 competitive with the terms of other participants considering the 195.27 nature of the population served. Payment for services provided 195.28 pursuant to this subdivision shall be as provided to medical 195.29 assistance vendors of these services under sections 256B.02, 195.30 subdivision 8, and 256B.0625. For payments made during fiscal 195.31 year 1990 and later years, the commissioner shall consult with 195.32 an independent actuary in establishing prepayment rates, but 195.33 shall retain final control over the rate methodology. 195.34 Notwithstanding the provisions of subdivision 3, an individual 195.35 who becomes ineligible for general assistance medical care 195.36 because of failure to submit income reports or recertification 196.1 forms in a timely manner, shall remain enrolled in the prepaid 196.2 health plan and shall remain eligible for general assistance 196.3 medical care coverage through the last day of the month in which 196.4 the enrollee became ineligible for general assistance medical 196.5 care. 196.6 (e) The commissioner of human services may reduce payments 196.7 provided under sections 256D.01 to 256D.21 and 261.23 in order 196.8 to remain within the amount appropriated for general assistance 196.9 medical care, within the following restrictions.: 196.10 (i) For the period July 1, 1985 to December 31, 1985, 196.11 reductions below the cost per service unit allowable under 196.12 section 256.966, are permitted only as follows: payments for 196.13 inpatient and outpatient hospital care provided in response to a 196.14 primary diagnosis of chemical dependency or mental illness may 196.15 be reduced no more than 30 percent; payments for all other 196.16 inpatient hospital care may be reduced no more than 20 percent. 196.17 Reductions below the payments allowable under general assistance 196.18 medical care for the remaining general assistance medical care 196.19 services allowable under this subdivision may be reduced no more 196.20 than ten percent. 196.21 (ii) For the period January 1, 1986 to December 31, 1986, 196.22 reductions below the cost per service unit allowable under 196.23 section 256.966 are permitted only as follows: payments for 196.24 inpatient and outpatient hospital care provided in response to a 196.25 primary diagnosis of chemical dependency or mental illness may 196.26 be reduced no more than 20 percent; payments for all other 196.27 inpatient hospital care may be reduced no more than 15 percent. 196.28 Reductions below the payments allowable under general assistance 196.29 medical care for the remaining general assistance medical care 196.30 services allowable under this subdivision may be reduced no more 196.31 than five percent. 196.32 (iii) For the period January 1, 1987 to June 30, 1987, 196.33 reductions below the cost per service unit allowable under 196.34 section 256.966 are permitted only as follows: payments for 196.35 inpatient and outpatient hospital care provided in response to a 196.36 primary diagnosis of chemical dependency or mental illness may 197.1 be reduced no more than 15 percent; payments for all other 197.2 inpatient hospital care may be reduced no more than ten 197.3 percent. Reductions below the payments allowable under medical 197.4 assistance for the remaining general assistance medical care 197.5 services allowable under this subdivision may be reduced no more 197.6 than five percent. 197.7 (iv) For the period July 1, 1987 to June 30, 1988, 197.8 reductions below the cost per service unit allowable under 197.9 section 256.966 are permitted only as follows: payments for 197.10 inpatient and outpatient hospital care provided in response to a 197.11 primary diagnosis of chemical dependency or mental illness may 197.12 be reduced no more than 15 percent; payments for all other 197.13 inpatient hospital care may be reduced no more than five percent. 197.14 Reductions below the payments allowable under medical assistance 197.15 for the remaining general assistance medical care services 197.16 allowable under this subdivision may be reduced no more than 197.17 five percent. 197.18 (v) For the period July 1, 1988 to June 30, 1989, 197.19 reductions below the cost per service unit allowable under 197.20 section 256.966 are permitted only as follows: payments for 197.21 inpatient and outpatient hospital care provided in response to a 197.22 primary diagnosis of chemical dependency or mental illness may 197.23 be reduced no more than 15 percent; payments for all other 197.24 inpatient hospital care may not be reduced. Reductions below 197.25 the payments allowable under medical assistance for the 197.26 remaining general assistance medical care services allowable 197.27 under this subdivision may be reduced no more than five percent. 197.28 (f) There shall be no copayment required of any recipient 197.29 of benefits for any services provided under this subdivision. A 197.30 hospital receiving a reduced payment as a result of this section 197.31 may apply the unpaid balance toward satisfaction of the 197.32 hospital's bad debts. 197.33(f)(g) Any county may, from its own resources, provide 197.34 medical payments for which state payments are not made. 197.35(g)(h) Chemical dependency services that are reimbursed 197.36 under chapter 254B must not be reimbursed under general 198.1 assistance medical care. 198.2(h)(i) The maximum payment for new vendors enrolled in the 198.3 general assistance medical care program after the base year 198.4 shall be determined from the average usual and customary charge 198.5 of the same vendor type enrolled in the base year. 198.6(i)(j) The conditions of payment for services under this 198.7 subdivision are the same as the conditions specified in rules 198.8 adopted under chapter 256B governing the medical assistance 198.9 program, unless otherwise provided by statute or rule. 198.10 Sec. 45. Minnesota Statutes 1996, section 256D.03, is 198.11 amended by adding a subdivision to read: 198.12 Subd. 9. [PAYMENT FOR AMBULANCE SERVICES.] Effective July 198.13 1, 1999, general assistance medical care payments for ambulance 198.14 services shall be increased by ten percent. 198.15 Sec. 46. Minnesota Statutes 1997 Supplement, section 198.16 256L.07, subdivision 2, is amended to read: 198.17 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 198.18 COVERAGE.] (a) To be eligible for subsidized premium payments 198.19 based on a sliding scale, a family or individual must not have 198.20 access to subsidized health coverage through an employer, and 198.21 must not have had access to subsidized health coverage through 198.22 an employer for the 18 months prior to application for 198.23 subsidized coverage under the MinnesotaCare program. The 198.24 requirement that the family or individual must not have had 198.25 access to employer-subsidized coverage during the previous 18 198.26 months does not apply if: (1) employer-subsidized coverage was 198.27 lost due to the death of an employee or divorce; (2) 198.28 employer-subsidized coverage was lost because an individual 198.29 became ineligible for coverage as a child or dependent; or (3) 198.30 employer-subsidized coverage was lost for reasons that would not 198.31 disqualify the individual for unemployment benefits under 198.32 section 268.09 and the family or individual has not had access 198.33 to employer-subsidized coverage since the loss of coverage. If 198.34 employer-subsidized coverage was lost for reasons that 198.35 disqualify an individual for unemployment benefits under section 198.36 268.09, children of that individual are exempt from the 199.1 requirement of no access to employer subsidized coverage for the 199.2 18 months prior to application, as long as the children have not 199.3 had access to employer subsidized coverage since the 199.4 disqualifying event. The requirement that the family or 199.5 individual must not have had access to employer-subsidized 199.6 coverage during the previous 18 months does apply if 199.7 employer-subsidized coverage is lost due to an employer 199.8 terminating health care coverage as an employee benefit, unless 199.9 that coverage was provided under section 256M.03. 199.10 (b) For purposes of this requirement, subsidized health 199.11 coverage means health coverage for which the employer pays at 199.12 least 50 percent of the cost of coverage for the employee, 199.13 excluding dependent coverage, or a higher percentage as 199.14 specified by the commissioner. Children are eligible for 199.15 employer-subsidized coverage through either parent, including 199.16 the noncustodial parent. The commissioner must treat employer 199.17 contributions to Internal Revenue Code Section 125 plans as 199.18 qualified employer subsidies toward the cost of health coverage 199.19 for employees for purposes of this subdivision. 199.20 Sec. 47. Minnesota Statutes 1997 Supplement, section 199.21 256L.07, subdivision 3, is amended to read: 199.22 Subd. 3. [PERIOD UNINSURED.] To be eligible for subsidized 199.23 premium payments based on a sliding scale, families and 199.24 individuals initially enrolled in the MinnesotaCare program 199.25 under section 256L.04, subdivisions 5 and 7, must have had no 199.26 health coverage for at least four months prior to application. 199.27 The commissioner may change this eligibility criterion for 199.28 sliding scale premiums in order to remain within the limits of 199.29 available appropriations. The requirement of at least four 199.30 months of no health coverage prior to application for the 199.31 MinnesotaCare program does not apply to: 199.32 (1) families, children, and individuals who apply for the 199.33 MinnesotaCare program upon termination from or as required by 199.34 the medical assistance program, general assistance medical care 199.35 program, or coverage under a regional demonstration project for 199.36 the uninsured funded under section 256B.73, the Hennepin county 200.1 assured care program, or the Group Health, Inc., community 200.2 health plan; 200.3 (2) families and individuals initially enrolled under 200.4 section 256L.04, subdivisions 1, paragraph (a), and 3; 200.5 (3) children enrolled pursuant to Laws 1992, chapter 549, 200.6 article 4, section 17;or200.7 (4) individuals currently serving or who have served in the 200.8 military reserves, and dependents of these individuals, if these 200.9 individuals: (i) reapply for MinnesotaCare coverage after a 200.10 period of active military service during which they had been 200.11 covered by the Civilian Health and Medical Program of the 200.12 Uniformed Services (CHAMPUS); (ii) were covered under 200.13 MinnesotaCare immediately prior to obtaining coverage under 200.14 CHAMPUS; and (iii) have maintained continuous coverage; or 200.15 (5) children who lose coverage under section 256M.03 due to 200.16 an employer terminating health coverage as an employee benefit 200.17 or due to an employee layoff. 200.18 Sec. 48. [256M.01] [DEFINITIONS.] 200.19 Subdivision 1. [APPLICABILITY.] For purposes of this 200.20 chapter, the terms defined in this section have the meanings 200.21 given. 200.22 Subd. 2. [COMMISSIONER.] "Commissioner" means the 200.23 commissioner of human services. 200.24 Subd. 3. [EMPLOYER-SUBSIDIZED 200.25 INSURANCE.] "Employer-subsidized insurance" has the meaning 200.26 provided in section 256L.07, subdivision 2. 200.27 Sec. 49. [256M.03] [COVERAGE OF CHILDREN INELIGIBLE FOR 200.28 MINNESOTACARE.] 200.29 Subdivision 1. [PAYMENTS FOR EMPLOYER-SUBSIDIZED 200.30 COVERAGE.] A child who would otherwise be eligible for coverage 200.31 under MinnesotaCare, except for the availability of 200.32 employer-subsidized coverage, is eligible for payment of the 200.33 employee share of employer-subsidized coverage for the child 200.34 under the state children's health insurance program established 200.35 in title 21 of the Social Security Act, according to the sliding 200.36 scale in subdivision 2. In order to be eligible under this 201.1 subdivision, a child must not have employer-subsidized coverage 201.2 at the time of application for payment, and the 201.3 employer-subsidized coverage must qualify as benchmark coverage 201.4 or benchmark equivalent coverage under title 21 of the Social 201.5 Security Act, section 2103. Payments shall be made directly to 201.6 the employer providing employer-subsidized insurance. 201.7 Subd. 2. [SLIDING SCALE PAYMENTS.] Upon federal approval 201.8 of the plan, the commissioner shall pay the difference of the 201.9 MinnesotaCare sliding premium scale as specified in Minnesota 201.10 Statutes, section 256L.08, up to a maximum of five percent of 201.11 the qualifying family's income and the employee share of the 201.12 coverage. 201.13 Subd. 3. [LIMITATION.] The availability of payments under 201.14 this section is subject to the limits of available 201.15 appropriations. The commissioner may set limits on the number 201.16 of children receiving payments under this section, or modify 201.17 payment levels, in order to remain within the limits of 201.18 appropriations. 201.19 Subd. 4. [ADVISORY TASK FORCE.] The commissioner shall 201.20 convene an advisory task force comprised of representatives of 201.21 small businesses, health plan companies, and insurance agents in 201.22 order to develop a plan to implement this section. 201.23 Sec. 50. [256M.05] [MAINTENANCE OF EMPLOYER SUBSIDY.] 201.24 Employers providing employer-subsidized coverage to 201.25 employees who receive payments on behalf of an employee eligible 201.26 under section 256M.03, subdivision 1, shall maintain at least 201.27 the same percentage level of subsidy for employee and family 201.28 coverage that was in place on July 1, 1998, for a period of one 201.29 year following receipt of the initial payment for an eligible 201.30 employee. After the initial year, an employer may not decrease 201.31 the percentage level of subsidy to employee and family coverage 201.32 by more than five percentage points. 201.33 Sec. 51. Laws 1997, chapter 195, section 5, is amended to 201.34 read: 201.35 Sec. 5. [PERSONAL CARE ASSISTANT PROVIDERS.] 201.36 The commissioner of health shall create a unique category 202.1 of licensure as appropriate for providers offering, providing, 202.2 or arranging personal care assistant services to more than one 202.3 individual. The commissioner shall work with the department of 202.4 human services, providers, consumers, and advocates in 202.5 developing the licensure standards. The licensure standards 202.6 must include requirements for providers to provide consumers 202.7 advance written notice of service termination, a service 202.8 transition plan, and an appeal process. If the commissioner 202.9 determines there are costs related to rulemaking under this 202.10 section, the commissioner shall include a budget request for 202.11 this item in the 2000-2001 biennial budget. Prior to 202.12 promulgating the rule, the commissioner shall submit the 202.13 proposed rule to the legislature by January 15, 1999. 202.14 Sec. 52. Laws 1997, chapter 203, article 4, section 64, is 202.15 amended to read: 202.16 Sec. 64. [STUDY OF ELDERLY WAIVER EXPANSION.] 202.17 The commissioner of human services shall appoint a task 202.18 force that includes representatives of counties, health plans, 202.19 consumers, and legislators to study the impact of the expansion 202.20 of the elderly waiver program under section 4 and to make 202.21 recommendations for any changes in law necessary to facilitate 202.22 an efficient and equitable relationship between the elderly 202.23 waiver program and the Minnesota senior health options project. 202.24 Based on the results of the task force study, the commissioner 202.25 may seek any federal waivers needed to improve the relationship 202.26 between the elderly waiver and the Minnesota senior health 202.27 options project. The commissioner shall report the results of 202.28 the task force study to the legislature byJanuary 15, 1998July 202.29 1, 2000. 202.30 Sec. 53. Laws 1997, chapter 225, article 2, section 64, is 202.31 amended to read: 202.32 Sec. 64. [EFFECTIVE DATE.] 202.33 Section 8 is effective for payments made for MinnesotaCare 202.34 services on or after July 1, 1996. Section 23 is effective the 202.35 day following final enactment. Section 46 is effective January 202.36 1, 1998, and applies to high deductible health plans issued or 203.1 renewed on or after that date. 203.2 Sec. 54. [SUBMITTAL OF PLAN TO ACCESS STATE CHILDREN'S 203.3 HEALTH INSURANCE FUNDING.] 203.4 The commissioner of human services shall submit a plan to 203.5 implement Minnesota Statutes, sections 256M.01 to 256M.05, to 203.6 the secretary of health and human services, in order to obtain 203.7 funding through the state children's health insurance program 203.8 established in title 21 of the Social Security Act. The 203.9 commissioner shall also request a waiver to purchase family 203.10 coverage as specified in title 21 of the Social Security Act, 203.11 section 2105(c)(3). Upon approval of the waiver, the 203.12 commissioner shall expand the definition of those eligible for 203.13 coverage under Minnesota Statutes, section 256M.03, to include 203.14 all adults eligible for coverage under the employee's policy. 203.15 Sec. 55. [OFFSET OF HMO SURCHARGE.] 203.16 Beginning October 1, 1998, and ending December 31, 1998, 203.17 the commissioner of human services shall offset monthly charges 203.18 for the health maintenance organization surcharge by the monthly 203.19 amount the health maintenance organization overpaid from August 203.20 1, 1997, to September 30, 1998, due to taxation of Medicare 203.21 revenues prohibited by section 256.9657, subdivision 3. 203.22 Sec. 56. [MR/RC WAIVER PROPOSAL.] 203.23 By November 15, 1998, the commissioner of human services 203.24 shall provide to the chairs of the house health and human 203.25 services finance division and the senate health and family 203.26 security finance division a detailed budget proposal for 203.27 providing services under the home and community-based waiver for 203.28 persons with mental retardation or related conditions to those 203.29 individuals who are screened and waiting for services. 203.30 Sec. 57. [COVERAGE OF REHABILITATIVE AND THERAPEUTIC 203.31 SERVICES.] 203.32 (a) The threshold limits for fee-for-service medical 203.33 assistance rehabilitative and therapeutic services for January 203.34 1, 1998 through June 30, 1999, shall be the limits prescribed in 203.35 the department of human services health care programs provider 203.36 manual for calendar year 1997. Rehabilitative and therapeutic 204.1 services are: occupational therapy services provided to medical 204.2 assistance recipients pursuant to Minnesota Statutes, section 204.3 256B.0625, subdivision 8; physical therapy services provided to 204.4 medical assistance recipients pursuant to Minnesota Statutes, 204.5 section 256B.0625, subdivision 8a; and speech language pathology 204.6 services provided to medical assistance recipients pursuant to 204.7 Minnesota Rules, part 9505.0390. 204.8 (b) The commissioner of human services, in consultation 204.9 with the department of human services rehabilitative work group, 204.10 shall report to the chair of the senate health and family 204.11 security committee and the chair of the house health and human 204.12 services committee by January 15, 1999, recommendations and 204.13 proposed legislation for the appropriate level of rehabilitative 204.14 services delivered to medical assistance recipients before prior 204.15 authorization. The recommendations shall also include proposed 204.16 legislation to clarify the rehabilitative and therapeutic 204.17 benefit set for medical assistance, as well as the appropriate 204.18 response time for requests for prior authorization. 204.19 Sec. 58. [DISPROPORTIONATE SHARE ADJUSTMENT FOR DENTAL 204.20 SERVICES.] 204.21 The commissioner of human services shall develop a 204.22 disproportionate share adjustment for dental services provided 204.23 under the medical assistance, general assistance medical care, 204.24 and MinnesotaCare programs. The adjustment must provide 204.25 progressive increases above current fee-for-service rates for 204.26 dental providers whose medical assistance, general assistance 204.27 medical care, and MinnesotaCare caseloads in total comprise more 204.28 than specified percentages of their total caseloads. The 204.29 disproportionate share adjustment must also apply to managed 204.30 care capitation rates. 204.31 The commissioner shall present recommendations and proposed 204.32 legislation for a disproportionate share adjustment to the 204.33 legislature by December 15, 1998. 204.34 Sec. 59. [REPORT ON COUNTY ALLOCATIONS.] 204.35 Beginning August 1, 1998, the commissioner of human 204.36 services shall issue an annual report on the home and 205.1 community-based waiver for persons with mental retardation or a 205.2 related condition, which includes a list of the counties in 205.3 which less than 95 percent of the allocation provided, excluding 205.4 the county waivered services reserve, has been committed for two 205.5 or more quarters during the previous state fiscal year. For 205.6 each listed county, the report shall include the amount of funds 205.7 allocated but not used, the number and ages of individuals 205.8 screened and waiting for services, the services needed, a 205.9 description of the technical assistance provided by the 205.10 commissioner to assist the county in jointly planning with other 205.11 counties in order to serve more persons, and additional actions 205.12 which will be taken to serve those screened and waiting for 205.13 services. 205.14 Sec. 60. [DENTAL ACCESS.] 205.15 The commissioner of human services shall make 205.16 recommendations to the legislature by February 1, 1999, on how 205.17 access to dental services for medical assistance, general 205.18 assistance medical care, and MinnesotaCare enrollees could be 205.19 expanded. In preparing the recommendations, the commissioner 205.20 shall consult with consumers, the board of dentistry, dental 205.21 providers, the dental hygiene association, consumer advocates, 205.22 legislators, and other affected parties. 205.23 Sec. 61. [REPORT BY UNIVERSITY OF MINNESOTA ACADEMIC 205.24 HEALTH CENTER.] 205.25 The University of Minnesota academic health center, after 205.26 consultation with the health care community and the medical 205.27 education and research cost (MERC) advisory committee, is 205.28 requested to report to the commissioner of health and the 205.29 legislative commission on health care access by January 15, 205.30 1999, on plans for the strategic direction and vision of the 205.31 academic health center. The report shall address plans for the 205.32 ongoing assessment of health provider workforce needs; plans for 205.33 the ongoing assessment of the educational needs of health 205.34 professionals and the implications for their education and 205.35 training programs; and plans for ongoing, meaningful input from 205.36 the health care community on health-related research and 206.1 education programs administered by the academic health center. 206.2 Sec. 62. [COUNTY BILLING BY CLINICS.] 206.3 Clinics that (1) serve the primary health care needs of 206.4 low-income population groups; (2) use a sliding fee scale based 206.5 on ability to pay and do not limit access to care because of 206.6 financial limitations of the client; and (3) are nonprofit under 206.7 Minnesota Statutes, chapter 317, or are federally qualified 206.8 health centers, shall be eligible for a special payment for 206.9 uncompensated care. The clinics may bill a county of residence 206.10 for services provided to a resident of that county provided: 206.11 (1) the patient is from a county other than that in which 206.12 the clinic resides; and 206.13 (2) the clinic has made a preliminary determination at the 206.14 delivery of service that the patient was indigent based on 206.15 current medical assistance guidelines. 206.16 Counties that are billed under this program shall pay 206.17 eligible clinics at the rates established under the medical 206.18 assistance program. If the county can establish eligibility for 206.19 medical assistance after the service has been delivered, the 206.20 state shall reimburse the county for any funds paid to the 206.21 eligible clinic. 206.22 Sec. 63. [RECOMMENDATIONS FOR RECYCLING PROGRAM.] 206.23 The commissioner of human services shall develop 206.24 recommendations for a recycling program for used augmentative 206.25 and alternative communications systems that would allow these 206.26 systems to be reissued and used for trials and short-term use, 206.27 when appropriate. The commissioner shall present 206.28 recommendations to the legislature by December 15, 1998. 206.29 Sec. 64. [REPEALER.] 206.30 Minnesota Statutes 1996, section 144.0721, subdivision 3a; 206.31 and Minnesota Statutes 1997 Supplement, sections 144.0721, 206.32 subdivision 3; and 256B.0913, subdivision 15, are repealed. 206.33 Sec. 65. [EFFECTIVE DATES.] 206.34 (a) Section 8 (256.9657, subdivision 3) is effective 206.35 retroactive to August 1, 1997. 206.36 (b) Sections 14 (256B.055, subdivision 7a) and 17 (256B.06, 207.1 subdivision 4) are effective retroactive to July 1, 1997. 207.2 (c) Sections 12 (256.969, subdivision 17), 19 (256B.0625, 207.3 subdivision 20), and 44 (256D.03, subdivision 4) are effective 207.4 January 1, 1999. 207.5 (d) Section 25 (256B.0645) is effective for changes in 207.6 eligibility that occur on or after July 1, 1998. 207.7 (e) Sections 5 (245.462, subdivision 8) and 36 (256B.69, 207.8 subdivision 25) are effective 30 days after final enactment. 207.9 (f) Section 24 (256B.0627, subdivision 8), related to 207.10 shared care, and section 57 (coverage of rehab.) are effective 207.11 the day following final enactment. 207.12 (g) Sections 18 and 45 (256B.0625, subdivision 17a, and 207.13 256D.03, subdivision 9) are effective July 1, 1999. 207.14 (h) Sections 46 to 50 (256L.07, subdivision 2; 256L.07, 207.15 subdivision 3; 256M.01; 256M.03; 256M.05) are effective only if 207.16 federal funding under the state children's health insurance 207.17 program is made available to the state and legislative approval 207.18 has been obtained. If the funding is made available and 207.19 legislative approval has been obtained, sections 46 to 50 are 207.20 effective on the date specified in the state plan. The 207.21 commissioner of human services shall publish a notice in the 207.22 State Register if federal funding is made available to implement 207.23 sections 46 to 50 and shall notify the revisor of statutes. 207.24 Section 54 (Submittal of plan) is effective the day following 207.25 final enactment. 207.26 ARTICLE 5 207.27 MINNESOTACARE 207.28 Section 1. Minnesota Statutes 1997 Supplement, section 207.29 60A.15, subdivision 1, is amended to read: 207.30 Subdivision 1. [DOMESTIC AND FOREIGN COMPANIES.] (a) On or 207.31 before April 1, June 1, and December 1 of each year, every 207.32 domestic and foreign company, including town and farmers' mutual 207.33 insurance companies, domestic mutual insurance companies, marine 207.34 insurance companies, health maintenance organizations, community 207.35 integrated service networks, and nonprofit health service plan 207.36 corporations, shall pay to the commissioner of revenue 208.1 installments equal to one-third of the insurer's total estimated 208.2 tax for the current year. Except as provided in paragraphs (d), 208.3 (e), (h), and (i), installments must be based on a sum equal to 208.4 two percent of the premiums described in paragraph (b). 208.5 (b) Installments under paragraph (a), (d), or (e) are 208.6 percentages of gross premiums less return premiums on all direct 208.7 business received by the insurer in this state, or by its agents 208.8 for it, in cash or otherwise, during such year. 208.9 (c) Failure of a company to make payments of at least 208.10 one-third of either (1) the total tax paid during the previous 208.11 calendar year or (2) 80 percent of the actual tax for the 208.12 current calendar year shall subject the company to the penalty 208.13 and interest provided in this section, unless the total tax for 208.14 the current tax year is $500 or less. 208.15 (d) For health maintenance organizations, nonprofit health 208.16 service plan corporations, and community integrated service 208.17 networks, the installments must be based on an amount determined 208.18 under paragraph (h) or (i). 208.19 (e) For purposes of computing installments for town and 208.20 farmers' mutual insurance companies and for mutual property 208.21 casualty companies with total assets on December 31, 1989, of 208.22 $1,600,000,000 or less, the following rates apply: 208.23 (1) for all life insurance, two percent; 208.24 (2) for town and farmers' mutual insurance companies and 208.25 for mutual property and casualty companies with total assets of 208.26 $5,000,000 or less, on all other coverages, one percent; and 208.27 (3) for mutual property and casualty companies with total 208.28 assets on December 31, 1989, of $1,600,000,000 or less, on all 208.29 other coverages, 1.26 percent. 208.30 (f) If the aggregate amount of premium tax payments under 208.31 this section and the fire marshal tax payments under section 208.32 299F.21 made during a calendar year is equal to or exceeds 208.33 $120,000, all tax payments in the subsequent calendar year must 208.34 be paid by means of a funds transfer as defined in section 208.35 336.4A-104, paragraph (a). The funds transfer payment date, as 208.36 defined in section 336.4A-401, must be on or before the date the 209.1 payment is due. If the date the payment is due is not a funds 209.2 transfer business day, as defined in section 336.4A-105, 209.3 paragraph (a), clause (4), the payment date must be on or before 209.4 the funds transfer business day next following the date the 209.5 payment is due. 209.6 (g) Premiums under medical assistance, general assistance 209.7 medical care, the MinnesotaCare program, and the Minnesota 209.8 comprehensive health insurance plan and all payments, revenues, 209.9 and reimbursements received from the federal government for 209.10 Medicare-related coverage as defined in section 62A.31, 209.11 subdivision 3, paragraph (e), are not subject to tax under this 209.12 section. 209.13 (h) For calendar years 1997, 1998, and 1999, the 209.14 installments for health maintenance organizations, community 209.15 integrated service networks, and nonprofit health service plan 209.16 corporations must be based on an amount equal to one percent of 209.17 premiums described under paragraph (b). Health maintenance 209.18 organizations, community integrated service networks, and 209.19 nonprofit health service plan corporations that have met the 209.20 cost containment goals established under section 62J.04 in the 209.21 individual and small employer market for calendar year 1996 are 209.22 exempt from payment of the tax imposed under this section for 209.23 premiums paid after March 30, 1997, and before April 1, 1998. 209.24 Health maintenance organizations, community integrated service 209.25 networks, and nonprofit health service plan corporations that 209.26 have met the cost containment goals established under section 209.27 62J.04 in the individual and small employer market for calendar 209.28 year 1997 are exempt from payment of the tax imposed under this 209.29 section for premiums paid after March 30, 1998, and before April 209.30 1, 1999. Health maintenance organizations, community integrated 209.31 service networks, and nonprofit health service plan corporations 209.32 that have met the cost containment goals established under 209.33 section 62J.04 in the individual and small employer market for 209.34 calendar year 1998 are exempt from payment of the tax imposed 209.35 under this section for premiums paid after March 30, 1999, and 209.36 before January 1, 2000. 210.1 (i) For calendar years after 1999, the commissioner of 210.2 finance shall determine the balance of the health care access 210.3 fund on September 1 of each year beginning September 1, 1999. 210.4 If the commissioner determines that there is no structural 210.5 deficit for the next fiscal year, no tax shall be imposed under 210.6 paragraph (d) for the following calendar year. If the 210.7 commissioner determines that there will be a structural deficit 210.8 in the fund for the following fiscal year, then the 210.9 commissioner, in consultation with the commissioner of revenue, 210.10 shall determine the amount needed to eliminate the structural 210.11 deficit and a tax shall be imposed under paragraph (d) for the 210.12 following calendar year. The commissioner shall determine the 210.13 rate of the tax as either one-quarter of one percent, one-half 210.14 of one percent, three-quarters of one percent, or one percent of 210.15 premiums described in paragraph (b), whichever is the lowest of 210.16 those rates that the commissioner determines will produce 210.17 sufficient revenue to eliminate the projected structural 210.18 deficit. The commissioner of finance shall publish in the State 210.19 Register by October 1 of each year the amount of tax to be 210.20 imposed for the following calendar year. 210.21 (j) In approving the premium rates as required in sections 210.22 62L.08, subdivision 8, and 62A.65, subdivision 3, the 210.23 commissioners of health and commerce shall ensure that any 210.24 exemption from the tax as described in paragraphs (h) and (i) is 210.25 reflected in the premium rate. 210.26 Sec. 2. Minnesota Statutes 1997 Supplement, section 210.27 256B.04, subdivision 18, is amended to read: 210.28 Subd. 18. [APPLICATIONS FOR MEDICAL ASSISTANCE.] The state 210.29 agency may take applications for medical assistance and conduct 210.30 eligibility determinations for MinnesotaCare enrolleeswho are210.31required to apply for medical assistance according to section210.32256L.03, subdivision 3, paragraph (b). 210.33 Sec. 3. Minnesota Statutes 1996, section 256B.057, is 210.34 amended by adding a subdivision to read: 210.35 Subd. 7. [WAIVER OF MAINTENANCE OF EFFORT REQUIREMENT.] 210.36 Unless a federal waiver of the maintenance of effort requirement 211.1 of section 2105(d) of title XXI of the Balanced Budget Act of 211.2 1997, Public Law Number 105-33, Statutes at Large, volume 111, 211.3 page 251, is granted by the federal Department of Health and 211.4 Human Services by September 30, 1998, eligibility for children 211.5 under age 21 must be determined without regard to asset 211.6 standards established in section 256B.056, subdivision 3. The 211.7 commissioner of human services shall publish a notice in the 211.8 State Register upon receipt of a federal waiver. 211.9 Sec. 4. Minnesota Statutes 1996, section 256B.057, is 211.10 amended by adding a subdivision to read: 211.11 Subd. 8. [CHILDREN UNDER AGE TWO.] Medical assistance may 211.12 be paid for a child under two years of age whose countable 211.13 family income is above 275 percent of the federal poverty 211.14 guidelines for the same size family but less than or equal to 211.15 280 percent of the federal poverty guidelines for the same size 211.16 family. 211.17 Sec. 5. Minnesota Statutes 1997 Supplement, section 211.18 256D.03, subdivision 3, is amended to read: 211.19 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 211.20 (a) General assistance medical care may be paid for any person 211.21 who is not eligible for medical assistance under chapter 256B, 211.22 including eligibility for medical assistance based on a 211.23 spenddown of excess income according to section 256B.056, 211.24 subdivision 5, or MinnesotaCare as defined in clause (4), except 211.25 as provided in paragraph (b); and: 211.26 (1) who is receiving assistance under section 256D.05, 211.27 except for families with children who are eligible under 211.28 Minnesota family investment program-statewide (MFIP-S), who is 211.29 having a payment made on the person's behalf under sections 211.30 256I.01 to 256I.06, or who resides in group residential housing 211.31 as defined in chapter 256I and can meet a spenddown using the 211.32 cost of remedial services received through group residential 211.33 housing; or 211.34 (2)(i) who is a resident of Minnesota; and whose equity in 211.35 assets is not in excess of $1,000 per assistance unit. Exempt 211.36 assets, the reduction of excess assets, and the waiver of excess 212.1 assets must conform to the medical assistance program in chapter 212.2 256B, with the following exception: the maximum amount of 212.3 undistributed funds in a trust that could be distributed to or 212.4 on behalf of the beneficiary by the trustee, assuming the full 212.5 exercise of the trustee's discretion under the terms of the 212.6 trust, must be applied toward the asset maximum; and 212.7 (ii) who has countable income not in excess of the 212.8 assistance standards established in section 256B.056, 212.9 subdivision 4, or whose excess income is spent down according to 212.10 section 256B.056, subdivision 5, using a six-month budget 212.11 period. The method for calculating earned income disregards and 212.12 deductions for a person who resides with a dependent child under 212.13 age 21 shall follow section 256B.056, subdivision 1a. However, 212.14 if a disregard of $30 and one-third of the remainder has been 212.15 applied to the wage earner's income, the disregard shall not be 212.16 applied again until the wage earner's income has not been 212.17 considered in an eligibility determination for general 212.18 assistance, general assistance medical care, medical assistance, 212.19 or MFIP-S for 12 consecutive months. The earned income and work 212.20 expense deductions for a person who does not reside with a 212.21 dependent child under age 21 shall be the same as the method 212.22 used to determine eligibility for a person under section 212.23 256D.06, subdivision 1, except the disregard of the first $50 of 212.24 earned income is not allowed; or 212.25 (3) who would be eligible for medical assistance except 212.26 that the person resides in a facility that is determined by the 212.27 commissioner or the federal Health Care Financing Administration 212.28 to be an institution for mental diseases. 212.29 (4) BeginningJuly 1, 1998January 1, 2000, applicants or 212.30 recipients who meet all eligibility requirements of 212.31 MinnesotaCare as defined in sections 256L.01 to 256L.16, and are: 212.32 (i) adults with dependent children under 21 whose gross 212.33 family income is equal to or less than 275 percent of the 212.34 federal poverty guidelines; or 212.35 (ii) adults without children with earned income and whose 212.36 family gross income is between 75 percent of the federal poverty 213.1 guidelines and the amount set by section 256L.04, subdivision 7, 213.2 shall be terminated from general assistance medical care upon 213.3 enrollment in MinnesotaCare. 213.4 (b) For services rendered on or after July 1, 1997, 213.5 eligibility is limited to one month prior to application if the 213.6 person is determined eligible in the prior month. A 213.7 redetermination of eligibility must occur every 12 months. 213.8 BeginningJuly 1, 1998January 1, 2000, Minnesota health care 213.9 program applications completed by recipients and applicants who 213.10 are persons described in paragraph (a), clause (4), may be 213.11 returned to the county agency to be forwarded to the department 213.12 of human services or sent directly to the department of human 213.13 services for enrollment in MinnesotaCare. If all other 213.14 eligibility requirements of this subdivision are met, 213.15 eligibility for general assistance medical care shall be 213.16 available in any month during which a MinnesotaCare eligibility 213.17 determination and enrollment are pending. Upon notification of 213.18 eligibility for MinnesotaCare, notice of termination for 213.19 eligibility for general assistance medical care shall be sent to 213.20 an applicant or recipient. If all other eligibility 213.21 requirements of this subdivision are met, eligibility for 213.22 general assistance medical care shall be available until 213.23 enrollment in MinnesotaCare subject to the provisions of 213.24 paragraph (d). 213.25 (c) The date of an initial Minnesota health care program 213.26 application necessary to begin a determination of eligibility 213.27 shall be the date the applicant has provided a name, address, 213.28 and social security number, signed and dated, to the county 213.29 agency or the department of human services. If the applicant is 213.30 unable to provide an initial application when health care is 213.31 delivered due to a medical condition or disability, a health 213.32 care provider may act on the person's behalf to complete the 213.33 initial application. The applicant must complete the remainder 213.34 of the application and provide necessary verification before 213.35 eligibility can be determined. The county agency must assist 213.36 the applicant in obtaining verification if necessary. 214.1 (d) County agencies are authorized to use all automated 214.2 databases containing information regarding recipients' or 214.3 applicants' income in order to determine eligibility for general 214.4 assistance medical care or MinnesotaCare. Such use shall be 214.5 considered sufficient in order to determine eligibility and 214.6 premium payments by the county agency. 214.7 (e) General assistance medical care is not available for a 214.8 person in a correctional facility unless the person is detained 214.9 by law for less than one year in a county correctional or 214.10 detention facility as a person accused or convicted of a crime, 214.11 or admitted as an inpatient to a hospital on a criminal hold 214.12 order, and the person is a recipient of general assistance 214.13 medical care at the time the person is detained by law or 214.14 admitted on a criminal hold order and as long as the person 214.15 continues to meet other eligibility requirements of this 214.16 subdivision. 214.17 (f) General assistance medical care is not available for 214.18 applicants or recipients who do not cooperate with the county 214.19 agency to meet the requirements of medical assistance. General 214.20 assistance medical care is limited to payment of emergency 214.21 services only for applicants or recipients as described in 214.22 paragraph (a), clause (4), whose MinnesotaCare coverage is 214.23 denied or terminated for nonpayment of premiums as required by 214.24 sections 256L.06to 256L.08and 256L.07. 214.25 (g) In determining the amount of assets of an individual, 214.26 there shall be included any asset or interest in an asset, 214.27 including an asset excluded under paragraph (a), that was given 214.28 away, sold, or disposed of for less than fair market value 214.29 within the 60 months preceding application for general 214.30 assistance medical care or during the period of eligibility. 214.31 Any transfer described in this paragraph shall be presumed to 214.32 have been for the purpose of establishing eligibility for 214.33 general assistance medical care, unless the individual furnishes 214.34 convincing evidence to establish that the transaction was 214.35 exclusively for another purpose. For purposes of this 214.36 paragraph, the value of the asset or interest shall be the fair 215.1 market value at the time it was given away, sold, or disposed 215.2 of, less the amount of compensation received. For any 215.3 uncompensated transfer, the number of months of ineligibility, 215.4 including partial months, shall be calculated by dividing the 215.5 uncompensated transfer amount by the average monthly per person 215.6 payment made by the medical assistance program to skilled 215.7 nursing facilities for the previous calendar year. The 215.8 individual shall remain ineligible until this fixed period has 215.9 expired. The period of ineligibility may exceed 30 months, and 215.10 a reapplication for benefits after 30 months from the date of 215.11 the transfer shall not result in eligibility unless and until 215.12 the period of ineligibility has expired. The period of 215.13 ineligibility begins in the month the transfer was reported to 215.14 the county agency, or if the transfer was not reported, the 215.15 month in which the county agency discovered the transfer, 215.16 whichever comes first. For applicants, the period of 215.17 ineligibility begins on the date of the first approved 215.18 application. 215.19 (h) When determining eligibility for any state benefits 215.20 under this subdivision, the income and resources of all 215.21 noncitizens shall be deemed to include their sponsor's income 215.22 and resources as defined in the Personal Responsibility and Work 215.23 Opportunity Reconciliation Act of 1996, title IV, Public Law 215.24 Number 104-193, sections 421 and 422, and subsequently set out 215.25 in federal rules. 215.26 (i) An undocumented noncitizen or a nonimmigrant is 215.27 ineligible for general assistance medical care other than 215.28 emergency services. For purposes of this subdivision, a 215.29 nonimmigrant is an individual in one or more of the classes 215.30 listed in United States Code, title 8, section 1101(a)(15), and 215.31 an undocumented noncitizen is an individual who resides in the 215.32 United States without the approval or acquiescence of the 215.33 Immigration and Naturalization Service. 215.34 (j) This paragraph does not apply to a child under age 18, 215.35 to a Cuban or Haitian entrant as defined in Public Law Number 215.36 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 216.1 aged, blind, or disabled as defined in Code of Federal 216.2 Regulations, title 42, sections 435.520, 435.530, 435.531, 216.3 435.540, and 435.541, who cooperates with the Immigration and 216.4 Naturalization Service to pursue any applicable immigration 216.5 status, including citizenship, that would qualify the individual 216.6 for medical assistance with federal financial participation. 216.7 (k) For purposes of paragraphs (f) and (i), "emergency 216.8 services" has the meaning given in Code of Federal Regulations, 216.9 title 42, section 440.255(b)(1), except that it also means 216.10 services rendered because of suspected or actual pesticide 216.11 poisoning. 216.12 (l) Notwithstanding any other provision of law, a 216.13 noncitizen who is ineligible for medical assistance due to the 216.14 deeming of a sponsor's income and resources, is ineligible for 216.15 general assistance medical care. 216.16 Sec. 6. Minnesota Statutes 1997 Supplement, section 216.17 256L.01, is amended to read: 216.18 256L.01 [DEFINITIONS.] 216.19 Subdivision 1. [SCOPE.] For purposes of sections 256L.01 216.20 to256L.10256L.18, the following terms shall have the meanings 216.21 given them. 216.22 Subd. 1a. [CHILD.] "Child" means an individual under 21 216.23 years of age, including the unborn child of a pregnant woman, an 216.24 emancipated minor, and an emancipated minor's spouse. 216.25 Subd. 2. [COMMISSIONER.] "Commissioner" means the 216.26 commissioner of human services. 216.27 Subd. 3. [ELIGIBLE PROVIDERS.] "Eligible providers" means 216.28 those health care providers who provide covered health services 216.29 to medical assistance recipients under rules established by the 216.30 commissioner for that program. 216.31 Subd. 3a. [FAMILY WITH CHILDREN.] (a) "Family with 216.32 children" means: 216.33 (1) parents, their children, and dependent siblings 216.34 residing in the same household; or 216.35 (2) grandparents, foster parents, relative caretakers as 216.36 defined in the medical assistance program, or legal guardians; 217.1 their wards who are children; and dependent siblings residing in 217.2 the same household. 217.3 (b) The term includes children and dependent siblings who 217.4 are temporarily absent from the household in settings such as 217.5 schools, camps, or visitation with noncustodial parents. 217.6 (c) For purposes of this subdivision, a dependent sibling 217.7 means an unmarried child who is a full-time student under the 217.8 age of 25 years who is financially dependent upon a parent, 217.9 grandparent, foster parent, relative caretaker, or legal 217.10 guardian. Proof of school enrollment is required. 217.11 Subd. 4. [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] "Gross 217.12 individual or gross family income" for farm and nonfarm 217.13 self-employed means income calculated using as the baseline the 217.14 adjusted gross income reported on the applicant's federal income 217.15 tax form for the previous year and adding back in reported 217.16 depreciation, carryover loss, and net operating loss amounts 217.17 that apply to the business in which the family is currently 217.18 engaged. Applicants shall report the most recent financial 217.19 situation of the family if it has changed from the period of 217.20 time covered by the federal income tax form. The report may be 217.21 in the form of percentage increase or decrease. 217.22 Subd. 5. [INCOME.] "Income" has the meaning given for 217.23 earned and unearned income for families and children in the 217.24 medical assistance program, according to the state's aid to 217.25 families with dependent children plan in effect as of July 16, 217.26 1996. The definition does not include medical assistance income 217.27 methodologies and deeming requirements. The earned income of 217.28 full-time and part-time students under age 19 is not counted as 217.29 income. Public assistance payments and supplemental security 217.30 income are not excluded income. 217.31 Sec. 7. Minnesota Statutes 1997 Supplement, section 217.32 256L.02, subdivision 3, is amended to read: 217.33 Subd. 3. [FINANCIAL MANAGEMENT.] (a) The commissioner 217.34 shall manage spending for the MinnesotaCare program in a manner 217.35 that maintains a minimum reserve in accordance with section 217.36 16A.76. As part of each state revenue and expenditure forecast, 218.1 the commissioner must makea quarterlyan assessment of the 218.2 expected expenditures for the covered services for the remainder 218.3 of the current biennium and for the following biennium. The 218.4 estimated expenditure, including the reserve requirements 218.5 described in section 16A.76, shall be compared to an estimate of 218.6 the revenues that will bedepositedavailable in the health care 218.7 access fund. Based on this comparison, and after consulting 218.8 with the chairs of the house ways and means committee and the 218.9 senate finance committee, and the legislative commission on 218.10 health care access, the commissioner shall, as necessary, make 218.11 the adjustments specified in paragraph (b) to ensure that 218.12 expenditures remain within the limits of available revenues for 218.13 the remainder of the current biennium and for the following 218.14 biennium. The commissioner shall not hire additional staff 218.15 using appropriations from the health care access fund until the 218.16 commissioner of finance makes a determination that the 218.17 adjustments implemented under paragraph (b) are sufficient to 218.18 allow MinnesotaCare expenditures to remain within the limits of 218.19 available revenues for the remainder of the current biennium and 218.20 for the following biennium. 218.21 (b) The adjustments the commissioner shall use must be 218.22 implemented in this order: first, stop enrollment of single 218.23 adults and households without children; second, upon 45 days' 218.24 notice, stop coverage of single adults and households without 218.25 children already enrolled in the MinnesotaCare program; third, 218.26 upon 90 days' notice, decrease the premium subsidy amounts by 218.27 ten percent for families with gross annual income above 200 218.28 percent of the federal poverty guidelines; fourth, upon 90 days' 218.29 notice, decrease the premium subsidy amounts by ten percent for 218.30 families with gross annual income at or below 200 percent; and 218.31 fifth, require applicants to be uninsured for at least six 218.32 months prior to eligibility in the MinnesotaCare program. If 218.33 these measures are insufficient to limit the expenditures to the 218.34 estimated amount of revenue, the commissioner shall further 218.35 limit enrollment or decrease premium subsidies. 218.36 Sec. 8. Minnesota Statutes 1997 Supplement, section 219.1 256L.02, is amended by adding a subdivision to read: 219.2 Subd. 4. [FUNDING FOR PREGNANT WOMEN AND CHILDREN UNDER 219.3 AGE TWO.] For fiscal years beginning on or after July 1, 1999, 219.4 the state cost of health care services provided to MinnesotaCare 219.5 enrollees who are pregnant women or children under age two shall 219.6 be paid out of the general fund rather than the health care 219.7 access fund. If the commissioner of finance decides to pay for 219.8 these costs using a source other than the general fund, the 219.9 commissioner shall include the change as a budget initiative in 219.10 the biennial or supplemental budget, and shall not change the 219.11 funding source through a forecast modification. 219.12 Sec. 9. Minnesota Statutes 1997 Supplement, section 219.13 256L.03, subdivision 1, is amended to read: 219.14 Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health 219.15 services" means the health services reimbursed under chapter 219.16 256B, with the exception of inpatient hospital services, special 219.17 education services, private duty nursing services, adult dental 219.18 care services other than preventive services, orthodontic 219.19 services, nonemergency medical transportation services, personal 219.20 care assistant and case management services, nursing home or 219.21 intermediate care facilities services, inpatient mental health 219.22 services, and chemical dependency services. Effective July 1, 219.23 1998, adult dental care for nonpreventive services with the 219.24 exception of orthodontic services is available to persons who 219.25 qualify under section 256L.04, subdivisions 1 to 7,or 256L.13,219.26 with family gross income equal to or less than 175 percent of 219.27 the federal poverty guidelines. Outpatient mental health 219.28 services covered under the MinnesotaCare program are limited to 219.29 diagnostic assessments, psychological testing, explanation of 219.30 findings, medication management by a physician, day treatment, 219.31 partial hospitalization, and individual, family, and group 219.32 psychotherapy. 219.33 No public funds shall be used for coverage of abortion 219.34 under MinnesotaCare except where the life of the female would be 219.35 endangered or substantial and irreversible impairment of a major 219.36 bodily function would result if the fetus were carried to term; 220.1 or where the pregnancy is the result of rape or incest. 220.2 Covered health services shall be expanded as provided in 220.3 this section. 220.4 Sec. 10. Minnesota Statutes 1997 Supplement, section 220.5 256L.03, is amended by adding a subdivision to read: 220.6 Subd. 1a. [COVERED SERVICES FOR PREGNANT WOMEN AND 220.7 CHILDREN UNDER MINNESOTACARE HEALTH CARE REFORM WAIVER.] 220.8 Children and pregnant women are eligible for coverage of all 220.9 services that are eligible for reimbursement under the medical 220.10 assistance program according to chapter 256B, except that 220.11 abortion services under MinnesotaCare shall be limited as 220.12 provided under section 256L.03, subdivision 1. Pregnant women 220.13 and children are exempt from the provisions of subdivision 5, 220.14 regarding copayments. Pregnant women and children who are 220.15 lawfully residing in the United States but who are not 220.16 "qualified noncitizens" under title IV of the Personal 220.17 Responsibility and Work Opportunity Reconciliation Act of 1996, 220.18 Public Law Number 104-193, Statutes at Large, volume 110, page 220.19 2105, are eligible for coverage of all services provided under 220.20 the medical assistance program according to chapter 256B. 220.21 Sec. 11. Minnesota Statutes 1997 Supplement, section 220.22 256L.03, is amended by adding a subdivision to read: 220.23 Subd. 1b. [PREGNANT WOMEN; ELIGIBILITY FOR FULL MEDICAL 220.24 ASSISTANCE SERVICES.] A woman who is enrolled in MinnesotaCare 220.25 when her pregnancy is diagnosed is eligible for coverage of all 220.26 services provided under the medical assistance program according 220.27 to chapter 256B retroactive to the date the pregnancy is 220.28 medically diagnosed. Copayments totaling $30 or more, paid 220.29 after the date the pregnancy is diagnosed, shall be refunded. 220.30 Sec. 12. Minnesota Statutes 1997 Supplement, section 220.31 256L.03, subdivision 3, is amended to read: 220.32 Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a)Beginning July220.331, 1993,Covered health services shall include inpatient 220.34 hospital services, including inpatient hospital mental health 220.35 services and inpatient hospital and residential chemical 220.36 dependency treatment, subject to those limitations necessary to 221.1 coordinate the provision of these services with eligibility 221.2 under the medical assistance spenddown. Prior to July 1, 1997, 221.3 the inpatient hospital benefit for adult enrollees is subject to 221.4 an annual benefit limit of $10,000.Effective July 1, 1997,The 221.5 inpatient hospital benefit for adult enrollees who qualify under 221.6 section 256L.04, subdivision 7, or who qualify under section 221.7 256L.04, subdivisions 1to 6and 2,or 256L.13with family gross 221.8 income that exceeds 175 percent of the federal poverty 221.9 guidelines and who are not pregnant, is subject to an annual 221.10 limit of $10,000. 221.11 (b)Enrollees who qualify under section 256L.04,221.12subdivision 7, or who qualify under section 256L.04,221.13subdivisions 1 to 6, or 256L.13 with family gross income that221.14exceeds 175 percent of the federal poverty guidelines and who221.15are not pregnant, and are determined by the commissioner to have221.16a basis of eligibility for medical assistance shall apply for221.17and cooperate with the requirements of medical assistance by the221.18last day of the third month following admission to an inpatient221.19hospital. If an enrollee fails to apply for medical assistance221.20within this time period, the enrollee and the enrollee's family221.21shall be disenrolled from the plan and they may not reenroll221.22until 12 calendar months have elapsed. Enrollees and enrollees'221.23families disenrolled for not applying for or not cooperating221.24with medical assistance may not reenroll.221.25(c)Admissions for inpatient hospital services paid for 221.26 under section 256L.11, subdivision 3, must be certified as 221.27 medically necessary in accordance with Minnesota Rules, parts 221.28 9505.0500 to 9505.0540, except as provided in clauses (1) and 221.29 (2): 221.30 (1) all admissions must be certified, except those 221.31 authorized under rules established under section 254A.03, 221.32 subdivision 3, or approved under Medicare; and 221.33 (2) payment under section 256L.11, subdivision 3, shall be 221.34 reduced by five percent for admissions for which certification 221.35 is requested more than 30 days after the day of admission. The 221.36 hospital may not seek payment from the enrollee for the amount 222.1 of the payment reduction under this clause. 222.2(d) Any enrollee or family member of an enrollee who has222.3previously been permanently disenrolled from MinnesotaCare for222.4not applying for and cooperating with medical assistance shall222.5be eligible to reenroll if 12 calendar months have elapsed since222.6the date of disenrollment.222.7 Sec. 13. Minnesota Statutes 1997 Supplement, section 222.8 256L.03, subdivision 4, is amended to read: 222.9 Subd. 4. [COORDINATION WITH MEDICAL ASSISTANCE.] The 222.10 commissioner shall coordinate the provision of hospital 222.11 inpatient services under the MinnesotaCare program with enrollee 222.12 eligibility under the medical assistance spenddown, and shall222.13apply to the secretary of health and human services for any222.14necessary federal waivers or approvals. 222.15 Sec. 14. Minnesota Statutes 1997 Supplement, section 222.16 256L.03, subdivision 5, is amended to read: 222.17 Subd. 5. [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 222.18 benefit plan shall include the following copayments and 222.19 coinsurance requirements: 222.20 (1) ten percent of the paid charges for inpatient hospital 222.21 services for adult enrolleesnot eligible for medical222.22assistance, subject to an annual inpatient out-of-pocket maximum 222.23 of $1,000 per individual and $3,000 per family; 222.24 (2) $3 per prescription for adult enrollees; 222.25 (3) $25 for eyeglasses for adult enrollees; and 222.26 (4) effective July 1, 1998, 50 percent of the 222.27 fee-for-service rate for adult dental care services other than 222.28 preventive care services for persons eligible under section 222.29 256L.04, subdivisions 1 to 7,or 256L.13,with income equal to 222.30 or less than 175 percent of the federal poverty guidelines. 222.31Prior to July 1, 1997, enrollees who are not eligible for222.32medical assistance with or without a spenddown shall be222.33financially responsible for the coinsurance amount and amounts222.34which exceed the $10,000 benefit limit.Effective July 1, 1997, 222.35 adult enrolleeswho qualify under section 256L.04, subdivision222.367, or who qualify under section 256L.04, subdivisions 1 to 6, or223.1256L.13with family gross income that exceeds 175 percent of the 223.2 federal poverty guidelines and who are not pregnant, and who are223.3not eligible for medical assistance with or without a spenddown,223.4 shall be financially responsible for the coinsurance amount and 223.5 amounts which exceed the $10,000 inpatient hospital benefit 223.6 limit. 223.7 When a MinnesotaCare enrollee becomes a member of a prepaid 223.8 health plan, or changes from one prepaid health plan to another 223.9 during a calendar year, any charges submitted towards the 223.10 $10,000 annual inpatient benefit limit, and any out-of-pocket 223.11 expenses incurred by the enrollee for inpatient services, that 223.12 were submitted or incurred prior to enrollment, or prior to the 223.13 change in health plans, shall be disregarded. 223.14 Sec. 15. Minnesota Statutes 1997 Supplement, section 223.15 256L.04, subdivision 1, is amended to read: 223.16 Subdivision 1. [CHILDREN; EXPANSION AND CONTINUATION OF223.17ELIGIBILITYFAMILIES WITH CHILDREN.] (a)[CHILDREN.] Prior to223.18October 1, 1992, "eligible persons" means children who are one223.19year of age or older but less than 18 years of age who have223.20gross family incomes that are equal to or less than 185 percent223.21of the federal poverty guidelines and who are not eligible for223.22medical assistance without a spenddown under chapter 256B and223.23who are not otherwise insured for the covered services. The223.24period of eligibility extends from the first day of the month in223.25which the child's first birthday occurs to the last day of the223.26month in which the child becomes 18 years old.Families with 223.27 children with family income equal to or less than 275 percent of 223.28 the federal poverty guidelines for the applicable family size 223.29 shall be eligible for MinnesotaCare according to this section. 223.30 All other provisions of sections 256L.01 to 256L.18, including 223.31 the insurance-related barriers to enrollment under section 223.32 256L.07, shall apply unless otherwise specified. 223.33 (b)[EXPANSION OF ELIGIBILITY.] Eligibility for223.34MinnesotaCare shall be expanded as provided in subdivisions 3 to223.357, except children who meet the criteria in this subdivision223.36shall continue to be enrolled pursuant to this subdivision. The224.1enrollment requirements in this paragraph apply to enrollment224.2under subdivisions 1 to 7.Parents who enroll in the 224.3 MinnesotaCare program must also enroll their children and 224.4 dependent siblings, if the children and their dependent siblings 224.5 are eligible. Children and dependent siblings may be enrolled 224.6 separately without enrollment by parents. However, if one 224.7 parent in the household enrolls, both parents must enroll, 224.8 unless other insurance is available. If one child from a family 224.9 is enrolled, all children must be enrolled, unless other 224.10 insurance is available. If one spouse in a household enrolls, 224.11 the other spouse in the household must also enroll, unless other 224.12 insurance is available. Families cannot choose to enroll only 224.13 certain uninsured members.For purposes of this section, a224.14"dependent sibling" means an unmarried child who is a full-time224.15student under the age of 25 years who is financially dependent224.16upon a parent. Proof of school enrollment will be required.224.17(c) [CONTINUATION OF ELIGIBILITY.] Individuals who224.18initially enroll in the MinnesotaCare program under the224.19eligibility criteria in subdivisions 3 to 7 remain eligible for224.20the MinnesotaCare program, regardless of age, place of224.21residence, or the presence or absence of children in the same224.22household, as long as all other eligibility criteria are met and224.23residence in Minnesota and continuous enrollment in the224.24MinnesotaCare program or medical assistance are maintained. In224.25order for either parent or either spouse in a household to224.26remain enrolled, both must remain enrolled, unless other224.27insurance is available.224.28 Sec. 16. Minnesota Statutes 1997 Supplement, section 224.29 256L.04, subdivision 2, is amended to read: 224.30 Subd. 2. [COOPERATION IN ESTABLISHING THIRD PARTY 224.31 LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 224.32 eligible for MinnesotaCare, individuals and families must 224.33 cooperate with the state agency to identify potentially liable 224.34 third party payers and assist the state in obtaining third party 224.35 payments. "Cooperation" includes, but is not limited to, 224.36 identifying any third party who may be liable for care and 225.1 services provided under MinnesotaCare to the enrollee, providing 225.2 relevant information to assist the state in pursuing a 225.3 potentially liable third party, and completing forms necessary 225.4 to recover third party payments. 225.5 (b) A parent, guardian, or child enrolled in the 225.6 MinnesotaCare program must cooperate with the department of 225.7 human services and the local agency in establishing the 225.8 paternity of an enrolled child and in obtaining medical care 225.9 support and payments for the child and any other person for whom 225.10 the person can legally assign rights, in accordance with 225.11 applicable laws and rules governing the medical assistance 225.12 program. A child shall not be ineligible for or disenrolled 225.13 from the MinnesotaCare program solely because the child's parent 225.14 or guardian fails to cooperate in establishing paternity or 225.15 obtaining medical support. 225.16 Sec. 17. Minnesota Statutes 1997 Supplement, section 225.17 256L.04, subdivision 7, is amended to read: 225.18 Subd. 7. [ADDITION OFSINGLE ADULTS AND HOUSEHOLDS WITH NO 225.19 CHILDREN.](a) Beginning October 1, 1994, the definition of225.20"eligible persons" is expanded to include all individuals and225.21households with no children who have gross family incomes that225.22are equal to or less than 125 percent of the federal poverty225.23guidelines and who are not eligible for medical assistance225.24without a spenddown under chapter 256B.225.25(b) Beginning July 1, 1997,The definition of eligible 225.26 personsis expanded to includeincludes all individuals and 225.27 households with no children who have gross family incomes that 225.28 are equal to or less than 175 percent of the federal poverty 225.29 guidelinesand who are not eligible for medical assistance225.30without a spenddown under chapter 256B. 225.31(c) All eligible persons under paragraphs (a) and (b) are225.32eligible for coverage through the MinnesotaCare program but must225.33pay a premium as determined under sections 256L.07 and 256L.08.225.34Individuals and families whose income is greater than the limits225.35established under section 256L.08 may not enroll in the225.36MinnesotaCare program.226.1 Sec. 18. Minnesota Statutes 1997 Supplement, section 226.2 256L.04, is amended by adding a subdivision to read: 226.3 Subd. 7a. [INELIGIBILITY.] Applicants whose income is 226.4 greater than the limits established under this section may not 226.5 enroll in the MinnesotaCare program. 226.6 Sec. 19. Minnesota Statutes 1997 Supplement, section 226.7 256L.04, subdivision 8, is amended to read: 226.8 Subd. 8. [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 226.9 ASSISTANCE.] (a) Individuals whoapply for MinnesotaCarereceive 226.10 supplemental security income or retirement, survivors, or 226.11 disability benefits due to a disability, or other 226.12 disability-based pension, who qualify under section 256L.04, 226.13 subdivision 7, but who are potentially eligible for medical 226.14 assistance without a spenddown shall be allowed to enroll in 226.15 MinnesotaCare for a period of 60 days, so long as the applicant 226.16 meets all other conditions of eligibility. The commissioner 226.17 shall identify and refer the applications of such individuals to 226.18 their county social service agency. The county and the 226.19 commissioner shall cooperate to ensure that the individuals 226.20 obtain medical assistance coverage for any months for which they 226.21 are eligible. 226.22 (b) The enrollee must cooperate with the county social 226.23 service agency in determining medical assistance eligibility 226.24 within the 60-day enrollment period. Enrollees who do notapply226.25for andcooperate with medical assistance within the 60-day 226.26 enrollment period, and their other family members,shall be 226.27 disenrolled from the plan within one calendar month. Persons 226.28 disenrolled for nonapplication for medical assistance may not 226.29 reenroll until they have obtained a medical assistance 226.30 eligibility determinationfor the family member or members who226.31were referred to the county agency. Persons disenrolled for 226.32 noncooperation with medical assistance may not reenroll until 226.33 they have cooperated with the county agency and have obtained a 226.34 medical assistance eligibility determination. 226.35 (c) Beginning January 1, 2000, counties that choose to 226.36 become MinnesotaCare enrollment sites shall consider 227.1 MinnesotaCare applications of individuals described in paragraph 227.2 (a) to also be applications for medical assistance and shall 227.3 first determine whether medical assistance eligibility exists. 227.4 Adults with children with family income under 175 percent of the 227.5 federal poverty guidelines for the applicable family size, 227.6 pregnant women, and children who qualify under subdivision 1 who 227.7 are potentially eligible for medical assistance without a 227.8 spenddown may choose to enroll in either MinnesotaCare or 227.9 medical assistance. 227.10 (d) The commissioner shall redetermine provider payments 227.11 made under MinnesotaCare to the appropriate medical assistance 227.12 payments for those enrollees who subsequently become eligible 227.13 for medical assistance. 227.14 Sec. 20. Minnesota Statutes 1997 Supplement, section 227.15 256L.04, subdivision 9, is amended to read: 227.16 Subd. 9. [GENERAL ASSISTANCE MEDICAL CARE.] A person 227.17 cannot have coverage under both MinnesotaCare and general 227.18 assistance medical care in the same month. Eligibility for 227.19 MinnesotaCare cannot be replaced by eligibility for general 227.20 assistance medical care, and eligibility for general assistance 227.21 medical care cannot be replaced by eligibility for MinnesotaCare. 227.22 Sec. 21. Minnesota Statutes 1997 Supplement, section 227.23 256L.04, subdivision 10, is amended to read: 227.24 Subd. 10. [SPONSOR'S INCOME AND RESOURCES DEEMED 227.25 AVAILABLE; DOCUMENTATION.] When determining eligibility for any 227.26 federal or state benefits under sections 256L.01 to256L.16227.27 256L.18, the income and resources of all noncitizens whose 227.28 sponsor signed an affidavit of support as defined under United 227.29 States Code, title 8, section 1183a, shall be deemed to include 227.30 their sponsors' income and resources as defined in the Personal 227.31 Responsibility and Work Opportunity Reconciliation Act of 1996, 227.32 title IV, Public Law Number 104-193, sections 421 and 422, and 227.33 subsequently set out in federal rules. To be eligible for the 227.34 program, noncitizens must provide documentation of their 227.35 immigration status. 227.36 Sec. 22. Minnesota Statutes 1997 Supplement, section 228.1 256L.04, is amended by adding a subdivision to read: 228.2 Subd. 12. [PERSONS IN DETENTION.] An applicant residing in 228.3 a correctional or detention facility is not eligible for 228.4 MinnesotaCare. An enrollee residing in a correctional or 228.5 detention facility is not eligible at renewal of eligibility 228.6 under section 256L.05, subdivision 3b. 228.7 Sec. 23. Minnesota Statutes 1997 Supplement, section 228.8 256L.04, is amended by adding a subdivision to read: 228.9 Subd. 13. [FAMILIES WITH GRANDPARENTS, RELATIVE 228.10 CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] In families 228.11 that include a grandparent, relative caretaker as defined in the 228.12 medical assistance program, foster parent, or legal guardian, 228.13 the grandparent, relative caretaker, foster parent, or legal 228.14 guardian may apply as a family or may apply separately for the 228.15 child. If the grandparent, relative caretaker, foster parent, 228.16 or legal guardian applies with the family, their income is 228.17 included in the gross family income for determining eligibility 228.18 and premium amount. 228.19 Sec. 24. Minnesota Statutes 1997 Supplement, section 228.20 256L.05, is amended by adding a subdivision to read: 228.21 Subd. 1a. [PERSON AUTHORIZED TO APPLY ON APPLICANT'S 228.22 BEHALF.] A family member who is age 18 or over or who is an 228.23 authorized representative, as defined in the medical assistance 228.24 program, may apply on an applicant's behalf. 228.25 Sec. 25. Minnesota Statutes 1997 Supplement, section 228.26 256L.05, subdivision 2, is amended to read: 228.27 Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall 228.28 use individuals' social security numbers as identifiers for 228.29 purposes of administering the plan and conduct data matches to 228.30 verify income. Applicants shall submit evidence of individual 228.31 and family income, earned and unearned,includingsuch as the 228.32 most recent income tax return, wage slips, or other 228.33 documentation that is determined by the commissioner as 228.34 necessary to verify income eligibility. The commissioner shall 228.35 perform random audits to verify reported income and 228.36 eligibility. The commissioner may execute data sharing 229.1 arrangements with the department of revenue and any other 229.2 governmental agency in order to perform income verification 229.3 related to eligibility and premium payment under the 229.4 MinnesotaCare program. 229.5 Sec. 26. Minnesota Statutes 1997 Supplement, section 229.6 256L.05, subdivision 3, is amended to read: 229.7 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] The effective date 229.8 of coverage is the first day of the month following the month in 229.9 which eligibility is approved and the first premium payment has 229.10 been received. As provided in section 256B.057, coverage for 229.11 newborns is automatic from the date of birth and must be 229.12 coordinated with other health coverage. The effective date of 229.13 coverage foreligible newborns oreligible newly adoptive 229.14 children added to a family receiving covered health services is 229.15 the date of entry into the family. The effective date of 229.16 coverage for other new recipients added to the family receiving 229.17 covered health services is the first day of the month following 229.18 the month in which eligibility is approvedand the first premium229.19payment has been receivedor at renewal, whichever the family 229.20 receiving covered health services prefers. All eligibility 229.21 criteria must be met by the family at the time the new family 229.22 member is added. The income of the new family member is 229.23 included with the family's gross income and the adjusted premium 229.24 begins in the month the new family member is added. The premium 229.25 must be received eight working days prior to the end of the 229.26 month for coverage to begin the following month. Benefits are 229.27 not available until the day following discharge if an enrollee 229.28 is hospitalized on the first day of coverage. Notwithstanding 229.29 any other law to the contrary, benefits under sections 256L.01 229.30 to256L.10256L.18 are secondary to a plan of insurance or 229.31 benefit program under which an eligible person may have coverage 229.32 and the commissioner shall use cost avoidance techniques to 229.33 ensure coordination of any other health coverage for eligible 229.34 persons. The commissioner shall identify eligible persons who 229.35 may have coverage or benefits under other plans of insurance or 229.36 who become eligible for medical assistance. 230.1 Sec. 27. Minnesota Statutes 1997 Supplement, section 230.2 256L.05, is amended by adding a subdivision to read: 230.3 Subd. 3a. [RENEWAL OF ELIGIBILITY.] An enrollee's 230.4 eligibility must be renewed every 12 months. The 12-month 230.5 period begins in the month after the month the application is 230.6 approved. An enrollee must meet all applicable eligibility 230.7 criteria at the time of renewal. An enrollee whose income 230.8 exceeds the income limits specified in section 256L.04, 230.9 subdivision 1 or 7 is subject to section 256L.07, subdivision 1. 230.10 Sec. 28. Minnesota Statutes 1997 Supplement, section 230.11 256L.05, is amended by adding a subdivision to read: 230.12 Subd. 3b. [REAPPLICATION.] Families and individuals must 230.13 reapply after a lapse in coverage of one calendar month or more 230.14 and must meet all eligibility criteria. 230.15 Sec. 29. Minnesota Statutes 1997 Supplement, section 230.16 256L.05, subdivision 4, is amended to read: 230.17 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 230.18 human services shall determine an applicant's eligibility for 230.19 MinnesotaCare no more than 30 days from the date that the 230.20 application is received by the department of human services. 230.21 Beginning January 1, 2000, this requirement also applies to 230.22 local county human services agencies that determine eligibility 230.23 for MinnesotaCare. To prevent processing delays, applicants who 230.24 appear to meet eligibility requirements shall be enrolled. The 230.25 enrollee must provide all required verifications within 30 days 230.26 of enrollment or coverage from the program shall be terminated. 230.27 Enrollees who are determined to be ineligible when verifications 230.28 are provided shall be terminated. 230.29 Sec. 30. Minnesota Statutes 1997 Supplement, section 230.30 256L.06, subdivision 3, is amended to read: 230.31 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 230.32 Premiums are dedicated to the commissioner for MinnesotaCare. 230.33The commissioner shall make an annual redetermination of230.34continued eligibility and identify people who may become230.35eligible for medical assistance.230.36 (b) The commissioner shall develop and implement procedures 231.1 to: (1) require enrollees to report changes in income; (2) 231.2 adjust sliding scale premium payments, based upon changes in 231.3 enrollee income; and (3) disenroll enrollees from MinnesotaCare 231.4 for failure to pay required premiums. Failure to pay includes 231.5 payment with a dishonored check. The commissioner may demand a 231.6 guaranteed form of payment as the only means to replace a 231.7 dishonored check. 231.8 (c) Premiums are calculated on a calendar month basis and 231.9 may be paid on a monthly, quarterly, or annual basis, with the 231.10 first payment due upon notice from the commissioner of the 231.11 premium amount required. The commissioner shall inform 231.12 applicants and enrollees of these premium payment options. 231.13 Premium payment is required before enrollment is complete and to 231.14 maintain eligibility in MinnesotaCare. 231.15 (d) Nonpayment of the premium will result in disenrollment 231.16 from the plan within one calendar month after the due date. 231.17 Persons disenrolled for nonpayment or who voluntarily terminate 231.18 coverage from the program may not reenroll until four calendar 231.19 months have elapsed. Persons disenrolled for nonpayment or who 231.20 voluntarily terminate coverage from the program may not reenroll 231.21 for four calendar months unless the person demonstrates good 231.22 cause for nonpayment. Good cause does not exist if a person 231.23 chooses to pay other family expenses instead of the premium. 231.24 The commissioner shall define good cause in rule. 231.25 Sec. 31. Minnesota Statutes 1997 Supplement, section 231.26 256L.07, is amended to read: 231.27 256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON 231.28 SLIDING SCALE.] 231.29 Subdivision 1. [GENERAL REQUIREMENTS.]Families and231.30individuals who enroll on or after October 1, 1992, are eligible231.31for subsidized premium payments based on a sliding scale under231.32section 256L.08 only if the family or individual meets the231.33requirements in subdivisions 2 and 3. Children already enrolled231.34in the children's health plan as of September 30, 1992, eligible231.35under section 256L.04, subdivision 1, paragraph (a), children231.36who enroll in the MinnesotaCare program after September 30,232.11992, pursuant to Laws 1992, chapter 549, article 4, section 17,232.2and children who enroll under section 256L.04, subdivision 6,232.3are eligible for subsidized premium payments without meeting232.4these requirements, as long as they maintain continuous coverage232.5in the MinnesotaCare plan or medical assistance.232.6 Familiesand individuals who initiallyenrolled in 232.7 MinnesotaCare under section 256L.04,andsubdivision 1, whose 232.8 income increases abovethe limits established in section 256L.08232.9 275 percent of the federal poverty guidelines, may continue 232.10 enrollment and pay the full cost of coverage. Individuals 232.11 enrolled in MinnesotaCare under section 256L.04, subdivision 7, 232.12 whose income increases above 175 percent of the federal poverty 232.13 guidelines may continue enrollment and pay premiums according to 232.14 the sliding fee scale. These individuals must pay the full cost 232.15 of coverage when their income increases above 275 percent of the 232.16 federal poverty guidelines. 232.17 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 232.18 COVERAGE.] (a) To be eligible for subsidized premium payments 232.19 based on a sliding scale, a family or individual must not have 232.20 access to subsidized health coverage through an employer, and232.21must not have had access to subsidized health coverage through232.22an employer for the 18 months prior to application for232.23subsidized coverage under the MinnesotaCare program.The232.24requirement that the family or individual must not have had232.25access to employer-subsidized coverage during the previous 18232.26months does not apply if: (1) employer-subsidized coverage was232.27lost due to the death of an employee or divorce; (2)232.28employer-subsidized coverage was lost because an individual232.29became ineligible for coverage as a child or dependent; or (3)232.30employer-subsidized coverage was lost for reasons that would not232.31disqualify the individual for unemployment benefits under232.32section 268.09 and the family or individual has not had access232.33to employer-subsidized coverage since the loss of coverage. If232.34employer-subsidized coverage was lost for reasons that232.35disqualify an individual for unemployment benefits under section232.36268.09, children of that individual are exempt from the233.1requirement of no access to employer subsidized coverage for the233.218 months prior to application, as long as the children have not233.3had access to employer subsidized coverage since the233.4disqualifying event. The requirement that the. A family or 233.5 individualmust not have had access to employer-subsidized233.6coverage during the previous 18 months does apply ifwhose 233.7 employer-subsidized coverage is lost due to an employer 233.8 terminating health care coverage as an employee benefit during 233.9 the previous 18 months is not eligible. 233.10 (b) For purposes of this requirement, subsidized health 233.11 coverage means health coverage for which the employer pays at 233.12 least 50 percent of the cost of coverage for the employee,233.13excluding dependent coverageor dependent, or a higher 233.14 percentage as specified by the commissioner. Children are 233.15 eligible for employer-subsidized coverage through either parent, 233.16 including the noncustodial parent. The commissioner must treat 233.17 employer contributions to Internal Revenue Code Section 125 233.18 plans and any other employer benefits intended to pay health 233.19 care costs as qualified employer subsidies toward the cost of 233.20 health coverage for employees for purposes of this subdivision. 233.21 Subd. 3. [PERIOD UNINSUREDOTHER HEALTH COVERAGE.]To be233.22eligible for subsidized premium payments based on a sliding233.23scale,(a) Families and individualsinitiallyenrolled in the 233.24 MinnesotaCare programunder section 256L.04, subdivisions 5 and233.257,must havehadno health coverage while enrolled or for at 233.26 least four months prior to application and renewal. A child in 233.27 a family with income equal to or less than 150 percent of the 233.28 federal poverty guidelines, who has other health coverage, is 233.29 eligible if the other health coverage meets the requirements of 233.30 Minnesota Rules, part 9506.0020, subpart 3, item B. The 233.31 commissioner may change this eligibility criterion for sliding 233.32 scale premiums in order to remain within the limits of available 233.33 appropriations. The requirement ofat least four months ofno 233.34 health coverageprior to application for the MinnesotaCare233.35programdoes not apply to:newborns. 233.36(1) families, children, and individuals who apply for the234.1MinnesotaCare program upon termination from or as required by234.2the medical assistance program, general assistance medical care234.3program, or coverage under a regional demonstration project for234.4the uninsured funded under section 256B.73, the Hennepin county234.5assured care program, or the Group Health, Inc., community234.6health plan;234.7(2) families and individuals initially enrolled under234.8section 256L.04, subdivisions 1, paragraph (a), and 3;234.9(3) children enrolled pursuant to Laws 1992, chapter 549,234.10article 4, section 17; or234.11(4) individuals currently serving or who have served in the234.12military reserves, and dependents of these individuals, if these234.13individuals: (i) reapply for MinnesotaCare coverage after a234.14period of active military service during which they had been234.15covered by the Civilian Health and Medical Program of the234.16Uniformed Services (CHAMPUS); (ii) were covered under234.17MinnesotaCare immediately prior to obtaining coverage under234.18CHAMPUS; and (iii) have maintained continuous coverage.234.19 (b) For purposes of this section, medical assistance, 234.20 general assistance medical care, and civilian health and medical 234.21 program of the uniformed service (CHAMPUS) are not considered 234.22 insurance or health coverage. 234.23 (c) For purposes of this section, Medicare part A or B 234.24 coverage under title XVIII of the Social Security Act, United 234.25 States Code, title 42, sections 1395c to 1395w-4, is considered 234.26 health coverage. An applicant or enrollee may not refuse 234.27 Medicare coverage to establish eligibility for MinnesotaCare. 234.28 Subd. 4. [EXEMPTION FOR PERSONS WITH CONTINUATION 234.29 COVERAGE.] (a) Families, children, and individuals who want to 234.30 apply for the MinnesotaCare program upon termination from 234.31 continuation coverage required under federal or state law are 234.32 exempt from the requirements of subdivisions 2 and 3. 234.33 (b) For purposes of paragraph (a), "termination from 234.34 continuation coverage" means involuntary termination for any 234.35 reason, other than nonpayment of premium by the family, child, 234.36 or individual. Involuntary termination includes termination of 235.1 coverage due to reaching the end of the maximum period for 235.2 continuation coverage required under federal or state law. 235.3 Sec. 32. Minnesota Statutes 1997 Supplement, section 235.4 256L.09, subdivision 2, is amended to read: 235.5 Subd. 2. [RESIDENCY REQUIREMENT.] (a)Prior to July 1,235.61997, to be eligible for health coverage under the MinnesotaCare235.7program, families and individuals must be permanent residents of235.8Minnesota.235.9(b) Effective July 1, 1997,To be eligible for health 235.10 coverage under the MinnesotaCare program, adults without 235.11 children must be permanent residents of Minnesota. 235.12(c) Effective July 1, 1997,(b) To be eligible for health 235.13 coverage under the MinnesotaCare program, pregnant women, 235.14 families, and children must meet the residency requirements as 235.15 provided by Code of Federal Regulations, title 42, section 235.16 435.403, except that the provisions of section 256B.056, 235.17 subdivision 1, shall apply upon receipt of federal approval. 235.18 Sec. 33. Minnesota Statutes 1997 Supplement, section 235.19 256L.09, subdivision 4, is amended to read: 235.20 Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 235.21 purposes of this section, a permanent Minnesota resident is a 235.22 person who has demonstrated, through persuasive and objective 235.23 evidence, that the person is domiciled in the state and intends 235.24 to live in the state permanently. 235.25 (b) To be eligible as a permanent resident,all applicants235.26 an applicant must demonstrate the requisite intent to live in 235.27 the state permanently by: 235.28 (1) showing that the applicant maintains a residence at a 235.29 verified address other than a place of public accommodation, 235.30 through the use of evidence of residence described in section 235.31 256D.02, subdivision 12a, clause (1); 235.32 (2) demonstrating that the applicant has been continuously 235.33 domiciled in the state for no less than 180 days immediately 235.34 before the application; and 235.35 (3) signing an affidavit declaring that (A) the applicant 235.36 currently resides in the state and intends to reside in the 236.1 state permanently; and (B) the applicant did not come to the 236.2 state for the primary purpose of obtaining medical coverage or 236.3 treatment. 236.4 (c) A person who is temporarily absent from the state does 236.5 not lose eligibility for MinnesotaCare. "Temporarily absent 236.6 from the state" means the person is out of the state for a 236.7 temporary purpose and intends to return when the purpose of the 236.8 absence has been accomplished. A person is not temporarily 236.9 absent from the state if another state has determined that the 236.10 person is a resident for any purpose. If temporarily absent 236.11 from the state, the person must follow the requirements of the 236.12 health plan in which he or she is enrolled to receive services. 236.13 Sec. 34. Minnesota Statutes 1997 Supplement, section 236.14 256L.09, subdivision 6, is amended to read: 236.15 Subd. 6. [12-MONTH PREEXISTING EXCLUSION.] If the 180-day 236.16 requirement in subdivision 4, paragraph (b), clause (2), is 236.17 determined by a court to be unconstitutional, the commissioner 236.18 of human services shall impose a 12-month preexisting condition 236.19 exclusion on coverage for persons who have been domiciled in the 236.20 state for less than 180 days. 236.21 Sec. 35. Minnesota Statutes 1997 Supplement, section 236.22 256L.11, subdivision 6, is amended to read: 236.23 Subd. 6. [ENROLLEES 18 OR OLDER.] Payment by the 236.24 MinnesotaCare program for inpatient hospital services provided 236.25 to MinnesotaCare enrollees eligible under section 256L.04, 236.26 subdivision 7, or who qualify under section 256L.04, 236.27 subdivisions 1to 6and 2,or 256L.13with family gross income 236.28 that exceeds 175 percent of the federal poverty guidelines and 236.29 who are not pregnant, who are 18 years old or older on the date 236.30 of admission to the inpatient hospital must be in accordance 236.31 with paragraphs (a) and (b). Payment for adults who are not 236.32 pregnant and are eligible under section 256L.04, subdivisions 236.33 1to 6and 2,or 256L.13,and whose incomes are equal to or less 236.34 than 175 percent of the federal poverty guidelines, shall be as 236.35 provided for under paragraph (c). 236.36 (a) If the medical assistance rate minus any copayment 237.1 required under section 256L.03, subdivision 4, is less than or 237.2 equal to the amount remaining in the enrollee's benefit limit 237.3 under section 256L.03, subdivision 3, payment must be the 237.4 medical assistance rate minus any copayment required under 237.5 section 256L.03, subdivision 4. The hospital must not seek 237.6 payment from the enrollee in addition to the copayment. The 237.7 MinnesotaCare payment plus the copayment must be treated as 237.8 payment in full. 237.9 (b) If the medical assistance rate minus any copayment 237.10 required under section 256L.03, subdivision 4, is greater than 237.11 the amount remaining in the enrollee's benefit limit under 237.12 section 256L.03, subdivision 3, payment must be the lesser of: 237.13 (1) the amount remaining in the enrollee's benefit limit; 237.14 or 237.15 (2) charges submitted for the inpatient hospital services 237.16 less any copayment established under section 256L.03, 237.17 subdivision 4. 237.18 The hospital may seek payment from the enrollee for the 237.19 amount by which usual and customary charges exceed the payment 237.20 under this paragraph. If payment is reduced under section 237.21 256L.03, subdivision 3, paragraph(c)(b), the hospital may not 237.22 seek payment from the enrollee for the amount of the reduction. 237.23 (c) For admissions occurring during the period of July 1, 237.24 1997, through June 30, 1998, for adults who are not pregnant and 237.25 are eligible under section 256L.04, subdivisions 1to 6and 237.26 2,or 256L.13,and whose incomes are equal to or less than 175 237.27 percent of the federal poverty guidelines, the commissioner 237.28 shall pay hospitals directly, up to the medical assistance 237.29 payment rate, for inpatient hospital benefits in excess of the 237.30 $10,000 annual inpatient benefit limit. 237.31 Sec. 36. Minnesota Statutes 1997 Supplement, section 237.32 256L.12, subdivision 5, is amended to read: 237.33 Subd. 5. [ELIGIBILITY FOR OTHER STATE PROGRAMS.] 237.34 MinnesotaCare enrollees who become eligible for medical 237.35 assistance or general assistance medical care will remain in the 237.36 same managed care plan if the managed care plan has a contract 238.1 for that population. Effective January 1, 1998, MinnesotaCare 238.2 enrollees who were formerly eligible for general assistance 238.3 medical care pursuant to section 256D.03, subdivision 3, within 238.4 six months of MinnesotaCare enrollment and were enrolled in a 238.5 prepaid health plan pursuant to section 256D.03, subdivision 4, 238.6 paragraph (d), must remain in the same managed care plan if the 238.7 managed care plan has a contract for that population.Contracts238.8between the department of human services and managed care plans238.9must include MinnesotaCare, and medical assistance and may, at238.10the option of the commissioner of human services, also include238.11general assistance medical care.Managed care plans must 238.12 participate in the MinnesotaCare and general assistance medical 238.13 care programs under a contract with the department of human 238.14 services in service areas where they participate in the medical 238.15 assistance program. 238.16 Sec. 37. Minnesota Statutes 1997 Supplement, section 238.17 256L.15, is amended to read: 238.18 256L.15 [PREMIUMS.] 238.19 Subdivision 1. [PREMIUM DETERMINATION.] Familiesandwith 238.20 childrenenrolled according to sections 256L.13 to 256L.16and 238.21 individuals shall pay an enrollment fee or a premium determined 238.22 according to a sliding fee based on the cost of coverage as a 238.23 percentage of the family's gross family income. Pregnant women 238.24 and children under age two are exempt from the provisions of 238.25 section 256L.06, subdivision 3, paragraph (b), clause (3), 238.26 requiring disenrollment for failure to pay premiums. For 238.27 pregnant women, this exemption continues until the first day of 238.28 the month following the 60th day postpartum. Women who remain 238.29 enrolled during pregnancy or the postpartum period, despite 238.30 nonpayment of premiums, shall be disenrolled on the first of the 238.31 month following the 60th day postpartum for the penalty period 238.32 that otherwise applies under section 256L.06, unless they begin 238.33 paying premiums. 238.34 Subd. 1a. [PAYMENT OPTIONS.] The commissioner may offer 238.35 the following payment options to an enrollee: 238.36 (1) payment by check; 239.1 (2) payment by credit card; 239.2 (3) payment by recurring automatic checking withdrawal; 239.3 (4) payment by one-time electronic transfer of funds; or 239.4 (5) payment by wage withholding with the consent of the 239.5 employer and the employee. 239.6 Subd. 1b. [PAYMENTS NONREFUNDABLE.] MinnesotaCare premiums 239.7 and enrollment fees are not refundable. 239.8 Subd. 2. [SLIDING SCALE TO DETERMINE PERCENTAGE OF GROSS 239.9 INDIVIDUAL OR FAMILY INCOME.] The commissioner shall establish a 239.10 sliding fee scale to determine the percentage of 239.11 gross individual or family income that households at different 239.12 income levels must pay to obtain coverage through the 239.13 MinnesotaCare program. The sliding fee scale must be based on 239.14 the enrollee's gross individual or family income during the 239.15 previous four months. The sliding fee scale begins with a 239.16 premium of 1.5 percent of gross individual or family income for 239.17 individuals or families with incomes below the limits for the 239.18 medical assistance program for families and children and 239.19 proceeds through the following evenly spaced steps: 1.8, 2.3, 239.20 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. These percentages are 239.21 matched to evenly spaced income steps ranging from the medical 239.22 assistance income limit for families and children to 275 percent 239.23 of the federal poverty guidelines for the applicable family 239.24 size. An adult without children whose income is equal to or 239.25 less than 175 percent of the federal poverty guidelines shall 239.26 pay premiums according to the sliding fee scale. When an 239.27 enrollee's income exceeds the eligibility limit established for 239.28 families with children under section 256L.04, subdivision 1, the 239.29 enrollee must pay the full cost of coverage as required under 239.30 section 256L.07, subdivision 1. The sliding fee scale and 239.31 percentages are not subject to the provisions of chapter 14. If 239.32 a family or individual reports increased income after 239.33 enrollment, premiums shall not be adjusted until eligibility 239.34 renewal. 239.35Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium239.36of $48 is required for all children who are eligible according240.1to section 256L.13, subdivision 4.240.2 Subd. 4. [CHILDREN IN FAMILIES WITH INCOME AT OR LESS THAN 240.3 150 PERCENT OF FEDERAL POVERTY GUIDELINES.] Children in families 240.4 with income at or below 150 percent of the federal poverty 240.5 guidelines, when only the children are enrolled, may pay an 240.6 annual enrollment fee of $48 per child. Payment of the $48 240.7 annual enrollment fee in families with only the children 240.8 enrolled guarantees eligibility for 12 months regardless of 240.9 changes in circumstances. If the entire family is enrolled, the 240.10 children are required to pay a monthly premium of $4. 240.11 Sec. 38. Minnesota Statutes 1997 Supplement, section 240.12 256L.17, is amended by adding a subdivision to read: 240.13 Subd. 6. [WAIVER OF MAINTENANCE OF EFFORT 240.14 REQUIREMENT.] Unless a federal waiver of the maintenance of 240.15 effort requirements of section 2105(d) of title XXI of the 240.16 Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 240.17 at Large, volume 111, page 251, is granted by the federal 240.18 Department of Health and Human Services by September 30, 1998, 240.19 this section does not apply to children. The commissioner shall 240.20 publish a notice in the State Register upon receipt of a federal 240.21 waiver. 240.22 Sec. 39. [256L.19] [STATE CHILDREN'S HEALTH INSURANCE 240.23 PROGRAM.] 240.24 Subdivision 1. [AUTHORITY.] The commissioner is authorized 240.25 to claim enhanced federal matching funds under sections 240.26 2105(a)(2) and 2110 of the Balanced Budget Act of 1997, Public 240.27 Law Number 105-33, for any and all state or local expenditures 240.28 eligible as child health assistance for targeted low income 240.29 children and health service initiatives for low income 240.30 children. If required by federal law or regulations, the 240.31 commissioner is authorized to establish accounts, make 240.32 appropriate payments, and receive reimbursement from state and 240.33 local entities providing child health assistance or health 240.34 services for low income children, in order to obtain enhanced 240.35 federal matching funds. Enhanced federal matching funds 240.36 received as a result of authority exercised under this section 241.1 shall be deposited in the general fund. 241.2 Subd. 2. [ENHANCED MATCHING FUNDS FOR CHILDREN'S HEALTH 241.3 CARE INITIATIVES.] The commissioner shall submit to the health 241.4 care financing administration all plans and waiver requests 241.5 necessary to obtain enhanced matching funds under the state 241.6 children's health insurance program established as Title 21 of 241.7 the Balanced Budget Act of 1997, Public Law Number 105-33, for: 241.8 (1) expenditures made under section 256B.057, subdivision 9; and 241.9 (2) expenditures made under the MinnesotaCare program. The 241.10 commissioner shall submit to the legislature, by January 15, 241.11 1999, all statutory changes to the MinnesotaCare program 241.12 necessary to receive enhanced federal matching funds. 241.13 Sec. 40. [UNCOMPENSATED CARE STUDY.] 241.14 The commissioner of health, in consultation with the 241.15 commissioner of human services, shall present to the legislative 241.16 commission on health care access, by January 15, 1999, a report 241.17 and recommendations on the provision and financing of 241.18 uncompensated care in Minnesota. The report must: 241.19 (1) document the extent of uncompensated care provided in 241.20 Minnesota; 241.21 (2) discuss options for financing uncompensated care; 241.22 (3) describe other state approaches to monitoring and 241.23 financing uncompensated care; and 241.24 (4) describe alternative approaches to encourage health 241.25 care coverage. 241.26 Sec. 41. [SPECIAL PREMIUM TAX PAYMENT.] 241.27 Health maintenance organizations, community integrated 241.28 service networks, and nonprofit health service plan corporations 241.29 that have met the cost containment goals established in 241.30 Minnesota Statutes, section 62J.04, in the individual and small 241.31 employer market for calendar year 1996 shall pay a special, 241.32 one-time 1999 premium tax payment. The tax payment must be 241.33 based on an amount equal to one percent of gross premiums less 241.34 return premiums on all direct business received by the insurer 241.35 in this state, or by its agents for it, in cash or otherwise 241.36 after March 30, 1997, and before January 1, 1998. Payment of 242.1 the tax under this section is due January 2, 1999. Provisions 242.2 relating to the payment, assessment, and collection of the tax 242.3 assessed under Minnesota Statutes, section 60A.15, shall apply 242.4 to the special tax payment assessed under this section. 242.5 Sec. 42. [REVISOR'S INSTRUCTION.] 242.6 In each section of Minnesota Statutes referred to in column 242.7 A, the revisor of statutes shall delete the reference in column 242.8 B and insert the reference in column C. 242.9 Column A Column B Column C 242.10 256B.057, subd. 1a 256L.08 256L.15 242.11 256B.0645 256L.14 256L.03, subd. 1a 242.12 256L.16 256L.14 256L.03, subd. 1a 242.13 Sec. 43. [REPEALER.] 242.14 Minnesota Statutes 1997 Supplement, sections 256B.057, 242.15 subdivision 1a; 256L.04, subdivisions 3, 4, 5, and 6; 256L.06, 242.16 subdivisions 1 and 2; 256L.08; 256L.09, subdivision 3; 256L.13; 242.17 256L.14; and 256L.15, subdivision 3, are repealed. 242.18 Sec. 44. [EFFECTIVE DATE.] 242.19 (a) Sections 2 (256B.04, subdivision 18), 5 to 7, 9 to 37, 242.20 42 (Revisor Instruction), and 43 (Repealer) are effective 242.21 January 1, 1999. 242.22 (b) Sections 3 (256B.057, subdivision 7), 4 (256B.057, 242.23 subdivision 8), 38 (256L.17, subdivision 6), and 39 (256L.19) 242.24 are effective September 30, 1998. 242.25 ARTICLE 6 242.26 WELFARE REFORM; WORK FIRST; ASSISTANCE PROGRAM 242.27 AND CHILD SUPPORT CHANGES; AND LICENSING 242.28 Section 1. Minnesota Statutes 1997 Supplement, section 242.29 119B.01, subdivision 16, is amended to read: 242.30 Subd. 16. [TRANSITION YEAR FAMILIES.] "Transition year 242.31 families" means families who have received AFDC, or who were 242.32 eligible to receive AFDC after choosing to discontinue receipt 242.33 of the cash portion of MFIP-S assistance under section 256J.31, 242.34 subdivision 12, for at least three of the last six months before 242.35 losing eligibility for AFDC due to increased hours of 242.36 employment, increased income from employment or child or spousal 243.1 support, or the loss of income disregards due to time 243.2 limitations. 243.3 Sec. 2. Minnesota Statutes 1996, section 245A.03, is 243.4 amended by adding a subdivision to read: 243.5 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 243.6 clause (2), does not apply to: 243.7 (1) a child care provider who as an applicant for licensure 243.8 or as a licenseholder has received a license denial under 243.9 section 245A.05, a fine under section 245A.06, or a sanction 243.10 under 245A.07 from the commissioner that has not been reversed 243.11 on appeal; or 243.12 (2) a child care provider, or a child care provider who has 243.13 a household member who, as a result of a licensing process, has 243.14 a disqualification under chapter 245A that has not been set 243.15 aside by the commissioner. 243.16 Sec. 3. Minnesota Statutes 1996, section 245A.03, is 243.17 amended by adding a subdivision to read: 243.18 Subd. 4. [EXCLUDED CHILD CARE PROGRAMS; RIGHT TO SEEK 243.19 LICENSURE.] Nothing in this section shall prohibit a child care 243.20 program that is excluded from licensure under subdivision 2, 243.21 clause (2), or under Laws 1997, chapter 248, section 46, as 243.22 amended by Laws 1997, First Special Session chapter 5, section 243.23 10, from seeking a license under this chapter. The commissioner 243.24 shall ensure that any application received from such an excluded 243.25 provider is processed in the same manner as all other 243.26 applications for licensed family day care. 243.27 Sec. 4. Minnesota Statutes 1996, section 245A.14, 243.28 subdivision 4, is amended to read: 243.29 Subd. 4. [SPECIAL FAMILY DAY CARE HOMES.] Nonresidential 243.30 child care programs serving 14 or fewer children that are 243.31 conducted at a location other than the license holder's own 243.32 residence shall be licensed under this section and the rules 243.33 governing family day care or group family day care if: 243.34 (a) the license holder is the primary provider of care;243.35(b)and the nonresidential child care program is conducted 243.36 in a dwelling that is located on a residential lot;andor 244.1(c) the license holder complies with all other requirements244.2of sections 245A.01 to 245A.15 and the rules governing family244.3day care or group family day care.244.4 (b) the license holder is an employer who may or may not be 244.5 the primary provider of care, and the purpose for the child care 244.6 program is to provide child care services to children of the 244.7 license holder's employees. 244.8 Sec. 5. Minnesota Statutes 1997 Supplement, section 244.9 256.01, subdivision 2, is amended to read: 244.10 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 244.11 section 241.021, subdivision 2, the commissioner of human 244.12 services shall: 244.13 (1) Administer and supervise all forms of public assistance 244.14 provided for by state law and other welfare activities or 244.15 services as are vested in the commissioner. Administration and 244.16 supervision of human services activities or services includes, 244.17 but is not limited to, assuring timely and accurate distribution 244.18 of benefits, completeness of service, and quality program 244.19 management. In addition to administering and supervising human 244.20 services activities vested by law in the department, the 244.21 commissioner shall have the authority to: 244.22 (a) require county agency participation in training and 244.23 technical assistance programs to promote compliance with 244.24 statutes, rules, federal laws, regulations, and policies 244.25 governing human services; 244.26 (b) monitor, on an ongoing basis, the performance of county 244.27 agencies in the operation and administration of human services, 244.28 enforce compliance with statutes, rules, federal laws, 244.29 regulations, and policies governing welfare services and promote 244.30 excellence of administration and program operation; 244.31 (c) develop a quality control program or other monitoring 244.32 program to review county performance and accuracy of benefit 244.33 determinations; 244.34 (d) require county agencies to make an adjustment to the 244.35 public assistance benefits issued to any individual consistent 244.36 with federal law and regulation and state law and rule and to 245.1 issue or recover benefits as appropriate; 245.2 (e) delay or deny payment of all or part of the state and 245.3 federal share of benefits and administrative reimbursement 245.4 according to the procedures set forth in section 256.017;and245.5 (f) make contracts with and grants to public and private 245.6 agencies and organizations, both profit and nonprofit, and 245.7 individuals, using appropriated funds; and 245.8 (g) enter into contractual agreements with federally 245.9 recognized Indian tribes with a reservation in Minnesota to the 245.10 extent necessary for the tribe to operate a federally approved 245.11 family assistance program or any other program under the 245.12 supervision of the commissioner. The commissioner may establish 245.13 necessary accounts for the purposes of receiving and disbursing 245.14 funds as necessary for the operation of the programs. 245.15 (2) Inform county agencies, on a timely basis, of changes 245.16 in statute, rule, federal law, regulation, and policy necessary 245.17 to county agency administration of the programs. 245.18 (3) Administer and supervise all child welfare activities; 245.19 promote the enforcement of laws protecting handicapped, 245.20 dependent, neglected and delinquent children, and children born 245.21 to mothers who were not married to the children's fathers at the 245.22 times of the conception nor at the births of the children; 245.23 license and supervise child-caring and child-placing agencies 245.24 and institutions; supervise the care of children in boarding and 245.25 foster homes or in private institutions; and generally perform 245.26 all functions relating to the field of child welfare now vested 245.27 in the state board of control. 245.28 (4) Administer and supervise all noninstitutional service 245.29 to handicapped persons, including those who are visually 245.30 impaired, hearing impaired, or physically impaired or otherwise 245.31 handicapped. The commissioner may provide and contract for the 245.32 care and treatment of qualified indigent children in facilities 245.33 other than those located and available at state hospitals when 245.34 it is not feasible to provide the service in state hospitals. 245.35 (5) Assist and actively cooperate with other departments, 245.36 agencies and institutions, local, state, and federal, by 246.1 performing services in conformity with the purposes of Laws 246.2 1939, chapter 431. 246.3 (6) Act as the agent of and cooperate with the federal 246.4 government in matters of mutual concern relative to and in 246.5 conformity with the provisions of Laws 1939, chapter 431, 246.6 including the administration of any federal funds granted to the 246.7 state to aid in the performance of any functions of the 246.8 commissioner as specified in Laws 1939, chapter 431, and 246.9 including the promulgation of rules making uniformly available 246.10 medical care benefits to all recipients of public assistance, at 246.11 such times as the federal government increases its participation 246.12 in assistance expenditures for medical care to recipients of 246.13 public assistance, the cost thereof to be borne in the same 246.14 proportion as are grants of aid to said recipients. 246.15 (7) Establish and maintain any administrative units 246.16 reasonably necessary for the performance of administrative 246.17 functions common to all divisions of the department. 246.18 (8) Act as designated guardian of both the estate and the 246.19 person of all the wards of the state of Minnesota, whether by 246.20 operation of law or by an order of court, without any further 246.21 act or proceeding whatever, except as to persons committed as 246.22 mentally retarded. For children under the guardianship of the 246.23 commissioner whose interests would be best served by adoptive 246.24 placement, the commissioner may contract with a licensed 246.25 child-placing agency to provide adoption services. A contract 246.26 with a licensed child-placing agency must be designed to 246.27 supplement existing county efforts and may not replace existing 246.28 county programs, unless the replacement is agreed to by the 246.29 county board and the appropriate exclusive bargaining 246.30 representative or the commissioner has evidence that child 246.31 placements of the county continue to be substantially below that 246.32 of other counties. 246.33 (9) Act as coordinating referral and informational center 246.34 on requests for service for newly arrived immigrants coming to 246.35 Minnesota. 246.36 (10) The specific enumeration of powers and duties as 247.1 hereinabove set forth shall in no way be construed to be a 247.2 limitation upon the general transfer of powers herein contained. 247.3 (11) Establish county, regional, or statewide schedules of 247.4 maximum fees and charges which may be paid by county agencies 247.5 for medical, dental, surgical, hospital, nursing and nursing 247.6 home care and medicine and medical supplies under all programs 247.7 of medical care provided by the state and for congregate living 247.8 care under the income maintenance programs. 247.9 (12) Have the authority to conduct and administer 247.10 experimental projects to test methods and procedures of 247.11 administering assistance and services to recipients or potential 247.12 recipients of public welfare. To carry out such experimental 247.13 projects, it is further provided that the commissioner of human 247.14 services is authorized to waive the enforcement of existing 247.15 specific statutory program requirements, rules, and standards in 247.16 one or more counties. The order establishing the waiver shall 247.17 provide alternative methods and procedures of administration, 247.18 shall not be in conflict with the basic purposes, coverage, or 247.19 benefits provided by law, and in no event shall the duration of 247.20 a project exceed four years. It is further provided that no 247.21 order establishing an experimental project as authorized by the 247.22 provisions of this section shall become effective until the 247.23 following conditions have been met: 247.24 (a) The secretary of health, education, and welfare of the 247.25 United States has agreed, for the same project, to waive state 247.26 plan requirements relative to statewide uniformity. 247.27 (b) A comprehensive plan, including estimated project 247.28 costs, shall be approved by the legislative advisory commission 247.29 and filed with the commissioner of administration. 247.30 (13) According to federal requirements, establish 247.31 procedures to be followed by local welfare boards in creating 247.32 citizen advisory committees, including procedures for selection 247.33 of committee members. 247.34 (14) Allocate federal fiscal disallowances or sanctions 247.35 which are based on quality control error rates for the aid to 247.36 families with dependent children, Minnesota family investment 248.1 program-statewide, medical assistance, or food stamp program in 248.2 the following manner: 248.3 (a) One-half of the total amount of the disallowance shall 248.4 be borne by the county boards responsible for administering the 248.5 programs. For the medical assistance, MFIP-S, and AFDC 248.6 programs, disallowances shall be shared by each county board in 248.7 the same proportion as that county's expenditures for the 248.8 sanctioned program are to the total of all counties' 248.9 expenditures for the AFDC, MFIP-S, and medical assistance 248.10 programs. For the food stamp program, sanctions shall be shared 248.11 by each county board, with 50 percent of the sanction being 248.12 distributed to each county in the same proportion as that 248.13 county's administrative costs for food stamps are to the total 248.14 of all food stamp administrative costs for all counties, and 50 248.15 percent of the sanctions being distributed to each county in the 248.16 same proportion as that county's value of food stamp benefits 248.17 issued are to the total of all benefits issued for all 248.18 counties. Each county shall pay its share of the disallowance 248.19 to the state of Minnesota. When a county fails to pay the 248.20 amount due hereunder, the commissioner may deduct the amount 248.21 from reimbursement otherwise due the county, or the attorney 248.22 general, upon the request of the commissioner, may institute 248.23 civil action to recover the amount due. 248.24 (b) Notwithstanding the provisions of paragraph (a), if the 248.25 disallowance results from knowing noncompliance by one or more 248.26 counties with a specific program instruction, and that knowing 248.27 noncompliance is a matter of official county board record, the 248.28 commissioner may require payment or recover from the county or 248.29 counties, in the manner prescribed in paragraph (a), an amount 248.30 equal to the portion of the total disallowance which resulted 248.31 from the noncompliance, and may distribute the balance of the 248.32 disallowance according to paragraph (a). 248.33 (15) Develop and implement special projects that maximize 248.34 reimbursements and result in the recovery of money to the 248.35 state. For the purpose of recovering state money, the 248.36 commissioner may enter into contracts with third parties. Any 249.1 recoveries that result from projects or contracts entered into 249.2 under this paragraph shall be deposited in the state treasury 249.3 and credited to a special account until the balance in the 249.4 account reaches $1,000,000. When the balance in the account 249.5 exceeds $1,000,000, the excess shall be transferred and credited 249.6 to the general fund. All money in the account is appropriated 249.7 to the commissioner for the purposes of this paragraph. 249.8 (16) Have the authority to make direct payments to 249.9 facilities providing shelter to women and their children 249.10 according to section 256D.05, subdivision 3. Upon the written 249.11 request of a shelter facility that has been denied payments 249.12 under section 256D.05, subdivision 3, the commissioner shall 249.13 review all relevant evidence and make a determination within 30 249.14 days of the request for review regarding issuance of direct 249.15 payments to the shelter facility. Failure to act within 30 days 249.16 shall be considered a determination not to issue direct payments. 249.17 (17) Have the authority to establish and enforce the 249.18 following county reporting requirements: 249.19 (a) The commissioner shall establish fiscal and statistical 249.20 reporting requirements necessary to account for the expenditure 249.21 of funds allocated to counties for human services programs. 249.22 When establishing financial and statistical reporting 249.23 requirements, the commissioner shall evaluate all reports, in 249.24 consultation with the counties, to determine if the reports can 249.25 be simplified or the number of reports can be reduced. 249.26 (b) The county board shall submit monthly or quarterly 249.27 reports to the department as required by the commissioner. 249.28 Monthly reports are due no later than 15 working days after the 249.29 end of the month. Quarterly reports are due no later than 30 249.30 calendar days after the end of the quarter, unless the 249.31 commissioner determines that the deadline must be shortened to 249.32 20 calendar days to avoid jeopardizing compliance with federal 249.33 deadlines or risking a loss of federal funding. Only reports 249.34 that are complete, legible, and in the required format shall be 249.35 accepted by the commissioner. 249.36 (c) If the required reports are not received by the 250.1 deadlines established in clause (b), the commissioner may delay 250.2 payments and withhold funds from the county board until the next 250.3 reporting period. When the report is needed to account for the 250.4 use of federal funds and the late report results in a reduction 250.5 in federal funding, the commissioner shall withhold from the 250.6 county boards with late reports an amount equal to the reduction 250.7 in federal funding until full federal funding is received. 250.8 (d) A county board that submits reports that are late, 250.9 illegible, incomplete, or not in the required format for two out 250.10 of three consecutive reporting periods is considered 250.11 noncompliant. When a county board is found to be noncompliant, 250.12 the commissioner shall notify the county board of the reason the 250.13 county board is considered noncompliant and request that the 250.14 county board develop a corrective action plan stating how the 250.15 county board plans to correct the problem. The corrective 250.16 action plan must be submitted to the commissioner within 45 days 250.17 after the date the county board received notice of noncompliance. 250.18 (e) The final deadline for fiscal reports or amendments to 250.19 fiscal reports is one year after the date the report was 250.20 originally due. If the commissioner does not receive a report 250.21 by the final deadline, the county board forfeits the funding 250.22 associated with the report for that reporting period and the 250.23 county board must repay any funds associated with the report 250.24 received for that reporting period. 250.25 (f) The commissioner may not delay payments, withhold 250.26 funds, or require repayment under paragraph (c) or (e) if the 250.27 county demonstrates that the commissioner failed to provide 250.28 appropriate forms, guidelines, and technical assistance to 250.29 enable the county to comply with the requirements. If the 250.30 county board disagrees with an action taken by the commissioner 250.31 under paragraph (c) or (e), the county board may appeal the 250.32 action according to sections 14.57 to 14.69. 250.33 (g) Counties subject to withholding of funds under 250.34 paragraph (c) or forfeiture or repayment of funds under 250.35 paragraph (e) shall not reduce or withhold benefits or services 250.36 to clients to cover costs incurred due to actions taken by the 251.1 commissioner under paragraph (c) or (e). 251.2 (18) Allocate federal fiscal disallowances or sanctions for 251.3 audit exceptions when federal fiscal disallowances or sanctions 251.4 are based on a statewide random sample for the foster care 251.5 program under title IV-E of the Social Security Act, United 251.6 States Code, title 42, in direct proportion to each county's 251.7 title IV-E foster care maintenance claim for that period. 251.8 (19) Be responsible for ensuring the detection, prevention, 251.9 investigation, and resolution of fraudulent activities or 251.10 behavior by applicants, recipients, and other participants in 251.11 the human services programs administered by the department. 251.12 (20) Require county agencies to identify overpayments, 251.13 establish claims, and utilize all available and cost-beneficial 251.14 methodologies to collect and recover these overpayments in the 251.15 human services programs administered by the department. 251.16 (21) Have the authority to administer a drug rebate program 251.17 for drugs purchased pursuant to the senior citizen drug program 251.18 established under section 256.955 after the beneficiary's 251.19 satisfaction of any deductible established in the program. The 251.20 commissioner shall require a rebate agreement from all 251.21 manufacturers of covered drugs as defined in section 256B.0625, 251.22 subdivision 13. For each drug, the amount of the rebate shall 251.23 be equal to the basic rebate as defined for purposes of the 251.24 federal rebate program in United States Code, title 42, section 251.25 1396r-8(c)(1). This basic rebate shall be applied to 251.26 single-source and multiple-source drugs. The manufacturers must 251.27 provide full payment within 30 days of receipt of the state 251.28 invoice for the rebate within the terms and conditions used for 251.29 the federal rebate program established pursuant to section 1927 251.30 of title XIX of the Social Security Act. The manufacturers must 251.31 provide the commissioner with any information necessary to 251.32 verify the rebate determined per drug. The rebate program shall 251.33 utilize the terms and conditions used for the federal rebate 251.34 program established pursuant to section 1927 of title XIX of the 251.35 Social Security Act. 251.36 Sec. 6. Minnesota Statutes 1996, section 256.014, 252.1 subdivision 1, is amended to read: 252.2 Subdivision 1. [ESTABLISHMENT OF SYSTEMS.] The 252.3 commissioner of human services shall establish and enhance 252.4 computer systems necessary for the efficient operation of the 252.5 programs the commissioner supervises, including: 252.6 (1) management and administration of the food stamp and 252.7 income maintenance programs, including the electronic 252.8 distribution of benefits; 252.9 (2) management and administration of the child support 252.10 enforcement program; and 252.11 (3) administration of medical assistance and general 252.12 assistance medical care. 252.13 The commissioner shall distribute the nonfederal share of 252.14 the costs of operating and maintaining the systems to the 252.15 commissioner and to the counties participating in the system in 252.16 a manner that reflects actual system usage, except that the 252.17 nonfederal share of the costs of the MAXIS computer system and 252.18 child support enforcement systems shall be borne entirely by the 252.19 commissioner. Development costs must not be assessed against 252.20 county agencies. 252.21 The commissioner may enter into contractual agreements with 252.22 federally recognized Indian tribes with a reservation in 252.23 Minnesota to participate in state-operated computer systems 252.24 related to the management and administration of the food stamp, 252.25 income maintenance, child support enforcement, medical 252.26 assistance, and general assistance medical care programs to the 252.27 extent necessary for the tribe to operate a federally approved 252.28 family assistance program or any other program under the 252.29 supervision of the commissioner. 252.30 Sec. 7. Minnesota Statutes 1997 Supplement, section 252.31 256.031, subdivision 6, is amended to read: 252.32 Subd. 6. [END OF FIELD TRIALS.] (a) Upon agreement with 252.33 the federal government, the field trials of the Minnesota family 252.34 investment plan will end June 30, 1998. 252.35 (b) Families in the comparison group under subdivision 3, 252.36 paragraph (d), clause (i), receiving aid to families with 253.1 dependent children under sections 256.72 to 256.87, and STRIDE 253.2 services under section 256.736 will continue in those programs 253.3 until June 30, 1998. After June 30, 1998, families who cease 253.4 receiving assistance under the Minnesota family investment plan 253.5 and comparison group families who cease receiving assistance 253.6 under AFDC and STRIDE who are eligible for the Minnesota family 253.7 investment program-statewide (MFIP-S), medical assistance, 253.8 general assistance medical care, or the food stamp program shall 253.9 be placed with their consent on the programs for which they are 253.10 eligible. 253.11 (c) Families who cease receiving assistance under the MFIP 253.12 and comparison families who cease receiving assistance under 253.13 AFDC and STRIDE who are ineligible for MFIP-S due to increased 253.14 income from employment, or increased child or spousal support or 253.15 a combination of employment income and child or spousal support, 253.16 shall be eligible for extended medical assistance under section 253.17 256B.0635. For the purpose of determining receipt of extended 253.18 medical assistance, receipt of AFDC and MFIP shall be considered 253.19 to be the same as receipt of MFIP-S. 253.20 Sec. 8. Minnesota Statutes 1997 Supplement, section 253.21 256.741, is amended by adding a subdivision to read: 253.22 Subd. 2a. [FAMILIES-FIRST DISTRIBUTION OF CHILD SUPPORT 253.23 ARREARAGES.] Child support collected on behalf of a family that 253.24 formerly received assistance under AFDC, MFIP, MFIP-R, MFIP-S, 253.25 or Work First must be distributed as follows: 253.26 (1) to the extent that the amount collected does not exceed 253.27 the amount required to be paid to the family for the month in 253.28 which collected, the state shall distribute the amount to the 253.29 family; and 253.30 (2) to the extent that the amount collected exceeds the 253.31 amount required to be paid to the family for the month in which 253.32 collected, the state shall distribute the amount as follows: 253.33 (i) the state shall first distribute the amount collected 253.34 to the family to the extent necessary to satisfy any support 253.35 arrearages accrued after the family ceased to receive assistance 253.36 from the state; and 254.1 (ii) the state shall then distribute the amount collected 254.2 to the family to the extent necessary to satisfy any support 254.3 arrearages with respect to the family that accrued before the 254.4 family received assistance from the state. 254.5 Sec. 9. Minnesota Statutes 1997 Supplement, section 254.6 256.9864, is amended to read: 254.7 256.9864 [REPORTS BY RECIPIENT.] 254.8 (a) An assistance unit with a recent work history or with 254.9 earned income shall report monthly to the county agency on 254.10 income received and other circumstances affecting eligibility or 254.11 assistance amounts. All other assistance units shall report on 254.12 income and other circumstances affecting eligibility and 254.13 assistance amounts, as specified by the state agency. 254.14 (b) An assistance unit required to submit a report on the 254.15 form designated by the commissioner and within ten days of the 254.16 due date or the date of the significant change, whichever is 254.17 later, or otherwise report significant changes which would 254.18 affect eligibility or assistance amounts, is considered to have 254.19 continued its application for assistance effective the date the 254.20 required report is received by the county agency, if a complete 254.21 report is received within a calendar month in which assistance 254.22 was received, except that no assistance shall be paid for the254.23period beginning with the end of the month in which the report254.24was due and ending with the date the report was received by the254.25county agency. 254.26 Sec. 10. Minnesota Statutes 1997 Supplement, section 254.27 256B.062, is amended to read: 254.28 256B.062 [CONTINUED ELIGIBILITY.] 254.29 Medical assistance may be paid for persons who received aid 254.30 to families with dependent children in at least three of the six 254.31 months preceding the month in which the person became ineligible 254.32 for aid to families with dependent children, if the 254.33 ineligibility was due to an increase in hours of employment or 254.34 employment income or due to the loss of an earned income 254.35 disregard. A person who is eligible for extended medical 254.36 assistance is entitled to six months of assistance without 255.1 reapplication, unless the assistance unit ceases to include a 255.2 dependent child. For a person under 21 years of age, medical 255.3 assistance may not be discontinued within the six-month period 255.4 of extended eligibility until it has been determined that the 255.5 person is not otherwise eligible for medical assistance. 255.6 Medical assistance may be continued for an additional six months 255.7 if the person meets all requirements for the additional six 255.8 months, according to Title XIX of the Social Security Act, as 255.9 amended by section 303 of the Family Support Act of 1988, Public 255.10 Law Number 100-485. This section is repealed effectiveMarch 31255.11 July 1, 1998. 255.12 Sec. 11. Minnesota Statutes 1997 Supplement, section 255.13 256B.0635, is amended by adding a subdivision to read: 255.14 Subd. 3. [EXTENDED MEDICAL ASSISTANCE FOR MFIP-S 255.15 PARTICIPANTS WHO OPT TO DISCONTINUE MONTHLY CASH 255.16 ASSISTANCE.] Upon federal approval, medical assistance is 255.17 available to persons who received MFIP-S in at least three of 255.18 the six months preceding the month in which the person opted to 255.19 discontinue receiving MFIP-S cash assistance under section 255.20 256J.31, subdivision 12. A person who is eligible for medical 255.21 assistance under this section may receive medical assistance 255.22 without reapplication as long as the person meets MFIP-S 255.23 eligibility requirements, unless the assistance unit does not 255.24 include a dependent child. Medical assistance may be paid 255.25 pursuant to subdivisions 1 and 2 for persons who are no longer 255.26 eligible for MFIP-S due to increased employment or child support. 255.27 Sec. 12. Minnesota Statutes 1997 Supplement, section 255.28 256D.05, subdivision 8, is amended to read: 255.29 Subd. 8. [CITIZENSHIP.] (a) Effective July 1, 1997, 255.30 citizenship requirements for applicants and recipients under 255.31 sections 256D.01 to 256D.03, subdivision 2, and 256D.04 to 255.32 256D.21 shall be determined the same as under section 256J.11,255.33except that legal noncitizens who are applicants or recipients255.34must have been residents of Minnesota on March 1, 1997. Legal255.35noncitizens who arrive in Minnesota after March 1, 1997, and255.36become elderly or disabled after that date, and are otherwise256.1eligible for general assistance can receive benefits under this256.2section. The income and assets of sponsors of noncitizens shall 256.3 be deemed available to general assistance applicants and 256.4 recipients according to the Personal Responsibility and Work 256.5 Opportunity Reconciliation Act of 1996, Public Law Number 256.6 104-193, title IV, sections 421 and 422, and subsequently set 256.7 out in federal rules. 256.8 (b) As a condition of eligibility, each legal adult 256.9 noncitizen in the assistance unit who has resided in the country 256.10 for four years or more and who is under 70 years of age must: 256.11 (1) be enrolled in a literacy class, English as a second 256.12 language class, or a citizen class; 256.13 (2) be applying for admission to a literacy class, English 256.14 as a second language class, and is on a waiting list; 256.15 (3) be in the process of applying for a waiver from the 256.16 Immigration and Naturalization Service of the English language 256.17 or civics requirements of the citizenship test; 256.18 (4) have submitted an application for citizenship to the 256.19 Immigration and Naturalization Service and is waiting for a 256.20 testing date or a subsequent swearing in ceremony; or 256.21 (5) have been denied citizenship due to a failure to pass 256.22 the test after two attempts or because of an inability to 256.23 understand the rights and responsibilities of becoming a United 256.24 States citizen, as documented by the Immigration and 256.25 Naturalization Service or the county. 256.26 If the county social service agency determines that a legal 256.27 noncitizen subject to the requirements of this subdivision will 256.28 require more than one year of English language training, then 256.29 the requirements of clause (1) or (2) shall be imposed after the 256.30 legal noncitizen has resided in the country for three years. 256.31 Individuals who reside in a facility licensed under chapter 256.32 144A, 144D, 245A, or 256I are exempt from the requirements of 256.33 this section. 256.34 Sec. 13. Minnesota Statutes 1996, section 256D.051, is 256.35 amended by adding a subdivision to read: 256.36 Subd. 18. [WAIVER OF SERVICE COST REIMBURSEMENT LIMIT FOR 257.1 PARTICIPANTS WITH SIGNIFICANT BARRIERS TO EMPLOYMENT.] 257.2 (a) To the extent of available resources, the commissioner 257.3 may waive the $400 service cost limit specified in subdivision 6 257.4 for county agencies who propose to provide enhanced services 257.5 under the food stamp employment and training program to 257.6 hard-to-employ individuals. A "hard-to-employ individual" is 257.7 defined as: 257.8 (1) a recipient of general assistance under chapter 256D; 257.9 or 257.10 (2) an individual with at least one of the following three 257.11 barriers to employment: 257.12 (i) the individual has not completed secondary school or 257.13 obtained a general equivalency development diploma or an adult 257.14 diploma, and has low skills in reading or mathematics; 257.15 (ii) the individual requires substance abuse treatment for 257.16 employment; and 257.17 (iii) the individual has a poor work history. 257.18 (b) To obtain a waiver, the county agency must submit a 257.19 waiver request to the commissioner. The request must specify: 257.20 (1) the number of hard-to-employ individuals the agency 257.21 plans to serve; 257.22 (2) the nature of the enhanced employment and training 257.23 services the agency will provide; and 257.24 (3) the agency's plan for providing referrals for substance 257.25 abuse assessment and treatment for hard-to-employ individuals 257.26 who require substance abuse treatment for employment. 257.27 Sec. 14. [256D.053] [MINNESOTA FOOD ASSISTANCE PROGRAM.] 257.28 Subdivision 1. [PROGRAM ESTABLISHED.] For the period from 257.29 July 1, 1998, to June 30, 1999, the Minnesota food assistance 257.30 program is established to provide food assistance to legal 257.31 noncitizens residing in this state who are ineligible to 257.32 participate in the federal food stamp program solely due to the 257.33 provisions of section 402 or 403 of Public Law Number 104-193, 257.34 as authorized by Title VII of the 1997 Emergency Supplemental 257.35 Appropriations Act, Public Law Number 105-18. 257.36 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 258.1 the Minnesota food assistance program, all of the following 258.2 conditions must be met: 258.3 (1) the applicant must meet the initial and ongoing 258.4 eligibility requirements for the federal food stamp program, 258.5 except for the applicant's ineligible immigration status; 258.6 (2) the applicant must be either a qualified noncitizen as 258.7 defined in section 256J.08, subdivision 73, or a noncitizen 258.8 otherwise residing lawfully in the United States; 258.9 (3) the applicant must be a resident of the state; and 258.10 (4) the applicant must not be receiving assistance under 258.11 the Minnesota family investment program-statewide or the work 258.12 first program. 258.13 Subd. 3. [PROGRAM ADMINISTRATION.] (a) The rules for the 258.14 Minnesota food assistance program shall follow exactly the 258.15 regulations for the federal food stamp program, except for the 258.16 provisions pertaining to immigration status under section 402 or 258.17 403 of Public Law Number 104-193. 258.18 (b) The county agency shall use the income, budgeting, and 258.19 benefit allotment regulations of the federal food stamp program 258.20 to calculate an eligible recipient's monthly Minnesota food 258.21 assistance program benefit. Until September 30, 1998, eligible 258.22 recipients under this subdivision shall receive the average per 258.23 person food stamp issuance in Minnesota in the fiscal year 258.24 ending June 30, 1997. Beginning October 1, 1998, eligible 258.25 recipients shall receive the same level of benefits as those 258.26 provided by the federal food stamp program to similarly situated 258.27 citizen recipients. The monthly Minnesota food assistance 258.28 program benefits shall not exceed an amount equal to the amount 258.29 of federal food stamp benefits the household would receive if 258.30 all members of the household were eligible for the federal food 258.31 stamp program. 258.32 (c) Minnesota food assistance program benefits must be 258.33 disregarded as income in all programs that do not count food 258.34 stamps as income. 258.35 (d) The county agency must redetermine a Minnesota food 258.36 assistance program recipient's eligibility for the federal food 259.1 stamp program when the agency receives information that the 259.2 recipient's legal immigration status has changed in such a way 259.3 that would make the recipient potentially eligible for the 259.4 federal food stamp program. 259.5 (e) Until October 1, 1998, the commissioner may provide 259.6 benefits under this section in cash. 259.7 Subd. 4. [STATE PLAN REQUIRED.] The commissioner shall 259.8 submit a state plan to the secretary of agriculture to allow the 259.9 commissioner to purchase federal food stamp benefits for each 259.10 Minnesota food assistance program recipient who is ineligible to 259.11 participate in the federal food stamp program solely due to the 259.12 provisions of section 402 or 403 of Public Law Number 104-193, 259.13 as authorized by Title VII of the 1997 Emergency Supplemental 259.14 Appropriations Act, Public Law Number 105-18. The commissioner 259.15 shall enter into a contract as necessary with the secretary to 259.16 use the existing federal food stamp benefit delivery system for 259.17 the purposes of administering the Minnesota food assistance 259.18 program under this section. 259.19 Sec. 15. Minnesota Statutes 1996, section 256D.46, 259.20 subdivision 2, is amended to read: 259.21 Subd. 2. [INCOME AND RESOURCE TEST.] All income and 259.22 resources available to the recipient must be considered in 259.23 determining the recipient's ability to meet the emergency need. 259.24 Property that can be liquidated in time to resolve the emergency 259.25 and income,(excludingMinnesota supplemental aid issued for259.26current month's need)an amount equal to the Minnesota 259.27 supplemental aid standard of assistance, that is normally 259.28 disregarded or excluded under the Minnesota supplemental aid 259.29 program must be considered available to meet the emergency need. 259.30 Sec. 16. Minnesota Statutes 1997 Supplement, section 259.31 256J.02, subdivision 4, is amended to read: 259.32 Subd. 4. [AUTHORITY TO TRANSFER.] Subject to limitations 259.33 of title I of Public Law Number 104-193, the Personal 259.34 Responsibility and Work Opportunity Reconciliation Act of 259.35 1996, as amended, the legislature may transfer money from the 259.36 TANF block grant to the child care fund under chapter 119B, or 260.1 the Title XX block grant under section 256E.07. 260.2 Sec. 17. Minnesota Statutes 1997 Supplement, section 260.3 256J.03, is amended to read: 260.4 256J.03 [TANF RESERVE ACCOUNT.] 260.5 Subdivision 1. TheMinnesota family investment260.6program-statewide/TANFTANF reserve account is created in the 260.7 state treasury. Funds retained or deposited in the TANF reserve 260.8 shall include: (1) funds designated by the legislatureand; (2) 260.9 unexpended state funds resulting from the acceleration of TANF 260.10 expenditures under subdivision 2; (3) earnings available from 260.11 the federal TANF block grant appropriated to the commissioner 260.12 but not expended in the biennium beginning July 1, 1997, shall260.13be retained; and (4) TANF funds available in fiscal years 1998, 260.14 1999, 2000, and 2001 that are not spent or not budgeted to be 260.15 spent in those years. 260.16 Funds deposited in the reserve accounttomust be expended 260.17 for the Minnesota family investment program-statewidein fiscal260.18year 2000 and subsequent fiscal yearsand directly related state 260.19 programs for the purposes in subdivision 3. 260.20 Subd. 2. [AUTHORIZATION TO ACCELERATE EXPENDITURE OF TANF 260.21 FUNDS.] The commissioner may expend federal Temporary Assistance 260.22 to Needy Families block grant funds in excess of appropriated 260.23 levels for the purpose of accelerating federal funding of the 260.24 MFIP program. By the end of the fiscal year in which the 260.25 additional federal expenditures are made, the commissioner must 260.26 deposit into the reserve account an amount of unexpended state 260.27 funds appropriated for assistance to families grants, aid to 260.28 families with dependent children, and Minnesota family 260.29 investment plan equal to the additional federal expenditures. 260.30 Reserve funds may be spent as TANF appropriations if 260.31 insufficient TANF funds are available because of acceleration. 260.32 Subd. 3. [ALLOWED TRANSFER PURPOSE.] Funds from the 260.33 reserve account may be used for the following purposes: 260.34 (1) unanticipated Temporary Assistance to Needy Families 260.35 block grant maintenance of effort shortfalls; 260.36 (2) MFIP cost increases due to reduced federal revenues and 261.1 federal law changes; 261.2 (3) one-half of the MFIP general fund cost increase in 261.3 fiscal year 2000 and subsequent fiscal years due to caseload 261.4 increases over fiscal year 1999; and 261.5 (4) transfers allowed under section 256J.02, subdivision 4. 261.6 Sec. 18. Minnesota Statutes 1997 Supplement, section 261.7 256J.08, subdivision 11, is amended to read: 261.8 Subd. 11. [CAREGIVER.] "Caregiver" means a minor child's 261.9 natural or adoptive parent or parents and stepparent who live in 261.10 the home with the minor child. For purposes of determining 261.11 eligibility for this program, caregiver also means any of the 261.12 following individuals, if adults, who live with and provide care 261.13 and support to a minor child when the minor child's natural or 261.14 adoptive parent or parents or stepparent do not reside in the 261.15 same home: legalcustodianscustodian or guardian, grandfather, 261.16 grandmother, brother, sister,stepfather, stepmother,261.17 stepbrother, stepsister, uncle, aunt, first cousin, nephew, 261.18 niece, person of preceding generation as denoted by prefixes of 261.19 "great," "great-great," or "great-great-great," or a spouse of 261.20 any person named in the above groups even after the marriage 261.21 ends by death or divorce. 261.22 Sec. 19. Minnesota Statutes 1997 Supplement, section 261.23 256J.08, is amended by adding a subdivision to read: 261.24 Subd. 24a. [DISQUALIFIED.] "Disqualified" means being 261.25 ineligible to receive MFIP-S due to noncooperation with program 261.26 requirements. Except for persons whose disqualification is 261.27 based on fraud, a disqualified person can take action to correct 261.28 the reason for ineligibility. 261.29 Sec. 20. Minnesota Statutes 1997 Supplement, section 261.30 256J.08, subdivision 26, is amended to read: 261.31 Subd. 26. [EARNED INCOME.] "Earned income" means cash or 261.32 in-kind income earned through the receipt of wages, salary, 261.33 commissions, profit from employment activities, net profit from 261.34 self-employment activities, payments made by an employer for 261.35 regularly accrued vacation or sick leave, and any other profit 261.36 from activity earned through effort or labor. The income must 262.1 be in return for, or as a result of, legal activity. 262.2 Sec. 21. Minnesota Statutes 1997 Supplement, section 262.3 256J.08, subdivision 28, is amended to read: 262.4 Subd. 28. [EMERGENCY.] "Emergency" means a situation or a 262.5 set of circumstances that causes or threatens to cause 262.6 destitution to aminor childfamily with a child under age 21. 262.7 Sec. 22. Minnesota Statutes 1997 Supplement, section 262.8 256J.08, subdivision 40, is amended to read: 262.9 Subd. 40. [GROSS EARNED INCOME.] "Gross earned income" 262.10 means earned income from employment before mandatory and 262.11 voluntary payroll deductions. Gross earned income includes 262.12 salaries, wages, tips, gratuities, commissions, incentive 262.13 payments from work or training programs, payments made by an 262.14 employer for regularly accrued vacation or sick leave, and 262.15 profits from other activity earned by an individual's effort or 262.16 labor. Gross earned income includes uniform and meal allowances 262.17 if federal income tax is deducted from the allowance. Gross 262.18 earned income includes flexible work benefits received from an 262.19 employer if the employee has the option of receiving the benefit 262.20 or benefits in cash. For self-employment, gross earned income 262.21 is the nonexcluded income minus expenses for the business. 262.22 Sec. 23. Minnesota Statutes 1997 Supplement, section 262.23 256J.08, is amended by adding a subdivision to read: 262.24 Subd. 46a. [SHELTER COSTS.] "Shelter costs" means rent, 262.25 manufactured home lot rental costs, or monthly principal, 262.26 interest, insurance premiums, and property taxes due for 262.27 mortgages or contracts for deed. 262.28 Sec. 24. Minnesota Statutes 1997 Supplement, section 262.29 256J.08, is amended by adding a subdivision to read: 262.30 Subd. 50a. [INTERSTATE TRANSITIONAL STANDARD.] "Interstate 262.31 transitional standard" means a combination of the cash 262.32 assistance a family with no other income would have received in 262.33 the state of previous residence and the Minnesota food portion 262.34 for the appropriate size family. 262.35 Sec. 25. Minnesota Statutes 1997 Supplement, section 262.36 256J.08, is amended by adding a subdivision to read: 263.1 Subd. 51a. [LEGAL CUSTODIAN.] "Legal custodian" means any 263.2 person who is under a legal obligation to provide care and 263.3 support for a minor and who is in fact providing care and 263.4 support for a minor. For an Indian child, custodian means any 263.5 Indian person who has legal custody of an Indian child under 263.6 tribal law or custom or under state law or to whom temporary 263.7 physical care, custody, and control has been transferred by the 263.8 parent of the child, as provided in section 257.351, subdivision 263.9 8. 263.10 Sec. 26. Minnesota Statutes 1997 Supplement, section 263.11 256J.08, subdivision 60, is amended to read: 263.12 Subd. 60. [MINOR CHILD.] "Minor child" means a child who 263.13 is living in the same home of a parent or other caregiver, is 263.14 not the parent of a child in the home, and is either less than 263.15 18 years of age or is under the age of 19 years and isregularly263.16attending asa full-time studentand is expected to complete a263.17high school orin a secondary school or pursuing a full-time 263.18 secondary level course of vocational or technical training 263.19 designed to fit students for gainful employmentbefore reaching263.20age 19. 263.21 Sec. 27. Minnesota Statutes 1997 Supplement, section 263.22 256J.08, is amended by adding a subdivision to read: 263.23 Subd. 61a. [NONCUSTODIAL PARENT.] "Noncustodial parent" 263.24 means a minor child's parent who does not live in the same home 263.25 as the child. 263.26 Sec. 28. Minnesota Statutes 1997 Supplement, section 263.27 256J.08, subdivision 68, is amended to read: 263.28 Subd. 68. [PERSONAL PROPERTY.] "Personal property" means 263.29 an item of value that is not real property, including the value 263.30 of a contract for deed held by a seller, assets held in trust on 263.31 behalf of members of an assistance unit,cash surrender value of263.32life insurance,value of a prepaid burial, savings account, 263.33 value of stocks and bonds, and value of retirement accounts. 263.34 Sec. 29. Minnesota Statutes 1997 Supplement, section 263.35 256J.08, subdivision 73, is amended to read: 263.36 Subd. 73. [QUALIFIED NONCITIZEN.] "Qualified noncitizen" 264.1 means a person: 264.2 (1) who was lawfully admitted for permanent residence 264.3 pursuant to United States Code, title 8; 264.4 (2) who was admitted to the United States as a refugee 264.5 pursuant to United States Code, title 8; section 1157; 264.6 (3) whose deportation is being withheld pursuant to United 264.7 States Code, title 8, section 1253(h); 264.8 (4) who was paroled for a period of at least one year 264.9 pursuant to United States Code, title 8, section 1182(d)(5); 264.10 (5) who was granted conditional entry pursuant to United 264.11 State Code, title 8, section 1153(a)(7); 264.12 (6) who was granted asylum pursuant to United States Code, 264.13 title 8, section 1158;or264.14 (7) determined to be a battered noncitizen by the United 264.15 States Attorney General according to the Illegal Immigration 264.16 Reform and Immigrant Responsibility Act of 1996, Title V of the 264.17 Omnibus Consolidated Appropriations Bill, Public Law Number 264.18 104-208; or 264.19 (8) who was admitted as a Cuban or Haitian entrant. 264.20 Sec. 30. Minnesota Statutes 1997 Supplement, section 264.21 256J.08, subdivision 83, is amended to read: 264.22 Subd. 83. [SIGNIFICANT CHANGE.] "Significant change" means 264.23 a decline in gross income of3536 percent or more from the 264.24 income used to determine the grant for the current month. 264.25 Sec. 31. Minnesota Statutes 1997 Supplement, section 264.26 256J.09, subdivision 6, is amended to read: 264.27 Subd. 6. [INVALID REASON FOR DELAY.] A county agency must 264.28 not delay a decision on eligibility or delay issuing the 264.29 assistance payment except to establish state residence as 264.30 provided in section 256J.12 by: 264.31 (1) treating the 30-day processing period as a waiting 264.32 period; 264.33 (2) delaying approval or issuance of the assistance payment 264.34 pending the decision of the county board; or 264.35 (3) awaiting the result of a referral to a county agency in 264.36 another county when the county receiving the application does 265.1 not believe it is the county of financial responsibility. 265.2 Sec. 32. Minnesota Statutes 1997 Supplement, section 265.3 256J.09, subdivision 9, is amended to read: 265.4 Subd. 9. [ADDENDUM TO AN EXISTING APPLICATION.] (a) An 265.5 addendum to an existing application must be used to add persons 265.6 to an assistance unit regardless of whether the persons being 265.7 added are required to be in the assistance unit. When a person 265.8 is added by addendum to an assistance unit, eligibility for that 265.9 person begins on the first of the month the addendum was filed 265.10 except as provided in section 256J.74, subdivision 2, clause (1). 265.11 (b) An overpayment must be determined when a change in 265.12 household composition is not reported within the deadlines in 265.13 section 256J.30, subdivision 9. Any overpayment must be 265.14 calculated from the month of the change including the needs, 265.15 income, and assets of any individual who is required to be 265.16 included in the assistance unit under section 256J.24, 265.17 subdivision 2. Individuals not included in the assistance unit 265.18 who are identified in section 256J.37, subdivisions 1 to 2, must 265.19 have their income and assets considered when determining the 265.20 amount of the overpayment. 265.21 Sec. 33. Minnesota Statutes 1997 Supplement, section 265.22 256J.11, subdivision 2, as amended by Laws 1997, Third Special 265.23 Session chapter 1, section 1, is amended to read: 265.24 Subd. 2. [NONCITIZENS; FOOD PORTION.] (a) For the period 265.25 September 1, 1997, to October 31, 1997, noncitizens who do not 265.26 meet one of the exemptions in section 412 of the Personal 265.27 Responsibility and Work Opportunity Reconciliation Act of 1996, 265.28 but were residing in this state as of July 1, 1997, are eligible 265.29 for the 6/10 of the average value of food stamps for the same 265.30 family size and composition until MFIP-S is operative in the 265.31 noncitizen's county of financial responsibility and thereafter, 265.32 the 6/10 of the food portion of MFIP-S. However, federal food 265.33 stamp dollars cannot be used to fund the food portion of MFIP-S 265.34 benefits for an individual under this subdivision. 265.35 (b) For the period November 1, 1997, to June 30,19981999, 265.36 noncitizens who do not meet one of the exemptions in section 412 266.1 of the Personal Responsibility and Work Opportunity 266.2 Reconciliation Act of 1996,but were residing in this state as266.3of July 1, 1997,and are receiving cash assistance under the 266.4 AFDC, family general assistance, MFIP or MFIP-S programs are 266.5 eligible for the average value of food stamps for the same 266.6 family size and composition until MFIP-S is operative in the 266.7 noncitizen's county of financial responsibility and thereafter, 266.8 the food portion of MFIP-S. However, federal food stamp dollars 266.9 cannot be used to fund the food portion of MFIP-S benefits for 266.10 an individual under this subdivision. The assistance provided 266.11 under this subdivision, which is designated as a supplement to 266.12 replace lost benefits under the federal food stamp program, must 266.13 be disregarded as income in all programs that do not count food 266.14 stamps as income where the commissioner has the authority to 266.15 make the income disregard determination for the program. 266.16 (c) The commissioner shall submit a state plan to the 266.17 secretary of agriculture to allow the commissioner to purchase 266.18 federal food stamp benefits in an amount equal to the MFIP-S 266.19 food portion for each legal noncitizen receiving MFIP-S 266.20 assistance who is ineligible to participate in the federal food 266.21 stamp program solely due to the provisions of section 402 or 403 266.22 of Public Law Number 104-193, as authorized by Title VII of the 266.23 1997 Emergency Supplemental Appropriations Act, Public Law 266.24 Number 105-18. The commissioner shall enter into a contract as 266.25 necessary with the secretary to use the existing federal food 266.26 stamp benefit delivery system for the purposes of administering 266.27 the food portion of MFIP-S under this subdivision. 266.28 Sec. 34. Minnesota Statutes 1997 Supplement, section 266.29 256J.12, is amended to read: 266.30 256J.12 [MINNESOTA RESIDENCE.] 266.31 Subdivision 1. [SIMPLE RESIDENCY.] To be eligible for AFDC 266.32 or MFIP-S, whichever is in effect,a familyan assistance unit 266.33 must have established residency in this state which means 266.34 thefamilyassistance unit is present in the state and intends 266.35 to remain here. 266.36 Subd. 1a. [30-DAY RESIDENCY REQUIREMENT.]A familyAn 267.1 assistance unit is considered to have established residency in 267.2 this state only when a child or caregiver has resided in this 267.3 state for at least 30 days with the intention of making the 267.4 person's home here and not for any temporary purpose. The birth 267.5 of a child in Minnesota to a member of the assistance unit does 267.6 not automatically establish the residency in this state under 267.7 this subdivision of the other members of the assistance unit. 267.8 Time spent in a shelter for battered women shall count toward 267.9 satisfying the 30-day residency requirement. 267.10 Subd. 2. [EXCEPTIONS.] (a) A county shall waive the 30-day 267.11 residency requirement where unusual hardship would result from 267.12 denial of assistance. 267.13 (b) For purposes of this section, unusual hardship meansa267.14familyan assistance unit: 267.15 (1) is without alternative shelter; or 267.16 (2) is without available resources for food. 267.17 (c) For purposes of this subdivision, the following 267.18 definitions apply (1) "metropolitan statistical area" is as 267.19 defined by the U.S. Census Bureau; (2) "alternative shelter" 267.20 includes any shelter that is located within the metropolitan 267.21 statistical area containing the county and for which the family 267.22 is eligible, provided thefamilyassistance unit does not have 267.23 to travel more than 20 miles to reach the shelter and has access 267.24 to transportation to the shelter. Clause (2) does not apply to 267.25 counties in the Minneapolis-St. Paul metropolitan statistical 267.26 area. 267.27 (d) Applicants are considered to meet the residency 267.28 requirement under subdivision 1a if they once resided in 267.29 Minnesota and: 267.30 (1) joined the United States armed services, returned to 267.31 Minnesota within 30 days of leaving the armed services, and 267.32 intend to remain in Minnesota; or 267.33 (2) left to attend school in another state, paid 267.34 nonresident tuition or Minnesota tuition rates under a 267.35 reciprocity agreement, and returned to Minnesota within 30 days 267.36 of graduation with the intent to remain in Minnesota. 268.1 (e) The 30-day residence requirement is met when: 268.2 (1) a minor child or a minor caregiver moves from another 268.3 state to the residence of a relative caregiver; 268.4 (2) the minor caregiver applies for and receives family 268.5 cash assistance; 268.6 (3) the relative caregiver chooses not to be part of the 268.7 MFIP-S assistance unit; and 268.8 (4) the relative caregiver has resided in Minnesota for at 268.9 least 30 days prior to the date the assistance unit applies for 268.10 cash assistance. 268.11 (f) Ineligible mandatory unit members who have resided in 268.12 Minnesota for 12 months immediately before the unit's date of 268.13 application establish the other assistance unit members' 268.14 eligibility for the MFIP-S transitional standard. 268.15 Subd. 2a. [MIGRANT WORKERS.] Migrant workers, as defined 268.16 in section 256J.08, and their immediate families are exempt from 268.17 the requirements of subdivisions 1 and 1a, provided the migrant 268.18 worker provides verification that the migrant family worked in 268.19 this state within the last 12 months and earned at least $1,000 268.20 in gross wages during the time the migrant worker worked in this 268.21 state. 268.22 Subd. 3. [PAYMENT PLAN FOR NEW RESIDENTS.] Assistance paid 268.23 to an eligiblefamilyassistance unit in which all members have 268.24 resided in this state for fewer than 12 consecutive calendar 268.25 months immediately preceding the date of application shall be at 268.26 the standard and in the form specified in section 256J.43. 268.27 Subd. 4. [SEVERABILITY CLAUSE.] If any subdivision in this 268.28 section is enjoined from implementation or found 268.29 unconstitutional by any court of competent jurisdiction, the 268.30 remaining subdivisions shall remain valid and shall be given 268.31 full effect. 268.32 Sec. 35. Minnesota Statutes 1997 Supplement, section 268.33 256J.14, is amended to read: 268.34 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 268.35 (a) The definitions in this paragraph only apply to this 268.36 subdivision. 269.1 (1) "Household of a parent, legal guardian, or other adult 269.2 relative" means the place of residence of: 269.3 (i) a natural or adoptive parent; 269.4 (ii) a legal guardian according to appointment or 269.5 acceptance under section 260.242, 525.615, or 525.6165, and 269.6 related laws;or269.7 (iii) a caregiver as defined in section 256J.08, 269.8 subdivision 11; or 269.9 (iv) an appropriate adult relative designated by a county 269.10 agency. 269.11 (2) "Adult-supervised supportive living arrangement" means 269.12 a private family setting which assumes responsibility for the 269.13 care and control of the minor parent and minor child, or other 269.14 living arrangement, not including a public institution, licensed 269.15 by the commissioner of human services which ensures that the 269.16 minor parent receives adult supervision and supportive services, 269.17 such as counseling, guidance, independent living skills 269.18 training, or supervision. 269.19 (b) A minor parent and the minor child who is in the care 269.20 of the minor parent must reside in the household of a parent, 269.21 legal guardian, otherappropriateadult relative,or other269.22caregiver,or in an adult-supervised supportive living 269.23 arrangement in order to receive MFIP-S unless: 269.24 (1) the minor parent has no living parent, other 269.25appropriateadult relative, or legal guardian whose whereabouts 269.26 is known; 269.27 (2) no living parent, otherappropriateadult relative, or 269.28 legal guardian of the minor parent allows the minor parent to 269.29 live in the parent's,appropriateother adult relative's, or 269.30 legal guardian's home; 269.31 (3) the minor parent lived apart from the minor parent's 269.32 own parent or legal guardian for a period of at least one year 269.33 before either the birth of the minor child or the minor parent's 269.34 application for MFIP-S; 269.35 (4) the physical or emotional health or safety of the minor 269.36 parent or minor child would be jeopardized if the minor parent 270.1 and the minor child resided in the same residence with the minor 270.2 parent's parent, otherappropriateadult relative, or legal 270.3 guardian; or 270.4 (5) an adult supervised supportive living arrangement is 270.5 not available for the minor parent andthe dependentchild in 270.6 the county in which the minor parent and child currentlyresides270.7 reside. If an adult supervised supportive living arrangement 270.8 becomes available within the county, the minor parent and child 270.9 must reside in that arrangement. 270.10 (c) Minor applicants must be informed orally and in writing 270.11 about the eligibility requirements and their rights and 270.12 obligations under the MFIP-S program. The county must advise 270.13 the minor of the possible exemptions and specifically ask 270.14 whether one or more of these exemptions is applicable. If the 270.15 minor alleges one or more of these exemptions, then the county 270.16 must assist the minor in obtaining the necessary verifications 270.17 to determine whether or not these exemptions apply. 270.18 (d) If the county worker has reason to suspect that the 270.19 physical or emotional health or safety of the minor parent or 270.20 minor child would be jeopardized if they resided with the minor 270.21 parent's parent, other adult relative, or legal guardian, then 270.22 the county worker must make a referral to child protective 270.23 services to determine if paragraph (b), clause (4), applies. A 270.24 new determination by the county worker is not necessary if one 270.25 has been made within the last six months, unless there has been 270.26 a significant change in circumstances which justifies a new 270.27 referral and determination. 270.28 (e) If a minor parent is not living with a parentor, legal 270.29 guardian, or other adult relative due to paragraph (b), clause 270.30 (1), (2), or (4), the minor parent must reside, when possible, 270.31 in a living arrangement that meets the standards of paragraph 270.32 (a), clause (2). 270.33 (f) When a minor parent and minor childlivelives with 270.34anothera parent, other adult relative, legal guardian, or in an 270.35 adult-supervised supportive living arrangement, MFIP-S must be 270.36 paid, when possible, in the form of a protective payment on 271.1 behalf of the minor parent and minor childin accordance with271.2 according to section 256J.39, subdivisions 2 to 4. 271.3 Sec. 36. Minnesota Statutes 1997 Supplement, section 271.4 256J.15, subdivision 2, is amended to read: 271.5 Subd. 2. [ELIGIBILITY DURING LABOR DISPUTES.] To receive 271.6 assistanceunder MFIP-S,when a member of an assistance unitwho271.7 is on strike, or when an individual identified under section 271.8 256J.37, subdivisions 1 to 2, whose income and assets must be 271.9 considered when determining the unit's eligibility is on strike, 271.10 the assistance unit must have beenanreceiving MFIP-S 271.11participant on the day before the strike,or have been eligible 271.12 for MFIP-S on the day before the strike. 271.13 The county agency must count the striker's prestrike 271.14 earnings as current earnings.WhenA significant change cannot 271.15 be invoked when a member of an assistance unit, or an individual 271.16 identified under section 256J.37, subdivisions 1 to 2, is on 271.17 strike. A member of an assistance unitwho, or an individual 271.18 identified under section 256J.37, subdivisions 1 to 2, is not 271.19 considered a striker when that person is not in the bargaining 271.20 unit that voted for the strike and does not cross the picket 271.21 line for fear of personal injury, the assistance unit member is271.22not a striker. Except for a member of an assistance unit who is271.23not in the bargaining unit that voted for the strike and who271.24does not cross the picket line for fear of personal injury, a271.25significant change cannot be invoked as a result of a labor271.26dispute. 271.27 Sec. 37. Minnesota Statutes 1997 Supplement, section 271.28 256J.20, subdivision 2, is amended to read: 271.29 Subd. 2. [REAL PROPERTY LIMITATIONS.] Ownership of real 271.30 property by an applicant or participant is subject to the 271.31 limitations in paragraphs (a) and (b). 271.32 (a) A county agency shall exclude the homestead of an 271.33 applicant or participant according to clauses (1) to(4)(5): 271.34 (1) an applicant or participant who is purchasing real 271.35 property through a contract for deed and using that property as 271.36 a home is considered the owner of real property; 272.1 (2) the total amount of land that can be excluded under 272.2 this subdivision is limited to surrounding property which is not 272.3 separated from the home by intervening property owned by 272.4 others. Additional property must be assessed as to its legal 272.5 and actual availability according to subdivision 1; 272.6 (3) when real property that has been used as a home by a 272.7 participant is sold, the county agency must treat the cash 272.8 proceeds from the sale as excluded property for six months when 272.9 the participant intends to reinvest the proceeds in another home 272.10 and maintains those proceeds, unused for other purposes, in a 272.11 separate account;and272.12 (4) when the homestead is jointly owned, but the client 272.13 does not reside in it because of legal separation, pending 272.14 divorce, or battering or abuse by the spouse or partner, the 272.15 homestead is excluded.; and 272.16 (5) the homestead shall continue to be excluded if it is 272.17 temporarily unoccupied due to employment, illness, or as the 272.18 result of compliance with a county-approved employability plan. 272.19 The education, training, or job search must be within the state, 272.20 but can be outside the immediate geographic area. A homestead 272.21 temporarily unoccupied because it is not habitable due to a 272.22 casualty or natural disaster is excluded. The homestead is 272.23 excluded during periods only if the client intends to return to 272.24 it. 272.25 (b) The equity value of real property that is not excluded 272.26 under paragraph (a) and which is legally available must be 272.27 applied against the limits in subdivision 3. When the equity 272.28 value of the real property exceeds the limits under subdivision 272.29 3, the applicant or participant may qualify to receive 272.30 assistance when the applicant or participant continues to make a 272.31 good faith effort to sell the property and signs a legally 272.32 binding agreement to repay the amount of assistance, less child 272.33 support collected by the agency. Repayment must be made within 272.34 five working days after the property is sold. Repayment to the 272.35 county agency must be in the amount of assistance received or 272.36 the proceeds of the sale, whichever is less. 273.1 Sec. 38. Minnesota Statutes 1997 Supplement, section 273.2 256J.20, subdivision 3, is amended to read: 273.3 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 273.4 MFIP-S, the equity value of all nonexcluded real and personal 273.5 property of the assistance unit must not exceed $2,000 for 273.6 applicants and $5,000 for ongoingrecipientsparticipants. The 273.7 value of assets in clauses (1) to(18)(20) must be excluded 273.8 when determining the equity value of real and personal property: 273.9 (1) a licensedvehiclesvehicle up to atotal marketloan 273.10 value of less than or equal to $7,500. The county agency shall 273.11 apply any excessmarketloan value as if it were equity value to 273.12 the asset limit described in this section. If the assistance 273.13 unit owns more than one licensed vehicle, the county agency 273.14 shall determine the vehicle with the highestmarketloan value 273.15 and count only themarketloan value over $7,500. The county 273.16 agency shall count themarketloan value of all other vehicles 273.17 and apply this amount as if it were equity value to the asset 273.18 limit described in this section. The value of special equipment 273.19 for a handicapped member of the assistance unit is excluded. To 273.20 establish themarketloan value of vehicles, a county agency 273.21 must use the N.A.D.A. Official Used Car Guide, Midwest Edition, 273.22 for newer model cars.The N.A.D.A. Official Used Car Guide,273.23Midwest Edition, is incorporated by reference.When a vehicle 273.24 is not listed in the guidebook, or when the applicant or 273.25 participant disputes the loan value listed in the guidebook as 273.26 unreasonable given the condition of the particular vehicle, the 273.27 county agency may require the applicant or participantto273.28 document the loan value by securing a written statement from a 273.29 motor vehicle dealer licensed under section 168.27, stating the 273.30 amount that the dealer would pay to purchase the vehicle. The 273.31 county agency shall reimburse the applicant or participant for 273.32 the cost of a written statement that documents a lower loan 273.33 value; 273.34 (2) the value of life insurance policies for members of the 273.35 assistance unit; 273.36 (3) one burial plot per member of an assistance unit; 274.1 (4) the value of personal property needed to produce earned 274.2 income, including tools, implements, farm animals, inventory, 274.3 business loans, business checking and savings accounts used at 274.4 least annually and used exclusively for the operation of a 274.5 self-employment business, and any motor vehicles if the vehicles 274.6 are essential for the self-employment business; 274.7 (5) the value of personal property not otherwise specified 274.8 which is commonly used by household members in day-to-day living 274.9 such as clothing, necessary household furniture, equipment, and 274.10 other basic maintenance items essential for daily living; 274.11 (6) the value of real and personal property owned by a 274.12 recipient of Supplemental Security Income or Minnesota 274.13 supplemental aid; 274.14 (7) the value of corrective payments, but only for the 274.15 month in which the payment is received and for the following 274.16 month; 274.17 (8) a mobile home used by an applicant or participant as 274.18 the applicant's or participant's home; 274.19 (9) money in a separate escrow account that is needed to 274.20 pay real estate taxes or insurance and that is used for this 274.21 purpose; 274.22 (10) money held in escrow to cover employee FICA, employee 274.23 tax withholding, sales tax withholding, employee worker 274.24 compensation, business insurance, property rental, property 274.25 taxes, and other costs that are paid at least annually, but less 274.26 often than monthly; 274.27 (11) monthly assistanceand, emergency assistance, and 274.28 diversionary payments for the current month's needs; 274.29 (12) the value of school loans, grants, or scholarships for 274.30 the period they are intended to cover; 274.31 (13) payments listed in section 256J.21, subdivision 2, 274.32 clause (9), which are held in escrow for a period not to exceed 274.33 three months to replace or repair personal or real property; 274.34 (14) income received in a budget month through the end of 274.35 thebudgetpayment month; 274.36 (15) savings from earned income of a minor child or a minor 275.1 parent that are set aside in a separate account designated 275.2 specifically for future education or employment costs; 275.3 (16) the federal earned incometaxcreditand, Minnesota 275.4 working family credit, state and federal income tax refunds, 275.5 state homeowners and renters credits under chapter 290A, 275.6 property tax rebates under Laws 1997, chapter 231, article 1, 275.7 section 16, and other federal or state tax rebates in the month 275.8 received and the following month; 275.9 (17) payments excluded under federal law as long as those 275.10 payments are held in a separate account from any nonexcluded 275.11 funds;and275.12 (18) money received by a participant of the corps to career 275.13 program under section 84.0887, subdivision 2, paragraph (b), as 275.14 a postservice benefit under the federal Americorps Act; 275.15 (19) the assets of children ineligible to receive MFIP-S 275.16 benefits because foster care or adoption assistance payments are 275.17 made on their behalf; and 275.18 (20) the assets of persons whose income is excluded under 275.19 section 256J.21, subdivision 2, clause 43. 275.20 Sec. 39. Minnesota Statutes 1997 Supplement, section 275.21 256J.21, is amended to read: 275.22 256J.21 [INCOME LIMITATIONS.] 275.23 Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP-S 275.24 eligibility, the county agency must evaluate income received by 275.25 members of an assistance unit, or by other persons whose income 275.26 is considered available to the assistance unit, and only count 275.27 income that is available to the member of the assistance unit. 275.28 Income is available if the individual has legal access to the 275.29 income. The income of an unrelated adult living in the same 275.30 household as the assistance unit who contributes financially to 275.31 the household in any way that subsidizes the expenses for which 275.32 the assistance unit is receiving a grant is considered to be 275.33 available to the assistance unit. All payments, unless 275.34 specifically excluded in subdivision 2, must be counted as 275.35 income. 275.36 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 276.1 excluded in determining a family's available income: 276.2 (1) payments for basic care, difficulty of care, and 276.3 clothing allowances received for providing family foster care to 276.4 children or adults under Minnesota Rules, parts 9545.0010 to 276.5 9545.0260 and 9555.5050 to 9555.6265, and payments received and 276.6 used for care and maintenance of a third-party beneficiary who 276.7 is not a household member; 276.8 (2) reimbursements for employment training received through 276.9 the Job Training Partnership Act, United States Code, title 29, 276.10 chapter 19, sections 1501 to 1792b; 276.11 (3) reimbursement for out-of-pocket expenses incurred while 276.12 performing volunteer services, jury duty, or employment; 276.13 (4) all educational assistance, except the county agency 276.14 must count graduate student teaching assistantships, 276.15 fellowships, and other similar paid work as earned income and, 276.16 after allowing deductions for any unmet and necessary 276.17 educational expenses, shall count scholarships or grants awarded 276.18 to graduate students that do not require teaching or research as 276.19 unearned income; 276.20 (5) loans, regardless of purpose, from public or private 276.21 lending institutions, governmental lending institutions, or 276.22 governmental agencies; 276.23 (6) loans from private individuals, regardless of purpose, 276.24 provided an applicant or participant documents that the lender 276.25 expects repayment; 276.26 (7)(i) stateand federalincome tax refunds; 276.27 (ii) federal income tax refunds; 276.28 (8)(i)state andfederal earned income credits; 276.29 (ii) Minnesota working family credits; 276.30 (iii) state homeowners and renters credits under chapter 276.31 290A; 276.32 (iv) property tax rebates under Laws 1997, chapter 231, 276.33 article 1, section 16; and 276.34 (v) other federal or state tax rebates; 276.35 (9) funds received for reimbursement, replacement, or 276.36 rebate of personal or real property when these payments are made 277.1 by public agencies, awarded by a court, solicited through public 277.2 appeal, or made as a grant by a federal agency, state or local 277.3 government, or disaster assistance organizations, subsequent to 277.4 a presidential declaration of disaster; 277.5 (10) the portion of an insurance settlement that is used to 277.6 pay medical, funeral, and burial expenses, or to repair or 277.7 replace insured property; 277.8 (11) reimbursements for medical expenses that cannot be 277.9 paid by medical assistance; 277.10 (12) payments by a vocational rehabilitation program 277.11 administered by the state under chapter 268A, except those 277.12 payments that are for current living expenses; 277.13 (13) in-kind income, including any payments directly made 277.14 by a third party to a provider of goods and services; 277.15 (14) assistance payments to correct underpayments, but only 277.16 for the month in which the payment is received; 277.17 (15) emergency assistance payments; 277.18 (16) funeral and cemetery payments as provided by section 277.19 256.935; 277.20 (17) nonrecurring cash gifts of $30 or less, not exceeding 277.21 $30 per participant in a calendar month; 277.22 (18) any form of energy assistance payment made through 277.23 Public Law Number 97-35, Low-Income Home Energy Assistance Act 277.24 of 1981, payments made directly to energy providers by other 277.25 public and private agencies, and any form of credit or rebate 277.26 payment issued by energy providers; 277.27 (19) Supplemental Security Income, including retroactive 277.28 payments; 277.29 (20) Minnesota supplemental aid, including retroactive 277.30 payments; 277.31 (21) proceeds from the sale of real or personal property; 277.32 (22) adoption assistance payments under section 259.67; 277.33 (23) state-funded family subsidy program payments made 277.34 under section 252.32 to help families care for children with 277.35 mental retardation or related conditions; 277.36 (24) interest payments and dividends from property that is 278.1 not excluded from and that does not exceed the asset limit; 278.2 (25) rent rebates; 278.3 (26) income earned by a minor caregiver or minor child who 278.4 is at least a half-time student in an approved secondary 278.5 education program; 278.6 (27) income earned by a caregiver under age 20 who is at 278.7 least a half-time student in an approved secondary education 278.8 program; 278.9 (28) MFIP-S child care payments under section 119B.05; 278.10 (29) all other payments made through MFIP-S to support a 278.11 caregiver's pursuit of greater self-support; 278.12 (30) income a participant receives related to shared living 278.13 expenses; 278.14 (31) reverse mortgages; 278.15 (32) benefits provided by the Child Nutrition Act of 1966, 278.16 United States Code, title 42, chapter 13A, sections 1771 to 278.17 1790; 278.18 (33) benefits provided by the women, infants, and children 278.19 (WIC) nutrition program, United States Code, title 42, chapter 278.20 13A, section 1786; 278.21 (34) benefits from the National School Lunch Act, United 278.22 States Code, title 42, chapter 13, sections 1751 to 1769e; 278.23 (35) relocation assistance for displaced persons under the 278.24 Uniform Relocation Assistance and Real Property Acquisition 278.25 Policies Act of 1970, United States Code, title 42, chapter 61, 278.26 subchapter II, section 4636, or the National Housing Act, United 278.27 States Code, title 12, chapter 13, sections 1701 to 1750jj; 278.28 (36) benefits from the Trade Act of 1974, United States 278.29 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 278.30 (37) war reparations payments to Japanese Americans and 278.31 Aleuts under United States Code, title 50, sections 1989 to 278.32 1989d; 278.33 (38) payments to veterans or their dependents as a result 278.34 of legal settlements regarding Agent Orange or other chemical 278.35 exposure under Public Law Number 101-239, section 10405, 278.36 paragraph (a)(2)(E); 279.1 (39) income that is otherwise specifically excluded from 279.2 the MFIP-S program consideration in federal law, state law, or 279.3 federal regulation; 279.4 (40) security and utility deposit refunds; 279.5 (41) American Indian tribal land settlements excluded under 279.6 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 279.7 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 279.8 reservations and payments to members of the White Earth Band, 279.9 under United States Code, title 25, chapter 9, section 331, and 279.10 chapter 16, section 1407; 279.11 (42) all income of the minor parent's parent and stepparent 279.12 when determining the grant for the minor parent in households 279.13 that include a minor parent living with a parent or stepparent 279.14 on MFIP-S with otherdependentchildren; and 279.15 (43) income of the minor parent's parent and stepparent 279.16 equal to 200 percent of the federal poverty guideline for a 279.17 family size not including the minor parent and the minor 279.18 parent's child in households that include a minor parent living 279.19 with a parent or stepparent not on MFIP-S when determining the 279.20 grant for the minor parent. The remainder of income is deemed 279.21 as specified in section 256J.37, subdivision11b; 279.22 (44) payments made to children eligible for relative 279.23 custody assistance under section 257.85; 279.24 (45) vendor payments for goods and services made on behalf 279.25 of a client unless the client has the option of receiving the 279.26 payment in cash; and 279.27 (46) the principal portion of a contract for deed payment. 279.28 Subd. 3. [INITIAL INCOME TEST.] The county agency shall 279.29 determine initial eligibility by considering all earned and 279.30 unearned income that is not excluded under subdivision 2. To be 279.31 eligible for MFIP-S, the assistance unit's countable income 279.32 minus the disregards in paragraphs (a) and (b) must be below the 279.33 transitional standard of assistance according to section 256J.24 279.34 for that size assistance unit. 279.35 (a) The initial eligibility determination must disregard 279.36 the following items: 280.1 (1) the employment disregard is 18 percent of the gross 280.2 earned income whether or not the member is working full time or 280.3 part time; 280.4 (2) dependent care costs must be deducted from gross earned 280.5 income for the actual amount paid for dependent care up tothea 280.6 maximumdisregard allowedof $200 per month for each child less 280.7 than two years of age, and $175 per month for each child two 280.8 years of age and older under this chapter and chapter 119B;and280.9 (3) all payments made according to a court order 280.10 for spousal support or the support of children not living in the 280.11 assistance unit's household shall be disregarded from the income 280.12 of the person with the legal obligation to pay support, provided 280.13 that, if there has been a change in the financial circumstances 280.14 of the person with the legal obligation to pay support since the 280.15 support order was entered, the person with the legal obligation 280.16 to pay support has petitioned for a modification of the support 280.17 order; and 280.18 (4) an allocation for the unmet need of an ineligible 280.19 spouse or an ineligible child under the age of 21 for whom the 280.20 caregiver is financially responsible and who lives with the 280.21 caregiver according to section 256J.36. 280.22 (b) Notwithstanding paragraph (a), when determining initial 280.23 eligibility forapplicants who haveapplicant units when at 280.24 least one member has received AFDC, family general assistance, 280.25 MFIP, MFIP-R, work first, or MFIP-S in this state within four 280.26 months of the most recent application for MFIP-S, the employment 280.27 disregard for all unit members is 36 percent of the gross earned 280.28 income. 280.29 After initial eligibility is established, the assistance 280.30 payment calculation is based on the monthly income test. 280.31 Subd. 4. [MONTHLY INCOME TEST AND DETERMINATION OF 280.32 ASSISTANCE PAYMENT.] The county agency shall determine ongoing 280.33 eligibility and the assistance payment amount according to the 280.34 monthly income test. To be eligible for MFIP-S, the result of 280.35 the computations in paragraphs (a) to (e) must be at least $1. 280.36 (a) Apply a 36 percent income disregard to gross earnings 281.1 and subtract this amount from the family wage level. If the 281.2 difference is equal to or greater than the transitional 281.3 standard, the assistance payment is equal to the transitional 281.4 standard. If the difference is less than the transitional 281.5 standard, the assistance payment is equal to the difference. 281.6 The employment disregard in this paragraph must be deducted 281.7 every month there is earned income. 281.8 (b) All payments made according to a court order 281.9 for spousal support or the support of children not living in the 281.10 assistance unit's household must be disregarded from the income 281.11 of the person with the legal obligation to pay support, provided 281.12 that, if there has been a change in the financial circumstances 281.13 of the person with the legal obligation to pay support since the 281.14 support order was entered, the person with the legal obligation 281.15 to pay support has petitioned for a modification of the court 281.16 order. 281.17 (c) An allocation for the unmet need of an ineligible 281.18 spouse or an ineligible child under the age of 21 for whom the 281.19 caregiver is financially responsible and who lives with the 281.20 caregiver must be made according to section 256J.36. 281.21 (d) Subtract unearned income dollar for dollar from the 281.22 transitional standard to determine the assistance payment amount. 281.23(d)(e) When income is both earned and unearned, the amount 281.24 of the assistance payment must be determined by first treating 281.25 gross earned income as specified in paragraph (a). After 281.26 determining the amount of the assistance payment under paragraph 281.27 (a), unearned income must be subtracted from that amount dollar 281.28 for dollar to determine the assistance payment amount. 281.29(e)(f) When the monthly income is greater than the 281.30 transitional or family wage level standard after applicable 281.31 deductions and the income will only exceed the standard for one 281.32 month, the county agency must suspend the assistance payment for 281.33 the payment month. 281.34 Subd. 5. [DISTRIBUTION OF INCOME.] The income of all 281.35 members of the assistance unit must be counted. Income may also 281.36 be deemed from ineligible persons to the assistance unit. 282.1 Income must be attributed to the person who earns it or to the 282.2 assistance unit according to paragraphs (a) to (c). 282.3 (a) Funds distributed from a trust, whether from the 282.4 principal holdings or sale of trust property or from the 282.5 interest and other earnings of the trust holdings, must be 282.6 considered income when the income is legally available to an 282.7 applicant or participant. Trusts are presumed legally available 282.8 unless an applicant or participant can document that the trust 282.9 is not legally available. 282.10 (b) Income from jointly owned property must be divided 282.11 equally among property owners unless the terms of ownership 282.12 provide for a different distribution. 282.13 (c) Deductions are not allowed from the gross income of a 282.14 financially responsible household member or by the members of an 282.15 assistance unit to meet a current or prior debt. 282.16 Sec. 40. Minnesota Statutes 1997 Supplement, section 282.17 256J.24, subdivision 1, is amended to read: 282.18 Subdivision 1. [MFIP-S ASSISTANCE UNIT.] An MFIP-S 282.19 assistance unit is either a group of individuals with at least 282.20 one minor child who live together whose needs, assets, and 282.21 income are considered together and who receive MFIP-S 282.22 assistance, or a pregnant woman and her spouse whoreceives282.23 receive MFIP-S assistance. 282.24 Individuals identified in subdivision 2 must be included in 282.25 the MFIP-S assistance unit. Individuals identified in 282.26 subdivision 3must be excluded from the assistance unitare 282.27 ineligible to receive MFIP-S. Individuals identified in 282.28 subdivision 4 may be included in the assistance unit at their 282.29 option. Individuals not included in the assistance unit who are 282.30 identified in section 256J.37,subdivisionsubdivisions 1orto 282.31 2, must have their income and assets considered when determining 282.32 eligibility and benefits for an MFIP-S assistance unit. All 282.33 assistance unit members, whether mandatory or elective, who live 282.34 together and for whom one caregiver or two caregivers apply must 282.35 be included in a single assistance unit. 282.36 Sec. 41. Minnesota Statutes 1997 Supplement, section 283.1 256J.24, subdivision 2, is amended to read: 283.2 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 283.3 for minor caregivers and their children whoaremust be in a 283.4 separate assistance unit from the other persons in the 283.5 household, when the following individuals live together, they 283.6 must be included in the assistance unit: 283.7 (1) a minor child, including a pregnant minor; 283.8 (2) the minor child's siblings, half-siblings, and 283.9 step-siblings;and283.10 (3) the minor child's natural, adoptive parents, and 283.11 stepparents; and 283.12 (4) the spouse of a pregnant woman. 283.13 Sec. 42. Minnesota Statutes 1997 Supplement, section 283.14 256J.24, subdivision 3, is amended to read: 283.15 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 283.16 ASSISTANCE UNIT.] (a) The following individualsmust be excluded283.17from an assistance unitwho are part of the assistance unit 283.18 determined under subdivision 2 are ineligible to receive MFIP-S: 283.19 (1) individuals receiving Supplemental Security Income or 283.20 Minnesota supplemental aid; 283.21 (2) individuals living at home while performing 283.22 court-imposed, unpaid community service work due to a criminal 283.23 conviction; 283.24 (3) individuals disqualified from the food stamp program or 283.25 MFIP-S, until the disqualification ends; 283.26 (4) children on whose behalf federal, state or local foster 283.27 care paymentsunder title IV-E of the Social Security Actare 283.28 made, except as provided insectionsections 256J.13, 283.29 subdivision 2, and 256J.74, subdivision 2; and 283.30 (5) children receiving ongoing monthly adoption assistance 283.31 payments under section 269.67. 283.32 (b) The exclusion of a person under this subdivision does 283.33 not alter the mandatory assistance unit composition. 283.34 Sec. 43. Minnesota Statutes 1997 Supplement, section 283.35 256J.24, subdivision 4, is amended to read: 283.36 Subd. 4. [INDIVIDUALS WHO MAY ELECT TO BE INCLUDED IN THE 284.1 ASSISTANCE UNIT.] (a) The minor child's eligible caregiver may 284.2 choose to be in the assistance unit, if the caregiver is not 284.3 required to be in the assistance unit under subdivision 2. If 284.4 therelativeeligible caregiver chooses to be in the assistance 284.5 unit, that person's spouse must also be in the unit. 284.6 (b) Any minor child not related as a sibling, stepsibling, 284.7 or adopted sibling to the minor child in the unit, but for whom 284.8 there is an eligible caregiver may elect to be in the unit. 284.9 (c) A foster care provider of a minor child who is 284.10 receiving federal, state, or local foster care maintenance 284.11 payments may elect to receive MFIP-S if the provider meets the 284.12 definition of caregiver under section 256J.08, subdivision 11. 284.13 If the provider chooses to receive MFIP-S, the spouse of the 284.14 provider must also be included in the assistance unit with the 284.15 provider. The provider and spouse are eligible for assistance 284.16 even if the only minor child living in the provider's home is 284.17 receiving foster care maintenance payments. 284.18 (d) The adult caregiver or caregivers of a minor parent are 284.19 eligible to be a separate assistance unit from the minor parent 284.20 and the minor parent's child when: 284.21 (1) the adult caregiver or caregivers have no other minor 284.22 children in the household; 284.23 (2) the minor parent and the minor parent's child are 284.24 living together with the adult caregiver or caregivers; and 284.25 (3) the minor parent and the minor parent's child receive 284.26 MFIP-S, or would be eligible to receive MFIP-S, if they were not 284.27 receiving SSI benefits. 284.28 Sec. 44. Minnesota Statutes 1997 Supplement, section 284.29 256J.24, is amended by adding a subdivision to read: 284.30 Subd. 5a. [FOOD PORTION OF MFIP-S TRANSITIONAL 284.31 STANDARD.] The commissioner shall adjust the food portion of the 284.32 MFIP-S transitional standard by October 1 each year beginning 284.33 October 1998 to reflect the cost-of-living adjustments to the 284.34 Food Stamp Program. The commissioner shall annually publish in 284.35 the State Register the transitional standard for an assistance 284.36 unit of sizes 1 to 10. 285.1 Sec. 45. Minnesota Statutes 1997 Supplement, section 285.2 256J.24, is amended by adding a subdivision to read: 285.3 Subd. 8. [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE 285.4 UNITS.] For all applicants who are eligible for MFIP-S 285.5 assistance, payments for shelter and utilities up to the amount 285.6 of MFIP-S benefits for which the assistance unit is eligible 285.7 may, upon county option, be vendor paid for as many months as 285.8 the assistance unit is eligible or six months, whichever comes 285.9 first. The residual amount of the grant after vendor payment, 285.10 if any, must be paid to the MFIP-S caregiver. A county that 285.11 chooses this method of payment must use it for all eligible 285.12 applicants. 285.13 Sec. 46. Minnesota Statutes 1997 Supplement, section 285.14 256J.26, subdivision 1, is amended to read: 285.15 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 285.16 Applicants orrecipientsparticipants who have been convicted of 285.17 a drug offense after July 1, 1997, may, if otherwise eligible, 285.18 receive AFDC or MFIP-S benefits subject to the following 285.19 conditions: 285.20 (1) Benefits for the entire assistance unit must be paid in 285.21 vendor form for shelter and utilities during any time the 285.22 applicant is part of the assistance unit;. 285.23 (2) The convicted applicant orrecipientparticipant shall 285.24 be subject to random drug testing as a condition of continued 285.25 eligibility andis subject to sanctions under section 256J.46285.26 following any positive test for an illegal controlled substance,285.27except that the grant must continue to be vendor paid under285.28clause (1).285.29For purposes of this subdivision, section 256J.46 is285.30effective July 1, 1997.285.31This subdivision also applies to persons who receive food285.32stamps under section 115 of the Personal Responsibility and Work285.33Opportunity Reconciliation Act of 1996.is subject to the 285.34 following sanctions: 285.35 (i) for failing a drug test the first time, the 285.36 participant's grant shall be reduced by ten percent of the 286.1 MFIP-S transitional standard or the interstate transitional 286.2 standard, whichever is applicable prior to making vendor 286.3 payments for shelter and utility costs; or 286.4 (ii) for failing a drug test two or more times, the 286.5 residual amount of the participant's grant after making vendor 286.6 payments for shelter and utility costs, if any, must be reduced 286.7 by an amount equal to 30 percent of the MFIP-S transitional 286.8 standard or the interstate transitional standard, whichever is 286.9 applicable. 286.10 (b) Applicants or participants who have been convicted of a 286.11 drug offense after July 1, 1997, may, if otherwise eligible, 286.12 receive food stamps if the convicted applicant or participant is 286.13 subject to random drug testing as a condition of continued 286.14 eligibility. Following a positive test for an illegal 286.15 controlled substance, the applicant is subject to the following 286.16 sanctions: 286.17 (1) for failing a drug test the first time, food stamps 286.18 shall be reduced by ten percent of the applicable food stamp 286.19 allotment; and 286.20 (2) for failing a drug test two or more times, food stamps 286.21 shall be reduced by an amount equal to 30 percent of the 286.22 applicable food stamp allotment. 286.23(b)(c) For the purposes of this subdivision, "drug offense" 286.24 means a conviction that occurred after July 1, 1997, of sections 286.25 152.021 to 152.025, 152.0261, or 152.096. Drug offense also 286.26 means a conviction in another jurisdiction of the possession, 286.27 use, or distribution of a controlled substance, or conspiracy to 286.28 commit any of these offenses, if the offense occurred after July 286.29 1, 1997, and the conviction is a felony offense in that 286.30 jurisdiction, or in the case of New Jersey, a high misdemeanor. 286.31 Sec. 47. Minnesota Statutes 1997 Supplement, section 286.32 256J.26, subdivision 2, is amended to read: 286.33 Subd. 2. [PAROLE VIOLATORS.] An individual violating a 286.34 condition of probation or parole or supervised release imposed 286.35 under federal law or the law of any state isineligible to286.36receivedisqualified from receiving AFDC or MFIP-S. 287.1 Sec. 48. Minnesota Statutes 1997 Supplement, section 287.2 256J.26, subdivision 3, is amended to read: 287.3 Subd. 3. [FLEEING FELONS.] An individual who is fleeing to 287.4 avoid prosecution, or custody, or confinement after conviction 287.5 for a crime that is a felony under the laws of the jurisdiction 287.6 from which the individual flees, or in the case of New Jersey, 287.7 is a high misdemeanor, isineligible to receivedisqualified 287.8 from receiving AFDC or MFIP-S. 287.9 Sec. 49. Minnesota Statutes 1997 Supplement, section 287.10 256J.26, subdivision 4, is amended to read: 287.11 Subd. 4. [DENIAL OF ASSISTANCE FOR TEN YEARS TO A PERSON 287.12 FOUND TO HAVE FRAUDULENTLY MISREPRESENTED RESIDENCY.] An 287.13 individual who is convicted in federal or state court of having 287.14 made a fraudulent statement or representation with respect to 287.15 the place of residence of the individual in order to receive 287.16 assistance simultaneously from two or more states isineligible287.17to receivedisqualified from receiving AFDC or MFIP-S for ten 287.18 years beginning on the date of the conviction. 287.19 Sec. 50. Minnesota Statutes 1997 Supplement, section 287.20 256J.28, subdivision 1, is amended to read: 287.21 Subdivision 1. [EXPEDITED ISSUANCE OF FOOD STAMP 287.22 ASSISTANCE.] The following households are entitled to expedited 287.23 issuance of food stamp assistance: 287.24 (1) households with less than $150 in monthly gross income 287.25 provided their liquid assets do not exceed $100; 287.26 (2) migrant or seasonal farm worker households who are 287.27 destitute as defined in Code of Federal Regulations, title 7, 287.28 subtitle B, chapter 2, subchapter C, part 273, section 273.10, 287.29 paragraph (e)(3), provided their liquid assets do not exceed 287.30 $100; and 287.31 (3) eligible households whose combined monthly gross income 287.32 and liquid resources are less than the household's monthly rent 287.33 or mortgage and utilities. 287.34The benefits issued through expedited issuance of food287.35stamp assistance must be deducted from the amount of the full287.36monthly MFIP-S assistance payment and a supplemental payment for288.1the difference must be issued.For any month an individual 288.2 receives expedited food stamp benefits, the individual is not 288.3 eligible for the MFIP-S food portion of assistance. 288.4 Sec. 51. Minnesota Statutes 1997 Supplement, section 288.5 256J.28, subdivision 2, is amended to read: 288.6 Subd. 2. [FOOD STAMPS FOR HOUSEHOLD MEMBERS NOT IN THE 288.7 ASSISTANCE UNIT.] (a) For household members who purchase and 288.8 prepare food with the MFIP-S assistance unit but are not part of 288.9 the assistance unit, the county agency must determine a separate 288.10 food stamp benefit based on regulations agreed upon with the 288.11 United States Department of Agriculture. 288.12(b) This subdivision does not apply to optional members who288.13have chosen not to be in the assistance unit.288.14(c)(b) Fair hearing requirements for persons who receive 288.15 food stamps under this subdivision are governed by section 288.16 256.045, and Code of Federal Regulations, title 7, subtitle B, 288.17 chapter II, part 273, section 273.15. 288.18 Sec. 52. Minnesota Statutes 1997 Supplement, section 288.19 256J.28, is amended by adding a subdivision to read: 288.20 Subd. 5. [FOOD STAMPS FOR PERSONS RESIDING IN A BATTERED 288.21 WOMAN'S SHELTER.] Members of an MFIP-S assistance unit residing 288.22 in a battered woman's shelter may receive food stamps or the 288.23 food portion twice in a month if the unit that initially 288.24 received the food stamps or food portion included the alleged 288.25 abuser. 288.26 Sec. 53. Minnesota Statutes 1997 Supplement, section 288.27 256J.30, subdivision 10, is amended to read: 288.28 Subd. 10. [COOPERATION WITH HEALTH CARE BENEFITS.] (a) The 288.29 caregiver of a minor child must cooperate with the county agency 288.30 to identify and provide information to assist the county agency 288.31 in pursuing third-party liability for medical services. 288.32 (b) A caregiver must assign to the department any rights to 288.33 health insurance policy benefits the caregiver has during the 288.34 period of MFIP-S eligibility. 288.35 (c) A caregiver must identify any third party who may be 288.36 liable for care and services available under the medical 289.1 assistance program on behalf of the applicant or participant and 289.2 all other assistance unit members. 289.3 (d) When a participant refuses to identify any third party 289.4 who may be liable for care and services, the recipient must be 289.5 sanctioned as provided in section 256J.46, subdivision 1. The 289.6 recipient is also ineligible for medical assistancefor a289.7minimum of one month anduntil the recipient cooperates with the 289.8 requirements of this subdivision. 289.9 Sec. 54. Minnesota Statutes 1997 Supplement, section 289.10 256J.30, subdivision 11, is amended to read: 289.11 Subd. 11. [REQUIREMENT TO ASSIGN SUPPORT AND MAINTENANCE 289.12 RIGHTS.]To be eligibleAn assistance unit is ineligible for 289.13 MFIP-S,unless the caregivermust assignassigns all rights to 289.14 child support and spousal maintenance benefits according 289.15 tosections 256.74, subdivision 5, andsection 256.741, if289.16enacted. 289.17 Sec. 55. Minnesota Statutes 1997 Supplement, section 289.18 256J.31, subdivision 5, is amended to read: 289.19 Subd. 5. [MAILING OF NOTICE.] The notice of adverse action 289.20 shall be issued according to paragraphs (a) to (c). 289.21 (a) A county agency shall mail a notice of adverse action 289.22 at least ten days before the effective date of the adverse 289.23 action, except as provided in paragraphs (b) and (c). 289.24 (b) A county agency must mail a notice of adverse action at 289.25 least five days before the effective date of the adverse action 289.26 when the county agency has factual information that requires an 289.27 action to reduce, suspend, or terminate assistance based on 289.28 probable fraud. 289.29 (c) A county agency shall mail a notice of adverse action 289.30 before or on the effective date of the adverse action when the 289.31 county agency: 289.32 (1) receives the caregiver's signed monthly MFIP-S 289.33 household report form that includes information that requires 289.34 payment reduction, suspension, or termination; 289.35 (2) is informed of the death of a participant or the payee; 289.36 (3) receives a signed statement from the caregiver that 290.1 assistance is no longer wanted; 290.2 (4) receives a signed statement from the caregiver that 290.3 provides information that requires the termination or reduction 290.4 of assistance; 290.5 (5) verifies that a member of the assistance unit is absent 290.6 from the home and does not meet temporary absence provisions in 290.7 section 256J.13; 290.8 (6) verifies that a member of the assistance unit has 290.9 entered a regional treatment center or a licensed residential 290.10 facility for medical or psychological treatment or 290.11 rehabilitation; 290.12 (7) verifies that a member of an assistance unit has been 290.13 placed in foster care, and the provisions of section 256J.13, 290.14 subdivision 2, paragraph(b)(c), clause (2), do not apply; 290.15 (8) verifies that a member of an assistance unit has been 290.16 approved to receive assistance by another state; or 290.17 (9) cannot locate a caregiver. 290.18 Sec. 56. Minnesota Statutes 1997 Supplement, section 290.19 256J.31, subdivision 10, is amended to read: 290.20 Subd. 10. [PROTECTION FROM GARNISHMENT.] MFIP-S grants or 290.21 earnings of a caregiverwhile participating in full or part-time290.22employment or trainingshall be protected from garnishment. 290.23 This protection for earnings shall extend for a period of six 290.24 months from the date of termination from MFIP-S. 290.25 Sec. 57. Minnesota Statutes 1997 Supplement, section 290.26 256J.31, is amended by adding a subdivision to read: 290.27 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 290.28 participant may discontinue receipt of the cash assistance 290.29 portion of MFIP-S assistance and retain eligibility for child 290.30 care assistance under section 119B.05 and for medical assistance 290.31 under sections 256B.055, subdivision 3a, and 256B.0635. 290.32 Sec. 58. [256J.311] [PROCEDURES TO IDENTIFY DOMESTIC 290.33 VIOLENCE VICTIMS.] The commissioner shall develop procedures for 290.34 county agencies and their contractors under this chapter and 290.35 chapter 256K to identify victims of domestic violence from among 290.36 applicants and recipients of assistance. The procedures must 291.1 provide, at a minimum, universal notification to all applicants 291.2 and recipients of MFIP-S that: 291.3 (1) referrals to counseling and supportive services are 291.4 available for victims of domestic violence; 291.5 (2) nonpermanent resident battered individuals married to 291.6 United States citizens or permanent residents may be eligible to 291.7 petition for permanent residency under the federal Violence 291.8 Against Women Act, and referrals to appropriate legal services 291.9 are available; 291.10 (3) victims of domestic violence are exempt from the 291.11 60-month limit on assistance while the individual is complying 291.12 with an approved safety plan, as defined in section 256J.49, 291.13 subdivision 11; and 291.14 (4) victims of domestic violence may choose to be exempt or 291.15 deferred from MFIP-S work requirements for up to 12 months while 291.16 the individual is complying with an approved safety plan as 291.17 defined in section 256J.49, subdivision 11. 291.18 The procedures must require that the notification must be 291.19 given in writing and orally at the time of application and 291.20 recertification, when the individual is referred to the title 291.21 IV-D child support enforcement agency, and at the beginning of 291.22 any employment and training services program. 291.23 Sec. 59. Minnesota Statutes 1997 Supplement, section 291.24 256J.32, subdivision 4, is amended to read: 291.25 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 291.26 verify the following at application: 291.27 (1) identity of adults; 291.28 (2) presence of the minor child in the home, if 291.29 questionable; 291.30 (3) relationship of a minor child to caregivers in the 291.31 assistance unit; 291.32 (4) age, if necessary to determine MFIP-S eligibility; 291.33 (5) immigration status; 291.34 (6) social security numberin accordance withaccording to 291.35 the requirements of section 256J.30, subdivision 12; 291.36 (7) income; 292.1 (8) self-employment expenses used as a deduction; 292.2 (9) source and purpose of deposits and withdrawals from 292.3 business accounts; 292.4 (10) spousal support and child support payments made to 292.5 persons outside the household; 292.6 (11) real property; 292.7 (12) vehicles; 292.8 (13) checking and savings accounts; 292.9 (14) savings certificates, savings bonds, stocks, and 292.10 individual retirement accounts; 292.11 (15) pregnancy, if related to eligibility; 292.12 (16) inconsistent information, if related to eligibility; 292.13 (17) medical insurance; 292.14 (18) anticipated graduation date of an 18-year-old; 292.15 (19) burial accounts; 292.16 (20) school attendance, if related to eligibility;and292.17 (21) residence; 292.18 (22) a claim of domestic violence if used as a basis for a 292.19 deferral or exemption from the 60-month time limit in section 292.20 256J.42 or employment and training services requirements in 292.21 section 256J.56; and 292.22 (23) disability if used as an exemption from employment and 292.23 training services requirements under section 256J.56. 292.24 Sec. 60. Minnesota Statutes 1997 Supplement, section 292.25 256J.32, subdivision 6, is amended to read: 292.26 Subd. 6. [RECERTIFICATION.] (a) The county agency shall 292.27 recertify eligibility in an annual face-to-face interview with 292.28 the participant and verify the following: 292.29 (1) presence of the minor child in the home, if 292.30 questionable; 292.31 (2) income, unless excluded, including self-employment 292.32 expenses used as a deduction or deposits or withdrawals from 292.33 business accounts; 292.34 (3) assets when the value is within $200 of the asset 292.35 limit; and 292.36 (4) inconsistent information, if related to eligibility. 293.1 (b) As part of the recertification process, each recipient 293.2 must be asked if the applicant has symptoms of a drug or alcohol 293.3 dependency or substance abuse problems. 293.4 Sec. 61. Minnesota Statutes 1997 Supplement, section 293.5 256J.32, is amended by adding a subdivision to read: 293.6 Subd. 7. [NOTICE TO UNDOCUMENTED PERSONS; RELEASE OF 293.7 PRIVATE DATA.] County agencies in consultation with the 293.8 commissioner of human services shall provide notification to 293.9 undocumented persons regarding the release of personal data to 293.10 the immigration and naturalization service and develop protocol 293.11 regarding the release or sharing of data about undocumented 293.12 persons with the Immigration and Naturalization Service as 293.13 required under sections 404, 434, and 411A of the Personal 293.14 Responsibility and Work Opportunity Reconciliation Act of 1996. 293.15 Sec. 62. Minnesota Statutes 1997 Supplement, section 293.16 256J.33, subdivision 1, is amended to read: 293.17 Subdivision 1. [DETERMINATION OF ELIGIBILITY.] A county 293.18 agency must determine MFIP-S eligibility prospectively for a 293.19 payment month based on retrospectively assessing income and the 293.20 county agency's best estimate of the circumstances that will 293.21 exist in the payment month. 293.22 Except as described in section 256J.34, subdivision 1, when 293.23 prospective eligibility exists, a county agency must calculate 293.24 the amount of the assistance payment using retrospective 293.25 budgeting. To determine MFIP-S eligibility and the assistance 293.26 payment amount, a county agency must apply countable income, 293.27 described in section 256J.37, subdivisions 3 to 10, received by 293.28 members of an assistance unit or by other persons whose income 293.29 is counted for the assistance unit, described under sections 293.30 256J.21 and 256J.37, subdivisions 1andto 2. 293.31 This income must be applied to the transitional standard or 293.32 family wage standard subject to this section and sections 293.33 256J.34 to 256J.36. Income received in a calendar month and not 293.34 otherwise excluded under section 256J.21, subdivision 2, must be 293.35 applied to the needs of an assistance unit. 293.36 Sec. 63. Minnesota Statutes 1997 Supplement, section 294.1 256J.33, subdivision 4, is amended to read: 294.2 Subd. 4. [MONTHLY INCOME TEST.] A county agency must apply 294.3 the monthly income test retrospectively for each month of MFIP-S 294.4 eligibility. An assistance unit is not eligible when the 294.5 countable income equals or exceeds the transitional standard or 294.6 the family wage level for the assistance unit. The income 294.7 applied against the monthly income test must include: 294.8 (1) gross earned income from employment, prior to mandatory 294.9 payroll deductions, voluntary payroll deductions, wage 294.10 authorizations, and after the disregards in section 256J.21, 294.11 subdivision34, and the allocations in section 256J.36, unless 294.12 the employment income is specifically excluded under section 294.13 256J.21, subdivision 2; 294.14 (2) gross earned income from self-employment less 294.15 deductions for self-employment expenses in section 256J.37, 294.16 subdivision 5, but prior to any reductions for personal or 294.17 business state and federal income taxes, personal FICA, personal 294.18 health and life insurance, and after the disregards in section 294.19 256J.21, subdivision34, and the allocations in section 294.20 256J.36; 294.21 (3) unearned income after deductions for allowable expenses 294.22 in section 256J.37, subdivision 9, and allocations in section 294.23 256J.36, unless the income has been specifically excluded in 294.24 section 256J.21, subdivision 2; 294.25 (4) gross earned income from employment as determined under 294.26 clause (1) which is received by a member of an assistance unit 294.27 who is a minor child or minor caregiver and less than a 294.28 half-time student; 294.29 (5) child support and spousal support received or 294.30 anticipated to be received by an assistance unit; 294.31 (6) the income of a parent when that parent is not included 294.32 in the assistance unit; 294.33 (7) the income of an eligible relative and spouse who seek 294.34 to be included in the assistance unit; and 294.35 (8) the unearned income of a minor child included in the 294.36 assistance unit. 295.1 Sec. 64. Minnesota Statutes 1997 Supplement, section 295.2 256J.35, is amended to read: 295.3 256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 295.4 Except as provided in paragraphs (a) to(c)(d), the amount 295.5 of an assistance payment is equal to the difference between the 295.6 transitional standard or the Minnesota family wage level in 295.7 section 256J.24, whichever is less, and countable income. 295.8 (a) When MFIP-S eligibility exists for the month of 295.9 application, the amount of the assistance payment for the month 295.10 of application must be prorated from the date of application or 295.11 the date all other eligibility factors are met for that 295.12 applicant, whichever is later. This provision applies when an 295.13 applicant loses at least one day of MFIP-S eligibility. 295.14 (b) MFIP-S overpayments to an assistance unit must be 295.15 recouped according to section 256J.38, subdivision 4. 295.16 (c) An initial assistance payment must not be made to an 295.17 applicant who is not eligible on the date payment is made. 295.18 (d) An individual whose needs have been otherwise provided 295.19 for in another state, in whole or in part by county, state, or 295.20 federal dollars during a month, is ineligible to receive MFIP-S 295.21 for the month. 295.22 Sec. 65. Minnesota Statutes 1997 Supplement, section 295.23 256J.36, is amended to read: 295.24 256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 295.25 MEMBERS.] 295.26 Except as prohibited in paragraphs (a) and (b), an 295.27 allocation of income is allowed from the caregiver's income to 295.28 meet the unmet need of an ineligible spouse or an ineligible 295.29 child under the age of 21 for whom the caregiver is financially 295.30 responsible who also lives with the caregiver.An allocation is295.31allowed from the caregiver's income to meet the need of an295.32ineligible or excluded person.That allocation is allowed in an 295.33 amount up to the difference between the MFIP-Sfamily allowance295.34 transitional standard for the assistance unit when thatexcluded295.35orineligible person is included in the assistance unit and the 295.36 MFIP-S family allowance for the assistance unit when 296.1 theexcluded orineligible person is not included in the 296.2 assistance unit. These allocations must be deducted from the 296.3 caregiver's counted earnings and from unearned income subject to 296.4 paragraphs (a) and (b). 296.5 (a) Income of a minor child in the assistance unit must not 296.6 be allocated to meet the need ofaan ineligible personwho is296.7not a member of the assistance unit, including the child's 296.8 parent, even when that parent is the payee of the child's income. 296.9 (b) Income ofan assistance unita caregiver must not be 296.10 allocated to meet the needs of a disqualified personineligible296.11for failure to cooperate with program requirements including296.12child support requirements, a person ineligible due to fraud, or296.13a relative caregiver and the caregiver's spouse who opt out of296.14the assistance unit. 296.15 Sec. 66. Minnesota Statutes 1997 Supplement, section 296.16 256J.37, subdivision 1, is amended to read: 296.17 Subdivision 1. [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 296.18 MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 296.19 the income of ineligible household members must be deemed after 296.20 allowing the following disregards: 296.21 (1) the first 18 percent of theexcludedineligible family 296.22 member's gross earned income; 296.23 (2) amounts the ineligible person actually paid to 296.24 individuals not living in the same household but whom the 296.25 ineligible person claims or could claim as dependents for 296.26 determining federal personal income tax liability; 296.27 (3)child or spousal support paid to a person who lives296.28outside of the householdall payments made by the ineligible 296.29 person according to a court order for spousal support or the 296.30 support of children not living in the assistance unit's 296.31 household, provided that, if there has been a change in the 296.32 financial circumstances of the ineligible person since the 296.33 support order was entered, the ineligible person has petitioned 296.34 for a modification of the support order; and 296.35 (4) an amount for the needs of the ineligible person and 296.36 other persons who live in the household but are not included in 297.1 the assistance unit and are or could be claimed by an ineligible 297.2 person as dependents for determining federal personal income tax 297.3 liability. This amount is equal to the difference between the 297.4 MFIP-Sneedtransitional standard when theexcludedineligible 297.5 person is included in the assistance unit and the MFIP-Sneed297.6 transitional standard when theexcludedineligible person is not 297.7 included in the assistance unit. 297.8 Sec. 67. Minnesota Statutes 1997 Supplement, section 297.9 256J.37, is amended by adding a subdivision to read: 297.10 Subd. 1a. [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 297.11 income of disqualified members must be deemed after allowing the 297.12 following disregards: 297.13 (1) the first 18 percent of the disqualified member's gross 297.14 earned income; 297.15 (2) amounts the disqualified member actually paid to 297.16 individuals not living in the same household but whom the 297.17 disqualified member claims or could claim as dependents for 297.18 determining federal personal income tax liability; 297.19 (3) all payments made by the disqualified member according 297.20 to a court order for spousal support or the support of children 297.21 not living in the assistance unit's household, provided that, if 297.22 there has been a change in the financial circumstances of the 297.23 disqualified member's legal obligation to pay support since the 297.24 support order was entered, the disqualified member has 297.25 petitioned for a modification of the support order; and 297.26 (4) an amount for the needs of other persons who live in 297.27 the household but are not included in the assistance unit and 297.28 are or could be claimed by the disqualified member as dependents 297.29 for determining federal personal income tax liability. This 297.30 amount is equal to the difference between the MFIP-S 297.31 transitional standard when the ineligible person is included in 297.32 the assistance unit and the MFIP-S transitional standard when 297.33 the ineligible person is not included in the assistance unit. 297.34 An amount shall not be allowed for the needs of a disqualified 297.35 member. 297.36 Sec. 68. Minnesota Statutes 1997 Supplement, section 298.1 256J.37, is amended by adding a subdivision to read: 298.2 Subd. 1b. [DEEMED INCOME FROM PARENTS OF MINOR 298.3 CAREGIVERS.] In households where minor caregivers live with a 298.4 parent or parents who do not receive MFIP-S, the income of the 298.5 parents must be deemed after allowing the following disregards: 298.6 (1) income of the parents equal to 200 percent of the 298.7 federal poverty guideline for a family size not including the 298.8 minor parent and the minor parent's child in the household 298.9 according to section 256J.21, subdivision 2, clause (43); 298.10 (2) 18 percent of the parents' gross earned income; 298.11 (3) amounts the parents actually paid to individuals not 298.12 living in the same household but whom the parents claim or could 298.13 claim as dependents for determining federal personal income tax 298.14 liability; and 298.15 (4) all payments made by parents according to a court order 298.16 for spousal support or the support of children not living in the 298.17 parent's household, provided that, if there has been a change in 298.18 the financial circumstances of the parent's legal obligation to 298.19 pay support since the support order was entered, the parents 298.20 have petitioned for a modification of the support order. 298.21 Sec. 69. Minnesota Statutes 1997 Supplement, section 298.22 256J.37, subdivision 2, is amended to read: 298.23 Subd. 2. [DEEMED INCOME AND ASSETS OF SPONSOR OF 298.24 NONCITIZENS.]All income and assets of a sponsor, or sponsor's298.25spouse, who executed an affidavit of support for a noncitizen298.26must be deemed to be unearned income of the noncitizen as298.27specified in the Personal Responsibility and Work Opportunity298.28Reconciliation Act of 1996, title IV, Public Law Number 104-193,298.29sections 421 and 422, and subsequently set out in federal298.30rules.If a noncitizen applies for or receives MFIP-S, the 298.31 county must deem the income and assets of the noncitizen's 298.32 sponsor and the sponsor's spouse who have signed an affidavit of 298.33 support for the noncitizen as specified in sections 421 and 422 298.34 of the Personal Responsibility and Work Opportunity 298.35 Reconciliation Act of 1996, title IV, Public Law Number 298.36 104-193. The income of a sponsor and the sponsor's spouse is 299.1 considered unearned income of the noncitizen. The assets of a 299.2 sponsor and the sponsor's spouse are considered available assets 299.3 of the noncitizen. 299.4 Sec. 70. Minnesota Statutes 1997 Supplement, section 299.5 256J.37, subdivision 9, is amended to read: 299.6 Subd. 9. [UNEARNED INCOME.] (a) The county agency must 299.7 apply unearned income, including housing subsidies as in299.8paragraph (b),to the transitional standard. When determining 299.9 the amount of unearned income, the county agency must deduct the 299.10 costs necessary to secure payments of unearned income. These 299.11 costs include legal fees, medical fees, and mandatory deductions 299.12 such as federal and state income taxes. 299.13 (b) Effective July 1,19981999, the county agency shall 299.14 count $100 of the value of public and assisted rental subsidies 299.15 provided through the Department of Housing and Urban Development 299.16 (HUD) as unearned income. The full amount of the subsidy must 299.17 be counted as unearned income when the subsidy is less than $100. 299.18 (c) For the period from July 1, 1998, to June 30, 1999, the 299.19 provisions of paragraph (b) shall not apply to MFIP-S 299.20 participants who are exempt from the employment and training 299.21 services component because they are: 299.22 (i) individuals who are age 60 or older; 299.23 (ii) individuals who are suffering from a professionally 299.24 certified permanent or temporary illness, injury, or incapacity 299.25 which is expected to continue for more than 30 days and which 299.26 prevents the person from obtaining or retaining employment; or 299.27 (iii) caregivers whose presence in the home is required 299.28 because of the professionally certified illness or incapacity of 299.29 another member in the household which is expected to last for 299.30 more than 30 days and the caregiver's presence replaces other 299.31 specialized care arrangements. 299.32 Sec. 71. Minnesota Statutes 1997 Supplement, section 299.33 256J.38, subdivision 1, is amended to read: 299.34 Subdivision 1. [SCOPE OF OVERPAYMENT.] When a participant 299.35 or former participant receives an overpayment due to agency, 299.36 client, or ATM error, or due to assistance received while an 300.1 appeal is pending and the participant or former participant is 300.2 determined ineligible for assistance or for less assistance than 300.3 was received, the county agency must recoup or recover the 300.4 overpaymentunderusing theconditions of this300.5section.following methods: 300.6 (1) reconstruct each affected budget month and 300.7 corresponding payment month; 300.8 (2) use the policies and procedures that were in effect for 300.9 the payment month; and 300.10 (3) do not allow employment disregards in section 256J.21, 300.11 subdivision 3 or 4, in the calculation of the overpayment when 300.12 the unit has not reported within two calendar months following 300.13 the end of the month in which the income was received. 300.14 Sec. 72. Minnesota Statutes 1997 Supplement, section 300.15 256J.39, subdivision 2, is amended to read: 300.16 Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 300.17 paying assistance directly to a participant may be used when: 300.18 (1) a county agency determines that a vendor payment is the 300.19 most effective way to resolve an emergency situation pertaining 300.20 to basic needs; 300.21 (2) a caregiver makes a written request to the county 300.22 agency asking that part or all of the assistance payment be 300.23 issued by protective or vendor payments for shelter and utility 300.24 service only. The caregiver may withdraw this request in 300.25 writing at any time; 300.26 (3)a caregiver has exhibited a continuing pattern of300.27mismanaging funds as determined by the county agency;300.28(4)the vendor payment is part of a sanction under section 300.29 256J.46, subdivision 2;or300.30(5)(4) the vendor payment is required under section 300.31 256J.24, subdivision 8, 256J.26, or 256J.43; 300.32 (5) a protective payment is required for a minor parent 300.33 under section 256J.14; or 300.34 (6) a caregiver has exhibited a continuing pattern of 300.35 mismanaging funds as determined by the county agency. 300.36 The director of a county agency must approve a proposal for 301.1 protective or vendor payment for money mismanagement when there 301.2 is a pattern of mismanagement under clause (6). During the time 301.3 a protective or vendor payment is being made, the county agency 301.4 must provide services designed to alleviate the causes of the 301.5 mismanagement. 301.6 The continuing need for and method of payment must be 301.7 documented and reviewed every 12 months. The director of a 301.8 county agency must approve the continuation of protective or 301.9 vendor payments. When it appears that the need for protective 301.10 or vendor payments will continue or is likely to continue beyond 301.11 two years because the county agency's efforts have not resulted 301.12 in sufficiently improved use of assistance on behalf of the 301.13 minor child, judicial appointment of a legal guardian or other 301.14 legal representative must be sought by the county agency. 301.15 Sec. 73. Minnesota Statutes 1997 Supplement, section 301.16 256J.395, is amended to read: 301.17 256J.395 [VENDOR PAYMENT OFRENTSHELTER COSTS AND 301.18 UTILITIES.] 301.19 Subdivision 1. [VENDOR PAYMENT.] (a) Effective July 1, 301.20 1997, when a county is required to provide assistance to 301.21 arecipientparticipant in vendor form forrentshelter costs 301.22 and utilities under this chapter, or chapter 256, 256D, or 256K, 301.23 the cost of utilities for a given family may be assumed to be: 301.24 (1) the average of the actual monthly cost of utilities for 301.25 that family for the prior 12 months at the family's current 301.26 residence, if applicable; 301.27 (2) the monthly plan amount, if any, set by the local 301.28 utilities for that family at the family's current residence; or 301.29 (3) the estimated monthly utility costs for the dwelling in 301.30 which the family currently resides. 301.31 (b) For purposes of this section, "utility" means any of 301.32 the following: municipal water and sewer service; electric, 301.33 gas, or heating fuel service; or wood, if that is the heating 301.34 source. 301.35 (c) In any instance where a vendor payment for rent is 301.36 directed to a landlord not legally entitled to the payment, the 302.1 county social services agency shall immediately institute 302.2 proceedings to collect the amount of the vendored rent payment, 302.3 which shall be considered a debt under section 270A.03, 302.4 subdivision 5. 302.5 Subd. 2. [VENDOR PAYMENT NOTIFICATION.] (a) When a county 302.6 agency is required to provide assistance to a participant in 302.7 vendor payment form for shelter costs or utilities under 302.8 subdivision 1, and the participant does not give the agency the 302.9 information needed to pay the vendor, the county agency shall 302.10 notify the participant of the intent to terminate assistance by 302.11 mail at least ten days before the effective date of the adverse 302.12 action. 302.13 (b) The notice of action shall include a request for 302.14 information about: 302.15 (1) the amount of the participant's shelter costs or 302.16 utilities; 302.17 (2) the due date of the shelter costs or utilities; and 302.18 (3) the name and address of the landlord, contract for deed 302.19 holder, mortgage company, and utility vendor. 302.20 (c) If the participant fails to provide the requested 302.21 information by the effective date of the adverse action, the 302.22 county must terminate the MFIP-S grant. If the applicant or 302.23 participant verifies they do not have shelter costs or utility 302.24 obligations, the county shall not terminate assistance if the 302.25 assistance unit is otherwise eligible. 302.26 Sec. 74. Minnesota Statutes 1997 Supplement, section 302.27 256J.42, is amended to read: 302.28 256J.42 [60-MONTH TIME LIMIT.] 302.29 Subdivision 1. [TIME LIMIT.] (a) Except for the exemptions 302.30 in this section and in section 256J.11, subdivision 2, An 302.31 assistance unit in which any adult caregiver has received 60 302.32 months of cash assistance funded in whole or in part by the TANF 302.33 block grant in this or any other state or United States 302.34 territory, MFIP-S, AFDC, or family general assistance, funded in 302.35 whole or in part by state appropriations, is ineligible to 302.36 receive MFIP-S. Any cash assistance funded with TANF dollars in 303.1 this or any other state or United States territory, or MFIP-S 303.2 assistance funded in whole or in part by state appropriations, 303.3 that was received by the unit on or after the date TANF was 303.4 implemented, including any assistance received in states or 303.5 United States territories of prior residence, counts toward the 303.6 60-month limitation. The 60-month limit applies to a minor who 303.7 is the head of a household or who is married to the head of a 303.8 household except under subdivision 5. The 60-month time period 303.9 does not need to be consecutive months for this provision to 303.10 apply. 303.11 (b) Months before July 1998 in which individuals receive 303.12 assistance as part of an MFIP, MFIP-R, or MFIP or MFIP-R 303.13 comparison group family under sections 256.031 to 256.0361 or 303.14 sections 256.047 to 256.048 are not included in the 60-month 303.15 time limit. 303.16Subd. 2. [ASSISTANCE FROM ANOTHER STATE.] An individual303.17whose needs have been otherwise provided for in another state,303.18in whole or in part by the TANF block grant during a month, is303.19ineligible to receive MFIP-S for the month.303.20 Subd. 3. [ADULTS LIVING ON AN INDIAN RESERVATION.] In 303.21 determining the number of months for which an adult has received 303.22 assistance under MFIP-S, the county agency must disregard any 303.23 month during which the adult lived on an Indian reservation if,303.24 during the month:303.25(1) at least 1,000 individuals were living on the303.26reservation; and303.27(2)at least 50 percent of the adults living on the 303.28 reservation wereunemployednot employed. 303.29 Subd. 4. [VICTIMS OF DOMESTIC VIOLENCE.] Any cash 303.30 assistance received by an assistance unit in a month when a 303.31 caregiver is complying with a safety plan under the MFIP-S 303.32 employment and training component does not count toward the 303.33 60-month limitation on assistance. 303.34 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 303.35 assistance received by an assistance unit does not count toward 303.36 the 60-month limit on assistance during a month in which 304.1 theparentalcaregiver is in the category in section 256J.56, 304.2 clause (1). The exemption applies for the period of time the 304.3 caregiver belongs to one of the categories specified in this 304.4 subdivision. 304.5 (b) From July 1, 1997, until the date MFIP-S is operative 304.6 in the caregiver's county of financial responsibility, any cash 304.7 assistance received by a caregiver who is complying with 304.8 sections 256.73, subdivision 5a, and 256.736, if applicable, 304.9 does not count toward the 60-month limit on assistance. 304.10 Thereafter, any cash assistance received by a minor caregiver 304.11 who is complying with the requirements of sections 256J.14 and 304.12 256J.54, if applicable, does not count towards the 60-month 304.13 limit on assistance. 304.14 (c) Any diversionary assistance or emergency assistance 304.15 received does not count toward the 60-month limit. 304.16 (d) Any cash assistance received by an 18 or 19 year old 304.17 caregiver during a month when the caregiver is complying with 304.18 the requirements of section 256J.54 does not count toward the 304.19 60-month limit. 304.20 Sec. 75. Minnesota Statutes 1997 Supplement, section 304.21 256J.43, is amended to read: 304.22 256J.43 [INTERSTATE PAYMENT STANDARDS.] 304.23 Subdivision 1. [PAYMENT.] (a) Effective July 1, 1997, the 304.24 amount of assistance paid to an eligiblefamilyunit in which 304.25 all members have resided in this state for fewer than 12 304.26 consecutive calendar months immediately preceding the date of 304.27 application shall be the lesser of either thepaymentinterstate 304.28 transitional standard that would have been received by 304.29 thefamilyassistance unit from the state of immediate prior 304.30 residence, or the amount calculated in accordance with AFDC or 304.31 MFIP-S standards. The lesser payment must continue until 304.32 thefamilyassistance unit meets the 12-month requirement. An 304.33 assistance unit that has not resided in Minnesota for 12 months 304.34 from the date of application is not exempt from the interstate 304.35 payment provisions solely because a child is born in Minnesota 304.36 to a member of the assistance unit. Payment must be calculated 305.1 by applying this state's budgeting policies, and the unit's net 305.2 income must be deducted from the payment standard in the other 305.3 state or in this state, whichever is lower. Payment shall be 305.4 made in vendor form for rent and utilities, up to the limit of 305.5 the grant amount, and residual amounts, if any, shall be paid 305.6 directly to the assistance unit. 305.7 (b) During the first 12 monthsa familyan assistance unit 305.8 resides in this state, the number of months that afamilyunit 305.9 is eligible to receive AFDC or MFIP-S benefits is limited to the 305.10 number of months thefamilyassistance unit would have been 305.11 eligible to receive similar benefits in the state of immediate 305.12 prior residence. 305.13 (c) This policy applies whether or not thefamily305.14 assistance unit received similar benefits while residing in the 305.15 state of previous residence. 305.16 (d) Whena familyan assistance unit moves to this state 305.17 from another state where thefamilyassistance unit has 305.18 exhausted that state's time limit for receiving benefits under 305.19 that state's TANF program, thefamilyunit will not be eligible 305.20 to receive any AFDC or MFIP-S benefits in this state for 12 305.21 months from the date thefamilyassistance unit moves here. 305.22 (e) For the purposes of this section, "state of immediate 305.23 prior residence" means: 305.24 (1) the state in which the applicant declares the applicant 305.25 spent the most time in the 30 days prior to moving to this 305.26 state; or 305.27 (2) the state in which an applicant who is a migrant worker 305.28 maintains a home. 305.29 (f) The commissioner shall annually verify and update all 305.30 other states' payment standards as they are to be in effect in 305.31 July of each year. 305.32 (g) Applicants must provide verification of their state of 305.33 immediate prior residence, in the form of tax statements, a 305.34 driver's license, automobile registration, rent receipts, or 305.35 other forms of verification approved by the commissioner. 305.36 (h) Migrant workers, as defined in section 256J.08, and 306.1 their immediate families are exempt from this section, provided 306.2 the migrant worker provides verification that the migrant family 306.3 worked in this state within the last 12 months and earned at 306.4 least $1,000 in gross wages during the time the migrant worker 306.5 worked in this state. 306.6 Subd. 2. [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 306.7 assistance unit that has met the requirements of section 306.8 256J.12, the number of months that the assistance unit receives 306.9 benefits under the interstate payment standards in this section 306.10 is not affected by an absence from Minnesota for fewer than 30 306.11 consecutive days. 306.12 (b) For an assistance unit that has met the requirements of 306.13 section 256J.12, the number of months that the assistance unit 306.14 receives benefits under the interstate payment standards in this 306.15 section is not affected by an absence from Minnesota for more 306.16 than 30 consecutive days but fewer than 90 consecutive days, 306.17 provided the assistance unit continues to maintain a residence 306.18 in Minnesota during the period of absence. 306.19 Subd. 3. [EXCEPTIONS TO THE INTERSTATE PAYMENT 306.20 POLICY.] Applicants who lived in another state in the 12 months 306.21 prior to applying for assistance are exempt from the interstate 306.22 payment policy for the months that a member of the unit: 306.23 (1) served in the United States armed services, provided 306.24 the person returned to Minnesota within 30 days of leaving the 306.25 armed forces, and intends to remain in Minnesota; 306.26 (2) attended school in another state, paid nonresident 306.27 tuition or Minnesota tuition rates under a reciprocity 306.28 agreement, provided the person left Minnesota specifically to 306.29 attend school and returned to Minnesota within 30 days of 306.30 graduation with the intent to remain in Minnesota; or 306.31 (3) meets the following criteria: 306.32 (i) a minor child or a minor caregiver moves from another 306.33 state to the residence of a relative caregiver; 306.34 (ii) the minor caregiver applies for and receives family 306.35 cash assistance; 306.36 (iii) the relative caregiver chooses not to be part of the 307.1 MFIP-S assistance unit; and 307.2 (iv) the relative caregiver has resided in Minnesota for at 307.3 least 12 months from the date the assistance unit applies for 307.4 cash assistance. 307.5 Subd. 4. [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 307.6 mandatory unit members who have resided in Minnesota for 12 307.7 months immediately before the unit's date of application 307.8 establish the other assistance unit members' eligibility for the 307.9 MFIP-S transitional standard. 307.10 Sec. 76. Minnesota Statutes 1997 Supplement, section 307.11 256J.44, is amended by adding a subdivision to read: 307.12 Subd. 3. [INTERVIEW TO IDENTIFY APPLICANTS WITH DRUG OR 307.13 ALCOHOL DEPENDENCIES.] As part of the initial screening under 307.14 this section, each applicant must also be asked if the applicant 307.15 has symptoms of a drug or alcohol dependency or substance abuse 307.16 problems. If this interview indicates that the applicant may 307.17 have a drug or alcohol dependency, the applicant must be 307.18 referred for further assessment. If the further assessment 307.19 indicates that the applicant or recipient has a drug or alcohol 307.20 dependency or substance abuse problem that requires treatment, 307.21 and that the individual's dependency is amenable to treatment, 307.22 the county must offer the individual a referral to an 307.23 appropriate treatment option. 307.24 Sec. 77. Minnesota Statutes 1997 Supplement, section 307.25 256J.45, subdivision 1, is amended to read: 307.26 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 307.27 county agency must provide each MFIP-S caregiver with a 307.28 face-to-face orientation. The caregiver must attend the 307.29 orientation. The county agency must inform the caregiver that 307.30 failure to attend the orientation is considereda firstan 307.31 occurrence of noncompliance with program requirements, and will 307.32 result in the imposition of a sanction under section 307.33 256J.46. If the client complies with the orientation 307.34 requirement prior to the effective date of the sanction, the 307.35 orientation sanction shall be lifted. 307.36 Sec. 78. Minnesota Statutes 1997 Supplement, section 308.1 256J.45, subdivision 2, is amended to read: 308.2 Subd. 2. [GENERAL INFORMATION.] The MFIP-S orientation 308.3 must consist of a presentation that informs caregivers of: 308.4 (1) the necessity to obtain immediate employment; 308.5 (2) the work incentives under MFIP-S; 308.6 (3) the requirement to comply with the employment plan and 308.7 other requirements of the employment and training services 308.8 component of MFIP-S; 308.9 (4) the consequences for failing to comply with the 308.10 employment plan and other program requirements; 308.11 (5) the rights, responsibilities, and obligations of 308.12 participants; 308.13 (6) the types and locations of child care services 308.14 available through the county agency; 308.15 (7) the availability and the benefits of the early 308.16 childhood health and developmental screening under sections 308.17 123.701 to 123.74; 308.18 (8) the caregiver's eligibility for transition year child 308.19 care assistance under section 119B.05; 308.20 (9) the caregiver's eligibility for extended medical 308.21 assistance when the caregiver loses eligibility for MFIP-S due 308.22 to increased earnings or increased child or spousal support;and308.23 (10) the caregiver's option to choose an employment and 308.24 training provider and information about each provider, including 308.25 but not limited to, services offered, program components, job 308.26 placement rates, job placement wages, and job retention rates; 308.27 and 308.28 (11) the caregiver's option to request approval of an 308.29 education and training plan according to section 256J.52. 308.30 Sec. 79. Minnesota Statutes 1997 Supplement, section 308.31 256J.45, is amended by adding a subdivision to read: 308.32 Subd. 3. [GOOD CAUSE FOR NOT ATTENDING ORIENTATION.] (a) 308.33 The county agency shall not impose the sanction under section 308.34 256J.46 if it determines that the participant has good cause for 308.35 failing to attend orientation. Good cause exists when: 308.36 (1) appropriate child care is not available; 309.1 (2) the participant is ill or injured; 309.2 (3) a family member is ill and needs care by the 309.3 participant that prevents the participant from attending 309.4 orientation; 309.5 (4) the caregiver is unable to secure necessary 309.6 transportation; 309.7 (5) the caregiver is in an emergency situation that 309.8 prevents orientation attendance; 309.9 (6) the orientation conflicts with the caregiver's work, 309.10 training, or school schedule; or 309.11 (7) the caregiver documents other verifiable impediments to 309.12 orientation attendance beyond the caregiver's control. 309.13 (b) Counties must work with clients to provide child care 309.14 and transportation necessary to ensure a caregiver has every 309.15 opportunity to attend orientation. 309.16 Sec. 80. Minnesota Statutes 1997 Supplement, section 309.17 256J.46, subdivision 1, is amended to read: 309.18 Subdivision 1. [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 309.19 WITH PROGRAM REQUIREMENTS.] (a) The following participants are 309.20 subject to a sanction under this subdivision: 309.21 (1) a participant who fails without good cause to comply 309.22 with the requirements of this chapter, and who is not subject to 309.23 a sanction under subdivision 2, shall be subject to a sanction309.24as provided in this subdivision; and 309.25 (2) a participant who has not complied with the orientation 309.26 requirement before the effective date of the sanction. 309.27 A sanction under this subdivision becomes effective ten 309.28 days after the required notice is given. For purposes of this 309.29 subdivision, each month that a participant fails to comply with 309.30 a requirement of this chapter shall be considered a separate 309.31 occurrence of noncompliance. A participant who has had one or 309.32 more sanctions imposed must remain in compliance with the 309.33 provisions of this chapter for six months in order for a 309.34 subsequent occurrence of noncompliance to be considered a first 309.35 occurrence. 309.36 (b) Sanctions for noncompliance shall be imposed as follows: 310.1 (1) For the first occurrence of noncompliance by a 310.2 participant in a single-parent household or by one participant 310.3 in a two-parent household, theparticipant'sassistance unit's 310.4 grant shall be reduced by ten percent of theapplicableMFIP-S 310.5 transitional standard or the interstate transitional standard 310.6 for an assistance unit of the same size, whichever is 310.7 applicable, with the residual paid to the participant. The 310.8 reduction in the grant amount must be in effect for a minimum of 310.9 one month and shall be removed in the month following the month 310.10 that the participant returns to compliance or in the month 310.11 following the minimum one-month sanction, whichever is later. 310.12 (2) For a second or subsequent occurrence of noncompliance, 310.13 or when both participants in a two-parent household are out of 310.14 compliance at the same time, theparticipant's rentassistance 310.15 unit's shelter costs shall be vendor paid up to the amount of 310.16 the cash portion of the MFIP-S grant for which the participant's 310.17 assistance unit is eligible. At county option, 310.18 theparticipant'sassistance unit's utilities may also be vendor 310.19 paid up to the amount of the cash portion of the MFIP-S grant 310.20 remaining after vendor payment of theparticipant's rent310.21 assistance unit's shelter costs.The vendor payment of rent310.22and, if in effect, utilities, must be in effect for six months310.23from the date that a sanction is imposed under this clause.The 310.24 residual amount of the grant after vendor payment, if any, must 310.25 be reduced by an amount equal to 30 percent of theapplicable310.26 MFIP-S transitional standard, or the interstate transitional 310.27 standard for an assistance unit of the same size, whichever is 310.28 applicable, before the residual is paid to theparticipant310.29 assistance unit. The reduction in the grant amount must be in 310.30 effect for a minimum of one month and shall be removed in the 310.31 month following the month thatthea participant in a one-parent 310.32 household returns to compliance or in the month following the 310.33 minimum one-month sanction, whichever is later. In a two-parent 310.34 household, the grant reduction shall be removed in the month 310.35 following the month both participants return to compliance or in 310.36 the month following the minimum one-month sanction, whichever is 311.1 later. The vendor payment ofrentshelter costs and, if 311.2 applicable, utilities shall be removed six months after the 311.3 month in which the participantreturnsor participants return to 311.4 compliance. 311.5 (c) No later than during the second month that a sanction 311.6 under paragraph (b), clause (2), is in effect due to 311.7 noncompliance with employment services, the participant's case 311.8 file must be reviewed to determine if: 311.9 (i) the continued noncompliance can be explained and 311.10 mitigated by providing a needed preemployment activity, as 311.11 defined in section 256J.49, subdivision 13, clause (16); 311.12 (ii) the participant qualifies for a good cause exception 311.13 under section 256J.57; or 311.14 (iii) the participant qualifies for an exemption under 311.15 section 256J.56. 311.16 If the lack of an identified activity can explain the 311.17 noncompliance, the county must work with the participant to 311.18 provide the identified activity, and the county must restore the 311.19 participant's grant amount to the full amount for which the 311.20 assistance unit is eligible. The grant must be restored 311.21 retroactively to the first day of the month in which the 311.22 participant was found to lack preemployment activities or to 311.23 qualify for an exemption or good cause exception. 311.24 If the participant is found to qualify for a good cause 311.25 exception or an exemption, the county must restore the 311.26 participant's grant to the full amount for which the assistance 311.27 unit is eligible.If the participant's grant is restored under311.28this paragraph, the vendor payment of rent and if applicable,311.29utilities, shall be removed six months after the month in which311.30the sanction was imposed and the county must consider a311.31subsequent occurrence of noncompliance to be a first occurrence.311.32 Sec. 81. Minnesota Statutes 1997 Supplement, section 311.33 256J.46, subdivision 2, is amended to read: 311.34 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 311.35 REQUIREMENTS.] The grant of an MFIP-S caregiver who refuses to 311.36 cooperate, as determined by the child support enforcement 312.1 agency, with support requirements under section 256.741, if 312.2 enacted, shall be subject to sanction as specified in this 312.3 subdivision. The assistance unit's grant must be reduced by 25 312.4 percent of the applicable transitional standard. The residual 312.5 amount of the grant, if any, must be paid to the caregiver. A 312.6 sanction under this subdivision becomes effective ten days after 312.7 the required notice is given. The sanction must be in effect 312.8 for a minimum of one month and shall be removed only when the 312.9 caregiver cooperates with the support requirements or in the 312.10 month following the minimum one-month sanction, whichever is 312.11 later. Each month that an MFIP-S caregiver fails to comply with 312.12 the requirements of section 256.741 must be considered a 312.13 separate occurrence of noncompliance. An MFIP-S caregiver who 312.14 has had one or more sanctions imposed must remain in compliance 312.15 with the requirements of section 256.741 for six months in order 312.16 for a subsequent sanction to be considered a first occurrence. 312.17 Sec. 82. Minnesota Statutes 1997 Supplement, section 312.18 256J.47, subdivision 4, is amended to read: 312.19 Subd. 4. [INELIGIBILITY FOR MFIP-S; EMERGENCY ASSISTANCE; 312.20 AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of diversionary 312.21 assistance, the family is ineligible for MFIP-S, emergency 312.22 assistance, and emergency general assistance for a period of 312.23 time. To determine the period of ineligibility, the county 312.24 shall use the following formula: regardless of household 312.25 changes, the county agency must calculate the number of days of 312.26 ineligibility by dividing the diversionary assistance issued by 312.27 the transitional standard a family of the same size and 312.28 composition would have received under MFIP-S, or if applicable 312.29 the interstate transitional standard, multiplied by 30, 312.30 truncating the result. The ineligibility period begins the date 312.31 the diversionary assistance is issued. 312.32 Sec. 83. Minnesota Statutes 1997 Supplement, section 312.33 256J.48, subdivision 2, is amended to read: 312.34 Subd. 2. [ELIGIBILITY.] Notwithstanding other eligibility 312.35 provisions of this chapter, any family without resources 312.36 immediately available to meet emergency needs identified in 313.1 subdivision 3 shall be eligible for an emergency grant under the 313.2 following conditions: 313.3 (1) a family member has resided in this state for at least 313.4 30 days; 313.5 (2) the family is without resources immediately available 313.6 to meet emergency needs; 313.7 (3) assistance is necessary to avoid destitution or provide 313.8 emergency shelter arrangements;and313.9 (4) the family's destitution or need for shelter or 313.10 utilities did not arise because the child or relative caregiver 313.11 refused without good cause under section 256J.57 to accept 313.12 employment or training for employment in this state or another 313.13 state; and 313.14 (5) at least one child or pregnant woman in the emergency 313.15 assistance unit meets MFIP-S citizenship requirements in section 313.16 256J.11. 313.17 Sec. 84. Minnesota Statutes 1997 Supplement, section 313.18 256J.48, subdivision 3, is amended to read: 313.19 Subd. 3. [EMERGENCY NEEDS.] Emergency needs are limited to 313.20 the following: 313.21 (a) [RENT.] A county agency may deny assistance to prevent 313.22 eviction from rented or leased shelter of an otherwise eligible 313.23 applicant when the county agency determines that an applicant's 313.24 anticipated income will not cover continued payment for shelter, 313.25 subject to conditions in clauses (1) to (3): 313.26 (1) a county agency must not deny assistance when an 313.27 applicant can document that the applicant is unable to locate 313.28 habitable shelter, unless the county agency can document that 313.29 one or more habitable shelters are available in the community 313.30 that will result in at least a 20 percent reduction in monthly 313.31 expense for shelter and that this shelter will be cost-effective 313.32 for the applicant; 313.33 (2) when no alternative shelter can be identified by either 313.34 the applicant or the county agency, the county agency shall not 313.35 deny assistance because anticipated income will not cover rental 313.36 obligation; and 314.1 (3) when cost-effective alternative shelter is identified, 314.2 the county agency shall issue assistance for moving expenses as 314.3 provided in paragraph(d)(e). 314.4 (b) [DEFINITIONS.] For purposes of paragraph (a), the 314.5 following definitions apply (1) "metropolitan statistical area" 314.6 is as defined by the United States Census Bureau; (2) 314.7 "alternative shelter" includes any shelter that is located 314.8 within the metropolitan statistical area containing the county 314.9 and for which the applicant is eligible, provided the applicant 314.10 does not have to travel more than 20 miles to reach the shelter 314.11 and has access to transportation to the shelter. Clause (2) 314.12 does not apply to counties in the Minneapolis-St. Paul 314.13 metropolitan statistical area. 314.14 (c) [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 314.15 agency shall issue assistance for mortgage or contract for deed 314.16 arrearages on behalf of an otherwise eligible applicant 314.17 according to clauses (1) to (4): 314.18 (1) assistance for arrearages must be issued only when a 314.19 home is owned, occupied, and maintained by the applicant; 314.20 (2) assistance for arrearages must be issued only when no 314.21 subsequent foreclosure action is expected within the 12 months 314.22 following the issuance; 314.23 (3) assistance for arrearages must be issued only when an 314.24 applicant has been refused refinancing through a bank or other 314.25 lending institution and the amount payable, when combined with 314.26 any payments made by the applicant, will be accepted by the 314.27 creditor as full payment of the arrearage; 314.28 (4) costs paid by a family which are counted toward the 314.29 payment requirements in this clause are:principleprincipal 314.30 and interest payments on mortgages or contracts for deed, 314.31 balloon payments, homeowner's insurance payments, manufactured 314.32 home lot rental payments, and tax or special assessment payments 314.33 related to the homestead. Costs which are not counted include 314.34 closing costs related to the sale or purchase of real property. 314.35 To be eligible for assistance for costs specified in clause 314.36 (4) which are outstanding at the time of foreclosure, an 315.1 applicant must have paid at least 40 percent of the family's 315.2 gross income toward these costs in the month of application and 315.3 the 11-month period immediately preceding the month of 315.4 application. 315.5 When an applicant is eligible under clause (4), a county 315.6 agency shall issue assistance up to a maximum of four times the 315.7 MFIP-S transitional standard for a comparable assistance unit. 315.8 (d) [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 315.9 issue assistance for damage or utility deposits when necessary 315.10 to alleviate the emergency. The county may require that 315.11 assistance paid in the form of a damage depositor a utility315.12deposit, less any amount retained by the landlord to remedy a 315.13 tenant's default in payment of rent or other funds due to the 315.14 landlord under a rental agreement, or to restore the premises to 315.15 the condition at the commencement of the tenancy, ordinary wear 315.16 and tear excepted, be returned to the county when the individual 315.17 vacates the premises or be paid to the recipient's new landlord 315.18 as a vendor payment. The county may require that assistance 315.19 paid in the form of a utility deposit less any amount retained 315.20 to satisfy outstanding utility costs be returned to the county 315.21 when the person vacates the premises, or be paid for the 315.22 person's new housing unit as a vendor payment. The vendor 315.23 payment of returned funds shall not be considered a new use of 315.24 emergency assistance. 315.25 (e) [MOVING EXPENSES.] A county agency shall issue 315.26 assistance for expenses incurred when a family must move to a 315.27 different shelter according to clauses (1) to (4): 315.28 (1) moving expenses include the cost to transport personal 315.29 property belonging to a family, the cost for utility connection, 315.30 and the cost for securing different shelter; 315.31 (2) moving expenses must be paid only when the county 315.32 agency determines that a move is cost-effective; 315.33 (3) moving expenses must be paid at the request of an 315.34 applicant, but only when destitution or threatened destitution 315.35 exists; and 315.36 (4) moving expenses must be paid when a county agency 316.1 denies assistance to prevent an eviction because the county 316.2 agency has determined that an applicant's anticipated income 316.3 will not cover continued shelter obligation in paragraph (a). 316.4 (f) [HOME REPAIRS.] A county agency shall pay for repairs 316.5 to the roof, foundation, wiring, heating system, chimney, and 316.6 water and sewer system of a home that is owned and lived in by 316.7 an applicant. 316.8 The applicant shall document, and the county agency shall 316.9 verify the need for and method of repair. 316.10 The payment must be cost-effective in relation to the 316.11 overall condition of the home and in relation to the cost and 316.12 availability of alternative housing. 316.13 (g) [UTILITY COSTS.] Assistance for utility costs must be 316.14 made when an otherwise eligible family has had a termination or 316.15 is threatened with a termination of municipal water and sewer 316.16 service, electric, gas or heating fuel service, or lacks wood 316.17 when that is the heating source, subject to the conditions in 316.18 clauses (1) and (2): 316.19 (1) a county agency must not issue assistance unless the 316.20 county agency receives confirmation from the utility provider 316.21 that assistance combined with payment by the applicant will 316.22 continue or restore the utility; and 316.23 (2) a county agency shall not issue assistance for utility 316.24 costs unless a family paid at least eight percent of the 316.25 family's gross income toward utility costs due during the 316.26 preceding 12 months. 316.27 Clauses (1) and (2) must not be construed to prevent the 316.28 issuance of assistance when a county agency must take immediate 316.29 and temporary action necessary to protect the life or health of 316.30 a child. 316.31 (h) [SPECIAL DIETS.] Effective January 1, 1998, a county 316.32 shall pay for special diets or dietary items for MFIP-S 316.33 participants. Persons receiving emergency assistance funds for 316.34 special diets or dietary items are also eligible to receive 316.35 emergency assistance for shelter and utility emergencies, if 316.36 otherwise eligible. The need for special diets or dietary items 317.1 must be prescribed by a licensed physician. Costs for special 317.2 diets shall be determined as percentages of the allotment for a 317.3 one-person household under the Thrifty Food Plan as defined by 317.4 the United States Department of Agriculture. The types of diets 317.5 and the percentages of the Thrifty Food Plan that are covered 317.6 are as follows: 317.7 (1) high protein diet, at least 80 grams daily, 25 percent 317.8 of Thrifty Food Plan; 317.9 (2) controlled protein diet, 40 to 60 grams and requires 317.10 special products, 100 percent of Thrifty Food Plan; 317.11 (3) controlled protein diet, less than 40 grams and 317.12 requires special products, 125 percent of Thrifty Food Plan; 317.13 (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 317.14 (5) high residue diet, 20 percent of Thrifty Food Plan; 317.15 (6) pregnancy and lactation diet, 35 percent of Thrifty 317.16 Food Plan; 317.17 (7) gluten-free diet, 25 percent of Thrifty Food Plan; 317.18 (8) lactose-free diet, 25 percent of Thrifty Food Plan; 317.19 (9) antidumping diet, 15 percent of Thrifty Food Plan; 317.20 (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 317.21 (11) ketogenic diet, 25 percent of Thrifty Food Plan. 317.22 Sec. 85. Minnesota Statutes 1997 Supplement, section 317.23 256J.50, subdivision 5, is amended to read: 317.24 Subd. 5. [PARTICIPATION REQUIREMENTS FOR SINGLE-PARENT AND 317.25 TWO-PARENT CASES.] (a) A county must establish a uniform 317.26 schedule for requiring participation by single parents. 317.27 Mandatory participation must be required within six months of 317.28 eligibility for cash assistance. For two-parent cases, 317.29 participation is required concurrent with the receipt of MFIP-S 317.30 cash assistance. 317.31 (b) Beginning January 1, 1998, with the exception of 317.32 caregivers required to attend high school under the provisions 317.33 of section 256J.54, subdivision 5, MFIP caregivers, upon 317.34 completion of the secondary assessment, must develop an 317.35 employment plan and participate in work activities. 317.36 (c) Upon completion of the secondary assessment: 318.1 (1) In single-parent families with no children under six 318.2 years of age, the job counselor and the caregiver must develop 318.3 an employment plan that includes 20 to 35 hours per week of work 318.4 activities for the period January 1, 1998, to September 30, 318.5 1998; 25 to 35 hours of work activities per week in federal 318.6 fiscal year 1999; and 30 to 35 hours per week of work activities 318.7 in federal fiscal year 2000 and thereafter. 318.8 (2) In single-parent families with a child under six years 318.9 of age, the job counselor and the caregiver must develop an 318.10 employment plan that includes 20 to 35 hours per week of work 318.11 activities. 318.12 (3) In two-parent families, the job counselor and the 318.13 caregivers must develop employment plans which result in a 318.14 combined total of at least 55 hours per week of work activities. 318.15 Sec. 86. Minnesota Statutes 1997 Supplement, section 318.16 256J.50, is amended by adding a subdivision to read: 318.17 Subd. 10. [COORDINATION.] The county agency and the county 318.18 agency's employment and training providers must consult and 318.19 coordinate with other providers of employment and training 318.20 services to identify existing resources, in order to prevent 318.21 duplication of services, to assure that other programs' services 318.22 are available to enable participants to achieve 318.23 self-sufficiency, and to assure that costs for these other 318.24 services for which participants are eligible are not incurred by 318.25 MFIP-S. At a minimum, the county agency and its providers must 318.26 coordinate with Jobs Training and Partnership Act providers and 318.27 with any other relevant employment, training, and education 318.28 programs in the county. 318.29 Sec. 87. Minnesota Statutes 1997 Supplement, section 318.30 256J.515, is amended to read: 318.31 256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 318.32 During the first meeting with participants, job counselors 318.33 must ensure that an overview of employment and training services 318.34 is provided that: (1) stresses the necessity and opportunity of 318.35 immediate employment,; (2) outlines the job search resources 318.36 offered,; (3) outlines education or training opportunities 319.1 available; (4) describes the range of work activities that are 319.2 allowable under MFIP-S to meet the individual needs of 319.3 participants; (5) explains the requirements to comply with an 319.4 employment planand; (6) explains the consequences for failing 319.5 to comply,; and (7) explains the services that are available to 319.6 support job search and work and education. 319.7 Sec. 88. Minnesota Statutes 1997 Supplement, section 319.8 256J.52, subdivision 2, is amended to read: 319.9 Subd. 2. [INITIAL ASSESSMENT.] (a) The job counselor must, 319.10 with the cooperation of the participant, assess the 319.11 participant's ability to obtain and retain employment. This 319.12 initial assessment must include a review of the participant's 319.13 education level, prior employment or work experience, 319.14 transferable work skills, and existing job markets. The job 319.15 counselor must assess each participant's literacy and math 319.16 skills as part of an initial assessment. If a participant lacks 319.17 basic math or literacy skills at or below an eighth grade level, 319.18 the participant must be allowed to enroll in adult basic 319.19 education activities as part of the participant's job search 319.20 support plan or employment plan. A participant with low-level 319.21 math and literacy skills should not be categorically assumed to 319.22 be unemployable. 319.23 (b) In assessing the participant, the job counselor must 319.24 determine if the participant needs refresher courses for 319.25 professional certification or licensure, in which case, the job 319.26 search plan under subdivision 3 must include the courses 319.27 necessary to obtain the certification or licensure, in addition 319.28 to other work activities, provided the combination of the 319.29 courses and other work activities are at least for 40 hours per 319.30 week. 319.31 (c)If a participant can demonstrate to the satisfaction of319.32the county agency thatIf the job counselor determines that a 319.33 lack of proficiency in English is a barrier to obtaining 319.34 suitable employment, the job counselor must include 319.35 participation in an intensive English as a second language 319.36 program if available or otherwise a regular English as a second 320.1 language program in the individual's employment plan under 320.2 subdivision 5 for as long as the participant is making 320.3 satisfactory progress and the individual's lack of proficiency 320.4 in English remains a barrier to obtaining suitable employment. 320.5 Lack of proficiency in English is not necessarily a barrier to 320.6 employment. 320.7 (d) Understanding that education may provide the best 320.8 opportunity for unsubsidized employment, the job counselor may 320.9 approve an education or training plan as a first option, and 320.10 postpone the job search requirement, if the participant has a 320.11 proposal for an education program, including those that may lead 320.12 to a certificate, diploma, or degree and which: 320.13 (1) can be completed within 12 months or within 18 months 320.14 if remedial education courses are necessary; 320.15 (2) meets the criteria of section 256J.53, subdivisions 2, 320.16 3, and 5; and 320.17 (3) is likely, without additional training, to lead to 320.18 monthly employment earnings which, after subtraction of the 320.19 earnings disregard under section 256J.21, equal or exceed the 320.20 family wage level for the participant's assistance unit. 320.21 (e) A participant who, at the time of the initial 320.22 assessment, presents a plan that includes farming as a 320.23 self-employed work activity must have an employment plan 320.24 developed under subdivision 5 that includes the farming as an 320.25 approved work activity. 320.26 Sec. 89. Minnesota Statutes 1997 Supplement, section 320.27 256J.52, subdivision 3, is amended to read: 320.28 Subd. 3. [JOB SEARCH; JOB SEARCH SUPPORT PLAN.] (a) If, 320.29 after the initial assessment, the job counselor determines that 320.30 the participant possesses sufficient skills that the participant 320.31 is likely to succeed in obtaining suitable employment, the 320.32 participant must conduct job search for a period of up to eight 320.33 weeks, for at least 30 hours per week. The participant must 320.34 accept any offer of suitable employment. The job counselor and 320.35 participant must develop a job search support plan which 320.36 specifies, at a minimum: whether the job search is to be 321.1 supervised or unsupervised; the number of hours of job search 321.2 that will be required; support services that will be provided 321.3 while the participant conducts job search activities; the 321.4 courses necessary to obtain certification or licensure, if 321.5 applicable, and after obtaining the license or certificate, the 321.6 client must comply with subdivision 5; and how frequently the 321.7 participant must report to the job counselor on the status of 321.8 the participant's job search activities. The job counselor may 321.9 approve other work activities listed in section 256J.49, 321.10 subdivision 13, to be included in a job search support plan. 321.11 (b) During the eight-week job search period, either the job 321.12 counselor or the participant may request a review of the 321.13 participant's job search plan and progress towards obtaining 321.14 suitable employment. If a review is requested by the 321.15 participant, the job counselor must concur that the review is 321.16 appropriate for the participant at that time. If a review is 321.17 conducted, the job counselor may make a determination to conduct 321.18 a secondary assessment prior to the conclusion of the job search. 321.19 (c) Failure to conduct the required job search, to accept 321.20 any offer of suitable employment, to develop or comply with a 321.21 job search support plan, or voluntarily quitting suitable 321.22 employment without good cause results in the imposition of a 321.23 sanction under section 256J.46. If at the end of eight weeks 321.24 the participant has not obtained suitable employment, the job 321.25 counselor must conduct a secondary assessment of the participant 321.26 under subdivision 3. 321.27 Sec. 90. Minnesota Statutes 1997 Supplement, section 321.28 256J.52, subdivision 4, is amended to read: 321.29 Subd. 4. [SECONDARY ASSESSMENT.] (a) The job counselor 321.30 must conduct a secondary assessment for those participants who: 321.31 (1) in the judgment of the job counselor, have barriers to 321.32 obtaining employment that will not be overcome with a job search 321.33 support plan under subdivision 3; 321.34 (2) have completed eight weeks of job search under 321.35 subdivision 3 without obtaining suitable employment;or321.36 (3) have not received a secondary assessment, are working 322.1 at least 20 hours per week, and the participant, job counselor, 322.2 or county agency requests a secondary assessment; or 322.3 (4) have an existing plan or are already involved in 322.4 training or education activities under section 256J.55, 322.5 subdivision 5. 322.6 (b) In the secondary assessment the job counselor must 322.7 evaluate the participant's skills and prior work experience, 322.8 family circumstances, interests and abilities, need for 322.9 preemployment activities, supportive or educational services, 322.10 and the extent of any barriers to employment. The job counselor 322.11 must use the information gathered through the secondary 322.12 assessment to develop an employment plan under subdivision 5. 322.13 (c) The provider shall make available to participants 322.14 information regarding additional vendors or resources which 322.15 provide employment and training services that may be available 322.16 to the participant under a plan developed under this section. 322.17 The information must include a brief summary of services 322.18 provided and related performance indicators. Performance 322.19 indicators must include, but are not limited to, the average 322.20 time to complete program offerings, placement rates, entry and 322.21 average wages, and retention rates. To be included in the 322.22 information given to participants, a vendor or resource must 322.23 provide counties with relevant information in the format 322.24 required by the county. 322.25 Sec. 91. Minnesota Statutes 1997 Supplement, section 322.26 256J.52, is amended by adding a subdivision to read: 322.27 Subd. 8. [ADMINISTRATIVE SUPPORT FOR POSTEMPLOYMENT 322.28 EDUCATION AND TRAINING.] After a caregiver has been employed for 322.29 six consecutive months, or after the first month in which the 322.30 caregiver works on average more than 20 hours per week, the 322.31 caregiver's job counselor shall inform the caregiver that the 322.32 caregiver may request a secondary assessment and shall provide 322.33 information about: 322.34 (1) part-time education and training options available to 322.35 the caregiver; and 322.36 (2) child care and transportation resources available to 323.1 support postemployment education and training. 323.2 Sec. 92. Minnesota Statutes 1997 Supplement, section 323.3 256J.52, is amended by adding a subdivision to read: 323.4 Subd. 9. [TRAINING CONCURRENT WITH EMPLOYMENT.] An MFIP 323.5 caregiver who is meeting the minimum hourly work participation 323.6 requirements under the Personal Responsibility and Work 323.7 Opportunity Reconciliation Act of 1996 through employment must 323.8 be allowed to meet any additional MFIP-S hourly work 323.9 participation requirements through training or education that 323.10 meets the requirements of section 256J.53. 323.11 Sec. 93. Minnesota Statutes 1997 Supplement, section 323.12 256J.54, subdivision 2, is amended to read: 323.13 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 323.14 PLAN.] For caregivers who are under age 18 without a high school 323.15 diploma or its equivalent, the assessment under subdivision 1 323.16 and the employment plan under subdivision 3 must be completed by 323.17 the social services agency under section 257.33. For caregivers 323.18 who are age 18 or 19 without a high school diploma or its 323.19 equivalent, the assessment under subdivision 1 and the 323.20 employment plan under subdivision 3 must be completed by the job 323.21 counselor. The social services agency or the job counselor 323.22 shall consult with representatives of educational agencies that 323.23 are required to assist in developing educational plans under 323.24 section 126.235. 323.25 Sec. 94. Minnesota Statutes 1997 Supplement, section 323.26 256J.54, subdivision 3, is amended to read: 323.27 Subd. 3. [EDUCATIONAL OPTION DEVELOPED.] If the job 323.28 counselor or county social services agency identifies an 323.29 appropriate educational option for a caregiver under the age of 323.30 20 without a high school diploma or its equivalent,itthe 323.31 counselor or agency must develop an employment plan which 323.32 reflects the identified option. The plan must specify that 323.33 participation in an educational activity is required, what 323.34 school or educational program is most appropriate, the services 323.35 that will be provided, the activities the caregiver will take 323.36 part in, including child care and supportive services, the 324.1 consequences to the caregiver for failing to participate or 324.2 comply with the specified requirements, and the right to appeal 324.3 any adverse action. The employment plan must, to the extent 324.4 possible, reflect the preferences of the caregiver. 324.5 Sec. 95. Minnesota Statutes 1997 Supplement, section 324.6 256J.54, subdivision 4, is amended to read: 324.7 Subd. 4. [NO APPROPRIATE EDUCATIONAL OPTION.] If the job 324.8 counselor determines that there is no appropriate educational 324.9 option for a caregiver who is age 18 or 19 without a high school 324.10 diploma or its equivalent, the job counselor must develop an 324.11 employment plan, as defined in section 256J.49, subdivision 5, 324.12 for the caregiver. If the county social services agency 324.13 determines that school attendance is not appropriate for a 324.14 caregiver under age 18 without a high school diploma or its 324.15 equivalent, the county agency shall refer the caregiver to 324.16 social services for services as provided in section 257.33. 324.17 Sec. 96. Minnesota Statutes 1997 Supplement, section 324.18 256J.54, subdivision 5, is amended to read: 324.19 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 324.20 the provisions of section 256J.56, minor parents, or 18- or 324.21 19-year-old parents without a high school diploma or its 324.22 equivalent must attend school unless: 324.23 (1) transportation services needed to enable the caregiver 324.24 to attend school are not available; 324.25 (2) appropriate child care services needed to enable the 324.26 caregiver to attend school are not available; 324.27 (3) the caregiver is ill or incapacitated seriously enough 324.28 to prevent attendance at school; or 324.29 (4) the caregiver is needed in the home because of the 324.30 illness or incapacity of another member of the household. This 324.31 includes a caregiver of a child who is younger than six weeks of 324.32 age. 324.33 (b) The caregiver must be enrolled in a secondary school 324.34 and meeting the school's attendance requirements. The county, 324.35 social service agency, or job counselor must verify at least 324.36 once per quarter that the caregiver is meeting the school's 325.1 attendance requirements. An enrolled caregiver is considered to 325.2 be meeting the attendance requirements when the school is not in 325.3 regular session, including during holiday and summer breaks. 325.4 Sec. 97. Minnesota Statutes 1997 Supplement, section 325.5 256J.55, subdivision 5, is amended to read: 325.6 Subd. 5. [OPTION TO UTILIZE EXISTING PLAN.] With job 325.7 counselor approval, if a participant is already complying with a 325.8 job search support or employment plan that was developed for a 325.9 different program or is already involved in education or 325.10 training activities, the participant mayutilizecontinue that 325.11 planand that program's services, subject to the requirements of325.12subdivision 3,or activity to be in compliance with sections 325.13 256J.52 to 256J.57 so long as the plan meets, or is modified to 325.14 meet, the requirements of those sections. 325.15 Sec. 98. Minnesota Statutes 1997 Supplement, section 325.16 256J.56, is amended to read: 325.17 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 325.18 EXEMPTIONS.] 325.19 (a) An MFIP-S caregiver is exempt from the requirements of 325.20 sections 256J.52 to 256J.55 if the caregiver belongs to any of 325.21 the following groups: 325.22 (1) individuals who are age 60 or older; 325.23 (2) individuals who are suffering from a professionally 325.24 certified permanent or temporary illness, injury, or incapacity 325.25 which is expected to continue for more than 30 days and which 325.26 prevents the person from obtaining or retaining employment. 325.27 Persons in this category with a temporary illness, injury, or 325.28 incapacity must be reevaluated at least quarterly; 325.29 (3) caregivers whose presence in the home is required 325.30 because of the professionally certified illness or incapacity of 325.31 another member in the assistance unit, a relative in the 325.32 household, or a foster child in the household; 325.33 (4) women who are pregnant, if the pregnancy has resulted 325.34 in a professionally certified incapacity that prevents the woman 325.35 from obtaining or retaining employment; 325.36 (5) caregivers of a child under the age of one year who 326.1 personally provide full-time care for the child. This exemption 326.2 may be used for only 12 months in a lifetime. In two-parent 326.3 households, only one parent or other relative may qualify for 326.4 this exemption; 326.5 (6)individualssingle parents, or one parent in a 326.6 two-parent family, employed at least40 hours per week or at326.7least 30 hours per week and engaged in job search for at least326.8an additional ten35 hours per week; 326.9 (7) individuals experiencing a personal or family crisis 326.10 that makes them incapable of participating in the program, as 326.11 determined by the county agency. If the participant does not 326.12 agree with the county agency's determination, the participant 326.13 may seek professional certification, as defined in section 326.14 256J.08, that the participant is incapable of participating in 326.15 the program. 326.16 Persons in this exemption category must be reevaluated 326.17 every 60 days; or 326.18 (8) second parents in two-parent families, provided the326.19second parent isemployed for 20 or more hours per week, 326.20 provided the first parent is employed at least 35 hours per week. 326.21 A caregiver who is exempt under clause (5) must enroll in 326.22 and attend an early childhood and family education class, a 326.23 parenting class, or some similar activity, if available, during 326.24 the period of time the caregiver is exempt under this section. 326.25 Notwithstanding section 256J.46, failure to attend the required 326.26 activity shall not result in the imposition of a sanction. 326.27 (b) The county agency must provide employment and training 326.28 services to MFIP-S caregivers who are exempt under this section, 326.29 but who volunteer to participate. Exempt volunteers may request 326.30 approval for any work activity under section 256J.49, 326.31 subdivision 13. The hourly participation requirements for 326.32 nonexempt caregivers under section 256J.50, subdivision 5, do 326.33 not apply to exempt caregivers who volunteer to participate. 326.34 Sec. 99. Minnesota Statutes 1997 Supplement, section 326.35 256J.57, subdivision 1, is amended to read: 326.36 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 327.1 county agency shall not impose the sanction under section 327.2 256J.46 if it determines that the participant has good cause for 327.3 failing to comply with the requirements ofsection 256J.45 or327.4 sections 256J.52 to 256J.55. Good cause exists when: 327.5 (1) appropriate child care is not available; 327.6 (2) the job does not meet the definition of suitable 327.7 employment; 327.8 (3) the participant is ill or injured; 327.9 (4) afamilymember of the assistance unit, a relative in 327.10 the household, or a foster child in the household is ill and 327.11 needs care by the participant that prevents the participant from 327.12 complying with the job search support plan or employment plan; 327.13 (5) the parental caregiver is unable to secure necessary 327.14 transportation; 327.15 (6) the parental caregiver is in an emergency situation 327.16 that prevents compliance with the job search support plan or 327.17 employment plan; 327.18 (7) the schedule of compliance with the job search support 327.19 plan or employment plan conflicts with judicial proceedings; 327.20 (8) the parental caregiver is already participating in 327.21 acceptable work activities; 327.22 (9) the employment plan requires an educational program for 327.23 a caregiver under age 20, but the educational program is not 327.24 available; 327.25 (10) activities identified in the job search support plan 327.26 or employment plan are not available; 327.27 (11) the parental caregiver is willing to accept suitable 327.28 employment, but suitable employment is not available; or 327.29 (12) the parental caregiver documents other verifiable 327.30 impediments to compliance with the job search support plan or 327.31 employment plan beyond the parental caregiver's control. 327.32 Sec. 100. Minnesota Statutes 1997 Supplement, section 327.33 256J.74, subdivision 2, is amended to read: 327.34 Subd. 2. [CONCURRENT ELIGIBILITY, LIMITATIONS.] A county 327.35 agency must not count an applicant or participant as a member of 327.36 more than one assistance unit in a given payment month, except 328.1 as provided in clauses (1) and (2). 328.2 (1) A participant who is a member of an assistance unit in 328.3 this state is eligible to be included in a second assistance 328.4 unitinthe first full monththatafter the month the 328.5 participantleaves the first assistance unit and lives with328.6ajoins the secondassistanceunit. 328.7 (2) An applicant whose needs are met through foster care 328.8 that is reimbursed under title IV-E of the Social Security Act 328.9 for the first part of an application month is eligible to 328.10 receive assistance for the remaining part of the month in which 328.11 the applicant returns home. Title IV-E payments and adoption 328.12 assistance payments must be considered prorated payments rather 328.13 than a duplication of MFIP-S need. 328.14 Sec. 101. Minnesota Statutes 1997 Supplement, section 328.15 256J.74, is amended by adding a subdivision to read: 328.16 Subd. 5. [FOOD STAMPS.] For any month an individual 328.17 receives food stamp benefits, the individual is not eligible for 328.18 the MFIP-S food portion of assistance, except as provided under 328.19 section 256J.28, subdivision 5. 328.20 Sec. 102. [256J.77] [AGING OF CASH BENEFITS.] 328.21 Cash benefits under chapters 256D, 256J, and 256K by 328.22 warrants or electronic benefit transfer that have not been 328.23 accessed within 90 days of issuance, shall be canceled. Cash 328.24 benefits may be replaced after they are canceled, for up to one 328.25 year after the date of issuance, if failure to do so would place 328.26 the client or family at risk. For the purposes of this section, 328.27 "accessed" means cashing a warrant or making at least one 328.28 withdrawal from benefits deposited in an electronic benefit 328.29 account. 328.30 Sec. 103. Minnesota Statutes 1997 Supplement, section 328.31 256K.03, subdivision 5, is amended to read: 328.32 Subd. 5. [EXEMPTION CATEGORIES.] (a) The applicant will be 328.33 exempt from the job search requirements and development of a job 328.34 search plan and an employability development plan under 328.35 subdivisions 3, 4, and 8 if the applicant belongs to any of the 328.36 following groups: 329.1 (1)caregivers under age 20 who have not completed a high329.2school education and are attending high school on a full-time329.3basis;329.4(2)individuals who are age 60 or older; 329.5(3)(2) individuals who are suffering from a professionally 329.6 certified permanent or temporary illness, injury, or incapacity 329.7 which is expected to continue for more than 30 days and which 329.8 prevents the person from obtaining or retaining employment. 329.9 Persons in this category with a temporary illness, injury, or 329.10 incapacity must be reevaluated at least quarterly; 329.11(4)(3) caregivers whose presence in the home is needed 329.12 because of the professionally certified illness or incapacity of 329.13 another member in the assistance unit, a relative in the 329.14 household, or a foster child in the household; 329.15(5)(4) women who are pregnant, ifitthe pregnancy has 329.16been medically verifiedresulted in a professionally certified 329.17 incapacity thatthe child is expected to be born within the next329.18six monthsprevents the woman from obtaining and retaining 329.19 employment; 329.20(6)(5) caregiversor other caregiver relativesof a child 329.21 under the age ofthreeone year who personally provide full-time 329.22 care for the child. This exemption may be used for only 12 329.23 months in a lifetime. In two-parent households, only one parent 329.24 or other relative may qualify for this exemption; 329.25(7) individuals(6) single parents, or one parent in a 329.26 two-parent family, employed at least3035 hours per week; 329.27(8) individuals for whom participation would require a329.28round trip commuting time by available transportation of more329.29than two hours, excluding transporting of children for child329.30care;329.31(9) individuals for whom lack of proficiency in English is329.32a barrier to employment, provided such individuals are329.33participating in an intensive program which lasts no longer than329.34six months and is designed to remedy their language deficiency;329.35(10) individuals who, because of advanced age or lack of329.36ability, are incapable of gaining proficiency in English, as330.1determined by the county social worker, shall continue to be330.2exempt under this subdivision and are not subject to the330.3requirement that they be participating in a language program;330.4(11)(7) individualsunder such duress that they are330.5incapable of participating in the program, as determined by the330.6county social workerexperiencing a personal or family crisis 330.7 that makes them incapable of participating in the program, as 330.8 determined by the county agency. If the participant does not 330.9 agree with the county agency's determination, the participant 330.10 may seek professional certification, as defined in section 330.11 256J.08, that the participant is incapable of participating in 330.12 the program. Persons in this exemption category must be 330.13 reevaluated every 60 days; or 330.14(12) individuals in need of refresher courses for purposes330.15of obtaining professional certification or licensure.330.16(b) In a two-parent family, only one caregiver may be330.17exempted under paragraph (a), clauses (4) and (6).330.18 (8) second parents in two-parent families employed for 20 330.19 or more hours per week, provided the first parent is employed at 330.20 least 35 hours per week. 330.21 (b) A caregiver who is exempt under clause (5) must enroll 330.22 in and attend an early childhood and family education class, a 330.23 parenting class, or some similar activity, if available, during 330.24 the period of time the caregiver is exempt under this section. 330.25 Notwithstanding section 256J.46, failure to attend the required 330.26 activity shall not result in the imposition of a sanction. 330.27 Sec. 104. Minnesota Statutes 1996, section 268.88, is 330.28 amended to read: 330.29 268.88 [LOCAL SERVICE UNIT PLANS.] 330.30 (a) By April 15,19911999, and by April 15 of each second 330.31 year thereafter, local service units shall prepare and submit to 330.32 the commissioner a plan that covers the next two state fiscal 330.33 years. At least 30 days prior to submission of the plan, the 330.34 local service unit shall solicit comments from the public on the 330.35 contents of the proposed plan. The commissioner shall notify 330.36 each local service unit within 60 days of receipt of its plan 331.1 that the plan has been approved or disapproved. The plan must 331.2 include: 331.3 (1) a statement of objectives for the employment and 331.4 training services the local service unit administers; 331.5 (2) the establishment of job placement and job retention 331.6 goals, the establishment of public assistance caseload reduction 331.7 goals, and the strategies and programs that will be used to 331.8 achieve these goals; 331.9 (3) a statement of whether the goals from the preceding 331.10 year were met and an explanation if the local service unit 331.11 failed to meet the goals; 331.12 (4) the amount proposed to be allocated to each employment 331.13 and training service; 331.14 (5) the proposed types of employment and training services 331.15 the local service unit plans to utilize; 331.16 (6) a description of how the local service unit will use 331.17 funds provided undersection 256.736 to meet the requirements of331.18that section. The description must include the two work331.19programs required by section 256.736, subdivision 10, paragraph331.20(a), clause (13), what services will be provided, number of331.21clients served, per service expenditures, type of clients331.22served, and projected outcomeschapter 256J to meet the 331.23 requirements of that chapter. The description must include what 331.24 services will be provided, per service expenditures, how many 331.25 employment and training slots the local service unit will 331.26 provide, how slots will be allocated between providers, how many 331.27 dollars the local service unit will provide per slot per 331.28 provider, how many participants per slot, the ratio of 331.29 participants per job counselor, and an accounting of proposed 331.30 uses for any residual funds not included in slot allocations to 331.31 providers; 331.32 (7) a report on the use of wage subsidies, grant 331.33 diversions, community investment programs, and other services 331.34 administered under this chapter; 331.35 (8) a performance review of the employment and training 331.36 service providers delivering employment and training services 332.1 for the local service unit; 332.2 (9) a copy of any contract between the local service unit 332.3 and an employment and training service provider including 332.4 expected outcomes and service levels for public assistance 332.5 clients;and332.6 (10) a copy of any other agreements between educational 332.7 institutions, family support services, and child care providers; 332.8 and 332.9 (11) a description of how the local service unit ensures 332.10 compliance with section 256J.06, requiring community involvement 332.11 in the administration of MFIP-S. 332.12 (b) In counties with a city of the first class, the county 332.13 and the city shall develop and submit a joint plan. The plan 332.14 may not be submitted until agreed to by both the city and the 332.15 county. The plan must provide for the direct allocation of 332.16 employment and training money to the city and the county unless 332.17 waived by either. If the county and the city cannot concur on a 332.18 plan, the commissioner shall resolve their dispute. In counties 332.19 in which a federally recognized Indian tribe is operating an 332.20 employment and training program under an agreement with the 332.21 commissioner of human services, the plan must provide that the 332.22 county will coordinate its employment and training programs, 332.23 including developing a system for referrals, sanctions, and the 332.24 provision of supporting services such as access to child care 332.25 funds and transportation with programs operated by the Indian 332.26 tribe. The plan may not be given final approval by the 332.27 commissioner until the tribal unit and county have submitted 332.28 written agreement on these provisions in the plan. If the 332.29 county and Indian tribe cannot agree on these provisions, the 332.30 local service unit shall notify the commissioner of economic 332.31 security and the commissioners of economic security and human 332.32 services shall resolve the dispute. 332.33 (c) The commissioner may withhold the distribution of 332.34 employment and training money from a local service unit that 332.35 does not submit a plan to the commissioner by the date set by 332.36 this section, and shall withhold the distribution of employment 333.1 and training money from a local service unit whose plan has been 333.2 disapproved by the commissioner until an acceptable amended plan 333.3 has been submitted. 333.4 (d) Beginning April 15, 1992, and by April 15 of each 333.5 second year thereafter, local service units must prepare and 333.6 submit to the commissioner an interim year plan update that 333.7 deals with performance in that state fiscal year and changes 333.8 anticipated for the second year of the biennium. The update 333.9 must include information about employment and training programs 333.10 addressed in the local service unit's two-year plan and shall be 333.11 completed in accordance with criteria established by the 333.12 commissioner. 333.13 Sec. 105. [REPORT REQUIRED.] 333.14 Beginning January 1, 1999, the commissioner shall report 333.15 annually to the legislature on the percent, for each of the four 333.16 quarters of the immediate preceding year, of the MFIP-S caseload 333.17 participants who are exempt from work under the provisions of 333.18 Minnesota Statutes, section 256J.56, clause (2) or (3). 333.19 Sec. 106. [DEVELOPMENT OF REQUIRED ROUTINE INTERVIEW 333.20 TOOLS.] 333.21 The commissioner of human services shall develop a list of 333.22 no more than six questions to be used by county agencies and 333.23 their contractors under Minnesota Statutes, section 256J.44, 333.24 subdivision 3, to identify MFIP-S applicants and recipients who 333.25 have drug or alcohol dependencies or substance abuse problems. 333.26 Sec. 107. Laws 1997, chapter 248, section 46, as amended 333.27 by Laws 1997, First Special Session chapter 5, section 10, is 333.28 amended to read: 333.29 Sec. 46. [UNLICENSED CHILD CARE PROVIDERS; INTERIM 333.30 EXPANSION.] 333.31 (a) Notwithstanding Minnesota Statutes, section 245A.03, 333.32 subdivision 2, clause (2), until June 30, 1999, nonresidential 333.33 child care programs or services that are provided by an 333.34 unrelated individual to persons from two or three other 333.35 unrelated families are excluded from the licensure provisions of 333.36 Minnesota Statutes, chapter 245A, provided that: 334.1 (1) the individual provides services at any one time to no 334.2 more than four children who are unrelated to the individual; 334.3 (2) no more than two of the children are under two years of 334.4 age; and 334.5 (3) the total number of children being cared for at any one 334.6 time does not exceed five. 334.7 (b) Paragraph (a), clauses (1) to (3), do not apply to: 334.8 (1) nonresidential programs that are provided by an 334.9 unrelated individual to persons from a single related family; 334.10 (2) a child care provider whose child care services meet 334.11 the criteria in paragraph (a), clauses (1) to (3), but who 334.12 chooses to apply for licensure; 334.13 (3) a child care provider who, as an applicant for 334.14 licensure or as a licenseholder, has received a license denial 334.15 under Minnesota Statutes, section 245A.05, a fine under section 334.16 245A.06, or a sanction under section 245A.07 from the 334.17 commissioner that has not been reversed on appeal; or 334.18 (4) a child care provider, or a child care provider who has 334.19 a household member who, as a result of a licensing process, has 334.20 a disqualification under Minnesota Statutes, chapter 245A, that 334.21 has not been set aside by the commissioner. 334.22 Sec. 108. [TRANSFER OF STATE MONEY FROM TANF RESERVE.] 334.23 For fiscal year 1999, the commissioner of human services 334.24 may transfer to the general fund up to 100 percent of the state 334.25 money that remains in the TANF reserve account for the purposes 334.26 of sections 1 to 4 (256D.05, subdivision 8; 256D.053, 334.27 subdivisions 1, 2, 3, and 4; 256J.11, subdivision 2; and 334.28 256J.37, subdivision 9). 334.29 Sec. 109. [REPEALER.] 334.30 (a) Minnesota Statutes 1997 Supplement, section 256J.28, 334.31 subdivision 4, is repealed effective January 1, 1998. 334.32 (b) Minnesota Statutes 1997 Supplement, section 256B.062, 334.33 is repealed effective July 1, 1998. 334.34 (c) Minnesota Statutes 1997 Supplement, section 256J.25, is 334.35 repealed. 334.36 (d) Minnesota Statutes 1996, sections 256.031, as amended 335.1 by Laws 1997, chapter 85, article 3, section 1; article 4, 335.2 section 11; 256.032; 256.033, as amended by Laws 1997, chapter 335.3 85, article 3, sections 2 and 3; 256.034; 256.035; 256.036; 335.4 256.0361; 256.047; 256.0475; 256.048; and 256.049; Minnesota 335.5 Statutes 1997 Supplement, sections 256J.32, subdivision 5; and 335.6 256J.34, subdivision 5, are repealed effective July 1, 1998. 335.7 (e) Minnesota Rules (exempt), parts 9500.9100 to 9500.9220, 335.8 are repealed effective July 1, 1998. 335.9 (f) Laws 1997, chapter 85, article 1, sections 61 and 71, 335.10 and article 3, section 55, are repealed. 335.11 Sec. 110. [EFFECTIVE DATE.] 335.12 (a) Sections 5 (256.01, subdivision 2) and 6 (256.014, 335.13 subdivision 1) are effective the day following final enactment. 335.14 Section 45 (256J.24, subdivision 8) is effective October 1, 1998. 335.15 (b) Sections 2, 3, and 92 (245A.03, subdivision 2b; 335.16 245A.03, subdivision 4; Laws 1997, chapter 248, section 46) are 335.17 effective the day following final enactment. 335.18 (c) Sections 5, 6, and 17 (256.01, subdivision 2; 256.014, 335.19 subdivision 1; 256J.03, subdivision 1) are effective the day 335.20 following final enactment. 335.21 Section 12 (256D.05, subdivision 8) is effective the day 335.22 following final enactment. 335.23 ARTICLE 7 335.24 TRIBAL CHILD CARE ASSISTANCE 335.25 Section 1. Minnesota Statutes 1997 Supplement, section 335.26 119B.02, is amended to read: 335.27 119B.02 [DUTIES OF COMMISSIONER.] 335.28 Subdivision 1. [CHILD CARE SERVICES.] The commissioner 335.29 shall develop standards for county and human services boards to 335.30 provide child care services to enable eligible families to 335.31 participate in employment, training, or education programs. 335.32 Within the limits of available appropriations, the commissioner 335.33 shall distribute money to counties to reduce the costs of child 335.34 care for eligible families. The commissioner shall adopt rules 335.35 to govern the program in accordance with this section. The 335.36 rules must establish a sliding schedule of fees for parents 336.1 receiving child care services. The rules shall provide that 336.2 funds received as a lump sum payment of child support arrearages 336.3 shall not be counted as income to a family in the month received 336.4 but shall be prorated over the 12 months following receipt and 336.5 added to the family income during those months. In the rules 336.6 adopted under this section, county and human services boards 336.7 shall be authorized to establish policies for payment of child 336.8 care spaces for absent children, when the payment is required by 336.9 the child's regular provider. The rules shall not set a maximum 336.10 number of days for which absence payments can be made, but 336.11 instead shall direct the county agency to set limits and pay for 336.12 absences according to the prevailing market practice in the 336.13 county. County policies for payment of absences shall be 336.14 subject to the approval of the commissioner. The commissioner 336.15 shall maximize the use of federal money in section 256.736 and 336.16 other programs that provide federal or state reimbursement for 336.17 child care services for low-income families who are in 336.18 education, training, job search, or other activities allowed 336.19 under those programs. Money appropriated under this section 336.20 must be coordinated with the programs that provide federal 336.21 reimbursement for child care services to accomplish this 336.22 purpose. Federal reimbursement obtained must be allocated to 336.23 the county that spent money for child care that is federally 336.24 reimbursable under programs that provide federal reimbursement 336.25 for child care services. The counties shall use the federal 336.26 money to expand child care services. The commissioner may adopt 336.27 rules under chapter 14 to implement and coordinate federal 336.28 program requirements. 336.29 Subd. 2. [CONTRACTUAL AGREEMENTS WITH TRIBES.] The 336.30 commissioner may enter into contractual agreements with a 336.31 federally recognized Indian tribe with a reservation in 336.32 Minnesota to carry out the responsibilities of county human 336.33 service agencies to the extent necessary for the tribe to 336.34 operate child care assistance programs under the supervision of 336.35 the commissioner. Funding to support services under sections 336.36 119B.03 and 119B.05 may be transferred to the federally 337.1 recognized Indian tribe with a reservation in Minnesota from 337.2 allocations available to counties in which reservation 337.3 boundaries lie. When funding is transferred under section 337.4 119B.03, the amount shall be commensurate to estimates of the 337.5 proportion of reservation residents with characteristics 337.6 identified in section 119B.03, subdivision 6, to the total 337.7 population of county residents with those same characteristics. 337.8 Sec. 2. [EFFECTIVE DATE.] 337.9 Section 1 (119B.02, subdivision 1) is effective the day 337.10 following final enactment. 337.11 ARTICLE 8 337.12 MISCELLANEOUS 337.13 Section 1. Minnesota Statutes 1996, section 62A.65, 337.14 subdivision 5, is amended to read: 337.15 Subd. 5. [PORTABILITY OF COVERAGE.] (a) No individual 337.16 health plan may be offered, sold, issued, or with respect to 337.17 children age 18 or under renewed, to a Minnesota resident that 337.18 contains a preexisting condition limitation, preexisting 337.19 condition exclusion, or exclusionary rider, unless the 337.20 limitation or exclusion is permitted under this subdivision, 337.21 provided that, except for children age 18 or under, underwriting 337.22 restrictions may be retained on individual contracts that are 337.23 issued without evidence of insurability as a replacement for 337.24 prior individual coverage that was sold before May 17, 1993. 337.25 The individual may be subjected to an 18-month preexisting 337.26 condition limitation, unless the individual has maintained 337.27 continuous coverage as defined in section 62L.02. The 337.28 individual must not be subjected to an exclusionary rider. An 337.29 individual who has maintained continuous coverage may be 337.30 subjected to a one-time preexisting condition limitation of up 337.31 to 12 months, with credit for time covered under qualifying 337.32 coverage as defined in section 62L.02, at the time that the 337.33 individual first is covered under an individual health plan by 337.34 any health carrier. Credit must be given for all qualifying 337.35 coverage with respect to all preexisting conditions, regardless 337.36 of whether the conditions were preexisting with respect to any 338.1 previous qualifying coverage. The individual must not be 338.2 subjected to an exclusionary rider. Thereafter, the individual 338.3 must not be subject to any preexisting condition limitation, 338.4 preexisting condition exclusion, or exclusionary rider under an 338.5 individual health plan by any health carrier, except an 338.6 unexpired portion of a limitation under prior coverage, so long 338.7 as the individual maintains continuous coverage as defined in 338.8 section 62L.02. 338.9 (b) A health carrier must offer an individual health plan 338.10 to any individual previously covered under a group health plan 338.11 issued by that health carrier, regardless of the size of the 338.12 group, so long as the individual maintained continuous coverage 338.13 as defined in section 62L.02. If the individual has available 338.14 any continuation coverage provided under sections 62A.146; 338.15 62A.148; 62A.17, subdivisions 1 and 2; 62A.20; 62A.21; 62C.142; 338.16 62D.101; or 62D.105, or continuation coverage provided under 338.17 federal law, the health carrier need not offer coverage under 338.18 this paragraph until the individual has exhausted the 338.19 continuation coverage. The offer must not be subject to 338.20 underwriting, except as permitted under this paragraph. A 338.21 health plan issued under this paragraph must be a qualified plan 338.22 as defined in section 62E.02 and must not contain any 338.23 preexisting condition limitation, preexisting condition 338.24 exclusion, or exclusionary rider, except for any unexpired 338.25 limitation or exclusion under the previous coverage. The 338.26 individual health plan must cover pregnancy on the same basis as 338.27 any other covered illness under the individual health plan. The 338.28 initial premium rate for the individual health plan must comply 338.29 with subdivision 3. The premium rate upon renewal must comply 338.30 with subdivision 2. In no event shall the premium rate exceed 338.31 90 percent of the premium charged for comparable individual 338.32 coverage by the Minnesota comprehensive health association, and 338.33 the premium rate must be less than that amount if necessary to 338.34 otherwise comply with this section. An individual health plan 338.35 offered under this paragraph to a person satisfies the health 338.36 carrier's obligation to offer conversion coverage under section 339.1 62E.16, with respect to that person. Coverage issued under this 339.2 paragraph must provide that it cannot be canceled or nonrenewed 339.3 as a result of the health carrier's subsequent decision to leave 339.4 the individual, small employer, or other group market. Section 339.5 72A.20, subdivision 28, applies to this paragraph. 339.6 Sec. 2. Minnesota Statutes 1996, section 62D.042, 339.7 subdivision 2, is amended to read: 339.8 Subd. 2. [BEGINNING ORGANIZATIONSNET WORTH REQUIREMENTS.] 339.9 (a) Beginning organizations shall maintain net worth of at least 339.10 8-1/3 percent of the sum of all expenses expected to be incurred 339.11 in the 12 months following the date the certificate of authority 339.12 is granted, or $1,500,000, whichever is greater. 339.13 (b) After the first full calendar year of operation, 339.14 organizations shall maintain net worth of at least 8-1/3 percent 339.15 and at most16-2/325 percent of the sum of all expenses 339.16 incurred during the most recent calendar year, but in no case 339.17 shall net worth fall below $1,000,000. 339.18 (c) Notwithstanding paragraphs (a) and (b), any health 339.19 maintenance organization owned by a political subdivision of 339.20 this state, which has a higher than average percentage of 339.21 enrollees who are enrolled in medical assistance or general 339.22 assistance medical care, may exceed the maximum net worth limits 339.23 provided in paragraphs (a) and (b), with the advance approval of 339.24 the commissioner. 339.25 Sec. 3. Minnesota Statutes 1996, section 62E.16, is 339.26 amended to read: 339.27 62E.16 [POLICY CONVERSION RIGHTS.] 339.28 Every program of self-insurance, policy of group accident 339.29 and health insurance or contract of coverage by a health 339.30 maintenance organization written or renewed in this state, shall 339.31 include, in addition to the provisions required by section 339.32 62A.17, the right to convert to an individual coverage qualified 339.33 plan without the addition of underwriting restrictionsifafter 339.34 the individual insured has exhausted any continuation coverage 339.35 provided under section 62A.146; 62A.148; 62A.17, subdivisions 1 339.36 and 2; 62A.20; 62A.21; 62C.142; 62D.101; or 62D.105, or 340.1 continuation coverage provided under federal law, if any 340.2 continuation coverage is available to the individual, and then 340.3 leaves the group regardless of the reason for leaving the group 340.4 or if an employer member of a group ceases to remit payment so 340.5 as to terminate coverage for its employees, or upon cancellation 340.6 or termination of the coverage for the group except where 340.7 uninterrupted and continuous group coverage is otherwise 340.8 provided to the group. If the health maintenance organization 340.9 has canceled coverage for the group because of a loss of 340.10 providers in a service area, the health maintenance organization 340.11 shall arrange for other health maintenance or indemnity 340.12 conversion options that shall be offered to enrollees without 340.13 the addition of underwriting restrictions. The required 340.14 conversion contract must treat pregnancy the same as any other 340.15 covered illness under the conversion contract. The person may 340.16 exercise this right to conversion within 30 days of exhausting 340.17 any continuation coverage provided under section 62A.146; 340.18 62A.148; 62A.17, subdivisions 1 and 2; 62A.20; or 62A.21, or 340.19 continuation coverage provided under federal law, and then 340.20 leaving the group or within 30 days following receipt of due 340.21 notice of cancellation or termination of coverage of the group 340.22 or of the employer member of the group and upon payment of 340.23 premiums from the date of termination or cancellation. Due 340.24 notice of cancellation or termination of coverage for a group or 340.25 of the employer member of the group shall be provided to each 340.26 employee having coverage in the group by the insurer, 340.27 self-insurer or health maintenance organization canceling or 340.28 terminating the coverage except where reasonable evidence 340.29 indicates that uninterrupted and continuous group coverage is 340.30 otherwise provided to the group. Every employer having a policy 340.31 of group accident and health insurance, group subscriber or 340.32 contract of coverage by a health maintenance organization shall, 340.33 upon request, provide the insurer or health maintenance 340.34 organization a list of the names and addresses of covered 340.35 employees. Plans of health coverage shall also include a 340.36 provision which, upon the death of the individual in whose name 341.1 the contract was issued, permits every other individual then 341.2 covered under the contract to elect, within the period specified 341.3 in the contract, to continue coverage under the same or a 341.4 different contract without the addition of underwriting 341.5 restrictions until the individual would have ceased to have been 341.6 entitled to coverage had the individual in whose name the 341.7 contract was issued lived. An individual conversion contract 341.8 issued by a health maintenance organization shall not be deemed 341.9 to be an individual enrollment contract for the purposes of 341.10 section 62D.10. An individual health plan offered under section 341.11 62A.65, subdivision 5, paragraph (b), to a person satisfies the 341.12 health carrier's obligation to offer conversion coverage under 341.13 this section with respect to that person. 341.14 Sec. 4. [62Q.096] [CREDENTIALING OF PROVIDERS.] 341.15 If a health plan company has initially credentialed, as 341.16 providers in its provider network, individual providers employed 341.17 by or under contract with an entity that: (1) is authorized to 341.18 bill under section 256B.0625, subdivision 5; (2) meets the 341.19 requirements of Minnesota Rules, parts 9520.0750 to 9520.0870; 341.20 (3) is designated an essential community provider under section 341.21 62Q.19; and (4) is under contract with the health plan company 341.22 to provide mental health services, the health plan company must 341.23 continue to credential at least the same number of providers 341.24 from that entity, as long as those providers meet the health 341.25 plan company's credentialing standards. A health plan company 341.26 shall not refuse to credential these providers on the grounds 341.27 that their provider network has a sufficient number of providers 341.28 of that type. 341.29 Sec. 5. Minnesota Statutes 1997 Supplement, section 341.30 171.29, subdivision 2, is amended to read: 341.31 Subd. 2. [FEES, ALLOCATION.] (a) A person whose driver's 341.32 license has been revoked as provided in subdivision 1, except 341.33 under section 169.121 or 169.123, shall pay a $30 fee before the 341.34 driver's license is reinstated. 341.35 (b) A person whose driver's license has been revoked as 341.36 provided in subdivision 1 under section 169.121 or 169.123 shall 342.1 pay a $250 fee plus a $10 surcharge before the driver's license 342.2 is reinstated. The $250 fee is to be credited as follows: 342.3 (1) Twenty percent shall be credited to the trunk highway 342.4 fund. 342.5 (2) Fifty-five percent shall be credited to the general 342.6 fund. 342.7 (3) Eight percent shall be credited to a separate account 342.8 to be known as the bureau of criminal apprehension account. 342.9 Money in this account may be appropriated to the commissioner of 342.10 public safety and the appropriated amount shall be apportioned 342.11 80 percent for laboratory costs and 20 percent for carrying out 342.12 the provisions of section 299C.065. 342.13 (4) Twelve percent shall be credited to a separate account 342.14 to be known as the alcohol-impaired driver education account. 342.15 Money in the account is appropriated as follows: 342.16 (i) The first $200,000 in a fiscal year is to the 342.17 commissioner of children, families, and learning for programs in 342.18 elementary and secondary schools. 342.19 (ii) The remainder credited in a fiscal year is 342.20 appropriated to the commissioner of transportation to be spent 342.21 as grants to the Minnesota highway safety center at St. Cloud 342.22 State University for programs relating to alcohol and highway 342.23 safety education in elementary and secondary schools. 342.24 (5) Five percent shall be credited to a separate account to 342.25 be known as the traumatic brain injury and spinal cord injury 342.26 account.$100,000 is annually appropriated from the account to342.27the commissioner of human services for traumatic brain injury342.28case management services.Theremainingmoney in the account is 342.29 annually appropriated to the commissioner of health to be used 342.30 as follows: 35 percent for a contract with a qualified 342.31 community-based organization to provide information, resources, 342.32 and support to assist persons with traumatic brain injury and 342.33 their families to access services, and 65 percent toestablish342.34andmaintain the traumatic brain injury and spinal cord injury 342.35 registry created in section 144.662 and to reimburse the 342.36 commissioner of economic security for the reasonable cost of 343.1 services provided under section 268A.03, clause (o). For the 343.2 purposes of this clause, a "qualified community-based 343.3 organization" is a private, not-for-profit organization of 343.4 consumers of traumatic brain injury services and their family 343.5 members. The organization must be registered with the United 343.6 States Internal Revenue Service under the provisions of section 343.7 501(c)(3) as a tax exempt organization and must have as its 343.8 purposes: 343.9 (i) the promotion of public, family, survivor, and 343.10 professional awareness of the incidence and consequences of 343.11 traumatic brain injury; 343.12 (ii) the provision of a network of support for persons with 343.13 traumatic brain injury, their families, and friends; 343.14 (iii) the development and support of programs and services 343.15 to prevent traumatic brain injury; 343.16 (iv) the establishment of education programs for persons 343.17 with traumatic brain injury; and 343.18 (v) the empowerment of persons with traumatic brain injury 343.19 through participation in its governance. 343.20 (c) The $10 surcharge shall be credited to a separate 343.21 account to be known as the remote electronic alcohol monitoring 343.22 pilot program account. The commissioner shall transfer the 343.23 balance of this account to the commissioner of finance on a 343.24 monthly basis for deposit in the general fund. 343.25 Sec. 6. Minnesota Statutes 1997 Supplement, section 343.26 256F.05, subdivision 8, is amended to read: 343.27 Subd. 8. [USES OF FAMILY PRESERVATION FUND GRANTS.] (a) A 343.28 county which has not demonstrated that year that its family 343.29 preservation core services are developed as provided in 343.30 subdivision 1a, must use its family preservation fund grant 343.31 exclusively for family preservation services defined in section 343.32 256F.03, subdivision 5, paragraphs (a), (b), (c), and (e). 343.33 (b) A county which has demonstrated that year that its 343.34 family preservation core services are developed becomes eligible 343.35 either to continue using its family preservation fund grant as 343.36 provided in paragraph (a), or to exercise the expanded service 344.1 option under paragraph (c). 344.2 (c) The expanded service option permits an eligible county 344.3 to use its family preservation fund grant for child welfare 344.4 preventive services. For purposes of this section, child 344.5 welfare preventive services are those services directed toward a 344.6 specific child or family that further the goals of section 344.7 256F.01 and include assessments, family preservation services, 344.8 service coordination, community-based treatment, crisis nursery 344.9 services when the parents retain custody and there is no 344.10 voluntary placement agreement with a child-placing agency, 344.11 respite care except when it is provided under a medical 344.12 assistance waiver, home-based services, and other related 344.13 services. For purposes of this section, child welfare 344.14 preventive services shall not include shelter care or other 344.15 placement services under the authority of the court or public 344.16 agency to address an emergency. To exercise this option, an 344.17 eligible county must notify the commissioner in writing of its 344.18 intention to do so no later than 30 days into the quarter during 344.19 which it intends to begin or in its county plan, as provided in 344.20 section 256F.04, subdivision 2. Effective with the first day of 344.21 that quarter, the county must maintain its base level of 344.22 expenditures for child welfare preventive services and use the 344.23 family preservation fund to expand them. The base level of 344.24 expenditures for a county shall be that established under 344.25 section 256F.10, subdivision 7. For counties which have no such 344.26 base established, a comparable base shall be established with 344.27 the base year being the calendar year ending at least two 344.28 calendar quarters before the first calendar quarter in which the 344.29 county exercises its expanded service option. The commissioner 344.30 shall, at the request of the counties, reduce, suspend, or 344.31 eliminate either or both of a county's obligations to continue 344.32 the base level of expenditures and to expand child welfare 344.33 preventive services under extraordinary circumstances. 344.34 (d) Notwithstanding paragraph (a), a county that is 344.35 participating in the child protection assessments or 344.36 investigations community collaboration pilot program under 345.1 section 626.5560, or in the concurrent permanency planning pilot 345.2 program under section 257.0711, may use its family preservation 345.3 fund grant for those programs. 345.4 Sec. 7. Laws 1997, chapter 207, section 7, is amended to 345.5 read: 345.6 Sec. 7. [PRIVATE SALE OF TAX-FORFEITED LAND; CARLTON 345.7 COUNTY.] 345.8 (a) Notwithstanding Minnesota Statutes, sections 92.45 and 345.9 282.018, subdivision 1, and the public sale provisions of 345.10 Minnesota Statutes, chapter 282, Carlton county may sell by 345.11 private sale the tax-forfeited land described in paragraph (d) 345.12 under the remaining provisions of Minnesota Statutes, chapter 345.13 282. 345.14 (b) The land described in paragraph (d) may be sold by 345.15 private sale. The considerationfor the conveyance must include345.16the taxes due on the property and any penalties, interest, and345.17costsshall be the appraised value of the land. If the lands 345.18 are sold, the conveyance must reserve to the state a 345.19 conservation easement, in a form prescribed by the commissioner 345.20 of natural resources, for the land within 100 feet of the 345.21 ordinary high water level of Slaughterhouse creek for public 345.22 angler access and stream habitat protection and enhancement. 345.23 (c) The conveyance must be in a form approved by the 345.24 attorney general. 345.25 (d) The land to be conveyed is located in Carlton county 345.26 and is described as: 345.27 North 6.66 acres of the West Half of the Northeast Quarter 345.28 of the Southwest Quarter, subject to pipeline easement, Section 345.29 6, Township 48 North, Range 16 West, City of Carlton. 345.30 (e) Carlton county has determined that this sale best 345.31 serves the land management interests of Carlton county. 345.32 Sec. 8. [CONVEYANCE OF STATE LAND; ANOKA COUNTY.] 345.33 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 345.34 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 345.35 subdivision 3, or any other law to the contrary, the 345.36 commissioner of administration may convey all, or any part of, 346.1 the land and associated buildings described in subdivision 3 to 346.2 Anoka county after the commissioner of human services declares 346.3 said property surplus to its needs. 346.4 Subd. 2. [FORM.] (a) The conveyance shall be in a form 346.5 approved by the attorney general. 346.6 (b) The conveyance is subject to a scenic easement, as 346.7 defined in Minnesota Statutes, section 103F.311, subdivision 6, 346.8 to be under the custodial control of the commissioner of natural 346.9 resources, on that portion of the conveyed land that is 346.10 designated for inclusion in the wild and scenic river system 346.11 under Minnesota Statutes, section 103F.325. The scenic easement 346.12 shall allow for continued use of the structures located within 346.13 the easement and for development of a walking path within the 346.14 easement. 346.15 (c) The conveyance shall restrict use of the land to 346.16 governmental, including recreational, purposes and shall provide 346.17 that ownership of any portion of the land that ceases to be used 346.18 for such purposes shall revert to the state of Minnesota. 346.19 (d) The commissioner of administration may convey any part 346.20 of the property described in subdivision 3 any time after the 346.21 land is declared surplus by the commissioner of human services 346.22 and the execution and recording of the scenic easement under 346.23 paragraph (b) has been completed. 346.24 (e) Notwithstanding any law, regulation, or ordinance to 346.25 the contrary, the instrument of conveyance to Anoka county may 346.26 be recorded in the office of the Anoka county recorder without 346.27 compliance with any subdivision requirement. 346.28 Subd. 3. [LAND DESCRIPTION.] Subject to right-of-way for 346.29 Grant Street, Northview Lane, Garfield Street, 5th Avenue, and 346.30 State Trunk Highway No. 288, also known as 4th Avenue, the land 346.31 to be conveyed may include all, or part of, that which is 346.32 described as follows: 346.33 (1) all that part of Government Lots 3 and 4 and that part 346.34 of the Southeast Quarter of the Southwest Quarter, all in 346.35 Section 31, Township 32 North, Range 24 West, Anoka county, 346.36 Minnesota, described as follows: 347.1 Beginning at the southwest corner of said Southeast Quarter 347.2 of the Southwest Quarter of Section 31; thence North 13 347.3 degrees 16 minutes 11 seconds East, assumed bearing, 473.34 347.4 feet; thence North 07 degrees 54 minutes 43 seconds East 347.5 186.87 feet; thence North 14 degrees 08 minutes 33 seconds 347.6 West 154.77 feet; thence North 62 degrees 46 minutes 44 347.7 seconds West 526.92 feet; thence North 25 degrees 45 347.8 minutes 30 seconds East 74.43 feet; thence northerly 88.30 347.9 feet along a tangential curve concave to the west having a 347.10 radius of 186.15 feet and a central angle of 27 degrees 10 347.11 minutes 50 seconds; thence North 01 degrees 25 minutes 20 347.12 seconds West, tangent to said curve, 140.53 feet; thence 347.13 North 71 degrees 56 minutes 34 seconds West to the 347.14 southeasterly shoreline of the Rum river; thence 347.15 southwesterly along said shoreline to the south line of 347.16 said Government Lot 4; thence easterly along said south 347.17 line to the point of beginning. For the purpose of this 347.18 description the south line of said Southeast Quarter of the 347.19 Southwest Quarter of Section 31 has an assumed bearing of 347.20 North 89 degrees 08 minutes 19 seconds East; 347.21 (2) Government Lot 1, Section 6, Township 31 North, Range 347.22 24 West, Anoka county, Minnesota; EXCEPT that part platted as 347.23 Grant Properties, Anoka county, Minnesota; ALSO EXCEPT that part 347.24 lying southerly of the westerly extension of the south line of 347.25 Block 6, Woodbury's Addition to the city of Anoka, Anoka county, 347.26 Minnesota, and lying westerly of the west line of said plat of 347.27 Grant Properties, said line also being the centerline of 4th 347.28 Avenue; 347.29 (3) all that part of said Block 6, Woodbury's Addition to 347.30 the city of Anoka lying westerly of Northview 1st Addition, 347.31 Anoka county, Minnesota; 347.32 (4) all that part of said Northview 1st Addition lying 347.33 westerly of the east line of Lots 11 through 20, Block 1, 347.34 inclusive, thereof; and 347.35 (5) all that part of the Northeast Quarter of the Northwest 347.36 Quarter of said Section 6, Township 31 North, Range 24 West, 348.1 Anoka county, Minnesota, lying northerly of the centerline of 348.2 Grant Street as defined by said plat of Grant Properties and 348.3 lying westerly of said east line of Lots 11 through 20, Block 1, 348.4 inclusive, Northview 1st Addition and said line's extension 348.5 north and south. 348.6 Subd. 4. [DETERMINATION.] The commissioner of human 348.7 services has determined that the land described in subdivision 3 348.8 will no longer be needed for the Anoka metro regional treatment 348.9 center upon the completion of the state facilities currently 348.10 under construction, and the completion of renovation work to 348.11 state buildings that are not located on the land described in 348.12 subdivision 3. The state's land and building management 348.13 interests may best be served by conveying all, or part of, the 348.14 land and associated buildings located on the land described in 348.15 subdivision 3. 348.16 Sec. 9. [CONVEYANCE OF STATE LAND; CROW WING COUNTY.] 348.17 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 348.18 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 348.19 subdivision 3, or any other law to the contrary, the 348.20 commissioner of administration may convey, all or any part of, 348.21 the land, and the state building located on said land, described 348.22 in subdivision 3 to Crow Wing county after the commissioner of 348.23 human services declares said property surplus to its needs. 348.24 Subd. 2. [FORM.] (a) The conveyance shall be in a form 348.25 approved by the attorney general. 348.26 (b) The conveyance shall restrict use of the land to county 348.27 governmental purposes, including community corrections programs, 348.28 and shall provide that ownership of any portion of the land or 348.29 building that ceases to be used for such purposes shall revert 348.30 to the state of Minnesota. 348.31 Subd. 3. [LAND DESCRIPTION.] The land to be conveyed is 348.32 that part of the Northeast Quarter of Section 30, Township 45 348.33 North, Range 30 West, Crow Wing county, Minnesota, described as 348.34 follows: 348.35 Commencing at the southeast corner of said Northeast 348.36 Quarter; thence North 00 degrees 46 minutes 05 seconds 349.1 West, bearing based on the Crow Wing county coordinate 349.2 database NAD 83/94, 1520.06 feet along the east line of 349.3 said Northeast Quarter to the point of beginning; thence 349.4 continue North 00 degrees 46 minutes 05 seconds West 634.14 349.5 feet along said east line of the Northeast Quarter; thence 349.6 South 89 degrees 13 minutes 20 seconds West 550.00 feet; 349.7 thence South 18 degrees 57 minutes 23 seconds East 115.59 349.8 feet; thence South 42 degrees 44 minutes 39 seconds East 349.9 692.37 feet; thence South 62 degrees 46 minutes 19 seconds 349.10 East 20.24 feet; thence North 89 degrees 13 minutes 55 349.11 seconds East 33.00 feet to the point of beginning. 349.12 Containing 4.69 acres, more or less. Subject to the 349.13 right-of-way of the township road along the east side 349.14 thereof, subject to other easements, reservations, and 349.15 restrictions of record, if any. 349.16 Subd. 4. [DETERMINATION.] The commissioner of human 349.17 services has determined that the land described in subdivision 3 349.18 and the building on the land will not be needed for future 349.19 operations of the Brainerd regional human services center. The 349.20 state's land management interests would best be served by 349.21 conveying the land to Crow Wing county for governmental use. 349.22 Sec. 10. [TOWN OF WHITE, ST. LOUIS COUNTY.] 349.23 Subdivision 1. [TRANSFER.] Notwithstanding any provision 349.24 of Minnesota Statutes to the contrary, the town of White is 349.25 hereby authorized to transfer the following property and any 349.26 buildings, equipment, and other improvements located thereon to 349.27 the White community hospital corporation, a nonprofit 349.28 corporation organized and existing under Minnesota Statutes, 349.29 chapter 317: 349.30 That part of the southeast quarter of southwest quarter (SE 349.31 1/4 of SW 1/4), section 10, township 58 north of range 15 west 349.32 of the fourth principal meridian, according to the United States 349.33 government survey thereof, St. Louis county, Minnesota, 349.34 described as follows: 349.35 Commencing at the southeast corner of said SE 1/4 of SW 349.36 1/4, section 10, township 58, range 15, thence proceeding north 350.1 along the east line thereof for a distance of 550 feet; thence 350.2 west and parallel to the south line thereof for a distance of 350.3 800 feet; thence south and parallel to the east line thereof, 350.4 for a distance of 550 feet to the south line; thence east along 350.5 said south line thereof, for a distance of 800 feet to the point 350.6 of beginning. 350.7 Subd. 2. [NO CONSIDERATION OR ELECTION REQUIRED.] The 350.8 transfer authorized by subdivision 1 shall be without 350.9 consideration and no vote of the electors of the town of White 350.10 or city of Aurora shall be required. 350.11 Subd. 3. [USE; PUBLIC PROPERTY.] The property legally 350.12 described in subdivision 1 shall be used for health care and 350.13 related purposes and shall be considered public property for 350.14 purposes of Minnesota Statutes, section 16A.695. The activities 350.15 conducted on the property described in subdivision 1 by the 350.16 White community hospital corporation, its successors and assigns 350.17 shall be considered a governmental program as authorized by 350.18 Minnesota Statutes, chapter 447. 350.19 Subd. 4. [NAME.] The public name of the buildings and 350.20 improvements located on the real property legally described in 350.21 subdivision 1 shall always include the words "White community." 350.22 Sec. 11. [LOAN GUARANTEE.] 350.23 The director of the division of emergency management of the 350.24 department of public safety shall, as the governor's authorized 350.25 representative and on behalf of the state, agree to provide 350.26 security for and guarantee a promissory note or similar document 350.27 for a loan from the Federal Emergency Management Agency under 350.28 its community disaster loan program to the city of Ada in the 350.29 amount of approximately $1,200,000. The loan is to cover 350.30 operating losses for a publicly owned health care facility that 350.31 was damaged in the spring floods of 1997. 350.32 Sec. 12. [LICENSING MORATORIUM; JUVENILE FACILITIES.] 350.33 Subdivision 1. [MORATORIUM; COMMISSIONER OF 350.34 CORRECTIONS.] Except as provided in subdivision 4, the 350.35 commissioner of corrections may not: 350.36 (1) issue any license under Minnesota Statutes, section 351.1 241.021, to operate a new correctional facility for the 351.2 detention or confinement of juvenile offenders that will include 351.3 more than 25 beds for juveniles; or 351.4 (2) renew a license under Minnesota Statutes, section 351.5 241.021, to operate a correctional facility licensed before the 351.6 effective date of this moratorium, for the detention or 351.7 confinement of juvenile offenders, if the number of beds in the 351.8 facility will increase by more than 25 beds since the time the 351.9 most recent license was issued. 351.10 Subd. 2. [MORATORIUM; COMMISSIONER OF HUMAN 351.11 SERVICES.] Except as provided in subdivision 4, the commissioner 351.12 of human services may not: 351.13 (1) issue any license under Minnesota Rules, parts 351.14 9545.0905 to 9545.1125, for the residential placement of 351.15 juveniles at a facility that will include more than 25 beds for 351.16 juveniles; or 351.17 (2) renew a license under Minnesota Rules, parts 9545.0905 351.18 to 9545.1125, for the residential placement of juveniles at a 351.19 facility licensed before the effective date of this moratorium, 351.20 if the number of beds in the facility will increase by more than 351.21 25 beds since the time the most recent license was issued. 351.22 Subd. 3. [MORATORIUM; OTHER BEDS.] Except as provided in 351.23 subdivision 4, no state agency may: 351.24 (1) issue a license for any new facility that will provide 351.25 an out-of-home placement for more than 25 juveniles at one time; 351.26 or 351.27 (2) renew a license for any existing facility licensed 351.28 before the effective date of this moratorium, if the number of 351.29 beds in the facility will increase by more than 25 beds since 351.30 the time the most recent license was issued. 351.31 For the purposes of this subdivision, "juvenile" means a 351.32 delinquent child, as defined in Minnesota Statutes, section 351.33 260.015, subdivision 5; a juvenile petty offender, as defined in 351.34 Minnesota Statutes, section 260.015, subdivision 21; or a child 351.35 in need of protection or services, as defined in Minnesota 351.36 Statutes, section 260.015, subdivision 2a. 352.1 Subd. 4. [EXEMPTIONS.] The moratorium in this section does 352.2 not apply to: 352.3 (1) any secure juvenile detention and treatment facility, 352.4 which is funded in part through a grant under Laws 1994, chapter 352.5 643, section 79; 352.6 (2) the department of corrections' facilities at Red Wing 352.7 and Sauk Centre; 352.8 (3) the proposed department of corrections' facility at 352.9 Camp Ripley; 352.10 (4) any facility that submitted a formal request for 352.11 licensure under Minnesota Statutes, section 241.021, before 352.12 December 31, 1997; and 352.13 (5) any residential academy receiving state funding for 352.14 fiscal year 1998 or 1999 for capital improvements. 352.15 Subd. 5. [MORATORIUM; LENGTH.] The moratorium in this 352.16 section stays in effect until June 30, 1999. 352.17 Sec. 13. [JUVENILE PLACEMENT STUDY.] 352.18 The legislative audit commission is requested to direct the 352.19 legislative auditor to conduct a study of juvenile out-of-home 352.20 placements. The study must include: 352.21 (1) an evaluation of existing placements for juveniles, 352.22 including, but not limited to, the number of beds at each 352.23 facility, the average number of beds occupied each day at each 352.24 facility, and the location of each facility, and an analysis of 352.25 the projected need for an increased number of beds for juvenile 352.26 out-of-home placements, including the geographic area where beds 352.27 will be needed; 352.28 (2) an evaluation of existing services and programming 352.29 provided in juvenile out-of-home placements and an assessment of 352.30 the types of services and programming that are needed in 352.31 juvenile out-of-home placements, by geographic area; 352.32 (3) an evaluation of the utilization of continuum of care; 352.33 (4) an assessment of the reasons why juveniles are placed 352.34 outside their homes; 352.35 (5) a summary of the demographics of juveniles placed 352.36 outside their homes, by county, including information on race, 353.1 gender, age, and other relevant factors; 353.2 (6) a summary of the geographic distance between the 353.3 juvenile's home and the location of the out-of-home placement, 353.4 including observations for the reasons a juvenile was placed at 353.5 a particular location; 353.6 (7) a determination of the average length of time that a 353.7 juvenile in Minnesota spends in an out-of-home placement and a 353.8 determination of the average length of time that a juvenile 353.9 spends in each type of out-of-home placement, including, but not 353.10 limited to, residential treatment centers, correctional 353.11 facilities, and group homes; 353.12 (8) a determination of the completion rates of juveniles 353.13 participating in programming in out-of-home placements and an 353.14 analysis of the reasons for noncompletion of programming; 353.15 (9) a determination of the percentage of juveniles whose 353.16 out-of-home placement ends due to the juvenile's failure to meet 353.17 the rules and conditions of the out-of-home placement and an 353.18 analysis of the reasons the juvenile failed; 353.19 (10) an analysis of the effectiveness of the juvenile 353.20 out-of-home placement, including information on recidivism, 353.21 where applicable, and the child's performance after returning to 353.22 the child's home; 353.23 (11) an estimate of the cost each county spends on juvenile 353.24 out-of-home placements; 353.25 (12) a description and examination of the per diem 353.26 components per offender at state, local, and private facilities 353.27 providing placements for juveniles; and 353.28 (13) other issues that may affect juvenile out-of-home 353.29 placements. 353.30 If the commission directs the auditor to conduct this 353.31 study, the auditor shall report its findings to the chairs of 353.32 the house and senate committees and divisions with jurisdiction 353.33 over criminal justice and health and human services policy and 353.34 funding by January 15, 1999. 353.35 Sec. 14. [CITY OF EVELETH; LOAN FORGIVENESS.] 353.36 Notwithstanding the provisions of any other law or charter, 354.1 the city of Eveleth may, by resolution of its city council, 354.2 forgive all or any portion of the principal and interest due or 354.3 to become due to the city, pursuant to any loan or loans made by 354.4 the city, in an amount not exceeding $100,000, prior to January 354.5 1, 1998, to any hospital, nursing home, other health care 354.6 facility or corporation, partnership, or limited liability 354.7 company operating such a facility within the city of Eveleth. 354.8 Sec. 15. [REPEALER.] 354.9 (a) Minnesota Rules, part 2740.1600, subpart 1, is repealed. 354.10 (b) Minnesota Statutes 1997 Supplement, section 62D.042, 354.11 subdivision 3, is repealed. 354.12 Sec. 16. [EFFECTIVE DATE.] 354.13 (a) Section 2 (62D.042, subdivision 2) is effective January 354.14 1, 1999. 354.15 (b) Section 15, paragraph (b) (repealing section 62D.042, 354.16 subdivision 3) is effective the day following final enactment. 354.17 (c) Section 7 (Laws 1997, chapter 207, section 7) is 354.18 effective the day following final enactment. 354.19 (d) Section 10 (TOWN OF WHITE, ST. LOUIS COUNTY) is 354.20 effective upon compliance with Minnesota Statutes, section 354.21 645.021, subdivision 2. 354.22 (e) Sections 12 and 13 (licensing and juvenile placement) 354.23 are effective the day following final enactment. 354.24 (f) Section 14 (loan forgiveness by the city of Eveleth) is 354.25 effective the day following final enactment without local 354.26 approval according to Minnesota Statutes, section 645.023, 354.27 subdivision 1, clause (a).