Minnesota Legislature
SF 3346
2nd Engrossment - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
1.1 A bill for an act 1.2 relating to human services; appropriating money; 1.3 changing provisions for long-term care, health care 1.4 programs and provisions, including MA and GAMC, 1.5 MinnesotaCare, welfare reform, and regional treatment 1.6 centers; providing for the sale of certain nursing 1.7 home property; regulating compulsive gambling; 1.8 imposing penalties; amending Minnesota Statutes 1996, 1.9 sections 119B.24; 144.701, subdivisions 1, 2, and 4; 1.10 144.702, subdivisions 1, 2, and 8; 144A.09, 1.11 subdivision 1; 144A.44, subdivision 2; 214.03; 1.12 245.462, subdivisions 4 and 8; 245.4871, subdivision 1.13 4; 245A.03, by adding a subdivision; 245A.14, 1.14 subdivision 4; 256.014, subdivision 1; 256.969, 1.15 subdivisions 16 and 17; 256B.03, subdivision 3; 1.16 256B.04, by adding a subdivision; 256B.055, 1.17 subdivision 7, and by adding a subdivision; 256B.057, 1.18 subdivision 3a, and by adding subdivisions; 256B.0625, 1.19 subdivisions 7, 17, 19a, 20, 34, and by adding 1.20 subdivisions; 256B.0627, subdivision 4; 256B.0911, 1.21 subdivision 4; 256B.0916; 256B.41, subdivision 1; 1.22 256B.431, subdivisions 2b, 4, 11, 22, and by adding a 1.23 subdivision; 256B.501, subdivision 2; 256B.69, by 1.24 adding subdivisions; 256D.03, subdivision 4, and by 1.25 adding subdivisions; 256D.051, by adding a 1.26 subdivision; 256D.46, subdivision 2; 256I.04, 1.27 subdivisions 1, 3, and by adding a subdivision; 1.28 256I.05, subdivision 2; and 609.115, subdivision 9; 1.29 Minnesota Statutes 1997 Supplement, sections 60A.15, 1.30 subdivision 1; 62J.685; 62J.69, subdivisions 1, 2, and 1.31 by adding a subdivision; 62J.75; 103I.208, subdivision 1.32 2; 144.1494, subdivision 1; 144A.071, subdivision 4a; 1.33 171.29, subdivision 2; 214.32, subdivision 1; 245B.06, 1.34 subdivision 2; 256.01, subdivision 2; 256.031, 1.35 subdivision 6; 256.9657, subdivision 3; 256.9685, 1.36 subdivision 1; 256.9864; 256B.04, subdivision 18; 1.37 256B.056, subdivisions 1a and 4; 256B.06, subdivision 1.38 4; 256B.062; 256B.0625, subdivision 31a; 256B.0627, 1.39 subdivision 5; 256B.0645; 256B.0911, subdivisions 2 1.40 and 7; 256B.0913, subdivision 14; 256B.0915, 1.41 subdivisions 1d and 3; 256B.0951, by adding a 1.42 subdivision; 256B.431, subdivisions 3f and 26; 1.43 256B.433, subdivision 3a; 256B.434, subdivision 10; 1.44 256B.69, subdivisions 2 and 3a; 256B.692, subdivisions 1.45 2 and 5; 256B.77, subdivisions 3, 7a, 10, and 12; 1.46 256D.05, subdivision 8; 256J.02, subdivision 4; 2.1 256J.03; 256J.08, subdivisions 11, 26, 28, 40, 60, 68, 2.2 73, 83, and by adding subdivisions; 256J.09, 2.3 subdivisions 6 and 9; 256J.11, subdivision 2, as 2.4 amended; 256J.12; 256J.14; 256J.15, subdivision 2; 2.5 256J.20, subdivisions 2 and 3; 256J.21; 256J.24, 2.6 subdivisions 1, 2, 3, 4, and by adding subdivisions; 2.7 256J.26, subdivisions 1, 2, 3, and 4; 256J.28, 2.8 subdivisions 1, 2, and by adding a subdivision; 2.9 256J.30, subdivisions 10 and 11; 256J.31, subdivisions 2.10 5 and 10; 256J.32, subdivisions 4, 6, and by adding a 2.11 subdivision; 256J.33, subdivisions 1 and 4; 256J.35; 2.12 256J.36; 256J.37, subdivisions 1, 2, 9, and by adding 2.13 subdivisions; 256J.38, subdivision 1; 256J.39, 2.14 subdivision 2; 256J.395; 256J.42; 256J.43; 256J.45, 2.15 subdivisions 1, 2, and by adding a subdivision; 2.16 256J.46, subdivisions 1, 2, and 2a; 256J.47, 2.17 subdivision 4; 256J.48, subdivisions 2, 3, and by 2.18 adding a subdivision; 256J.49, subdivision 4; 256J.50, 2.19 subdivision 5, and by adding a subdivision; 256J.52, 2.20 subdivision 4; 256J.54, subdivisions 2, 3, 4, and 5; 2.21 256J.55, subdivision 5; 256J.56; 256J.57, subdivision 2.22 1; 256J.645, subdivision 3; 256J.74, subdivision 2, 2.23 and by adding a subdivision; 256K.03, subdivision 5; 2.24 256L.01; 256L.02, subdivisions 2 and 3; 256L.03, 2.25 subdivisions 1, 3, 4, 5, and by adding subdivisions; 2.26 256L.04, subdivisions 1, 2, 7, 8, 9, 10, and by adding 2.27 subdivisions; 256L.05, subdivisions 2, 3, 4, and by 2.28 adding subdivisions; 256L.06, subdivision 3; 256L.07; 2.29 256L.09, subdivisions 2, 4, and 6; 256L.11, 2.30 subdivision 6; 256L.12, subdivision 5; 256L.15; 2.31 256L.17, by adding a subdivision; and 270A.03, 2.32 subdivision 5; Laws 1994, chapter 633, article 7, 2.33 section 3; Laws 1997, chapter 203, article 4, section 2.34 64; and article 9, section 21; chapter 207, section 7; 2.35 chapter 225, article 2, section 64; and chapter 248, 2.36 section 46, as amended; proposing coding for new law 2.37 in Minnesota Statutes, chapters 144; 145; 245; 256; 2.38 256B; 256D; 256J; and 256L; repealing Minnesota 2.39 Statutes 1996, sections 144.0721, subdivision 3a; 2.40 256.031, subdivisions 1, 2, 3, and 4; 256.032; 2.41 256.033, subdivisions 2, 3, 4, 5, and 6; 256.034; 2.42 256.035; 256.036; 256.0361; 256.047; 256.0475; 2.43 256.048; 256.049; and 256B.501, subdivision 3g; 2.44 Minnesota Statutes 1997 Supplement, sections 62J.685; 2.45 144.0721, subdivision 3; 256.031, subdivisions 5 and 2.46 6; 256.033, subdivisions 1 and 1a; 256B.057, 2.47 subdivision 1a; 256B.062; 256B.0913, subdivision 15; 2.48 256J.25; 256J.28, subdivision 4; 256J.32, subdivision 2.49 5; 256J.34, subdivision 5; 256J.76; 256L.04, 2.50 subdivisions 3, 4, 5, and 6; 256L.06, subdivisions 1 2.51 and 2; 256L.08; 256L.09, subdivision 3; 256L.13; and 2.52 256L.14; Laws 1997, chapter 85, article 1, sections 61 2.53 and 71; and article 3, section 55; Minnesota Rules 2.54 (Exempt), parts 9500.9100; 9500.9110; 9500.9120; 2.55 9500.9130; 9500.9140; 9500.9150; 9500.9160; 9500.9170; 2.56 9500.9180; 9500.9190; 9500.9200; 9500.9210; and 2.57 9500.9220. 2.58 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 2.59 ARTICLE 1 2.60 APPROPRIATIONS 2.61 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 2.62 The sums shown in the columns marked "APPROPRIATIONS" are 2.63 appropriated from the general fund, or any other fund named, to 2.64 the agencies and for the purposes specified in the following 3.1 sections of this article, to be available for the fiscal years 3.2 indicated for each purpose. The figures "1998" and "1999" where 3.3 used in this article, mean that the appropriation or 3.4 appropriations listed under them are available for the fiscal 3.5 year ending June 30, 1998, or June 30, 1999, respectively. 3.6 Where a dollar amount appears in parentheses, it means a 3.7 reduction of an appropriation. 3.8 SUMMARY BY FUND 3.9 APPROPRIATIONS BIENNIAL 3.10 1998 1999 TOTAL 3.11 General $ (119,518,000)$ (120,237,000)$ (239,755,000) 3.12 State Government 3.13 Special Revenue 113,000 224,000 337,000 3.14 Health Care Access 3.15 Fund 6,616,000 (255,000) 6,361,000 3.16 TOTAL $ (112,789,000)$ (120,268,000)$ (233,057,000) 3.17 APPROPRIATIONS 3.18 Available for the Year 3.19 Ending June 30 3.20 1998 1999 3.21 Sec. 2. COMMISSIONER OF 3.22 HUMAN SERVICES 3.23 Subdivision 1. Total 3.24 Appropriation $ (112,902,000)$ (127,343,000) 3.25 Summary by Fund 3.26 General (119,518,000) (126,579,000) 3.27 Health Care Access 6,616,000 (764,000) 3.28 This appropriation is taken from the 3.29 appropriation in Laws 1997, chapter 3.30 203, article 1, section 2. 3.31 The amounts that are added to or 3.32 reduced from the appropriation for each 3.33 program are specified in the following 3.34 subdivisions. 3.35 Subd. 2. Agency Management 3.36 -0- 80,000 3.37 Subd. 3. Children's Grants 3.38 (600,000) 2,771,000 3.39 [CRISIS NURSERY PROGRAMS.] Of this 3.40 appropriation, $200,000 in fiscal year 3.41 1999 is from the general fund to the 3.42 commissioner to contract for technical 3.43 assistance with counties that are 3.44 interested in developing a crisis 3.45 nursery program. The technical 3.46 assistance must be designed to assist 4.1 interested counties in building 4.2 capacity to develop and maintain a 4.3 crisis nursery program in the county. 4.4 The grant amounts to counties must 4.5 range from $10,000 to $20,000. To be 4.6 eligible to receive a grant under this 4.7 program, the county must not have an 4.8 existing crisis nursery program and 4.9 must not be a metropolitan county, as 4.10 that term is defined in Minnesota 4.11 Statutes, section 473.121. This 4.12 appropriation shall not become part of 4.13 base level funding for the 2000-2001 4.14 biennium. 4.15 [CHILDREN'S MENTAL HEALTH SERVICES.] 4.16 (1) Of this appropriation, $500,000 in 4.17 fiscal year 1999 from the general fund 4.18 is to the commissioner for the purpose 4.19 of awarding grants to counties for 4.20 children's mental health services. 4.21 (2) Funds shall be used to provide 4.22 services according to an individual 4.23 family community support plan as 4.24 described in Minnesota Statutes, 4.25 section 245.4881, subdivision 4. The 4.26 plan must be developed using a process 4.27 that enhances consumer empowerment. 4.28 (3) In awarding grants to counties, the 4.29 commissioner shall follow the process 4.30 established in Minnesota Statutes, 4.31 section 245.4886, subdivision 2. The 4.32 commissioner shall ensure that grant 4.33 funds are not used to replace existing 4.34 funds. 4.35 [INDIAN FAMILY PRESERVATION ACT.] Of 4.36 this appropriation, $100,000 from the 4.37 general fund for fiscal year 1999 is to 4.38 provide a grant under Minnesota 4.39 Statutes, section 257.3571, subdivision 4.40 1, to an Indian organization licensed 4.41 as an adoption agency. The grant must 4.42 be used to provide primary support for 4.43 implementation of the Minnesota Indian 4.44 Family Preservation Act and compliance 4.45 with the Indian Child Welfare Act. 4.46 [FAMILY PRESERVATION PROGRAM TANF 4.47 FUNDING.] $10,000,000 of federal funds 4.48 shall be transferred from TANF to the 4.49 family preservation program in the 4.50 fiscal year beginning July 1, 1998. 4.51 Notwithstanding Minnesota Statutes, 4.52 section 256E.07, the commissioner shall 4.53 distribute this money according to the 4.54 family preservation formula in 4.55 Minnesota Statutes, section 256F.05, 4.56 subdivision 3. Counties may use the 4.57 allocation for the purposes of family 4.58 preservation services, the child 4.59 protection assessments, and community 4.60 collaborations pilot program and the 4.61 concurrent permanency planning pilot 4.62 program provided county staff have 4.63 received necessary training and the 4.64 pilot programs have been approved by 4.65 the commissioner. Prior to 4.66 distributing these funds to the 5.1 counties, the commissioner may allocate 5.2 up to $150,000 for departmental 5.3 administrative costs associated with 5.4 training county staff and approval of 5.5 county plans for the pilot programs. 5.6 Funds allocated to the counties must be 5.7 used in accordance with federal TANF 5.8 requirements and Minnesota Statutes, 5.9 chapter 256F. 5.10 Subd. 4. Children's Services Management 5.11 [SOCIAL SERVICES INFORMATION SYSTEM.] 5.12 Notwithstanding Laws 1997, chapter 203, 5.13 article 1, section 2, subdivision 4, 5.14 the appropriation in that subdivision 5.15 for the social services information 5.16 system shall become part of the base 5.17 for the biennium beginning July 1, 1999. 5.18 Subd. 5. Basic Health Care Grants 5.19 (67,836,000) (88,240,000) 5.20 Summary by Fund 5.21 General (74,644,000) (84,818,000) 5.22 Health Care Access 6,808,000 (3,422,000) 5.23 The amounts that may be spent from this 5.24 appropriation for each purpose are as 5.25 follows: 5.26 (a) Minnesota Care Grants 5.27 Health Care Access Fund 5.28 6,808,000 (3,422,000) 5.29 [SUBSIDIZED FAMILY HEALTH COVERAGE.] 5.30 (1) Of this appropriation, $500,000 5.31 from the health care access fund in 5.32 fiscal year 1999 is to implement the 5.33 program described in Minnesota 5.34 Statutes, section 256L.07, subdivision 5.35 2, paragraph (b). 5.36 (2) The commissioner shall submit to 5.37 the health care financing 5.38 administration a plan to obtain federal 5.39 funding, according to section 5.40 2105(c)(3) of the Balanced Budget Act 5.41 of 1997, Public Law Number 105-33, to 5.42 subsidize health insurance coverage for 5.43 families who are ineligible for 5.44 MinnesotaCare under Minnesota Statutes, 5.45 section 256L.07, subdivision 2, 5.46 paragraph (b), due to the availability 5.47 of employer subsidized insurance for 5.48 which the employer pays 50 percent or 5.49 more of the cost of the coverage. Upon 5.50 federal approval of the plan, the 5.51 commissioner shall implement a program 5.52 to pay the difference of the 5.53 MinnesotaCare sliding premium scale as 5.54 specified in Minnesota Statutes, 5.55 section 256L.08, up to a maximum of 5.56 five percent of a qualifying family's 5.57 income and the employee share of the 5.58 cost of health insurance coverage. To 5.59 qualify, a family must meet all 6.1 MinnesotaCare eligibility criteria 6.2 according to Minnesota Statutes, 6.3 sections 256L.01 to 256L.18, except the 6.4 requirements of Minnesota Statutes, 6.5 section 256L.07, subdivision 2, 6.6 paragraph (b). Implementation of the 6.7 program shall be limited to the funds 6.8 appropriated from the health care 6.9 access fund for the fiscal year ending 6.10 June 30, 1999. 6.11 (b) MA Basic Health Care Grants- 6.12 Families and Children 6.13 General (23,231,000) (38,768,000) 6.14 [RESERVE ACCOUNT.] The commissioner 6.15 shall establish a reserve account for 6.16 the deposit of savings in prepaid 6.17 medical assistance and prepaid general 6.18 assistance medical care programs in 6.19 fiscal year 1999 as a result of the 6.20 delayed implementation of those 6.21 programs in certain counties. The 6.22 savings, in the amount of $7,943,000 in 6.23 medical assistance and $2,964,000 in 6.24 general assistance medical care, shall 6.25 be used in fiscal year 2000 for costs 6.26 in the prepaid programs. 6.27 Notwithstanding section 7, this 6.28 paragraph shall not expire. 6.29 (c) MA Basic Health Care Grants- 6.30 Elderly and Disabled 6.31 General (23,784,000) (37,807,000) 6.32 [MEDICAL EDUCATION RESEARCH TRUST FUND 6.33 BASE.] The appropriation in Laws 1997, 6.34 chapter 203, article 1. section 2, 6.35 subdivision 5, to the medical 6.36 assistance account for distribution to 6.37 medical assistance providers using the 6.38 methodology in Minnesota Statutes, 6.39 section 62J.69, shall become part of 6.40 the base for the biennium beginning 6.41 July 1, 1999, at the level of 6.42 $2,500,000 per year. Notwithstanding 6.43 section 7, this paragraph shall not 6.44 expire. 6.45 (d) General Assistance Medical Care 6.46 General (27,629,000) (8,243,000) 6.47 [PRESCRIPTION DRUG BENEFIT.] (a) If, by 6.48 September 15, 1998, federal approval is 6.49 obtained to provide a prescription drug 6.50 benefit for qualified Medicare 6.51 beneficiaries at no less than 100 6.52 percent of the federal poverty 6.53 guidelines and service-limited Medicare 6.54 beneficiaries under Minnesota Statutes, 6.55 section 256B.057, subdivision 3a, at no 6.56 less than 120 percent of federal 6.57 poverty guidelines, the commissioner of 6.58 human services shall not implement the 6.59 senior citizen drug program under 6.60 Minnesota Statutes, section 256.955, 6.61 but shall implement a drug benefit in 6.62 accordance with the approved waiver. 7.1 Upon approval of this waiver, the total 7.2 appropriation for the senior citizen 7.3 drug program under Laws 1997, chapter 7.4 225, article 7, section 2, shall be 7.5 transferred to the medical assistance 7.6 account to supplement funding for the 7.7 federally approved coverage for 7.8 eligible persons. 7.9 (b) The commissioner may seek approval 7.10 for a higher copayment for eligible 7.11 persons above 100 percent of the 7.12 federal poverty guidelines. 7.13 (c) The commissioner shall report by 7.14 October 15, 1998, to the chairs of the 7.15 health and human services policy and 7.16 fiscal committees of the house and 7.17 senate whether the waiver referred to 7.18 in paragraph (a) has been approved and 7.19 will be implemented or whether the 7.20 state senior citizen drug program will 7.21 be implemented. 7.22 (d) If the commissioner does not 7.23 receive federal waiver approval at or 7.24 above the level of eligibility defined 7.25 in paragraph (b), the commissioner 7.26 shall implement the program under 7.27 Minnesota Statutes, section 256.955. 7.28 The commissioner may transfer funds 7.29 appropriated to implement the waiver to 7.30 the senior drug program account. 7.31 [HEALTH CARE ACCESS FUND TRANSFERS TO 7.32 THE GENERAL FUND.] Notwithstanding Laws 7.33 1997, chapter 203, article 1, section 7.34 2, subdivision 5, the commissioner 7.35 shall transfer funds from the health 7.36 care access fund to the general fund to 7.37 offset the projected savings to general 7.38 assistance medical care (GAMC) that 7.39 would result from the transition of 7.40 GAMC parents and adults without 7.41 children to MinnesotaCare. For fiscal 7.42 year 1998, the amount transferred from 7.43 the health care access fund to the 7.44 general fund shall be $13,700,000. The 7.45 amount of transfer for fiscal year 1999 7.46 shall be $2,659,000. 7.47 Subd. 6. Basic Health Care Management 7.48 (192,000) 2,448,000 7.49 Summary by Fund 7.50 General -0- 874,000 7.51 Health Care Access (192,000) 1,574,000 7.52 The amounts that may be spent from this 7.53 appropriation for each purpose are as 7.54 follows: 7.55 (a) Health Care Policy Administration 7.56 General -0- 786,000 7.57 Health Care Access (192,000) 37,000 8.1 [DELAY IN TRANSFERRING GAMC CLIENTS.] 8.2 Due to the delay in transferring GAMC 8.3 clients to MinnesotaCare until January 8.4 1, 2000, $192,000 in fiscal year 1998 8.5 health care access fund administrative 8.6 funds, appropriated in Laws 1997, 8.7 chapter 225, article 7, section 2, 8.8 subdivision 1, are canceled. 8.9 [HEALTH CARE MANUAL PRODUCTION COSTS.] 8.10 For the biennium ending June 30, 1999, 8.11 the difference between the cost of 8.12 producing and distributing the 8.13 department of human services health 8.14 care manual and the subsidized price 8.15 charged to individuals and private 8.16 entities on January 1, 1998, is 8.17 appropriated to the commissioner to 8.18 defray manual production and 8.19 distribution costs. 8.20 [TRANSFER.] For fiscal years 2000 and 8.21 2001, the commissioner of finance shall 8.22 transfer from the health care access 8.23 fund to the general fund an amount to 8.24 cover the expenditures associated with 8.25 the services provided to pregnant women 8.26 and children under the age of two 8.27 enrolled in the MinnesotaCare program. 8.28 Notwithstanding section 7, this 8.29 paragraph shall not expire. 8.30 [PAYMENTS FOR PREGNANT WOMEN AND 8.31 CHILDREN UNDER THE AGE OF TWO.] 8.32 Beginning in fiscal year 2000, the 8.33 expenditures for pregnant women and 8.34 children under the age of two enrolled 8.35 in the MinnesotaCare program shall be 8.36 paid out of the general fund. 8.37 Notwithstanding section 7, this 8.38 paragraph shall not expire. 8.39 [FEDERAL CONTINGENCY RESERVE LIMIT.] 8.40 Notwithstanding Minnesota Statutes, 8.41 section 16A.76, subdivision 2, the 8.42 federal contingency reserve limit shall 8.43 be reduced for fiscal years 1999, 2000, 8.44 and 2001 by the cumulative amount of 8.45 the expenditures associated with 8.46 services provided to pregnant women and 8.47 children enrolled in the MinnesotaCare 8.48 program in these fiscal years. 8.49 Notwithstanding section 7, this 8.50 paragraph shall not expire. 8.51 (b) Health Care Operations 8.52 General -0- 88,000 8.53 Health Care Access -0- 1,537,000 8.54 [MINNESOTACARE OUTREACH.] Unexpended 8.55 money in fiscal year 1998 for 8.56 MinnesotaCare outreach activities 8.57 appropriated in Laws 1997, chapter 225, 8.58 article 7, section 2, subdivision 1, 8.59 does not cancel, but is available for 8.60 those purposes in fiscal year 1999. 8.61 Subd. 7. State-Operated Services 9.1 -0- 508,000 9.2 The amounts that may be spent from this 9.3 appropriation for each purpose are as 9.4 follows: 9.5 (a) RTC Facilities 9.6 -0- 825,000 9.7 [LEAVE LIABILITIES.] The accrued leave 9.8 liabilities of state employees 9.9 transferred to state-operated services 9.10 programs may be paid from the 9.11 appropriation for state-operated 9.12 services in Laws 1997, chapter 203, 9.13 article 1, section 2, subdivision 7a. 9.14 Funds set aside for this purpose shall 9.15 not exceed the amount of the actual 9.16 leave liability calculated as of June 9.17 30, 1999, and shall be available until 9.18 expended. This paragraph is effective 9.19 the day following final enactment. 9.20 [GRAVE MARKERS.] Of the $195,000 9.21 retained by the commissioner out of the 9.22 $200,000 appropriation in Laws 1997, 9.23 chapter 203, article 1, section 2, 9.24 subdivision 7, paragraph (a), for grave 9.25 markers at regional treatment centers, 9.26 $29,250 is for community organizing, 9.27 coordination, fundraising, and 9.28 administration. 9.29 [RTC BUILDING AND SPACE ANALYSIS.] Of 9.30 this appropriation, $175,000 from the 9.31 general fund in fiscal year 1999 is for 9.32 the commissioner to conduct an analysis 9.33 of surplus land and buildings on the 9.34 regional treatment center campuses and 9.35 to develop recommendations for future 9.36 utilization of this property. The 9.37 commissioner shall report to the 9.38 legislature by January 15, 1999, with 9.39 recommendations for an orderly process 9.40 to sell, lease, demolish, transfer, or 9.41 otherwise dispose of unneeded buildings 9.42 and land. 9.43 (b) State-Operated Community 9.44 Services - DD 9.45 -0- (317,000) 9.46 Subd. 8. Continuing Care and 9.47 Community Support Grants 9.48 (35,100,000) (22,107,000) 9.49 The amounts that may be spent from this 9.50 appropriation for each purpose are as 9.51 follows: 9.52 (a) Community Services Block Grants 9.53 130,000 280,000 9.54 [WILKIN COUNTY FLOOD COSTS.] Of this 9.55 appropriation, $130,000 for fiscal year 9.56 1998 is to reimburse Wilkin county for 9.57 flood-related human service and public 10.1 health costs which cannot be reimbursed 10.2 through any other source. 10.3 (b) Aging Adult Service Grants 10.4 -0- 350,000 10.5 [METROPOLITAN AREA AGENCY ON AGING.] Of 10.6 this appropriation, $100,000 in fiscal 10.7 year 1999 from the general fund is for 10.8 the commissioner for the metropolitan 10.9 area agency on aging to provide 10.10 technical support and planning services 10.11 to enable older adults to remain living 10.12 in the community. This appropriation 10.13 shall not cancel but is available until 10.14 expended. 10.15 [HOME SHARING.] Of this appropriation, 10.16 $250,000 in fiscal year 1999 is from 10.17 the general fund to the commissioner 10.18 for the home-sharing program under 10.19 Minnesota Statutes, section 256.973, 10.20 which links elderly, disabled, and 10.21 families together to share a home. 10.22 (c) Deaf and Hard-of-Hearing 10.23 Services Grants 10.24 -0- 200,000 10.25 This appropriation is in addition to 10.26 the appropriation in Laws 1997, chapter 10.27 203, article 1, section 2, subdivision 10.28 8, paragraph (d), for a grant to a 10.29 nonprofit agency that currently 10.30 provides these services. 10.31 [SERVICES FOR DEAF-BLIND PERSONS.] Of 10.32 this appropriation, $200,000 in fiscal 10.33 year 1999 is for the following: 10.34 (1) $125,000 for a grant to Deaf Blind 10.35 Services Minnesota, Inc., in order to 10.36 provide services to deaf-blind children 10.37 and their families. The services 10.38 include providing intervenors to assist 10.39 deaf-blind children in participating in 10.40 their community and providing family 10.41 education specialists to teach siblings 10.42 and parents skills to support the 10.43 deaf-blind child in the family. 10.44 (2) $75,000 is for a grant to Deaf 10.45 Blind Services Minnesota, Inc., and 10.46 Duluth Lighthouse for the Blind, Inc., 10.47 in order to provide assistance to 10.48 deaf-blind persons who are working 10.49 toward establishing and maintaining 10.50 independence. 10.51 (d) Mental Health Grants 10.52 300,000 2,226,000 10.53 [FLOOD COSTS.] Of this appropriation, 10.54 $300,000 for fiscal year 1998 and 10.55 $1,000,000 for fiscal year 1999 is to 10.56 pay for flood-related mental health 10.57 services and to reimburse mental health 10.58 centers for the cost of disruptions in 11.1 the mental health centers' other 11.2 services that were caused by diversion 11.3 of staff to flood efforts. Funding is 11.4 limited to costs for services which 11.5 cannot be reimbursed through any other 11.6 source in counties officially declared 11.7 as disaster areas. 11.8 [COMPULSIVE GAMBLING CARRYFORWARD.] 11.9 Unexpended funds appropriated to the 11.10 commissioner for compulsive gambling 11.11 programs for fiscal year 1998 do not 11.12 cancel but are available for these 11.13 purposes for fiscal year 1999. 11.14 (e) Developmental Disabilities 11.15 Support Grants 11.16 -0- 54,000 11.17 (f) Medical Assistance Long-Term 11.18 Care Waivers and Home Care 11.19 (8,463,000) (12,308,000) 11.20 [JANUARY 1, 1999, PROVIDER RATE 11.21 INCREASE.] (1) Effective for services 11.22 rendered on or after January 1, 1999, 11.23 the commissioner shall increase 11.24 reimbursement or allocation rates by 11.25 two percent, and county boards shall 11.26 adjust provider contracts as needed, 11.27 for home and community-based waiver 11.28 services for persons with mental 11.29 retardation or related conditions under 11.30 Minnesota Statutes, section 256B.501; 11.31 home and community-based waiver 11.32 services for the elderly under 11.33 Minnesota Statutes, section 256B.0915; 11.34 waivered services under community 11.35 alternatives for disabled individuals 11.36 under Minnesota Statutes, section 11.37 256B.49; community alternative care 11.38 waivered services under Minnesota 11.39 Statutes, section 256B.49; traumatic 11.40 brain injury waivered services under 11.41 Minnesota Statutes, section 256B.49; 11.42 nursing services and home health 11.43 services under Minnesota Statutes, 11.44 section 256B.0625, subdivision 6a; 11.45 personal care services and nursing 11.46 supervision of personal care services 11.47 under Minnesota Statutes, section 11.48 256B.0625, subdivision 19a; private 11.49 duty nursing services under Minnesota 11.50 Statutes, section 256B.0625, 11.51 subdivision 7; day training and 11.52 habilitation services for adults with 11.53 mental retardation or related 11.54 conditions under Minnesota Statutes, 11.55 sections 252.40 to 252.46; physical 11.56 therapy services under Minnesota 11.57 Statutes, sections 256B.0625, 11.58 subdivision 8, and 256D.03, subdivision 11.59 4; occupational therapy services under 11.60 Minnesota Statutes, sections 256B.0625, 11.61 subdivision 8a, and 256D.03, 11.62 subdivision 4; speech-language therapy 11.63 services under Minnesota Statutes, 11.64 section 256D.03, subdivision 4, and 11.65 Minnesota Rules, part 9505.0390; 12.1 respiratory therapy services under 12.2 Minnesota Statutes, section 256D.03, 12.3 subdivision 4, and Minnesota Rules, 12.4 part 9505.0295; dental services under 12.5 Minnesota Statutes, sections 256B.0625, 12.6 subdivision 9, and 256D.03, subdivision 12.7 4; alternative care services under 12.8 Minnesota Statutes, section 256B.0913; 12.9 adult residential program grants under 12.10 Minnesota Rules, parts 9535.2000 to 12.11 9535.3000; adult and family community 12.12 support grants under Minnesota Rules, 12.13 parts 9535.1700 to 9535.1760; and 12.14 semi-independent living services under 12.15 Minnesota Statutes, section 252.275, 12.16 including SILS funding under county 12.17 social services grants formerly funded 12.18 under Minnesota Statutes, chapter 256I. 12.19 (2) The commissioner shall increase 12.20 prepaid medical assistance program 12.21 capitation rates as appropriate to 12.22 reflect the rate increases in paragraph 12.23 (l). 12.24 (g) Medical Assistance Long-Term 12.25 Care Facilities 12.26 (18,272,000) (18,426,000) 12.27 [ICFs/MR AND NURSING FACILITY 12.28 FLOOD-RELATED REPORTING.] For the 12.29 reporting year ending December 31, 12.30 1997, for ICFs/MR that temporarily 12.31 admitted victims of the flood of 1997, 12.32 the resident days related to the 12.33 temporary placement of persons not 12.34 formally admitted who continued to be 12.35 billed under the evacuated facility's 12.36 provider number will not be counted in 12.37 the cost report submitted to calculate 12.38 October 1, 1998, rates, and the 12.39 additional expenditures will be 12.40 considered nonallowable. 12.41 For the reporting year ending September 12.42 30, 1997, for nursing facilities that 12.43 temporarily admitted victims of the 12.44 flood of 1997, the resident days 12.45 related to the temporary placement of 12.46 persons not formally admitted who 12.47 continued to be billed under the 12.48 evacuated facility's provider number 12.49 will not be counted in the cost report 12.50 submitted to calculate July 1, 1998, 12.51 rates, and the additional expenditures 12.52 will be considered nonallowable. 12.53 [NURSING HOME MORATORIUM EXCEPTIONS.] 12.54 Base level funding for medical 12.55 assistance long-term care facilities is 12.56 increased by $255,000 in fiscal year 12.57 2000 and by $278,000 in fiscal year 12.58 2001 for the additional medical 12.59 assistance costs of the nursing home 12.60 moratorium exceptions under Minnesota 12.61 Statutes, section 144A.071, subdivision 12.62 4a, paragraphs (w) and (x). 12.63 Notwithstanding the provisions of 12.64 section 7, this paragraph shall not 12.65 expire. 13.1 (h) Alternative Care Grants 13.2 -0- 21,986,000 13.3 (i) Group Residential Housing 13.4 (8,795,000) (8,971,000) 13.5 [SERVICES TO DEAF PERSONS WITH MENTAL 13.6 ILLNESS.] Of this appropriation, 13.7 $70,000 in fiscal year 1999 is for a 13.8 grant to a nonprofit agency that 13.9 currently serves deaf and 13.10 hard-of-hearing adults with mental 13.11 illness through residential programs 13.12 and supported housing outreach 13.13 activities to increase by five percent, 13.14 retroactive to July 1, 1997, the 13.15 compensation packages of staff at the 13.16 nonprofit agency that currently 13.17 provides these services. 13.18 (j) Chemical Dependency 13.19 Entitlement Grants 13.20 -0- (7,498,000) 13.21 Subd. 9. Continuing Care and 13.22 Community Support Management 13.23 -0- 75,000 13.24 [REGION 10 COMMISSION CARRYOVER 13.25 AUTHORITY.] Any unspent portion of the 13.26 appropriation to the commissioner in 13.27 Laws 1997, chapter 203, article 1, 13.28 section 2, subdivision 9, for the 13.29 region 10 quality assurance commission 13.30 for fiscal year 1998 shall not cancel 13.31 but shall be available for the 13.32 commission for fiscal year 1999. 13.33 [STUDY OF DAY TRAINING CAPITAL NEEDS.] 13.34 (a) Of this appropriation, $25,000 in 13.35 fiscal year 1999 is from the general 13.36 fund to the commissioner to conduct a 13.37 study to: 13.38 (1) determine the extent to which day 13.39 training and habilitation programs have 13.40 unmet capital improvement needs; 13.41 (2) ascertain the degree to which these 13.42 unmet capital needs impact consumers of 13.43 day training and habilitation programs; 13.44 (3) determine the state's role and 13.45 responsibility in meeting the capital 13.46 improvement needs of day training and 13.47 habilitation programs; and 13.48 (4) examine the relationship among the 13.49 state, counties, and community 13.50 resources in meeting the capital 13.51 improvement needs of day training and 13.52 habilitation programs. 13.53 (b) The commissioner shall report to 13.54 the legislature by January 15, 1999, 13.55 the results of the study along with 13.56 recommendations for involving the 14.1 state, counties, and community 14.2 resources in collaborative initiatives 14.3 to assist in meeting the capital 14.4 improvement needs of day training and 14.5 habilitation programs. 14.6 (c) This appropriation shall not become 14.7 part of base level funding for the 14.8 2000-2001 biennium. 14.9 Subd. 10. Economic Support Grants 14.10 (9,174,000) (23,997,000) 14.11 The amounts that may be spent from this 14.12 appropriation for each purpose are as 14.13 follows: 14.14 (a) Assistance to Families Grants 14.15 -0- (20,343,000) 14.16 [FEDERAL TANF FUNDS.] Notwithstanding 14.17 any contrary provisions of Laws 1997, 14.18 chapter 203, article 1, section 2, 14.19 subdivision 12, federal TANF block 14.20 grant funds are appropriated to the 14.21 commissioner in amounts up to 14.22 $241,027,000 in fiscal year 1998 and 14.23 $294,860,000 in fiscal year 1999. 14.24 Additional federal TANF funds may be 14.25 expended but only to the extent that an 14.26 equal amount of state funds have been 14.27 transferred to the TANF reserve under 14.28 Minnesota Statutes, section 256J.03. 14.29 The commissioner may use TANF reserve 14.30 funds to meet TANF maintenance of 14.31 effort requirements and to offset 14.32 federal TANF block grants reduction. 14.33 Notwithstanding Minnesota Statutes, 14.34 section 256J.03, the commissioner shall 14.35 transfer $3,500,000 from the state TANF 14.36 reserve to the general fund for the 14.37 food stamp costs for legal noncitizens 14.38 who do not receive TANF benefits. This 14.39 paragraph is effective the day 14.40 following final enactment. 14.41 (b) General Assistance 14.42 (6,933,000) (905,000) 14.43 (c) Minnesota Supplemental Aid 14.44 (2,241,000) (2,749,000) 14.45 Subd. 11. Economic Support 14.46 Management 14.47 -0- 1,119,000 14.48 Summary by Fund 14.49 General -0- 35,000 14.50 Health Care Access -0- 1,084,000 14.51 [EBT TRANSACTION COSTS.] Retailers 14.52 electing to integrate electronic 14.53 benefit transfer (EBT) with other 14.54 commercial systems, such as credit or 15.1 debit, on the retailer's own equipment, 15.2 shall be paid two cents by the 15.3 commissioner for each food stamp 15.4 withdrawal transaction. 15.5 Sec. 3. COMMISSIONER OF HEALTH 15.6 Subdivision 1. Total 15.7 Appropriation -0- 6,874,000 15.8 Summary by Fund 15.9 General -0- 6,264,000 15.10 State Government 15.11 Special Revenue -0- 101,000 15.12 Health Care Access -0- 509,000 15.13 This appropriation is added to the 15.14 appropriation in Laws 1997, chapter 15.15 203, article 1, section 3. 15.16 The amounts that may be spent from this 15.17 appropriation for each program are 15.18 specified in the following subdivisions. 15.19 Subd. 2. Health Systems 15.20 and Special Populations -0- 3,584,000 15.21 Summary by Fund 15.22 General -0- 3,075,000 15.23 Health Care Access -0- 509,000 15.24 [FETAL ALCOHOL SYNDROME.] (a) of the 15.25 general fund appropriation, $3,000,000 15.26 is for the following: 15.27 (1) $750,000 to administer community 15.28 grants for fetal alcohol syndrome 15.29 prevention and intervention as defined 15.30 in Minnesota Statutes, section 15.31 145.9266, subdivision 4; 15.32 (2) $750,000 to expand maternal and 15.33 child service programs under Minnesota 15.34 Statutes, section 254A.17, subdivision 15.35 1; 15.36 (3) $750,000 to expand treatment 15.37 services and halfway houses for 15.38 pregnant women and women with children; 15.39 and 15.40 (4) $750,000 to develop and implement a 15.41 public awareness campaign. 15.42 (b) The commissioner shall transfer 15.43 money appropriated in paragraph (a) to 15.44 the appropriate agencies involved in 15.45 implementing fetal alcohol syndrome 15.46 initiatives. 15.47 [GRANTS TO MEDICAL CLINICS.] Of the 15.48 appropriation for fiscal year 1999 from 15.49 the health care access fund to the 15.50 commissioner, $250,000 is for grants to 15.51 medical clinics receiving federal funds 15.52 under Public Law Number 91-572, title X 16.1 of the Public Health Service Act. The 16.2 appropriation of the funds under this 16.3 paragraph must comply with the same 16.4 requirements specified for the 16.5 allocation of the grants under 16.6 Minnesota Statutes, section 145.925. 16.7 [CONSUMER ADVISORY BOARD.] Of the 16.8 appropriation for fiscal year 1999 from 16.9 the general fund to the commissioner, 16.10 $75,000 is for a grant to the consumer 16.11 advisory board to use on expenses 16.12 incurred in arranging and conducting 16.13 board duties and compensation for the 16.14 members. 16.15 Subd. 3. Health Protection -0- 3,290,000 16.16 Summary by Fund 16.17 General -0- 3,189,000 16.18 State Government 16.19 Special Revenue -0- 101,000 16.20 [RESPIRATORY DISEASE STUDY.] Of the 16.21 general fund appropriation, $250,000 is 16.22 to collect and analyze information 16.23 regarding the increased incidence of 16.24 respiratory diseases, including 16.25 mesothelioma and asbestosis, in 16.26 northeastern and central Minnesota to 16.27 determine the cause of these diseases. 16.28 None of the information released to the 16.29 commissioner will be individually 16.30 identifiable information unless prior 16.31 voluntary written consent is given by 16.32 the patient or employee, or if the 16.33 patient or employee is a minor, by the 16.34 parent or guardian of the patient or 16.35 employee. The commissioner shall also 16.36 make recommendations for the 16.37 implementation of a statewide 16.38 occupational respiratory disease 16.39 information system. The commissioner 16.40 shall submit a report on the findings 16.41 and recommendations to the legislature 16.42 by January 15, 1999. 16.43 [LEAD-SAFE HOUSING.] Of this 16.44 appropriation, $50,000 in fiscal year 16.45 1999 from the general fund is to the 16.46 commissioner to create a lead-safe 16.47 housing certification program within 16.48 the private sector. This appropriation 16.49 shall be used to recruit and train 16.50 individuals certified as independent 16.51 home inspectors and truth-in-sale-of 16.52 housing evaluators to be lead risk 16.53 assessors, and to subsidize the cost of 16.54 assessing and doing follow-up research 16.55 on 300 single family and rental units 16.56 that are demonstration cases for the 16.57 lead-safe property certification 16.58 program. 16.59 [CANCER SCREENING.] Of the general fund 16.60 appropriation, $910,000 is for 16.61 increased cancer screening and 16.62 diagnostic services for women, 16.63 particularly underserved women, and to 17.1 improve cancer screening rates for the 17.2 general population. Of this amount, at 17.3 least $700,000 is for grants and up to 17.4 $210,000 is for technical assistance, 17.5 consultation, and outreach. The grants 17.6 support local boards of health in 17.7 providing outreach and coordination and 17.8 reimburse health care providers for 17.9 screening and diagnostic tests. 17.10 [SEXUALLY TRANSMITTED DISEASE.](a) of 17.11 this appropriation, $350,000 in fiscal 17.12 year 1999 is from the general fund to 17.13 the commissioner to do the following, 17.14 in consultation with the HIV/STD 17.15 prevention task force and the 17.16 commissioner of children, families, and 17.17 learning: 17.18 (1) $150,000 to conduct a statewide 17.19 assessment of need and capacity to 17.20 prevent and treat sexually transmitted 17.21 diseases and prepare a comprehensive 17.22 plan for how to prevent and treat 17.23 sexually transmitted diseases, 17.24 including strategies for reducing 17.25 infection and for increasing access to 17.26 treatment; and 17.27 (2) $200,000 to conduct research on the 17.28 prevalence of sexually transmitted 17.29 diseases among populations at highest 17.30 risk for infection. The research may 17.31 be done in collaboration with the 17.32 University of Minnesota and nonprofit 17.33 community health clinics. 17.34 (b) This appropriation shall not become 17.35 part of the base for the 2000-2001 17.36 biennium. 17.37 [DIABETES PREVENTION.] Of this 17.38 appropriation, $75,000 in fiscal year 17.39 1999 from the general fund is to the 17.40 commissioner for statewide activities 17.41 related to general diabetes prevention, 17.42 the development and dissemination of 17.43 prevention materials to health care 17.44 providers, and for other statewide 17.45 activities related to diabetes 17.46 prevention and control for targeted 17.47 populations who are at high risk for 17.48 developing diabetes or health 17.49 complications from diabetes. 17.50 Sec. 4. HEALTH-RELATED BOARDS 17.51 Subdivision 1. Total 17.52 Appropriation 113,000 123,000 17.53 This appropriation is added to the 17.54 appropriation in Laws 1997, chapter 17.55 203, article 1, section 5. 17.56 [STATE GOVERNMENT SPECIAL REVENUE 17.57 FUND.] The appropriations in this 17.58 section are from the state government 17.59 special revenue fund. 17.60 [NO SPENDING IN EXCESS OF REVENUES.] 17.61 The commissioner of finance shall not 18.1 permit the allotment, encumbrance, or 18.2 expenditure of money appropriated in 18.3 this section in excess of the 18.4 anticipated biennial revenues or 18.5 accumulated surplus revenues from fees 18.6 collected by the boards. Neither this 18.7 provision nor Minnesota Statutes, 18.8 section 214.06, applies to transfers 18.9 from the general contingent account. 18.10 Subd. 2. Board of Medical 18.11 Practice 80,000 90,000 18.12 Subd. 3. Board of Veterinary 18.13 Medicine 33,000 33,000 18.14 Sec. 5. EMERGENCY MEDICAL 18.15 SERVICES BOARD -0- 78,000 18.16 This appropriation is added to the 18.17 appropriation in Laws 1997, chapter 18.18 203, article 1, section 6. 18.19 [EMERGENCY MEDICAL SERVICES 18.20 COMMUNICATIONS NEEDS ASSESSMENT.] (a) 18.21 Of this appropriation, $78,000 in 18.22 fiscal year 1999 is from the general 18.23 fund to the board to conduct an 18.24 emergency medical services needs 18.25 assessment for areas outside the 18.26 seven-county metropolitan area. The 18.27 assessment shall determine the current 18.28 status of and need for emergency 18.29 medical services communications 18.30 equipment. All regional emergency 18.31 medical services programs designated by 18.32 the board under Minnesota Statutes, 18.33 section 144.8093, shall cooperate in 18.34 the preparation of the assessment. 18.35 (b) The appropriation for this project 18.36 shall be distributed through the 18.37 emergency medical services system fund 18.38 under Minnesota Statutes, section 18.39 144E.50, through a request-for-proposal 18.40 process. The commissioner must select 18.41 a regional EMS program that receives at 18.42 least 20 percent of its funding from 18.43 nonstate sources to conduct the 18.44 assessment. The request for proposals 18.45 must be issued by August 1, 1998. 18.46 (c) A final report with recommendations 18.47 shall be presented to the board and the 18.48 legislature by July 1, 1999. 18.49 (d) This appropriation shall not become 18.50 part of base level funding for the 18.51 2000-2001 biennium. 18.52 Sec. 6. [CARRYOVER LIMITATION.] None 18.53 of the appropriations in this act which 18.54 are allowed to be carried forward from 18.55 fiscal year 1998 to fiscal year 1999 18.56 shall become part of the base level 18.57 funding for the 2000-2001 biennial 18.58 budget, unless specifically directed by 18.59 the legislature. 18.60 Sec. 7. [SUNSET OF UNCODIFIED 18.61 LANGUAGE.] All uncodified language 19.1 contained in this article expires on 19.2 June 30, 1999, unless a different 19.3 expiration date is explicit. 19.4 ARTICLE 2 19.5 HEALTH DEPARTMENT AND MISCELLANEOUS HEALTH PROVISIONS 19.6 Section 1. Minnesota Statutes 1997 Supplement, section 19.7 62J.685, is amended to read: 19.8 62J.685 [PRESCRIPTION DRUG PRICE DISCLOSURE.] 19.9 By January 1, 1998, and annually thereafter, a health plan 19.10 company or hospital licensed under chapter 144 must submit to 19.11 theattorney generalcommissioner of health the total amount of: 19.12 (1) aggregate purchases of prescription drugs, and (2) discount, 19.13 rebate, or other payment received during the previous calendar 19.14 year for aggregate purchases of prescription drugs, including 19.15 any fee associated with education, data collection, research, 19.16 training or market share movement received from a manufacturer 19.17 as defined under section 151.44, paragraph (c), or wholesale 19.18 drug distributor as defined under section 151.44, paragraph 19.19 (d). The identification of individual manufacturers or 19.20 wholesalers or specific drugs is not required. Theattorney19.21generalcommissioner shall make this information available to 19.22 the public through the information clearinghouse under section 19.23 62J.2930. 19.24 Sec. 2. Minnesota Statutes 1997 Supplement, section 19.25 62J.69, subdivision 1, is amended to read: 19.26 Subdivision 1. [DEFINITIONS.] For purposes of this 19.27 section, the following definitions apply: 19.28 (a) "Medical education" means the accredited clinical 19.29 training of physicians (medical students and residents), doctor 19.30 of pharmacy practitioners, doctors of chiropractic, dentists, 19.31 advanced practice nurses (clinical nurse specialist, certified 19.32 registered nurse anesthetists, nurse practitioners, and 19.33 certified nurse midwives), and physician assistants. 19.34 (b) "Clinical training" means accredited training for the 19.35 health care practitioners listed in paragraph (a) that is funded 19.36and was historically fundedin part byinpatientpatient care 19.37 revenues and that occurs inbotheither an inpatientandor 20.1 ambulatory patient caresettingstraining site. 20.2 (c) "Trainee" means students involved in an accredited 20.3 clinical training program for medical education as defined in 20.4 paragraph (a). 20.5 (d) "Eligible trainee" means a student involved in an 20.6 accredited training program for medical education as defined in 20.7 paragraph (a), which meets the definition of clinical training 20.8 in paragraph (b), who is in a training site that is located in 20.9 Minnesota and which has a medical assistance provider number. 20.10 (e) "Health care research" means approved clinical, 20.11 outcomes, and health services investigations that are funded by 20.12 patient out-of-pocket expenses or a third-party payer. 20.13(e)(f) "Commissioner" means the commissioner of health. 20.14(f)(g) "Teaching institutions" means any hospital, medical 20.15 center, clinic, or other organization that currently sponsors or 20.16 conducts accredited medical education programs or clinical 20.17 research in Minnesota. 20.18 (h) "Accredited training" means training provided by a 20.19 program that is accredited through an organization recognized by 20.20 the department of education or the health care financing 20.21 administration as the official accrediting body for that program. 20.22 (i) "Sponsoring institution" means a hospital, school, or 20.23 consortium that sponsors and maintains primary organizational 20.24 and financial responsibility for an accredited medical education 20.25 program in Minnesota and which is accountable to the accrediting 20.26 body. 20.27 Sec. 3. Minnesota Statutes 1997 Supplement, section 20.28 62J.69, subdivision 2, is amended to read: 20.29 Subd. 2. [ALLOCATION AND FUNDING FOR MEDICAL EDUCATION AND 20.30 RESEARCH.] (a) The commissioner may establish a trust fund for 20.31 the purposes of funding medical education and research 20.32 activities in the state of Minnesota. 20.33 (b) By January 1, 1997, the commissioner may appoint an 20.34 advisory committee to provide advice and oversight on the 20.35 distribution of funds from the medical education and research 20.36 trust fund. If a committee is appointed, the commissioner 21.1 shall: (1) consider the interest of all stakeholders when 21.2 selecting committee members; (2) select members that represent 21.3 both urban and rural interest; and (3) select members that 21.4 include ambulatory care as well as inpatient perspectives. The 21.5 commissioner shall appoint to the advisory committee 21.6 representatives of the following groups: medical researchers, 21.7 public and private academic medical centers, managed care 21.8 organizations, Blue Cross and Blue Shield of Minnesota, 21.9 commercial carriers, Minnesota Medical Association, Minnesota 21.10 Nurses Association, medical product manufacturers, employers, 21.11 and other relevant stakeholders, including consumers. The 21.12 advisory committee is governed by section 15.059, for membership 21.13 terms and removal of members and will sunset on June 30, 1999. 21.14 (c) Eligible applicants for funds are accredited medical 21.15 education teaching institutions, consortia, and programs 21.16 operating in Minnesota. Applications must be submitted by the 21.17 sponsoring institution on behalf of the teaching program, and 21.18 must be received by September 30 of each year for distribution 21.19 in January of the following year. An application for funds must 21.20 include the following: 21.21 (1) the official name and address of the sponsoring 21.22 institution and the official name and address of the facility or 21.23programprograms on whose behalf the institution is applying for 21.24 funding; 21.25 (2) the name, title, and business address of those persons 21.26 responsible for administering the funds; 21.27 (3)the total number, type, and specialty orientation of21.28eligible Minnesota-based trainees infor each accredited medical 21.29 education program for which funds are being sought the type and 21.30 specialty orientation of trainees in the program, the name, 21.31 address, and medical assistance provider number of each training 21.32 site used in the program, the total number of trainees at each 21.33 site, and the total number of eligible trainees at each training 21.34 site; 21.35 (4) audited clinical training costs per trainee for each 21.36 medical education program where available or estimates of 22.1 clinical training costs based on audited financial data; 22.2 (5) a description of current sources of funding for medical 22.3 education costs including a description and dollar amount of all 22.4 state and federal financial support, including Medicare direct 22.5 and indirect payments; 22.6 (6) other revenue received for the purposes of clinical 22.7 training; and 22.8 (7)a statement identifying unfunded costs; and22.9(8)other supporting information the commissioner, with 22.10 advice from the advisory committee, determines is necessary for 22.11 the equitable distribution of funds. 22.12 (d) The commissioner shall distribute medical education 22.13 funds to all qualifying applicants based on the following basic 22.14 criteria: (1) total medical education funds available; (2) 22.15 total eligible trainees in each eligible education program; and 22.16 (3) the statewide average cost per trainee, by type of trainee, 22.17 in each medical education program. Funds distributed shall not 22.18 be used to displace current funding appropriations from federal 22.19 or state sources. Funds shall be distributed to the sponsoring 22.20 institutions indicating the amount to be paid to each of the 22.21 sponsor's medical education programs based on the criteria in 22.22 this paragraph. Sponsoring institutions which receive funds 22.23 from the trust fund must distribute approved funds to the 22.24 medical education program according to the commissioner's 22.25 approval letter. Further, programs must distribute funds among 22.26 the sites of trainingbased on the percentage of total program22.27training performed at each site.as specified in the 22.28 commissioner's approval letter. Any funds not distributed as 22.29 directed by the commissioner's approval letter shall be returned 22.30 to the medical education and research trust fund within 30 days 22.31 of a notice from the commissioner. The commissioner shall 22.32 distribute returned funds to the appropriate entities in 22.33 accordance with the commissioner's approval letter. 22.34 (e) Medical education programs receiving funds from the 22.35 trust fund must submitannual cost and program reportsa medical 22.36 education and research grant verification report (GVR) through 23.1 the sponsoring institution based on criteria established by the 23.2 commissioner. If the sponsoring institution fails to submit the 23.3 GVR by the stated deadline, or to request and meet the deadline 23.4 for an extension, the sponsoring institution is required to 23.5 return the full amount of the medical education and research 23.6 trust fund grant to the medical education and research trust 23.7 fund within 30 days of a notice from the commissioner. The 23.8 commissioner shall distribute returned funds to the appropriate 23.9 entities in accordance with the commissioner's approval letter. 23.10 The reports must include: 23.11 (1) the total number of eligible trainees in the program; 23.12 (2) the programs and residencies funded, the amounts of 23.13 trust fund payments to each program, and within each program, 23.14 thepercentagedollar amount distributed to each training site; 23.15 and 23.16 (3)the average cost per trainee and a detailed breakdown23.17of the components of those costs;23.18(4) other state or federal appropriations received for the23.19purposes of clinical training;23.20(5) other revenue received for the purposes of clinical23.21training; and23.22(6)other information the commissioner, with advice from 23.23 the advisory committee, deems appropriate to evaluate the 23.24 effectiveness of the use of funds for clinical training. 23.25 The commissioner, with advice from the advisory committee, 23.26 will provide an annual summary report to the legislature on 23.27 program implementation due February 15 of each year. 23.28 (f) The commissioner is authorized to distribute funds made 23.29 available through: 23.30 (1) voluntary contributions by employers or other entities; 23.31 (2) allocations for the department of human services to 23.32 support medical education and research; and 23.33 (3) other sources as identified and deemed appropriate by 23.34 the legislature for inclusion in the trust fund. 23.35 (g) The advisory committee shall continue to study and make 23.36 recommendations on: 24.1 (1) the funding of medical research consistent with work 24.2 currently mandated by the legislature and under way at the 24.3 department of health; and 24.4 (2) the costs and benefits associated with medical 24.5 education and research. 24.6 Sec. 4. Minnesota Statutes 1997 Supplement, section 24.7 62J.69, is amended by adding a subdivision to read: 24.8 Subd. 4. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 24.9 SERVICES.] (a) The amount transferred in accordance with section 24.10 256B.69, subdivision 5c, shall be distributed to qualifying 24.11 applicants based on a distribution formula that reflects a 24.12 summation of two factors: 24.13 (1) an education factor, which is determined by the total 24.14 number of eligible trainees and the total statewide average 24.15 costs per trainee, by type of trainee, in each program; and 24.16 (2) a public program volume factor, which is determined by 24.17 the total volume of public program revenue received by each 24.18 training site as a percentage of all public program revenue 24.19 received by all training sites in the trust fund pool. 24.20 In this formula, the education factor shall be weighted at 24.21 50 percent and the public program volume factor shall be 24.22 weighted at 50 percent. 24.23 (b) Public program revenue for the above formula shall 24.24 include revenue from medical assistance, prepaid medical 24.25 assistance, general assistance medical care, and prepaid general 24.26 assistance medical care. 24.27 (c) Training sites that receive no public program revenue 24.28 shall be ineligible for payments from the prepaid medical 24.29 assistance program transfer pool. 24.30 Sec. 5. Minnesota Statutes 1997 Supplement, section 24.31 62J.75, is amended to read: 24.32 62J.75 [CONSUMER ADVISORY BOARD.] 24.33 (a) The consumer advisory board consists of 18 members 24.34 appointed in accordance with paragraph (b). All members must be 24.35 public, consumer members who: 24.36 (1) do not have and never had a material interest in either 25.1 the provision of health care services or in an activity directly 25.2 related to the provision of health care services, such as health 25.3 insurance sales or health plan administration; 25.4 (2) are not registered lobbyists; and 25.5 (3) are not currently responsible for or directly involved 25.6 in the purchasing of health insurance for a business or 25.7 organization. 25.8 (b) The governor, the speaker of the house of 25.9 representatives, and the subcommittee on committees of the 25.10 committee on rules and administration of the senate shall each 25.11 appoint two members. The Indian affairs council, the council on 25.12 affairs of Chicano/Latino people, the council on Black 25.13 Minnesotans, the council on Asian-Pacific Minnesotans, 25.14 mid-Minnesota legal assistance, and the Minnesota chamber of 25.15 commerce shall each appoint one member. The member appointed by 25.16 the Minnesota chamber of commerce must represent small business 25.17 interests. The health care campaign of Minnesota, Minnesotans 25.18 for affordable health care, and consortium for citizens with 25.19 disabilities shall each appoint two members.Members serve25.20without compensation or reimbursement for expenses.Members may 25.21 be compensated in accordance with section 15.059, subdivision 3. 25.22 (c) The board shall advise the commissioners of health and 25.23 commerce on the following: 25.24 (1) the needs of health care consumers and how to better 25.25 serve and educate the consumers on health care concerns and 25.26 recommend solutions to identified problems; and 25.27 (2) consumer protection issues in the self-insured market, 25.28 including, but not limited to, public education needs. 25.29 The board also may make recommendations to the legislature 25.30 on these issues. 25.31 (d) The board and this section expire June 30, 2001. 25.32 Sec. 6. Minnesota Statutes 1997 Supplement, section 25.33 103I.208, subdivision 2, is amended to read: 25.34 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 25.35 property owner is: 25.36 (1) for a well that is not in use under a maintenance 26.1 permit, $100 annually; 26.2 (2) for construction of a monitoring well, $120, which 26.3 includes the state core function fee; 26.4 (3) for a monitoring well that is unsealed under a 26.5 maintenance permit, $100 annually; 26.6 (4) for monitoring wells used as a leak detection device at 26.7 a single motor fuel retail outletor, a single petroleum bulk 26.8 storage site excluding tank farms, or a single agricultural 26.9 chemical facility site, the construction permit fee is $120, 26.10 which includes the state core function fee, per site regardless 26.11 of the number of wells constructed on the site, and the annual 26.12 fee for a maintenance permit for unsealed monitoring wells is 26.13 $100 per site regardless of the number of monitoring wells 26.14 located on site; 26.15 (5) for a groundwater thermal exchange device, in addition 26.16 to the notification fee for wells, $120, which includes the 26.17 state core function fee; 26.18 (6) for a vertical heat exchanger, $120; 26.19 (7) for a dewatering well that is unsealed under a 26.20 maintenance permit, $100 annually for each well, except a 26.21 dewatering project comprising more than five wells shall be 26.22 issued a single permit for $500 annually for wells recorded on 26.23 the permit; and 26.24 (8) for excavating holes for the purpose of installing 26.25 elevator shafts, $120 for each hole. 26.26 Sec. 7. Minnesota Statutes 1997 Supplement, section 26.27 144.1494, subdivision 1, is amended to read: 26.28 Subdivision 1. [CREATION OF ACCOUNT.] A rural physician 26.29 education account is established in the health care access 26.30 fund. The commissioner shall use money from the account to 26.31 establish a loan forgiveness program for medical residents 26.32 agreeing to practice in designated rural areas, as defined by 26.33 the commissioner. Appropriations made to this account are 26.34 available until expended. 26.35 Sec. 8. Minnesota Statutes 1996, section 144.701, 26.36 subdivision 1, is amended to read: 27.1 Subdivision 1. [CONSUMER INFORMATION.] The commissioner of 27.2 health shall ensure that the total costs, total 27.3 revenues, overall utilization, and total services of each 27.4 hospital and each outpatient surgical center are reported to the 27.5 public in a form understandable to consumers. 27.6 Sec. 9. Minnesota Statutes 1996, section 144.701, 27.7 subdivision 2, is amended to read: 27.8 Subd. 2. [DATA FOR POLICY MAKING.] The commissioner of 27.9 health shall compile relevant financial and accounting, 27.10 utilization, and services data concerning hospitals and 27.11 outpatient surgical centers in order to have statistical 27.12 information available for legislative policy making. 27.13 Sec. 10. Minnesota Statutes 1996, section 144.701, 27.14 subdivision 4, is amended to read: 27.15 Subd. 4. [FILING FEES.] Each report which is required to 27.16 be submitted to the commissioner of health under sections 27.17 144.695 to 144.703 and which is not submitted to a voluntary, 27.18 nonprofit reporting organization in accordance with section 27.19 144.702 shall be accompanied by a filing fee in an amount 27.20 prescribed by rule of the commissioner of health.Fees received27.21pursuant to this subdivision shall be deposited in the general27.22fund of the state treasury.Upon the withdrawal of approval of 27.23 a reporting organization, or the decision of the commissioner to 27.24 not renew a reporting organization, fees collected under section 27.25 144.702 shall be submitted to the commissionerand deposited in27.26the general fund. Fees received under this subdivision shall be 27.27 deposited in a revolving fund and are hereby appropriated to the 27.28 commissioner of health for the purposes of sections 144.695 to 27.29 144.703. The commissioner shall report the termination or 27.30 nonrenewal of the voluntary reporting organization to the chair 27.31 of the health and human services subdivision of the 27.32 appropriations committee of the house of representatives, to the 27.33 chair of the health and human services division of the finance 27.34 committee of the senate, and the commissioner of finance. 27.35 Sec. 11. Minnesota Statutes 1996, section 144.702, 27.36 subdivision 1, is amended to read: 28.1 Subdivision 1. [REPORTING THROUGH A REPORTING 28.2 ORGANIZATION.] A hospital or outpatient surgical center may 28.3 agree to submit its financial, utilization, and services reports 28.4 to a voluntary, nonprofit reporting organization whose reporting 28.5 procedures have been approved by the commissioner of health in 28.6 accordance with this section. Each report submitted under this 28.7 section shall be accompanied by a filing fee to the voluntary, 28.8 nonprofit reporting organization. 28.9 Sec. 12. Minnesota Statutes 1996, section 144.702, 28.10 subdivision 2, is amended to read: 28.11 Subd. 2. [APPROVAL OF ORGANIZATION'S REPORTING 28.12 PROCEDURES.] The commissioner of health may approve voluntary 28.13 reporting procedures consistent with written operating 28.14 requirements for the voluntary, nonprofit reporting organization 28.15 which shall be established annually by the commissioner. These 28.16 written operating requirements shall specify reports, analyses, 28.17 and other deliverables to be produced by the voluntary, 28.18 nonprofit reporting organization, and the dates on which those 28.19 deliverables must be submitted to the commissioner. These 28.20 written operating requirements shall specify deliverable dates 28.21 sufficient to enable the commissioner of health to process and 28.22 report health care cost information system data to the 28.23 commissioner of human services by August 15 of each year. The 28.24 commissioner of health shall, by rule, prescribe standards for 28.25 submission of data by hospitals and outpatient surgical centers 28.26 to the voluntary, nonprofit reporting organization or to the 28.27 commissioner. These standards shall provide for: 28.28 (a) the filing of appropriate financial, utilization, and 28.29 services information with the reporting organization; 28.30 (b) adequate analysis and verification of that financial, 28.31 utilization, and services information; and 28.32 (c) timely publication of the costs, revenues, and rates of 28.33 individual hospitals and outpatient surgical centers prior to 28.34 the effective date of any proposed rate increase. The 28.35 commissioner of health shall annually review the procedures 28.36 approved pursuant to this subdivision. 29.1 Sec. 13. Minnesota Statutes 1996, section 144.702, 29.2 subdivision 8, is amended to read: 29.3 Subd. 8. [TERMINATION OR NONRENEWAL OF REPORTING 29.4 ORGANIZATION.] The commissioner may withdraw approval of any 29.5 voluntary, nonprofit reporting organization for failure on the 29.6 part of the voluntary, nonprofit reporting organization to 29.7 comply with the written operating requirements under subdivision 29.8 2. Upon the effective date of the withdrawal, all funds 29.9 collected by the voluntary, nonprofit reporting organization 29.10 under section144.701144.702, subdivision41, but not expended 29.11 shall be deposited inthe general funda revolving fund and are 29.12 hereby appropriated to the commissioner of health for the 29.13 purposes of sections 144.695 to 144.703. 29.14 The commissioner may choose not to renew approval of a 29.15 voluntary, nonprofit reporting organization if the organization 29.16 has failed to perform its obligations satisfactorily under the 29.17 written operating requirements under subdivision 2. 29.18 Sec. 14. [144.7022] [ADMINISTRATIVE PENALTY ORDERS FOR 29.19 REPORTING ORGANIZATIONS.] 29.20 Subdivision 1. [AUTHORIZATION.] The commissioner may issue 29.21 an order to the voluntary, nonprofit reporting organization 29.22 requiring violations to be corrected and administratively assess 29.23 monetary penalties for violations of this chapter or rules, 29.24 written operating requirements, orders, stipulation agreements, 29.25 settlements, or compliance agreements adopted, enforced, or 29.26 issued by the commissioner. 29.27 Subd. 2. [CONTENTS OF ORDER.] An order assessing an 29.28 administrative penalty under this section must include: 29.29 (1) a concise statement of the facts alleged to constitute 29.30 a violation; 29.31 (2) a reference to the section of law, rule, written 29.32 operating requirement, order, stipulation agreement, settlement, 29.33 or compliance agreement that has been violated; 29.34 (3) a statement of the amount of the administrative penalty 29.35 to be imposed and the factors upon which the penalty is based; 29.36 (4) a statement of the corrective actions necessary to 30.1 correct the violation; and 30.2 (5) a statement of the right to request a hearing according 30.3 to sections 14.57 to 14.62. 30.4 Subd. 3. [CONCURRENT CORRECTIVE ORDER.] The commissioner 30.5 may issue an order assessing an administrative penalty and 30.6 requiring the violations cited in the order be corrected within 30.7 30 calendar days from the date the order is received. The 30.8 voluntary, nonprofit reporting organization that is subject to 30.9 the order shall provide to the commissioner before the 31st day 30.10 after the order was received, information demonstrating that the 30.11 violation has been corrected or that a corrective plan, 30.12 acceptable to the commissioner, has been developed. The 30.13 commissioner shall determine whether the violation has been 30.14 corrected and notify the voluntary, nonprofit reporting 30.15 organization of the commissioner's determination. 30.16 Subd. 4. [PENALTY.] If the commissioner determines that 30.17 the violation has been corrected or an acceptable corrective 30.18 plan has been developed, the penalty may be forgiven, except, 30.19 where there are repeated or serious violations, the commissioner 30.20 may issue an order with a penalty that will not be forgiven 30.21 after corrective action is taken. Unless there is a request for 30.22 review of the order under subdivision 6 before the penalty is 30.23 due, the penalty is due and payable: 30.24 (1) on the 31st calendar day after the order was received, 30.25 if the voluntary, nonprofit reporting organization fails to 30.26 provide information to the commissioner showing that the 30.27 violation has been corrected or that appropriate steps have been 30.28 taken toward correcting the violation; 30.29 (2) on the 20th day after the voluntary, nonprofit 30.30 reporting organization receives the commissioner's determination 30.31 that the information provided is not sufficient to show that 30.32 either the violation has been corrected or that appropriate 30.33 steps have been taken toward correcting the violation; or 30.34 (3) on the 31st day after the order was received where the 30.35 penalty is for repeated or serious violations and, according to 30.36 the order issued, the penalty will not be forgiven after 31.1 corrective action is taken. 31.2 All penalties due under this section are payable to the 31.3 treasurer, state of Minnesota, and shall be credited to the 31.4 general fund. 31.5 Subd. 5. [AMOUNT OF PENALTY; CONSIDERATIONS.] (a) The 31.6 maximum amount of an administrative penalty order is $5,000 for 31.7 each specific violation identified in an inspection, 31.8 investigation, or compliance review, up to an annual maximum 31.9 total for all violations of ten percent of the fees collected by 31.10 the voluntary, nonprofit reporting organization under section 31.11 144.702, subdivision 1. The annual maximum is based on a 31.12 reporting year. 31.13 (b) In determining the amount of the administrative 31.14 penalty, the commissioner shall consider the following: 31.15 (1) the willfulness of the violation; 31.16 (2) the gravity of the violation; 31.17 (3) the history of past violations; 31.18 (4) the number of violations; 31.19 (5) the economic benefit gained by the person allowing or 31.20 committing the violation; and 31.21 (6) other factors as justice may require, if the 31.22 commissioner specifically identifies the additional factors in 31.23 the commissioner's order. 31.24 (c) In determining the amount of a penalty for a violation 31.25 subsequent to an initial violation under paragraph (a), the 31.26 commissioner shall also consider: 31.27 (1) the similarity of the most recent previous violation 31.28 and the violation to be penalized; 31.29 (2) the time elapsed since the last violation; and 31.30 (3) the response of the voluntary, nonprofit reporting 31.31 organization to the most recent previous violation. 31.32 Subd. 6. [REQUEST FOR HEARING; HEARING; AND FINAL 31.33 ORDER.] A request for hearing must be in writing, delivered to 31.34 the commissioner by certified mail within 20 calendar days after 31.35 the receipt of the order, and specifically state the reasons for 31.36 seeking review of the order. The commissioner must initiate a 32.1 hearing within 30 calendar days from the date of receipt of the 32.2 written request for hearing. The hearing shall be conducted 32.3 pursuant to the contested case procedures in sections 14.57 to 32.4 14.62. No earlier than ten calendar days after and within 30 32.5 calendar days of receipt of the presiding administrative law 32.6 judge's report, the commissioner shall, based on all relevant 32.7 facts, issue a final order modifying, vacating, or making the 32.8 original order permanent. If, within 20 calendar days of 32.9 receipt of the original order, the voluntary, nonprofit 32.10 reporting organization fails to request a hearing in writing, 32.11 the order becomes the final order of the commissioner. 32.12 Subd. 7. [REVIEW OF FINAL ORDER AND PAYMENT OF 32.13 PENALTY.] Once the commissioner issues a final order, any 32.14 penalty due under that order shall be paid within 30 calendar 32.15 days after the date of the final order, unless review of the 32.16 final order is requested. The final order of the commissioner 32.17 may be appealed in the manner prescribed in sections 14.63 to 32.18 14.69. If the final order is reviewed and upheld, the penalty 32.19 shall be paid 30 calendar days after the date of the decision of 32.20 the reviewing court. Failure to request an administrative 32.21 hearing pursuant to subdivision 6 shall constitute a waiver of 32.22 the right to further agency or judicial review of the final 32.23 order. 32.24 Subd. 8. [REINSPECTIONS AND EFFECT OF NONCOMPLIANCE.] If, 32.25 upon reinspection, or in the determination of the commissioner, 32.26 it is found that any deficiency specified in the order has not 32.27 been corrected or an acceptable corrective plan has not been 32.28 developed, the voluntary, nonprofit reporting organization is in 32.29 noncompliance. The commissioner shall issue a notice of 32.30 noncompliance and may impose any additional remedy available 32.31 under this chapter. 32.32 Subd. 9. [ENFORCEMENT.] The attorney general may proceed 32.33 on behalf of the commissioner to enforce penalties that are due 32.34 and payable under this section in any manner provided by law for 32.35 the collection of debts. 32.36 Subd. 10. [TERMINATION OR NONRENEWAL OF REPORTING 33.1 ORGANIZATION.] The commissioner may withdraw or not renew 33.2 approval of any voluntary, nonprofit reporting organization for 33.3 failure on the part of the voluntary, nonprofit reporting 33.4 organization to pay penalties owed under this section. 33.5 Subd. 11. [CUMULATIVE REMEDY.] The authority of the 33.6 commissioner to issue an administrative penalty order is in 33.7 addition to other lawfully available remedies. 33.8 Subd. 12. [MEDIATION.] In addition to review under 33.9 subdivision 6, the commissioner is authorized to enter into 33.10 mediation concerning an order issued under this section if the 33.11 commissioner and the voluntary, nonprofit reporting organization 33.12 agree to mediation. 33.13 Sec. 15. Minnesota Statutes 1996, section 144A.44, 33.14 subdivision 2, is amended to read: 33.15 Subd. 2. [INTERPRETATION AND ENFORCEMENT OF RIGHTS.] These 33.16 rights are established for the benefit of persons who receive 33.17 home care services. "Home care services" means home care 33.18 services as defined in section 144A.43, subdivision 3. A home 33.19 care provider may not require a person to surrender these rights 33.20 as a condition of receiving services. A guardian or conservator 33.21 or, when there is no guardian or conservator, a designated 33.22 person, may seek to enforce these rights. This statement of 33.23 rights does not replace or diminish other rights and liberties 33.24 that may exist relative to persons receiving home care services, 33.25 persons providing home care services, or providers licensed 33.26 under Laws 1987, chapter 378. A copy of these rights must be 33.27 provided to an individual at the time home care services are 33.28 initiated. The copy shall also contain the address and phone 33.29 number of the office of health facility complaints and the 33.30 office of the ombudsman for older Minnesotans and a brief 33.31 statement describing how to file a complaint withthat office33.32 these offices. Information about how to contact the office of 33.33 the ombudsman for older Minnesotans shall be included in notices 33.34 of change in client fees and in notices from home care providers 33.35 transferring or discontinuing services. 33.36 Sec. 16. [145.926] [ABSTINENCE EDUCATION GRANT PROGRAM.] 34.1 The commissioner of health shall expend federal funds for 34.2 abstinence education programs provided under United States Code, 34.3 title 42, section 710, and state matching funds for abstinence 34.4 education programs only to an abstinence education program that 34.5 complies with the state plan that has been submitted to and 34.6 approved by the federal Department of Health and Human Services. 34.7 Sec. 17. Minnesota Statutes 1996, section 214.03, is 34.8 amended to read: 34.9 214.03 [STANDARDIZED TESTS.] 34.10 (a) All state examining and licensing boards, other than 34.11 the state board of law examiners, the state board of 34.12 professional responsibility or any other board established by 34.13 the supreme court to regulate the practice of law and judicial 34.14 functions, shall use national standardized tests for the 34.15 objective, nonpractical portion of any examination given to 34.16 prospective licensees to the extent that such national 34.17 standardized tests are appropriate, except when the subject 34.18 matter of the examination relates to the application of 34.19 Minnesota law to the profession or calling being licensed. 34.20 (b) The health-related boards may establish an account in 34.21 the special revenue fund to deposit applicant payments for 34.22 national or regional standardized tests. Money in the account 34.23 is appropriated to pay for the use of national or regional 34.24 standardized tests. 34.25 Sec. 18. Minnesota Statutes 1997 Supplement, section 34.26 214.32, subdivision 1, is amended to read: 34.27 Subdivision 1. [MANAGEMENT.] (a) A health professionals 34.28 services program committee is established, consisting of one 34.29 person appointed by each participating board, with each 34.30 participating board having one vote. The committee shall 34.31 designate one board to provide administrative management of the 34.32 program, set the program budget and the pro rata share of 34.33 program expenses to be borne by each participating board, 34.34 provide guidance on the general operation of the program, 34.35 including hiring of program personnel, and ensure that the 34.36 program's direction is in accord with its authority. No more 35.1 than half plus one of the members of the committee may be of one 35.2 gender. If the participating boards change the board designated 35.3 to provide administrative management of the program, any 35.4 appropriation remaining for the program shall transfer to the 35.5 newly designated board. The boards must inform the chairs of 35.6 the senate health and family security budget division and the 35.7 house health and human services finance division, and the 35.8 commissioner of finance of any change in administrative 35.9 management of the program and of the amount transferred to the 35.10 newly designated board. 35.11 (b) The designated board, upon recommendation of the health 35.12 professional services program committee, shall hire the program 35.13 manager and employees and pay expenses of the program from funds 35.14 appropriated for that purpose. The designated board may apply 35.15 for grants to pay program expenses and may enter into contracts 35.16 on behalf of the program to carry out the purposes of the 35.17 program. The participating boards shall enter into written 35.18 agreements with the designated board. 35.19 (c) An advisory committee is established to advise the 35.20 program committee consisting of: 35.21 (1) one member appointed by each of the following: the 35.22 Minnesota Academy of Physician Assistants, the Minnesota Dental 35.23 Association, the Minnesota Chiropractic Association, the 35.24 Minnesota Licensed Practical Nurse Association, the Minnesota 35.25 Medical Association, the Minnesota Nurses Association, and the 35.26 Minnesota Podiatric Medicine Association; 35.27 (2) one member appointed by each of the professional 35.28 associations of the other professions regulated by a 35.29 participating board not specified in clause (1); and 35.30 (3) two public members, as defined by section 214.02. 35.31 Members of the advisory committee shall be appointed for two 35.32 years and members may be reappointed. 35.33 No more than half plus one of the members of the committee 35.34 may be of one gender. 35.35 The advisory committee expires June 30, 2001. 35.36 Sec. 19. [REPORT BY THE UNIVERSITY OF MINNESOTA ACADEMIC 36.1 HEALTH CENTER.] 36.2 The University of Minnesota academic health center, after 36.3 consultation with the health care community and the medical 36.4 education and research costs advisory committee, is requested to 36.5 report to the commissioner of health and the legislative 36.6 commission on health care access by January 15, 1999, on plans 36.7 for the strategic direction and vision of the academic health 36.8 center. The report shall address plans for the ongoing 36.9 assessment of health provider workforce needs; plans for the 36.10 ongoing assessment of the educational needs of health 36.11 professionals and the implications for their education and 36.12 training programs; and plans for ongoing, meaningful input from 36.13 the health care community on health-related research and 36.14 education programs administered by the academic health center. 36.15 Sec. 20. [ADVICE AND RECOMMENDATIONS.] 36.16 The commissioners of health and commerce shall convene an 36.17 ad hoc advisory panel of selected representatives of health plan 36.18 companies, purchasers, and provider groups engaged in the 36.19 practice of health care in Minnesota, and interested 36.20 legislators. This advisory panel shall meet and assist the 36.21 commissioners in developing measures to prevent discrimination 36.22 against providers and provider groups in managed care in 36.23 Minnesota and clarify the requirements of Minnesota Statutes, 36.24 section 62Q.23, paragraph (c). Any such measures shall be 36.25 reported to the legislature prior to November 15, 1998. 36.26 Sec. 21. [EFFECTIVE DATE.] 36.27 Section 20 is effective the day following final enactment. 36.28 ARTICLE 3 36.29 LONG-TERM CARE 36.30 Section 1. Minnesota Statutes 1997 Supplement, section 36.31 144A.071, subdivision 4a, is amended to read: 36.32 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 36.33 best interest of the state to ensure that nursing homes and 36.34 boarding care homes continue to meet the physical plant 36.35 licensing and certification requirements by permitting certain 36.36 construction projects. Facilities should be maintained in 37.1 condition to satisfy the physical and emotional needs of 37.2 residents while allowing the state to maintain control over 37.3 nursing home expenditure growth. 37.4 The commissioner of health in coordination with the 37.5 commissioner of human services, may approve the renovation, 37.6 replacement, upgrading, or relocation of a nursing home or 37.7 boarding care home, under the following conditions: 37.8 (a) to license or certify beds in a new facility 37.9 constructed to replace a facility or to make repairs in an 37.10 existing facility that was destroyed or damaged after June 30, 37.11 1987, by fire, lightning, or other hazard provided: 37.12 (i) destruction was not caused by the intentional act of or 37.13 at the direction of a controlling person of the facility; 37.14 (ii) at the time the facility was destroyed or damaged the 37.15 controlling persons of the facility maintained insurance 37.16 coverage for the type of hazard that occurred in an amount that 37.17 a reasonable person would conclude was adequate; 37.18 (iii) the net proceeds from an insurance settlement for the 37.19 damages caused by the hazard are applied to the cost of the new 37.20 facility or repairs; 37.21 (iv) the new facility is constructed on the same site as 37.22 the destroyed facility or on another site subject to the 37.23 restrictions in section 144A.073, subdivision 5; 37.24 (v) the number of licensed and certified beds in the new 37.25 facility does not exceed the number of licensed and certified 37.26 beds in the destroyed facility; and 37.27 (vi) the commissioner determines that the replacement beds 37.28 are needed to prevent an inadequate supply of beds. 37.29 Project construction costs incurred for repairs authorized under 37.30 this clause shall not be considered in the dollar threshold 37.31 amount defined in subdivision 2; 37.32 (b) to license or certify beds that are moved from one 37.33 location to another within a nursing home facility, provided the 37.34 total costs of remodeling performed in conjunction with the 37.35 relocation of beds does not exceed $750,000; 37.36 (c) to license or certify beds in a project recommended for 38.1 approval under section 144A.073; 38.2 (d) to license or certify beds that are moved from an 38.3 existing state nursing home to a different state facility, 38.4 provided there is no net increase in the number of state nursing 38.5 home beds; 38.6 (e) to certify and license as nursing home beds boarding 38.7 care beds in a certified boarding care facility if the beds meet 38.8 the standards for nursing home licensure, or in a facility that 38.9 was granted an exception to the moratorium under section 38.10 144A.073, and if the cost of any remodeling of the facility does 38.11 not exceed $750,000. If boarding care beds are licensed as 38.12 nursing home beds, the number of boarding care beds in the 38.13 facility must not increase beyond the number remaining at the 38.14 time of the upgrade in licensure. The provisions contained in 38.15 section 144A.073 regarding the upgrading of the facilities do 38.16 not apply to facilities that satisfy these requirements; 38.17 (f) to license and certify up to 40 beds transferred from 38.18 an existing facility owned and operated by the Amherst H. Wilder 38.19 Foundation in the city of St. Paul to a new unit at the same 38.20 location as the existing facility that will serve persons with 38.21 Alzheimer's disease and other related disorders. The transfer 38.22 of beds may occur gradually or in stages, provided the total 38.23 number of beds transferred does not exceed 40. At the time of 38.24 licensure and certification of a bed or beds in the new unit, 38.25 the commissioner of health shall delicense and decertify the 38.26 same number of beds in the existing facility. As a condition of 38.27 receiving a license or certification under this clause, the 38.28 facility must make a written commitment to the commissioner of 38.29 human services that it will not seek to receive an increase in 38.30 its property-related payment rate as a result of the transfers 38.31 allowed under this paragraph; 38.32 (g) to license and certify nursing home beds to replace 38.33 currently licensed and certified boarding care beds which may be 38.34 located either in a remodeled or renovated boarding care or 38.35 nursing home facility or in a remodeled, renovated, newly 38.36 constructed, or replacement nursing home facility within the 39.1 identifiable complex of health care facilities in which the 39.2 currently licensed boarding care beds are presently located, 39.3 provided that the number of boarding care beds in the facility 39.4 or complex are decreased by the number to be licensed as nursing 39.5 home beds and further provided that, if the total costs of new 39.6 construction, replacement, remodeling, or renovation exceed ten 39.7 percent of the appraised value of the facility or $200,000, 39.8 whichever is less, the facility makes a written commitment to 39.9 the commissioner of human services that it will not seek to 39.10 receive an increase in its property-related payment rate by 39.11 reason of the new construction, replacement, remodeling, or 39.12 renovation. The provisions contained in section 144A.073 39.13 regarding the upgrading of facilities do not apply to facilities 39.14 that satisfy these requirements; 39.15 (h) to license as a nursing home and certify as a nursing 39.16 facility a facility that is licensed as a boarding care facility 39.17 but not certified under the medical assistance program, but only 39.18 if the commissioner of human services certifies to the 39.19 commissioner of health that licensing the facility as a nursing 39.20 home and certifying the facility as a nursing facility will 39.21 result in a net annual savings to the state general fund of 39.22 $200,000 or more; 39.23 (i) to certify, after September 30, 1992, and prior to July 39.24 1, 1993, existing nursing home beds in a facility that was 39.25 licensed and in operation prior to January 1, 1992; 39.26 (j) to license and certify new nursing home beds to replace 39.27 beds in a facilitycondemnedacquired by the Minneapolis 39.28 Community Development Agency as part ofan economic39.29 redevelopmentplanactivities in a city of the first class, 39.30 provided the new facility is located withinone milethree miles 39.31 of the site of the old facility. Operating and property costs 39.32 for the new facility must be determined and allowed 39.33 underexisting reimbursement rulessection 256B.431 or 256B.434; 39.34 (k) to license and certify up to 20 new nursing home beds 39.35 in a community-operated hospital and attached convalescent and 39.36 nursing care facility with 40 beds on April 21, 1991, that 40.1 suspended operation of the hospital in April 1986. The 40.2 commissioner of human services shall provide the facility with 40.3 the same per diem property-related payment rate for each 40.4 additional licensed and certified bed as it will receive for its 40.5 existing 40 beds; 40.6 (l) to license or certify beds in renovation, replacement, 40.7 or upgrading projects as defined in section 144A.073, 40.8 subdivision 1, so long as the cumulative total costs of the 40.9 facility's remodeling projects do not exceed $750,000; 40.10 (m) to license and certify beds that are moved from one 40.11 location to another for the purposes of converting up to five 40.12 four-bed wards to single or double occupancy rooms in a nursing 40.13 home that, as of January 1, 1993, was county-owned and had a 40.14 licensed capacity of 115 beds; 40.15 (n) to allow a facility that on April 16, 1993, was a 40.16 106-bed licensed and certified nursing facility located in 40.17 Minneapolis to layaway all of its licensed and certified nursing 40.18 home beds. These beds may be relicensed and recertified in a 40.19 newly-constructed teaching nursing home facility affiliated with 40.20 a teaching hospital upon approval by the legislature. The 40.21 proposal must be developed in consultation with the interagency 40.22 committee on long-term care planning. The beds on layaway 40.23 status shall have the same status as voluntarily delicensed and 40.24 decertified beds, except that beds on layaway status remain 40.25 subject to the surcharge in section 256.9657. This layaway 40.26 provision expires July 1, 1998; 40.27 (o) to allow a project which will be completed in 40.28 conjunction with an approved moratorium exception project for a 40.29 nursing home in southern Cass county and which is directly 40.30 related to that portion of the facility that must be repaired, 40.31 renovated, or replaced, to correct an emergency plumbing problem 40.32 for which a state correction order has been issued and which 40.33 must be corrected by August 31, 1993; 40.34 (p) to allow a facility that on April 16, 1993, was a 40.35 368-bed licensed and certified nursing facility located in 40.36 Minneapolis to layaway, upon 30 days prior written notice to the 41.1 commissioner, up to 30 of the facility's licensed and certified 41.2 beds by converting three-bed wards to single or double 41.3 occupancy. Beds on layaway status shall have the same status as 41.4 voluntarily delicensed and decertified beds except that beds on 41.5 layaway status remain subject to the surcharge in section 41.6 256.9657, remain subject to the license application and renewal 41.7 fees under section 144A.07 and shall be subject to a $100 per 41.8 bed reactivation fee. In addition, at any time within three 41.9 years of the effective date of the layaway, the beds on layaway 41.10 status may be: 41.11 (1) relicensed and recertified upon relocation and 41.12 reactivation of some or all of the beds to an existing licensed 41.13 and certified facility or facilities located in Pine River, 41.14 Brainerd, or International Falls; provided that the total 41.15 project construction costs related to the relocation of beds 41.16 from layaway status for any facility receiving relocated beds 41.17 may not exceed the dollar threshold provided in subdivision 2 41.18 unless the construction project has been approved through the 41.19 moratorium exception process under section 144A.073; 41.20 (2) relicensed and recertified, upon reactivation of some 41.21 or all of the beds within the facility which placed the beds in 41.22 layaway status, if the commissioner has determined a need for 41.23 the reactivation of the beds on layaway status. 41.24 The property-related payment rate of a facility placing 41.25 beds on layaway status must be adjusted by the incremental 41.26 change in its rental per diem after recalculating the rental per 41.27 diem as provided in section 256B.431, subdivision 3a, paragraph 41.28 (d). The property-related payment rate for a facility 41.29 relicensing and recertifying beds from layaway status must be 41.30 adjusted by the incremental change in its rental per diem after 41.31 recalculating its rental per diem using the number of beds after 41.32 the relicensing to establish the facility's capacity day 41.33 divisor, which shall be effective the first day of the month 41.34 following the month in which the relicensing and recertification 41.35 became effective. Any beds remaining on layaway status more 41.36 than three years after the date the layaway status became 42.1 effective must be removed from layaway status and immediately 42.2 delicensed and decertified; 42.3 (q) to license and certify beds in a renovation and 42.4 remodeling project to convert 12 four-bed wards into 24 two-bed 42.5 rooms, expand space, and add improvements in a nursing home 42.6 that, as of January 1, 1994, met the following conditions: the 42.7 nursing home was located in Ramsey county; had a licensed 42.8 capacity of 154 beds; and had been ranked among the top 15 42.9 applicants by the 1993 moratorium exceptions advisory review 42.10 panel. The total project construction cost estimate for this 42.11 project must not exceed the cost estimate submitted in 42.12 connection with the 1993 moratorium exception process; 42.13 (r) to license and certify up to 117 beds that are 42.14 relocated from a licensed and certified 138-bed nursing facility 42.15 located in St. Paul to a hospital with 130 licensed hospital 42.16 beds located in South St. Paul, provided that the nursing 42.17 facility and hospital are owned by the same or a related 42.18 organization and that prior to the date the relocation is 42.19 completed the hospital ceases operation of its inpatient 42.20 hospital services at that hospital. After relocation, the 42.21 nursing facility's status under section 256B.431, subdivision 42.22 2j, shall be the same as it was prior to relocation. The 42.23 nursing facility's property-related payment rate resulting from 42.24 the project authorized in this paragraph shall become effective 42.25 no earlier than April 1, 1996. For purposes of calculating the 42.26 incremental change in the facility's rental per diem resulting 42.27 from this project, the allowable appraised value of the nursing 42.28 facility portion of the existing health care facility physical 42.29 plant prior to the renovation and relocation may not exceed 42.30 $2,490,000; 42.31 (s) to license and certify two beds in a facility to 42.32 replace beds that were voluntarily delicensed and decertified on 42.33 June 28, 1991; 42.34 (t) to allow 16 licensed and certified beds located on July 42.35 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 42.36 facility in Minneapolis, notwithstanding the licensure and 43.1 certification after July 1, 1995, of the Minneapolis facility as 43.2 a 147-bed nursing home facility after completion of a 43.3 construction project approved in 1993 under section 144A.073, to 43.4 be laid away upon 30 days' prior written notice to the 43.5 commissioner. Beds on layaway status shall have the same status 43.6 as voluntarily delicensed or decertified beds except that they 43.7 shall remain subject to the surcharge in section 256.9657. The 43.8 16 beds on layaway status may be relicensed as nursing home beds 43.9 and recertified at any time within five years of the effective 43.10 date of the layaway upon relocation of some or all of the beds 43.11 to a licensed and certified facility located in Watertown, 43.12 provided that the total project construction costs related to 43.13 the relocation of beds from layaway status for the Watertown 43.14 facility may not exceed the dollar threshold provided in 43.15 subdivision 2 unless the construction project has been approved 43.16 through the moratorium exception process under section 144A.073. 43.17 The property-related payment rate of the facility placing 43.18 beds on layaway status must be adjusted by the incremental 43.19 change in its rental per diem after recalculating the rental per 43.20 diem as provided in section 256B.431, subdivision 3a, paragraph 43.21 (d). The property-related payment rate for the facility 43.22 relicensing and recertifying beds from layaway status must be 43.23 adjusted by the incremental change in its rental per diem after 43.24 recalculating its rental per diem using the number of beds after 43.25 the relicensing to establish the facility's capacity day 43.26 divisor, which shall be effective the first day of the month 43.27 following the month in which the relicensing and recertification 43.28 became effective. Any beds remaining on layaway status more 43.29 than five years after the date the layaway status became 43.30 effective must be removed from layaway status and immediately 43.31 delicensed and decertified; 43.32 (u) to license and certify beds that are moved within an 43.33 existing area of a facility or to a newly constructed addition 43.34 which is built for the purpose of eliminating three- and 43.35 four-bed rooms and adding space for dining, lounge areas, 43.36 bathing rooms, and ancillary service areas in a nursing home 44.1 that, as of January 1, 1995, was located in Fridley and had a 44.2 licensed capacity of 129 beds; 44.3 (v) to relocate 36 beds in Crow Wing county and four beds 44.4 from Hennepin county to a 160-bed facility in Crow Wing county, 44.5 provided all the affected beds are under common ownership; 44.6 (w) to license and certify a total replacement project of 44.7 up to 49 beds located in Norman county that are relocated from a 44.8 nursing home destroyed by flood and whose residents were 44.9 relocated to other nursing homes. The operating cost payment 44.10 rates for the new nursing facility shall be determined based on 44.11 the interim and settle-up payment provisions of Minnesota Rules, 44.12 part 9549.0057, and the reimbursement provisions of section 44.13 256B.431, except that subdivision 26, paragraphs (a) and (b), 44.14 shall not apply until the second rate year after the settle-up 44.15 cost report is filed. Property-related reimbursement rates 44.16 shall be determined under section 256B.431, taking into account 44.17 any federal or state flood-related loans or grants provided to 44.18 the facility; 44.19 (x) to license and certify a total replacement project of 44.20 up to 129 beds located in Polk county that are relocated from a 44.21 nursing home destroyed by flood and whose residents were 44.22 relocated to other nursing homes. The operating cost payment 44.23 rates for the new nursing facility shall be determined based on 44.24 the interim and settle-up payment provisions of Minnesota Rules, 44.25 part 9549.0057, and the reimbursement provisions of section 44.26 256B.431, except that subdivision 26, paragraphs (a) and (b), 44.27 shall not apply until the second rate year after the settle-up 44.28 cost report is filed. Property-related reimbursement rates 44.29 shall be determined under section 256B.431, taking into account 44.30 any federal or state flood-related loans or grants provided to 44.31 the facility;or44.32 (y) to license and certify beds in a renovation and 44.33 remodeling project to convert 13 three-bed wards into 13 two-bed 44.34 rooms and 13 single-bed rooms, expand space, and add 44.35 improvements in a nursing home that, as of January 1, 1994, met 44.36 the following conditions: the nursing home was located in 45.1 Ramsey county, was not owned by a hospital corporation, had a 45.2 licensed capacity of 64 beds, and had been ranked among the top 45.3 15 applicants by the 1993 moratorium exceptions advisory review 45.4 panel. The total project construction cost estimate for this 45.5 project must not exceed the cost estimate submitted in 45.6 connection with the 1993 moratorium exception process.; or 45.7 (z) to allow the commissioner of human services to license 45.8 an additional 36 beds to provide residential services for the 45.9 physically handicapped under Minnesota Rules, parts 9570.2000 to 45.10 9570.3400, in a 198-bed nursing home located in Red Wing, and to 45.11 allow the commissioner of health to license and certify nursing 45.12 home beds to replace a 74-bed nursing home in Waite Park 45.13 operated under common ownership with the Red Wing facility, 45.14 provided that the new facility is located within five miles of 45.15 the existing site in Waite Park. The commissioner of health may 45.16 license and certify an additional 20 beds at the new site 45.17 provided that the licensed capacity at the Red Wing site is 45.18 decreased by at least 30 beds. 45.19 Sec. 2. Minnesota Statutes 1996, section 144A.09, 45.20 subdivision 1, is amended to read: 45.21 Subdivision 1. [SPIRITUAL MEANS FOR HEALING.]No rule45.22establishedSections 144A.04, subdivision 5, and 144A.18 to 45.23 144A.27, and rules adopted under sections 144A.01 to 144A.16 45.24 other than a rule relating to sanitation and safety of premises, 45.25 to cleanliness of operation, or to physical equipmentshalldo 45.26 not apply to a nursing home conducted by and for the adherents 45.27 of any recognized church or religious denomination for the 45.28 purpose of providing care and treatment for those who select and 45.29 depend upon spiritual means through prayer alone, in lieu of 45.30 medical care, for healing. 45.31 Sec. 3. Minnesota Statutes 1997 Supplement, section 45.32 256B.431, subdivision 3f, is amended to read: 45.33 Subd. 3f. [PROPERTY COSTS AFTER JULY 1, 1988.] (a) 45.34 [INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 45.35 1988, the replacement-cost-new per bed limit must be $32,571 per 45.36 licensed bed in multiple bedrooms and $48,857 per licensed bed 46.1 in a single bedroom. For the rate year beginning July 1, 1989, 46.2 the replacement-cost-new per bed limit for a single bedroom must 46.3 be $49,907 adjusted according to Minnesota Rules, part 46.4 9549.0060, subpart 4, item A, subitem (1). Beginning January 1, 46.5 1990, the replacement-cost-new per bed limits must be adjusted 46.6 annually as specified in Minnesota Rules, part 9549.0060, 46.7 subpart 4, item A, subitem (1). Beginning January 1, 1991, the 46.8 replacement-cost-new per bed limits will be adjusted annually as 46.9 specified in Minnesota Rules, part 9549.0060, subpart 4, item A, 46.10 subitem (1), except that the index utilized will be the Bureau 46.11 of the Census: Composite fixed-weighted price index as 46.12 published in the C30 Report, Value of New Construction Put in 46.13 Place. 46.14 (b) [RENTAL FACTOR.] For the rate year beginning July 1, 46.15 1988, the commissioner shall increase the rental factor as 46.16 established in Minnesota Rules, part 9549.0060, subpart 8, item 46.17 A, by 6.2 percent rounded to the nearest 100th percent for the 46.18 purpose of reimbursing nursing facilities for soft costs and 46.19 entrepreneurial profits not included in the cost valuation 46.20 services used by the state's contracted appraisers. For rate 46.21 years beginning on or after July 1, 1989, the rental factor is 46.22 the amount determined under this paragraph for the rate year 46.23 beginning July 1, 1988. 46.24 (c) [OCCUPANCY FACTOR.] For rate years beginning on or 46.25 after July 1, 1988, in order to determine property-related 46.26 payment rates under Minnesota Rules, part 9549.0060, for all 46.27 nursing facilities except those whose average length of stay in 46.28 a skilled level of care within a nursing facility is 180 days or 46.29 less, the commissioner shall use 95 percent of capacity days. 46.30 For a nursing facility whose average length of stay in a skilled 46.31 level of care within a nursing facility is 180 days or less, the 46.32 commissioner shall use the greater of resident days or 80 46.33 percent of capacity days but in no event shall the divisor 46.34 exceed 95 percent of capacity days. 46.35 (d) [EQUIPMENT ALLOWANCE.] For rate years beginning on 46.36 July 1, 1988, and July 1, 1989, the commissioner shall add ten 47.1 cents per resident per day to each nursing facility's 47.2 property-related payment rate. The ten-cent property-related 47.3 payment rate increase is not cumulative from rate year to rate 47.4 year. For the rate year beginning July 1, 1990, the 47.5 commissioner shall increase each nursing facility's equipment 47.6 allowance as established in Minnesota Rules, part 9549.0060, 47.7 subpart 10, by ten cents per resident per day. For rate years 47.8 beginning on or after July 1, 1991, the adjusted equipment 47.9 allowance must be adjusted annually for inflation as in 47.10 Minnesota Rules, part 9549.0060, subpart 10, item E. For the 47.11 rate period beginning October 1, 1992, the equipment allowance 47.12 for each nursing facility shall be increased by 28 percent. For 47.13 rate years beginning after June 30, 1993, the allowance must be 47.14 adjusted annually for inflation. 47.15 (e) [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND 47.16 INTEREST EXPENSE.] For rate years beginning on or after July 1, 47.17 1990, Minnesota Rules, part 9549.0060, subpart 5, item E, shall 47.18 not apply to outstanding related organization debt incurred 47.19 prior to May 23, 1983, provided that the debt was an allowable 47.20 debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the 47.21 debt is subject to repayment through annual principal payments, 47.22 and the nursing facility demonstrates to the commissioner's 47.23 satisfaction that the interest rate on the debt was less than 47.24 market interest rates for similar arms-length transactions at 47.25 the time the debt was incurred. If the debt was incurred due to 47.26 a sale between family members, the nursing facility must also 47.27 demonstrate that the seller no longer participates in the 47.28 management or operation of the nursing facility. Debts meeting 47.29 the conditions of this paragraph are subject to all other 47.30 provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. 47.31 (f) [BUILDING CAPITAL ALLOWANCE FOR NURSING FACILITIES 47.32 WITH OPERATING LEASES.] For rate years beginning on or after 47.33 July 1, 1990, a nursing facility with operating lease costs 47.34 incurred for the nursing facility's buildings shall receive its 47.35 building capital allowance computed in accordance with Minnesota 47.36 Rules, part 9549.0060, subpart 8. If an operating lease 48.1 provides that the lessee's rent is adjusted to recognize 48.2 improvements made by the lessor and related debt, the costs for 48.3 capital improvements and related debt shall be allowed in the 48.4 computation of the lessee's building capital allowance, provided 48.5 that reimbursement for these costs under an operating lease 48.6 shall not exceed the rate otherwise paid. 48.7 Sec. 4. Minnesota Statutes 1996, section 256B.431, 48.8 subdivision 4, is amended to read: 48.9 Subd. 4. [SPECIAL RATES.] (a) For the rate years beginning 48.10 July 1, 1983, and July 1, 1984, a newly constructed nursing 48.11 facility or one with a capacity increase of 50 percent or more 48.12 may, upon written application to the commissioner, receive an 48.13 interim payment rate for reimbursement for property-related 48.14 costs calculated pursuant to the statutes and rules in effect on 48.15 May 1, 1983, and for operating costs negotiated by the 48.16 commissioner based upon the 60th percentile established for the 48.17 appropriate group under subdivision 2a, to be effective from the 48.18 first day a medical assistance recipient resides in the facility 48.19 or for the added beds. For newly constructed nursing facilities 48.20 which are not included in the calculation of the 60th percentile 48.21 for any group, subdivision 2f, the commissioner shall establish 48.22 by rule procedures for determining interim operating cost 48.23 payment rates and interim property-related cost payment rates. 48.24 The interim payment rate shall not be in effect for more than 17 48.25 months. The commissioner shall establish, by emergency and 48.26 permanent rules, procedures for determining the interim rate and 48.27 for making a retroactive cost settle-up after the first year of 48.28 operation; the cost settled operating cost per diem shall not 48.29 exceed 110 percent of the 60th percentile established for the 48.30 appropriate group. Until procedures determining operating cost 48.31 payment rates according to mix of resident needs are 48.32 established, the commissioner shall establish by rule procedures 48.33 for determining payment rates for nursing facilities which 48.34 provide care under a lesser care level than the level for which 48.35 the nursing facility is certified. 48.36 (b) For the rate years beginning on or after July 1, 1985, 49.1 a newly constructed nursing facility or one with a capacity 49.2 increase of 50 percent or more may, upon written application to 49.3 the commissioner, receive an interim payment rate for 49.4 reimbursement for property related costs, operating costs, and 49.5 real estate taxes and special assessments calculated under rules 49.6 promulgated by the commissioner. 49.7(c) For rate years beginning on or after July 1, 1983, the49.8commissioner may exclude from a provision of 12 MCAR S 2.050 any49.9facility that is licensed by the commissioner of health only as49.10a boarding care home, certified by the commissioner of health as49.11an intermediate care facility, is licensed by the commissioner49.12of human services under Minnesota Rules, parts 9520.0500 to49.139520.0690, and has less than five percent of its licensed49.14boarding care capacity reimbursed by the medical assistance49.15program. Until a permanent rule to establish the payment rates49.16for facilities meeting these criteria is promulgated, the49.17commissioner shall establish the medical assistance payment rate49.18as follows:49.19(1) The desk audited payment rate in effect on June 30,49.201983, remains in effect until the end of the facility's fiscal49.21year. The commissioner shall not allow any amendments to the49.22cost report on which this desk audited payment rate is based.49.23(2) For each fiscal year beginning between July 1, 1983,49.24and June 30, 1985, the facility's payment rate shall be49.25established by increasing the desk audited operating cost49.26payment rate determined in clause (1) at an annual rate of five49.27percent.49.28(3) For fiscal years beginning on or after July 1, 1985,49.29but before January 1, 1988, the facility's payment rate shall be49.30established by increasing the facility's payment rate in the49.31facility's prior fiscal year by the increase indicated by the49.32consumer price index for Minneapolis and St. Paul.49.33(4) For the fiscal year beginning on January 1, 1988, the49.34facility's payment rate must be established using the following49.35method: The commissioner shall divide the real estate taxes and49.36special assessments payable as stated in the facility's current50.1property tax statement by actual resident days to compute a real50.2estate tax and special assessment per diem. Next, the prior50.3year's payment rate must be adjusted by the higher of (1) the50.4percentage change in the consumer price index (CPI-U U.S. city50.5average) as published by the Bureau of Labor Statistics between50.6the previous two Septembers, new series index (1967-100), or (2)50.72.5 percent, to determine an adjusted payment rate. The50.8facility's payment rate is the adjusted prior year's payment50.9rate plus the real estate tax and special assessment per diem.50.10(5) For fiscal years beginning on or after January 1, 1989,50.11the facility's payment rate must be established using the50.12following method: The commissioner shall divide the real estate50.13taxes and special assessments payable as stated in the50.14facility's current property tax statement by actual resident50.15days to compute a real estate tax and special assessment per50.16diem. Next, the prior year's payment rate less the real estate50.17tax and special assessment per diem must be adjusted by the50.18higher of (1) the percentage change in the consumer price index50.19(CPI-U U.S. city average) as published by the Bureau of Labor50.20Statistics between the previous two Septembers, new series index50.21(1967-100), or (2) 2.5 percent, to determine an adjusted payment50.22rate. The facility's payment rate is the adjusted payment rate50.23plus the real estate tax and special assessment per diem.50.24(6) For the purpose of establishing payment rates under50.25this paragraph, the facility's rate and reporting years coincide50.26with the facility's fiscal year.50.27(d) A facility that meets the criteria of paragraph (c)50.28shall submit annual cost reports on forms prescribed by the50.29commissioner.50.30(e)(c) For the rate year beginning July 1, 1985, each 50.31 nursing facility total payment rate must be effective two 50.32 calendar months from the first day of the month after the 50.33 commissioner issues the rate notice to the nursing facility. 50.34 From July 1, 1985, until the total payment rate becomes 50.35 effective, the commissioner shall make payments to each nursing 50.36 facility at a temporary rate that is the prior rate year's 51.1 operating cost payment rate increased by 2.6 percent plus the 51.2 prior rate year's property-related payment rate and the prior 51.3 rate year's real estate taxes and special assessments payment 51.4 rate. The commissioner shall retroactively adjust the 51.5 property-related payment rate and the real estate taxes and 51.6 special assessments payment rate to July 1, 1985, but must not 51.7 retroactively adjust the operating cost payment rate. 51.8(f)(d) For the purposes of Minnesota Rules, part 51.9 9549.0060, subpart 13, item F, the following types of 51.10 transactions shall not be considered a sale or reorganization of 51.11 a provider entity: 51.12 (1) the sale or transfer of a nursing facility upon death 51.13 of an owner; 51.14 (2) the sale or transfer of a nursing facility due to 51.15 serious illness or disability of an owner as defined under the 51.16 social security act; 51.17 (3) the sale or transfer of the nursing facility upon 51.18 retirement of an owner at 62 years of age or older; 51.19 (4) any transaction in which a partner, owner, or 51.20 shareholder acquires an interest or share of another partner, 51.21 owner, or shareholder in a nursing facility business provided 51.22 the acquiring partner, owner, or shareholder has less than 50 51.23 percent ownership after the acquisition; 51.24 (5) a sale and leaseback to the same licensee which does 51.25 not constitute a change in facility license; 51.26 (6) a transfer of an interest to a trust; 51.27 (7) gifts or other transfers for no consideration; 51.28 (8) a merger of two or more related organizations; 51.29 (9) a transfer of interest in a facility held in 51.30 receivership; 51.31 (10) a change in the legal form of doing business other 51.32 than a publicly held organization which becomes privately held 51.33 or vice versa; 51.34 (11) the addition of a new partner, owner, or shareholder 51.35 who owns less than 20 percent of the nursing facility or the 51.36 issuance of stock; or 52.1 (12) an involuntary transfer including foreclosure, 52.2 bankruptcy, or assignment for the benefit of creditors. 52.3 Any increase in allowable debt or allowable interest 52.4 expense or other cost incurred as a result of the foregoing 52.5 transactions shall be a nonallowable cost for purposes of 52.6 reimbursement under Minnesota Rules, parts 9549.0010 to 52.7 9549.0080. 52.8 Sec. 5. Minnesota Statutes 1996, section 256B.431, 52.9 subdivision 11, is amended to read: 52.10 Subd. 11. [SPECIAL PROPERTY RATE SETTING PROCEDURES FOR 52.11 CERTAIN NURSING FACILITIES.] (a) Notwithstanding Minnesota 52.12 Rules, part 9549.0060, subpart 13, item H, to the contrary, for 52.13 the rate year beginning July 1, 1990, a nursing facility leased 52.14 prior to January 1, 1986, and currently subject to adverse 52.15 licensure action under section 144A.04, subdivision 4, paragraph 52.16 (a), or section 144A.11, subdivision 2, and whose ownership 52.17 changes prior to July 1, 1990, shall be allowed a 52.18 property-related payment equal to the lesser of its current 52.19 lease obligation divided by its capacity days as determined in 52.20 Minnesota Rules, part 9549.0060, subpart 11, as modified by 52.21 subdivision 3f, paragraph (c), or the frozen property-related 52.22 payment rate in effect for the rate year beginning July 1, 52.23 1989. For rate years beginning on or after July 1, 1991, the 52.24 property-related payment rate shall be its rental rate computed 52.25 using the previous owner's allowable principal and interest 52.26 expense as allowed by the department prior to that prior owner's 52.27 sale and lease-back transaction of December 1985. 52.28 (b) Notwithstanding other provisions of applicable law, a 52.29 nursing facility licensed for 122 beds on January 1, 1998, and 52.30 located in Columbia Heights shall have its property-related 52.31 payment rate set under this subdivision. The commissioner shall 52.32 make a rate adjustment by adding $2.41 to the facility's July 1, 52.33 1997, property-related payment rate. The adjusted 52.34 property-related payment rate shall be effective for rate years 52.35 beginning on or after July 1, 1998. The adjustment in this 52.36 paragraph shall remain in effect as long as the facility's rates 53.1 are set under this section. If the facility participates in the 53.2 alternative payment system under section 256B.434, the 53.3 adjustment in this paragraph shall be included in the facility's 53.4 contract payment rate. If historical rates or property costs 53.5 recognized under this section become the basis for future 53.6 medical assistance payments to the facility under a managed 53.7 care, capitation, or other alternative payment system, the 53.8 adjustment in this paragraph shall be included in the 53.9 computation of the facility's payments. 53.10 Sec. 6. Minnesota Statutes 1996, section 256B.431, 53.11 subdivision 22, is amended to read: 53.12 Subd. 22. [CHANGES TO NURSING FACILITY REIMBURSEMENT.] The 53.13 nursing facility reimbursement changes in paragraphs (a) to (e) 53.14 apply to Minnesota Rules, parts 9549.0010 to 9549.0080, and this 53.15 section, and are effective for rate years beginning on or after 53.16 July 1, 1993, unless otherwise indicated. 53.17 (a) In addition to the approved pension or profit sharing 53.18 plans allowed by the reimbursement rule, the commissioner shall 53.19 allow those plans specified in Internal Revenue Code, sections 53.20 403(b) and 408(k). 53.21 (b) The commissioner shall allow as workers' compensation 53.22 insurance costs under section 256B.421, subdivision 14, the 53.23 costs of workers' compensation coverage obtained under the 53.24 following conditions: 53.25 (1) a plan approved by the commissioner of commerce as a 53.26 Minnesota group or individual self-insurance plan as provided in 53.27 section 79A.03; 53.28 (2) a plan in which: 53.29 (i) the nursing facility, directly or indirectly, purchases 53.30 workers' compensation coverage in compliance with section 53.31 176.181, subdivision 2, from an authorized insurance carrier; 53.32 (ii) a related organization to the nursing facility 53.33 reinsures the workers' compensation coverage purchased, directly 53.34 or indirectly, by the nursing facility; and 53.35 (iii) all of the conditions in clause (4) are met; 53.36 (3) a plan in which: 54.1 (i) the nursing facility, directly or indirectly, purchases 54.2 workers' compensation coverage in compliance with section 54.3 176.181, subdivision 2, from an authorized insurance carrier; 54.4 (ii) the insurance premium is calculated retrospectively, 54.5 including a maximum premium limit, and paid using the paid loss 54.6 retro method; and 54.7 (iii) all of the conditions in clause (4) are met; 54.8 (4) additional conditions are: 54.9 (i) the costs of the plan are allowable under the federal 54.10 Medicare program; 54.11 (ii) the reserves for the plan are maintained in an account 54.12 controlled and administered by a person which is not a related 54.13 organization to the nursing facility; 54.14 (iii) the reserves for the plan cannot be used, directly or 54.15 indirectly, as collateral for debts incurred or other 54.16 obligations of the nursing facility or related organizations to 54.17 the nursing facility; 54.18 (iv) if the plan provides workers' compensation coverage 54.19 for non-Minnesota nursing facilities, the plan's cost 54.20 methodology must be consistent among all nursing facilities 54.21 covered by the plan, and if reasonable, is allowed 54.22 notwithstanding any reimbursement laws regarding cost allocation 54.23 to the contrary; 54.24 (v) central, affiliated, corporate, or nursing facility 54.25 costs related to their administration of the plan are costs 54.26 which must remain in the nursing facility's administrative cost 54.27 category and must not be allocated to other cost categories;and54.28 (vi) required security deposits, whether in the form of 54.29 cash, investments, securities, assets, letters of credit, or in 54.30 any other form are not allowable costs for purposes of 54.31 establishing the facilities payment rate.; and 54.32 (vii) for rate years beginning on or after July 1, 1998, a 54.33 group of nursing facilities related by common ownership that 54.34 self-insures workers' compensation may allocate its directly 54.35 identified costs of self-insuring its Minnesota nursing facility 54.36 workers among those nursing facilities in the group that are 55.1 reimbursed under this section or section 256B.434. The method 55.2 of cost allocation shall be based on each nursing facility's 55.3 total allowable salaries and wages to that of the nursing 55.4 facility group's total allowable salaries and wages, then 55.5 similarly allocated within each nursing facility's operating 55.6 cost categories. The costs associated with the administration 55.7 of the group's self-insurance plan must remain classified in the 55.8 nursing facility's administrative cost category. A written 55.9 request of the nursing facility group's election to use this 55.10 alternate method of allocation of self-insurance costs must be 55.11 received by the commissioner no later than May 1, 1998, to take 55.12 effect July 1, 1998, or no later than December 31 of any year to 55.13 take effect the following rate year, or such costs shall 55.14 continue to be allocated under the existing cost allocation 55.15 methods. Once a nursing facility group elects this method of 55.16 cost allocation for its workers' compensation self-insurance 55.17 costs, it shall remain in effect until such time as the group no 55.18 longer self-insures these costs; 55.19 (5) any costs allowed pursuant to clauses (1) to (3) are 55.20 subject to the following requirements: 55.21 (i) if the nursing facility is sold or otherwise ceases 55.22 operations, the plan's reserves must be subject to an 55.23 actuarially based settle-up after 36 months from the date of 55.24 sale or the date on which operations ceased. The facility's 55.25 medical assistance portion of the total excess plan reserves 55.26 must be paid to the state within 30 days following the date on 55.27 which excess plan reserves are determined; 55.28 (ii) any distribution of excess plan reserves made to or 55.29 withdrawals made by the nursing facility or a related 55.30 organization are applicable credits and must be used to reduce 55.31 the nursing facility's workers' compensation insurance costs in 55.32 the reporting period in which a distribution or withdrawal is 55.33 received; 55.34 (iii) if reimbursement for the plan is sought under the 55.35 federal Medicare program, and is audited pursuant to the 55.36 Medicare program, the nursing facility must provide a copy of 56.1 Medicare's final audit report, including attachments and 56.2 exhibits, to the commissioner within 30 days of receipt by the 56.3 nursing facility or any related organization. The commissioner 56.4 shall implement the audit findings associated with the plan upon 56.5 receipt of Medicare's final audit report. The department's 56.6 authority to implement the audit findings is independent of its 56.7 authority to conduct a field audit. 56.8 (c) In the determination of incremental increases in the 56.9 nursing facility's rental rate as required in subdivisions 14 to 56.10 21, except for a refinancing permitted under subdivision 19, the 56.11 commissioner must adjust the nursing facility's property-related 56.12 payment rate for both incremental increases and decreases in 56.13 recomputations of its rental rate; 56.14 (d) A nursing facility's administrative cost limitation 56.15 must be modified as follows: 56.16 (1) if the nursing facility's licensed beds exceed 195 56.17 licensed beds, the general and administrative cost category 56.18 limitation shall be 13 percent; 56.19 (2) if the nursing facility's licensed beds are more than 56.20 150 licensed beds, but less than 196 licensed beds, the general 56.21 and administrative cost category limitation shall be 14 percent; 56.22 or 56.23 (3) if the nursing facility's licensed beds is less than 56.24 151 licensed beds, the general and administrative cost category 56.25 limitation shall remain at 15 percent. 56.26 (e) The care related operating rate shall be increased by 56.27 eight cents to reimburse facilities for unfunded federal 56.28 mandates, including costs related to hepatitis B vaccinations. 56.29 (f) For rate years beginning on or after July 1, 1998, a 56.30 group of nursing facilities related by common ownership that 56.31 self-insures group health, dental, or life insurance may 56.32 allocate its directly identified costs of self-insuring its 56.33 Minnesota nursing facility workers among those nursing 56.34 facilities in the group that are reimbursed under this section 56.35 or section 256B.434. The method of cost allocation shall be 56.36 based on each nursing facility's total allowable salaries and 57.1 wages to that of the nursing facility group's total allowable 57.2 salaries and wages, then similarly allocated within each nursing 57.3 facility's operating cost categories. The costs associated with 57.4 the administration of the group's self-insurance plan must 57.5 remain classified in the nursing facility's administrative cost 57.6 category. A written request of the nursing facility group's 57.7 election to use this alternate method of allocation of 57.8 self-insurance costs must be received by the commissioner no 57.9 later than May 1, 1998, to take effect July 1, 1998, or no later 57.10 than December 31 of any year to take effect the following rate 57.11 year, or those self-insurance costs shall continue to be 57.12 allocated under the existing cost allocation methods. Once a 57.13 nursing facility group elects this method of cost allocation for 57.14 its group health, dental, or life insurance self-insurance 57.15 costs, it shall remain in effect until such time as the group no 57.16 longer self-insures these costs. 57.17 Sec. 7. Minnesota Statutes 1997 Supplement, section 57.18 256B.431, subdivision 26, is amended to read: 57.19 Subd. 26. [CHANGES TO NURSING FACILITY REIMBURSEMENT 57.20 BEGINNING JULY 1, 1997.] The nursing facility reimbursement 57.21 changes in paragraphs (a) to (f) shall apply in the sequence 57.22 specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 57.23 this section, beginning July 1, 1997. 57.24 (a) For rate years beginning on or after July 1, 1997, the 57.25 commissioner shall limit a nursing facility's allowable 57.26 operating per diem for each case mix category for each rate year. 57.27 The commissioner shall group nursing facilities into two groups, 57.28 freestanding and nonfreestanding, within each geographic group, 57.29 using their operating cost per diem for the case mix A 57.30 classification. A nonfreestanding nursing facility is a nursing 57.31 facility whose other operating cost per diem is subject to the 57.32 hospital attached, short length of stay, or the rule 80 limits. 57.33 All other nursing facilities shall be considered freestanding 57.34 nursing facilities. The commissioner shall then array all 57.35 nursing facilities in each grouping by their allowable case mix 57.36 A operating cost per diem. In calculating a nursing facility's 58.1 operating cost per diem for this purpose, the commissioner shall 58.2 exclude the raw food cost per diem related to providing special 58.3 diets that are based on religious beliefs, as determined in 58.4 subdivision 2b, paragraph (h). For those nursing facilities in 58.5 each grouping whose case mix A operating cost per diem: 58.6 (1) is at or below the median of the array, the 58.7 commissioner shall limit the nursing facility's allowable 58.8 operating cost per diem for each case mix category to the lesser 58.9 of the prior reporting year's allowable operating cost per diem 58.10 as specified in Laws 1996, chapter 451, article 3, section 11, 58.11 paragraph (h), plus the inflation factor as established in 58.12 paragraph (d), clause (2), increased by two percentage points, 58.13 or the current reporting year's corresponding allowable 58.14 operating cost per diem; or 58.15 (2) is above the median of the array, the commissioner 58.16 shall limit the nursing facility's allowable operating cost per 58.17 diem for each case mix category to the lesser of the prior 58.18 reporting year's allowable operating cost per diem as specified 58.19 in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 58.20 plus the inflation factor as established in paragraph (d), 58.21 clause (2), increased by one percentage point, or the current 58.22 reporting year's corresponding allowable operating cost per diem. 58.23 For rate years beginning on or after July 1, 1999, if a 58.24 facility reports a reduction in costs because of a credit or 58.25 refund received based on costs from prior reporting years, the 58.26 limit shall be increased in the second rate year following that 58.27 reporting year by the amount of the reduction divided by the 58.28 resident days used to compute the rate of the second following 58.29 rate year. 58.30 (b) For rate years beginning on or after July 1, 1997, the 58.31 commissioner shall limit the allowable operating cost per diem 58.32 for high cost nursing facilities. After application of the 58.33 limits in paragraph (a) to each nursing facility's operating 58.34 cost per diem, the commissioner shall group nursing facilities 58.35 into two groups, freestanding or nonfreestanding, within each 58.36 geographic group. A nonfreestanding nursing facility is a 59.1 nursing facility whose other operating cost per diem are subject 59.2 to hospital attached, short length of stay, or rule 80 limits. 59.3 All other nursing facilities shall be considered freestanding 59.4 nursing facilities. The commissioner shall then array all 59.5 nursing facilities within each grouping by their allowable case 59.6 mix A operating cost per diem. In calculating a nursing 59.7 facility's operating cost per diem for this purpose, the 59.8 commissioner shall exclude the raw food cost per diem related to 59.9 providing special diets that are based on religious beliefs, as 59.10 determined in subdivision 2b, paragraph (h). For those nursing 59.11 facilities in each grouping whose case mix A operating cost per 59.12 diem exceeds 1.0 standard deviation above the median, the 59.13 commissioner shall reduce their allowable operating cost per 59.14 diem by three percent. For those nursing facilities in each 59.15 grouping whose case mix A operating cost per diem exceeds 0.5 59.16 standard deviation above the median but is less than or equal to 59.17 1.0 standard deviation above the median, the commissioner shall 59.18 reduce their allowable operating cost per diem by two percent. 59.19 However, in no case shall a nursing facility's operating cost 59.20 per diem be reduced below its grouping's limit established at 59.21 0.5 standard deviations above the median. 59.22 (c) For rate years beginning on or after July 1, 1997, the 59.23 commissioner shall determine a nursing facility's efficiency 59.24 incentive by first computing the allowable difference, which is 59.25 the lesser of $4.50 or the amount by which the facility's other 59.26 operating cost limit exceeds its nonadjusted other operating 59.27 cost per diem for that rate year. The commissioner shall 59.28 compute the efficiency incentive by: 59.29 (1) subtracting the allowable difference from $4.50 and 59.30 dividing the result by $4.50; 59.31 (2) multiplying 0.20 by the ratio resulting from clause 59.32 (1), and then; 59.33 (3) adding 0.50 to the result from clause (2); and 59.34 (4) multiplying the result from clause (3) times the 59.35 allowable difference. 59.36 The nursing facility's efficiency incentive payment shall 60.1 be the lesser of $2.25 or the product obtained in clause (4). 60.2 (d) For rate years beginning on or after July 1, 1997, the 60.3 forecasted price index for a nursing facility's allowable 60.4 operating cost per diem shall be determined under clauses (1) 60.5 and (2) using the change in the Consumer Price Index-All Items 60.6 (United States city average) (CPI-U) as forecasted by Data 60.7 Resources, Inc. The commissioner shall use the indices as 60.8 forecasted in the fourth quarter of the calendar year preceding 60.9 the rate year, subject to subdivision 2l, paragraph (c). 60.10 (1) The CPI-U forecasted index for allowable operating cost 60.11 per diem shall be based on the 21-month period from the midpoint 60.12 of the nursing facility's reporting year to the midpoint of the 60.13 rate year following the reporting year. 60.14 (2) For rate years beginning on or after July 1, 1997, the 60.15 forecasted index for operating cost limits referred to in 60.16 subdivision 21, paragraph (b), shall be based on the CPI-U for 60.17 the 12-month period between the midpoints of the two reporting 60.18 years preceding the rate year. 60.19 (e) After applying these provisions for the respective rate 60.20 years, the commissioner shall index these allowable operating 60.21 cost per diem by the inflation factor provided for in paragraph 60.22 (d), clause (1), and add the nursing facility's efficiency 60.23 incentive as computed in paragraph (c). 60.24 (f) For rate years beginning on or after July 1, 1997, the 60.25 total operating cost payment rates for a nursing facility shall 60.26 be the greater of the total operating cost payment rates 60.27 determined under this section or the total operating cost 60.28 payment rates in effect on June 30, 1997, subject to rate 60.29 adjustments due to field audit or rate appeal resolution. This 60.30 provision shall not apply to subsequent field audit adjustments 60.31 of the nursing facility's operating cost rates for rate years 60.32 beginning on or after July 1, 1997. 60.33 (g) For the rate years beginning on July 1, 1997,andJuly 60.34 1, 1998, and July 1, 1999, a nursing facility licensed for 40 60.35 beds effective May 1, 1992, with a subsequent increase of 20 60.36 Medicare/Medicaid certified beds, effective January 26, 1993, in 61.1 accordance with an increase in licensure is exempt from 61.2 paragraphs (a) and (b). 61.3 (h) For a nursing facility whose construction project was 61.4 authorized according to section 144A.073, subdivision 5, 61.5 paragraph (g), the operating cost payment rates for the third 61.6 location shall be determined based on Minnesota Rules, part 61.7 9549.0057. Paragraphs (a) and (b) shall not apply until the 61.8 second rate year after the settle-up cost report is filed. 61.9 Notwithstanding subdivision 2b, paragraph (g), real estate taxes 61.10 and special assessments payable by the third location, a 61.11 501(c)(3) nonprofit corporation, shall be included in the 61.12 payment rates determined under this subdivision for all 61.13 subsequent rate years. 61.14 (i) For the rate year beginning July 1, 1997, the 61.15 commissioner shall compute the payment rate for a nursing 61.16 facility licensed for 94 beds on September 30, 1996, that 61.17 applied in October 1993 for approval of a total replacement 61.18 under the moratorium exception process in section 144A.073, and 61.19 completed the approved replacement in June 1995, with other 61.20 operating cost spend-up limit under paragraph (a), increased by 61.21 $3.98, and after computing the facility's payment rate according 61.22 to this section, the commissioner shall make a one-year positive 61.23 rate adjustment of $3.19 for operating costs related to the 61.24 newly constructed total replacement, without application of 61.25 paragraphs (a) and (b). The facility's per diem, before the 61.26 $3.19 adjustment, shall be used as the prior reporting year's 61.27 allowable operating cost per diem for payment rate calculation 61.28 for the rate year beginning July 1, 1998. A facility described 61.29 in this paragraph is exempt from paragraph (b) for the rate 61.30 years beginning July 1, 1997, and July 1, 1998. 61.31 (j) For the purpose of applying the limit stated in 61.32 paragraph (a), a nursing facility in Kandiyohi county licensed 61.33 for 86 beds that was granted hospital-attached status on 61.34 December 1, 1994, shall have the prior year's allowable 61.35 care-related per diem increased by $3.207 and the prior year's 61.36 other operating cost per diem increased by $4.777 before adding 62.1 the inflation in paragraph (d), clause (2), for the rate year 62.2 beginning on July 1, 1997. 62.3 (k) For the purpose of applying the limit stated in 62.4 paragraph (a), a 117 bed nursing facility located in Pine county 62.5 shall have the prior year's allowable other operating cost per 62.6 diem increased by $1.50 before adding the inflation in paragraph 62.7 (d), clause (2), for the rate year beginning on July 1, 1997. 62.8 (l) For the purpose of applying the limit under paragraph 62.9 (a), a nursing facility in Hibbing licensed for 192 beds shall 62.10 have the prior year's allowable other operating cost per diem 62.11 increased by $2.67 before adding the inflation in paragraph (d), 62.12 clause (2), for the rate year beginning July 1, 1997. 62.13 Sec. 8. Minnesota Statutes 1996, section 256B.431, is 62.14 amended by adding a subdivision to read: 62.15 Subd. 27. [CHANGES TO NURSING FACILITY REIMBURSEMENT 62.16 BEGINNING JULY 1, 1998.] (a) For the purpose of applying the 62.17 limit stated in subdivision 26, paragraph (a), a nursing 62.18 facility in Hennepin county licensed for 181 beds on September 62.19 30, 1996, shall have the prior year's allowable care-related per 62.20 diem increased by $1.455 and the prior year's other operating 62.21 cost per diem increased by $0.439 before adding the inflation in 62.22 subdivision 26, paragraph (d), clause (2), for the rate year 62.23 beginning on July 1, 1998. 62.24 (b) For the purpose of applying the limit stated in 62.25 subdivision 26, paragraph (a), a nursing facility in Hennepin 62.26 county licensed for 161 beds on September 30, 1996, shall have 62.27 the prior year's allowable care-related per diem increased by 62.28 $1.154 and the prior year's other operating cost per diem 62.29 increased by $0.256 before adding the inflation in subdivision 62.30 26, paragraph (d), clause (2), for the rate year beginning on 62.31 July 1, 1998. 62.32 (c) For the purpose of applying the limit stated in 62.33 subdivision 26, paragraph (a), a nursing facility in Ramsey 62.34 county licensed for 176 beds on September 30, 1996, shall have 62.35 the prior year's allowable care-related per diem increased by 62.36 $0.803 and the prior year's other operating cost per diem 63.1 increased by $0.272 before adding the inflation in subdivision 63.2 26, paragraph (d), clause (2), for the rate year beginning on 63.3 July 1, 1998. 63.4 (d) For the purpose of applying the limit stated in 63.5 subdivision 26, paragraph (a), a nursing facility in Brown 63.6 county licensed for 86 beds on September 30, 1996, shall have 63.7 the prior year's allowable care-related per diem increased by 63.8 $0.850 and the prior year's other operating cost per diem 63.9 increased by $0.275 before adding the inflation in subdivision 63.10 26, paragraph (d), clause (2), for the rate year beginning on 63.11 July 1, 1998. 63.12 (e) For the rate year beginning July 1, 1998, the 63.13 commissioner shall compute the payment rate for a nursing 63.14 facility, which was licensed for 110 beds on September 8, 1996, 63.15 was granted approval in January 1994 for a replacement and 63.16 remodeling project under the moratorium exception process in 63.17 section 144A.073, and completed the approved replacement and 63.18 remodeling project in April 1997, by computing the facility's 63.19 payment rate for the rate year beginning July 1, 1998, according 63.20 to this section, and then making a one-year positive rate 63.21 adjustment of 48 cents for increased real estate taxes resulting 63.22 from completion of the moratorium exception project, without 63.23 application of subdivision 26, paragraphs (a) and (b). 63.24 (f) For the rate year beginning July 1, 1998, the 63.25 commissioner shall compute the payment rate for a nursing 63.26 facility exempted from care-related limits under subdivision 2b, 63.27 paragraph (d), clause (2), with a minimum of three-quarters of 63.28 its beds licensed to provide residential services for the 63.29 physically handicapped under Minnesota Rules, parts 9570.2000 to 63.30 9570.3400, with the care-related spend-up limit under 63.31 subdivision 26, paragraph (a), increased by $13.21 for the rate 63.32 year beginning July 1, 1998, without application of subdivision 63.33 26, paragraph (b). For rate years beginning on or after July 1, 63.34 1999, the commissioner shall exclude that amount in calculating 63.35 the facility's operating cost per diem for purposes of applying 63.36 subdivision 26, paragraph (b). 64.1 (g) For the rate year beginning July 1, 1998, a nursing 64.2 facility in Canby, Minnesota, licensed for 75 beds shall be 64.3 reimbursed without the limitation imposed under subdivision 26, 64.4 paragraph (a), and for rate years beginning on or after July 1, 64.5 1999, its base costs shall be calculated on the basis of its 64.6 September 30, 1997, cost report. 64.7 (h) The nursing facility reimbursement changes in 64.8 paragraphs (i) and (j) shall apply in the sequence specified in 64.9 this section and Minnesota Rules, parts 9549.0010 to 9549.0080, 64.10 beginning July 1, 1998. 64.11 (i) For rate years beginning on or after July 1, 1998, the 64.12 operating cost limits established in subdivisions 2, 2b, 2i, 3c, 64.13 and 22, paragraph (d), and any previously effective 64.14 corresponding limits in law or rule shall not apply, except that 64.15 these cost limits shall still be calculated for purposes of 64.16 determining efficiency incentive per diems. For rate years 64.17 beginning on or after July 1, 1998, the total operating cost 64.18 payment rates for a nursing facility shall be the greater of the 64.19 total operating cost payment rates determined under this section 64.20 or the total operating cost payment rates in effect on June 30, 64.21 1998, subject to rate adjustments due to field audit or rate 64.22 appeal resolution. 64.23 (j) For rate years beginning on or after July 1, 1998, the 64.24 operating cost per diem referred to in subdivision 26, paragraph 64.25 (a), clauses (1) and (2), is the sum of the care-related and 64.26 other operating per diems for a given case mix class. Any 64.27 reductions to the combined operating per diem shall be divided 64.28 proportionately between the care-related and other operating per 64.29 diems. 64.30 Sec. 9. Minnesota Statutes 1997 Supplement, section 64.31 256B.433, subdivision 3a, is amended to read: 64.32 Subd. 3a. [EXEMPTION FROM REQUIREMENT FOR SEPARATE THERAPY 64.33 BILLING.] The provisions of subdivision 3 do not apply to 64.34 nursing facilities that are reimbursed according to the 64.35 provisions of section 256B.431 and are located in a county 64.36 participating in the prepaid medical assistance 65.1 program. Nursing facilities that are reimbursed according to 65.2 the provisions of section 256B.434 and are located in a county 65.3 participating in the prepaid medical assistance program are 65.4 exempt from the maximum therapy rent revenue provisions of 65.5 subdivision 3, paragraph (c). 65.6 Sec. 10. Minnesota Statutes 1997 Supplement, section 65.7 256B.434, subdivision 10, is amended to read: 65.8 Subd. 10. [EXEMPTIONS.] (a) To the extent permitted by 65.9 federal law, (1) a facility that has entered into a contract 65.10 under this section is not required to file a cost report, as 65.11 defined in Minnesota Rules, part 9549.0020, subpart 13, for any 65.12 year after the base year that is the basis for the calculation 65.13 of the contract payment rate for the first rate year of the 65.14 alternative payment demonstration project contract; and (2) a 65.15 facility under contract is not subject to audits of historical 65.16 costs or revenues, or paybacks or retroactive adjustments based 65.17 on these costs or revenues, except audits, paybacks, or 65.18 adjustments relating to the cost report that is the basis for 65.19 calculation of the first rate year under the contract. 65.20 (b) A facility that is under contract with the commissioner 65.21 under this section is not subject to the moratorium on licensure 65.22 or certification of new nursing home beds in section 144A.071, 65.23 unless the project results in a net increase in bed capacity or 65.24 involves relocation of beds from one site to another. Contract 65.25 payment rates must not be adjusted to reflect any additional 65.26 costs that a nursing facility incurs as a result of a 65.27 construction project undertaken under this paragraph. In 65.28 addition, as a condition of entering into a contract under this 65.29 section, a nursing facility must agree that any future medical 65.30 assistance payments for nursing facility services will not 65.31 reflect any additional costs attributable to the sale of a 65.32 nursing facility under this section and to construction 65.33 undertaken under this paragraph that otherwise would not be 65.34 authorized under the moratorium in section 144A.073. Nothing in 65.35 this section prevents a nursing facility participating in the 65.36 alternative payment demonstration project under this section 66.1 from seeking approval of an exception to the moratorium through 66.2 the process established in section 144A.073, and if approved the 66.3 facility's rates shall be adjusted to reflect the cost of the 66.4 project. Nothing in this section prevents a nursing facility 66.5 participating in the alternative payment demonstration project 66.6 from seeking legislative approval of an exception to the 66.7 moratorium under section 144A.071, and, if enacted, the 66.8 facility's rates shall be adjusted to reflect the cost of the 66.9 project. 66.10 (c) Notwithstanding section 256B.48, subdivision 6, 66.11 paragraphs (c), (d), and (e), and pursuant to any terms and 66.12 conditions contained in the facility's contract, a nursing 66.13 facility that is under contract with the commissioner under this 66.14 section is in compliance with section 256B.48, subdivision 6, 66.15 paragraph (b), if the facility is Medicare certified. 66.16 (d) Notwithstanding paragraph (a), if by April 1, 1996, the 66.17 health care financing administration has not approved a required 66.18 waiver, or the health care financing administration otherwise 66.19 requires cost reports to be filed prior to the waiver's 66.20 approval, the commissioner shall require a cost report for the 66.21 rate year. 66.22 (e) A facility that is under contract with the commissioner 66.23 under this section shall be allowed to change therapy 66.24 arrangements from an unrelated vendor to a related vendor during 66.25 the term of the contract. The commissioner may develop 66.26 reasonable requirements designed to prevent an increase in 66.27 therapy utilization for residents enrolled in the medical 66.28 assistance program. 66.29 Sec. 11. [256B.435] [NURSING FACILITY REIMBURSEMENT SYSTEM 66.30 EFFECTIVE JULY 1, 2000.] 66.31 Subdivision 1. [IN GENERAL.] Effective July 1, 2000, the 66.32 commissioner shall implement a performance-based contracting 66.33 system to replace the current method of setting operating cost 66.34 payment rates under sections 256B.431 and 256B.434 and Minnesota 66.35 Rules, parts 9549.0010 to 9549.0080. A nursing facility in 66.36 operation on May 1, 1998, with payment rates not established 67.1 under section 256B.431 or 256B.434 on that date, is ineligible 67.2 for this performance-based contracting system. In determining 67.3 prospective payment rates of nursing facility services, the 67.4 commissioner shall distinguish between operating costs and 67.5 property-related costs. The operating cost portion of the 67.6 payment rates shall be indexed annually by an inflation factor 67.7 as specified in subdivision 3, and according to section 67.8 256B.431, subdivision 2i, paragraph (c). Property-related 67.9 payment rates, including real estate taxes and special 67.10 assessments, shall be determined under section 256B.431 or 67.11 256B.434. 67.12 Subd. 2. [CONTRACT PROVISIONS.] (a) The performance-based 67.13 contract with each nursing facility must include provisions that: 67.14 (1) apply the resident case mix assessment provisions of 67.15 Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 67.16 another assessment system, with the goal of moving to a single 67.17 assessment system; 67.18 (2) monitor resident outcomes through various methods, such 67.19 as quality indicators based on the minimum data set and other 67.20 utilization and performance measures; 67.21 (3) require the establishment and use of a continuous 67.22 quality improvement process that integrates information from 67.23 quality indicators and regular resident and family satisfaction 67.24 interviews; 67.25 (4) require annual reporting of facility statistical 67.26 information, including resident days by case mix category, 67.27 productive nursing hours, wages and benefits, and raw food costs 67.28 for use by the commissioner in the development of facility 67.29 profiles that include trends in payment and service utilization; 67.30 (5) require from each nursing facility an annual certified 67.31 audited financial statement consisting of a balance sheet, 67.32 income and expense statements, and an opinion from either a 67.33 licensed or certified public accountant, if a certified audit 67.34 was prepared, or unaudited financial statements if no certified 67.35 audit was prepared; and 67.36 (6) establish additional requirements and penalties for 68.1 nursing facilities not meeting the standards set forth in the 68.2 performance-based contract. 68.3 (b) The commissioner may develop additional incentive-based 68.4 payments for achieving outcomes specified in each contract. The 68.5 specified facility-specific outcomes must be measurable and 68.6 approved by the commissioner. 68.7 (c) The commissioner may also contract with nursing 68.8 facilities in other ways through requests for proposals, 68.9 including contracts on a risk or nonrisk basis, with nursing 68.10 facilities or consortia of nursing facilities, to provide 68.11 comprehensive long-term care coverage on a premium or capitated 68.12 basis. 68.13 Subd. 3. [PAYMENT RATE PROVISIONS.] (a) For rate years 68.14 beginning on or after July 1, 2000, the commissioner shall 68.15 determine operating cost payment rates for each licensed and 68.16 certified nursing facility by indexing its operating cost 68.17 payment rates in effect on June 30, 2000, for inflation. The 68.18 inflation factor to be used must be based on the change in the 68.19 Consumer Price Index-All Items, United States city average 68.20 (CPI-U) as forecasted by Data Resources, Inc. in the fourth 68.21 quarter preceding the rate year. The CPI-U forecasted index for 68.22 operating cost payment rates shall be based on the 12-month 68.23 period from the midpoint of the nursing facility's prior rate 68.24 year to the midpoint of the rate year for which the operating 68.25 payment rate is being determined. 68.26 (b) Beginning July 1, 2000, each nursing facility subject 68.27 to a performance-based contract under this section shall choose 68.28 one of two methods of payment for property-related costs: 68.29 (1) the method established in section 256B.434; or 68.30 (2) the method established in section 256B.431. Once the 68.31 nursing facility has made its election, that election shall 68.32 remain in effect for at least four years or until an alternative 68.33 property payment system is developed. 68.34 Sec. 12. [256B.5011] [ICF/MR REIMBURSEMENT SYSTEM 68.35 EFFECTIVE OCTOBER 1, 2000.] 68.36 Subdivision 1. [IN GENERAL.] Effective October 1, 2000, 69.1 the commissioner shall implement a performance-based contracting 69.2 system to replace the current method of setting total cost 69.3 payment rates under section 256B.501 and Minnesota Rules, parts 69.4 9553.0010 to 9553.0080. In determining prospective payment 69.5 rates of intermediate care facilities for persons with mental 69.6 retardation or related conditions, the commissioner shall index 69.7 each facility's total payment rate by an inflation factor as 69.8 described in subdivision 3. The commissioner of finance shall 69.9 include annual inflation adjustments in operating costs for 69.10 intermediate care facilities for persons with mental retardation 69.11 and related conditions as a budget change request in each 69.12 biennial detailed expenditure budget submitted to the 69.13 legislature under section 16A.11. 69.14 Subd. 2. [CONTRACT PROVISIONS.] The performance-based 69.15 contract with each intermediate care facility must include 69.16 provisions for: 69.17 (1) modifying payments when significant changes occur in 69.18 the needs of the consumers; 69.19 (2) monitoring service quality using performance indicators 69.20 that measure consumer outcomes; 69.21 (3) the establishment and use of continuous quality 69.22 improvement processes using the results attained through service 69.23 quality monitoring; 69.24 (4) the annual reporting of facility statistical 69.25 information on all supervisory personnel, direct care personnel, 69.26 specialized support personnel, hours, wages and benefits, 69.27 staff-to-consumer ratios, and staffing patterns; 69.28 (5) annual aggregate facility financial information or an 69.29 annual certified audited financial statement, including a 69.30 balance sheet and income and expense statements for each 69.31 facility, if a certified audit was prepared; and 69.32 (6) additional requirements and penalties for intermediate 69.33 care facilities not meeting the standards set forth in the 69.34 performance-based contract. 69.35 Subd. 3. [PAYMENT RATE PROVISIONS.] For rate years 69.36 beginning on or after October 1, 2000, the commissioner shall 70.1 determine the total payment rate for each licensed and certified 70.2 intermediate care facility by indexing the total payment rate in 70.3 effect on September 30, 2000, for inflation. The inflation 70.4 factor to be used must be based on the change in the Consumer 70.5 Price Index-All Items (United States city average) (CPI-U) as 70.6 forecasted by Data Resources, Inc. in the first quarter of the 70.7 calendar year during which the rate year begins. The CPI-U 70.8 forecasted index for total payment rates shall be based on the 70.9 12-month period from the midpoint of the ICF/MR's prior rate 70.10 year to the midpoint of the rate year for which the operating 70.11 payment rate is being determined. 70.12 Sec. 13. Minnesota Statutes 1996, section 256B.69, is 70.13 amended by adding a subdivision to read: 70.14 Subd. 26. [CONTINUATION OF PAYMENTS THROUGH 70.15 DISCHARGE.] (a) In the event a medical assistance recipient or 70.16 beneficiary enrolled in a health plan under this section is 70.17 denied nursing facility services after residing in the facility 70.18 for more than 180 days, any denial of medical assistance payment 70.19 to a provider under this section shall be prospective only and 70.20 payments to the provider shall continue until the resident is 70.21 discharged or 30 days after the effective date of the service 70.22 denial, whichever is sooner. 70.23 (b) For a medical assistance recipient or beneficiary who 70.24 is enrolled in a health plan and who has resided in the nursing 70.25 facility for less than 180 days, when a decision to terminate 70.26 nursing facility services is made by the health plan, any appeal 70.27 of the health plan decision must be made under subdivisions 11 70.28 and 18, and section 256.045, subdivision 3, paragraph (a). A 70.29 decision may not be appealed under section 144A.135. All other 70.30 appeals of termination of nursing facility services shall be 70.31 made under section 144A.135. 70.32 Sec. 14. Minnesota Statutes 1996, section 256I.04, 70.33 subdivision 1, is amended to read: 70.34 Subdivision 1. [INDIVIDUAL ELIGIBILITY REQUIREMENTS.] An 70.35 individual is eligible for and entitled to a group residential 70.36 housing payment to be made on the individual's behalf if the 71.1 county agency has approved the individual's residence in a group 71.2 residential housing setting and the individual meets the 71.3 requirements in paragraph (a) or (b). 71.4 (a) The individual is aged, blind, or is over 18 years of 71.5 age and disabled as determined under the criteria used by the 71.6 title II program of the Social Security Act, and meets the 71.7 resource restrictions and standards of the supplemental security 71.8 income program, and the individual's countable income after 71.9 deducting the (1) exclusions and disregards of the SSI 71.10 programand, (2) the medical assistance personal needs allowance 71.11 under section 256B.35, and (3) an amount equal to the allocation 71.12 of income to a spouse living in the community under the 71.13 provisions of section 256B.0915, subdivision 2, is less than the 71.14 monthly rate specified in the county agency's agreement with the 71.15 provider of group residential housing in which the individual 71.16 resides. 71.17 (b) The individual meets a category of eligibility under 71.18 section 256D.05, subdivision 1, paragraph (a), and the 71.19 individual's resources are less than the standards specified by 71.20 section 256D.08, and the individual's countable income as 71.21 determined under sections 256D.01 to 256D.21, less the medical 71.22 assistance personal needs allowance under section 256B.35 is 71.23 less than the monthly rate specified in the county agency's 71.24 agreement with the provider of group residential housing in 71.25 which the individual resides. 71.26 Sec. 15. Minnesota Statutes 1996, section 256I.04, 71.27 subdivision 3, is amended to read: 71.28 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 71.29 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 71.30 into agreements for new group residential housing beds with 71.31 total rates in excess of the MSA equivalent rate except: (1) 71.32 for group residential housing establishments meeting the 71.33 requirements of subdivision 2a, clause (2) with department 71.34 approval; (2) for group residential housing establishments 71.35 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 71.36 provided the facility is needed to meet the census reduction 72.1 targets for persons with mental retardation or related 72.2 conditions at regional treatment centers; (3) to ensure 72.3 compliance with the federal Omnibus Budget Reconciliation Act 72.4 alternative disposition plan requirements for inappropriately 72.5 placed persons with mental retardation or related conditions or 72.6 mental illness; (4) up to 80 beds in a single, specialized 72.7 facility located in Hennepin county that will provide housing 72.8 for chronic inebriates who are repetitive users of 72.9 detoxification centers and are refused placement in emergency 72.10 shelters because of their state of intoxication., and planning 72.11 for the specialized facility must have been initiated before 72.12 July 1, 1991, in anticipation of receiving a grant from the 72.13 housing finance agency under section 462A.05, subdivision 20a, 72.14 paragraph (b); or (5) notwithstanding the provisions of 72.15 subdivision 2a, for up to180200 supportive housing units in 72.16 Anoka, Dakota, Hennepin, or Ramsey county for homeless adults 72.17 with a mental illness, a history of substance abuse, or human 72.18 immunodeficiency virus or acquired immunodeficiency syndrome. 72.19 For purposes of this section, "homeless adult" means a person 72.20 who is living on the street or in a shelteror is evicted from a72.21dwelling unitor discharged from a regional treatment center, 72.22 community hospital, or residential treatment program and has no 72.23 appropriate housing available and lacks the resources and 72.24 support necessary to access appropriate housing. At least 70 72.25 percent of the supportive housing units must serve homeless 72.26 adults with mental illness, substance abuse problems, or human 72.27 immunodeficiency virus or acquired immunodeficiency syndrome who 72.28 are about to be or, within the previous six months, has been 72.29 discharged from a regional treatment center, or a 72.30 state-contracted psychiatric bed in a community hospital, or a 72.31 residential mental health or chemical dependency treatment 72.32 program. If a person meets the requirements of subdivision 1, 72.33 paragraph (a), and receives a federalSection 8or state housing 72.34 subsidy, the group residential housing rate for that person is 72.35 limited to the supplementary rate under section 256I.05, 72.36 subdivision 1a, and is determined by subtracting the amount of 73.1 the person's countable income that exceeds the MSA equivalent 73.2 rate from the group residential housing supplementary rate. A 73.3 resident in a demonstration project site who no longer 73.4 participates in the demonstration program shall retain 73.5 eligibility for a group residential housing payment in an amount 73.6 determined under section 256I.06, subdivision 8, using the MSA 73.7 equivalent rate. Service funding under section 256I.05, 73.8 subdivision 1a, will end June 30, 1997, if federal matching 73.9 funds are available and the services can be provided through a 73.10 managed care entity. If federal matching funds are not 73.11 available, then service funding will continue under section 73.12 256I.05, subdivision 1a. 73.13 (b) A county agency may enter into a group residential 73.14 housing agreement for beds with rates in excess of the MSA 73.15 equivalent rate in addition to those currently covered under a 73.16 group residential housing agreement if the additional beds are 73.17 only a replacement of beds with rates in excess of the MSA 73.18 equivalent rate which have been made available due to closure of 73.19 a setting, a change of licensure or certification which removes 73.20 the beds from group residential housing payment, or as a result 73.21 of the downsizing of a group residential housing setting. The 73.22 transfer of available beds from one county to another can only 73.23 occur by the agreement of both counties. 73.24 Sec. 16. Minnesota Statutes 1996, section 256I.04, is 73.25 amended by adding a subdivision to read: 73.26 Subd. 4. [RENTAL ASSISTANCE.] For participants in the 73.27 Minnesota supportive housing demonstration program under 73.28 subdivision 3, paragraph (a), clause (5), notwithstanding the 73.29 provisions of section 256I.06, subdivision 8, the amount of the 73.30 group residential housing payment for room and board must be 73.31 calculated by subtracting 30 percent of the recipient's adjusted 73.32 income as defined by the United States Department of Housing and 73.33 Urban Development for the Section 8 program from the fair market 73.34 rent established for the recipient's living unit by the federal 73.35 Department of Housing and Urban Development. This payment shall 73.36 be regarded as a state housing subsidy for the purposes of 74.1 subdivision 3. Notwithstanding the provisions of section 74.2 256I.06, subdivision 6, the recipient's countable income will 74.3 only be adjusted when a change of greater than $100 in a month 74.4 occurs or upon annual redetermination of eligibility, whichever 74.5 is sooner. The supportive housing demonstration program with 74.6 rental assistance shall be evaluated by an independent evaluator 74.7 to determine the cost effectiveness of the program in serving 74.8 its formerly homeless disabled clientele. The evaluation and 74.9 report shall be submitted to the commissioner of human services 74.10 no later than December 31, 1998. The commissioner is directed 74.11 to study the feasibility of developing a rental assistance 74.12 program to serve persons traditionally served in group 74.13 residential housing settings and report to the legislature by 74.14 February 15, 1999. 74.15 Sec. 17. Minnesota Statutes 1996, section 256I.05, 74.16 subdivision 2, is amended to read: 74.17 Subd. 2. [MONTHLY RATES; EXEMPTIONS.] The maximum group 74.18 residential housing rate does not apply to a residence that on 74.19 August 1, 1984, was licensed by the commissioner of health only 74.20 as a boarding care home, certified by the commissioner of health 74.21 as an intermediate care facility, and licensed by the 74.22 commissioner of human services under Minnesota Rules, parts 74.23 9520.0500 to 9520.0690. Notwithstanding the provisions of 74.24 subdivision 1c, the rate paid to a facility reimbursed under 74.25 this subdivision shall be determined under Minnesota Rules, 74.26 parts9510.0010 to 9510.04809549.0010 to 9549.0080, or under 74.27 section 256B.434 if the facility is accepted by the commissioner 74.28 for participation in the alternative payment demonstration 74.29 project. 74.30 Sec. 18. Laws 1997, chapter 207, section 7, is amended to 74.31 read: 74.32 Sec. 7. [PRIVATE SALE OF TAX-FORFEITED LAND; CARLTON 74.33 COUNTY.] 74.34 (a) Notwithstanding Minnesota Statutes, sections 92.45 and 74.35 282.018, subdivision 1, and the public sale provisions of 74.36 Minnesota Statutes, chapter 282, Carlton county may sell by 75.1 private sale the tax-forfeited land described in paragraph (d) 75.2 under the remaining provisions of Minnesota Statutes, chapter 75.3 282. 75.4 (b) The land described in paragraph (d) may be sold by 75.5 private sale. The considerationfor the conveyance must include75.6the taxes due on the property and any penalties, interest, and75.7costsshall be the appraised value of the land. If the lands 75.8 are sold, the conveyance must reserveto the statea 75.9conservationperpetual easement, in a form prescribed by the75.10commissioner of natural resources, for the land within 100 feet75.11of the ordinary high water level of Slaughterhouse creek for75.12public angler access and stream habitat protection and75.13enhancementfor the benefit of the state of Minnesota, 75.14 department of natural resources, over the following lands: 75.15 A strip of land lying in the North 6.66 acres of the West 75.16 Half of the Northeast Quarter of the Southwest Quarter of 75.17 Section 6, Township 48 North, Range 16 West, Carlton county. 75.18 Said strip lying 100 feet on each side of the centerline of 75.19 Slaughterhouse Creek. 75.20 (c) The conveyance must be in a form approved by the 75.21 attorney general. 75.22 (d) The land to be conveyed is located in Carlton county 75.23 and is described as: 75.24 North 6.66 acres of the West Half of the Northeast Quarter 75.25 of the Southwest Quarter, subject to pipeline easement, Section 75.26 6, Township 48 North, Range 16 West, City of Carlton. 75.27 (e) Carlton county has determined that this sale best 75.28 serves the land management interests of Carlton county. 75.29 Sec. 19. [STUDY OF COSTS AND IMPACT OF REGULATION OF 75.30 ASSISTED LIVING HOME CARE PROVIDER LICENSEES.] 75.31 The legislature recommends that by January 15, 1999, the 75.32 legislative auditor, in consultation with owners and operators 75.33 of registered housing establishments under Minnesota Statutes, 75.34 chapter 144D, consumers of registered housing and services, and 75.35 representatives of elderly housing associations, report to the 75.36 health and human services policy and fiscal committees of the 76.1 house and senate on the costs incurred under rules, as proposed 76.2 by the commissioner of health, to implement Laws 1997, chapter 76.3 113, section 6, and: 76.4 (1) provide an analysis of the implications of added 76.5 regulatory costs to the affordability, accessibility, and 76.6 quality of elderly housing; and 76.7 (2) provide recommendations for alternatives to added home 76.8 care regulation for registered with services settings. 76.9 Sec. 20. [RECOMMENDATIONS TO IMPLEMENT NEW REIMBURSEMENT 76.10 SYSTEM.] 76.11 (a) By January 15, 1999, the commissioner shall make 76.12 recommendations to the chairs of the health and human services 76.13 policy and fiscal committees on the repeal of specific statutes 76.14 and rules as well as any other additional recommendations 76.15 related to implementation of sections 11 and 12. 76.16 (b) In developing recommendations for nursing facility 76.17 reimbursement, the commissioner shall consider making each 76.18 nursing facility's total payment rates, both operating and 76.19 property rate components, prospective. The commissioner shall 76.20 involve nursing facility industry and consumer representatives 76.21 in the development of these recommendations. 76.22 (c) In making recommendations for ICF/MR reimbursement, the 76.23 commissioner may consider methods of establishing payment rates 76.24 that take into account individual client costs and needs, 76.25 include provisions to establish links between performance 76.26 indicators and reimbursement and other performance incentives, 76.27 and allow local control over resources necessary for local 76.28 agencies to set rates and contract with ICF/MR facilities. In 76.29 addition, the commissioner may establish methods that provide 76.30 information to consumers regarding service quality as measured 76.31 by performance indicators. The commissioner shall involve 76.32 ICF/MR industry and consumer representatives in the development 76.33 of these recommendations. 76.34 Sec. 21. [APPROVAL EXTENDED.] 76.35 Notwithstanding Minnesota Statutes, section 144A.073, 76.36 subdivision 3, the commissioner of health shall grant an 77.1 additional 18 months of approval for a proposed exception to the 77.2 nursing home licensure and certification moratorium, if the 77.3 proposal is to replace a 96-bed nursing home facility in Carlton 77.4 county and if initial approval for the proposal was granted in 77.5 November 1996. 77.6 Sec. 22. [EFFECTIVE DATE.] 77.7 Section 21 is effective the day following final enactment. 77.8 ARTICLE 4 77.9 HEALTH CARE PROGRAMS 77.10 Section 1. Minnesota Statutes 1997 Supplement, section 77.11 171.29, subdivision 2, is amended to read: 77.12 Subd. 2. [FEES, ALLOCATION.] (a) A person whose driver's 77.13 license has been revoked as provided in subdivision 1, except 77.14 under section 169.121 or 169.123, shall pay a $30 fee before the 77.15 driver's license is reinstated. 77.16 (b) A person whose driver's license has been revoked as 77.17 provided in subdivision 1 under section 169.121 or 169.123 shall 77.18 pay a $250 fee plus a $10 surcharge before the driver's license 77.19 is reinstated. The $250 fee is to be credited as follows: 77.20 (1) Twenty percent shall be credited to the trunk highway 77.21 fund. 77.22 (2) Fifty-five percent shall be credited to the general 77.23 fund. 77.24 (3) Eight percent shall be credited to a separate account 77.25 to be known as the bureau of criminal apprehension account. 77.26 Money in this account may be appropriated to the commissioner of 77.27 public safety and the appropriated amount shall be apportioned 77.28 80 percent for laboratory costs and 20 percent for carrying out 77.29 the provisions of section 299C.065. 77.30 (4) Twelve percent shall be credited to a separate account 77.31 to be known as the alcohol-impaired driver education account. 77.32 Money in the account is appropriated as follows: 77.33 (i) The first $200,000 in a fiscal year is to the 77.34 commissioner of children, families, and learning for programs in 77.35 elementary and secondary schools. 77.36 (ii) The remainder credited in a fiscal year is 78.1 appropriated to the commissioner of transportation to be spent 78.2 as grants to the Minnesota highway safety center at St. Cloud 78.3 State University for programs relating to alcohol and highway 78.4 safety education in elementary and secondary schools. 78.5 (5) Five percent shall be credited to a separate account to 78.6 be known as the traumatic brain injury and spinal cord injury 78.7 account.$100,000 is annually appropriated from the account to78.8the commissioner of human services for traumatic brain injury78.9case management services.Theremainingmoney in the account is 78.10 annually appropriated to the commissioner of health to be used 78.11 as follows: 35 percent for a contract with a qualified 78.12 community-based organization to provide information, resources, 78.13 and support to assist persons with traumatic brain injury and 78.14 their families to access services, and 65 percent toestablish78.15andmaintain the traumatic brain injury and spinal cord injury 78.16 registry created in section 144.662 and to reimburse the 78.17 commissioner of economic security for the reasonable cost of 78.18 services provided under section 268A.03, clause (o). For the 78.19 purposes of this clause, a "qualified community-based 78.20 organization" is a private, not-for-profit organization of 78.21 consumers of traumatic brain injury services and their family 78.22 members. The organization must be registered with the United 78.23 States Internal Revenue Service under the provisions of section 78.24 501(c)(3) as a tax exempt organization and must have as its 78.25 purpose: 78.26 (1) the promotion of public, family, survivor, and 78.27 professional awareness of the incidence and consequences of 78.28 traumatic brain injury; 78.29 (2) the provision of a network of support for persons with 78.30 traumatic brain injury, their families, and friends; 78.31 (3) the development and support of programs and services to 78.32 prevent traumatic brain injury; 78.33 (4) the establishment of education programs for persons 78.34 with traumatic brain injury; and 78.35 (5) the empowerment of persons with traumatic brain injury 78.36 through participation in its governance. 79.1 (c) The $10 surcharge shall be credited to a separate 79.2 account to be known as the remote electronic alcohol monitoring 79.3 pilot program account. The commissioner shall transfer the 79.4 balance of this account to the commissioner of finance on a 79.5 monthly basis for deposit in the general fund. 79.6 Sec. 2. Minnesota Statutes 1996, section 245.462, 79.7 subdivision 4, is amended to read: 79.8 Subd. 4. [CASE MANAGER.] (a) "Case manager" means an 79.9 individual employed by the county or other entity authorized by 79.10 the county board to provide case management services specified 79.11 in section 245.4711. A case manager must have a bachelor's 79.12 degree in one of the behavioral sciences or related fields from 79.13 an accredited college or university and have at least 2,000 79.14 hours of supervised experience in the delivery of services to 79.15 adults with mental illness, must be skilled in the process of 79.16 identifying and assessing a wide range of client needs, and must 79.17 be knowledgeable about local community resources and how to use 79.18 those resources for the benefit of the client. The case manager 79.19 shall meet in person with a mental health professional at least 79.20 once each month to obtain clinical supervision of the case 79.21 manager's activities. Case managers with a bachelor's degree 79.22 but without 2,000 hours of supervised experience in the delivery 79.23 of services to adults with mental illness must complete 40 hours 79.24 of training approved by the commissioner of human services in 79.25 case management skills and in the characteristics and needs of 79.26 adults with serious and persistent mental illness and must 79.27 receive clinical supervision regarding individual service 79.28 delivery from a mental health professional at least once each 79.29 week until the requirement of 2,000 hours of supervised 79.30 experience is met. Clinical supervision must be documented in 79.31 the client record. 79.32 Until June 30, 1999,a refugeean immigrant who does not 79.33 have the qualifications specified in this subdivision may 79.34 provide case management services to adultrefugeesimmigrants 79.35 with serious and persistent mental illness who are members of 79.36 the same ethnic group as the case manager if the person: (1) is 80.1 actively pursuing credits toward the completion of a bachelor's 80.2 degree in one of the behavioral sciences or a related field from 80.3 an accredited college or university; (2) completes 40 hours of 80.4 training as specified in this subdivision; and (3) receives 80.5 clinical supervision at least once a week until the requirements 80.6 ofobtaining a bachelor's degree and 2,000 hours of supervised80.7experiencethis subdivision are met. 80.8 (b) The commissioner may approve waivers submitted by 80.9 counties to allow case managers without a bachelor's degree but 80.10 with 6,000 hours of supervised experience in the delivery of 80.11 services to adults with mental illness if the person: 80.12 (1) meets the qualifications for a mental health 80.13 practitioner in subdivision 26; 80.14 (2) has completed 40 hours of training approved by the 80.15 commissioner in case management skills and in the 80.16 characteristics and needs of adults with serious and persistent 80.17 mental illness; and 80.18 (3) demonstrates that the 6,000 hours of supervised 80.19 experience are in identifying functional needs of persons with 80.20 mental illness, coordinating assessment information and making 80.21 referrals to appropriate service providers, coordinating a 80.22 variety of services to support and treat persons with mental 80.23 illness, and monitoring to ensure appropriate provision of 80.24 services. The county board is responsible to verify that all 80.25 qualifications, including content of supervised experience, have 80.26 been met. 80.27 Sec. 3. Minnesota Statutes 1996, section 245.462, 80.28 subdivision 8, is amended to read: 80.29 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 80.30 treatment services," or "day treatment program" means a 80.31 structured program of treatment and care provided to an adult in 80.32 or by: (1) a hospital accredited by the joint commission on 80.33 accreditation of health organizations and licensed under 80.34 sections 144.50 to 144.55; (2) a community mental health center 80.35 under section 245.62; or (3) an entity that is under contract 80.36 with the county board to operate a program that meets the 81.1 requirements of section 245.4712, subdivision 2, and Minnesota 81.2 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 81.3 group psychotherapy and other intensive therapeutic services 81.4 that are provided at least one day a weekfor a minimum81.5three-hour time blockby a multidisciplinary staff under the 81.6 clinical supervision of a mental health professional. The 81.7 services are aimed at stabilizing the adult's mental health 81.8 status, providing mental health services, and developing and 81.9 improving the adult's independent living and socialization 81.10 skills. The goal of day treatment is to reduce or relieve 81.11 mental illness and to enable the adult to live in the 81.12 community. Day treatment services are not a part of inpatient 81.13 or residential treatment services. Day treatment services are 81.14 distinguished from day care by their structured therapeutic 81.15 program of psychotherapy services. The commissioner may limit 81.16 medical assistance reimbursement for day treatment to 15 hours 81.17 per week per person instead of the three hours per day per 81.18 person specified in Minnesota Rules, part 9505.0323, subpart 15. 81.19 Sec. 4. Minnesota Statutes 1996, section 245.4871, 81.20 subdivision 4, is amended to read: 81.21 Subd. 4. [CASE MANAGER.] (a) "Case manager" means an 81.22 individual employed by the county or other entity authorized by 81.23 the county board to provide case management services specified 81.24 in subdivision 3 for the child with severe emotional disturbance 81.25 and the child's family. A case manager must have experience and 81.26 training in working with children. 81.27 (b) A case manager must: 81.28 (1) have at least a bachelor's degree in one of the 81.29 behavioral sciences or a related field from an accredited 81.30 college or university; 81.31 (2) have at least 2,000 hours of supervised experience in 81.32 the delivery of mental health services to children; 81.33 (3) have experience and training in identifying and 81.34 assessing a wide range of children's needs; and 81.35 (4) be knowledgeable about local community resources and 81.36 how to use those resources for the benefit of children and their 82.1 families. 82.2 (c) The case manager may be a member of any professional 82.3 discipline that is part of the local system of care for children 82.4 established by the county board. 82.5 (d) The case manager must meet in person with a mental 82.6 health professional at least once each month to obtain clinical 82.7 supervision. 82.8 (e) Case managers with a bachelor's degree but without 82.9 2,000 hours of supervised experience in the delivery of mental 82.10 health services to children with emotional disturbance must: 82.11 (1) begin 40 hours of training approved by the commissioner 82.12 of human services in case management skills and in the 82.13 characteristics and needs of children with severe emotional 82.14 disturbance before beginning to provide case management 82.15 services; and 82.16 (2) receive clinical supervision regarding individual 82.17 service delivery from a mental health professional at least once 82.18 each week until the requirement of 2,000 hours of experience is 82.19 met. 82.20 (f) Clinical supervision must be documented in the child's 82.21 record. When the case manager is not a mental health 82.22 professional, the county board must provide or contract for 82.23 needed clinical supervision. 82.24 (g) The county board must ensure that the case manager has 82.25 the freedom to access and coordinate the services within the 82.26 local system of care that are needed by the child. 82.27 (h) Until June 30, 1999, a refugee who does not have the 82.28 qualifications specified in this subdivision may provide case 82.29 management services to child refugees with severe emotional 82.30 disturbance of the same ethnic group as the refugee if the 82.31 person: 82.32 (1) is actively pursuing credits toward the completion of a 82.33 bachelor's degree in one of the behavioral sciences or related 82.34 fields at an accredited college or university; 82.35 (2) completes 40 hours of training as specified in this 82.36 subdivision; and 83.1 (3) receives clinical supervision at least once a week 83.2 until the requirements of obtaining a bachelor's degree and 83.3 2,000 hours of supervised experience are met. 83.4 (i) The commissioner may approve waivers submitted by 83.5 counties to allow case managers without a bachelor's degree but 83.6 with 6,000 hours of supervised experience in the delivery of 83.7 services to children with severe emotional disturbance if the 83.8 person: 83.9 (1) meets the qualifications for a mental health 83.10 practitioner in subdivision 26; 83.11 (2) has completed 40 hours of training approved by the 83.12 commissioner in case management skills and in the 83.13 characteristics and needs of children with severe emotional 83.14 disturbance; and 83.15 (3) demonstrates that the 6,000 hours of supervised 83.16 experience are in identifying functional needs of children with 83.17 severe emotional disturbance, coordinating assessment 83.18 information and making referrals to appropriate service 83.19 providers, coordinating a variety of services to support and 83.20 treat children with severe emotional disturbance, and monitoring 83.21 to ensure appropriate provision of services. The county board 83.22 is responsible to verify that all qualifications, including 83.23 content of supervised experience, have been met. 83.24 Sec. 5. [256.9364] [POST-KIDNEY TRANSPLANT DRUG PROGRAM.] 83.25 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 83.26 services shall establish and administer a program to pay for 83.27 costs of drugs prescribed exclusively for post-kidney transplant 83.28 maintenance when those costs are not otherwise reimbursed by a 83.29 third-party payer. The commissioner may contract with a 83.30 nonprofit entity to administer this program. 83.31 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 83.32 the program, an applicant must satisfy the following 83.33 requirements: 83.34 (1) the applicant's family gross income must not exceed 275 83.35 percent of the federal poverty level; and 83.36 (2) the applicant must be a Minnesota resident who has 84.1 resided in Minnesota for at least 12 months. 84.2 An applicant shall not be excluded because the applicant 84.3 received the transplant outside the state of Minnesota, so long 84.4 as the other requirements are met. 84.5 Subd. 3. [PAYMENT AMOUNTS.] (a) The amount of the payments 84.6 made for each eligible recipient shall be based on the following: 84.7 (1) available funds; and 84.8 (2) the cost of the post-kidney transplant maintenance 84.9 drugs. 84.10 (b) The payment rate under this program must be no greater 84.11 than the medical assistance reimbursement rate for the 84.12 prescribed drug. 84.13 (c) Payments shall be made to or on behalf of an eligible 84.14 recipient for the cost of the post-kidney transplant maintenance 84.15 drugs that is not covered, reimbursed, or eligible for 84.16 reimbursement by any other third party or government entity, 84.17 including, but not limited to, private or group health 84.18 insurance, medical assistance, Medicare, the Veterans 84.19 Administration, the senior citizen drug program established 84.20 under section 256.955, or under any waiver arrangement received 84.21 by the state to provide a prescription drug benefit for 84.22 qualified Medicare beneficiaries or service-limited Medicare 84.23 beneficiaries. 84.24 (d) The commissioner may restrict or categorize payments to 84.25 meet the appropriation allocated for this program. 84.26 (e) Any cost of the post-kidney transplant maintenance 84.27 drugs that is not reimbursed under this program is the 84.28 responsibility of the program recipient. 84.29 Subd. 4. [DRUG FORMULARY.] The commissioner shall maintain 84.30 a drug formulary that includes all drugs eligible for 84.31 reimbursement by the program. The commissioner may use the drug 84.32 formulary established under section 256B.0625, subdivision 13. 84.33 The commissioner shall establish an internal review procedure 84.34 for updating the formulary that allows for the addition and 84.35 deletion of drugs to the formulary. The drug formulary must be 84.36 reviewed at least quarterly per fiscal year. 85.1 Subd. 5. [PRIVATE DONATIONS.] The commissioner may accept 85.2 funding from other public or private sources. 85.3 Subd. 6. [SUNSET.] This program expires on July 1, 2000. 85.4 Sec. 6. Minnesota Statutes 1997 Supplement, section 85.5 256.9657, subdivision 3, is amended to read: 85.6 Subd. 3. [HEALTH MAINTENANCE ORGANIZATION; COMMUNITY 85.7 INTEGRATED SERVICE NETWORK SURCHARGE.] (a) Effective October 1, 85.8 1992, each health maintenance organization with a certificate of 85.9 authority issued by the commissioner of health under chapter 62D 85.10 and each community integrated service network licensed by the 85.11 commissioner under chapter 62N shall pay to the commissioner of 85.12 human services a surcharge equal to six-tenths of one percent of 85.13 the total premium revenues of the health maintenance 85.14 organization or community integrated service network as reported 85.15 to the commissioner of health according to the schedule in 85.16 subdivision 4. 85.17 (b) For purposes of this subdivision, total premium revenue 85.18 means: 85.19 (1) premium revenue recognized on a prepaid basis from 85.20 individuals and groups for provision of a specified range of 85.21 health services over a defined period of time which is normally 85.22 one month, excluding premiums paid to a health maintenance 85.23 organization or community integrated service network from the 85.24 Federal Employees Health Benefit Program; 85.25 (2) premiums from Medicare wrap-around subscribers for 85.26 health benefits which supplement Medicare coverage; 85.27 (3) Medicare revenue, as a result of an arrangement between 85.28 a health maintenance organization or a community integrated 85.29 service network and the health care financing administration of 85.30 the federal Department of Health and Human Services, for 85.31 services to a Medicare beneficiary, excluding Medicare revenue 85.32 that states are prohibited from taxing under sections 4001 and 85.33 4002 of Public Law Number 105-33 received by a health 85.34 maintenance organization or community integrated service network 85.35 through risk sharing or Medicare Choice + contracts; and 85.36 (4) medical assistance revenue, as a result of an 86.1 arrangement between a health maintenance organization or 86.2 community integrated service network and a Medicaid state 86.3 agency, for services to a medical assistance beneficiary. 86.4 If advance payments are made under clause (1) or (2) to the 86.5 health maintenance organization or community integrated service 86.6 network for more than one reporting period, the portion of the 86.7 payment that has not yet been earned must be treated as a 86.8 liability. 86.9 (c) When a health maintenance organization or community 86.10 integrated service network merges or consolidates with or is 86.11 acquired by another health maintenance organization or community 86.12 integrated service network, the surviving corporation or the new 86.13 corporation shall be responsible for the annual surcharge 86.14 originally imposed on each of the entities or corporations 86.15 subject to the merger, consolidation, or acquisition, regardless 86.16 of whether one of the entities or corporations does not retain a 86.17 certificate of authority under chapter 62D or a license under 86.18 chapter 62N. 86.19 (d) Effective July 1 of each year, the surviving 86.20 corporation's or the new corporation's surcharge shall be based 86.21 on the revenues earned in the second previous calendar year by 86.22 all of the entities or corporations subject to the merger, 86.23 consolidation, or acquisition regardless of whether one of the 86.24 entities or corporations does not retain a certificate of 86.25 authority under chapter 62D or a license under chapter 62N until 86.26 the total premium revenues of the surviving corporation include 86.27 the total premium revenues of all the merged entities as 86.28 reported to the commissioner of health. 86.29 (e) When a health maintenance organization or community 86.30 integrated service network, which is subject to liability for 86.31 the surcharge under this chapter, transfers, assigns, sells, 86.32 leases, or disposes of all or substantially all of its property 86.33 or assets, liability for the surcharge imposed by this chapter 86.34 is imposed on the transferee, assignee, or buyer of the health 86.35 maintenance organization or community integrated service network. 86.36 (f) In the event a health maintenance organization or 87.1 community integrated service network converts its licensure to a 87.2 different type of entity subject to liability for the surcharge 87.3 under this chapter, but survives in the same or substantially 87.4 similar form, the surviving entity remains liable for the 87.5 surcharge regardless of whether one of the entities or 87.6 corporations does not retain a certificate of authority under 87.7 chapter 62D or a license under chapter 62N. 87.8 (g) The surcharge assessed to a health maintenance 87.9 organization or community integrated service network ends when 87.10 the entity ceases providing services for premiums and the 87.11 cessation is not connected with a merger, consolidation, 87.12 acquisition, or conversion. 87.13 Sec. 7. Minnesota Statutes 1997 Supplement, section 87.14 256.9685, subdivision 1, is amended to read: 87.15 Subdivision 1. [AUTHORITY.] The commissioner shall 87.16 establish procedures for determining medical assistance and 87.17 general assistance medical care payment rates under a 87.18 prospective payment system for inpatient hospital services in 87.19 hospitals that qualify as vendors of medical assistance. The 87.20 commissioner shall establish, by rule, procedures for 87.21 implementing this section and sections 256.9686, 256.969, and 87.22 256.9695.The medical assistance payment rates must be based on87.23methods and standards that the commissioner finds are adequate87.24to provide for the costs that must be incurred for the care of87.25recipients in efficiently and economically operated hospitals.87.26 Services must meet the requirements of section 256B.04, 87.27 subdivision 15, or 256D.03, subdivision 7, paragraph (b), to be 87.28 eligible for payment. 87.29 Sec. 8. Minnesota Statutes 1996, section 256.969, 87.30 subdivision 16, is amended to read: 87.31 Subd. 16. [INDIAN HEALTH SERVICE FACILITIES.]Indian87.32health serviceFacilities of the Indian health service and 87.33 facilities operated by a tribe or tribal organization under 87.34 funding authorized by title III of the Indian Self-Determination 87.35 and Education Assistance Act, Public Law Number 93-638, or by 87.36 United States Code, title 25, chapter 14, subchapter II, 88.1 sections 450f to 450n, are exempt from the rate establishment 88.2 methods required by this section and shall bereimbursed at88.3charges as limited to the amount allowed under federal lawpaid 88.4 according to the rate published by the United States assistant 88.5 secretary for health under authority of United States Code, 88.6 title 42, sections 248A and 248B. 88.7 Sec. 9. Minnesota Statutes 1996, section 256.969, 88.8 subdivision 17, is amended to read: 88.9 Subd. 17. [OUT-OF-STATE HOSPITALS IN LOCAL TRADE AREAS.] 88.10 Out-of-state hospitals that are located within a Minnesota local 88.11 trade area and that have more than 20 admissions in the base 88.12 year shall have rates established using the same procedures and 88.13 methods that apply to Minnesota hospitals. For this subdivision 88.14 and subdivision 18, local trade area means a county contiguous 88.15 to Minnesota and located in a metropolitan statistical area as 88.16 determined by Medicare for October 1 prior to the most current 88.17 rebased rate year. Hospitals that are not required by law to 88.18 file information in a format necessary to establish rates shall 88.19 have rates established based on the commissioner's estimates of 88.20 the information. Relative values of the diagnostic categories 88.21 shall not be redetermined under this subdivision until required 88.22 by rule. Hospitals affected by this subdivision shall then be 88.23 included in determining relative values. However, hospitals 88.24 that have rates established based upon the commissioner's 88.25 estimates of information shall not be included in determining 88.26 relative values. This subdivision is effective for hospital 88.27 fiscal years beginning on or after July 1, 1988. A hospital 88.28 shall provide the information necessary to establish rates under 88.29 this subdivision at least 90 days before the start of the 88.30 hospital's fiscal year. 88.31 Sec. 10. Minnesota Statutes 1996, section 256B.03, 88.32 subdivision 3, is amended to read: 88.33 Subd. 3. [AMERICAN INDIAN HEALTH FUNDINGTRIBAL PURCHASING 88.34 MODEL.] Notwithstanding subdivision 1 and sections 256B.0625 and 88.35 256D.03, subdivision 4, paragraph(f)(i), the commissioner may 88.36 make payments to federally recognized Indian tribes with a 89.1 reservation in the state to provide medical assistance and 89.2 general assistance medical care to Indians, as defined under 89.3 federal law, who reside on or near the reservation. The 89.4 payments may be made in the form of a block grant or other 89.5 payment mechanism determined in consultation with the tribe. 89.6 Any alternative payment mechanism agreed upon by the tribes and 89.7 the commissioner under this subdivision is not dependent upon 89.8 county or health plan agreement but is intended to create a 89.9 direct payment mechanism between the state and the tribe for the 89.10 administration of the medical assistanceprogramand general 89.11 assistance medical care programs, and for covered services. 89.12 A tribe that implements a purchasing model under this 89.13 subdivision shall report to the commissioner at least annually 89.14 on the operation of the model. The commissioner and the tribe 89.15 shall cooperatively determine the data elements, format, and 89.16 timetable for the report. 89.17 For purposes of this subdivision, "Indian tribe" means a 89.18 tribe, band, or nation, or other organized group or community of 89.19 Indians that is recognized as eligible for the special programs 89.20 and services provided by the United States to Indians because of 89.21 their status as Indians and for which a reservation exists as is 89.22 consistent with Public Law Number 100-485, as amended. 89.23 Payments under this subdivision may not result in an 89.24 increase in expenditures that would not otherwise occur in the 89.25 medical assistance program under this chapter or the general 89.26 assistance medical care program under chapter 256D. 89.27 Sec. 11. [256B.038] [PROVIDER RATE INCREASES AFTER JUNE 89.28 30, 1999.] 89.29 (a) For fiscal years beginning on or after July 1, 1999, 89.30 the commissioner shall consider increasing payment rates for the 89.31 services listed in paragraph (b) by indexing the rates in effect 89.32 for inflation based on the change in the Consumer Price 89.33 Index-All Items (United States city average)(CPI-U) as 89.34 forecasted by Data Resources, Inc., in the fourth quarter of the 89.35 prior year for the calendar year during which the rate increase 89.36 occurs. 90.1 (b) The rate increases in paragraph (a) shall apply to home 90.2 and community-based waiver services for persons with mental 90.3 retardation or related conditions under section 256B.501; home 90.4 and community-based waiver services for the elderly under 90.5 section 256B.0915; waivered services under community 90.6 alternatives for disabled individuals under section 256B.49; 90.7 community alternative care waivered services under section 90.8 256B.49; traumatic brain injury waivered services under section 90.9 256B.49; nursing services and home health services under section 90.10 256B.0625, subdivision 6a; personal care services and nursing 90.11 supervision of personal care services under section 256B.0625, 90.12 subdivision 19a; private duty nursing services under section 90.13 256B.0625, subdivision 7; day training and habilitation services 90.14 for adults with mental retardation or related conditions under 90.15 sections 252.40 to 252.46; physical therapy services under 90.16 sections 256B.0625, subdivision 8, and 256D.03, subdivision 4; 90.17 occupational therapy services under sections 256B.0625, 90.18 subdivision 8a, and 256D.03, subdivision 4; speech-language 90.19 therapy services under section 256D.03, subdivision 4, and 90.20 Minnesota Rules, part 9505.0390; respiratory therapy services 90.21 under section 256D.03, subdivision 4, and Minnesota Rules, part 90.22 9505.0295; physician services under section 256B.0625, 90.23 subdivision 3; dental services under sections 256B.0625, 90.24 subdivision 9, and 256D.03, subdivision 4; alternative care 90.25 services under section 256B.0913; adult residential program 90.26 grants under Minnesota Rules, parts 9535.2000 to 9535.3000; 90.27 adult and family community support grants under Minnesota Rules, 90.28 parts 9535.1700 to 9535.1760; and semi-independent living 90.29 services under section 252.275, including SILS funding under 90.30 county social services grants formerly funded under chapter 256I. 90.31 (c) The commissioner shall increase prepaid medical 90.32 assistance program capitation rates as appropriate to reflect 90.33 the rate increases in this section. 90.34 (d) In implementing this section, the commissioner shall 90.35 consider proposing a schedule to equalize rates paid by 90.36 different programs for the same service. 91.1 Sec. 12. Minnesota Statutes 1996, section 256B.04, is 91.2 amended by adding a subdivision to read: 91.3 Subd. 19. [INFORMATION PROVIDED IN SEVERAL 91.4 LANGUAGES.] Upon request, the commissioner shall provide 91.5 applications and other information regarding medical assistance, 91.6 including all notices and disclosures provided to applicants and 91.7 recipients, in English, Spanish, Vietnamese, and Hmong. 91.8 Reasonable effort must be made to provide this information to 91.9 other non-English-speaking applicants and recipients. 91.10 Sec. 13. Minnesota Statutes 1996, section 256B.055, 91.11 subdivision 7, is amended to read: 91.12 Subd. 7. [AGED, BLIND, OR DISABLED PERSONS.] Medical 91.13 assistance may be paid for a person who meets the categorical 91.14 eligibility requirements of the supplemental security income 91.15 program or, who would meet those requirements except for excess 91.16 income or assets, and who meets the other eligibility 91.17 requirements of this section. 91.18Effective February 1, 1989, and to the extent allowed by91.19federal law the commissioner shall deduct state and federal91.20income taxes and federal insurance contributions act payments91.21withheld from the individual's earned income in determining91.22eligibility under this subdivision.91.23 Sec. 14. Minnesota Statutes 1996, section 256B.055, is 91.24 amended by adding a subdivision to read: 91.25 Subd. 7a. [SPECIAL CATEGORY FOR DISABLED 91.26 CHILDREN.] Medical assistance may be paid for a person who is 91.27 under age 18 and who meets income and asset eligibility 91.28 requirements of the Supplemental Security Income program if the 91.29 person was receiving Supplemental Security Income payments on 91.30 the date of enactment of section 211(a) of Public Law Number 91.31 104-193, the Personal Responsibility and Work Opportunity Act of 91.32 1996, and the person would have continued to receive such 91.33 payments except for the change in the childhood disability 91.34 criteria in section 211(a) of Public Law Number 104-193. 91.35 Sec. 15. Minnesota Statutes 1997 Supplement, section 91.36 256B.056, subdivision 1a, is amended to read: 92.1 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 92.2 specifically required by state law or rule or federal law or 92.3 regulation, the methodologies used in counting income and assets 92.4 to determine eligibility for medical assistance for persons 92.5 whose eligibility category is based on blindness, disability, or 92.6 age of 65 or more years, the methodologies for the supplemental 92.7 security income program shall be used, except that payments made92.8according to a court order for the support of children shall be92.9excluded from income in an amount not to exceed the difference92.10between the applicable income standard used in the state's92.11medical assistance program for aged, blind, and disabled persons92.12and the applicable income standard used in the state's medical92.13assistance program for families with children. Exclusion of92.14court-ordered child support payments is subject to the condition92.15that if there has been a change in the financial circumstances92.16of the person with the legal obligation to pay support since the92.17support order was entered, the person with the legal obligation92.18to pay support has petitioned for modification of the support92.19order. For families and children, which includes all other 92.20 eligibility categories, the methodologies under the state's AFDC 92.21 plan in effect as of July 16, 1996, as required by the Personal 92.22 Responsibility and Work Opportunity Reconciliation Act of 1996 92.23 (PRWORA), Public Law Number 104-193, shall be used. Effective 92.24 upon federal approval, in-kind contributions to, and payments 92.25 made on behalf of, a recipient, by an obligor, in satisfaction 92.26 of or in addition to a temporary or permanent order for child 92.27 support or maintenance, shall be considered income to the 92.28 recipient. For these purposes, a "methodology" does not include 92.29 an asset or income standard, or accounting method, or method of 92.30 determining effective dates. 92.31 Sec. 16. Minnesota Statutes 1997 Supplement, section 92.32 256B.056, subdivision 4, is amended to read: 92.33 Subd. 4. [INCOME.] To be eligible for medical assistance, 92.34 a personmust not have, or anticipate receiving, semiannual92.35income in excess of 120 percent of the income standards by92.36family size used under the aid to families with dependent93.1children state plan as of July 16, 1996, as required by the93.2Personal Responsibility and Work Opportunity Reconciliation Act93.3of 1996 (PRWORA), Public Law Number 104-193, except93.4thateligible under section 256B.055, subdivision 7, and 93.5 families and children may have an income up to 133-1/3 percent 93.6 of the AFDC income standard in effect under the July 16, 1996, 93.7 AFDC state plan. For rate years beginning on or after July 1, 93.8 1999, the commissioner shall consider increasing the base AFDC 93.9 standard in effect July 16, 1996, by an amount equal to the 93.10 percentage increase in the Consumer Price Index for all urban 93.11 consumers for the previous calendar year. In computing income 93.12 to determine eligibility of persons who are not residents of 93.13 long-term care facilities, the commissioner shall disregard 93.14 increases in income as required by Public Law Numbers 94-566, 93.15 section 503; 99-272; and 99-509. Veterans aid and attendance 93.16 benefits and Veterans Administration unusual medical expense 93.17 payments are considered income to the recipient. 93.18 Sec. 17. Minnesota Statutes 1996, section 256B.057, 93.19 subdivision 3a, is amended to read: 93.20 Subd. 3a. [ELIGIBILITY FOR PAYMENT OF MEDICARE PART B 93.21 PREMIUMS.] A person who would otherwise be eligible as a 93.22 qualified Medicare beneficiary under subdivision 3, except the 93.23 person's income is in excess of the limit, is eligible for 93.24 medical assistance reimbursement of Medicare Part B premiums if 93.25 the person's income is less than110120 percent of the official 93.26 federal poverty guidelines for the applicable family size.The93.27income limit shall increase to 120 percent of the official93.28federal poverty guidelines for the applicable family size on93.29January 1, 1995.93.30 Sec. 18. Minnesota Statutes 1996, section 256B.057, is 93.31 amended by adding a subdivision to read: 93.32 Subd. 3b. [QUALIFYING INDIVIDUALS.] Beginning July 1, 93.33 1998, to the extent of the federal allocation to Minnesota, a 93.34 person, who would otherwise be eligible as a qualified Medicare 93.35 beneficiary under subdivision 3, except that the person's income 93.36 is in excess of the limit, is eligible as a qualifying 94.1 individual according to the following criteria: 94.2 (1) if the person's income is greater than 120 percent, but 94.3 less than 135 percent of the official federal poverty guidelines 94.4 for the applicable family size, the person is eligible for 94.5 medical assistance reimbursement of Medicare Part B premiums; or 94.6 (2) if the person's income is greater than 135 percent but 94.7 less than 175 percent of the official federal poverty guidelines 94.8 for the applicable family size, the person is eligible for 94.9 medical assistance reimbursement of that portion of the Medicare 94.10 Part B premium attributable to an increase in Part B 94.11 expenditures which resulted from the shift of home care services 94.12 from Medicare Part A to Medicare Part B under Public Law Number 94.13 105-33, section 4732, the Balanced Budget Act of 1997. 94.14 The commissioner shall limit enrollment of qualifying 94.15 individuals under this subdivision according to the requirements 94.16 of Public Law Number 105-33, section 4732. 94.17 Sec. 19. Minnesota Statutes 1997 Supplement, section 94.18 256B.06, subdivision 4, is amended to read: 94.19 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 94.20 medical assistance is limited to citizens of the United States, 94.21 qualified noncitizens as defined in this subdivision, and other 94.22 persons residing lawfully in the United States. 94.23 (b) "Qualified noncitizen" means a person who meets one of 94.24 the following immigration criteria: 94.25 (1) admitted for lawful permanent residence according to 94.26 United States Code, title 8; 94.27 (2) admitted to the United States as a refugee according to 94.28 United States Code, title 8, section 1157; 94.29 (3) granted asylum according to United States Code, title 94.30 8, section 1158; 94.31 (4) granted withholding of deportation according to United 94.32 States Code, title 8, section 1253(h); 94.33 (5) paroled for a period of at least one year according to 94.34 United States Code, title 8, section 1182(d)(5); 94.35 (6) granted conditional entrant status according to United 94.36 States Code, title 8, section 1153(a)(7);or95.1 (7) determined to be a battered noncitizen by the United 95.2 States Attorney General according to the Illegal Immigration 95.3 Reform and Immigrant Responsibility Act of 1996, title V of the 95.4 Omnibus Consolidated Appropriations Bill, Public Law Number 95.5 104-200; 95.6 (8) is a child of a noncitizen determined to be a battered 95.7 noncitizen by the United States Attorney General according to 95.8 the Illegal Immigration Reform and Immigrant Responsibility Act 95.9 of 1996, title V, of the Omnibus Consolidated Appropriations 95.10 Bill, Public Law Number 104-200; or 95.11 (9) determined to be a Cuban or Haitian entrant as defined 95.12 in section 501(e) of Public Law Number 96-422, the Refugee 95.13 Education Assistance Act of 1980. 95.14 (c) All qualified noncitizens who were residing in the 95.15 United States before August 22, 1996, who otherwise meet the 95.16 eligibility requirements of chapter 256B, are eligible for 95.17 medical assistance with federal financial participation. 95.18 (d) All qualified noncitizens who entered the United States 95.19 on or after August 22, 1996, and who otherwise meet the 95.20 eligibility requirements of chapter 256B, are eligible for 95.21 medical assistance with federal financial participation through 95.22 November 30, 1996. 95.23 Beginning December 1, 1996, qualified noncitizens who 95.24 entered the United States on or after August 22, 1996, and who 95.25 otherwise meet the eligibility requirements of chapter 256B are 95.26 eligible for medical assistance with federal participation for 95.27 five years if they meet one of the following criteria: 95.28 (i) refugees admitted to the United States according to 95.29 United States Code, title 8, section 1157; 95.30 (ii) persons granted asylum according to United States 95.31 Code, title 8, section 1158; 95.32 (iii) persons granted withholding of deportation according 95.33 to United States Code, title 8, section 1253(h); 95.34 (iv) veterans of the United States Armed Forces with an 95.35 honorable discharge for a reason other than noncitizen status, 95.36 their spouses and unmarried minor dependent children; or 96.1 (v) persons on active duty in the United States Armed 96.2 Forces, other than for training, their spouses and unmarried 96.3 minor dependent children. 96.4 Beginning December 1, 1996, qualified noncitizens who do 96.5 not meet one of the criteria in items (i) to (v) are eligible 96.6 for medical assistance without federal financial participation 96.7 as described in paragraph (j). 96.8 (e) Noncitizens who are not qualified noncitizens as 96.9 defined in paragraph (b), who are lawfully residing in the 96.10 United States and who otherwise meet the eligibility 96.11 requirements of chapter 256B, are eligible for medical 96.12 assistance under clauses (1) to (3). These individuals must 96.13 cooperate with the Immigration and Naturalization Service to 96.14 pursue any applicable immigration status, including citizenship, 96.15 that would qualify them for medical assistance with federal 96.16 financial participation. 96.17 (1) Persons who were medical assistance recipients on 96.18 August 22, 1996, are eligible for medical assistance with 96.19 federal financial participation through December 31, 1996. 96.20 (2) Beginning January 1, 1997, persons described in clause 96.21 (1) are eligible for medical assistance without federal 96.22 financial participation as described in paragraph (j). 96.23 (3) Beginning December 1, 1996, persons residing in the 96.24 United States prior to August 22, 1996, who were not receiving 96.25 medical assistance and persons who arrived on or after August 96.26 22, 1996, are eligible for medical assistance without federal 96.27 financial participation as described in paragraph (j). 96.28 (f) Nonimmigrants who otherwise meet the eligibility 96.29 requirements of chapter 256B are eligible for the benefits as 96.30 provided in paragraphs (g) to (i). For purposes of this 96.31 subdivision, a "nonimmigrant" is a person in one of the classes 96.32 listed in United States Code, title 8, section 1101(a)(15). 96.33 (g) Payment shall also be made for care and services that 96.34 are furnished to noncitizens, regardless of immigration status, 96.35 who otherwise meet the eligibility requirements of chapter 256B, 96.36 if such care and services are necessary for the treatment of an 97.1 emergency medical condition, except for organ transplants and 97.2 related care and services and routine prenatal care. 97.3 (h) For purposes of this subdivision, the term "emergency 97.4 medical condition" means a medical condition that meets the 97.5 requirements of United States Code, title 42, section 1396b(v). 97.6 (i) Pregnant noncitizens who are undocumented or 97.7 nonimmigrants, who otherwise meet the eligibility requirements 97.8 of chapter 256B, are eligible for medical assistance payment 97.9 without federal financial participation for care and services 97.10 through the period of pregnancy, and 60 days postpartum, except 97.11 for labor and delivery. 97.12 (j) Qualified noncitizens as described in paragraph (d), 97.13 and all other noncitizens lawfully residing in the United States 97.14 as described in paragraph (e), who are ineligible for medical 97.15 assistance with federal financial participation and who 97.16 otherwise meet the eligibility requirements of chapter 256B and 97.17 of this paragraph, are eligible for medical assistance without 97.18 federal financial participation. Qualified noncitizens as 97.19 described in paragraph (d) are only eligible for medical 97.20 assistance without federal financial participation for five 97.21 years from their date of entry into the United States. 97.22 (k) The commissioner shall submit to the legislature by 97.23 December 31, 1998, a report on the number of recipients and cost 97.24 of coverage of care and services made according to paragraphs 97.25 (i) and (j). 97.26 Sec. 20. Minnesota Statutes 1996, section 256B.0625, is 97.27 amended by adding a subdivision to read: 97.28 Subd. 3a. [GENDER REASSIGNMENT SURGERY.] Gender 97.29 reassignment surgery and other gender reassignment medical 97.30 procedures including drug therapy for gender reassignment are 97.31 not medically necessary. 97.32 Sec. 21. Minnesota Statutes 1996, section 256B.0625, 97.33 subdivision 7, is amended to read: 97.34 Subd. 7. [PRIVATE DUTY NURSING.] Medical assistance covers 97.35 private duty nursing services in a recipient's home. Recipients 97.36 who are authorized to receive private duty nursing services in 98.1 their home may use approved hours outside of the home during 98.2 hours when normal life activities take them outside of their 98.3 home and when, without the provision of private duty nursing, 98.4 their health and safety would be jeopardized. To use private 98.5 duty nursing services at school, the recipient or responsible 98.6 party must provide written authorization in the care plan 98.7 identifying the chosen provider and the daily amount of services 98.8 to be used at school. Medical assistance does not cover private 98.9 duty nursing services for residents of a hospital, nursing 98.10 facility, intermediate care facility, or a health care facility 98.11 licensed by the commissioner of health, except as authorized in 98.12 section 256B.64 for ventilator-dependent recipients in hospitals 98.13 or unless a resident who is otherwise eligible is on leave from 98.14 the facility and the facility either pays for the private duty 98.15 nursing services or forgoes the facility per diem for the leave 98.16 days that private duty nursing services are used. Total hours 98.17 of service and payment allowed for services outside the home 98.18 cannot exceed that which is otherwise allowed in an in-home 98.19 setting according to section 256B.0627. All private duty 98.20 nursing services must be provided according to the limits 98.21 established under section 256B.0627. Private duty nursing 98.22 services may not be reimbursed if the nurse is the spouse of the 98.23 recipient or the parent or foster care provider of a recipient 98.24 who is under age 18, or the recipient's legal guardian. 98.25 Sec. 22. Minnesota Statutes 1996, section 256B.0625, 98.26 subdivision 17, is amended to read: 98.27 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 98.28 covers transportation costs incurred solely for obtaining 98.29 emergency medical care or transportation costs incurred by 98.30 nonambulatory persons in obtaining emergency or nonemergency 98.31 medical care when paid directly to an ambulance company, common 98.32 carrier, or other recognized providers of transportation 98.33 services. For the purpose of this subdivision, a person who is 98.34 incapable of transport by taxicab or bus shall be considered to 98.35 be nonambulatory. 98.36 (b) Medical assistance covers special transportation, as 99.1 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 99.2 if the provider receives and maintains a current physician's 99.3 order by the recipient's attending physician certifying that the 99.4 recipient has a physical or mental impairment that would 99.5 prohibit the recipient from safely accessing and using a bus, 99.6 taxi, other commercial transportation, or private automobile. 99.7 Special transportation includes driver-assisted service to 99.8 eligible individuals. Driver-assisted service includes 99.9 passenger pickup at and return to the individual's residence or 99.10 place of business, assistance with admittance of the individual 99.11 to the medical facility, and assistance in passenger securement 99.12 or in securing of wheelchairs or stretchers in the vehicle. The 99.13 commissioner shall establish maximum medical assistance 99.14 reimbursement rates for special transportation services for 99.15 persons who need a wheelchair lift van or stretcher-equipped 99.16 vehicle and for those who do not need a wheelchair lift van or 99.17 stretcher-equipped vehicle. The average of these two rates per 99.18 trip must not exceed$14$16 for the base rate and$1.10$1.30 99.19 per mile. Special transportation provided to nonambulatory 99.20 persons who do not need a wheelchair lift van or 99.21 stretcher-equipped vehicle, may be reimbursed at a lower rate 99.22 than special transportation provided to persons who need a 99.23 wheelchair lift van or stretcher-equipped vehicle. 99.24 Sec. 23. Minnesota Statutes 1996, section 256B.0625, is 99.25 amended by adding a subdivision to read: 99.26 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 99.27 services rendered on or after July 1, 1999, medical assistance 99.28 payments for ambulance services shall be increased by ten 99.29 percent. 99.30 Sec. 24. Minnesota Statutes 1996, section 256B.0625, 99.31 subdivision 19a, is amended to read: 99.32 Subd. 19a. [PERSONAL CARE SERVICES.] Medical assistance 99.33 covers personal care services in a recipient's home. To qualify 99.34 for personal care services, recipients or responsible parties 99.35 must be able to identify the recipient's needs, direct and 99.36 evaluate task accomplishment, and provide for health and 100.1 safety. Approved hours may be used outside the home when normal 100.2 life activities take them outside the home and when, without the 100.3 provision of personal care, their health and safety would be 100.4 jeopardized. To use personal care services at school, the 100.5 recipient or responsible party must provide written 100.6 authorization in the care plan identifying the chosen provider 100.7 and the daily amount of services to be used at school. Total 100.8 hours for services, whether actually performed inside or outside 100.9 the recipient's home, cannot exceed that which is otherwise 100.10 allowed for personal care services in an in-home setting 100.11 according to section 256B.0627. Medical assistance does not 100.12 cover personal care services for residents of a hospital, 100.13 nursing facility, intermediate care facility, health care 100.14 facility licensed by the commissioner of health, or unless a 100.15 resident who is otherwise eligible is on leave from the facility 100.16 and the facility either pays for the personal care services or 100.17 forgoes the facility per diem for the leave days that personal 100.18 care services are used. All personal care services must be 100.19 provided according to section 256B.0627. Personal care services 100.20 may not be reimbursed if the personal care assistant is the 100.21 spouse or legal guardian of the recipient or the parent of a 100.22 recipient under age 18, or the responsible party or the foster 100.23 care provider of a recipient who cannot direct the recipient's 100.24 own care unless, in the case of a foster care provider, a county 100.25 or state case manager visits the recipient as needed, but not 100.26 less than every six months, to monitor the health and safety of 100.27 the recipient and to ensure the goals of the care plan are met. 100.28 Parents of adult recipients, adult children of the recipient or 100.29 adult siblings of the recipient may be reimbursed for personal 100.30 care services if they are not the recipient's legal guardian and 100.31 are granted a waiver under section 256B.0627. 100.32 Sec. 25. Minnesota Statutes 1996, section 256B.0625, 100.33 subdivision 20, is amended to read: 100.34 Subd. 20. [MENTALILLNESSHEALTH CASE MANAGEMENT.] (a) To 100.35 the extent authorized by rule of the state agency, medical 100.36 assistance covers case management services to persons with 101.1 serious and persistent mental illnessor subject to federal101.2approval,and children with severe emotional disturbance. 101.3 Services provided under this section must meet the relevant 101.4 standards in sections 245.461 to 245.4888, the Comprehensive 101.5 Adult and Children's Mental Health Acts, Minnesota Rules, parts 101.6 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10. 101.7 (b) Entities meeting program standards set out in rules 101.8 governing family community support services as defined in 101.9 section 245.4871, subdivision 17, are eligible for medical 101.10 assistance reimbursement for case management services for 101.11 children with severe emotional disturbance when these services 101.12 meet the program standards in Minnesota Rules, parts 9520.0900 101.13 to 9520.0926 and 9505.0322, excludingsubpart 6subparts 6 and 101.14 10. 101.15(b) In counties where fewer than 50 percent of children101.16estimated to be eligible under medical assistance to receive101.17case management services for children with severe emotional101.18disturbance actually receive these services in state fiscal year101.191995, community mental health centers serving those counties,101.20entities meeting program standards in Minnesota Rules, parts101.219520.0570 to 9520.0870, and other entities authorized by the101.22commissioner are eligible for medical assistance reimbursement101.23for case management services for children with severe emotional101.24disturbance when these services meet the program standards in101.25Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322,101.26excluding subpart 6.101.27 (c) Medical assistance and MinnesotaCare payment for mental 101.28 health case management shall be made on a monthly basis. In 101.29 order to receive payment for an eligible child, the provider 101.30 must document at least a face-to-face contact with the child, 101.31 the child's parents, or the child's legal representative. To 101.32 receive payment for an eligible adult, the provider must 101.33 document at least a face-to-face contact with the adult or the 101.34 adult's legal representative. 101.35 (d) Payment for mental health case management provided by 101.36 county or state staff shall be based on the monthly rate 102.1 methodology under section 256B.094, subdivision 6, paragraph 102.2 (b), with separate rates calculated for child welfare and mental 102.3 health, and within mental health, separate rates for children 102.4 and adults. 102.5 (e) Payment for mental health case management provided by 102.6 county-contracted vendors shall be based on a monthly rate 102.7 negotiated by the host county. The negotiated rate must not 102.8 exceed the rate charged by the vendor for the same service to 102.9 other payers. If the service is provided by a team of 102.10 contracted vendors, the county may negotiate a team rate with a 102.11 vendor who is a member of the team. The team shall determine 102.12 how to distribute the rate among its members. No reimbursement 102.13 received by contracted vendors shall be returned to the county, 102.14 except to reimburse the county for advance funding provided by 102.15 the county to the vendor. 102.16 (f) If the service is provided by a team which includes 102.17 contracted vendors and county or state staff, the costs for 102.18 county or state staff participation in the team shall be 102.19 included in the rate for county-provided services. In this 102.20 case, the contracted vendor and the county may each receive 102.21 separate payment for services provided by each entity in the 102.22 same month. 102.23 (g) The commissioner shall calculate the nonfederal share 102.24 of actual medical assistance and general assistance medical care 102.25 payments for each county, based on the higher of calendar year 102.26 1995 or 1996, by service date, project that amount forward to 102.27 1999, and transfer the result from medical assistance and 102.28 general assistance medical care to each county's mental health 102.29 grants under sections 245.4886 and 256E.12 for calendar year 102.30 1999. The minimum amount added to each county's mental health 102.31 grant shall be $3,000 per year for children and $5,000 per year 102.32 for adults. The commissioner may reduce the statewide growth 102.33 factor in order to fund these minimums. The total amount 102.34 transferred shall become part of the base for future mental 102.35 health grants for each county. 102.36 (h) Any net increase in revenue to the county as a result 103.1 of the change in this section must be used to provide expanded 103.2 mental health services as defined in sections 245.461 to 103.3 245.4888, the Comprehensive Adult and Children's Mental Health 103.4 Acts, excluding inpatient and residential treatment. For 103.5 adults, increased revenue may also be used for services and 103.6 consumer supports which are part of adult mental health projects 103.7 approved under Laws 1997, chapter 203, article 7, section 25. 103.8 For children, increased revenue may also be used for respite 103.9 care and nonresidential individualized rehabilitation services 103.10 as defined in section 245.492, subdivisions 17 and 23. 103.11 "Increased revenue" has the meaning given in Minnesota Rules, 103.12 part 9520.0903, subpart 3. 103.13 (i) Notwithstanding section 256B.19, subdivision 1, the 103.14 nonfederal share of costs for mental health case management 103.15 shall be provided by the recipient's county of responsibility, 103.16 as defined in sections 256G.01 to 256G.12, from sources other 103.17 than federal funds or funds used to match other federal funds. 103.18 (j) The commissioner may suspend, reduce, or terminate the 103.19 reimbursement to a provider that does not meet the reporting or 103.20 other requirements of this section. The county of 103.21 responsibility, as defined in sections 256G.01 to 256G.12, is 103.22 responsible for any federal disallowances. The county may share 103.23 this responsibility with its contracted vendors. 103.24 (k) The commissioner shall set aside a portion of the 103.25 federal funds earned under this section to repay the special 103.26 revenue maximization account under section 256.01, subdivision 103.27 2, clause (15). The repayment is limited to: 103.28 (1) the costs of developing and implementing this section; 103.29 and 103.30 (2) programming the information systems. 103.31 (l) Notwithstanding section 256.025, subdivision 2, 103.32 payments to counties for case management expenditures under this 103.33 section shall only be made from federal earnings from services 103.34 provided under this section. Payments to contracted vendors 103.35 shall include both the federal earnings and the county share. 103.36 (m) Notwithstanding section 256B.041, county payments for 104.1 the cost of mental health case management services provided by 104.2 county or state staff shall not be made to the state treasurer. 104.3 For the purposes of mental health case management services 104.4 provided by county or state staff under this section, the 104.5 centralized disbursement of payments to counties under section 104.6 256B.041 consists only of federal earnings from services 104.7 provided under this section. 104.8 (n) Case management services under this subdivision do not 104.9 include therapy, treatment, legal, or outreach services. 104.10 (o) If the recipient is a resident of a nursing facility, 104.11 intermediate care facility, or hospital, and the recipient's 104.12 institutional care is paid by medical assistance, payment for 104.13 case management services under this subdivision is limited to 104.14 the last 30 days of the recipient's residency in that facility 104.15 and may not exceed more than two months in a calendar year. 104.16 (p) Payment for case management services under this 104.17 subdivision shall not duplicate payments made under other 104.18 program authorities for the same purpose. 104.19 (q) For each calendar year beginning with the calendar year 104.20 2001, the amount of state funds for each county determined under 104.21 paragraph (g) shall be adjusted by the county's percentage 104.22 change in the average number of clients per month who received 104.23 case management under this section during the fiscal year that 104.24 ended six months prior to the calendar year in question, in 104.25 comparison to the prior fiscal year. 104.26 Sec. 26. Minnesota Statutes 1997 Supplement, section 104.27 256B.0625, subdivision 31a, is amended to read: 104.28 Subd. 31a. [AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 104.29 SYSTEMS.] (a) Medical assistance covers augmentative and 104.30 alternative communication systems consisting of electronic or 104.31 nonelectronic devices and the related components necessary to 104.32 enable a person with severe expressive communication limitations 104.33 to produce or transmit messages or symbols in a manner that 104.34 compensates for that disability. 104.35 (b)By January 1, 1998, the commissioner, in cooperation104.36with the commissioner of administration, shall establish an105.1augmentative and alternative communication system purchasing105.2program within a state agency or by contract with a qualified105.3private entity. The purpose of this service is to facilitate105.4ready availability of the augmentative and alternative105.5communication systems needed to meet the needs of persons with105.6severe expressive communication limitations in an efficient and105.7cost-effective manner. This program shall:105.8(1) coordinate purchase and rental of augmentative and105.9alternative communication systems;105.10(2) negotiate agreements with manufacturers and vendors for105.11purchase of components of these systems, for warranty coverage,105.12and for repair service;105.13(3) when efficient and cost-effective, maintain and105.14refurbish if needed, an inventory of components of augmentative105.15and alternative communication systems for short- or long-term105.16loan to recipients;105.17(4) facilitate training sessions for service providers,105.18consumers, and families on augmentative and alternative105.19communication systems; and105.20(5) develop a recycling program for used augmentative and105.21alternative communications systems to be reissued and used for105.22trials and short-term use, when appropriate.105.23The availability of components of augmentative and105.24alternative communication systems through this program is105.25subject to prior authorization requirements established under105.26subdivision 25Until the volume of systems purchased increases 105.27 to allow a discount price, the commissioner shall reimburse 105.28 augmentative and alternative communication manufacturers and 105.29 vendors at the manufacturer's suggested retail price for 105.30 augmentative and alternative communication systems and related 105.31 components. The commissioner shall separately reimburse 105.32 providers for purchasing and integrating individual 105.33 communication systems which are unavailable as a package from an 105.34 augmentative and alternative communication vendor. 105.35 (c) Reimbursement rates established by this purchasing 105.36 program are not subject to Minnesota Rules, part 9505.0445, item 106.1 S or T. 106.2 Sec. 27. Minnesota Statutes 1996, section 256B.0625, 106.3 subdivision 34, is amended to read: 106.4 Subd. 34. [AMERICAN INDIAN HEALTH SERVICES FACILITIES.] 106.5 Medical assistance payments toAmerican Indian health services106.6facilities for outpatient medical services billed after June 30,106.71990, must befacilities of the Indian health service and 106.8 facilities operated by a tribe or tribal organization under 106.9 funding authorized by United States Code, title 25, sections 106.10 450f to 450n, or title III of the Indian Self-Determination and 106.11 Education Assistance Act, Public Law Number 93-638, shall be at 106.12 the option of the facility in accordance with the rate published 106.13 by the United States Assistant Secretary for Health under the 106.14 authority of United States Code, title 42, sections 248(a) and 106.15 249(b). General assistance medical care payments to facilities 106.16 of the American Indian health services and facilities operated 106.17 by a tribe or tribal organization for the provision of 106.18 outpatient medical care services billed after June 30, 1990, 106.19 must be in accordance with the general assistance medical care 106.20 rates paid for the same services when provided in a facility 106.21 other thanan Americana facility of the Indian health 106.22 service or a facility operated by a tribe or tribal organization. 106.23 Sec. 28. Minnesota Statutes 1996, section 256B.0627, 106.24 subdivision 4, is amended to read: 106.25 Subd. 4. [PERSONAL CARE SERVICES.] (a) The personal care 106.26 services that are eligible for payment are the following: 106.27 (1) bowel and bladder care; 106.28 (2) skin care to maintain the health of the skin; 106.29 (3) repetitive maintenance range of motion, muscle 106.30 strengthening exercises, and other tasks specific to maintaining 106.31 a recipient's optimal level of function; 106.32 (4) respiratory assistance; 106.33 (5) transfers and ambulation; 106.34 (6) bathing, grooming, and hairwashing necessary for 106.35 personal hygiene; 106.36 (7) turning and positioning; 107.1 (8) assistance with furnishing medication that is 107.2 self-administered; 107.3 (9) application and maintenance of prosthetics and 107.4 orthotics; 107.5 (10) cleaning medical equipment; 107.6 (11) dressing or undressing; 107.7 (12) assistance with eating and meal preparation and 107.8 necessary grocery shopping; 107.9 (13) accompanying a recipient to obtain medical diagnosis 107.10 or treatment; 107.11 (14) assisting, monitoring, or prompting the recipient to 107.12 complete the services in clauses (1) to (13); 107.13 (15) redirection, monitoring, and observation that are 107.14 medically necessary and an integral part of completing the 107.15 personal care services described in clauses (1) to (14); 107.16 (16) redirection and intervention for behavior, including 107.17 observation and monitoring; 107.18 (17) interventions for seizure disorders, including 107.19 monitoring and observation if the recipient has had a seizure 107.20 that requires intervention within the past three months;and107.21 (18) tracheostomy suctioning using a clean procedure if the 107.22 procedure is properly delegated by a registered nurse. Before 107.23 this procedure can be delegated to a personal care assistant, a 107.24 registered nurse must determine that the tracheostomy suctioning 107.25 can be accomplished utilizing a clean rather than a sterile 107.26 procedure and must ensure that the personal care assistant has 107.27 been taught the proper procedure; and 107.28 (19) incidental household services that are an integral 107.29 part of a personal care service described in clauses (1) to 107.30(17)(18). 107.31 For purposes of this subdivision, monitoring and observation 107.32 means watching for outward visible signs that are likely to 107.33 occur and for which there is a covered personal care service or 107.34 an appropriate personal care intervention. For purposes of this 107.35 subdivision, a clean procedure refers to a procedure that 107.36 reduces the numbers of microorganisms or prevents or reduces the 108.1 transmission of microorganisms from one person or place to 108.2 another. A clean procedure may be used beginning 14 days after 108.3 insertion. 108.4 (b) The personal care services that are not eligible for 108.5 payment are the following: 108.6 (1) services not ordered by the physician; 108.7 (2) assessments by personal care provider organizations or 108.8 by independently enrolled registered nurses; 108.9 (3) services that are not in the service plan; 108.10 (4) services provided by the recipient's spouse, legal 108.11 guardian for an adult or child recipient, or parent of a 108.12 recipient under age 18; 108.13 (5) services provided by a foster care provider of a 108.14 recipient who cannot direct the recipient's own care, unless 108.15 monitored by a county or state case manager under section 108.16 256B.0625, subdivision 19a; 108.17 (6) services provided by the residential or program license 108.18 holder in a residence for more than four persons; 108.19 (7) services that are the responsibility of a residential 108.20 or program license holder under the terms of a service agreement 108.21 and administrative rules; 108.22 (8) sterile procedures; 108.23 (9) injections of fluids into veins, muscles, or skin; 108.24 (10) services provided by parents of adult recipients, 108.25 adult children or adult siblings of the recipient, unless these 108.26 relatives meet one of the following hardship criteria and the 108.27 commissioner waives this requirement: 108.28 (i) the relative resigns from a part-time or full-time job 108.29 to provide personal care for the recipient; 108.30 (ii) the relative goes from a full-time to a part-time job 108.31 with less compensation to provide personal care for the 108.32 recipient; 108.33 (iii) the relative takes a leave of absence without pay to 108.34 provide personal care for the recipient; 108.35 (iv) the relative incurs substantial expenses by providing 108.36 personal care for the recipient; or 109.1 (v) because of labor conditions or intermittent hours of 109.2 care needed, the relative is needed in order to provide an 109.3 adequate number of qualified personal care assistants to meet 109.4 the medical needs of the recipient; 109.5 (11) homemaker services that are not an integral part of a 109.6 personal care services; 109.7 (12) home maintenance, or chore services; 109.8 (13) services not specified under paragraph (a); and 109.9 (14) services not authorized by the commissioner or the 109.10 commissioner's designee. 109.11 Sec. 29. Minnesota Statutes 1997 Supplement, section 109.12 256B.0627, subdivision 5, is amended to read: 109.13 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 109.14 payments for home care services shall be limited according to 109.15 this subdivision. 109.16 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 109.17 recipient may receive the following home care services during a 109.18 calendar year: 109.19 (1) any initial assessment; 109.20 (2) up to two reassessments per year done to determine a 109.21 recipient's need for personal care services; and 109.22 (3) up to five skilled nurse visits. 109.23 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 109.24 services above the limits in paragraph (a) must receive the 109.25 commissioner's prior authorization, except when: 109.26 (1) the home care services were required to treat an 109.27 emergency medical condition that if not immediately treated 109.28 could cause a recipient serious physical or mental disability, 109.29 continuation of severe pain, or death. The provider must 109.30 request retroactive authorization no later than five working 109.31 days after giving the initial service. The provider must be 109.32 able to substantiate the emergency by documentation such as 109.33 reports, notes, and admission or discharge histories; 109.34 (2) the home care services were provided on or after the 109.35 date on which the recipient's eligibility began, but before the 109.36 date on which the recipient was notified that the case was 110.1 opened. Authorization will be considered if the request is 110.2 submitted by the provider within 20 working days of the date the 110.3 recipient was notified that the case was opened; 110.4 (3) a third-party payor for home care services has denied 110.5 or adjusted a payment. Authorization requests must be submitted 110.6 by the provider within 20 working days of the notice of denial 110.7 or adjustment. A copy of the notice must be included with the 110.8 request; 110.9 (4) the commissioner has determined that a county or state 110.10 human services agency has made an error; or 110.11 (5) the professional nurse determines an immediate need for 110.12 up to 40 skilled nursing or home health aide visits per calendar 110.13 year and submits a request for authorization within 20 working 110.14 days of the initial service date, and medical assistance is 110.15 determined to be the appropriate payer. 110.16 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 110.17 authorization will be evaluated according to the same criteria 110.18 applied to prior authorization requests. 110.19 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 110.20 section 256B.0627, subdivision 1, paragraph (a), shall be 110.21 conducted initially, and at least annually thereafter, in person 110.22 with the recipient and result in a completed service plan using 110.23 forms specified by the commissioner. Within 30 days of 110.24 recipient or responsible party request for home care services, 110.25 the assessment, the service plan, and other information 110.26 necessary to determine medical necessity such as diagnostic or 110.27 testing information, social or medical histories, and hospital 110.28 or facility discharge summaries shall be submitted to the 110.29 commissioner. For personal care services: 110.30 (1) The amount and type of service authorized based upon 110.31 the assessment and service plan will follow the recipient if the 110.32 recipient chooses to change providers. 110.33 (2) If the recipient's medical need changes, the 110.34 recipient's provider may assess the need for a change in service 110.35 authorization and request the change from the county public 110.36 health nurse. Within 30 days of the request, the public health 111.1 nurse will determine whether to request the change in services 111.2 based upon the provider assessment, or conduct a home visit to 111.3 assess the need and determine whether the change is appropriate. 111.4 (3) To continue to receive personal care serviceswhen the111.5recipient displays no significant change, the county public111.6health nurse has the option to review with the commissioner, or111.7the commissioner's designee, the service plan on record and111.8receive authorization for up to an additional 12 months at a111.9time for up to three years.after the first year, the recipient 111.10 or the responsible party, in conjunction with the public health 111.11 nurse, may complete a service update on forms developed by the 111.12 commissioner. The service update may substitute for the annual 111.13 reassessment described in subdivision 1. 111.14 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 111.15 commissioner's designee, shall review the assessment, the 111.16 service plan, and any additional information that is submitted. 111.17 The commissioner shall, within 30 days after receiving a 111.18 complete request, assessment, and service plan, authorize home 111.19 care services as follows: 111.20 (1) [HOME HEALTH SERVICES.] All home health services 111.21 provided by a licensed nurse or a home health aide must be prior 111.22 authorized by the commissioner or the commissioner's designee. 111.23 Prior authorization must be based on medical necessity and 111.24 cost-effectiveness when compared with other care options. When 111.25 home health services are used in combination with personal care 111.26 and private duty nursing, the cost of all home care services 111.27 shall be considered for cost-effectiveness. The commissioner 111.28 shall limit nurse and home health aide visits to no more than 111.29 one visit each per day. 111.30 (2) [PERSONAL CARE SERVICES.] (i) All personal care 111.31 services and registered nurse supervision must be prior 111.32 authorized by the commissioner or the commissioner's designee 111.33 except for the assessments established in paragraph (a). The 111.34 amount of personal care services authorized must be based on the 111.35 recipient's home care rating. A child may not be found to be 111.36 dependent in an activity of daily living if because of the 112.1 child's age an adult would either perform the activity for the 112.2 child or assist the child with the activity and the amount of 112.3 assistance needed is similar to the assistance appropriate for a 112.4 typical child of the same age. Based on medical necessity, the 112.5 commissioner may authorize: 112.6 (A) up to two times the average number of direct care hours 112.7 provided in nursing facilities for the recipient's comparable 112.8 case mix level; or 112.9 (B) up to three times the average number of direct care 112.10 hours provided in nursing facilities for recipients who have 112.11 complex medical needs or are dependent in at least seven 112.12 activities of daily living and need physical assistance with 112.13 eating or have a neurological diagnosis; or 112.14 (C) up to 60 percent of the average reimbursement rate, as 112.15 of July 1, 1991, for care provided in a regional treatment 112.16 center for recipients who have Level I behavior, plus any 112.17 inflation adjustment as provided by the legislature for personal 112.18 care service; or 112.19 (D) up to the amount the commissioner would pay, as of July 112.20 1, 1991, plus any inflation adjustment provided for home care 112.21 services, for care provided in a regional treatment center for 112.22 recipients referred to the commissioner by a regional treatment 112.23 center preadmission evaluation team. For purposes of this 112.24 clause, home care services means all services provided in the 112.25 home or community that would be included in the payment to a 112.26 regional treatment center; or 112.27 (E) up to the amount medical assistance would reimburse for 112.28 facility care for recipients referred to the commissioner by a 112.29 preadmission screening team established under section 256B.0911 112.30 or 256B.092; and 112.31 (F) a reasonable amount of time for the provision of 112.32 nursing supervision of personal care services. 112.33 (ii) The number of direct care hours shall be determined 112.34 according to the annual cost report submitted to the department 112.35 by nursing facilities. The average number of direct care hours, 112.36 as established by May 1, 1992, shall be calculated and 113.1 incorporated into the home care limits on July 1, 1992. These 113.2 limits shall be calculated to the nearest quarter hour. 113.3 (iii) The home care rating shall be determined by the 113.4 commissioner or the commissioner's designee based on information 113.5 submitted to the commissioner by the county public health nurse 113.6 on forms specified by the commissioner. The home care rating 113.7 shall be a combination of current assessment tools developed 113.8 under sections 256B.0911 and 256B.501 with an addition for 113.9 seizure activity that will assess the frequency and severity of 113.10 seizure activity and with adjustments, additions, and 113.11 clarifications that are necessary to reflect the needs and 113.12 conditions of recipients who need home care including children 113.13 and adults under 65 years of age. The commissioner shall 113.14 establish these forms and protocols under this section and shall 113.15 use an advisory group, including representatives of recipients, 113.16 providers, and counties, for consultation in establishing and 113.17 revising the forms and protocols. 113.18 (iv) A recipient shall qualify as having complex medical 113.19 needs if the care required is difficult to perform and because 113.20 of recipient's medical condition requires more time than 113.21 community-based standards allow or requires more skill than 113.22 would ordinarily be required and the recipient needs or has one 113.23 or more of the following: 113.24 (A) daily tube feedings; 113.25 (B) daily parenteral therapy; 113.26 (C) wound or decubiti care; 113.27 (D) postural drainage, percussion, nebulizer treatments, 113.28 suctioning, tracheotomy care, oxygen, mechanical ventilation; 113.29 (E) catheterization; 113.30 (F) ostomy care; 113.31 (G) quadriplegia; or 113.32 (H) other comparable medical conditions or treatments the 113.33 commissioner determines would otherwise require institutional 113.34 care. 113.35 (v) A recipient shall qualify as having Level I behavior if 113.36 there is reasonable supporting evidence that the recipient 114.1 exhibits, or that without supervision, observation, or 114.2 redirection would exhibit, one or more of the following 114.3 behaviors that cause, or have the potential to cause: 114.4 (A) injury to the recipient's own body; 114.5 (B) physical injury to other people; or 114.6 (C) destruction of property. 114.7 (vi) Time authorized for personal care relating to Level I 114.8 behavior in subclause (v), items (A) to (C), shall be based on 114.9 the predictability, frequency, and amount of intervention 114.10 required. 114.11 (vii) A recipient shall qualify as having Level II behavior 114.12 if the recipient exhibits on a daily basis one or more of the 114.13 following behaviors that interfere with the completion of 114.14 personal care services under subdivision 4, paragraph (a): 114.15 (A) unusual or repetitive habits; 114.16 (B) withdrawn behavior; or 114.17 (C) offensive behavior. 114.18 (viii) A recipient with a home care rating of Level II 114.19 behavior in subclause (vii), items (A) to (C), shall be rated as 114.20 comparable to a recipient with complex medical needs under 114.21 subclause (iv). If a recipient has both complex medical needs 114.22 and Level II behavior, the home care rating shall be the next 114.23 complex category up to the maximum rating under subclause (i), 114.24 item (B). 114.25 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 114.26 nursing services shall be prior authorized by the commissioner 114.27 or the commissioner's designee. Prior authorization for private 114.28 duty nursing services shall be based on medical necessity and 114.29 cost-effectiveness when compared with alternative care options. 114.30 The commissioner may authorize medically necessary private duty 114.31 nursing services in quarter-hour units when: 114.32 (i) the recipient requires more individual and continuous 114.33 care than can be provided during a nurse visit; or 114.34 (ii) the cares are outside of the scope of services that 114.35 can be provided by a home health aide or personal care assistant. 114.36 The commissioner may authorize: 115.1 (A) up to two times the average amount of direct care hours 115.2 provided in nursing facilities statewide for case mix 115.3 classification "K" as established by the annual cost report 115.4 submitted to the department by nursing facilities in May 1992; 115.5 (B) private duty nursing in combination with other home 115.6 care services up to the total cost allowed under clause (2); 115.7 (C) up to 16 hours per day if the recipient requires more 115.8 nursing than the maximum number of direct care hours as 115.9 established in item (A) and the recipient meets the hospital 115.10 admission criteria established under Minnesota Rules, parts 115.11 9505.0500 to 9505.0540. 115.12 The commissioner may authorize up to 16 hours per day of 115.13 medically necessary private duty nursing services or up to 24 115.14 hours per day of medically necessary private duty nursing 115.15 services until such time as the commissioner is able to make a 115.16 determination of eligibility for recipients who are 115.17 cooperatively applying for home care services under the 115.18 community alternative care program developed under section 115.19 256B.49, or until it is determined by the appropriate regulatory 115.20 agency that a health benefit plan is or is not required to pay 115.21 for appropriate medically necessary health care services. 115.22 Recipients or their representatives must cooperatively assist 115.23 the commissioner in obtaining this determination. Recipients 115.24 who are eligible for the community alternative care program may 115.25 not receive more hours of nursing under this section than would 115.26 otherwise be authorized under section 256B.49. 115.27 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 115.28 ventilator-dependent, the monthly medical assistance 115.29 authorization for home care services shall not exceed what the 115.30 commissioner would pay for care at the highest cost hospital 115.31 designated as a long-term hospital under the Medicare program. 115.32 For purposes of this clause, home care services means all 115.33 services provided in the home that would be included in the 115.34 payment for care at the long-term hospital. 115.35 "Ventilator-dependent" means an individual who receives 115.36 mechanical ventilation for life support at least six hours per 116.1 day and is expected to be or has been dependent for at least 30 116.2 consecutive days. 116.3 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 116.4 or the commissioner's designee shall determine the time period 116.5 for which a prior authorization shall be effective. If the 116.6 recipient continues to require home care services beyond the 116.7 duration of the prior authorization, the home care provider must 116.8 request a new prior authorization. Under no circumstances, 116.9 other than the exceptions in paragraph (b), shall a prior 116.10 authorization be valid prior to the date the commissioner 116.11 receives the request or for more than 12 months. A recipient 116.12 who appeals a reduction in previously authorized home care 116.13 services may continue previously authorized services, other than 116.14 temporary services under paragraph (h), pending an appeal under 116.15 section 256.045. The commissioner must provide a detailed 116.16 explanation of why the authorized services are reduced in amount 116.17 from those requested by the home care provider. 116.18 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 116.19 the commissioner's designee shall determine the medical 116.20 necessity of home care services, the level of caregiver 116.21 according to subdivision 2, and the institutional comparison 116.22 according to this subdivision, the cost-effectiveness of 116.23 services, and the amount, scope, and duration of home care 116.24 services reimbursable by medical assistance, based on the 116.25 assessment, primary payer coverage determination information as 116.26 required, the service plan, the recipient's age, the cost of 116.27 services, the recipient's medical condition, and diagnosis or 116.28 disability. The commissioner may publish additional criteria 116.29 for determining medical necessity according to section 256B.04. 116.30 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 116.31 The agency nurse, the independently enrolled private duty nurse, 116.32 or county public health nurse may request a temporary 116.33 authorization for home care services by telephone. The 116.34 commissioner may approve a temporary level of home care services 116.35 based on the assessment, and service or care plan information, 116.36 and primary payer coverage determination information as required. 117.1 Authorization for a temporary level of home care services 117.2 including nurse supervision is limited to the time specified by 117.3 the commissioner, but shall not exceed 45 days, unless extended 117.4 because the county public health nurse has not completed the 117.5 required assessment and service plan, or the commissioner's 117.6 determination has not been made. The level of services 117.7 authorized under this provision shall have no bearing on a 117.8 future prior authorization. 117.9 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 117.10 Home care services provided in an adult or child foster care 117.11 setting must receive prior authorization by the department 117.12 according to the limits established in paragraph (a). 117.13 The commissioner may not authorize: 117.14 (1) home care services that are the responsibility of the 117.15 foster care provider under the terms of the foster care 117.16 placement agreement and administrative rules. Requests for home 117.17 care services for recipients residing in a foster care setting 117.18 must include the foster care placement agreement and 117.19 determination of difficulty of care; 117.20 (2) personal care services when the foster care license 117.21 holder is also the personal care provider or personal care 117.22 assistant unless the recipient can direct the recipient's own 117.23 care, or case management is provided as required in section 117.24 256B.0625, subdivision 19a; 117.25 (3) personal care services when the responsible party is an 117.26 employee of, or under contract with, or has any direct or 117.27 indirect financial relationship with the personal care provider 117.28 or personal care assistant, unless case management is provided 117.29 as required in section 256B.0625, subdivision 19a; 117.30 (4) home care services when the number of foster care 117.31 residents is greater than four unless the county responsible for 117.32 the recipient's foster placement made the placement prior to 117.33 April 1, 1992, requests that home care services be provided, and 117.34 case management is provided as required in section 256B.0625, 117.35 subdivision 19a; or 117.36 (5) home care services when combined with foster care 118.1 payments, other than room and board payments that exceed the 118.2 total amount that public funds would pay for the recipient's 118.3 care in a medical institution. 118.4 Sec. 30. Minnesota Statutes 1997 Supplement, section 118.5 256B.0645, is amended to read: 118.6 256B.0645 [PROVIDER PAYMENTS; RETROACTIVE CHANGES IN 118.7 ELIGIBILITY.] 118.8 Payment to a provider for a health care service provided to 118.9 a general assistance medical care recipient who is later 118.10 determined eligible for medical assistance or MinnesotaCare 118.11 according to section 256L.14 for the period in which the health 118.12 care service was provided,shall be considered payment in full,118.13and shall notmay be adjusted due to the change in eligibility. 118.14 This sectionappliesdoes not apply toboth fee-for-service118.15payments andpayments made to health plans on a prepaid 118.16 capitated basis. 118.17 Sec. 31. Minnesota Statutes 1997 Supplement, section 118.18 256B.0911, subdivision 2, is amended to read: 118.19 Subd. 2. [PERSONS REQUIRED TO BE SCREENED; EXEMPTIONS.] 118.20 All applicants to Medicaid certified nursing facilities must be 118.21 screened prior to admission, regardless of income, assets, or 118.22 funding sources, except the following: 118.23 (1) patients who, having entered acute care facilities from 118.24 certified nursing facilities, are returning to a certified 118.25 nursing facility; 118.26 (2) residents transferred from other certified nursing 118.27 facilities located within the state of Minnesota; 118.28 (3) individuals who have a contractual right to have their 118.29 nursing facility care paid for indefinitely by the veteran's 118.30 administration; 118.31 (4) individuals who are enrolled in the Ebenezer/Group 118.32 Health social health maintenance organization project, or 118.33 enrolled in a demonstration project under section 256B.69, 118.34 subdivision188, at the time of application to a nursing home; 118.35 (5) individuals previously screened and currently being 118.36 served under the alternative care program or under a home and 119.1 community-based services waiver authorized under section 1915(c) 119.2 of the Social Security Act; or 119.3 (6) individuals who are admitted to a certified nursing 119.4 facility for a short-term stay, which, based upon a physician's 119.5 certification, is expected to be 14 days or less in duration, 119.6 and who have been screened and approved for nursing facility 119.7 admission within the previous six months. This exemption 119.8 applies only if the screener determines at the time of the 119.9 initial screening of the six-month period that it is appropriate 119.10 to use the nursing facility for short-term stays and that there 119.11 is an adequate plan of care for return to the home or 119.12 community-based setting. If a stay exceeds 14 days, the 119.13 individual must be referred no later than the first county 119.14 working day following the 14th resident day for a screening, 119.15 which must be completed within five working days of the 119.16 referral. Payment limitations in subdivision 7 will apply to an 119.17 individual found at screening to not meet the level of care 119.18 criteria for admission to a certified nursing facility. 119.19 Regardless of the exemptions in clauses (2) to (6), persons 119.20 who have a diagnosis or possible diagnosis of mental illness, 119.21 mental retardation, or a related condition must receive a 119.22 preadmission screening before admission unless the admission 119.23 prior to screening is authorized by the local mental health 119.24 authority or the local developmental disabilities case manager, 119.25 or unless authorized by the county agency according to Public 119.26 Law Number 101-508. 119.27 Before admission to a Medicaid certified nursing home or 119.28 boarding care home, all persons must be screened and approved 119.29 for admission through an assessment process. The nursing 119.30 facility is authorized to conduct case mix assessments which are 119.31 not conducted by the county public health nurse under Minnesota 119.32 Rules, part 9549.0059. The designated county agency is 119.33 responsible for distributing the quality assurance and review 119.34 form for all new applicants to nursing homes. 119.35 Other persons who are not applicants to nursing facilities 119.36 must be screened if a request is made for a screening. 120.1 Sec. 32. Minnesota Statutes 1996, section 256B.0911, 120.2 subdivision 4, is amended to read: 120.3 Subd. 4. [RESPONSIBILITIES OF THE COUNTY AND THE SCREENING 120.4 TEAM.] (a) The county shall: 120.5 (1) provide information and education to the general public 120.6 regarding availability of the preadmission screening program; 120.7 (2) accept referrals from individuals, families, human 120.8 service and health professionals, and hospital and nursing 120.9 facility personnel; 120.10 (3) assess the health, psychological, and social needs of 120.11 referred individuals and identify services needed to maintain 120.12 these persons in the least restrictive environments; 120.13 (4) determine if the individual screened needs nursing 120.14 facility level of care; 120.15 (5) assess specialized service needs based upon an 120.16 evaluation by: 120.17 (i) a qualified independent mental health professional for 120.18 persons with a primary or secondary diagnosis of a serious 120.19 mental illness; and 120.20 (ii) a qualified mental retardation professional for 120.21 persons with a primary or secondary diagnosis of mental 120.22 retardation or related conditions. For purposes of this clause, 120.23 a qualified mental retardation professional must meet the 120.24 standards for a qualified mental retardation professional in 120.25 Code of Federal Regulations, title 42, section 483.430; 120.26 (6) make recommendations for individuals screened regarding 120.27 cost-effective community services which are available to the 120.28 individual; 120.29 (7) make recommendations for individuals screened regarding 120.30 nursing home placement when there are no cost-effective 120.31 community services available; 120.32 (8) develop an individual's community care plan and provide 120.33 follow-up services as needed; and 120.34 (9) prepare and submit reports that may be required by the 120.35 commissioner of human services. 120.36 (b) The screener shall document that the most 121.1 cost-effective alternatives available were offered to the 121.2 individual or the individual's legal representative. For 121.3 purposes of this section, "cost-effective alternatives" means 121.4 community services and living arrangements that cost the same or 121.5 less than nursing facility care. 121.6 (c)Screeners shall adhere to the level of care criteria121.7for admission to a certified nursing facility established under121.8section 144.0721.121.9(d)For persons who are eligible for medical assistance or 121.10 who would be eligible within 180 days of admission to a nursing 121.11 facility and who are admitted to a nursing facility, the nursing 121.12 facility must include a screener or the case manager in the 121.13 discharge planning process for those individuals who the team 121.14 has determined have discharge potential. The screener or the 121.15 case manager must ensure a smooth transition and follow-up for 121.16 the individual's return to the community. 121.17 Screeners shall cooperate with other public and private 121.18 agencies in the community, in order to offer a variety of 121.19 cost-effective services to the disabled and elderly. The 121.20 screeners shall encourage the use of volunteers from families, 121.21 religious organizations, social clubs, and similar civic and 121.22 service organizations to provide services. 121.23 Sec. 33. Minnesota Statutes 1997 Supplement, section 121.24 256B.0911, subdivision 7, is amended to read: 121.25 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 121.26 (a) Medical assistance reimbursement for nursing facilities 121.27 shall be authorized for a medical assistance recipient only if a 121.28 preadmission screening has been conducted prior to admission or 121.29 the local county agency has authorized an exemption. Medical 121.30 assistance reimbursement for nursing facilities shall not be 121.31 provided for any recipient who the local screener has determined 121.32 does not meet the level of care criteria for nursing facility 121.33 placement or, if indicated, has not had a level II PASARR 121.34 evaluation completed unless an admission for a recipient with 121.35 mental illness is approved by the local mental health authority 121.36 or an admission for a recipient with mental retardation or 122.1 related condition is approved by the state mental retardation 122.2 authority.The county preadmission screening team may deny122.3certified nursing facility admission using the level of care122.4criteria established under section 144.0721 and deny medical122.5assistance reimbursement for certified nursing facility care.122.6Persons receiving care in a certified nursing facility or122.7certified boarding care home who are reassessed by the122.8commissioner of health according to section 144.0722 and122.9determined to no longer meet the level of care criteria for a122.10certified nursing facility or certified boarding care home may122.11no longer remain a resident in the certified nursing facility or122.12certified boarding care home and must be relocated to the122.13community if the persons were admitted on or after July 1, 1998.122.14 (b)Persons receiving services under section 256B.0913,122.15subdivisions 1 to 14, or 256B.0915 who are reassessed and found122.16to not meet the level of care criteria for admission to a122.17certified nursing facility or certified boarding care home may122.18no longer receive these services if persons were admitted to the122.19program on or after July 1, 1998.The commissioner shall make a 122.20 request to the health care financing administration for a waiver 122.21 allowing screening team approval of Medicaid payments for 122.22 certified nursing facility care. An individual has a choice and 122.23 makes the final decision between nursing facility placement and 122.24 community placement after the screening team's recommendation, 122.25 except as provided in paragraphs (b) and (c). 122.26 (c) The local county mental health authority or the state 122.27 mental retardation authority under Public Law Numbers 100-203 122.28 and 101-508 may prohibit admission to a nursing facility, if the 122.29 individual does not meet the nursing facility level of care 122.30 criteria or needs specialized services as defined in Public Law 122.31 Numbers 100-203 and 101-508. For purposes of this section, 122.32 "specialized services" for a person with mental retardation or a 122.33 related condition means "active treatment" as that term is 122.34 defined in Code of Federal Regulations, title 42, section 122.35 483.440(a)(1). 122.36 (d) Upon the receipt by the commissioner of approval by the 123.1 Secretary of Health and Human Services of the waiver requested 123.2 under paragraph (a), the local screener shall deny medical 123.3 assistance reimbursement for nursing facility care for an 123.4 individual whose long-term care needs can be met in a 123.5 community-based setting and whose cost of community-based home 123.6 care services is less than 75 percent of the average payment for 123.7 nursing facility care for that individual's case mix 123.8 classification, and who is either: 123.9 (i) a current medical assistance recipient being screened 123.10 for admission to a nursing facility; or 123.11 (ii) an individual who would be eligible for medical 123.12 assistance within 180 days of entering a nursing facility and 123.13 who meets a nursing facility level of care. 123.14 (e) Appeals from the screening team's recommendation or the 123.15 county agency's final decision shall be made according to 123.16 section 256.045, subdivision 3. 123.17 Sec. 34. Minnesota Statutes 1997 Supplement, section 123.18 256B.0913, subdivision 14, is amended to read: 123.19 Subd. 14. [REIMBURSEMENT AND RATE ADJUSTMENTS.] (a) 123.20 Reimbursement for expenditures for the alternative care services 123.21 as approved by the client's case manager shall be through the 123.22 invoice processing procedures of the department's Medicaid 123.23 Management Information System (MMIS). To receive reimbursement, 123.24 the county or vendor must submit invoices within 12 months 123.25 following the date of service. The county agency and its 123.26 vendors under contract shall not be reimbursed for services 123.27 which exceed the county allocation. 123.28 (b) If a county collects less than 50 percent of the client 123.29 premiums due under subdivision 12, the commissioner may withhold 123.30 up to three percent of the county's final alternative care 123.31 program allocation determined under subdivisions 10 and 11. 123.32 (c)For fiscal years beginning on or after July 1, 1993,123.33the commissioner of human services shall not provide automatic123.34annual inflation adjustments for alternative care services. The123.35commissioner of finance shall include as a budget change request123.36in each biennial detailed expenditure budget submitted to the124.1legislature under section 16A.11 annual adjustments in124.2reimbursement rates for alternative care services based on the124.3forecasted percentage change in the Home Health Agency Market124.4Basket of Operating Costs, for the fiscal year beginning July 1,124.5compared to the previous fiscal year, unless otherwise adjusted124.6by statute. The Home Health Agency Market Basket of Operating124.7Costs is published by Data Resources, Inc. The forecast to be124.8used is the one published for the calendar quarter beginning124.9January 1, six months prior to the beginning of the fiscal year124.10for which rates are set.124.11(d)The county shall negotiate individual rates with 124.12 vendors and may be reimbursed for actual costs up to the greater 124.13 of the county's current approved rate or 60 percent of the 124.14 maximum rate in fiscal year 1994 and 65 percent of the maximum 124.15 rate in fiscal year 1995 for each alternative care service. 124.16 Notwithstanding any other rule or statutory provision to the 124.17 contrary, the commissioner shall not be authorized to increase 124.18 rates by an annual inflation factor, unless so authorized by the 124.19 legislature. 124.20(e)(d) On July 1, 1993, the commissioner shall increase 124.21 the maximum rate for home delivered meals to $4.50 per meal. 124.22 Sec. 35. Minnesota Statutes 1997 Supplement, section 124.23 256B.0915, subdivision 1d, is amended to read: 124.24 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 124.25 RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the 124.26 provisions of section 256B.056, the commissioner shall make the 124.27 following amendment to the medical assistance elderly waiver 124.28 program effective July 1,19971999, or upon federal approval, 124.29 whichever is later. 124.30 A recipient's maintenance needs will be an amount equal to 124.31 the Minnesota supplemental aid equivalent rate as defined in 124.32 section 256I.03, subdivision 5, plus the medical assistance 124.33 personal needs allowance as defined in section 256B.35, 124.34 subdivision 1, paragraph (a), when applying posteligibility 124.35 treatment of income rules to the gross income of elderly waiver 124.36 recipients, except for individuals whose income is in excess of 125.1 the special income standard according to Code of Federal 125.2 Regulations, title 42, section 435.236. Recipient maintenance 125.3 needs shall be adjusted under this provision each July 1. 125.4 (b) The commissioner of human services shall secure 125.5 approval of additional elderly waiver slots sufficient to serve 125.6 persons who will qualify under the revised income standard 125.7 described in paragraph (a) before implementing section 125.8 256B.0913, subdivision 16. 125.9 (c) In implementing this subdivision, the commissioner 125.10 shall consider allowing persons who would otherwise be eligible 125.11 for the alternative care program but would qualify for the 125.12 elderly waiver with a spenddown to remain on the alternative 125.13 care program. 125.14 Sec. 36. Minnesota Statutes 1997 Supplement, section 125.15 256B.0915, subdivision 3, is amended to read: 125.16 Subd. 3. [LIMITS OF CASES, RATES, REIMBURSEMENT, AND 125.17 FORECASTING.] (a) The number of medical assistance waiver 125.18 recipients that a county may serve must be allocated according 125.19 to the number of medical assistance waiver cases open on July 1 125.20 of each fiscal year. Additional recipients may be served with 125.21 the approval of the commissioner. 125.22 (b) The monthly limit for the cost of waivered services to 125.23 an individual waiver client shall be the statewide average 125.24 payment rate of the case mix resident class to which the waiver 125.25 client would be assigned under the medical assistance case mix 125.26 reimbursement system. If medical supplies and equipment or 125.27 adaptations are or will be purchased for an elderly waiver 125.28 services recipient, the costs may be prorated on a monthly basis 125.29 throughout the year in which they are purchased. If the monthly 125.30 cost of a recipient's other waivered services exceeds the 125.31 monthly limit established in this paragraph, the annual cost of 125.32 the waivered services shall be determined. In this event, the 125.33 annual cost of waivered services shall not exceed 12 times the 125.34 monthly limit calculated in this paragraph. The statewide 125.35 average payment rate is calculated by determining the statewide 125.36 average monthly nursing home rate, effective July 1 of the 126.1 fiscal year in which the cost is incurred, less the statewide 126.2 average monthly income of nursing home residents who are age 65 126.3 or older, and who are medical assistance recipients in the month 126.4 of March of the previous state fiscal year. The annual cost 126.5 divided by 12 of elderly or disabled waivered services for a 126.6 person who is a nursing facility resident at the time of 126.7 requesting a determination of eligibility for elderly or 126.8 disabled waivered services shall be the greater of the monthly 126.9 payment for: (i) the resident class assigned under Minnesota 126.10 Rules, parts 9549.0050 to 9549.0059, for that resident in the 126.11 nursing facility where the resident currently resides; or (ii) 126.12 the statewide average payment of the case mix resident class to 126.13 which the resident would be assigned under the medical 126.14 assistance case mix reimbursement system, provided that the 126.15 limit under this clause only applies to persons discharged from 126.16 a nursing facility and found eligible for waivered services on 126.17 or after July 1, 1997. The following costs must be included in 126.18 determining the total monthly costs for the waiver client: 126.19 (1) cost of all waivered services, including extended 126.20 medical supplies and equipment; and 126.21 (2) cost of skilled nursing, home health aide, and personal 126.22 care services reimbursable by medical assistance. 126.23 (c) Medical assistance funding for skilled nursing 126.24 services, private duty nursing, home health aide, and personal 126.25 care services for waiver recipients must be approved by the case 126.26 manager and included in the individual care plan. 126.27 (d) For both the elderly waiver and the nursing facility 126.28 disabled waiver, a county may purchase extended supplies and 126.29 equipment without prior approval from the commissioner when 126.30 there is no other funding source and the supplies and equipment 126.31 are specified in the individual's care plan as medically 126.32 necessary to enable the individual to remain in the community 126.33 according to the criteria in Minnesota Rules, part 9505.0210, 126.34 items A and B. A county is not required to contract with a 126.35 provider of supplies and equipment if the monthly cost of the 126.36 supplies and equipment is less than $250. 127.1 (e)For the fiscal year beginning on July 1, 1993, and for127.2subsequent fiscal years, the commissioner of human services127.3shall not provide automatic annual inflation adjustments for127.4home and community-based waivered services. The commissioner of127.5finance shall include as a budget change request in each127.6biennial detailed expenditure budget submitted to the127.7legislature under section 16A.11, annual adjustments in127.8reimbursement rates for home and community-based waivered127.9services, based on the forecasted percentage change in the Home127.10Health Agency Market Basket of Operating Costs, for the fiscal127.11year beginning July 1, compared to the previous fiscal year,127.12unless otherwise adjusted by statute. The Home Health Agency127.13Market Basket of Operating Costs is published by Data Resources,127.14Inc. The forecast to be used is the one published for the127.15calendar quarter beginning January 1, six months prior to the127.16beginning of the fiscal year for which rates are set. The adult127.17foster care rate shall be considered a difficulty of care127.18payment and shall not include room and board.127.19(f)The adult foster care daily rate for the elderly and 127.20 disabled waivers shall be negotiated between the county agency 127.21 and the foster care provider. The rate established under this 127.22 section shall not exceed the state average monthly nursing home 127.23 payment for the case mix classification to which the individual 127.24 receiving foster care is assigned; the rate must allow for other 127.25 waiver and medical assistance home care services to be 127.26 authorized by the case manager. 127.27(g)(f) The assisted living and residential care service 127.28 rates for elderly and community alternatives for disabled 127.29 individuals (CADI) waivers shall be made to the vendor as a 127.30 monthly rate negotiated with the county agency based on an 127.31 individualized service plan for each resident. The rate shall 127.32 not exceed the nonfederal share of the greater of either the 127.33 statewide or any of the geographic groups' weighted average 127.34 monthly medical assistance nursing facility payment rate of the 127.35 case mix resident class to which the elderly or disabled client 127.36 would be assigned under Minnesota Rules, parts 9549.0050 to 128.1 9549.0059, unless the services are provided by a home care 128.2 provider licensed by the department of health and are provided 128.3 in a building that is registered as a housing with services 128.4 establishment under chapter 144D and that provides 24-hour 128.5 supervision. For alternative care assisted living projects 128.6 established under Laws 1988, chapter 689, article 2, section 128.7 256, monthly rates may not exceed 65 percent of the greater of 128.8 either the statewide or any of the geographic groups' weighted 128.9 average monthly medical assistance nursing facility payment rate 128.10 for the case mix resident class to which the elderly or disabled 128.11 client would be assigned under Minnesota Rules, parts 9549.0050 128.12 to 9549.0059. The rate may not cover direct rent or food costs. 128.13(h)(g) The county shall negotiate individual rates with 128.14 vendors and may be reimbursed for actual costs up to the greater 128.15 of the county's current approved rate or 60 percent of the 128.16 maximum rate in fiscal year 1994 and 65 percent of the maximum 128.17 rate in fiscal year 1995 for each service within each program. 128.18(i)(h) On July 1, 1993, the commissioner shall increase 128.19 the maximum rate for home-delivered meals to $4.50 per meal. 128.20(j)(i) Reimbursement for the medical assistance recipients 128.21 under the approved waiver shall be made from the medical 128.22 assistance account through the invoice processing procedures of 128.23 the department's Medicaid Management Information System (MMIS), 128.24 only with the approval of the client's case manager. The budget 128.25 for the state share of the Medicaid expenditures shall be 128.26 forecasted with the medical assistance budget, and shall be 128.27 consistent with the approved waiver. 128.28(k)(j) Beginning July 1, 1991, the state shall reimburse 128.29 counties according to the payment schedule in section 256.025 128.30 for the county share of costs incurred under this subdivision on 128.31 or after January 1, 1991, for individuals who are receiving 128.32 medical assistance. 128.33(l)(k) For the community alternatives for disabled 128.34 individuals waiver, and nursing facility disabled waivers, 128.35 county may use waiver funds for the cost of minor adaptations to 128.36 a client's residence or vehicle without prior approval from the 129.1 commissioner if there is no other source of funding and the 129.2 adaptation: 129.3 (1) is necessary to avoid institutionalization; 129.4 (2) has no utility apart from the needs of the client; and 129.5 (3) meets the criteria in Minnesota Rules, part 9505.0210, 129.6 items A and B. 129.7 For purposes of this subdivision, "residence" means the client's 129.8 own home, the client's family residence, or a family foster 129.9 home. For purposes of this subdivision, "vehicle" means the 129.10 client's vehicle, the client's family vehicle, or the client's 129.11 family foster home vehicle. 129.12(m)(l) The commissioner shall establish a maximum rate 129.13 unit for baths provided by an adult day care provider that are 129.14 not included in the provider's contractual daily or hourly rate. 129.15 This maximum rate must equal the home health aide extended rate 129.16 and shall be paid for baths provided to clients served under the 129.17 elderly and disabled waivers. 129.18 Sec. 37. Minnesota Statutes 1996, section 256B.0916, is 129.19 amended to read: 129.20 256B.0916 [EXPANSION OF HOME AND COMMUNITY-BASED SERVICES; 129.21 MANAGEMENT AND ALLOCATION RESPONSIBILITIES.] 129.22 (a) The commissioner shall expand availability of home and 129.23 community-based services for persons with mental retardation and 129.24 related conditions to the extent allowed by federal law and 129.25 regulation and shall assist counties in transferring persons 129.26 from semi-independent living services to home and 129.27 community-based services. The commissioner may transfer funds 129.28 from the state semi-independent living services account 129.29 available under section 252.275, subdivision 8, and state 129.30 community social services aids available under section 256E.15 129.31 to the medical assistance account to pay for the nonfederal 129.32 share of nonresidential and residential home and community-based 129.33 services authorized under section 256B.092 for persons 129.34 transferring from semi-independent living services. 129.35 (b) Upon federal approval, county boards are not 129.36 responsible for funding semi-independent living services as a 130.1 social service for those persons who have transferred to the 130.2 home and community-based waiver program as a result of the 130.3 expansion under this subdivision. The county responsibility for 130.4 those persons transferred shall be assumed under section 130.5 256B.092. Notwithstanding the provisions of section 252.275, 130.6 the commissioner shall continue to allocate funds under that 130.7 section for semi-independent living services and county boards 130.8 shall continue to fund services under sections 256E.06 and 130.9 256E.14 for those persons who cannot access home and 130.10 community-based services under section 256B.092. 130.11 (c) Eighty percent of the state funds made available to the 130.12 commissioner under section 252.275 as a result of persons 130.13 transferring from the semi-independent living services program 130.14 to the home and community-based services program shall be used 130.15 to fund additional persons in the semi-independent living 130.16 services program. 130.17 (d) Beginning August 1, 1998, the commissioner shall issue 130.18 an annual report on the home and community-based waiver for 130.19 persons with mental retardation or related conditions, that 130.20 includes a list of the counties in which less than 95 percent of 130.21 the allocation provided, excluding the county waivered services 130.22 reserve, has been committed for two or more quarters during the 130.23 previous state fiscal year. For each listed county, the report 130.24 shall include the amount of funds allocated but not used, the 130.25 number and ages of individuals screened and waiting for 130.26 services, the services needed, a description of the technical 130.27 assistance provided by the commissioner to assist the counties 130.28 in jointly planning with other counties in order to serve more 130.29 persons, and additional actions which will be taken to serve 130.30 those screened and waiting for services. 130.31 (e) The commissioner shall make available to interested 130.32 parties, upon request, financial information by county including 130.33 the amount of resources allocated for the home and 130.34 community-based waiver for persons with mental retardation and 130.35 related conditions, the resources committed, the number of 130.36 persons screened and waiting for services, the type of services 131.1 requested by those waiting, and the amount of allocated 131.2 resources not committed. 131.3 Sec. 38. Minnesota Statutes 1997 Supplement, section 131.4 256B.0951, is amended by adding a subdivision to read: 131.5 Subd. 4a. [WAIVER OF RULES.] The commissioner of health 131.6 may exempt residents of intermediate care facilities for persons 131.7 with mental retardation (ICFs/MR) who participate in the 131.8 three-year quality assurance pilot project established in 131.9 section 256B.095 from the requirements of Minnesota Rules, part 131.10 4665, upon approval by the federal government of a waiver of 131.11 federal certification requirements for ICFs/MR. The 131.12 commissioners of health and human services shall apply for any 131.13 necessary waivers as soon as practicable and shall submit the 131.14 concept paper to the federal government by June 1, 1998. 131.15 Sec. 39. Minnesota Statutes 1996, section 256B.41, 131.16 subdivision 1, is amended to read: 131.17 Subdivision 1. [AUTHORITY.] The commissioner shall 131.18 establish, by rule, procedures for determining rates for care of 131.19 residents of nursing facilities which qualify as vendors of 131.20 medical assistance, and for implementing the provisions of this 131.21 section and sections 256B.421, 256B.431, 256B.432, 256B.433, 131.22 256B.47, 256B.48, 256B.50, and 256B.502. The procedures shall 131.23be based on methods and standards that the commissioner finds131.24are adequate to provide for the costs that must be incurred for131.25the care of residents in efficiently and economically operated131.26nursing facilities and shallspecify the costs that are 131.27 allowable for establishing payment rates through medical 131.28 assistance. 131.29 Sec. 40. Minnesota Statutes 1996, section 256B.431, 131.30 subdivision 2b, is amended to read: 131.31 Subd. 2b. [OPERATING COSTS, AFTER JULY 1, 1985.] (a) For 131.32 rate years beginning on or after July 1, 1985, the commissioner 131.33 shall establish procedures for determining per diem 131.34 reimbursement for operating costs. 131.35 (b) The commissioner shall contract with an econometric 131.36 firm with recognized expertise in and access to national 132.1 economic change indices that can be applied to the appropriate 132.2 cost categories when determining the operating cost payment rate. 132.3 (c) The commissioner shall analyze and evaluate each 132.4 nursing facility's cost report of allowable operating costs 132.5 incurred by the nursing facility during the reporting year 132.6 immediately preceding the rate year for which the payment rate 132.7 becomes effective. 132.8 (d) The commissioner shall establish limits on actual 132.9 allowable historical operating cost per diems based on cost 132.10 reports of allowable operating costs for the reporting year that 132.11 begins October 1, 1983, taking into consideration relevant 132.12 factors including resident needs, geographic location, and size 132.13 of the nursing facility, and the costs that must be incurred for132.14the care of residents in an efficiently and economically132.15operated nursing facility. In developing the geographic groups 132.16 for purposes of reimbursement under this section, the 132.17 commissioner shall ensure that nursing facilities in any county 132.18 contiguous to the Minneapolis-St. Paul seven-county metropolitan 132.19 area are included in the same geographic group. The limits 132.20 established by the commissioner shall not be less, in the 132.21 aggregate, than the 60th percentile of total actual allowable 132.22 historical operating cost per diems for each group of nursing 132.23 facilities established under subdivision 1 based on cost reports 132.24 of allowable operating costs in the previous reporting year. 132.25 For rate years beginning on or after July 1, 1989, facilities 132.26 located in geographic group I as described in Minnesota Rules, 132.27 part 9549.0052, on January 1, 1989, may choose to have the 132.28 commissioner apply either the care related limits or the other 132.29 operating cost limits calculated for facilities located in 132.30 geographic group II, or both, if either of the limits calculated 132.31 for the group II facilities is higher. The efficiency incentive 132.32 for geographic group I nursing facilities must be calculated 132.33 based on geographic group I limits. The phase-in must be 132.34 established utilizing the chosen limits. For purposes of these 132.35 exceptions to the geographic grouping requirements, the 132.36 definitions in Minnesota Rules, parts 9549.0050 to 9549.0059 133.1 (Emergency), and 9549.0010 to 9549.0080, apply. The limits 133.2 established under this paragraph remain in effect until the 133.3 commissioner establishes a new base period. Until the new base 133.4 period is established, the commissioner shall adjust the limits 133.5 annually using the appropriate economic change indices 133.6 established in paragraph (e). In determining allowable 133.7 historical operating cost per diems for purposes of setting 133.8 limits and nursing facility payment rates, the commissioner 133.9 shall divide the allowable historical operating costs by the 133.10 actual number of resident days, except that where a nursing 133.11 facility is occupied at less than 90 percent of licensed 133.12 capacity days, the commissioner may establish procedures to 133.13 adjust the computation of the per diem to an imputed occupancy 133.14 level at or below 90 percent. The commissioner shall establish 133.15 efficiency incentives as appropriate. The commissioner may 133.16 establish efficiency incentives for different operating cost 133.17 categories. The commissioner shall consider establishing 133.18 efficiency incentives in care related cost categories. The 133.19 commissioner may combine one or more operating cost categories 133.20 and may use different methods for calculating payment rates for 133.21 each operating cost category or combination of operating cost 133.22 categories. For the rate year beginning on July 1, 1985, the 133.23 commissioner shall: 133.24 (1) allow nursing facilities that have an average length of 133.25 stay of 180 days or less in their skilled nursing level of care, 133.26 125 percent of the care related limit and 105 percent of the 133.27 other operating cost limit established by rule; and 133.28 (2) exempt nursing facilities licensed on July 1, 1983, by 133.29 the commissioner to provide residential services for the 133.30 physically handicapped under Minnesota Rules, parts 9570.2000 to 133.31 9570.3600, from the care related limits and allow 105 percent of 133.32 the other operating cost limit established by rule. 133.33 For the purpose of calculating the other operating cost 133.34 efficiency incentive for nursing facilities referred to in 133.35 clause (1) or (2), the commissioner shall use the other 133.36 operating cost limit established by rule before application of 134.1 the 105 percent. 134.2 (e) The commissioner shall establish a composite index or 134.3 indices by determining the appropriate economic change 134.4 indicators to be applied to specific operating cost categories 134.5 or combination of operating cost categories. 134.6 (f) Each nursing facility shall receive an operating cost 134.7 payment rate equal to the sum of the nursing facility's 134.8 operating cost payment rates for each operating cost category. 134.9 The operating cost payment rate for an operating cost category 134.10 shall be the lesser of the nursing facility's historical 134.11 operating cost in the category increased by the appropriate 134.12 index established in paragraph (e) for the operating cost 134.13 category plus an efficiency incentive established pursuant to 134.14 paragraph (d) or the limit for the operating cost category 134.15 increased by the same index. If a nursing facility's actual 134.16 historic operating costs are greater than the prospective 134.17 payment rate for that rate year, there shall be no retroactive 134.18 cost settle-up. In establishing payment rates for one or more 134.19 operating cost categories, the commissioner may establish 134.20 separate rates for different classes of residents based on their 134.21 relative care needs. 134.22 (g) The commissioner shall include the reported actual real 134.23 estate tax liability or payments in lieu of real estate tax of 134.24 each nursing facility as an operating cost of that nursing 134.25 facility. Allowable costs under this subdivision for payments 134.26 made by a nonprofit nursing facility that are in lieu of real 134.27 estate taxes shall not exceed the amount which the nursing 134.28 facility would have paid to a city or township and county for 134.29 fire, police, sanitation services, and road maintenance costs 134.30 had real estate taxes been levied on that property for those 134.31 purposes. For rate years beginning on or after July 1, 1987, 134.32 the reported actual real estate tax liability or payments in 134.33 lieu of real estate tax of nursing facilities shall be adjusted 134.34 to include an amount equal to one-half of the dollar change in 134.35 real estate taxes from the prior year. The commissioner shall 134.36 include a reported actual special assessment, and reported 135.1 actual license fees required by the Minnesota department of 135.2 health, for each nursing facility as an operating cost of that 135.3 nursing facility. For rate years beginning on or after July 1, 135.4 1989, the commissioner shall include a nursing facility's 135.5 reported public employee retirement act contribution for the 135.6 reporting year as apportioned to the care-related operating cost 135.7 categories and other operating cost categories multiplied by the 135.8 appropriate composite index or indices established pursuant to 135.9 paragraph (e) as costs under this paragraph. Total adjusted 135.10 real estate tax liability, payments in lieu of real estate tax, 135.11 actual special assessments paid, the indexed public employee 135.12 retirement act contribution, and license fees paid as required 135.13 by the Minnesota department of health, for each nursing facility 135.14 (1) shall be divided by actual resident days in order to compute 135.15 the operating cost payment rate for this operating cost 135.16 category, (2) shall not be used to compute the care-related 135.17 operating cost limits or other operating cost limits established 135.18 by the commissioner, and (3) shall not be increased by the 135.19 composite index or indices established pursuant to paragraph 135.20 (e), unless otherwise indicated in this paragraph. 135.21 (h) For rate years beginning on or after July 1, 1987, the 135.22 commissioner shall adjust the rates of a nursing facility that 135.23 meets the criteria for the special dietary needs of its 135.24 residents and the requirements in section 31.651. The 135.25 adjustment for raw food cost shall be the difference between the 135.26 nursing facility's allowable historical raw food cost per diem 135.27 and 115 percent of the median historical allowable raw food cost 135.28 per diem of the corresponding geographic group. 135.29 The rate adjustment shall be reduced by the applicable 135.30 phase-in percentage as provided under subdivision 2h. 135.31(i) For the cost report year ending September 30, 1996, and135.32for all subsequent reporting years, certified nursing facilities135.33must identify, differentiate, and record resident day statistics135.34for residents in case mix classification A who, on or after July135.351, 1996, meet the modified level of care criteria in section135.36144.0721. The resident day statistics shall be separated into136.1case mix classification A-1 for any resident day meeting the136.2high-function class A level of care criteria and case mix136.3classification A-2 for other case mix class A resident days.136.4 Sec. 41. Minnesota Statutes 1996, section 256B.501, 136.5 subdivision 2, is amended to read: 136.6 Subd. 2. [AUTHORITY.] The commissioner shall establish 136.7 procedures and rules for determining rates for care of residents 136.8 of intermediate care facilities for persons with mental 136.9 retardation or related conditions which qualify as providers of 136.10 medical assistance and waivered services.Approved rates shall136.11be established on the basis of methods and standards that the136.12commissioner finds adequate to provide for the costs that must136.13be incurred for the quality care of residents in efficiently and136.14economically operated facilities and services.The procedures 136.15 shall specify the costs that are allowable for payment through 136.16 medical assistance. The commissioner may use experts from 136.17 outside the department in the establishment of the procedures. 136.18 Sec. 42. Minnesota Statutes 1997 Supplement, section 136.19 256B.69, subdivision 2, is amended to read: 136.20 Subd. 2. [DEFINITIONS.] For the purposes of this section, 136.21 the following terms have the meanings given. 136.22 (a) "Commissioner" means the commissioner of human services. 136.23 For the remainder of this section, the commissioner's 136.24 responsibilities for methods and policies for implementing the 136.25 project will be proposed by the project advisory committees and 136.26 approved by the commissioner. 136.27 (b) "Demonstration provider" means a health maintenance 136.28 organizationor, community integrated service network, or 136.29 accountable provider network authorized and operating under 136.30 chapter 62Dor, 62N, or 62T that participates in the 136.31 demonstration project according to criteria, standards, methods, 136.32 and other requirements established for the project and approved 136.33 by the commissioner. Notwithstanding the above, Itasca county 136.34 may continue to participate as a demonstration provider until 136.35 July 1, 2000. 136.36 (c) "Eligible individuals" means those persons eligible for 137.1 medical assistance benefits as defined in sections 256B.055, 137.2 256B.056, and 256B.06. 137.3 (d) "Limitation of choice" means suspending freedom of 137.4 choice while allowing eligible individuals to choose among the 137.5 demonstration providers. 137.6 (e) This paragraph supersedes paragraph (c) as long as the 137.7 Minnesota health care reform waiver remains in effect. When the 137.8 waiver expires, this paragraph expires and the commissioner of 137.9 human services shall publish a notice in the State Register and 137.10 notify the revisor of statutes. "Eligible individuals" means 137.11 those persons eligible for medical assistance benefits as 137.12 defined in sections 256B.055, 256B.056, and 256B.06. 137.13 Notwithstanding sections 256B.055, 256B.056, and 256B.06, an 137.14 individual who becomes ineligible for the program because of 137.15 failure to submit income reports or recertification forms in a 137.16 timely manner, shall remain enrolled in the prepaid health plan 137.17 and shall remain eligible to receive medical assistance coverage 137.18 through the last day of the month following the month in which 137.19 the enrollee became ineligible for the medical assistance 137.20 program. 137.21 Sec. 43. Minnesota Statutes 1997 Supplement, section 137.22 256B.69, subdivision 3a, is amended to read: 137.23 Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when 137.24 implementing the general assistance medical care, or medical 137.25 assistance prepayment program within a county, must include the 137.26 county board in the process of development, approval, and 137.27 issuance of the request for proposals to provide services to 137.28 eligible individuals within the proposed county. County boards 137.29 must be given reasonable opportunity to make recommendations 137.30 regarding the development, issuance, review of responses, and 137.31 changes needed in the request for proposals. The commissioner 137.32 must provide county boards the opportunity to review each 137.33 proposal based on the identification of community needs under 137.34 chapters 145A and 256E and county advocacy activities. If a 137.35 county board finds that a proposal does not address certain 137.36 community needs, the county board and commissioner shall 138.1 continue efforts for improving the proposal and network prior to 138.2 the approval of the contract. The county board shall make 138.3 recommendations regarding the approval of local networks and 138.4 their operations to ensure adequate availability and access to 138.5 covered services. The provider or health plan must respond 138.6 directly to county advocates and the state prepaid medical 138.7 assistance ombudsperson regarding service delivery and must be 138.8 accountable to the state regarding contracts with medical 138.9 assistance and general assistance medical care funds. The 138.10 county board may recommend a maximum number of participating 138.11 health plans after considering the size of the enrolling 138.12 population; ensuring adequate access and capacity; considering 138.13 the client and county administrative complexity; and considering 138.14 the need to promote the viability of locally developed health 138.15 plans. The county board or a single entity representing a group 138.16 of county boards and the commissioner shall mutually select 138.17 health plans for participation at the time of initial 138.18 implementation of the prepaid medical assistance program in that 138.19 county or group of counties and at the time of contract renewal. 138.20 The commissioner shall also seek input for contract requirements 138.21 from the county or single entity representing a group of county 138.22 boards at each contract renewal and incorporate those 138.23 recommendations into the contract negotiation process. The 138.24 commissioner, in conjunction with the county board, shall 138.25 actively seek to develop a mutually agreeable timetable prior to 138.26 the development of the request for proposal, but counties must 138.27 agree to initial enrollment beginning on or before January 1, 138.28 1999, in either the prepaid medical assistance and general 138.29 assistance medical care programs or county-based purchasing 138.30 under section 256B.692. At least 90 days before enrollment in 138.31 the medical assistance and general assistance medical care 138.32 prepaid programs begins in a county in which the prepaid 138.33 programs have not been established, the commissioner shall 138.34 provide a report to the chairs of senate and house committees 138.35 having jurisdiction over state health care programs which 138.36 verifies that the commissioner complied with the requirements 139.1 for county involvement that are specified in this subdivision. 139.2 (b) The commissioner shall seek a federal waiver to allow a 139.3 fee-for-service plan option to MinnesotaCare enrollees. The 139.4 commissioner shall develop an increase of the premium fees 139.5 required under section 256L.06 up to 20 percent of the premium 139.6 fees for the enrollees who elect the fee-for-service option. 139.7 Prior to implementation, the commissioner shall submit this fee 139.8 schedule to the chair and ranking minority member of the senate 139.9 health care committee, the senate health care and family 139.10 services funding division, the house of representatives health 139.11 and human services committee, and the house of representatives 139.12 health and human services finance division. 139.13 (c) At the option of the county board, the board may 139.14 develop contract requirements related to the achievement of 139.15 local public health goals to meet the health needs of medical 139.16 assistance and general assistance medical care enrollees. These 139.17 requirements must be reasonably related to the performance of 139.18 health plan functions and within the scope of the medical 139.19 assistance and general assistance medical care benefit sets. If 139.20 the county board and the commissioner mutually agree to such 139.21 requirements, the department shall include such requirements in 139.22 all health plan contracts governing the prepaid medical 139.23 assistance and general assistance medical care programs in that 139.24 county at initial implementation of the program in that county 139.25 and at the time of contract renewal. The county board may 139.26 participate in the enforcement of the contract provisions 139.27 related to local public health goals. 139.28 (d) For counties in which prepaid medical assistance and 139.29 general assistance medical care programs have not been 139.30 established, the commissioner shall not implement those programs 139.31 if a county board submits acceptable and timely preliminary and 139.32 final proposals under section 256B.692, until county-based 139.33 purchasing is no longer operational in that county. For 139.34 counties in which prepaid medical assistance and general 139.35 assistance medical care programs are in existence on or after 139.36 September 1, 1997, the commissioner must terminate contracts 140.1 with health plans according to section 256B.692, subdivision 5, 140.2 if the county board submits and the commissioner accepts 140.3 preliminary and final proposals according to that subdivision. 140.4 The commissioner is not required to terminate contracts that 140.5 begin on or after September 1, 1997, according to section 140.6 256B.692 until two years have elapsed from the date of initial 140.7 enrollment. 140.8 (e) In the event that a county board or a single entity 140.9 representing a group of county boards and the commissioner 140.10 cannot reach agreement regarding: (i) the selection of 140.11 participating health plans in that county; (ii) contract 140.12 requirements; or (iii) implementation and enforcement of county 140.13 requirements including provisions regarding local public health 140.14 goals, the commissioner shall resolve all disputes after taking 140.15 into account the recommendations of a three-person mediation 140.16 panel. The panel shall be composed of one designee of the 140.17 president of the association of Minnesota counties, one designee 140.18 of the commissioner of human services, and one designee of the 140.19 commissioner of health. 140.20 (f) If a county which elects to implement county-based 140.21 purchasing ceases to implement county-based purchasing, it is 140.22 prohibited from assuming the responsibility of county-based 140.23 purchasing for a period of five years from the date it 140.24 discontinues purchasing. 140.25 (g) Notwithstanding the requirement in this subdivision 140.26 that a county must agree to initial enrollment on or before 140.27 January 1, 1999, the commissioner shall grant a delay of up to 140.28 nine months in the implementation of the county-based purchasing 140.29 authorized in section 256B.692 if the county or group of 140.30 counties has submitted a preliminary proposal for county-based 140.31 purchasing by September 1, 1997, has not already implemented the 140.32 prepaid medical assistance program before January 1, 1998, and 140.33 has submitted a written request for the delay to the 140.34 commissioner by July 1, 1998. In order for the delay to be 140.35 continued, the county or group of counties must also submit to 140.36 the commissioner the following information by December 1, 1998. 141.1 The information must: 141.2 (1) identify the proposed date of implementation, not later 141.3 than October 1, 1999; 141.4 (2) include copies of the county board resolutions which 141.5 demonstrate the continued commitment to the implementation of 141.6 county-based purchasing by the proposed date. County board 141.7 authorization may remain contingent on the submission of a final 141.8 proposal which meets the requirements of section 256B.692, 141.9 subdivision 5, paragraph (b); 141.10 (3) demonstrate the establishment of a governance structure 141.11 between the participating counties and describe how the 141.12 fiduciary responsibilities of county-based purchasing will be 141.13 allocated between the counties, if more than one county is 141.14 involved in the proposal; 141.15 (4) describe how the risk of a deficit will be managed in 141.16 the event expenditures are greater than total capitation 141.17 payments. This description must identify how any of the 141.18 following strategies will be used: 141.19 (i) risk contracts with licensed health plans; 141.20 (ii) risk arrangements with providers who are not licensed 141.21 health plans; 141.22 (iii) risk arrangements with other licensed insurance 141.23 entities; and 141.24 (iv) funding from other county resources; 141.25 (5) include, if county-based purchasing will not contract 141.26 with licensed health plans or provider networks, letters of 141.27 interest from local providers in at least the categories of 141.28 hospital, physician, mental health, and pharmacy which express 141.29 interest in contracting for services. These letters must 141.30 recognize any risk transfer identified in clause (4), item (ii); 141.31 and 141.32 (6) describe the options being considered to obtain the 141.33 administrative services required in section 256B.692, 141.34 subdivision 3, clauses (3) and (5). 141.35 (h) For counties which receive a delay under this 141.36 subdivision, the final proposals required under section 142.1 256B.692, subdivision 5, paragraph (b), must be submitted at 142.2 least six months prior to the requested implementation date. 142.3 Authority to implement county-based purchasing remains 142.4 contingent on approval of the final proposal as required under 142.5 section 256B.692. 142.6 Sec. 44. Minnesota Statutes 1996, section 256B.69, is 142.7 amended by adding a subdivision to read: 142.8 Subd. 25. [EXEMPTION FROM ENROLLMENT.] (a) Beginning on or 142.9 after January 1, 1999, for American Indian recipients of medical 142.10 assistance who live on or near a reservation, as defined in Code 142.11 of Federal Regulations, title 42, section 36.22(a)(6), and who 142.12 are required to enroll with a demonstration provider under 142.13 subdivision 4, medical assistance shall cover health care 142.14 services provided at American Indian health services facilities 142.15 and facilities operated by a tribe or tribal organization under 142.16 funding authorized by United States Code, title 25, sections 142.17 450f to 450n, or title III of the Indian Self-Determination and 142.18 Education Assistance Act, Public Law Number 93-638, if those 142.19 services would otherwise be covered under section 256B.0625. 142.20 Payments for services provided under this subdivision shall be 142.21 made on a fee-for-service basis, and may, at the option of the 142.22 tribe or tribal organization, be made in accordance with rates 142.23 authorized under sections 256.959, subdivision 16, and 142.24 256B.0625, subdivision 34. Implementation of this purchasing 142.25 model is contingent on federal approval. 142.26 (b) For purposes of this subdivision, "American Indian" has 142.27 the meaning given to persons to whom services will be provided 142.28 for in Code of Federal Regulations, title 42, section 36.12. 142.29 (c) This subdivision also applies to American Indian 142.30 recipients of general assistance medical care and to the prepaid 142.31 general assistance medical care program under section 256D.03, 142.32 subdivision 4, paragraph (d). 142.33 (d) The commissioner of human services, in consultation 142.34 with the tribal governments, shall develop a plan for tribes to 142.35 assist in the enrollment process for American Indian recipients 142.36 enrolled in the prepaid medical assistance program under this 143.1 section or the prepaid general assistance program under section 143.2 256D.03, subdivision 4, paragraph (d). This plan also shall 143.3 address how tribes will be included in ensuring the coordination 143.4 of care for American Indian recipients between Indian health 143.5 service or tribal providers and other providers. 143.6 Sec. 45. Minnesota Statutes 1997 Supplement, section 143.7 256B.692, subdivision 2, is amended to read: 143.8 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] 143.9 Notwithstanding chapters 62D and 62N, a county that elects to 143.10 purchase medical assistance and general assistance medical care 143.11 in return for a fixed sum without regard to the frequency or 143.12 extent of services furnished to any particular enrollee is not 143.13 required to obtain a certificate of authority under chapter 62D 143.14 or 62N. A county that elects to purchase medical assistance and 143.15 general assistance medical care services under this section must 143.16 satisfy the commissioner of health that the requirements of 143.17 chapter 62D, applicable to health maintenance organizations, or 143.18 chapter 62N, applicable to community integrated service 143.19 networks, will be met. A county must also assure the 143.20 commissioner of health that the requirements ofsectionsections 143.21 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all 143.22 applicable provisions of chapter 62Q, including sections 62Q.07; 143.23 62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 143.24 62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 143.25 62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 143.26 will be met. All enforcement and rulemaking powers available 143.27 under chapters 62Dand, 62J, 62M, 62N, and 62Q are hereby 143.28 granted to the commissioner of health with respect to counties 143.29 that purchase medical assistance and general assistance medical 143.30 care services under this section. 143.31 Sec. 46. Minnesota Statutes 1997 Supplement, section 143.32 256B.692, subdivision 5, is amended to read: 143.33 Subd. 5. [COUNTY PROPOSALS.] (a) On or before September 1, 143.34 1997, a county board that wishes to purchase or provide health 143.35 care under this section must submit a preliminary proposal that 143.36 substantially demonstrates the county's ability to meet all the 144.1 requirements of this section in response to criteria for 144.2 proposals issued by the department on or before July 1, 1997. 144.3 Counties submitting preliminary proposals must establish a local 144.4 planning process that involves input from medical assistance and 144.5 general assistance medical care recipients, recipient advocates, 144.6 providers and representatives of local school districts, labor, 144.7 and tribal government to advise on the development of a final 144.8 proposal and its implementation. 144.9 (b) The county board must submit a final proposal on or 144.10 before July 1, 1998, that demonstrates the ability to meet all 144.11 the requirements of this section, including beginning enrollment 144.12 on January 1, 1999, unless a delay has been granted under 144.13 section 256B.69, subdivision 3a, paragraph (g). 144.14 (c) After January 1, 1999, for a county in which the 144.15 prepaid medical assistance program is in existence, the county 144.16 board must submit a preliminary proposal at least 15 months 144.17 prior to termination of health plan contracts in that county and 144.18 a final proposal six months prior to the health plan contract 144.19 termination date in order to begin enrollment after the 144.20 termination. Nothing in this section shall impede or delay 144.21 implementation or continuation of the prepaid medical assistance 144.22 and general assistance medical care programs in counties for 144.23 which the board does not submit a proposal, or submits a 144.24 proposal that is not in compliance with this section. 144.25 (d) The commissioner is not required to terminate contracts 144.26 for the prepaid medical assistance and prepaid general 144.27 assistance medical care programs that begin on or after 144.28 September 1, 1997, in a county for which a county board has 144.29 submitted a proposal under this paragraph, until two years have 144.30 elapsed from the date of initial enrollment in the prepaid 144.31 medical assistance and prepaid general assistance medical care 144.32 programs. 144.33 Sec. 47. Minnesota Statutes 1997 Supplement, section 144.34 256B.77, subdivision 3, is amended to read: 144.35 Subd. 3. [ASSURANCES TO THE COMMISSIONER OF HEALTH.] A 144.36 county authority that elects to participate in a demonstration 145.1 project for people with disabilities under this section is not 145.2 required to obtain a certificate of authority under chapter 62D 145.3 or 62N. A county authority that elects to participate in a 145.4 demonstration project for people with disabilities under this 145.5 section must assure the commissioner of health that the 145.6 requirements of chapters 62D and 62N, and section 256B.692, 145.7 subdivision 2, are met. All enforcement and rulemaking powers 145.8 available under chapters 62Dand, 62J, 62M, 62N, and 62Q are 145.9 granted to the commissioner of health with respect to the county 145.10 authorities that contract with the commissioner to purchase 145.11 services in a demonstration project for people with disabilities 145.12 under this section. 145.13 Sec. 48. Minnesota Statutes 1997 Supplement, section 145.14 256B.77, subdivision 7a, is amended to read: 145.15 Subd. 7a. [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 145.16 for the demonstration project as provided in this subdivision. 145.17 (b) "Eligible individuals" means those persons living in 145.18 the demonstration site who are eligible for medical assistance 145.19 and are disabled based on a disability determination under 145.20 section 256B.055, subdivisions 7 and 12, or who are eligible for 145.21 medical assistance and have been diagnosed as having: 145.22 (1) serious and persistent mental illness as defined in 145.23 section 245.462, subdivision 20; 145.24 (2) severe emotional disturbance as defined in section 145.25 245.487, subdivision 6; or 145.26 (3) mental retardation, or being a mentally retarded person 145.27 as defined in section 252A.02, or a related condition as defined 145.28 in section 252.27, subdivision 1a. 145.29 Other individuals may be included at the option of the county 145.30 authority based on agreement with the commissioner. 145.31 (c) Eligible individuals residing on a federally recognized 145.32 Indian reservation may be excluded from participation in the 145.33 demonstration project at the discretion of the tribal government 145.34 based on agreement with the commissioner, in consultation with 145.35 the county authority. 145.36 (d) Eligible individuals include individuals in excluded 146.1 time status, as defined in chapter 256G. Enrollees in excluded 146.2 time at the time of enrollment shall remain in excluded time 146.3 status as long as they live in the demonstration site and shall 146.4 be eligible for 90 days after placement outside the 146.5 demonstration site if they move to excluded time status in a 146.6 county within Minnesota other than their county of financial 146.7 responsibility. 146.8 (e) A person who is a sexual psychopathic personality as 146.9 defined in section 253B.02, subdivision 18a, or a sexually 146.10 dangerous person as defined in section 253B.02, subdivision 18b, 146.11 is excluded from enrollment in the demonstration project. 146.12 Sec. 49. Minnesota Statutes 1997 Supplement, section 146.13 256B.77, subdivision 10, is amended to read: 146.14 Subd. 10. [CAPITATION PAYMENT.] (a) The commissioner shall 146.15 pay a capitation payment to the county authority and, when 146.16 applicable under subdivision 6, paragraph (a), to the service 146.17 delivery organization for each medical assistance eligible 146.18 enrollee. The commissioner shall develop capitation payment 146.19 rates for the initial contract period for each demonstration 146.20 site in consultation with an independent actuary, to ensure that 146.21 the cost of services under the demonstration project does not 146.22 exceed the estimated cost for medical assistance services for 146.23 the covered population under the fee-for-service system for the 146.24 demonstration period. For each year of the demonstration 146.25 project, the capitation payment rate shall be based on 96 146.26 percent of the projected per person costs that would otherwise 146.27 have been paid under medical assistance fee-for-service during 146.28 each of those years. Rates shall be adjusted within the limits 146.29 of the available risk adjustment technology, as mandated by 146.30 section 62Q.03. In addition, the commissioner shall implement 146.31 appropriate risk and savings sharing provisions with county 146.32 administrative entities and, when applicable under subdivision 146.33 6, paragraph (a), service delivery organizations within the 146.34 projected budget limits. Capitation rates shall be adjusted, at 146.35 least annually, to include any rate increases and payments for 146.36 expanded or newly covered services for eligible individuals. 147.1 The initial demonstration project rate shall include an amount 147.2 in addition to the fee-for-service payments to adjust for 147.3 underutilization of dental services. Any savings beyond those 147.4 allowed for the county authority, county administrative entity, 147.5 or service delivery organization shall be first used to meet the 147.6 unmet needs of eligible individuals. Payments to providers 147.7 participating in the project are exempt from the requirements of 147.8 sections 256.966 and 256B.03, subdivision 2. 147.9 (b) The commissioner shall monitor and evaluate annually 147.10 the effect of the discount on consumers, the county authority, 147.11 and providers of disability services. Findings shall be 147.12 reported and recommendations made, as appropriate, to ensure 147.13 that the discount effect does not adversely affect the ability 147.14 of the county administrative entity or providers of services to 147.15 provide appropriate services to eligible individuals, and does 147.16 not result in cost shifting of eligible individuals to the 147.17 county authority. 147.18 Sec. 50. Minnesota Statutes 1997 Supplement, section 147.19 256B.77, subdivision 12, is amended to read: 147.20 Subd. 12. [SERVICE COORDINATION.] (a) For purposes of this 147.21 section, "service coordinator" means an individual selected by 147.22 the enrollee or the enrollee's legal representative and 147.23 authorized by the county administrative entity or service 147.24 delivery organization to work in partnership with the enrollee 147.25 to develop, coordinate, and in some instances, provide supports 147.26 and services identified in the personal support plan. Service 147.27 coordinators may only provide services and supports if the 147.28 enrollee is informed of potential conflicts of interest, is 147.29 given alternatives, and gives informed consent. Eligible 147.30 service coordinators are individuals age 18 or older who meet 147.31 the qualifications as described in paragraph (b). Enrollees, 147.32 their legal representatives, or their advocates are eligible to 147.33 be service coordinators if they have the capabilities to perform 147.34 the activities and functions outlined in paragraph (b). 147.35 Providers licensed under chapter 245A to provide residential 147.36 services, or providers who are providing residential services 148.1 covered under the group residential housing program may not act 148.2 as service coordinator for enrollees for whom they provide 148.3 residential services. This does not apply to providers of 148.4 short-term detoxification services. Each county administrative 148.5 entity or service delivery organization may develop further 148.6 criteria for eligible vendors of service coordination during the 148.7 demonstration period and shall determine whom it contracts with 148.8 or employs to provide service coordination. County 148.9 administrative entities and service delivery organizations may 148.10 pay enrollees or their advocates or legal representatives for 148.11 service coordination activities. 148.12 (b) The service coordinator shall act as a facilitator, 148.13 working in partnership with the enrollee to ensure that their 148.14 needs are identified and addressed. The level of involvement of 148.15 the service coordinator shall depend on the needs and desires of 148.16 the enrollee. The service coordinator shall have the knowledge, 148.17 skills, and abilities to, and is responsible for: 148.18 (1) arranging for an initial assessment, and periodic 148.19 reassessment as necessary, of supports and services based on the 148.20 enrollee's strengths, needs, choices, and preferences in life 148.21 domain areas; 148.22 (2) developing and updating the personal support plan based 148.23 on relevant ongoing assessment; 148.24 (3) arranging for and coordinating the provisions of 148.25 supports and services, including knowledgeable and skilled 148.26 specialty services and prevention and early intervention 148.27 services, within the limitations negotiated with the county 148.28 administrative entity or service delivery organization; 148.29 (4) assisting the enrollee and the enrollee's legal 148.30 representative, if any, to maximize informed choice of and 148.31 control over services and supports and to exercise the 148.32 enrollee's rights and advocate on behalf of the enrollee; 148.33 (5) monitoring the progress toward achieving the enrollee's 148.34 outcomes in order to evaluate and adjust the timeliness and 148.35 adequacy of the implementation of the personal support plan; 148.36 (6) facilitating meetings and effectively collaborating 149.1 with a variety of agencies and persons, including attending 149.2 individual family service plan and individual education plan 149.3 meetings when requested by the enrollee or the enrollee's legal 149.4 representative; 149.5 (7) soliciting and analyzing relevant information; 149.6 (8) communicating effectively with the enrollee and with 149.7 other individuals participating in the enrollee's plan; 149.8 (9) educating and communicating effectively with the 149.9 enrollee about good health care practices and risk to the 149.10 enrollee's health with certain behaviors; 149.11 (10) having knowledge of basic enrollee protection 149.12 requirements, including data privacy; 149.13 (11) informing, educating, and assisting the enrollee in 149.14 identifying available service providers and accessing needed 149.15 resources and services beyond the limitations of the medical 149.16 assistance benefit set covered services; and 149.17 (12) providing other services as identified in the personal 149.18 support plan. 149.19 (c) For the demonstration project, the qualifications and 149.20 standards for service coordination in this section shall replace 149.21 comparable existing provisions of existing statutes and rules 149.22 governing case management for eligible individuals. 149.23 (d) The provisions of this subdivision apply only to the 149.24 demonstration sitesthat begin implementation on July 1,149.251998designated by the commissioner under subdivision 5. All 149.26 other demonstration sites must comply with laws and rules 149.27 governing case management services for eligible individuals in 149.28 effect when the site begins the demonstration project. 149.29 Sec. 51. Minnesota Statutes 1996, section 256D.03, 149.30 subdivision 4, is amended to read: 149.31 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 149.32 For a person who is eligible under subdivision 3, paragraph (a), 149.33 clause (3), general assistance medical care covers, except as 149.34 provided in paragraph (c): 149.35 (1) inpatient hospital services; 149.36 (2) outpatient hospital services; 150.1 (3) services provided by Medicare certified rehabilitation 150.2 agencies; 150.3 (4) prescription drugs and other products recommended 150.4 through the process established in section 256B.0625, 150.5 subdivision 13; 150.6 (5) equipment necessary to administer insulin and 150.7 diagnostic supplies and equipment for diabetics to monitor blood 150.8 sugar level; 150.9 (6) eyeglasses and eye examinations provided by a physician 150.10 or optometrist; 150.11 (7) hearing aids; 150.12 (8) prosthetic devices; 150.13 (9) laboratory and X-ray services; 150.14 (10) physician's services; 150.15 (11) medical transportation; 150.16 (12) chiropractic services as covered under the medical 150.17 assistance program; 150.18 (13) podiatric services; 150.19 (14) dental services; 150.20 (15) outpatient services provided by a mental health center 150.21 or clinic that is under contract with the county board and is 150.22 established under section 245.62; 150.23 (16) day treatment services for mental illness provided 150.24 under contract with the county board; 150.25 (17) prescribed medications for persons who have been 150.26 diagnosed as mentally ill as necessary to prevent more 150.27 restrictive institutionalization; 150.28 (18)case management services for a person with serious and150.29persistent mental illness who would be eligible for medical150.30assistance except that the person resides in an institution for150.31mental diseases;150.32(19)psychological services, medical supplies and 150.33 equipment, and Medicare premiums, coinsurance and deductible 150.34 payments; 150.35(20)(19) medical equipment not specifically listed in this 150.36 paragraph when the use of the equipment will prevent the need 151.1 for costlier services that are reimbursable under this 151.2 subdivision; 151.3(21)(20) services performed by a certified pediatric nurse 151.4 practitioner, a certified family nurse practitioner, a certified 151.5 adult nurse practitioner, a certified obstetric/gynecological 151.6 nurse practitioner, or a certified geriatric nurse practitioner 151.7 in independent practice, if the services are otherwise covered 151.8 under this chapter as a physician service, and if the service is 151.9 within the scope of practice of the nurse practitioner's license 151.10 as a registered nurse, as defined in section 148.171; and 151.11(22)(21) services of a certified public health nurse or a 151.12 registered nurse practicing in a public health nursing clinic 151.13 that is a department of, or that operates under the direct 151.14 authority of, a unit of government, if the service is within the 151.15 scope of practice of the public health nurse's license as a 151.16 registered nurse, as defined in section 148.171. 151.17 (b) Except as provided in paragraph (c), for a recipient 151.18 who is eligible under subdivision 3, paragraph (a), clause (1) 151.19 or (2), general assistance medical care covers the services 151.20 listed in paragraph (a) with the exception of special 151.21 transportation services. 151.22 (c) Gender reassignment surgery and related services are 151.23 not covered services under this subdivision unless the 151.24 individual began receiving gender reassignment services prior to 151.25 July 1, 1995. 151.26 (d) In order to contain costs, the commissioner of human 151.27 services shall select vendors of medical care who can provide 151.28 the most economical care consistent with high medical standards 151.29 and shall where possible contract with organizations on a 151.30 prepaid capitation basis to provide these services. The 151.31 commissioner shall consider proposals by counties and vendors 151.32 for prepaid health plans, competitive bidding programs, block 151.33 grants, or other vendor payment mechanisms designed to provide 151.34 services in an economical manner or to control utilization, with 151.35 safeguards to ensure that necessary services are provided. 151.36 Before implementing prepaid programs in counties with a county 152.1 operated or affiliated public teaching hospital or a hospital or 152.2 clinic operated by the University of Minnesota, the commissioner 152.3 shall consider the risks the prepaid program creates for the 152.4 hospital and allow the county or hospital the opportunity to 152.5 participate in the program in a manner that reflects the risk of 152.6 adverse selection and the nature of the patients served by the 152.7 hospital, provided the terms of participation in the program are 152.8 competitive with the terms of other participants considering the 152.9 nature of the population served. Payment for services provided 152.10 pursuant to this subdivision shall be as provided to medical 152.11 assistance vendors of these services under sections 256B.02, 152.12 subdivision 8, and 256B.0625. For payments made during fiscal 152.13 year 1990 and later years, the commissioner shall consult with 152.14 an independent actuary in establishing prepayment rates, but 152.15 shall retain final control over the rate methodology. 152.16 Notwithstanding the provisions of subdivision 3, an individual 152.17 who becomes ineligible for general assistance medical care 152.18 because of failure to submit income reports or recertification 152.19 forms in a timely manner, shall remain enrolled in the prepaid 152.20 health plan and shall remain eligible for general assistance 152.21 medical care coverage through the last day of the month in which 152.22 the enrollee became ineligible for general assistance medical 152.23 care. 152.24 (e) The commissioner of human services may reduce payments 152.25 provided under sections 256D.01 to 256D.21 and 261.23 in order 152.26 to remain within the amount appropriated for general assistance 152.27 medical care, within the following restrictions.: 152.28 (i) For the period July 1, 1985 to December 31, 1985, 152.29 reductions below the cost per service unit allowable under 152.30 section 256.966, are permitted only as follows: payments for 152.31 inpatient and outpatient hospital care provided in response to a 152.32 primary diagnosis of chemical dependency or mental illness may 152.33 be reduced no more than 30 percent; payments for all other 152.34 inpatient hospital care may be reduced no more than 20 percent. 152.35 Reductions below the payments allowable under general assistance 152.36 medical care for the remaining general assistance medical care 153.1 services allowable under this subdivision may be reduced no more 153.2 than ten percent. 153.3 (ii) For the period January 1, 1986 to December 31, 1986, 153.4 reductions below the cost per service unit allowable under 153.5 section 256.966 are permitted only as follows: payments for 153.6 inpatient and outpatient hospital care provided in response to a 153.7 primary diagnosis of chemical dependency or mental illness may 153.8 be reduced no more than 20 percent; payments for all other 153.9 inpatient hospital care may be reduced no more than 15 percent. 153.10 Reductions below the payments allowable under general assistance 153.11 medical care for the remaining general assistance medical care 153.12 services allowable under this subdivision may be reduced no more 153.13 than five percent. 153.14 (iii) For the period January 1, 1987 to June 30, 1987, 153.15 reductions below the cost per service unit allowable under 153.16 section 256.966 are permitted only as follows: payments for 153.17 inpatient and outpatient hospital care provided in response to a 153.18 primary diagnosis of chemical dependency or mental illness may 153.19 be reduced no more than 15 percent; payments for all other 153.20 inpatient hospital care may be reduced no more than ten 153.21 percent. Reductions below the payments allowable under medical 153.22 assistance for the remaining general assistance medical care 153.23 services allowable under this subdivision may be reduced no more 153.24 than five percent. 153.25 (iv) For the period July 1, 1987 to June 30, 1988, 153.26 reductions below the cost per service unit allowable under 153.27 section 256.966 are permitted only as follows: payments for 153.28 inpatient and outpatient hospital care provided in response to a 153.29 primary diagnosis of chemical dependency or mental illness may 153.30 be reduced no more than 15 percent; payments for all other 153.31 inpatient hospital care may be reduced no more than five percent. 153.32 Reductions below the payments allowable under medical assistance 153.33 for the remaining general assistance medical care services 153.34 allowable under this subdivision may be reduced no more than 153.35 five percent. 153.36 (v) For the period July 1, 1988 to June 30, 1989, 154.1 reductions below the cost per service unit allowable under 154.2 section 256.966 are permitted only as follows: payments for 154.3 inpatient and outpatient hospital care provided in response to a 154.4 primary diagnosis of chemical dependency or mental illness may 154.5 be reduced no more than 15 percent; payments for all other 154.6 inpatient hospital care may not be reduced. Reductions below 154.7 the payments allowable under medical assistance for the 154.8 remaining general assistance medical care services allowable 154.9 under this subdivision may be reduced no more than five percent. 154.10 (f) There shall be no copayment required of any recipient 154.11 of benefits for any services provided under this subdivision. A 154.12 hospital receiving a reduced payment as a result of this section 154.13 may apply the unpaid balance toward satisfaction of the 154.14 hospital's bad debts. 154.15(f)(g) Any county may, from its own resources, provide 154.16 medical payments for which state payments are not made. 154.17(g)(h) Chemical dependency services that are reimbursed 154.18 under chapter 254B must not be reimbursed under general 154.19 assistance medical care. 154.20(h)(i) The maximum payment for new vendors enrolled in the 154.21 general assistance medical care program after the base year 154.22 shall be determined from the average usual and customary charge 154.23 of the same vendor type enrolled in the base year. 154.24(i)(j) The conditions of payment for services under this 154.25 subdivision are the same as the conditions specified in rules 154.26 adopted under chapter 256B governing the medical assistance 154.27 program, unless otherwise provided by statute or rule. 154.28 Sec. 52. Minnesota Statutes 1996, section 256D.03, is 154.29 amended by adding a subdivision to read: 154.30 Subd. 9. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 154.31 services rendered on or after July 1, 1999, general assistance 154.32 medical care payments for ambulance services shall be increased 154.33 by ten percent. 154.34 Sec. 53. Minnesota Statutes 1996, section 256D.03, is 154.35 amended by adding a subdivision to read: 154.36 Subd. 10. [INFORMATION PROVIDED IN SEVERAL 155.1 LANGUAGES.] Upon request, the commissioner shall provide 155.2 applications and other information regarding general assistance 155.3 medical care, including all notices and disclosures provided to 155.4 applicants and recipients, in English, Spanish, Vietnamese, and 155.5 Hmong. Reasonable effort must be made to provide this 155.6 information to other non-English-speaking applicants and 155.7 recipients. 155.8 Sec. 54. Laws 1997, chapter 203, article 4, section 64, is 155.9 amended to read: 155.10 Sec. 64. [STUDY OF ELDERLY WAIVER EXPANSION.] 155.11 The commissioner of human services shall appoint a task 155.12 force that includes representatives of counties, health plans, 155.13 consumers, and legislators to study the impact of the expansion 155.14 of the elderly waiver program under section 4 and to make 155.15 recommendations for any changes in law necessary to facilitate 155.16 an efficient and equitable relationship between the elderly 155.17 waiver program and the Minnesota senior health options project. 155.18 Based on the results of the task force study, the commissioner 155.19 may seek any federal waivers needed to improve the relationship 155.20 between the elderly waiver and the Minnesota senior health 155.21 options project. The commissioner shall report the results of 155.22 the task force study to the legislature byJanuary 15, 1998July 155.23 1, 2000. 155.24 Sec. 55. [ELIMINATION OF CASE MIX SCORES.] 155.25 It is the intent of the legislature to repeal the unneeded, 155.26 unused, and costly requirement that persons with mental 155.27 retardation be assessed by case mix scores for the following 155.28 reasons: the scores are incomplete measures of a person's 155.29 needs, the scores are exempt from the rate setting process at 155.30 least to October 1, 1999, and the department of human services 155.31 has no plans to use the instrument in a managed care/capitated 155.32 payment arrangement. 155.33 Sec. 56. [OFFSET OF HMO SURCHARGE.] 155.34 Beginning October 1, 1998, and ending December 31, 1998, 155.35 the commissioner of human services shall offset monthly charges 155.36 for the health maintenance organization surcharge by the monthly 156.1 amount the health maintenance organization overpaid from August 156.2 1, 1997, to September 30, 1998, due to taxation of Medicare 156.3 revenues prohibited by Minnesota Statutes, section 256.9657, 156.4 subdivision 3. 156.5 Sec. 57. [MR/RC WAIVER PROPOSAL.] 156.6 By November 15, 1998, the commissioner of human services 156.7 shall provide to the chairs of the house health and human 156.8 services finance division and the senate health and family 156.9 security finance division a detailed budget proposal for 156.10 providing services under the home and community-based waiver for 156.11 persons with mental retardation or related conditions to those 156.12 individuals who are screened and waiting for services. 156.13 Sec. 58. [HIV HEALTH CARE ACCESS STUDY.] 156.14 The commissioner of human services shall study, in 156.15 consultation with the commissioner of health and a task force of 156.16 affected community stakeholders, the impact of positive patient 156.17 responses to new HIV treatment on re-entry to the workplace, 156.18 including, but not limited to, addressing continued access to 156.19 health care and disability benefits. The commissioner shall 156.20 submit a report on the study with recommendations to the 156.21 legislature by January 15, 1999. 156.22 Sec. 59. [MENTAL HEALTH REPORT.] 156.23 (a) By December 1, 1998, the commissioner of human services 156.24 shall report to the legislature on recommendations to maximize 156.25 federal funding for mental health services for children and 156.26 adults. In developing the recommendations, the commissioner 156.27 shall seek advice from a children's and adults' mental health 156.28 services stakeholders advisory group including representatives 156.29 of state and county government, private and state-operated 156.30 mental health providers, mental health consumers, family 156.31 members, and advocates. 156.32 (b) The report shall include a proposal developed in 156.33 conjunction with the counties that does not shift caseload 156.34 growth to counties after July 1, 1999, and recommendations on 156.35 whether the state should directly participate in medical 156.36 assistance mental health case management by funding a portion of 157.1 the nonfederal share of Medicaid. 157.2 Sec. 60. [AFFILIATION OF THE HEALTH-RELATED OMBUDSMAN AND 157.3 ADVOCACY SERVICES.] 157.4 The ombudsman for mental health and mental retardation, the 157.5 ombudsman for older Minnesotans, the Minnesota managed care/PMAP 157.6 ombudsman, and the office of health care consumer assistance, 157.7 advocacy, and information shall enter into an interagency 157.8 agreement to create a formal affiliation of the health-related 157.9 ombudsman and advocacy services. 157.10 Sec. 61. [CONSUMER PRICE INDEX REPORT.] 157.11 By January 15, 1999, and each year thereafter, the 157.12 commissioner of human services shall report to the chair of the 157.13 senate health and family security budget division and the chair 157.14 of the house health and human services budget division on the 157.15 cost of increasing the income standard under Minnesota Statutes, 157.16 section 256B.056, subdivision 4, and the provider rates under 157.17 Minnesota Statutes, section 256B.038, by an amount equal to the 157.18 percentage increase in the Consumer Price Index for all urban 157.19 consumers for the previous calendar year. 157.20 Sec. 62. [REPEALER.] 157.21 Minnesota Statutes 1996, section 144.0721, subdivision 3a; 157.22 and Minnesota Statutes 1997 Supplement, sections 144.0721, 157.23 subdivision 3; and 256B.0913, subdivision 15, are repealed. 157.24 Minnesota Statutes 1996, section 256B.501, subdivision 3g, is 157.25 repealed effective October 1, 2000. 157.26 Sec. 63. [EFFECTIVE DATES.] 157.27 (a) Section 6 is effective retroactive to August 1, 1997. 157.28 (b) Sections 14 and 19 are effective retroactive to July 1, 157.29 1997. 157.30 (c) Sections 9, 12, 25, 51, and 53 are effective January 1, 157.31 1999. 157.32 (d) Section 30 is effective for changes in eligibility that 157.33 occur on or after July 1, 1998. 157.34 (e) Sections 43 and 46 are effective the day following 157.35 final enactment. 157.36 ARTICLE 5 158.1 MINNESOTACARE 158.2 Section 1. Minnesota Statutes 1997 Supplement, section 158.3 60A.15, subdivision 1, is amended to read: 158.4 Subdivision 1. [DOMESTIC AND FOREIGN COMPANIES.] (a) On or 158.5 before April 1, June 1, and December 1 of each year, every 158.6 domestic and foreign company, including town and farmers' mutual 158.7 insurance companies, domestic mutual insurance companies, marine 158.8 insurance companies, health maintenance organizations, community 158.9 integrated service networks, and nonprofit health service plan 158.10 corporations, shall pay to the commissioner of revenue 158.11 installments equal to one-third of the insurer's total estimated 158.12 tax for the current year. Except as provided in paragraphs (d), 158.13 (e), (h), and (i), installments must be based on a sum equal to 158.14 two percent of the premiums described in paragraph (b). 158.15 (b) Installments under paragraph (a), (d), or (e) are 158.16 percentages of gross premiums less return premiums on all direct 158.17 business received by the insurer in this state, or by its agents 158.18 for it, in cash or otherwise, during such year. 158.19 (c) Failure of a company to make payments of at least 158.20 one-third of either (1) the total tax paid during the previous 158.21 calendar year or (2) 80 percent of the actual tax for the 158.22 current calendar year shall subject the company to the penalty 158.23 and interest provided in this section, unless the total tax for 158.24 the current tax year is $500 or less. 158.25 (d) For health maintenance organizations, nonprofit health 158.26 service plan corporations, and community integrated service 158.27 networks, the installments must be based on an amount determined 158.28 under paragraph (h) or (i). 158.29 (e) For purposes of computing installments for town and 158.30 farmers' mutual insurance companies and for mutual property 158.31 casualty companies with total assets on December 31, 1989, of 158.32 $1,600,000,000 or less, the following rates apply: 158.33 (1) for all life insurance, two percent; 158.34 (2) for town and farmers' mutual insurance companies and 158.35 for mutual property and casualty companies with total assets of 158.36 $5,000,000 or less, on all other coverages, one percent; and 159.1 (3) for mutual property and casualty companies with total 159.2 assets on December 31, 1989, of $1,600,000,000 or less, on all 159.3 other coverages, 1.26 percent. 159.4 (f) If the aggregate amount of premium tax payments under 159.5 this section and the fire marshal tax payments under section 159.6 299F.21 made during a calendar year is equal to or exceeds 159.7 $120,000, all tax payments in the subsequent calendar year must 159.8 be paid by means of a funds transfer as defined in section 159.9 336.4A-104, paragraph (a). The funds transfer payment date, as 159.10 defined in section 336.4A-401, must be on or before the date the 159.11 payment is due. If the date the payment is due is not a funds 159.12 transfer business day, as defined in section 336.4A-105, 159.13 paragraph (a), clause (4), the payment date must be on or before 159.14 the funds transfer business day next following the date the 159.15 payment is due. 159.16 (g) Premiums under medical assistance, general assistance 159.17 medical care, the MinnesotaCare program, and the Minnesota 159.18 comprehensive health insurance plan and all payments, revenues, 159.19 and reimbursements received from the federal government for 159.20 Medicare-related coverage as defined in section 62A.31, 159.21 subdivision 3, paragraph (e), are not subject to tax under this 159.22 section. 159.23 (h) For calendar years 1998 and 1999, the installments for 159.24 health maintenance organizations, community integrated service 159.25 networks, and nonprofit health service plan corporations must be 159.26 based on an amount equal to one percent of premiums described 159.27 under paragraph (b). Health maintenance organizations, 159.28 community integrated service networks, and nonprofit health 159.29 service plan corporations that have met the cost containment 159.30 goals established under section 62J.04 in the individual and 159.31 small employer market for calendar year 1996 are exempt from 159.32 payment of the tax imposed under this section for premiums paid 159.33 after March 30, 1997, and before April 1, 1998. Health 159.34 maintenance organizations, community integrated service 159.35 networks, and nonprofit health service plan corporations that 159.36 have met the cost containment goals established under section 160.1 62J.04 in the individual and small employer market for calendar 160.2 year 1997 are exempt from payment of the tax imposed under this 160.3 section for premiums paid after March 30, 1998, and before April 160.4 1, 1999. 160.5 (i) For calendar years after 1999, the commissioner of 160.6 finance shall determine the balance of the health care access 160.7 fund on September 1 of each year beginning September 1, 1999. 160.8 If the commissioner determines that there is no structural 160.9 deficit for the next fiscal year, no tax shall be imposed under 160.10 paragraph (d) for the following calendar year. If the 160.11 commissioner determines that there will be a structural deficit 160.12 in the fund for the following fiscal year, then the 160.13 commissioner, in consultation with the commissioner of revenue, 160.14 shall determine the amount needed to eliminate the structural 160.15 deficit and a tax shall be imposed under paragraph (d) for the 160.16 following calendar year. The commissioner shall determine the 160.17 rate of the tax as either one-quarter of one percent, one-half 160.18 of one percent, three-quarters of one percent, or one percent of 160.19 premiums described in paragraph (b), whichever is the lowest of 160.20 those rates that the commissioner determines will produce 160.21 sufficient revenue to eliminate the projected structural 160.22 deficit. The commissioner of finance shall publish in the State 160.23 Register by October 1 of each year the amount of tax to be 160.24 imposed for the following calendar year. In determining the 160.25 structural balance of the health care access fund for fiscal 160.26 years 2000 and 2001, the commissioner shall disregard the 160.27 transfer amount from the health care access fund to the general 160.28 fund for expenditures associated with the services provided to 160.29 pregnant women and children under the age of two enrolled in the 160.30 MinnesotaCare program. 160.31 (j) In approving the premium rates as required in sections 160.32 62L.08, subdivision 8, and 62A.65, subdivision 3, the 160.33 commissioners of health and commerce shall ensure that any 160.34 exemption from the tax as described in paragraphs (h) and (i) is 160.35 reflected in the premium rate. 160.36 Sec. 2. Minnesota Statutes 1997 Supplement, section 161.1 256B.04, subdivision 18, is amended to read: 161.2 Subd. 18. [APPLICATIONS FOR MEDICAL ASSISTANCE.] The state 161.3 agency may take applications for medical assistance and conduct 161.4 eligibility determinations for MinnesotaCare enrolleeswho are161.5required to apply for medical assistance according to section161.6256L.03, subdivision 3, paragraph (b). 161.7 Sec. 3. Minnesota Statutes 1996, section 256B.057, is 161.8 amended by adding a subdivision to read: 161.9 Subd. 7. [WAIVER OF MAINTENANCE OF EFFORT 161.10 REQUIREMENT.] Unless a federal waiver of the maintenance of 161.11 effort requirement of section 2105(d) of title XXI of the 161.12 Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 161.13 at Large, volume 111, page 251, is granted by the federal 161.14 Department of Health and Human Services by September 30, 1998, 161.15 eligibility for children under age 21 must be determined without 161.16 regard to asset standards established in section 256B.056, 161.17 subdivision 3. The commissioner of human services shall publish 161.18 a notice in the State Register upon receipt of a federal waiver. 161.19 Sec. 4. Minnesota Statutes 1997 Supplement, section 161.20 256D.03, subdivision 3, is amended to read: 161.21 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 161.22 (a) General assistance medical care may be paid for any person 161.23 who is not eligible for medical assistance under chapter 256B, 161.24 including eligibility for medical assistance based on a 161.25 spenddown of excess income according to section 256B.056, 161.26 subdivision 5, or MinnesotaCare as defined in clause(4)(5), 161.27 except as provided in paragraph (b); and: 161.28 (1) who is receiving assistance under section 256D.05, 161.29 except for families with children who are eligible under 161.30 Minnesota family investment program-statewide (MFIP-S), who is 161.31 having a payment made on the person's behalf under sections 161.32 256I.01 to 256I.06, or who resides in group residential housing 161.33 as defined in chapter 256I and can meet a spenddown using the 161.34 cost of remedial services received through group residential 161.35 housing; or 161.36 (2)(i) who is a resident of Minnesota; and whose equity in 162.1 assets is not in excess of $1,000 per assistance unit. Exempt 162.2 assets, the reduction of excess assets, and the waiver of excess 162.3 assets must conform to the medical assistance program in chapter 162.4 256B, with the following exception: the maximum amount of 162.5 undistributed funds in a trust that could be distributed to or 162.6 on behalf of the beneficiary by the trustee, assuming the full 162.7 exercise of the trustee's discretion under the terms of the 162.8 trust, must be applied toward the asset maximum; and 162.9 (ii) who has countable income not in excess of the 162.10 assistance standards established in section 256B.056, 162.11 subdivision 4, or whose excess income is spent down according to 162.12 section 256B.056, subdivision 5, using a six-month budget 162.13 period. The method for calculating earned income disregards and 162.14 deductions for a person who resides with a dependent child under 162.15 age 21 shall follow section 256B.056, subdivision 1a. However, 162.16 if a disregard of $30 and one-third of the remainder has been 162.17 applied to the wage earner's income, the disregard shall not be 162.18 applied again until the wage earner's income has not been 162.19 considered in an eligibility determination for general 162.20 assistance, general assistance medical care, medical assistance, 162.21 or MFIP-S for 12 consecutive months. The earned income and work 162.22 expense deductions for a person who does not reside with a 162.23 dependent child under age 21 shall be the same as the method 162.24 used to determine eligibility for a person under section 162.25 256D.06, subdivision 1, except the disregard of the first $50 of 162.26 earned income is not allowed; or 162.27 (3) who would be eligible for medical assistance except 162.28 that the person resides in a facility that is determined by the 162.29 commissioner or the federal Health Care Financing Administration 162.30 to be an institution for mental diseases.; 162.31 (4) who is receiving care and rehabilitation services from 162.32 a nonprofit center established to serve victims of torture. 162.33 These individuals are eligible for general assistance medical 162.34 care only for the period during which they are receiving 162.35 services from the center. During this period of eligibility, 162.36 individuals eligible under this clause shall not be required to 163.1 participate in prepaid general assistance medical care; or 163.2(4)(5) beginningJuly 1, 1998January 1, 2000, applicants 163.3 or recipients who meet all eligibility requirements of 163.4 MinnesotaCare as defined in sections 256L.01 to 256L.16, and are: 163.5 (i) adults with dependent children under 21 whose gross 163.6 family income is equal to or less than 275 percent of the 163.7 federal poverty guidelines; or 163.8 (ii) adults without children with earned income and whose 163.9 family gross income is between 75 percent of the federal poverty 163.10 guidelines and the amount set by section 256L.04, subdivision 7, 163.11 shall be terminated from general assistance medical care upon 163.12 enrollment in MinnesotaCare. 163.13 (b) For services rendered on or after July 1, 1997, 163.14 eligibility is limited to one month prior to application if the 163.15 person is determined eligible in the prior month. A 163.16 redetermination of eligibility must occur every 12 months. 163.17 BeginningJuly 1, 1998January 1, 2000, Minnesota health care 163.18 program applications completed by recipients and applicants who 163.19 are persons described in paragraph (a), clause(4)(5), may be 163.20 returned to the county agency to be forwarded to the department 163.21 of human services or sent directly to the department of human 163.22 services for enrollment in MinnesotaCare. If all other 163.23 eligibility requirements of this subdivision are met, 163.24 eligibility for general assistance medical care shall be 163.25 available in any month during which a MinnesotaCare eligibility 163.26 determination and enrollment are pending. Upon notification of 163.27 eligibility for MinnesotaCare, notice of termination for 163.28 eligibility for general assistance medical care shall be sent to 163.29 an applicant or recipient. If all other eligibility 163.30 requirements of this subdivision are met, eligibility for 163.31 general assistance medical care shall be available until 163.32 enrollment in MinnesotaCare subject to the provisions of 163.33 paragraph (d). 163.34 (c) The date of an initial Minnesota health care program 163.35 application necessary to begin a determination of eligibility 163.36 shall be the date the applicant has provided a name, address, 164.1 and social security number, signed and dated, to the county 164.2 agency or the department of human services. If the applicant is 164.3 unable to provide an initial application when health care is 164.4 delivered due to a medical condition or disability, a health 164.5 care provider may act on the person's behalf to complete the 164.6 initial application. The applicant must complete the remainder 164.7 of the application and provide necessary verification before 164.8 eligibility can be determined. The county agency must assist 164.9 the applicant in obtaining verification if necessary. 164.10 (d) County agencies are authorized to use all automated 164.11 databases containing information regarding recipients' or 164.12 applicants' income in order to determine eligibility for general 164.13 assistance medical care or MinnesotaCare. Such use shall be 164.14 considered sufficient in order to determine eligibility and 164.15 premium payments by the county agency. 164.16 (e) General assistance medical care is not available for a 164.17 person in a correctional facility unless the person is detained 164.18 by law for less than one year in a county correctional or 164.19 detention facility as a person accused or convicted of a crime, 164.20 or admitted as an inpatient to a hospital on a criminal hold 164.21 order, and the person is a recipient of general assistance 164.22 medical care at the time the person is detained by law or 164.23 admitted on a criminal hold order and as long as the person 164.24 continues to meet other eligibility requirements of this 164.25 subdivision. 164.26 (f) General assistance medical care is not available for 164.27 applicants or recipients who do not cooperate with the county 164.28 agency to meet the requirements of medical assistance. General 164.29 assistance medical care is limited to payment of emergency 164.30 services only for applicants or recipients as described in 164.31 paragraph (a), clause(4)(5), whose MinnesotaCare coverage is 164.32 denied or terminated for nonpayment of premiums as required by 164.33 sections 256L.06to 256L.08and 256L.07. 164.34 (g) In determining the amount of assets of an individual, 164.35 there shall be included any asset or interest in an asset, 164.36 including an asset excluded under paragraph (a), that was given 165.1 away, sold, or disposed of for less than fair market value 165.2 within the 60 months preceding application for general 165.3 assistance medical care or during the period of eligibility. 165.4 Any transfer described in this paragraph shall be presumed to 165.5 have been for the purpose of establishing eligibility for 165.6 general assistance medical care, unless the individual furnishes 165.7 convincing evidence to establish that the transaction was 165.8 exclusively for another purpose. For purposes of this 165.9 paragraph, the value of the asset or interest shall be the fair 165.10 market value at the time it was given away, sold, or disposed 165.11 of, less the amount of compensation received. For any 165.12 uncompensated transfer, the number of months of ineligibility, 165.13 including partial months, shall be calculated by dividing the 165.14 uncompensated transfer amount by the average monthly per person 165.15 payment made by the medical assistance program to skilled 165.16 nursing facilities for the previous calendar year. The 165.17 individual shall remain ineligible until this fixed period has 165.18 expired. The period of ineligibility may exceed 30 months, and 165.19 a reapplication for benefits after 30 months from the date of 165.20 the transfer shall not result in eligibility unless and until 165.21 the period of ineligibility has expired. The period of 165.22 ineligibility begins in the month the transfer was reported to 165.23 the county agency, or if the transfer was not reported, the 165.24 month in which the county agency discovered the transfer, 165.25 whichever comes first. For applicants, the period of 165.26 ineligibility begins on the date of the first approved 165.27 application. 165.28 (h) When determining eligibility for any state benefits 165.29 under this subdivision, the income and resources of all 165.30 noncitizens shall be deemed to include their sponsor's income 165.31 and resources as defined in the Personal Responsibility and Work 165.32 Opportunity Reconciliation Act of 1996, title IV, Public Law 165.33 Number 104-193, sections 421 and 422, and subsequently set out 165.34 in federal rules. 165.35 (i) (1) An undocumented noncitizen or a nonimmigrant is 165.36 ineligible for general assistance medical care other than 166.1 emergency services. For purposes of this subdivision, a 166.2 nonimmigrant is an individual in one or more of the classes 166.3 listed in United States Code, title 8, section 1101(a)(15), and 166.4 an undocumented noncitizen is an individual who resides in the 166.5 United States without the approval or acquiescence of the 166.6 Immigration and Naturalization Service. 166.7(j)(2) This paragraph does not apply to a child under age 166.8 18, to a Cuban or Haitian entrant as defined in Public Law 166.9 Number 96-422, section 501(e)(1) or (2)(a), or to a noncitizen 166.10 who is aged, blind, or disabled as defined in Code of Federal 166.11 Regulations, title 42, sections 435.520, 435.530, 435.531, 166.12 435.540, and 435.541, or to an individual eligible for general 166.13 assistance medical care under paragraph (a), clause (4), who 166.14 cooperates with the Immigration and Naturalization Service to 166.15 pursue any applicable immigration status, including citizenship, 166.16 that would qualify the individual for medical assistance with 166.17 federal financial participation. 166.18(k)(3) For purposes ofparagraphs (f) and (i)this 166.19 paragraph, "emergency services" has the meaning given in Code of 166.20 Federal Regulations, title 42, section 440.255(b)(1), except 166.21 that it also means services rendered because of suspected or 166.22 actual pesticide poisoning. 166.23(l)(j) Notwithstanding any other provision of law, a 166.24 noncitizen who is ineligible for medical assistance due to the 166.25 deeming of a sponsor's income and resources, is ineligible for 166.26 general assistance medical care. 166.27 Sec. 5. Minnesota Statutes 1997 Supplement, section 166.28 256L.01, is amended to read: 166.29 256L.01 [DEFINITIONS.] 166.30 Subdivision 1. [SCOPE.] For purposes of sections 256L.01 166.31 to256L.10256L.18, the following terms shall have the meanings 166.32 given them. 166.33 Subd. 1a. [CHILD.] "Child" means an individual under 21 166.34 years of age, including the unborn child of a pregnant woman, an 166.35 emancipated minor, and an emancipated minor's spouse. 166.36 Subd. 2. [COMMISSIONER.] "Commissioner" means the 167.1 commissioner of human services. 167.2 Subd. 3. [ELIGIBLE PROVIDERS.] "Eligible providers" means 167.3 those health care providers who provide covered health services 167.4 to medical assistance recipients under rules established by the 167.5 commissioner for that program. 167.6 Subd. 3a. [FAMILY WITH CHILDREN.] (a) "Family with 167.7 children" means: 167.8 (1) parents, their children, and dependent siblings 167.9 residing in the same household; or 167.10 (2) grandparents, foster parents, relative caretakers as 167.11 defined in the medical assistance program, or legal guardians; 167.12 their wards who are children; and dependent siblings residing in 167.13 the same household. 167.14 (b) The term includes children and dependent siblings who 167.15 are temporarily absent from the household in settings such as 167.16 schools, camps, or visitation with noncustodial parents. 167.17 (c) For purposes of this subdivision, a dependent sibling 167.18 means an unmarried child who is a full-time student under the 167.19 age of 25 years who is financially dependent upon a parent, 167.20 grandparent, foster parent, relative caretaker, or legal 167.21 guardian. Proof of school enrollment is required. 167.22 Subd. 4. [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] "Gross 167.23 individual or gross family income" for farm and nonfarm 167.24 self-employed means income calculated using as the baseline the 167.25 adjusted gross income reported on the applicant's federal income 167.26 tax form for the previous year and adding back in reported 167.27 depreciation, carryover loss, and net operating loss amounts 167.28 that apply to the business in which the family is currently 167.29 engaged. Applicants shall report the most recent financial 167.30 situation of the family if it has changed from the period of 167.31 time covered by the federal income tax form. The report may be 167.32 in the form of percentage increase or decrease. 167.33 Subd. 5. [INCOME.] "Income" has the meaning given for 167.34 earned and unearned income for families and children in the 167.35 medical assistance program, according to the state's aid to 167.36 families with dependent children plan in effect as of July 16, 168.1 1996. The definition does not include medical assistance income 168.2 methodologies and deeming requirements. The earned income of 168.3 full-time and part-time students under age 19 is not counted as 168.4 income. Public assistance payments and supplemental security 168.5 income are not excluded income. 168.6 Sec. 6. Minnesota Statutes 1997 Supplement, section 168.7 256L.02, subdivision 2, is amended to read: 168.8 Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall 168.9 establish an office for the state administration of this plan. 168.10 The plan shall be used to provide covered health services for 168.11 eligible persons. Payment for these services shall be made to 168.12 all eligible providers. The commissioner shall adopt rules to 168.13 administer the MinnesotaCare program. The commissioner shall 168.14 establish marketing efforts to encourage potentially eligible 168.15 persons to receive information about the program and about other 168.16 medical care programs administered or supervised by the 168.17 department of human services. A toll-free telephone number must 168.18 be used to provide information about medical programs and to 168.19 promote access to the covered services. 168.20 Upon request, the commissioner shall provide applications 168.21 and other information regarding the MinnesotaCare program, 168.22 including all notices and disclosures provided to applicants and 168.23 enrollees, in English, Spanish, Vietnamese, and Hmong. 168.24 Reasonable efforts must be made to provide this information to 168.25 other non-English-speaking applicants and enrollees. 168.26 Sec. 7. Minnesota Statutes 1997 Supplement, section 168.27 256L.02, subdivision 3, is amended to read: 168.28 Subd. 3. [FINANCIAL MANAGEMENT.] (a) The commissioner 168.29 shall manage spending for the MinnesotaCare program in a manner 168.30 that maintains a minimum reserve in accordance with section 168.31 16A.76. As part of each state revenue and expenditure forecast, 168.32 the commissioner must makea quarterlyan assessment of the 168.33 expected expenditures for the covered services for the remainder 168.34 of the current biennium and for the following biennium. The 168.35 estimated expenditure, including the reserve requirements 168.36 described in section 16A.76, shall be compared to an estimate of 169.1 the revenues that will bedepositedavailable in the health care 169.2 access fund. Based on this comparison, and after consulting 169.3 with the chairs of the house ways and means committee and the 169.4 senate finance committee, and the legislative commission on 169.5 health care access, the commissioner shall, as necessary, make 169.6 the adjustments specified in paragraph (b) to ensure that 169.7 expenditures remain within the limits of available revenues for 169.8 the remainder of the current biennium and for the following 169.9 biennium. The commissioner shall not hire additional staff 169.10 using appropriations from the health care access fund until the 169.11 commissioner of finance makes a determination that the 169.12 adjustments implemented under paragraph (b) are sufficient to 169.13 allow MinnesotaCare expenditures to remain within the limits of 169.14 available revenues for the remainder of the current biennium and 169.15 for the following biennium. 169.16 (b) The adjustments the commissioner shall use must be 169.17 implemented in this order: first, stop enrollment of single 169.18 adults and households without children; second, upon 45 days' 169.19 notice, stop coverage of single adults and households without 169.20 children already enrolled in the MinnesotaCare program; third, 169.21 upon 90 days' notice, decrease the premium subsidy amounts by 169.22 ten percent for families with gross annual income above 200 169.23 percent of the federal poverty guidelines; fourth, upon 90 days' 169.24 notice, decrease the premium subsidy amounts by ten percent for 169.25 families with gross annual income at or below 200 percent; and 169.26 fifth, require applicants to be uninsured for at least six 169.27 months prior to eligibility in the MinnesotaCare program. If 169.28 these measures are insufficient to limit the expenditures to the 169.29 estimated amount of revenue, the commissioner shall further 169.30 limit enrollment or decrease premium subsidies. 169.31 Sec. 8. Minnesota Statutes 1997 Supplement, section 169.32 256L.03, subdivision 1, is amended to read: 169.33 Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health 169.34 services" means the health services reimbursed under chapter 169.35 256B, with the exception of inpatient hospital services, special 169.36 education services, private duty nursing services, adult dental 170.1 care services other than preventive services, orthodontic 170.2 services, nonemergency medical transportation services, personal 170.3 care assistant and case management services, nursing home or 170.4 intermediate care facilities services, inpatient mental health 170.5 services, and chemical dependency services. Effective July 1, 170.6 1998, adult dental care for nonpreventive services with the 170.7 exception of orthodontic services is available to persons who 170.8 qualify under section 256L.04, subdivisions 1 to 7,or 256L.13,170.9 with family gross income equal to or less than 175 percent of 170.10 the federal poverty guidelines. Outpatient mental health 170.11 services covered under the MinnesotaCare program are limited to 170.12 diagnostic assessments, psychological testing, explanation of 170.13 findings, medication management by a physician, day treatment, 170.14 partial hospitalization, and individual, family, and group 170.15 psychotherapy. 170.16 No public funds shall be used for coverage of abortion 170.17 under MinnesotaCare except where the life of the female would be 170.18 endangered or substantial and irreversible impairment of a major 170.19 bodily function would result if the fetus were carried to term; 170.20 or where the pregnancy is the result of rape or incest. 170.21 Covered health services shall be expanded as provided in 170.22 this section. 170.23 Sec. 9. Minnesota Statutes 1997 Supplement, section 170.24 256L.03, is amended by adding a subdivision to read: 170.25 Subd. 1a. [COVERED SERVICES FOR PREGNANT WOMEN AND 170.26 CHILDREN UNDER MINNESOTACARE HEALTH CARE REFORM 170.27 WAIVER.] Children and pregnant women are eligible for coverage 170.28 of all services that are eligible for reimbursement under the 170.29 medical assistance program according to chapter 256B. Pregnant 170.30 women and children are exempt from the provisions of subdivision 170.31 5, regarding copayments. Pregnant women and children who are 170.32 lawfully residing in the United States but who are not 170.33 "qualified noncitizens" under title IV of the Personal 170.34 Responsibility and Work Opportunity Reconciliation Act of 1996, 170.35 Public Law Number 104-193, Statutes at Large, volume 110, page 170.36 2105, are eligible for coverage of all services provided under 171.1 the medical assistance program according to chapter 256B. 171.2 Sec. 10. Minnesota Statutes 1997 Supplement, section 171.3 256L.03, is amended by adding a subdivision to read: 171.4 Subd. 1b. [PREGNANT WOMEN; ELIGIBILITY FOR FULL MEDICAL 171.5 ASSISTANCE SERVICES.] A woman who is enrolled in MinnesotaCare 171.6 when her pregnancy is diagnosed is eligible for coverage of all 171.7 services provided under the medical assistance program according 171.8 to chapter 256B retroactive to the date the pregnancy is 171.9 medically diagnosed. Copayments totaling $30 or more, paid 171.10 after the date the pregnancy is diagnosed, shall be refunded. 171.11 Sec. 11. Minnesota Statutes 1997 Supplement, section 171.12 256L.03, subdivision 3, is amended to read: 171.13 Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a)Beginning July171.141, 1993,Covered health services shall include inpatient 171.15 hospital services, including inpatient hospital mental health 171.16 services and inpatient hospital and residential chemical 171.17 dependency treatment, subject to those limitations necessary to 171.18 coordinate the provision of these services with eligibility 171.19 under the medical assistance spenddown. Prior to July 1, 1997, 171.20 the inpatient hospital benefit for adult enrollees is subject to 171.21 an annual benefit limit of $10,000.Effective July 1, 1997,The 171.22 inpatient hospital benefit for adult enrollees who qualify under 171.23 section 256L.04, subdivision 7, or who qualify under section 171.24 256L.04, subdivisions 1to 6and 2,or 256L.13with family gross 171.25 income that exceeds 175 percent of the federal poverty 171.26 guidelines and who are not pregnant, is subject to an annual 171.27 limit of $10,000. 171.28 (b)Enrollees who qualify under section 256L.04,171.29subdivision 7, or who qualify under section 256L.04,171.30subdivisions 1 to 6, or 256L.13 with family gross income that171.31exceeds 175 percent of the federal poverty guidelines and who171.32are not pregnant, and are determined by the commissioner to have171.33a basis of eligibility for medical assistance shall apply for171.34and cooperate with the requirements of medical assistance by the171.35last day of the third month following admission to an inpatient171.36hospital. If an enrollee fails to apply for medical assistance172.1within this time period, the enrollee and the enrollee's family172.2shall be disenrolled from the plan and they may not reenroll172.3until 12 calendar months have elapsed. Enrollees and enrollees'172.4families disenrolled for not applying for or not cooperating172.5with medical assistance may not reenroll.172.6(c)Admissions for inpatient hospital services paid for 172.7 under section 256L.11, subdivision 3, must be certified as 172.8 medically necessary in accordance with Minnesota Rules, parts 172.9 9505.0500 to 9505.0540, except as provided in clauses (1) and 172.10 (2): 172.11 (1) all admissions must be certified, except those 172.12 authorized under rules established under section 254A.03, 172.13 subdivision 3, or approved under Medicare; and 172.14 (2) payment under section 256L.11, subdivision 3, shall be 172.15 reduced by five percent for admissions for which certification 172.16 is requested more than 30 days after the day of admission. The 172.17 hospital may not seek payment from the enrollee for the amount 172.18 of the payment reduction under this clause. 172.19(d) Any enrollee or family member of an enrollee who has172.20previously been permanently disenrolled from MinnesotaCare for172.21not applying for and cooperating with medical assistance shall172.22be eligible to reenroll if 12 calendar months have elapsed since172.23the date of disenrollment.172.24 Sec. 12. Minnesota Statutes 1997 Supplement, section 172.25 256L.03, is amended by adding a subdivision to read: 172.26 Subd. 3a. [INTERPRETER SERVICES.] Covered services include 172.27 sign and spoken language interpreter services that assist an 172.28 enrollee in obtaining covered health care services. 172.29 Sec. 13. Minnesota Statutes 1997 Supplement, section 172.30 256L.03, subdivision 4, is amended to read: 172.31 Subd. 4. [COORDINATION WITH MEDICAL ASSISTANCE.] The 172.32 commissioner shall coordinate the provision of hospital 172.33 inpatient services under the MinnesotaCare program with enrollee 172.34 eligibility under the medical assistance spenddown, and shall172.35apply to the secretary of health and human services for any172.36necessary federal waivers or approvals. 173.1 Sec. 14. Minnesota Statutes 1997 Supplement, section 173.2 256L.03, subdivision 5, is amended to read: 173.3 Subd. 5. [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 173.4 benefit plan shall include the following copayments and 173.5 coinsurance requirements: 173.6 (1) ten percent of the paid charges for inpatient hospital 173.7 services for adult enrolleesnot eligible for medical173.8assistance, subject to an annual inpatient out-of-pocket maximum 173.9 of $1,000 per individual and $3,000 per family; 173.10 (2) $3 per prescription for adult enrollees; 173.11 (3) $25 for eyeglasses for adult enrollees; and 173.12 (4) effective July 1, 1998, 50 percent of the 173.13 fee-for-service rate for adult dental care services other than 173.14 preventive care services for persons eligible under section 173.15 256L.04, subdivisions 1 to 7,or 256L.13,with income equal to 173.16 or less than 175 percent of the federal poverty guidelines. 173.17Prior to July 1, 1997, enrollees who are not eligible for173.18medical assistance with or without a spenddown shall be173.19financially responsible for the coinsurance amount and amounts173.20which exceed the $10,000 benefit limit.Effective July 1, 1997, 173.21 adult enrolleeswho qualify under section 256L.04, subdivision173.227, or who qualify under section 256L.04, subdivisions 1 to 6, or173.23256L.13with family gross income that exceeds 175 percent of the 173.24 federal poverty guidelines and who are not pregnant, and who are173.25not eligible for medical assistance with or without a spenddown,173.26 shall be financially responsible for the coinsurance amount and 173.27 amounts which exceed the $10,000 inpatient hospital benefit 173.28 limit. 173.29 When a MinnesotaCare enrollee becomes a member of a prepaid 173.30 health plan, or changes from one prepaid health plan to another 173.31 during a calendar year, any charges submitted towards the 173.32 $10,000 annual inpatient benefit limit, and any out-of-pocket 173.33 expenses incurred by the enrollee for inpatient services, that 173.34 were submitted or incurred prior to enrollment, or prior to the 173.35 change in health plans, shall be disregarded. 173.36 Sec. 15. Minnesota Statutes 1997 Supplement, section 174.1 256L.04, subdivision 1, is amended to read: 174.2 Subdivision 1. [CHILDREN; EXPANSION AND CONTINUATION OF174.3ELIGIBILITYFAMILIES WITH CHILDREN.] (a)[CHILDREN.] Prior to174.4October 1, 1992, "eligible persons" means children who are one174.5year of age or older but less than 18 years of age who have174.6gross family incomes that are equal to or less than 185 percent174.7of the federal poverty guidelines and who are not eligible for174.8medical assistance without a spenddown under chapter 256B and174.9who are not otherwise insured for the covered services. The174.10period of eligibility extends from the first day of the month in174.11which the child's first birthday occurs to the last day of the174.12month in which the child becomes 18 years old.Families with 174.13 children with family income equal to or less than 275 percent of 174.14 the federal poverty guidelines for the applicable family size 174.15 shall be eligible for MinnesotaCare according to this section. 174.16 All other provisions of sections 256L.01 to 256L.18, including 174.17 the insurance-related barriers to enrollment under section 174.18 256L.07, shall apply unless otherwise specified. 174.19 (b)[EXPANSION OF ELIGIBILITY.] Eligibility for174.20MinnesotaCare shall be expanded as provided in subdivisions 3 to174.217, except children who meet the criteria in this subdivision174.22shall continue to be enrolled pursuant to this subdivision. The174.23enrollment requirements in this paragraph apply to enrollment174.24under subdivisions 1 to 7.Parents who enroll in the 174.25 MinnesotaCare program must also enroll their children and 174.26 dependent siblings, if the children and their dependent siblings 174.27 are eligible. Children and dependent siblings may be enrolled 174.28 separately without enrollment by parents. However, if one 174.29 parent in the household enrolls, both parents must enroll, 174.30 unless other insurance is available. If one child from a family 174.31 is enrolled, all children must be enrolled, unless other 174.32 insurance is available. If one spouse in a household enrolls, 174.33 the other spouse in the household must also enroll, unless other 174.34 insurance is available. Families cannot choose to enroll only 174.35 certain uninsured members.For purposes of this section, a174.36"dependent sibling" means an unmarried child who is a full-time175.1student under the age of 25 years who is financially dependent175.2upon a parent. Proof of school enrollment will be required.175.3(c) [CONTINUATION OF ELIGIBILITY.] Individuals who175.4initially enroll in the MinnesotaCare program under the175.5eligibility criteria in subdivisions 3 to 7 remain eligible for175.6the MinnesotaCare program, regardless of age, place of175.7residence, or the presence or absence of children in the same175.8household, as long as all other eligibility criteria are met and175.9residence in Minnesota and continuous enrollment in the175.10MinnesotaCare program or medical assistance are maintained. In175.11order for either parent or either spouse in a household to175.12remain enrolled, both must remain enrolled, unless other175.13insurance is available.175.14 Sec. 16. Minnesota Statutes 1997 Supplement, section 175.15 256L.04, subdivision 2, is amended to read: 175.16 Subd. 2. [COOPERATION IN ESTABLISHING THIRD PARTY 175.17 LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 175.18 eligible for MinnesotaCare, individuals and families must 175.19 cooperate with the state agency to identify potentially liable 175.20 third party payers and assist the state in obtaining third party 175.21 payments. "Cooperation" includes, but is not limited to, 175.22 identifying any third party who may be liable for care and 175.23 services provided under MinnesotaCare to the enrollee, providing 175.24 relevant information to assist the state in pursuing a 175.25 potentially liable third party, and completing forms necessary 175.26 to recover third party payments. 175.27 (b) A parent, guardian, or child enrolled in the 175.28 MinnesotaCare program must cooperate with the department of 175.29 human services and the local agency in establishing the 175.30 paternity of an enrolled child and in obtaining medical care 175.31 support and payments for the child and any other person for whom 175.32 the person can legally assign rights, in accordance with 175.33 applicable laws and rules governing the medical assistance 175.34 program. A child shall not be ineligible for or disenrolled 175.35 from the MinnesotaCare program solely because the child's parent 175.36 or guardian fails to cooperate in establishing paternity or 176.1 obtaining medical support. 176.2 Sec. 17. Minnesota Statutes 1997 Supplement, section 176.3 256L.04, subdivision 7, is amended to read: 176.4 Subd. 7. [ADDITION OFSINGLE ADULTS AND HOUSEHOLDS WITH NO 176.5 CHILDREN.](a) Beginning October 1, 1994, the definition of176.6"eligible persons" is expanded to include all individuals and176.7households with no children who have gross family incomes that176.8are equal to or less than 125 percent of the federal poverty176.9guidelines and who are not eligible for medical assistance176.10without a spenddown under chapter 256B.176.11(b) Beginning July 1, 1997,The definition of eligible 176.12 personsis expanded to includeincludes all individuals and 176.13 households with no children who have gross family incomes that 176.14 are equal to or less than 175 percent of the federal poverty 176.15 guidelinesand who are not eligible for medical assistance176.16without a spenddown under chapter 256B. 176.17(c) All eligible persons under paragraphs (a) and (b) are176.18eligible for coverage through the MinnesotaCare program but must176.19pay a premium as determined under sections 256L.07 and 256L.08.176.20Individuals and families whose income is greater than the limits176.21established under section 256L.08 may not enroll in the176.22MinnesotaCare program.176.23 Sec. 18. Minnesota Statutes 1997 Supplement, section 176.24 256L.04, is amended by adding a subdivision to read: 176.25 Subd. 7a. [INELIGIBILITY.] Applicants whose income is 176.26 greater than the limits established under this section may not 176.27 enroll in the MinnesotaCare program. 176.28 Sec. 19. Minnesota Statutes 1997 Supplement, section 176.29 256L.04, subdivision 8, is amended to read: 176.30 Subd. 8. [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 176.31 ASSISTANCE.] (a) Individuals whoapply for MinnesotaCarereceive 176.32 supplemental security income or retirement, survivors, or 176.33 disability benefits due to a disability, or other 176.34 disability-based pension, who qualify under section 256L.04, 176.35 subdivision 7, but who are potentially eligible for medical 176.36 assistance without a spenddown shall be allowed to enroll in 177.1 MinnesotaCare for a period of 60 days, so long as the applicant 177.2 meets all other conditions of eligibility. The commissioner 177.3 shall identify and refer the applications of such individuals to 177.4 their county social service agency. The county and the 177.5 commissioner shall cooperate to ensure that the individuals 177.6 obtain medical assistance coverage for any months for which they 177.7 are eligible. 177.8 (b) The enrollee must cooperate with the county social 177.9 service agency in determining medical assistance eligibility 177.10 within the 60-day enrollment period. Enrollees who do notapply177.11for andcooperate with medical assistance within the 60-day 177.12 enrollment period, and their other family members,shall be 177.13 disenrolled from the plan within one calendar month. Persons 177.14 disenrolled for nonapplication for medical assistance may not 177.15 reenroll until they have obtained a medical assistance 177.16 eligibility determinationfor the family member or members who177.17were referred to the county agency. Persons disenrolled for 177.18 noncooperation with medical assistance may not reenroll until 177.19 they have cooperated with the county agency and have obtained a 177.20 medical assistance eligibility determination. 177.21 (c) Beginning January 1, 2000, counties that choose to 177.22 become MinnesotaCare enrollment sites shall consider 177.23 MinnesotaCare applications of individuals described in paragraph 177.24 (a) to also be applications for medical assistance and shall 177.25 first determine whether medical assistance eligibility exists. 177.26 Adults with children with family income under 175 percent of the 177.27 federal poverty guidelines for the applicable family size, 177.28 pregnant women, and children who qualify under subdivision 1 who 177.29 are potentially eligible for medical assistance without a 177.30 spenddown may choose to enroll in either MinnesotaCare or 177.31 medical assistance. 177.32 (d) The commissioner shall redetermine provider payments 177.33 made under MinnesotaCare to the appropriate medical assistance 177.34 payments for those enrollees who subsequently become eligible 177.35 for medical assistance. 177.36 Sec. 20. Minnesota Statutes 1997 Supplement, section 178.1 256L.04, subdivision 9, is amended to read: 178.2 Subd. 9. [GENERAL ASSISTANCE MEDICAL CARE.] A person 178.3 cannot have coverage under both MinnesotaCare and general 178.4 assistance medical care in the same month. Eligibility for 178.5 MinnesotaCare cannot be replaced by eligibility for general 178.6 assistance medical care, and eligibility for general assistance 178.7 medical care cannot be replaced by eligibility for MinnesotaCare. 178.8 Sec. 21. Minnesota Statutes 1997 Supplement, section 178.9 256L.04, subdivision 10, is amended to read: 178.10 Subd. 10. [SPONSOR'S INCOME AND RESOURCES DEEMED 178.11 AVAILABLE; DOCUMENTATION.] When determining eligibility for any 178.12 federal or state benefits under sections 256L.01 to256L.16178.13 256L.18, the income and resources of all noncitizens whose 178.14 sponsor signed an affidavit of support as defined under United 178.15 States Code, title 8, section 1183a, shall be deemed to include 178.16 their sponsors' income and resources as defined in the Personal 178.17 Responsibility and Work Opportunity Reconciliation Act of 1996, 178.18 title IV, Public Law Number 104-193, sections 421 and 422, and 178.19 subsequently set out in federal rules. To be eligible for the 178.20 program, noncitizens must provide documentation of their 178.21 immigration status. 178.22 Sec. 22. Minnesota Statutes 1997 Supplement, section 178.23 256L.04, is amended by adding a subdivision to read: 178.24 Subd. 12. [PERSONS IN DETENTION.] An applicant residing in 178.25 a correctional or detention facility is not eligible for 178.26 MinnesotaCare. An enrollee residing in a correctional or 178.27 detention facility is not eligible at renewal of eligibility 178.28 under section 256L.05, subdivision 3b. 178.29 Sec. 23. Minnesota Statutes 1997 Supplement, section 178.30 256L.04, is amended by adding a subdivision to read: 178.31 Subd. 13. [FAMILIES WITH GRANDPARENTS, RELATIVE 178.32 CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] In families 178.33 that include a grandparent, relative caretaker as defined in the 178.34 medical assistance program, foster parent, or legal guardian, 178.35 the grandparent, relative caretaker, foster parent, or legal 178.36 guardian may apply as a family or may apply separately for the 179.1 children. If the caretaker applies separately for the children, 179.2 only the children's income is counted. If the grandparent, 179.3 relative caretaker, foster parent, or legal guardian applies 179.4 with the family, their income is included in the gross family 179.5 income for determining eligibility and premium amount. 179.6 Sec. 24. Minnesota Statutes 1997 Supplement, section 179.7 256L.05, is amended by adding a subdivision to read: 179.8 Subd. 1a. [PERSON AUTHORIZED TO APPLY ON APPLICANT'S 179.9 BEHALF.] A family member who is age 18 or over or who is an 179.10 authorized representative, as defined in the medical assistance 179.11 program, may apply on an applicant's behalf. 179.12 Sec. 25. Minnesota Statutes 1997 Supplement, section 179.13 256L.05, subdivision 2, is amended to read: 179.14 Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall 179.15 use individuals' social security numbers as identifiers for 179.16 purposes of administering the plan and conduct data matches to 179.17 verify income. Applicants shall submit evidence of individual 179.18 and family income, earned and unearned,includingsuch as the 179.19 most recent income tax return, wage slips, or other 179.20 documentation that is determined by the commissioner as 179.21 necessary to verify income eligibility. The commissioner shall 179.22 perform random audits to verify reported income and 179.23 eligibility. The commissioner may execute data sharing 179.24 arrangements with the department of revenue and any other 179.25 governmental agency in order to perform income verification 179.26 related to eligibility and premium payment under the 179.27 MinnesotaCare program. 179.28 Sec. 26. Minnesota Statutes 1997 Supplement, section 179.29 256L.05, subdivision 3, is amended to read: 179.30 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] The effective date 179.31 of coverage is the first day of the month following the month in 179.32 which eligibility is approved and the first premium payment has 179.33 been received. As provided in section 256B.057, coverage for 179.34 newborns is automatic from the date of birth and must be 179.35 coordinated with other health coverage. The effective date of 179.36 coverage foreligible newborns oreligible newly adoptive 180.1 children added to a family receiving covered health services is 180.2 the date of entry into the family. The effective date of 180.3 coverage for other new recipients added to the family receiving 180.4 covered health services is the first day of the month following 180.5 the month in which eligibility is approvedand the first premium180.6payment has been receivedor at renewal, whichever the family 180.7 receiving covered health services prefers. All eligibility 180.8 criteria must be met by the family at the time the new family 180.9 member is added. The income of the new family member is 180.10 included with the family's gross income and the adjusted premium 180.11 begins in the month the new family member is added. The premium 180.12 must be received eight working days prior to the end of the 180.13 month for coverage to begin the following month. Benefits are 180.14 not available until the day following discharge if an enrollee 180.15 is hospitalized on the first day of coverage. Notwithstanding 180.16 any other law to the contrary, benefits under sections 256L.01 180.17 to256L.10256L.18 are secondary to a plan of insurance or 180.18 benefit program under which an eligible person may have coverage 180.19 and the commissioner shall use cost avoidance techniques to 180.20 ensure coordination of any other health coverage for eligible 180.21 persons. The commissioner shall identify eligible persons who 180.22 may have coverage or benefits under other plans of insurance or 180.23 who become eligible for medical assistance. 180.24 Sec. 27. Minnesota Statutes 1997 Supplement, section 180.25 256L.05, is amended by adding a subdivision to read: 180.26 Subd. 3a. [RENEWAL OF ELIGIBILITY.] An enrollee's 180.27 eligibility must be renewed every 12 months. The 12-month 180.28 period begins in the month after the month the application is 180.29 approved. Individuals who initially enroll in the MinnesotaCare 180.30 program under section 256L.04, subdivision 1 or 7, remain 180.31 eligible for the MinnesotaCare program regardless of age, place 180.32 of residence, or the presence or absence of children in the same 180.33 household, as long as all other eligibility criteria are met, 180.34 and residence in Minnesota and continuous enrollment in the 180.35 MinnesotaCare program are maintained. 180.36 Sec. 28. Minnesota Statutes 1997 Supplement, section 181.1 256L.05, is amended by adding a subdivision to read: 181.2 Subd. 3b. [REAPPLICATION.] Families and individuals must 181.3 reapply after a lapse in coverage of one calendar month or more 181.4 and must meet all eligibility criteria. 181.5 Sec. 29. Minnesota Statutes 1997 Supplement, section 181.6 256L.05, subdivision 4, is amended to read: 181.7 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 181.8 human services shall determine an applicant's eligibility for 181.9 MinnesotaCare no more than 30 days from the date that the 181.10 application is received by the department of human services. 181.11 Beginning January 1, 2000, this requirement also applies to 181.12 local county human services agencies that determine eligibility 181.13 for MinnesotaCare. To prevent processing delays, applicants 181.14 who, from the information provided on the application, appear to 181.15 meet eligibility requirements shall be enrolled. The enrollee 181.16 must provide all required verifications within 30 days of 181.17 enrollment or coverage from the program shall be terminated. 181.18 Enrollees who are determined to be ineligible when verifications 181.19 are provided shall be disenrolled from the program. 181.20 Sec. 30. Minnesota Statutes 1997 Supplement, section 181.21 256L.06, subdivision 3, is amended to read: 181.22 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 181.23 Premiums are dedicated to the commissioner for MinnesotaCare. 181.24The commissioner shall make an annual redetermination of181.25continued eligibility and identify people who may become181.26eligible for medical assistance.181.27 (b) The commissioner shall develop and implement procedures 181.28 to: (1) require enrollees to report changes in income; (2) 181.29 adjust sliding scale premium payments, based upon changes in 181.30 enrollee income; and (3) disenroll enrollees from MinnesotaCare 181.31 for failure to pay required premiums. Failure to pay includes 181.32 payment with a dishonored check. The commissioner may demand a 181.33 guaranteed form of payment as the only means to replace a 181.34 dishonored check. 181.35 (c) Premiums are calculated on a calendar month basis and 181.36 may be paid on a monthly, quarterly, or annual basis, with the 182.1 first payment due upon notice from the commissioner of the 182.2 premium amount required. Premium payment is required before 182.3 enrollment is complete and to maintain eligibility in 182.4 MinnesotaCare. 182.5 (d) Nonpayment of the premium will result in disenrollment 182.6 from the plan within one calendar month after the due date. 182.7 Persons disenrolled for nonpayment or who voluntarily terminate 182.8 coverage from the program may not reenroll until four calendar 182.9 months have elapsed. Persons disenrolled for nonpayment or who 182.10 voluntarily terminate coverage from the program may not reenroll 182.11 for four calendar months unless the person demonstrates good 182.12 cause for nonpayment. Good cause does not exist if a person 182.13 chooses to pay other family expenses instead of the premium. 182.14 The commissioner shall define good cause in rule. 182.15 Sec. 31. Minnesota Statutes 1997 Supplement, section 182.16 256L.07, is amended to read: 182.17 256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON 182.18 SLIDING SCALE.] 182.19 Subdivision 1. [GENERAL REQUIREMENTS.]Families and182.20individuals who enroll on or after October 1, 1992, are eligible182.21for subsidized premium payments based on a sliding scale under182.22section 256L.08 only if the family or individual meets the182.23requirements in subdivisions 2 and 3. Children already enrolled182.24in the children's health plan as of September 30, 1992, eligible182.25under section 256L.04, subdivision 1, paragraph (a), children182.26who enroll in the MinnesotaCare program after September 30,182.271992, pursuant to Laws 1992, chapter 549, article 4, section 17,182.28and children who enroll under section 256L.04, subdivision 6,182.29are eligible for subsidized premium payments without meeting182.30these requirements, as long as they maintain continuous coverage182.31in the MinnesotaCare plan or medical assistance.(a) Children 182.32 enrolled in the original children's health plan as of September 182.33 30, 1992, children who enrolled in the MinnesotaCare program 182.34 after September 30, 1992, pursuant to Laws 1992, chapter 549, 182.35 article 4, section 17, and children who have family gross 182.36 incomes that are equal to or less than 150 percent of the 183.1 federal poverty guidelines are eligible for subsidized premium 183.2 payments without meeting the requirements of subdivision 2, as 183.3 long as they maintain continuous coverage in the MinnesotaCare 183.4 program or medical assistance. 183.5 (b)Families and individuals who initially enrolled in183.6MinnesotaCare under section 256L.04, and whose income increases183.7above the limits established in section 256L.08, may continue183.8enrollment and pay the full cost of coverage.Families enrolled 183.9 in MinnesotaCare under section 256L.04, subdivision 1, whose 183.10 income increases above 275 percent of the federal poverty 183.11 guidelines, are no longer eligible for the program and shall be 183.12 disenrolled by the commissioner. Individuals enrolled in 183.13 MinnesotaCare under section 256L.04, subdivision 7, whose income 183.14 increases above 175 percent of the federal poverty guidelines 183.15 are no longer eligible for the program and shall be disenrolled 183.16 by the commissioner. For persons disenrolled under this 183.17 subdivision, MinnesotaCare coverage terminates the last day of 183.18 the calendar month following the month in which the commissioner 183.19 determines that the income of a family or individual, determined 183.20 over a four-month period as required by section 256L.08, exceeds 183.21 program income limits. Persons disenrolled under this 183.22 subdivision may enter the transition pool established under 183.23 section 256L.19. 183.24 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 183.25 COVERAGE.] (a) To be eligible for subsidized premium payments 183.26 based on a sliding scale, a family or individual must not have 183.27 access to subsidized health coverage through an employer, and183.28must not have had access to subsidized health coverage through183.29an employer for the 18 months prior to application for183.30subsidized coverage under the MinnesotaCare program. The183.31requirement that the family or individual must not have had183.32access to employer-subsidized coverage during the previous 18183.33months does not apply if: (1) employer-subsidized coverage was183.34lost due to the death of an employee or divorce; (2)183.35employer-subsidized coverage was lost because an individual183.36became ineligible for coverage as a child or dependent; or (3)184.1employer-subsidized coverage was lost for reasons that would not184.2disqualify the individual for unemployment benefits under184.3section 268.09 and the family or individual has not had access184.4to employer-subsidized coverage since the loss of coverage. If184.5employer-subsidized coverage was lost for reasons that184.6disqualify an individual for unemployment benefits under section184.7268.09, children of that individual are exempt from the184.8requirement of no access to employer subsidized coverage for the184.918 months prior to application, as long as the children have not184.10had access to employer subsidized coverage since the184.11disqualifying event. The requirement that the. A family or 184.12 individualmust not have had access to employer-subsidized184.13coverage during the previous 18 months does apply ifwhose 184.14 employer-subsidized coverage is lost due to an employer 184.15 terminating health care coverage as an employee benefit during 184.16 the previous 18 months is not eligible. 184.17 (b) For purposes of this requirement, subsidized health 184.18 coverage means health coverage for which the employer pays at 184.19 least 50 percent of the cost of coverage for the employee,184.20excluding dependent coverageor dependent, or a higher 184.21 percentage as specified by the commissioner. Children are 184.22 eligible for employer-subsidized coverage through either parent, 184.23 including the noncustodial parent. The commissioner must treat 184.24 employer contributions to Internal Revenue Code Section 125 184.25 plans and any other employer benefits intended to pay health 184.26 care costs as qualified employer subsidies toward the cost of 184.27 health coverage for employees for purposes of this subdivision. 184.28 Subd. 3. [PERIOD UNINSUREDOTHER HEALTH COVERAGE.]To be184.29eligible for subsidized premium payments based on a sliding184.30scale,(a) Families and individualsinitiallyenrolled in the 184.31 MinnesotaCare programunder section 256L.04, subdivisions 5 and184.327,must havehadno health coverage while enrolled or for at 184.33 least four months prior to application and renewal. Children 184.34 enrolled in the original children's health plan and children in 184.35 families with income equal to or less than 150 percent of the 184.36 federal poverty guidelines, who have other health insurance, are 185.1 eligible if the other health coverage meets the requirements of 185.2 Minnesota Rules, part 9506.0020, subpart 3, item B. The 185.3 commissioner may change this eligibility criterion for sliding 185.4 scale premiums in order to remain within the limits of available 185.5 appropriations. The requirement ofat least four months ofno 185.6 health coverageprior to application for the MinnesotaCare185.7programdoes not apply to:newborns. 185.8(1) families, children, and individuals who apply for the185.9MinnesotaCare program upon termination from or as required by185.10the medical assistance program, general assistance medical care185.11program, or coverage under a regional demonstration project for185.12the uninsured funded under section 256B.73, the Hennepin county185.13assured care program, or the Group Health, Inc., community185.14health plan;185.15(2) families and individuals initially enrolled under185.16section 256L.04, subdivisions 1, paragraph (a), and 3;185.17(3) children enrolled pursuant to Laws 1992, chapter 549,185.18article 4, section 17; or185.19(4) individuals currently serving or who have served in the185.20military reserves, and dependents of these individuals, if these185.21individuals: (i) reapply for MinnesotaCare coverage after a185.22period of active military service during which they had been185.23covered by the Civilian Health and Medical Program of the185.24Uniformed Services (CHAMPUS); (ii) were covered under185.25MinnesotaCare immediately prior to obtaining coverage under185.26CHAMPUS; and (iii) have maintained continuous coverage.185.27 (b) For purposes of this section, medical assistance, 185.28 general assistance medical care, and civilian health and medical 185.29 program of the uniformed service, CHAMPUS, are not considered 185.30 insurance or health coverage. 185.31 (c) For purposes of this section, Medicare part A or B 185.32 coverage under title XVIII of the Social Security Act, United 185.33 States Code, title 42, sections 1395c to 1395w-4, is considered 185.34 health coverage. An applicant or enrollee may not refuse 185.35 Medicare coverage to establish eligibility for MinnesotaCare. 185.36 Sec. 32. Minnesota Statutes 1997 Supplement, section 186.1 256L.09, subdivision 2, is amended to read: 186.2 Subd. 2. [RESIDENCY REQUIREMENT.] (a)Prior to July 1,186.31997, to be eligible for health coverage under the MinnesotaCare186.4program, families and individuals must be permanent residents of186.5Minnesota.186.6(b) Effective July 1, 1997,To be eligible for health 186.7 coverage under the MinnesotaCare program, adults without 186.8 children must be permanent residents of Minnesota. 186.9(c) Effective July 1, 1997,(b) To be eligible for health 186.10 coverage under the MinnesotaCare program, pregnant women, 186.11 families, and children must meet the residency requirements as 186.12 provided by Code of Federal Regulations, title 42, section 186.13 435.403, except that the provisions of section 256B.056, 186.14 subdivision 1, shall apply upon receipt of federal approval. 186.15 Sec. 33. Minnesota Statutes 1997 Supplement, section 186.16 256L.09, subdivision 4, is amended to read: 186.17 Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 186.18 purposes of this section, a permanent Minnesota resident is a 186.19 person who has demonstrated, through persuasive and objective 186.20 evidence, that the person is domiciled in the state and intends 186.21 to live in the state permanently. 186.22 (b) To be eligible as a permanent resident,all applicants186.23 an applicant must demonstrate the requisite intent to live in 186.24 the state permanently by: 186.25 (1) showing that the applicant maintains a residence at a 186.26 verified address other than a place of public accommodation, 186.27 through the use of evidence of residence described in section 186.28 256D.02, subdivision 12a, clause (1); 186.29 (2) demonstrating that the applicant has been continuously 186.30 domiciled in the state for no less than 180 days immediately 186.31 before the application; and 186.32 (3) signing an affidavit declaring that (A) the applicant 186.33 currently resides in the state and intends to reside in the 186.34 state permanently; and (B) the applicant did not come to the 186.35 state for the primary purpose of obtaining medical coverage or 186.36 treatment. 187.1 (c) A person who is temporarily absent from the state does 187.2 not lose eligibility for MinnesotaCare. "Temporarily absent 187.3 from the state" means the person is out of the state for a 187.4 temporary purpose and intends to return when the purpose of the 187.5 absence has been accomplished. A person is not temporarily 187.6 absent from the state if another state has determined that the 187.7 person is a resident for any purpose. If temporarily absent 187.8 from the state, the person must follow the requirements of the 187.9 health plan in which he or she is enrolled to receive services. 187.10 Sec. 34. Minnesota Statutes 1997 Supplement, section 187.11 256L.09, subdivision 6, is amended to read: 187.12 Subd. 6. [12-MONTH PREEXISTING EXCLUSION.] If the 180-day 187.13 requirement in subdivision 4, paragraph (b), clause (2), is 187.14 determined by a court to be unconstitutional, the commissioner 187.15 of human services shall impose a 12-month preexisting condition 187.16 exclusion on coverage for persons who have been domiciled in the 187.17 state for less than 180 days. 187.18 Sec. 35. Minnesota Statutes 1997 Supplement, section 187.19 256L.11, subdivision 6, is amended to read: 187.20 Subd. 6. [ENROLLEES 18 OR OLDER.] Payment by the 187.21 MinnesotaCare program for inpatient hospital services provided 187.22 to MinnesotaCare enrollees eligible under section 256L.04, 187.23 subdivision 7, or who qualify under section 256L.04, 187.24 subdivisions 1to 6and 2,or 256L.13with family gross income 187.25 that exceeds 175 percent of the federal poverty guidelines and 187.26 who are not pregnant, who are 18 years old or older on the date 187.27 of admission to the inpatient hospital must be in accordance 187.28 with paragraphs (a) and (b). Payment for adults who are not 187.29 pregnant and are eligible under section 256L.04, subdivisions 187.30 1to 6and 2,or 256L.13,and whose incomes are equal to or less 187.31 than 175 percent of the federal poverty guidelines, shall be as 187.32 provided for under paragraph (c). 187.33 (a) If the medical assistance rate minus any copayment 187.34 required under section 256L.03, subdivision 4, is less than or 187.35 equal to the amount remaining in the enrollee's benefit limit 187.36 under section 256L.03, subdivision 3, payment must be the 188.1 medical assistance rate minus any copayment required under 188.2 section 256L.03, subdivision 4. The hospital must not seek 188.3 payment from the enrollee in addition to the copayment. The 188.4 MinnesotaCare payment plus the copayment must be treated as 188.5 payment in full. 188.6 (b) If the medical assistance rate minus any copayment 188.7 required under section 256L.03, subdivision 4, is greater than 188.8 the amount remaining in the enrollee's benefit limit under 188.9 section 256L.03, subdivision 3, payment must be the lesser of: 188.10 (1) the amount remaining in the enrollee's benefit limit; 188.11 or 188.12 (2) charges submitted for the inpatient hospital services 188.13 less any copayment established under section 256L.03, 188.14 subdivision 4. 188.15 The hospital may seek payment from the enrollee for the 188.16 amount by which usual and customary charges exceed the payment 188.17 under this paragraph. If payment is reduced under section 188.18 256L.03, subdivision 3, paragraph(c)(b), the hospital may not 188.19 seek payment from the enrollee for the amount of the reduction. 188.20 (c) For admissions occurring during the period of July 1, 188.21 1997, through June 30, 1998, for adults who are not pregnant and 188.22 are eligible under section 256L.04, subdivisions 1to 6and 188.23 2,or 256L.13,and whose incomes are equal to or less than 175 188.24 percent of the federal poverty guidelines, the commissioner 188.25 shall pay hospitals directly, up to the medical assistance 188.26 payment rate, for inpatient hospital benefits in excess of the 188.27 $10,000 annual inpatient benefit limit. 188.28 Sec. 36. Minnesota Statutes 1997 Supplement, section 188.29 256L.12, subdivision 5, is amended to read: 188.30 Subd. 5. [ELIGIBILITY FOR OTHER STATE PROGRAMS.] 188.31 MinnesotaCare enrollees who become eligible for medical 188.32 assistance or general assistance medical care will remain in the 188.33 same managed care plan if the managed care plan has a contract 188.34 for that population. Effective January 1, 1998, MinnesotaCare 188.35 enrollees who were formerly eligible for general assistance 188.36 medical care pursuant to section 256D.03, subdivision 3, within 189.1 six months of MinnesotaCare enrollment and were enrolled in a 189.2 prepaid health plan pursuant to section 256D.03, subdivision 4, 189.3 paragraph (d), must remain in the same managed care plan if the 189.4 managed care plan has a contract for that population.Contracts189.5between the department of human services and managed care plans189.6must include MinnesotaCare, and medical assistance and may, at189.7the option of the commissioner of human services, also include189.8general assistance medical care.Managed care plans must 189.9 participate in the MinnesotaCare and general assistance medical 189.10 care programs under a contract with the department of human 189.11 services in service areas where they participate in the medical 189.12 assistance program. 189.13 Sec. 37. Minnesota Statutes 1997 Supplement, section 189.14 256L.15, is amended to read: 189.15 256L.15 [PREMIUMS.] 189.16 Subdivision 1. [PREMIUM DETERMINATION.] Familiesandwith 189.17 childrenenrolled according to sections 256L.13 to 256L.16and 189.18 individuals shall pay a premium determined according to a 189.19 sliding fee based on the cost of coverage as a percentage of the 189.20 family's gross family income. Pregnant women and children under 189.21 age two are exempt from the provisions of section 256L.06, 189.22 subdivision 3, paragraph (b), clause (3), requiring 189.23 disenrollment for failure to pay premiums. For pregnant women, 189.24 this exemption continues until the first day of the month 189.25 following the 60th day postpartum. Women who remain enrolled 189.26 during pregnancy or the postpartum period, despite nonpayment of 189.27 premiums, shall be disenrolled on the first of the month 189.28 following the 60th day postpartum for the penalty period that 189.29 otherwise applies under section 256L.06, unless they begin 189.30 paying premiums. 189.31 Subd. 1a. [PAYMENT OPTIONS.] The commissioner may offer 189.32 the following payment options to an enrollee: 189.33 (1) payment by check; 189.34 (2) payment by credit card; 189.35 (3) payment by recurring automatic checking withdrawal; 189.36 (4) payment by one-time electronic transfer of funds; 190.1 (5) payment by wage withholding with the consent of the 190.2 employer and the employee; or 190.3 (6) payment by using state tax refund payments. 190.4 At application or reapplication, a MinnesotaCare applicant 190.5 or enrollee may authorize the commissioner to use the Revenue 190.6 Recapture Act in chapter 270A to collect funds from the 190.7 applicant's or enrollee's state income tax refund for the 190.8 purposes of meeting all or part of the applicant's or enrollee's 190.9 MinnesotaCare premium obligation for the forthcoming year. The 190.10 applicant or enrollee may authorize the commissioner to apply 190.11 for the state working family tax credit on behalf of the 190.12 applicant or enrollee. The setoff due under this subdivision 190.13 shall not be subject to the $10 fee under section 270A.07, 190.14 subdivision 1. 190.15 Subd. 1b. [PAYMENTS NONREFUNDABLE.] MinnesotaCare premiums 190.16 are not refundable. 190.17 Subd. 2. [SLIDING SCALE TO DETERMINE PERCENTAGE OF GROSS 190.18 INDIVIDUAL OR FAMILY INCOME.] The commissioner shall establish a 190.19 sliding fee scale to determine the percentage of 190.20 gross individual or family income that households at different 190.21 income levels must pay to obtain coverage through the 190.22 MinnesotaCare program. The sliding fee scale must be based on 190.23 the enrollee's gross individual or family income during the 190.24 previous four months. The sliding fee scale begins with a 190.25 premium of 1.5 percent of gross individual or family income for 190.26 individuals or families with incomes below the limits for the 190.27 medical assistance program for families and children and 190.28 proceeds through the following evenly spaced steps: 1.8, 2.3, 190.29 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. These percentages are 190.30 matched to evenly spaced income steps ranging from the medical 190.31 assistance income limit for families and children to 275 percent 190.32 of the federal poverty guidelines for the applicable family 190.33 size. The sliding fee scale and percentages are not subject to 190.34 the provisions of chapter 14. If a family or individual reports 190.35 increased income after enrollment, premiums shall not be 190.36 adjusted until eligibility renewal. 191.1 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 191.2 of $48 is required for all childrenwho are eligible according191.3to section 256L.13, subdivision 4in families with income at or 191.4 less than 150 percent of federal poverty guidelines. 191.5 Sec. 38. Minnesota Statutes 1997 Supplement, section 191.6 256L.17, is amended by adding a subdivision to read: 191.7 Subd. 6. [WAIVER OF MAINTENANCE OF EFFORT 191.8 REQUIREMENT.] Unless a federal waiver of the maintenance of 191.9 effort requirements of section 2105(d) of title XXI of the 191.10 Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 191.11 at Large, volume 111, page 251, is granted by the federal 191.12 Department of Health and Human Services by September 30, 1998, 191.13 this section does not apply to children. The commissioner shall 191.14 publish a notice in the State Register upon receipt of a federal 191.15 waiver. 191.16 Sec. 39. [256L.19] [TRANSITION POOL FOR MINNESOTACARE 191.17 ENROLLEES.] 191.18 Subdivision 1. [CREATION.] The commissioner of human 191.19 services shall create a purchasing pool for MinnesotaCare 191.20 enrollees whose income is at or above 275 percent of the federal 191.21 poverty guidelines. 191.22 Subd. 2. [HEALTH PLAN COVERAGE.] Any managed care plan 191.23 that participates in the MinnesotaCare program through a 191.24 contract with the department of human services must offer a 191.25 group product to the pool established under subdivision 1 with 191.26 guaranteed issuance and with a waiver of any preexisting 191.27 condition limitations. The coverage offered must be equivalent 191.28 to a qualified benefit plan under section 62E.06 offered by a 191.29 health maintenance organization. 191.30 Subd. 3. [RATES.] (a) The rates offered for this coverage 191.31 must meet the requirements of section 62L.08. 191.32 (b) All premiums for this coverage shall be the 191.33 responsibility of the enrollee. No state subsidies shall be 191.34 provided. 191.35 Sec. 40. Minnesota Statutes 1997 Supplement, section 191.36 270A.03, subdivision 5, is amended to read: 192.1 Subd. 5. [DEBT.] "Debt" means a legal obligation of a 192.2 natural person to pay a fixed and certain amount of money, which 192.3 equals or exceeds $25 and which is due and payable to a claimant 192.4 agency. The term includes criminal fines imposed under section 192.5 609.10 or 609.125 and restitution. A debt may arise under a 192.6 contractual or statutory obligation, a court order, or other 192.7 legal obligation, but need not have been reduced to judgment. 192.8 A debt includes any legal obligation of a current recipient 192.9 of assistance which is based on overpayment of an assistance 192.10 grant where that payment is based on a client waiver or an 192.11 administrative or judicial finding of an intentional program 192.12 violation; or where the debt is owed to a program wherein the 192.13 debtor is not a client at the time notification is provided to 192.14 initiate recovery under this chapter and the debtor is not a 192.15 current recipient of food stamps, transitional child care, or 192.16 transitional medical assistance. 192.17 A debt does not include any legal obligation to pay a 192.18 claimant agency for medical care, including hospitalization if 192.19 the income of the debtor at the time when the medical care was 192.20 rendered does not exceed the following amount: 192.21 (1) for an unmarried debtor, an income of $6,400 or less; 192.22 (2) for a debtor with one dependent, an income of $8,200 or 192.23 less; 192.24 (3) for a debtor with two dependents, an income of $9,700 192.25 or less; 192.26 (4) for a debtor with three dependents, an income of 192.27 $11,000 or less; 192.28 (5) for a debtor with four dependents, an income of $11,600 192.29 or less; and 192.30 (6) for a debtor with five or more dependents, an income of 192.31 $12,100 or less. 192.32 The income amounts in this subdivision shall be adjusted 192.33 for inflation for debts incurred in calendar years 1991 and 192.34 thereafter. The dollar amount of each income level that applied 192.35 to debts incurred in the prior year shall be increased in the 192.36 same manner as provided in section 290.06, subdivision 2d, for 193.1 the expansion of the tax rate brackets. 193.2 Debt also includes an agreement to pay a MinnesotaCare 193.3 premium, regardless of the dollar amount of the premium 193.4 authorized under section 256L.15, subdivision 1a. 193.5 Sec. 41. Laws 1997, chapter 225, article 2, section 64, is 193.6 amended to read: 193.7 Sec. 64. [EFFECTIVE DATE.] 193.8 Section 8 is effective for payments made for MinnesotaCare 193.9 services on or after July 1, 1996. Section 23 is effective the 193.10 day following final enactment. Section 46 is effective January 193.11 1, 1998, and applies to high deductible health plans issued or 193.12 renewed on or after that date. 193.13 Sec. 42. [FEDERAL EARNED INCOME TAX CREDIT.] 193.14 The commissioner of human services shall seek a federal 193.15 waiver from the appropriate federal agency to allow the state to 193.16 use the federal earned income tax credit for payment of state 193.17 subsidized health care premiums. 193.18 Sec. 43. [INPATIENT HOSPITAL COPAYMENT.] 193.19 If federal approval of a waiver to obtain federal Medicaid 193.20 funding for coverage provided to parents enrolled in the 193.21 MinnesotaCare program is contingent upon not applying the 193.22 inpatient hospital services copayment under section 256L.03, 193.23 subdivision 5, clause (1), the inpatient hospital services 193.24 copayment shall not be applied to enrollees for whom the state 193.25 receives federal Medicaid funding. 193.26 Sec. 44. [AUTHORIZATION TO SUBMIT PLANS AND REQUESTS FOR 193.27 WAIVERS TO OBTAIN FEDERAL FUNDS UNDER TITLE XXI.] 193.28 (a) The commissioner of human services is authorized to 193.29 claim enhanced federal matching funds available under sections 193.30 2105(a)(2) and 2110 of the Balanced Budget Act of 1997, Public 193.31 Law Number 105-33, for any and all state or local expenditures 193.32 eligible as child health assistance for targeted low-income 193.33 children and health service initiatives for low-income 193.34 children. If required by federal law or regulation, the 193.35 commissioner is authorized to establish accounts, make 193.36 appropriate payments, and receive reimbursement from any and all 194.1 state and local entities providing child health assistance or 194.2 health services for low-income children in order to obtain 194.3 federal matching funds. Federal matching funds received under 194.4 this section shall be deposited in the health care access fund. 194.5 (b) The commissioner of human services shall submit to the 194.6 health care financing administration all necessary plans or 194.7 requests for waivers in order to obtain enhanced matching funds 194.8 under the state children's health insurance program for 194.9 expenditures made under the MinnesotaCare program. The 194.10 commissioner shall report to the 1999 legislature all changes to 194.11 the MinnesotaCare program that may be required in order to 194.12 receive enhanced matching funds. 194.13 Sec. 45. [REVISOR'S INSTRUCTION.] 194.14 In each section of Minnesota Statutes referred to in column 194.15 A, the revisor of statutes shall delete the reference in column 194.16 B and insert the reference in column C. 194.17 Column A Column B Column C 194.18 256B.057, subd. 1a 256L.08 256L.15 194.19 256B.0645 256L.14 256L.03, subd. 1a 194.20 256L.16 256L.14 256L.03, subd. 1a 194.21 Sec. 46. [REPEALER.] 194.22 Minnesota Statutes 1997 Supplement, sections 256B.057, 194.23 subdivision 1a; 256L.04, subdivisions 3, 4, 5, and 6; 256L.06, 194.24 subdivisions 1 and 2; 256L.08; 256L.09, subdivision 3; 256L.13; 194.25 and 256L.14, are repealed. 194.26 Sec. 47. [EFFECTIVE DATE.] 194.27 Sections 2, 4 to 11, 13 to 37, 40, 45, and 46 are effective 194.28 January 1, 1999. Sections 3 and 38 are effective September 30, 194.29 1998. Sections 12, 41, 42, 43, and 44 are effective the day 194.30 following final enactment. 194.31 ARTICLE 6 194.32 WELFARE REFORM 194.33 Section 1. Minnesota Statutes 1996, section 119B.24, is 194.34 amended to read: 194.35 119B.24 [DUTIES OF COMMISSIONER.] 194.36 In addition to the powers and duties already conferred by 195.1 law, the commissioner of children, families, and learning shall: 195.2 (1) by September 1, 1998, and every five years thereafter, 195.3 survey and report on all components of the child care system, 195.4 including, but not limited to, availability of licensed child 195.5 care slots, the number of children in various kinds of child 195.6 care settings, staff wages, rate of staff turnover, 195.7 qualifications of child care workers, cost of child care by type 195.8 of service and ages of children, and child care availability 195.9 through school systems; 195.10 (2) by September 1, 1998, and every five years thereafter, 195.11 survey and report on the extent to which existing child care 195.12 services fulfill the need for child care, giving particular 195.13 attention to the need for part-time care and for care of 195.14 infants, sick children, children with special needs, low-income 195.15 children, toddlers, and school-age children; 195.16 (3) administer the child care fund, including the sliding 195.17 fee program authorized under sections 119B.01 to 119B.16; 195.18 (4) monitor the child care resource and referral programs 195.19 established under section 119B.19; and 195.20 (5) encourage child care providers to participate in a 195.21 nationally recognized accreditation system for early childhood 195.22 programs. The commissioner shall reimburse licensed child care 195.23 providers for one-half of the direct cost of accreditation fees, 195.24 upon successful completion of accreditation. 195.25 The commissioner may enter into contractual agreements with 195.26 a federally recognized Indian tribe with a reservation in 195.27 Minnesota to carry out any of the responsibilities of county 195.28 human service agencies to the extent necessary for the tribe to 195.29 operate a child care assistance program under the supervision of 195.30 the commissioner. 195.31 Funding to support services under section 119B.03 may be 195.32 transferred to the federally recognized Indian tribe with a 195.33 reservation in Minnesota from allocations available to counties 195.34 in which reservation boundaries lie. When funding is 195.35 transferred, the amount shall be commensurate to estimates of 195.36 the proportion of reservation residents to the total population 196.1 of county residents with characteristics identified in section 196.2 119B.03. 196.3 Sec. 2. Minnesota Statutes 1996, section 245A.03, is 196.4 amended by adding a subdivision to read: 196.5 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 196.6 clause (2), does not apply to: 196.7 (1) a child care provider who as an applicant for licensure 196.8 or as a license holder has received a license denial under 196.9 section 245A.05, a fine under section 245A.06, or a sanction 196.10 under section 245A.07 from the commissioner that has not been 196.11 reversed on appeal; or 196.12 (2) a child care provider, or a child care provider who has 196.13 a household member who, as a result of a licensing process, has 196.14 a disqualification under this chapter that has not been set 196.15 aside by the commissioner. 196.16 Sec. 3. Minnesota Statutes 1996, section 245A.14, 196.17 subdivision 4, is amended to read: 196.18 Subd. 4. [SPECIAL FAMILY DAY CARE HOMES.] (a) 196.19 Nonresidential child care programs serving 14 or fewer children 196.20 that are conducted at a location other than the license holder's 196.21 own residence shall be licensed under this section and the rules 196.22 governing family day care or group family day care if: 196.23(a)(1) the license holder is the primary provider of care;196.24(b)and the nonresidential child care program is conducted 196.25 in a dwelling that is located on a residential lot;andor 196.26(c) the license holder complies with all other requirements196.27of sections 245A.01 to 245A.15 and the rules governing family196.28day care or group family day care.196.29 (2) the license holder is an employer who may or may not be 196.30 the primary provider of care, and the purpose for the child care 196.31 program is to provide child care services to children of the 196.32 license holder's employees. 196.33 (b) Notwithstanding section 245A.16, subdivision 1, the 196.34 commissioner shall not delegate the authority to licensing 196.35 facilities under this section to county agencies or other 196.36 private agencies. 197.1 Sec. 4. Minnesota Statutes 1997 Supplement, section 197.2 245B.06, subdivision 2, is amended to read: 197.3 Subd. 2. [RISK MANAGEMENT PLAN.] The license holder must 197.4 develop and document in writing a risk management plan that 197.5 incorporates the individual abuse prevention plan as required in 197.6chapter 245Csection 245A.65. License holders jointly providing 197.7 services to a consumer shall coordinate and use the resulting 197.8 assessment of risk areas for the development of this plan. Upon 197.9 initiation of services, the license holder will have in place an 197.10 initial risk management plan that identifies areas in which the 197.11 consumer is vulnerable, including health, safety, and 197.12 environmental issues and the supports the provider will have in 197.13 place to protect the consumer and to minimize these risks. The 197.14 plan must be changed based on the needs of the individual 197.15 consumer and reviewed at least annually. 197.16 Sec. 5. Minnesota Statutes 1997 Supplement, section 197.17 256.01, subdivision 2, is amended to read: 197.18 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 197.19 section 241.021, subdivision 2, the commissioner of human 197.20 services shall: 197.21 (1) Administer and supervise all forms of public assistance 197.22 provided for by state law and other welfare activities or 197.23 services as are vested in the commissioner. Administration and 197.24 supervision of human services activities or services includes, 197.25 but is not limited to, assuring timely and accurate distribution 197.26 of benefits, completeness of service, and quality program 197.27 management. In addition to administering and supervising human 197.28 services activities vested by law in the department, the 197.29 commissioner shall have the authority to: 197.30 (a) require county agency participation in training and 197.31 technical assistance programs to promote compliance with 197.32 statutes, rules, federal laws, regulations, and policies 197.33 governing human services; 197.34 (b) monitor, on an ongoing basis, the performance of county 197.35 agencies in the operation and administration of human services, 197.36 enforce compliance with statutes, rules, federal laws, 198.1 regulations, and policies governing welfare services and promote 198.2 excellence of administration and program operation; 198.3 (c) develop a quality control program or other monitoring 198.4 program to review county performance and accuracy of benefit 198.5 determinations; 198.6 (d) require county agencies to make an adjustment to the 198.7 public assistance benefits issued to any individual consistent 198.8 with federal law and regulation and state law and rule and to 198.9 issue or recover benefits as appropriate; 198.10 (e) delay or deny payment of all or part of the state and 198.11 federal share of benefits and administrative reimbursement 198.12 according to the procedures set forth in section 256.017;and198.13 (f) make contracts with and grants to public and private 198.14 agencies and organizations, both profit and nonprofit, and 198.15 individuals, using appropriated funds; and 198.16 (g) enter into contractual agreements with federally 198.17 recognized Indian tribes with a reservation in Minnesota to the 198.18 extent necessary for the tribe to operate a federally approved 198.19 family assistance program or any other program under the 198.20 supervision of the commissioner. The commissioner may establish 198.21 necessary accounts for the purposes of receiving and disbursing 198.22 funds as necessary for the operation of the programs. 198.23 (2) Inform county agencies, on a timely basis, of changes 198.24 in statute, rule, federal law, regulation, and policy necessary 198.25 to county agency administration of the programs. 198.26 (3) Administer and supervise all child welfare activities; 198.27 promote the enforcement of laws protecting handicapped, 198.28 dependent, neglected and delinquent children, and children born 198.29 to mothers who were not married to the children's fathers at the 198.30 times of the conception nor at the births of the children; 198.31 license and supervise child-caring and child-placing agencies 198.32 and institutions; supervise the care of children in boarding and 198.33 foster homes or in private institutions; and generally perform 198.34 all functions relating to the field of child welfare now vested 198.35 in the state board of control. 198.36 (4) Administer and supervise all noninstitutional service 199.1 to handicapped persons, including those who are visually 199.2 impaired, hearing impaired, or physically impaired or otherwise 199.3 handicapped. The commissioner may provide and contract for the 199.4 care and treatment of qualified indigent children in facilities 199.5 other than those located and available at state hospitals when 199.6 it is not feasible to provide the service in state hospitals. 199.7 (5) Assist and actively cooperate with other departments, 199.8 agencies and institutions, local, state, and federal, by 199.9 performing services in conformity with the purposes of Laws 199.10 1939, chapter 431. 199.11 (6) Act as the agent of and cooperate with the federal 199.12 government in matters of mutual concern relative to and in 199.13 conformity with the provisions of Laws 1939, chapter 431, 199.14 including the administration of any federal funds granted to the 199.15 state to aid in the performance of any functions of the 199.16 commissioner as specified in Laws 1939, chapter 431, and 199.17 including the promulgation of rules making uniformly available 199.18 medical care benefits to all recipients of public assistance, at 199.19 such times as the federal government increases its participation 199.20 in assistance expenditures for medical care to recipients of 199.21 public assistance, the cost thereof to be borne in the same 199.22 proportion as are grants of aid to said recipients. 199.23 (7) Establish and maintain any administrative units 199.24 reasonably necessary for the performance of administrative 199.25 functions common to all divisions of the department. 199.26 (8) Act as designated guardian of both the estate and the 199.27 person of all the wards of the state of Minnesota, whether by 199.28 operation of law or by an order of court, without any further 199.29 act or proceeding whatever, except as to persons committed as 199.30 mentally retarded. For children under the guardianship of the 199.31 commissioner whose interests would be best served by adoptive 199.32 placement, the commissioner may contract with a licensed 199.33 child-placing agency to provide adoption services. A contract 199.34 with a licensed child-placing agency must be designed to 199.35 supplement existing county efforts and may not replace existing 199.36 county programs, unless the replacement is agreed to by the 200.1 county board and the appropriate exclusive bargaining 200.2 representative or the commissioner has evidence that child 200.3 placements of the county continue to be substantially below that 200.4 of other counties. 200.5 (9) Act as coordinating referral and informational center 200.6 on requests for service for newly arrived immigrants coming to 200.7 Minnesota. 200.8 (10) The specific enumeration of powers and duties as 200.9 hereinabove set forth shall in no way be construed to be a 200.10 limitation upon the general transfer of powers herein contained. 200.11 (11) Establish county, regional, or statewide schedules of 200.12 maximum fees and charges which may be paid by county agencies 200.13 for medical, dental, surgical, hospital, nursing and nursing 200.14 home care and medicine and medical supplies under all programs 200.15 of medical care provided by the state and for congregate living 200.16 care under the income maintenance programs. 200.17 (12) Have the authority to conduct and administer 200.18 experimental projects to test methods and procedures of 200.19 administering assistance and services to recipients or potential 200.20 recipients of public welfare. To carry out such experimental 200.21 projects, it is further provided that the commissioner of human 200.22 services is authorized to waive the enforcement of existing 200.23 specific statutory program requirements, rules, and standards in 200.24 one or more counties. The order establishing the waiver shall 200.25 provide alternative methods and procedures of administration, 200.26 shall not be in conflict with the basic purposes, coverage, or 200.27 benefits provided by law, and in no event shall the duration of 200.28 a project exceed four years. It is further provided that no 200.29 order establishing an experimental project as authorized by the 200.30 provisions of this section shall become effective until the 200.31 following conditions have been met: 200.32 (a) The secretary of health, education, and welfare of the 200.33 United States has agreed, for the same project, to waive state 200.34 plan requirements relative to statewide uniformity. 200.35 (b) A comprehensive plan, including estimated project 200.36 costs, shall be approved by the legislative advisory commission 201.1 and filed with the commissioner of administration. 201.2 (13) According to federal requirements, establish 201.3 procedures to be followed by local welfare boards in creating 201.4 citizen advisory committees, including procedures for selection 201.5 of committee members. 201.6 (14) Allocate federal fiscal disallowances or sanctions 201.7 which are based on quality control error rates for the aid to 201.8 families with dependent children, Minnesota family investment 201.9 program-statewide, medical assistance, or food stamp program in 201.10 the following manner: 201.11 (a) One-half of the total amount of the disallowance shall 201.12 be borne by the county boards responsible for administering the 201.13 programs. For the medical assistance, MFIP-S, and AFDC 201.14 programs, disallowances shall be shared by each county board in 201.15 the same proportion as that county's expenditures for the 201.16 sanctioned program are to the total of all counties' 201.17 expenditures for the AFDC, MFIP-S, and medical assistance 201.18 programs. For the food stamp program, sanctions shall be shared 201.19 by each county board, with 50 percent of the sanction being 201.20 distributed to each county in the same proportion as that 201.21 county's administrative costs for food stamps are to the total 201.22 of all food stamp administrative costs for all counties, and 50 201.23 percent of the sanctions being distributed to each county in the 201.24 same proportion as that county's value of food stamp benefits 201.25 issued are to the total of all benefits issued for all 201.26 counties. Each county shall pay its share of the disallowance 201.27 to the state of Minnesota. When a county fails to pay the 201.28 amount due hereunder, the commissioner may deduct the amount 201.29 from reimbursement otherwise due the county, or the attorney 201.30 general, upon the request of the commissioner, may institute 201.31 civil action to recover the amount due. 201.32 (b) Notwithstanding the provisions of paragraph (a), if the 201.33 disallowance results from knowing noncompliance by one or more 201.34 counties with a specific program instruction, and that knowing 201.35 noncompliance is a matter of official county board record, the 201.36 commissioner may require payment or recover from the county or 202.1 counties, in the manner prescribed in paragraph (a), an amount 202.2 equal to the portion of the total disallowance which resulted 202.3 from the noncompliance, and may distribute the balance of the 202.4 disallowance according to paragraph (a). 202.5 (15) Develop and implement special projects that maximize 202.6 reimbursements and result in the recovery of money to the 202.7 state. For the purpose of recovering state money, the 202.8 commissioner may enter into contracts with third parties. Any 202.9 recoveries that result from projects or contracts entered into 202.10 under this paragraph shall be deposited in the state treasury 202.11 and credited to a special account until the balance in the 202.12 account reaches $1,000,000. When the balance in the account 202.13 exceeds $1,000,000, the excess shall be transferred and credited 202.14 to the general fund. All money in the account is appropriated 202.15 to the commissioner for the purposes of this paragraph. 202.16 (16) Have the authority to make direct payments to 202.17 facilities providing shelter to women and their children 202.18 according to section 256D.05, subdivision 3. Upon the written 202.19 request of a shelter facility that has been denied payments 202.20 under section 256D.05, subdivision 3, the commissioner shall 202.21 review all relevant evidence and make a determination within 30 202.22 days of the request for review regarding issuance of direct 202.23 payments to the shelter facility. Failure to act within 30 days 202.24 shall be considered a determination not to issue direct payments. 202.25 (17) Have the authority to establish and enforce the 202.26 following county reporting requirements: 202.27 (a) The commissioner shall establish fiscal and statistical 202.28 reporting requirements necessary to account for the expenditure 202.29 of funds allocated to counties for human services programs. 202.30 When establishing financial and statistical reporting 202.31 requirements, the commissioner shall evaluate all reports, in 202.32 consultation with the counties, to determine if the reports can 202.33 be simplified or the number of reports can be reduced. 202.34 (b) The county board shall submit monthly or quarterly 202.35 reports to the department as required by the commissioner. 202.36 Monthly reports are due no later than 15 working days after the 203.1 end of the month. Quarterly reports are due no later than 30 203.2 calendar days after the end of the quarter, unless the 203.3 commissioner determines that the deadline must be shortened to 203.4 20 calendar days to avoid jeopardizing compliance with federal 203.5 deadlines or risking a loss of federal funding. Only reports 203.6 that are complete, legible, and in the required format shall be 203.7 accepted by the commissioner. 203.8 (c) If the required reports are not received by the 203.9 deadlines established in clause (b), the commissioner may delay 203.10 payments and withhold funds from the county board until the next 203.11 reporting period. When the report is needed to account for the 203.12 use of federal funds and the late report results in a reduction 203.13 in federal funding, the commissioner shall withhold from the 203.14 county boards with late reports an amount equal to the reduction 203.15 in federal funding until full federal funding is received. 203.16 (d) A county board that submits reports that are late, 203.17 illegible, incomplete, or not in the required format for two out 203.18 of three consecutive reporting periods is considered 203.19 noncompliant. When a county board is found to be noncompliant, 203.20 the commissioner shall notify the county board of the reason the 203.21 county board is considered noncompliant and request that the 203.22 county board develop a corrective action plan stating how the 203.23 county board plans to correct the problem. The corrective 203.24 action plan must be submitted to the commissioner within 45 days 203.25 after the date the county board received notice of noncompliance. 203.26 (e) The final deadline for fiscal reports or amendments to 203.27 fiscal reports is one year after the date the report was 203.28 originally due. If the commissioner does not receive a report 203.29 by the final deadline, the county board forfeits the funding 203.30 associated with the report for that reporting period and the 203.31 county board must repay any funds associated with the report 203.32 received for that reporting period. 203.33 (f) The commissioner may not delay payments, withhold 203.34 funds, or require repayment under paragraph (c) or (e) if the 203.35 county demonstrates that the commissioner failed to provide 203.36 appropriate forms, guidelines, and technical assistance to 204.1 enable the county to comply with the requirements. If the 204.2 county board disagrees with an action taken by the commissioner 204.3 under paragraph (c) or (e), the county board may appeal the 204.4 action according to sections 14.57 to 14.69. 204.5 (g) Counties subject to withholding of funds under 204.6 paragraph (c) or forfeiture or repayment of funds under 204.7 paragraph (e) shall not reduce or withhold benefits or services 204.8 to clients to cover costs incurred due to actions taken by the 204.9 commissioner under paragraph (c) or (e). 204.10 (18) Allocate federal fiscal disallowances or sanctions for 204.11 audit exceptions when federal fiscal disallowances or sanctions 204.12 are based on a statewide random sample for the foster care 204.13 program under title IV-E of the Social Security Act, United 204.14 States Code, title 42, in direct proportion to each county's 204.15 title IV-E foster care maintenance claim for that period. 204.16 (19) Be responsible for ensuring the detection, prevention, 204.17 investigation, and resolution of fraudulent activities or 204.18 behavior by applicants, recipients, and other participants in 204.19 the human services programs administered by the department. 204.20 (20) Require county agencies to identify overpayments, 204.21 establish claims, and utilize all available and cost-beneficial 204.22 methodologies to collect and recover these overpayments in the 204.23 human services programs administered by the department. 204.24 (21) Have the authority to administer a drug rebate program 204.25 for drugs purchased pursuant to the senior citizen drug program 204.26 established under section 256.955 after the beneficiary's 204.27 satisfaction of any deductible established in the program. The 204.28 commissioner shall require a rebate agreement from all 204.29 manufacturers of covered drugs as defined in section 256B.0625, 204.30 subdivision 13. For each drug, the amount of the rebate shall 204.31 be equal to the basic rebate as defined for purposes of the 204.32 federal rebate program in United States Code, title 42, section 204.33 1396r-8(c)(1). This basic rebate shall be applied to 204.34 single-source and multiple-source drugs. The manufacturers must 204.35 provide full payment within 30 days of receipt of the state 204.36 invoice for the rebate within the terms and conditions used for 205.1 the federal rebate program established pursuant to section 1927 205.2 of title XIX of the Social Security Act. The manufacturers must 205.3 provide the commissioner with any information necessary to 205.4 verify the rebate determined per drug. The rebate program shall 205.5 utilize the terms and conditions used for the federal rebate 205.6 program established pursuant to section 1927 of title XIX of the 205.7 Social Security Act. 205.8 Sec. 6. Minnesota Statutes 1996, section 256.014, 205.9 subdivision 1, is amended to read: 205.10 Subdivision 1. [ESTABLISHMENT OF SYSTEMS.] The 205.11 commissioner of human services shall establish and enhance 205.12 computer systems necessary for the efficient operation of the 205.13 programs the commissioner supervises, including: 205.14 (1) management and administration of the food stamp and 205.15 income maintenance programs, including the electronic 205.16 distribution of benefits; 205.17 (2) management and administration of the child support 205.18 enforcement program; and 205.19 (3) administration of medical assistance and general 205.20 assistance medical care. 205.21 The commissioner shall distribute the nonfederal share of 205.22 the costs of operating and maintaining the systems to the 205.23 commissioner and to the counties participating in the system in 205.24 a manner that reflects actual system usage, except that the 205.25 nonfederal share of the costs of the MAXIS computer system and 205.26 child support enforcement systems shall be borne entirely by the 205.27 commissioner. Development costs must not be assessed against 205.28 county agencies. 205.29 The commissioner may enter into contractual agreements with 205.30 federally recognized Indian tribes with a reservation in 205.31 Minnesota to participate in state-operated computer systems 205.32 related to the management and administration of the food stamp, 205.33 income maintenance, child support enforcement, and medical 205.34 assistance and general assistance medical care programs to the 205.35 extent necessary for the tribe to operate a federally approved 205.36 family assistance program or any other program under the 206.1 supervision of the commissioner. 206.2 Sec. 7. Minnesota Statutes 1997 Supplement, section 206.3 256.031, subdivision 6, is amended to read: 206.4 Subd. 6. [END OF FIELD TRIALS.] (a) Upon agreement with 206.5 the federal government, the field trials of the Minnesota family 206.6 investment plan will end June 30, 1998. 206.7 (b) Families in the comparison group under subdivision 3, 206.8 paragraph (d), clause (i), receiving aid to families with 206.9 dependent children under sections 256.72 to 256.87, and STRIDE 206.10 services under section 256.736 will continue in those programs 206.11 until June 30, 1998. After June 30, 1998, families who cease 206.12 receiving assistance under the Minnesota family investment plan 206.13 and comparison group families who cease receiving assistance 206.14 under AFDC and STRIDE who are eligible for the Minnesota family 206.15 investment program-statewide (MFIP-S), medical assistance, 206.16 general assistance medical care, or the food stamp program shall 206.17 be placed with their consent on the programs for which they are 206.18 eligible. 206.19 (c) Families who cease receiving assistance under the MFIP 206.20 and comparison families who cease receiving assistance under 206.21 AFDC and STRIDE who are ineligible for MFIP-S due to increased 206.22 income from employment, or increased child or spousal support or 206.23 a combination of employment income and child or spousal support, 206.24 will be eligible for extended medical assistance under section 206.25 256B.0635. For the purpose of determining receipt of extended 206.26 medical assistance, receipt of AFDC and MFIP will be the same as 206.27 receipt of MFIP-S. 206.28 Sec. 8. Minnesota Statutes 1997 Supplement, section 206.29 256.9864, is amended to read: 206.30 256.9864 [REPORTS BY RECIPIENT.] 206.31 (a) An assistance unit with a recent work history or with 206.32 earned income shall report monthly to the county agency on 206.33 income received and other circumstances affecting eligibility or 206.34 assistance amounts. All other assistance units shall report on 206.35 income and other circumstances affecting eligibility and 206.36 assistance amounts, as specified by the state agency. 207.1 (b) An assistance unit required to submit a report on the 207.2 form designated by the commissioner and within ten days of the 207.3 due date or the date of the significant change, whichever is 207.4 later, or otherwise report significant changes which would 207.5 affect eligibility or assistance amounts, is considered to have 207.6 continued its application for assistance effective the date the 207.7 required report is received by the county agency, if a complete 207.8 report is received within a calendar month in which assistance 207.9 was received, except that no assistance shall be paid for the207.10period beginning with the end of the month in which the report207.11was due and ending with the date the report was received by the207.12county agency. 207.13 Sec. 9. Minnesota Statutes 1997 Supplement, section 207.14 256B.062, is amended to read: 207.15 256B.062 [CONTINUED ELIGIBILITY.] 207.16 Medical assistance may be paid for persons who received aid 207.17 to families with dependent children in at least three of the six 207.18 months preceding the month in which the person became ineligible 207.19 for aid to families with dependent children, if the 207.20 ineligibility was due to an increase in hours of employment or 207.21 employment income or due to the loss of an earned income 207.22 disregard. A person who is eligible for extended medical 207.23 assistance is entitled to six months of assistance without 207.24 reapplication, unless the assistance unit ceases to include a 207.25 dependent child. For a person under 21 years of age, medical 207.26 assistance may not be discontinued within the six-month period 207.27 of extended eligibility until it has been determined that the 207.28 person is not otherwise eligible for medical assistance. 207.29 Medical assistance may be continued for an additional six months 207.30 if the person meets all requirements for the additional six 207.31 months, according to Title XIX of the Social Security Act, as 207.32 amended by section 303 of the Family Support Act of 1988, Public 207.33 Law Number 100-485. This section is repealed effectiveMarch 31207.34 July 1, 1998. 207.35 Sec. 10. Minnesota Statutes 1997 Supplement, section 207.36 256D.05, subdivision 8, is amended to read: 208.1 Subd. 8. [CITIZENSHIP.] (a) Effective July 1, 1997, 208.2 citizenship requirements for applicants and recipients under 208.3 sections 256D.01 to 256D.03, subdivision 2, and 256D.04 to 208.4 256D.21 shall be determined the same as under section 256J.11,208.5except that legal noncitizens who are applicants or recipients208.6must have been residents of Minnesota on March 1, 1997. Legal208.7noncitizens who arrive in Minnesota after March 1, 1997, and208.8become elderly or disabled after that date, and are otherwise208.9eligible for general assistance can receive benefits under this208.10section. The income and assets of sponsors of noncitizens shall 208.11 be deemed available to general assistance applicants and 208.12 recipients according to the Personal Responsibility and Work 208.13 Opportunity Reconciliation Act of 1996, Public Law Number 208.14 104-193, title IV, sections 421 and 422, and subsequently set 208.15 out in federal rules. 208.16 (b) As a condition of eligibility, each legal adult 208.17 noncitizen in the assistance unit who has resided in the country 208.18 for four years or more and who is under 70 years of age must: 208.19 (1) be enrolled in a literacy class, English as a second 208.20 language class, or a citizen class; 208.21 (2) be applying for admission to a literacy class, English 208.22 as a second language class, and is on a waiting list; 208.23 (3) be in the process of applying for a waiver from the 208.24 Immigration and Naturalization Service of the English language 208.25 or civics requirements of the citizenship test; 208.26 (4) have submitted an application for citizenship to the 208.27 Immigration and Naturalization Service and is waiting for a 208.28 testing date or a subsequent swearing in ceremony; or 208.29 (5) have been denied citizenship due to a failure to pass 208.30 the test after two attempts or because of an inability to 208.31 understand the rights and responsibilities of becoming a United 208.32 States citizen, as documented by the Immigration and 208.33 Naturalization Service or the county. 208.34 If the county social service agency determines that a legal 208.35 noncitizen subject to the requirements of this subdivision will 208.36 require more than one year of English language training, then 209.1 the requirements of clause (1) or (2) shall be imposed after the 209.2 legal noncitizen has resided in the country for three years. 209.3 Individuals who reside in a facility licensed under chapter 209.4 144A, 144D, 245A, or 256I are exempt from the requirements of 209.5 this section. 209.6 Sec. 11. Minnesota Statutes 1996, section 256D.051, is 209.7 amended by adding a subdivision to read: 209.8 Subd. 19. [WAIVER OF SERVICE COST REIMBURSEMENT LIMIT FOR 209.9 PARTICIPANTS WITH SIGNIFICANT BARRIERS TO EMPLOYMENT.] To the 209.10 extent of available resources, the commissioner may waive the 209.11 $400 service cost limit specified in subdivision 6 for county 209.12 agencies that propose to provide enhanced services under the 209.13 food stamp employment and training program for hard-to-employ 209.14 individuals. A "hard-to-employ individual" is defined as: 209.15 (1) a recipient of general assistance under chapter 256D; 209.16 or 209.17 (2) an individual with at least two of the following three 209.18 barriers to employment: 209.19 (i) the individual has not completed secondary school or 209.20 obtained a certificate of general equivalency, and has low 209.21 skills in reading or mathematics; 209.22 (ii) the individual requires substance abuse treatment for 209.23 employment; and 209.24 (iii) the individual has a poor work history. 209.25 To obtain a waiver, the county agency must submit a waiver 209.26 request to the commissioner. The request must specify: 209.27 (1) the number of hard-to-employ individuals the agency 209.28 plans to serve; and 209.29 (2) the nature of the enhanced employment and training 209.30 services the agency will provide. 209.31 Sec. 12. [256D.053] [MINNESOTA FOOD ASSISTANCE PROGRAM.] 209.32 Subdivision 1. [PROGRAM ESTABLISHED.] For the period of 209.33 July 1, 1998, to June 30, 1999, the Minnesota food assistance 209.34 program is established to provide food assistance to legal 209.35 noncitizens residing in this state who are ineligible to 209.36 participate in the federal Food Stamp Program solely due to the 210.1 provisions of section 402 or 403 of Public Law Number 104-193, 210.2 as authorized by Title VII of the 1997 Emergency Supplemental 210.3 Appropriations Act, Public Law Number 105-18. 210.4 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 210.5 the Minnesota food assistance program, all of the following 210.6 conditions must be met: 210.7 (1) the applicant must meet the initial and ongoing 210.8 eligibility requirements for the federal Food Stamp Program, 210.9 except for the applicant's ineligible immigration status; 210.10 (2) the applicant must be either a qualified noncitizen as 210.11 defined in section 256J.08, subdivision 73, or a noncitizen 210.12 otherwise residing lawfully in the United States; 210.13 (3) the applicant must be a resident of the state; and 210.14 (4) the applicant must not be receiving assistance under 210.15 the MFIP-S or the work first program. 210.16 Subd. 3. [PROGRAM ADMINISTRATION.] (a) The rules for the 210.17 Minnesota food assistance program shall follow exactly the 210.18 regulations for the federal Food Stamp Program, except for the 210.19 provisions pertaining to immigration status under sections 402 210.20 or 403 of Public Law Number 104-193. 210.21 (b) The county agency shall use the income, budgeting, and 210.22 benefit allotment regulations of the federal Food Stamp Program 210.23 to calculate an eligible recipient's monthly Minnesota food 210.24 assistance program benefit. Until September 30, 1998, eligible 210.25 recipients under this subdivision shall receive the average per 210.26 person food stamp issuance in Minnesota in the fiscal year 210.27 ending June 30, 1997. Beginning October 1, 1998, eligible 210.28 recipients shall receive the same level of benefits as those 210.29 provided by the federal Food Stamp Program to similarly situated 210.30 citizen recipients. The monthly Minnesota food assistance 210.31 program benefits shall not exceed an amount equal to the amount 210.32 of federal Food Stamp Program benefits the household would 210.33 receive if all members of the household were eligible for the 210.34 federal Food Stamp Program. 210.35 (c) Minnesota food assistance program benefits must be 210.36 disregarded as income in all programs that do not count food 211.1 stamps as income. 211.2 (d) The county agency must redetermine a Minnesota food 211.3 assistance program recipient's eligibility for the federal Food 211.4 Stamp Program when the agency receives information that the 211.5 recipient's legal immigration status has changed in such a way 211.6 that would make the recipient potentially eligible for the 211.7 federal Food Stamp Program. 211.8 (e) Until October 1, 1998, the commissioner may provide 211.9 benefits under this section in cash. 211.10 Subd. 4. [STATE PLAN REQUIRED.] The commissioner shall 211.11 submit a state plan to the secretary of agriculture to allow the 211.12 commissioner to purchase federal Food Stamp Program benefits for 211.13 each Minnesota food assistance program recipient who is 211.14 ineligible to participate in the federal Food Stamp Program 211.15 solely due to the provisions of section 402 or 403 of Public Law 211.16 Number 104-193, as authorized by Title VII of the 1997 Emergency 211.17 Supplemental Appropriations Act, Public Law Number 105-18. The 211.18 commissioner shall enter into a contract as necessary with the 211.19 secretary to use the existing federal Food Stamp Program 211.20 benefits delivery system for the purposes of administering the 211.21 Minnesota food assistance program under this section. 211.22 Sec. 13. Minnesota Statutes 1996, section 256D.46, 211.23 subdivision 2, is amended to read: 211.24 Subd. 2. [INCOME AND RESOURCE TEST.] All income and 211.25 resources available to the recipient must be considered in 211.26 determining the recipient's ability to meet the emergency need. 211.27 Property that can be liquidated in time to resolve the emergency 211.28 and income,(excludingMinnesota supplemental aid issued for211.29current month's need)an amount equal to the Minnesota 211.30 supplemental aid standard of assistance, that is normally 211.31 disregarded or excluded under the Minnesota supplemental aid 211.32 program must be considered available to meet the emergency need. 211.33 Sec. 14. Minnesota Statutes 1997 Supplement, section 211.34 256J.02, subdivision 4, is amended to read: 211.35 Subd. 4. [AUTHORITY TO TRANSFER.] Subject to limitations 211.36 of title I of Public Law Number 104-193, the Personal 212.1 Responsibility and Work Opportunity Reconciliation Act of 212.2 1996, as amended, the legislature may transfer money from the 212.3 TANF block grant to the child care fund under chapter 119B, or 212.4 the Title XX block grant under section 256E.07. 212.5 Sec. 15. Minnesota Statutes 1997 Supplement, section 212.6 256J.03, is amended to read: 212.7 256J.03 [TANF RESERVE ACCOUNT.] 212.8 Subdivision 1. TheMinnesota family investment212.9program-statewide/TANFTANF reserve account is created in the 212.10 state treasury. Funds retained or deposited in the TANF reserve 212.11 shall include: (1) funds designated by the legislatureand; (2) 212.12 unexpended state funds resulting from the acceleration of TANF 212.13 expenditures under subdivision 2; (3) earnings available from 212.14 the federal TANF block grant appropriated to the commissioner 212.15 but not expended in the biennium beginning July 1, 1997, shall212.16be retained; and (4) TANF funds available in fiscal years 1998, 212.17 1999, 2000, and 2001 that are not spent or not budgeted to be 212.18 spent in those years. 212.19 Funds deposited in the reserve accounttomust be expended 212.20 for the Minnesota family investment program-statewidein fiscal212.21year 2000 and subsequent fiscal yearsand directly related state 212.22 programs for the purposes in subdivision 3. 212.23 Subd. 2. [AUTHORIZATION TO ACCELERATE EXPENDITURE OF TANF 212.24 FUNDS.] The commissioner may expend federal TANF block grant 212.25 funds in excess of appropriated levels for the purpose of 212.26 accelerating federal funding of the MFIP program. By the end of 212.27 the fiscal year in which the additional federal expenditures are 212.28 made, the commissioner must deposit into the reserve account an 212.29 amount of unexpended state funds appropriated for assistance to 212.30 families grants, AFDC, and MFIP equal to the additional federal 212.31 expenditures. Reserve funds may be spent as TANF appropriations 212.32 if insufficient TANF funds are available because of acceleration. 212.33 Subd. 3. [ALLOWED TRANSFER PURPOSE.] Funds from the 212.34 reserve account may be used for the following purposes: 212.35 (1) unanticipated TANF block grant maintenance of effort 212.36 shortfalls; 213.1 (2) MFIP cost increases due to reduced federal revenues and 213.2 federal law changes; 213.3 (3) one-half of the MFIP general fund cost increase in 213.4 fiscal year 2000 and subsequent fiscal years due to caseload 213.5 increases over fiscal year 1999; and 213.6 (4) transfers allowed under section 256J.02, subdivision 4. 213.7 Sec. 16. Minnesota Statutes 1997 Supplement, section 213.8 256J.08, subdivision 11, is amended to read: 213.9 Subd. 11. [CAREGIVER.] "Caregiver" means a minor child's 213.10 natural or adoptive parent or parents and stepparent who live in 213.11 the home with the minor child. For purposes of determining 213.12 eligibility for this program, caregiver also means any of the 213.13 following individuals, if adults, who live with and provide care 213.14 and support to a minor child when the minor child's natural or 213.15 adoptive parent or parents or stepparents do not reside in the 213.16 same home: legalcustodianscustodian or guardian, grandfather, 213.17 grandmother, brother, sister,stepfather, stepmother,213.18 stepbrother, stepsister, uncle, aunt, first cousin, nephew, 213.19 niece, person of preceding generation as denoted by prefixes of 213.20 "great," "great-great," or "great-great-great," or a spouse of 213.21 any person named in the above groups even after the marriage 213.22 ends by death or divorce. 213.23 Sec. 17. Minnesota Statutes 1997 Supplement, section 213.24 256J.08, is amended by adding a subdivision to read: 213.25 Subd. 24a. [DISQUALIFIED.] "Disqualified" means being 213.26 ineligible to receive MFIP-S due to noncooperation with program 213.27 requirements. Except for persons whose disqualification is 213.28 based on fraud, a disqualified person can take action to correct 213.29 the reason for ineligibility. 213.30 Sec. 18. Minnesota Statutes 1997 Supplement, section 213.31 256J.08, subdivision 26, is amended to read: 213.32 Subd. 26. [EARNED INCOME.] "Earned income" means cash or 213.33 in-kind income earned through the receipt of wages, salary, 213.34 commissions, profit from employment activities, net profit from 213.35 self-employment activities, payments made by an employer for 213.36 regularly accrued vacation or sick leave, and any other profit 214.1 from activity earned through effort or labor. The income must 214.2 be in return for, or as a result of, legal activity. 214.3 Sec. 19. Minnesota Statutes 1997 Supplement, section 214.4 256J.08, subdivision 28, is amended to read: 214.5 Subd. 28. [EMERGENCY.] "Emergency" means a situation or a 214.6 set of circumstances that causes or threatens to cause 214.7 destitution to aminor childfamily with a child under age 21. 214.8 Sec. 20. Minnesota Statutes 1997 Supplement, section 214.9 256J.08, subdivision 40, is amended to read: 214.10 Subd. 40. [GROSS EARNED INCOME.] "Gross earned income" 214.11 means earned income from employment before mandatory and 214.12 voluntary payroll deductions. Gross earned income includes 214.13 salaries, wages, tips, gratuities, commissions, incentive 214.14 payments from work or training programs, payments made by an 214.15 employer for regularly accrued vacation or sick leave, and 214.16 profits from other activity earned by an individual's effort or 214.17 labor. Gross earned income includes uniform and meal allowances 214.18 if federal income tax is deducted from the allowance. Gross 214.19 earned income includes flexible work benefits received from an 214.20 employer if the employee has the option of receiving the benefit 214.21 or benefits in cash. For self-employment, gross earned income 214.22 is the nonexcluded income minus expenses for the business. 214.23 Sec. 21. Minnesota Statutes 1997 Supplement, section 214.24 256J.08, is amended by adding a subdivision to read: 214.25 Subd. 50a. [INTERSTATE TRANSITIONAL STANDARD.] "Interstate 214.26 transitional standard" means a combination of the cash 214.27 assistance a family with no other income would have received in 214.28 the state of previous residence and the Minnesota food portion 214.29 for the appropriate size family. 214.30 Sec. 22. Minnesota Statutes 1997 Supplement, section 214.31 256J.08, is amended by adding a subdivision to read: 214.32 Subd. 51a. [LEGAL CUSTODIAN.] "Legal custodian" means any 214.33 person who is under a legal obligation to provide care for a 214.34 minor and who is in fact providing care for a minor. For an 214.35 Indian child, "custodian" means any Indian person who has legal 214.36 custody of an Indian child under tribal law or custom, under 215.1 state law, or to whom temporary physical care, custody, and 215.2 control has been transferred by the parent of the child, as 215.3 provided in section 257.351, subdivision 8. 215.4 Sec. 23. Minnesota Statutes 1997 Supplement, section 215.5 256J.08, subdivision 60, is amended to read: 215.6 Subd. 60. [MINOR CHILD.] "Minor child" means a child who 215.7 is living in the same home of a parent or other caregiver, is 215.8 not the parent of a child in the home, and is either less than 215.9 18 years of age or is under the age of 19 years and isregularly215.10attending asa full-time studentand is expected to complete a215.11high school orin a secondary school or pursuing a full-time 215.12 secondary level course of vocational or technical training 215.13 designed to fit students for gainful employmentbefore reaching215.14age 19. 215.15 Sec. 24. Minnesota Statutes 1997 Supplement, section 215.16 256J.08, is amended by adding a subdivision to read: 215.17 Subd. 61a. [NONCUSTODIAL PARENT.] "Noncustodial parent" 215.18 means a minor child's parent who does not live in the same home 215.19 as the child. 215.20 Sec. 25. Minnesota Statutes 1997 Supplement, section 215.21 256J.08, subdivision 68, is amended to read: 215.22 Subd. 68. [PERSONAL PROPERTY.] "Personal property" means 215.23 an item of value that is not real property, including the value 215.24 of a contract for deed held by a seller, assets held in trust on 215.25 behalf of members of an assistance unit,cash surrender value of215.26life insurance,value of a prepaid burial, savings account, 215.27 value of stocks and bonds, and value of retirement accounts. 215.28 Sec. 26. Minnesota Statutes 1997 Supplement, section 215.29 256J.08, subdivision 73, is amended to read: 215.30 Subd. 73. [QUALIFIED NONCITIZEN.] "Qualified noncitizen" 215.31 means a person: 215.32 (1) who was lawfully admitted for permanent residence 215.33 pursuant to United States Code, title 8; 215.34 (2) who was admitted to the United States as a refugee 215.35 pursuant to United States Code, title 8; section 1157; 215.36 (3) whose deportation is being withheld pursuant to United 216.1 States Code, title 8, section 1253(h); 216.2 (4) who was paroled for a period of at least one year 216.3 pursuant to United States Code, title 8, section 1182(d)(5); 216.4 (5) who was granted conditional entry pursuant to United 216.5 State Code, title 8, section 1153(a)(7); 216.6 (6) who was granted asylum pursuant to United States Code, 216.7 title 8, section 1158;or216.8 (7) determined to be a battered noncitizen by the United 216.9 States Attorney General according to the Illegal Immigration 216.10 Reform and Immigrant Responsibility Act of 1996, Title V of the 216.11 Omnibus Consolidated Appropriations Bill, Public Law Number 216.12 104-208; or 216.13 (8) who was admitted as a Cuban or Haitian entrant. 216.14 Sec. 27. Minnesota Statutes 1997 Supplement, section 216.15 256J.08, is amended by adding a subdivision to read: 216.16 Subd. 82a. [SHELTER COSTS.] "Shelter costs" means rent, 216.17 manufactured home lot rental costs, or monthly principal, 216.18 interest, insurance premiums, and property taxes due for 216.19 mortgages or contracts for deed. 216.20 Sec. 28. Minnesota Statutes 1997 Supplement, section 216.21 256J.08, subdivision 83, is amended to read: 216.22 Subd. 83. [SIGNIFICANT CHANGE.] "Significant change" means 216.23 a decline in gross income of3536 percent or more from the 216.24 income used to determine the grant for the current month. 216.25 Sec. 29. Minnesota Statutes 1997 Supplement, section 216.26 256J.09, subdivision 6, is amended to read: 216.27 Subd. 6. [INVALID REASON FOR DELAY.] A county agency must 216.28 not delay a decision on eligibility or delay issuing the 216.29 assistance payment except to establish state residence as 216.30 provided in section 256J.12 by: 216.31 (1) treating the 30-day processing period as a waiting 216.32 period; 216.33 (2) delaying approval or issuance of the assistance payment 216.34 pending the decision of the county board; or 216.35 (3) awaiting the result of a referral to a county agency in 216.36 another county when the county receiving the application does 217.1 not believe it is the county of financial responsibility. 217.2 Sec. 30. Minnesota Statutes 1997 Supplement, section 217.3 256J.09, subdivision 9, is amended to read: 217.4 Subd. 9. [ADDENDUM TO AN EXISTING APPLICATION.] (a) An 217.5 addendum to an existing application must be used to add persons 217.6 to an assistance unit regardless of whether the persons being 217.7 added are required to be in the assistance unit. When a person 217.8 is added by addendum to an assistance unit, eligibility for that 217.9 person begins on the first of the month the addendum was filed 217.10 except as provided in section 256J.74, subdivision 2, clause (1). 217.11 (b) An overpayment must be determined when a change in 217.12 household composition is not reported within the deadlines in 217.13 section 256J.30, subdivision 9. Any overpayment must be 217.14 calculated from the month of the change including the needs, 217.15 income, and assets of any individual who is required to be 217.16 included in the assistance unit under section 256J.24, 217.17 subdivision 2. Individuals not included in the assistance unit 217.18 who are identified in section 256J.37, subdivisions 1 to 2, must 217.19 have their income and assets considered when determining the 217.20 amount of the overpayment. 217.21 Sec. 31. Minnesota Statutes 1997 Supplement, section 217.22 256J.11, subdivision 2, as amended by Laws 1997, Third Special 217.23 Session chapter 1, is amended to read: 217.24 Subd. 2. [NONCITIZENS; FOOD PORTION.] (a) For the period 217.25 September 1, 1997, to October 31, 1997, noncitizens who do not 217.26 meet one of the exemptions in section 412 of the Personal 217.27 Responsibility and Work Opportunity Reconciliation Act of 1996, 217.28 but were residing in this state as of July 1, 1997, are eligible 217.29 for the 6/10 of the average value of food stamps for the same 217.30 family size and composition until MFIP-S is operative in the 217.31 noncitizen's county of financial responsibility and thereafter, 217.32 the 6/10 of the food portion of MFIP-S. However, federal food 217.33 stamp dollars cannot be used to fund the food portion of MFIP-S 217.34 benefits for an individual under this subdivision. 217.35 (b) For the period November 1, 1997, to June 30,19981999, 217.36 noncitizens who do not meet one of the exemptions in section 412 218.1 of the Personal Responsibility and Work Opportunity 218.2 Reconciliation Act of 1996,but were residing in this state as218.3of July 1, 1997,and are receiving cash assistance under the 218.4 AFDC, family general assistance, MFIP or MFIP-S programs are 218.5 eligible for the average value of food stamps for the same 218.6 family size and composition until MFIP-S is operative in the 218.7 noncitizen's county of financial responsibility and thereafter, 218.8 the food portion of MFIP-S. However, federal food stamp dollars 218.9 cannot be used to fund the food portion of MFIP-S benefits for 218.10 an individual under this subdivision. The assistance provided 218.11 under this subdivision, which is designated as a supplement to 218.12 replace lost benefits under the federal food stamp program, must 218.13 be disregarded as income in all programs that do not count food 218.14 stamps as income where the commissioner has the authority to 218.15 make the income disregard determination for the program. 218.16 (c) The commissioner shall submit a state plan to the 218.17 secretary of agriculture to allow the commissioner to purchase 218.18 federal Food Stamp Program benefits in an amount equal to the 218.19 MFIP-S food portion for each legal noncitizen receiving MFIP-S 218.20 assistance who is ineligible to participate in the federal Food 218.21 Stamp Program solely due to the provisions of section 402 or 403 218.22 of Public Law Number 104-193, as authorized by Title VII of the 218.23 1997 Emergency Supplemental Appropriations Act, Public Law 218.24 Number 105-18. The commissioner shall enter into a contract as 218.25 necessary with the secretary to use the existing federal Food 218.26 Stamp Program benefits delivery system for the purposes of 218.27 administering the food portion of MFIP-S under this subdivision. 218.28 Sec. 32. Minnesota Statutes 1997 Supplement, section 218.29 256J.12, is amended to read: 218.30 256J.12 [MINNESOTA RESIDENCE.] 218.31 Subdivision 1. [SIMPLE RESIDENCY.] To be eligible for AFDC 218.32 or MFIP-S, whichever is in effect,a familyan assistance unit 218.33 must have established residency in this state which means 218.34 thefamilyassistance unit is present in the state and intends 218.35 to remain here. A person who lives in this state and who 218.36 entered this state with a job commitment or to seek employment 219.1 in this state, whether or not that person is currently employed, 219.2 meets the criteria in this subdivision. 219.3 Subd. 1a. [30-DAY RESIDENCY REQUIREMENT.]A familyAn 219.4 assistance unit is considered to have established residency in 219.5 this state only when a child or caregiver has resided in this 219.6 state for at least 30 days with the intention of making the 219.7 person's home here and not for any temporary purpose. The birth 219.8 of a child in Minnesota to a member of the assistance unit does 219.9 not automatically meet the 30-day residency requirement for the 219.10 members of the assistance unit. Time spent in a shelter for 219.11 battered women shall count toward satisfying the 30-day 219.12 residency requirement. 219.13 Subd. 2. [EXCEPTIONS.] (a) A county shall waive the 30-day 219.14 residency requirement where unusual hardship would result from 219.15 denial of assistance. 219.16 (b) For purposes of this section, unusual hardship meansa219.17familyan assistance unit: 219.18 (1) is without alternative shelter; or 219.19 (2) is without available resources for food. 219.20 (c) For purposes of this subdivision, the following 219.21 definitions apply (1) "metropolitan statistical area" is as 219.22 defined by the U.S. Census Bureau; (2) "alternative shelter" 219.23 includes any shelter that is located within the metropolitan 219.24 statistical area containing the county and for which the family 219.25 is eligible, provided thefamilyassistance unit does not have 219.26 to travel more than 20 miles to reach the shelter and has access 219.27 to transportation to the shelter. Clause (2) does not apply to 219.28 counties in the Minneapolis-St. Paul metropolitan statistical 219.29 area. 219.30 (d) Applicants meet the residency requirement if they once 219.31 resided in Minnesota and: 219.32 (1) joined the United States armed services, returned to 219.33 Minnesota within 30 days of leaving the armed services, and 219.34 intend to remain in Minnesota; or 219.35 (2) left to attend school in another state, paid 219.36 nonresident tuition or Minnesota tuition rates under a 220.1 reciprocity agreement, and returned to Minnesota within 30 days 220.2 of graduation with the intent to remain in Minnesota. 220.3 (e) The 30-day residence requirement is met when: 220.4 (1) a minor child or a minor caregiver moves from another 220.5 state to the residence of a relative caregiver; 220.6 (2) the minor caregiver applies for and receives family 220.7 cash assistance; 220.8 (3) the relative caregiver chooses not to be part of the 220.9 MFIP-S assistance unit; and 220.10 (4) the relative caregiver has resided in Minnesota for at 220.11 least 30 days prior to the date the assistance unit applies for 220.12 cash assistance. 220.13 (f) Ineligible mandatory unit members who have resided in 220.14 Minnesota for 12 months immediately before the date of 220.15 application meet eligibility for the Minnesota payment standard 220.16 for the other assistance unit members. 220.17 Subd. 2a. [MIGRANT WORKERS.] Migrant workers, as defined 220.18 in section 256J.08, and their immediate families are exempt from 220.19 the requirements of subdivisions 1 and 1a, provided the migrant 220.20 worker provides verification that the migrant family worked in 220.21 this state within the last 12 months and earned at least $1,000 220.22 in gross wages during the time the migrant worker worked in this 220.23 state. 220.24 Subd. 3. [PAYMENT PLAN FOR NEW RESIDENTS.] Assistance paid 220.25 to an eligiblefamilyassistance unit in which all members have 220.26 resided in this state for fewer than 12 consecutive calendar 220.27 months immediately preceding the date of application shall be at 220.28 the standard and in the form specified in section 256J.43. 220.29 Subd. 4. [SEVERABILITY CLAUSE.] If any subdivision in this 220.30 section is enjoined from implementation or found 220.31 unconstitutional by any court of competent jurisdiction, the 220.32 remaining subdivisions shall remain valid and shall be given 220.33 full effect. 220.34 Sec. 33. Minnesota Statutes 1997 Supplement, section 220.35 256J.14, is amended to read: 220.36 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 221.1 (a) The definitions in this paragraph only apply to this 221.2 subdivision. 221.3 (1) "Household of a parent, legal guardian, or other adult 221.4 relative" means the place of residence of: 221.5 (i) a natural or adoptive parent; 221.6 (ii) a legal guardian according to appointment or 221.7 acceptance under section 260.242, 525.615, or 525.6165, and 221.8 related laws;or221.9 (iii) a caregiver as defined in section 256J.08, 221.10 subdivision 11; or 221.11 (iv) an appropriate adult relative designated by a county 221.12 agency. 221.13 (2) "Adult-supervised supportive living arrangement" means 221.14 a private family setting which assumes responsibility for the 221.15 care and control of the minor parent and minor child, or other 221.16 living arrangement, not including a public institution, licensed 221.17 by the commissioner of human services which ensures that the 221.18 minor parent receives adult supervision and supportive services, 221.19 such as counseling, guidance, independent living skills 221.20 training, or supervision. 221.21 (b) A minor parent and the minor child who is in the care 221.22 of the minor parent must reside in the household of a parent, 221.23 legal guardian, otherappropriateadult relative,or other221.24caregiver,or in an adult-supervised supportive living 221.25 arrangement in order to receive MFIP-S unless: 221.26 (1) the minor parent has no living parent, other 221.27appropriateadult relative, or legal guardian whose whereabouts 221.28 is known; 221.29 (2) no living parent, otherappropriateadult relative, or 221.30 legal guardian of the minor parent allows the minor parent to 221.31 live in the parent's,appropriateother adult relative's, or 221.32 legal guardian's home; 221.33 (3) the minor parent lived apart from the minor parent's 221.34 own parent or legal guardian for a period of at least one year 221.35 before either the birth of the minor child or the minor parent's 221.36 application for MFIP-S; 222.1 (4) the physical or emotional health or safety of the minor 222.2 parent or minor child would be jeopardized if the minor parent 222.3 and the minor child resided in the same residence with the minor 222.4 parent's parent, otherappropriateadult relative, or legal 222.5 guardian; or 222.6 (5) an adult supervised supportive living arrangement is 222.7 not available for the minor parent andthe dependentchild in 222.8 the county in which the minor parent and child currentlyresides222.9 reside. If an adult supervised supportive living arrangement 222.10 becomes available within the county, the minor parent and child 222.11 must reside in that arrangement. 222.12 (c) Minor applicants must be informed orally and in writing 222.13 about the eligibility requirements and their rights and 222.14 obligations under the MFIP-S program. The county must advise 222.15 the minor of the possible exemptions and specifically ask 222.16 whether one or more of these exemptions is applicable. If the 222.17 minor alleges one or more of these exemptions, then the county 222.18 must assist the minor in obtaining the necessary verifications 222.19 to determine whether or not these exemptions apply. 222.20 (d) If the county worker has reason to suspect that the 222.21 physical or emotional health or safety of the minor parent or 222.22 minor child would be jeopardized if they resided with the minor 222.23 parent's parent, other adult relative, or legal guardian, then 222.24 the county worker must make a referral to child protective 222.25 services to determine if paragraph (b), clause (4), applies. A 222.26 new determination by the county worker is not necessary if one 222.27 has been made within the last six months, unless there has been 222.28 a significant change in circumstances which justifies a new 222.29 referral and determination. 222.30 (e) If a minor parent is not living with a parentor, legal 222.31 guardian, or other adult relative due to paragraph (b), clause 222.32 (1), (2), or (4), the minor parent must reside, when possible, 222.33 in a living arrangement that meets the standards of paragraph 222.34 (a), clause (2). 222.35 (f) When a minor parent and minor child live withanothera 222.36 parent, other adult relative, legal guardian, or in an 223.1 adult-supervised supportive living arrangement, MFIP-S must be 223.2 paid, when possible, in the form of a protective payment on 223.3 behalf of the minor parent and minor childin accordance with223.4 according to section 256J.39, subdivisions 2 to 4. 223.5 Sec. 34. Minnesota Statutes 1997 Supplement, section 223.6 256J.15, subdivision 2, is amended to read: 223.7 Subd. 2. [ELIGIBILITY DURING LABOR DISPUTES.]To receive223.8assistance under MFIP-S, a member of an assistance unit who is223.9on strike must have been an MFIP-S participant on the day before223.10the strike, or have been eligible for MFIP-S on the day before223.11the strike.223.12The county agency must count the striker's prestrike223.13earnings as current earnings. When a member of an assistance223.14unit who is not in the bargaining unit that voted for the strike223.15does not cross the picket line for fear of personal injury, the223.16assistance unit member is not a striker. Except for a member of223.17an assistance unit who is not in the bargaining unit that voted223.18for the strike and who does not cross the picket line for fear223.19of personal injury, a significant change cannot be invoked as a223.20result of a labor dispute.To receive assistance when a member 223.21 of an assistance unit is on strike, or when an individual 223.22 identified in section 256J.37, subdivisions 1 to 2, whose income 223.23 and assets must be considered when determining eligibility for 223.24 the unit is on strike, the assistance unit must have been 223.25 receiving or been eligible for MFIP-S on the day before the 223.26 strike. The county agency must count the striker's prestrike 223.27 earnings as current earnings. A significant change cannot be 223.28 invoked when a member of an assistance unit, or an individual 223.29 identified in section 256J.37, subdivisions 1 to 2, is on 223.30 strike. A member of an assistance unit, or an individual 223.31 identified in section 256J.37, subdivisions 1 and 2, is not 223.32 considered a striker when that person is not in the bargaining 223.33 unit that voted for the strike and does not cross the picket 223.34 line for fear of personal injury. 223.35 Sec. 35. Minnesota Statutes 1997 Supplement, section 223.36 256J.20, subdivision 2, is amended to read: 224.1 Subd. 2. [REAL PROPERTY LIMITATIONS.] Ownership of real 224.2 property by an applicant or participant is subject to the 224.3 limitations in paragraphs (a) and (b). 224.4 (a) A county agency shall exclude the homestead of an 224.5 applicant or participant according to clauses (1) to(4)(5): 224.6 (1) an applicant or participant who is purchasing real 224.7 property through a contract for deed and using that property as 224.8 a home is considered the owner of real property; 224.9 (2) the total amount of land that can be excluded under 224.10 this subdivision is limited to surrounding property which is not 224.11 separated from the home by intervening property owned by 224.12 others. Additional property must be assessed as to its legal 224.13 and actual availability according to subdivision 1; 224.14 (3) when real property that has been used as a home by a 224.15 participant is sold, the county agency must treat the cash 224.16 proceeds from the sale as excluded property for six months when 224.17 the participant intends to reinvest the proceeds in another home 224.18 and maintains those proceeds, unused for other purposes, in a 224.19 separate account;and224.20 (4) when the homestead is jointly owned, but the client 224.21 does not reside in it because of legal separation, pending 224.22 divorce, or battering or abuse by the spouse or partner, the 224.23 homestead is excluded; and 224.24 (5) the homestead shall continue to be excluded if it is 224.25 temporarily unoccupied due to employment, illness, or a 224.26 county-approved employability plan. The education, training, or 224.27 job search must be within the state, but can be outside the 224.28 immediate geographic area. A homestead temporarily unoccupied 224.29 because it is not habitable due to a casualty or natural 224.30 disaster is excluded. The homestead is excluded during periods 224.31 only if the client intends to return to it. 224.32 (b) The equity value of real property that is not excluded 224.33 under paragraph (a) and which is legally available must be 224.34 applied against the limits in subdivision 3. When the equity 224.35 value of the real property exceeds the limits under subdivision 224.36 3, the applicant or participant may qualify to receive 225.1 assistance when the applicant or participant continues to make a 225.2 good faith effort to sell the property and signs a legally 225.3 binding agreement to repay the amount of assistance, less child 225.4 support collected by the agency. Repayment must be made within 225.5 five working days after the property is sold. Repayment to the 225.6 county agency must be in the amount of assistance received or 225.7 the proceeds of the sale, whichever is less. 225.8 Sec. 36. Minnesota Statutes 1997 Supplement, section 225.9 256J.20, subdivision 3, is amended to read: 225.10 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 225.11 MFIP-S, the equity value of all nonexcluded real and personal 225.12 property of the assistance unit must not exceed $2,000 for 225.13 applicants and $5,000 for ongoingrecipientsparticipants. The 225.14 value of assets in clauses (1) to (18) must be excluded when 225.15 determining the equity value of real and personal property: 225.16 (1) a licensedvehiclesvehicle up to atotal marketloan 225.17 value of less than or equal to $7,500. The county agency shall 225.18 apply any excessmarketloan value as if it were equity value to 225.19 the asset limit described in this section. If the assistance 225.20 unit owns more than one licensed vehicle, the county agency 225.21 shall determine the vehicle with the highestmarketloan value 225.22 and count only themarketloan value over $7,500. The county 225.23 agency shall count themarketloan value of all other vehicles 225.24 and apply this amount as if it were equity value to the asset 225.25 limit described in this section. The value of special equipment 225.26 for a handicapped member of the assistance unit is excluded. To 225.27 establish themarketloan value of vehicles, a county agency 225.28 must use the N.A.D.A. Official Used Car Guide, Midwest Edition, 225.29 for newer model cars.The N.A.D.A. Official Used Car Guide,225.30Midwest Edition, is incorporated by reference.When a vehicle 225.31 is not listed in the guidebook, or when the applicant or 225.32 participant disputes the loan value listed in the guidebook as 225.33 unreasonable given the condition of the particular vehicle, the 225.34 county agency may require the applicant or participantto225.35 document the loan value by securing a written statement from a 225.36 motor vehicle dealer licensed under section 168.27, stating the 226.1 amount that the dealer would pay to purchase the vehicle. The 226.2 county agency shall reimburse the applicant or participant for 226.3 the cost of a written statement that documents a lower loan 226.4 value. If the loan value exceeds $7,500, the county agency 226.5 shall determine the equity value of the vehicle and exclude a 226.6 vehicle with a total equity value of less than or equal to 226.7 $7,500. "Equity value" is equal to loan value minus any 226.8 outstanding encumbrances; 226.9 (2) the value of life insurance policies for members of the 226.10 assistance unit; 226.11 (3) one burial plot per member of an assistance unit; 226.12 (4) the value of personal property needed to produce earned 226.13 income, including tools, implements, farm animals, inventory, 226.14 business loans, business checking and savings accounts used at 226.15 least annually and used exclusively for the operation of a 226.16 self-employment business, and any motor vehicles if the vehicles 226.17 are essential for the self-employment business; 226.18 (5) the value of personal property not otherwise specified 226.19 which is commonly used by household members in day-to-day living 226.20 such as clothing, necessary household furniture, equipment, and 226.21 other basic maintenance items essential for daily living; 226.22 (6) the value of real and personal property owned by a 226.23 recipient of Supplemental Security Income or Minnesota 226.24 supplemental aid; 226.25 (7) the value of corrective payments, but only for the 226.26 month in which the payment is received and for the following 226.27 month; 226.28 (8) a mobile home used by an applicant or participant as 226.29 the applicant's or participant's home; 226.30 (9) money in a separate escrow account that is needed to 226.31 pay real estate taxes or insurance and that is used for this 226.32 purpose; 226.33 (10) money held in escrow to cover employee FICA, employee 226.34 tax withholding, sales tax withholding, employee worker 226.35 compensation, business insurance, property rental, property 226.36 taxes, and other costs that are paid at least annually, but less 227.1 often than monthly; 227.2 (11) monthly assistanceand, emergency assistance, and 227.3 diversionary payments for the current month's needs; 227.4 (12) the value of school loans, grants, or scholarships for 227.5 the period they are intended to cover; 227.6 (13) payments listed in section 256J.21, subdivision 2, 227.7 clause (9), which are held in escrow for a period not to exceed 227.8 three months to replace or repair personal or real property; 227.9 (14) income received in a budget month through the end of 227.10 thebudgetpayment month; 227.11 (15) savings from earned income of a minor child or a minor 227.12 parent that are set aside in a separate account designated 227.13 specifically for future education or employment costs; 227.14 (16) the federal earned incometaxcreditand, Minnesota 227.15 working family credit, state and federal income tax refunds, 227.16 state homeowners' credit, and state renters' credit in the month 227.17 received and the following month; 227.18 (17) payments excluded under federal law as long as those 227.19 payments are held in a separate account from any nonexcluded 227.20 funds; and 227.21 (18) money received by a participant of the corps to career 227.22 program under section 84.0887, subdivision 2, paragraph (b), as 227.23 a postservice benefit under the federal Americorps Act. 227.24 Sec. 37. Minnesota Statutes 1997 Supplement, section 227.25 256J.21, is amended to read: 227.26 256J.21 [INCOME LIMITATIONS.] 227.27 Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP-S 227.28 eligibility, the county agency must evaluate income received by 227.29 members of an assistance unit, or by other persons whose income 227.30 is considered available to the assistance unit, and only count 227.31 income that is available to the member of the assistance unit. 227.32 Income is available if the individual has legal access to the 227.33 income. All payments, unless specifically excluded in 227.34 subdivision 2, must be counted as income. 227.35 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 227.36 excluded in determining a family's available income: 228.1 (1) payments for basic care, difficulty of care, and 228.2 clothing allowances received for providing family foster care to 228.3 children or adults under Minnesota Rules, parts 9545.0010 to 228.4 9545.0260 and 9555.5050 to 9555.6265, and payments received and 228.5 used for care and maintenance of a third-party beneficiary who 228.6 is not a household member; 228.7 (2) reimbursements for employment training received through 228.8 the Job Training Partnership Act, United States Code, title 29, 228.9 chapter 19, sections 1501 to 1792b; 228.10 (3) reimbursement for out-of-pocket expenses incurred while 228.11 performing volunteer services, jury duty, or employment; 228.12 (4) all educational assistance, except the county agency 228.13 must count graduate student teaching assistantships, 228.14 fellowships, and other similar paid work as earned income and, 228.15 after allowing deductions for any unmet and necessary 228.16 educational expenses, shall count scholarships or grants awarded 228.17 to graduate students that do not require teaching or research as 228.18 unearned income; 228.19 (5) loans, regardless of purpose, from public or private 228.20 lending institutions, governmental lending institutions, or 228.21 governmental agencies; 228.22 (6) loans from private individuals, regardless of purpose, 228.23 provided an applicant or participant documents that the lender 228.24 expects repayment; 228.25 (7)(i) stateand federalincome tax refunds; and 228.26 (ii) federal income tax refunds; 228.27 (8)state and(i) federal earned income credits; 228.28 (ii) Minnesota working family credits; 228.29 (iii) state homeowners' credits; 228.30 (iv) state renters' credits; and 228.31 (v) federal or state tax rebates; 228.32 (9) funds received for reimbursement, replacement, or 228.33 rebate of personal or real property when these payments are made 228.34 by public agencies, awarded by a court, solicited through public 228.35 appeal, or made as a grant by a federal agency, state or local 228.36 government, or disaster assistance organizations, subsequent to 229.1 a presidential declaration of disaster; 229.2 (10) the portion of an insurance settlement that is used to 229.3 pay medical, funeral, and burial expenses, or to repair or 229.4 replace insured property; 229.5 (11) reimbursements for medical expenses that cannot be 229.6 paid by medical assistance; 229.7 (12) payments by a vocational rehabilitation program 229.8 administered by the state under chapter 268A, except those 229.9 payments that are for current living expenses; 229.10 (13) in-kind income, including any payments directly made 229.11 by a third party to a provider of goods and services; 229.12 (14) assistance payments to correct underpayments, but only 229.13 for the month in which the payment is received; 229.14 (15) emergency assistance payments; 229.15 (16) funeral and cemetery payments as provided by section 229.16 256.935; 229.17 (17) nonrecurring cash gifts of $30 or less, not exceeding 229.18 $30 per participant in a calendar month; 229.19 (18) any form of energy assistance payment made through 229.20 Public Law Number 97-35, Low-Income Home Energy Assistance Act 229.21 of 1981, payments made directly to energy providers by other 229.22 public and private agencies, and any form of credit or rebate 229.23 payment issued by energy providers; 229.24 (19) Supplemental Security Income, including retroactive 229.25 payments; 229.26 (20) Minnesota supplemental aid, including retroactive 229.27 payments; 229.28 (21) proceeds from the sale of real or personal property; 229.29 (22) adoption assistance payments under section 259.67; 229.30 (23) state-funded family subsidy program payments made 229.31 under section 252.32 to help families care for children with 229.32 mental retardation or related conditions; 229.33 (24) interest payments and dividends from property that is 229.34 not excluded from and that does not exceed the asset limit; 229.35 (25) rent rebates; 229.36 (26) income earned by a minor caregiver or minor child who 230.1 is at least a half-time student in an approved secondary 230.2 education program; 230.3 (27) income earned by a caregiver under age 20 who is at 230.4 least a half-time student in an approved secondary education 230.5 program; 230.6 (28) MFIP-S child care payments under section 119B.05; 230.7 (29) all other payments made through MFIP-S to support a 230.8 caregiver's pursuit of greater self-support; 230.9 (30) income a participant receives related to shared living 230.10 expenses; 230.11 (31) reverse mortgages; 230.12 (32) benefits provided by the Child Nutrition Act of 1966, 230.13 United States Code, title 42, chapter 13A, sections 1771 to 230.14 1790; 230.15 (33) benefits provided by the women, infants, and children 230.16 (WIC) nutrition program, United States Code, title 42, chapter 230.17 13A, section 1786; 230.18 (34) benefits from the National School Lunch Act, United 230.19 States Code, title 42, chapter 13, sections 1751 to 1769e; 230.20 (35) relocation assistance for displaced persons under the 230.21 Uniform Relocation Assistance and Real Property Acquisition 230.22 Policies Act of 1970, United States Code, title 42, chapter 61, 230.23 subchapter II, section 4636, or the National Housing Act, United 230.24 States Code, title 12, chapter 13, sections 1701 to 1750jj; 230.25 (36) benefits from the Trade Act of 1974, United States 230.26 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 230.27 (37) war reparations payments to Japanese Americans and 230.28 Aleuts under United States Code, title 50, sections 1989 to 230.29 1989d; 230.30 (38) payments to veterans or their dependents as a result 230.31 of legal settlements regarding Agent Orange or other chemical 230.32 exposure under Public Law Number 101-239, section 10405, 230.33 paragraph (a)(2)(E); 230.34 (39) income that is otherwise specifically excluded from 230.35 the MFIP-S program consideration in federal law, state law, or 230.36 federal regulation; 231.1 (40) security and utility deposit refunds; 231.2 (41) American Indian tribal land settlements excluded under 231.3 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 231.4 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 231.5 reservations and payments to members of the White Earth Band, 231.6 under United States Code, title 25, chapter 9, section 331, and 231.7 chapter 16, section 1407; 231.8 (42) all income of the minor parent's parent and stepparent 231.9 when determining the grant for the minor parent in households 231.10 that include a minor parent living with a parent or stepparent 231.11 on MFIP-S with otherdependentchildren; and 231.12 (43) income of the minor parent's parent and stepparent 231.13 equal to 200 percent of the federal poverty guideline for a 231.14 family size not including the minor parent and the minor 231.15 parent's child in households that include a minor parent living 231.16 with a parent or stepparent not on MFIP-S when determining the 231.17 grant for the minor parent. The remainder of income is deemed 231.18 as specified in section 256J.37, subdivision11b; 231.19 (44) payments made to children eligible for relative 231.20 custody assistance under section 257.85; 231.21 (45) vendor payments for goods and services made on behalf 231.22 of a client unless the client has the option of receiving the 231.23 payment in cash; and 231.24 (46) the principal portion of a contract for deed payment. 231.25 Subd. 3. [INITIAL INCOME TEST.] The county agency shall 231.26 determine initial eligibility by considering all earned and 231.27 unearned income that is not excluded under subdivision 2. To be 231.28 eligible for MFIP-S, the assistance unit's countable income 231.29 minus the disregards in paragraphs (a) and (b) must be below the 231.30 transitional standard of assistance according to section 256J.24 231.31 for that size assistance unit. 231.32 (a) The initial eligibility determination must disregard 231.33 the following items: 231.34 (1) the employment disregard is 18 percent of the gross 231.35 earned income whether or not the member is working full time or 231.36 part time; 232.1 (2) dependent care costs must be deducted from gross earned 232.2 income for the actual amount paid for dependent care up tothea 232.3 maximumdisregard allowedof $200 per month for each child less 232.4 than two years of age, and $175 per month for each child two 232.5 years of age and older under this chapter and chapter 119B;and232.6 (3) all payments made according to a court order 232.7 for spousal support or the support of children not living in the 232.8 assistance unit's household shall be disregarded from the income 232.9 of the person with the legal obligation to pay support, provided 232.10 that, if there has been a change in the financial circumstances 232.11 of the person with the legal obligation to pay support since the 232.12 support order was entered, the person with the legal obligation 232.13 to pay support has petitioned for a modification of the support 232.14 order; and 232.15 (4) an allocation for the unmet need of an ineligible 232.16 spouse or an ineligible child under the age of 21 for whom the 232.17 caregiver is financially responsible and who lives with the 232.18 caregiver according to section 256J.36. 232.19 (b) Notwithstanding paragraph (a), when determining initial 232.20 eligibility forapplicants who haveapplicant units when at 232.21 least one member has received AFDC, family general assistance, 232.22 MFIP, MFIP-R, work first, or MFIP-S in this state within four 232.23 months of the most recent application for MFIP-S, the employment 232.24 disregard for all unit members is 36 percent of the gross earned 232.25 income. 232.26 After initial eligibility is established, the assistance 232.27 payment calculation is based on the monthly income test. 232.28 Subd. 4. [MONTHLY INCOME TEST AND DETERMINATION OF 232.29 ASSISTANCE PAYMENT.] The county agency shall determine ongoing 232.30 eligibility and the assistance payment amount according to the 232.31 monthly income test. To be eligible for MFIP-S, the result of 232.32 the computations in paragraphs (a) to (e) must be at least $1. 232.33 (a) Apply a 36 percent income disregard to gross earnings 232.34 and subtract this amount from the family wage level. If the 232.35 difference is equal to or greater than the transitional 232.36 standard, the assistance payment is equal to the transitional 233.1 standard. If the difference is less than the transitional 233.2 standard, the assistance payment is equal to the difference. 233.3 The employment disregard in this paragraph must be deducted 233.4 every month there is earned income. 233.5 (b) All payments made according to a court order 233.6 for spousal support or the support of children not living in the 233.7 assistance unit's household must be disregarded from the income 233.8 of the person with the legal obligation to pay support, provided 233.9 that, if there has been a change in the financial circumstances 233.10 of the person with the legal obligation to pay support since the 233.11 support order was entered, the person with the legal obligation 233.12 to pay support has petitioned for a modification of the court 233.13 order. 233.14 (c) An allocation for the unmet need of an ineligible 233.15 spouse or an ineligible child under the age of 21 for whom the 233.16 caregiver is financially responsible and who lives with the 233.17 caregiver according to section 256J.36. 233.18 (d) Subtract unearned income dollar for dollar from the 233.19 transitional standard to determine the assistance payment amount. 233.20(d)(e) When income is both earned and unearned, the amount 233.21 of the assistance payment must be determined by first treating 233.22 gross earned income as specified in paragraph (a). After 233.23 determining the amount of the assistance payment under paragraph 233.24 (a), unearned income must be subtracted from that amount dollar 233.25 for dollar to determine the assistance payment amount. 233.26(e)(f) When the monthly income is greater than the 233.27 transitional or family wage level standard after applicable 233.28 deductions and the income will only exceed the standard for one 233.29 month, the county agency must suspend the assistance payment for 233.30 the payment month. 233.31 Subd. 5. [DISTRIBUTION OF INCOME.] The income of all 233.32 members of the assistance unit must be counted. Income may also 233.33 be deemed from ineligible persons to the assistance unit. 233.34 Income must be attributed to the person who earns it or to the 233.35 assistance unit according to paragraphs (a) to (c). 233.36 (a) Funds distributed from a trust, whether from the 234.1 principal holdings or sale of trust property or from the 234.2 interest and other earnings of the trust holdings, must be 234.3 considered income when the income is legally available to an 234.4 applicant or participant. Trusts are presumed legally available 234.5 unless an applicant or participant can document that the trust 234.6 is not legally available. 234.7 (b) Income from jointly owned property must be divided 234.8 equally among property owners unless the terms of ownership 234.9 provide for a different distribution. 234.10 (c) Deductions are not allowed from the gross income of a 234.11 financially responsible household member or by the members of an 234.12 assistance unit to meet a current or prior debt. 234.13 Sec. 38. Minnesota Statutes 1997 Supplement, section 234.14 256J.24, subdivision 1, is amended to read: 234.15 Subdivision 1. [MFIP-S ASSISTANCE UNIT.] An MFIP-S 234.16 assistance unit is either a group of individuals with at least 234.17 one minor child who live together whose needs, assets, and 234.18 income are considered together and who receive MFIP-S 234.19 assistance, or a pregnant woman and her spouse whoreceives234.20 receive MFIP-S assistance. 234.21 Individuals identified in subdivision 2 must be included in 234.22 the MFIP-S assistance unit. Individuals identified in 234.23 subdivision 3must be excluded from the assistance unitare 234.24 ineligible to receive MFIP-S. Individuals identified in 234.25 subdivision 4 may be included in the assistance unit at their 234.26 option. Individuals not included in the assistance unit who are 234.27 identified in section 256J.37,subdivisionsubdivisions 1orto 234.28 2, must have their income and assets considered when determining 234.29 eligibility and benefits for an MFIP-S assistance unit. All 234.30 assistance unit members, whether mandatory or elective, who live 234.31 together and for whom one caregiver or two caregivers apply must 234.32 be included in a single assistance unit. 234.33 Sec. 39. Minnesota Statutes 1997 Supplement, section 234.34 256J.24, subdivision 2, is amended to read: 234.35 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 234.36 for minor caregivers and their children whoaremust be in a 235.1 separate assistance unit from the other persons in the 235.2 household, when the following individuals live together, they 235.3 must be included in the assistance unit: 235.4 (1) a minor child, including a pregnant minor; 235.5 (2) the minor child's siblings, half-siblings, and 235.6 step-siblings;and235.7 (3) the minor child's natural, adoptive parents, and 235.8 stepparents; and 235.9 (4) the spouse of a pregnant woman. 235.10 Sec. 40. Minnesota Statutes 1997 Supplement, section 235.11 256J.24, subdivision 3, is amended to read: 235.12 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 235.13 ASSISTANCE UNIT.] The following individualsmust be excluded235.14from an assistance unitwho are part of the assistance unit 235.15 determined under subdivision 2 are ineligible to receive MFIP-S: 235.16 (1) individuals receiving Supplemental Security Income or 235.17 Minnesota supplemental aid; 235.18 (2) individuals living at home while performing 235.19 court-imposed, unpaid community service work due to a criminal 235.20 conviction; 235.21 (3) individuals disqualified from the food stamp program or 235.22 MFIP-S, until the disqualification ends; 235.23 (4) children on whose behalf federal, state, or local 235.24 foster care paymentsunder title IV-E of the Social Security Act235.25 are made, except as provided insectionsections 256J.13, 235.26 subdivision 2, and 256J.74, subdivision 2; and 235.27 (5) children receiving ongoing monthly adoption assistance 235.28 payments under section269.67259.67. 235.29 The exclusion of a person under this subdivision does not 235.30 alter the mandatory assistance unit composition. 235.31 Sec. 41. Minnesota Statutes 1997 Supplement, section 235.32 256J.24, subdivision 4, is amended to read: 235.33 Subd. 4. [INDIVIDUALS WHO MAY ELECT TO BE INCLUDED IN THE 235.34 ASSISTANCE UNIT.] (a) The minor child's eligible caregiver may 235.35 choose to be in the assistance unit, if the caregiver is not 235.36 required to be in the assistance unit under subdivision 2. If 236.1 the relative caregiver chooses to be in the assistance unit, 236.2 that person's spouse must also be in the unit. 236.3 (b) Any minor child not related as a sibling, stepsibling, 236.4 or adopted sibling to the minor child in the unit, but for whom 236.5 there is an eligible caregiver may elect to be in the unit. 236.6 (c) A foster care provider of a minor child who is 236.7 receiving federal, state, or local foster care maintenance 236.8 payments may elect to receive MFIP-S if the provider meets the 236.9 definition of caregiver under section 256J.08, subdivision 11. 236.10 If the provider chooses to receive MFIP-S, the spouse of the 236.11 provider must also be included in the assistance unit with the 236.12 provider. The provider and spouse are eligible for assistance 236.13 even though the only minor child living in the provider's home 236.14 is receiving foster care maintenance payments. 236.15 (d) The adult caregiver or caregivers of a minor parent are 236.16 eligible to be a separate assistance unit from the minor parent 236.17 and the minor parent's child when: 236.18 (1) the adult caregiver or caregivers have no other minor 236.19 children in the household; 236.20 (2) the minor parent and the minor parent's child are 236.21 living together with the adult caregiver or caregivers; and 236.22 (3) the minor parent and the minor parent's child receive 236.23 MFIP-S or would be eligible to receive MFIP-S if they were not 236.24 receiving SSI benefits. 236.25 Sec. 42. Minnesota Statutes 1997 Supplement, section 236.26 256J.24, is amended by adding a subdivision to read: 236.27 Subd. 5a. [FOOD PORTION OF MFIP-S TRANSITIONAL 236.28 STANDARD.] The commissioner shall increase the food portion of 236.29 the MFIP-S transitional standard by October 1 each year 236.30 beginning October 1998 to reflect the cost-of-living adjustments 236.31 to the Food Stamp Program. The commissioner shall annually 236.32 publish in the State Register the transitional standard for an 236.33 assistance unit of sizes 1 to 10. 236.34 Sec. 43. Minnesota Statutes 1997 Supplement, section 236.35 256J.24, is amended by adding a subdivision to read: 236.36 Subd. 8. [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE 237.1 UNITS.] Payments for shelter and utilities up to the amount of 237.2 MFIP-S benefits for which the assistance unit is eligible shall 237.3 be vendor paid for as many months as the assistance unit is 237.4 eligible or six months, whichever comes first. The residual 237.5 amount of the grant after vendor payment, if any, must be paid 237.6 to the MFIP-S caregiver. 237.7 Sec. 44. Minnesota Statutes 1997 Supplement, section 237.8 256J.26, subdivision 1, is amended to read: 237.9 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 237.10 Applicants orrecipientsparticipants who have been convicted of 237.11 a drug offense after July 1, 1997, may, if otherwise eligible, 237.12 receive AFDC or MFIP-S benefits subject to the following 237.13 conditions: 237.14 (1) Benefits for the entire assistance unit must be paid in 237.15 vendor form for shelter and utilities during any time the 237.16 applicant is part of the assistance unit;. 237.17 (2) The convicted applicant orrecipientparticipant shall 237.18 be subject to random drug testing as a condition of continued 237.19 eligibility andis subject to sanctions under section 256J.46237.20 following any positive test for an illegal controlled substance,237.21except that the grant must continue to be vendor paid under237.22clause (1).237.23For purposes of this subdivision, section 256J.46 is237.24effective July 1, 1997.237.25This subdivision also applies to persons who receive food237.26stamps under section 115 of the Personal Responsibility and Work237.27Opportunity Reconciliation Act of 1996.is subject to the 237.28 following sanctions: 237.29 (i) for failing a drug test the first time, the 237.30 participant's grant shall be reduced by ten percent of the 237.31 MFIP-S transitional standard or the interstate transitional 237.32 standard, whichever is applicable, prior to making vendor 237.33 payments for shelter and utility costs; or 237.34 (ii) for failing a drug test more than once, the residual 237.35 amount of the participant's grant after making vendor payments 237.36 for shelter and utility costs, if any, must be reduced by an 238.1 amount equal to 30 percent of the MFIP-S transitional standard 238.2 or the interstate transitional standard, whichever is applicable. 238.3 (b) Applicants or participants who have been convicted of a 238.4 drug offense after July 1, 1997, may, if otherwise eligible, 238.5 receive food stamps if the convicted applicant or participant is 238.6 subject to random drug testing as a condition of continued 238.7 eligibility. Following a positive test for an illegal 238.8 controlled substance, the applicant is subject to the following 238.9 sanctions: 238.10 (1) for failing a drug test the first time, food stamps 238.11 shall be reduced by ten percent of the applicable food stamp 238.12 allotment; and 238.13 (2) for failing a drug test more than once, food stamps 238.14 shall be reduced by an amount equal to 30 percent of the 238.15 applicable food stamp allotment. 238.16(b)(c) For the purposes of this subdivision, "drug offense" 238.17 means a conviction that occurred after July 1, 1997, of sections 238.18 152.021 to 152.025, 152.0261, or 152.096. Drug offense also 238.19 means a conviction in another jurisdiction of the possession, 238.20 use, or distribution of a controlled substance, or conspiracy to 238.21 commit any of these offenses, if the offense occurred after July 238.22 1, 1997, and the conviction is a felony offense in that 238.23 jurisdiction, or in the case of New Jersey, a high misdemeanor. 238.24 Sec. 45. Minnesota Statutes 1997 Supplement, section 238.25 256J.26, subdivision 2, is amended to read: 238.26 Subd. 2. [PAROLE VIOLATORS.] An individual violating a 238.27 condition of probation or parole or supervised release imposed 238.28 under federal law or the law of any state isineligible to238.29receivedisqualified from receiving AFDC or MFIP-S. 238.30 Sec. 46. Minnesota Statutes 1997 Supplement, section 238.31 256J.26, subdivision 3, is amended to read: 238.32 Subd. 3. [FLEEING FELONS.] An individual who is fleeing to 238.33 avoid prosecution, or custody, or confinement after conviction 238.34 for a crime that is a felony under the laws of the jurisdiction 238.35 from which the individual flees, or in the case of New Jersey, 238.36 is a high misdemeanor, isineligible to receivedisqualified 239.1 from receiving AFDC or MFIP-S. 239.2 Sec. 47. Minnesota Statutes 1997 Supplement, section 239.3 256J.26, subdivision 4, is amended to read: 239.4 Subd. 4. [DENIAL OF ASSISTANCE FOR TEN YEARS TO A PERSON 239.5 FOUND TO HAVE FRAUDULENTLY MISREPRESENTED RESIDENCY.] An 239.6 individual who is convicted in federal or state court of having 239.7 made a fraudulent statement or representation with respect to 239.8 the place of residence of the individual in order to receive 239.9 assistance simultaneously from two or more states isineligible239.10to receivedisqualified from receiving AFDC or MFIP-S for ten 239.11 years beginning on the date of the conviction. 239.12 Sec. 48. Minnesota Statutes 1997 Supplement, section 239.13 256J.28, subdivision 1, is amended to read: 239.14 Subdivision 1. [EXPEDITED ISSUANCE OF FOOD STAMP 239.15 ASSISTANCE.] The following households are entitled to expedited 239.16 issuance of food stamp assistance: 239.17 (1) households with less than $150 in monthly gross income 239.18 provided their liquid assets do not exceed $100; 239.19 (2) migrant or seasonal farm worker households who are 239.20 destitute as defined in Code of Federal Regulations, title 7, 239.21 subtitle B, chapter 2, subchapter C, part 273, section 273.10, 239.22 paragraph (e)(3), provided their liquid assets do not exceed 239.23 $100; and 239.24 (3) eligible households whose combined monthly gross income 239.25 and liquid resources are less than the household's monthly rent 239.26 or mortgage and utilities. 239.27The benefits issued through expedited issuance of food239.28stamp assistance must be deducted from the amount of the full239.29monthly MFIP-S assistance payment and a supplemental payment for239.30the difference must be issued.For any month an individual 239.31 receives expedited Food Stamp Program benefits, the individual 239.32 is not eligible for the MFIP-S food portion of assistance. 239.33 Sec. 49. Minnesota Statutes 1997 Supplement, section 239.34 256J.28, subdivision 2, is amended to read: 239.35 Subd. 2. [FOOD STAMPS FOR HOUSEHOLD MEMBERS NOT IN THE 239.36 ASSISTANCE UNIT.] (a) For household members who purchase and 240.1 prepare food with the MFIP-S assistance unit but are not part of 240.2 the assistance unit, the county agency must determine a separate 240.3 food stamp benefit based on regulations agreed upon with the 240.4 United States Department of Agriculture. 240.5(b) This subdivision does not apply to optional members who240.6have chosen not to be in the assistance unit.240.7(c)(b) Fair hearing requirements for persons who receive 240.8 food stamps under this subdivision are governed by section 240.9 256.045, and Code of Federal Regulations, title 7, subtitle B, 240.10 chapter II, part 273, section 273.15. 240.11 Sec. 50. Minnesota Statutes 1997 Supplement, section 240.12 256J.28, is amended by adding a subdivision to read: 240.13 Subd. 5. [FOOD STAMPS FOR PERSONS RESIDING IN A BATTERED 240.14 WOMAN'S SHELTER.] Members of an MFIP-S assistance unit residing 240.15 in a battered woman's shelter may receive food stamps or the 240.16 food portion twice in a month if the unit that initially 240.17 received the food stamps or food portion included the alleged 240.18 abuser. 240.19 Sec. 51. Minnesota Statutes 1997 Supplement, section 240.20 256J.30, subdivision 10, is amended to read: 240.21 Subd. 10. [COOPERATION WITH HEALTH CARE BENEFITS.] (a) The 240.22 caregiver of a minor child must cooperate with the county agency 240.23 to identify and provide information to assist the county agency 240.24 in pursuing third-party liability for medical services. 240.25 (b) A caregiver must assign to the department any rights to 240.26 health insurance policy benefits the caregiver has during the 240.27 period of MFIP-S eligibility. 240.28 (c) A caregiver must identify any third party who may be 240.29 liable for care and services available under the medical 240.30 assistance program on behalf of the applicant or participant and 240.31 all other assistance unit members. 240.32 (d) When a participant refuses to identify any third party 240.33 who may be liable for care and services, the recipient must be 240.34 sanctioned as provided in section 256J.46, subdivision 1. The 240.35 recipient is also ineligible for medical assistancefor a240.36minimum of one month anduntil the recipient cooperates with the 241.1 requirements of this subdivision. 241.2 Sec. 52. Minnesota Statutes 1997 Supplement, section 241.3 256J.30, subdivision 11, is amended to read: 241.4 Subd. 11. [REQUIREMENT TO ASSIGN SUPPORT AND MAINTENANCE 241.5 RIGHTS.]To be eligibleAn assistance unit is ineligible for 241.6 MFIP-S,unless the caregivermust assignassigns all rights to 241.7 child support and spousal maintenance benefits according 241.8 tosections 256.74, subdivision 5, andsection 256.741, if241.9enacted. 241.10 Sec. 53. Minnesota Statutes 1997 Supplement, section 241.11 256J.31, subdivision 5, is amended to read: 241.12 Subd. 5. [MAILING OF NOTICE.] The notice of adverse action 241.13 shall be issued according to paragraphs (a) to (c). 241.14 (a) A county agency shall mail a notice of adverse action 241.15 at least ten days before the effective date of the adverse 241.16 action, except as provided in paragraphs (b) and (c). 241.17 (b) A county agency must mail a notice of adverse action at 241.18 least five days before the effective date of the adverse action 241.19 when the county agency has factual information that requires an 241.20 action to reduce, suspend, or terminate assistance based on 241.21 probable fraud. 241.22 (c) A county agency shall mail a notice of adverse action 241.23 before or on the effective date of the adverse action when the 241.24 county agency: 241.25 (1) receives the caregiver's signed monthly MFIP-S 241.26 household report form that includes information that requires 241.27 payment reduction, suspension, or termination; 241.28 (2) is informed of the death of a participant or the payee; 241.29 (3) receives a signed statement from the caregiver that 241.30 assistance is no longer wanted; 241.31 (4) receives a signed statement from the caregiver that 241.32 provides information that requires the termination or reduction 241.33 of assistance; 241.34 (5) verifies that a member of the assistance unit is absent 241.35 from the home and does not meet temporary absence provisions in 241.36 section 256J.13; 242.1 (6) verifies that a member of the assistance unit has 242.2 entered a regional treatment center or a licensed residential 242.3 facility for medical or psychological treatment or 242.4 rehabilitation; 242.5 (7) verifies that a member of an assistance unit has been 242.6 placed in foster care, and the provisions of section 256J.13, 242.7 subdivision 2, paragraph(b)(c), clause (2), do not apply; 242.8 (8) verifies that a member of an assistance unit has been 242.9 approved to receive assistance by another state; or 242.10 (9) cannot locate a caregiver. 242.11 Sec. 54. Minnesota Statutes 1997 Supplement, section 242.12 256J.31, subdivision 10, is amended to read: 242.13 Subd. 10. [PROTECTION FROM GARNISHMENT.] MFIP-S grants or 242.14 earnings of a caregiverwhile participating in full or part-time242.15employment or trainingshall be protected from garnishment. 242.16 This protection for earnings shall extend for a period of six 242.17 months from the date of termination from MFIP-S. 242.18 Sec. 55. Minnesota Statutes 1997 Supplement, section 242.19 256J.32, subdivision 4, is amended to read: 242.20 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 242.21 verify the following at application: 242.22 (1) identity of adults; 242.23 (2) presence of the minor child in the home, if 242.24 questionable; 242.25 (3) relationship of a minor child to caregivers in the 242.26 assistance unit; 242.27 (4) age, if necessary to determine MFIP-S eligibility; 242.28 (5) immigration status; 242.29 (6) social security numberin accordance withaccording to 242.30 the requirements of section 256J.30, subdivision 12; 242.31 (7) income; 242.32 (8) self-employment expenses used as a deduction; 242.33 (9) source and purpose of deposits and withdrawals from 242.34 business accounts; 242.35 (10) spousal support and child support payments made to 242.36 persons outside the household; 243.1 (11) real property; 243.2 (12) vehicles; 243.3 (13) checking and savings accounts; 243.4 (14) savings certificates, savings bonds, stocks, and 243.5 individual retirement accounts; 243.6 (15) pregnancy, if related to eligibility; 243.7 (16) inconsistent information, if related to eligibility; 243.8 (17) medical insurance; 243.9 (18) anticipated graduation date of an 18-year-old; 243.10 (19) burial accounts; 243.11 (20) school attendance, if related to eligibility;and243.12 (21) residence; 243.13 (22) a claim of domestic violence if used as a basis for a 243.14 deferral or exemption from the 60-month time limit in section 243.15 256J.42 or employment and training services requirements in 243.16 section 256J.56; and 243.17 (23) disability if used as an exemption from employment and 243.18 training services requirements under section 256J.56. 243.19 Sec. 56. Minnesota Statutes 1997 Supplement, section 243.20 256J.32, subdivision 6, is amended to read: 243.21 Subd. 6. [RECERTIFICATION.] The county agency shall 243.22 recertify eligibility in an annual face-to-face interview with 243.23 the participant and verify the following: 243.24 (1) presence of the minor child in the home, if 243.25 questionable; 243.26 (2) income, unless excluded, including self-employment 243.27 expenses used as a deduction or deposits or withdrawals from 243.28 business accounts; 243.29 (3) assets when the value is within $200 of the asset 243.30 limit; and 243.31 (4) inconsistent information, if related to eligibility. 243.32 Sec. 57. Minnesota Statutes 1997 Supplement, section 243.33 256J.32, is amended by adding a subdivision to read: 243.34 Subd. 7. [NOTICE TO UNDOCUMENTED PERSONS; RELEASE OF 243.35 PRIVATE DATA.] County agencies in consultation with the 243.36 commissioner of human services shall provide notification to 244.1 undocumented persons regarding the release of personal data to 244.2 the Immigration and Naturalization Service and develop protocol 244.3 regarding the release or sharing of data about undocumented 244.4 persons with the Immigration and Naturalization Service as 244.5 required under sections 404, 434, and 411A of the Personal 244.6 Responsibility and Work Opportunity Reconciliation Act of 1996. 244.7 Sec. 58. Minnesota Statutes 1997 Supplement, section 244.8 256J.33, subdivision 1, is amended to read: 244.9 Subdivision 1. [DETERMINATION OF ELIGIBILITY.] A county 244.10 agency must determine MFIP-S eligibility prospectively for a 244.11 payment month based on retrospectively assessing income and the 244.12 county agency's best estimate of the circumstances that will 244.13 exist in the payment month. 244.14 Except as described in section 256J.34, subdivision 1, when 244.15 prospective eligibility exists, a county agency must calculate 244.16 the amount of the assistance payment using retrospective 244.17 budgeting. To determine MFIP-S eligibility and the assistance 244.18 payment amount, a county agency must apply countable income, 244.19 described in section 256J.37, subdivisions 3 to 10, received by 244.20 members of an assistance unit or by other persons whose income 244.21 is counted for the assistance unit, described under sections 244.22 256J.21 and 256J.37, subdivisions 1andto 2. 244.23 This income must be applied to the transitional standard or 244.24 family wage standard subject to this section and sections 244.25 256J.34 to 256J.36. Income received in a calendar month and not 244.26 otherwise excluded under section 256J.21, subdivision 2, must be 244.27 applied to the needs of an assistance unit. 244.28 Sec. 59. Minnesota Statutes 1997 Supplement, section 244.29 256J.33, subdivision 4, is amended to read: 244.30 Subd. 4. [MONTHLY INCOME TEST.] A county agency must apply 244.31 the monthly income test retrospectively for each month of MFIP-S 244.32 eligibility. An assistance unit is not eligible when the 244.33 countable income equals or exceeds the transitional standard or 244.34 the family wage level for the assistance unit. The income 244.35 applied against the monthly income test must include: 244.36 (1) gross earned income from employment, prior to mandatory 245.1 payroll deductions, voluntary payroll deductions, wage 245.2 authorizations, and after the disregards in section 256J.21, 245.3 subdivision34, and the allocations in section 256J.36, unless 245.4 the employment income is specifically excluded under section 245.5 256J.21, subdivision 2; 245.6 (2) gross earned income from self-employment less 245.7 deductions for self-employment expenses in section 256J.37, 245.8 subdivision 5, but prior to any reductions for personal or 245.9 business state and federal income taxes, personal FICA, personal 245.10 health and life insurance, and after the disregards in section 245.11 256J.21, subdivision34, and the allocations in section 245.12 256J.36; 245.13 (3) unearned income after deductions for allowable expenses 245.14 in section 256J.37, subdivision 9, and allocations in section 245.15 256J.36, unless the income has been specifically excluded in 245.16 section 256J.21, subdivision 2; 245.17 (4) gross earned income from employment as determined under 245.18 clause (1) which is received by a member of an assistance unit 245.19 who is a minor child or minor caregiver and less than a 245.20 half-time student; 245.21 (5) child support and spousal support received or 245.22 anticipated to be received by an assistance unit; 245.23 (6) the income of a parent when that parent is not included 245.24 in the assistance unit; 245.25 (7) the income of an eligible relative and spouse who seek 245.26 to be included in the assistance unit; and 245.27 (8) the unearned income of a minor child included in the 245.28 assistance unit. 245.29 Sec. 60. Minnesota Statutes 1997 Supplement, section 245.30 256J.35, is amended to read: 245.31 256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 245.32 Except as provided in paragraphs (a) to(c)(d), the amount 245.33 of an assistance payment is equal to the difference between the 245.34 transitional standard or the Minnesota family wage level in 245.35 section 256J.24, whichever is less, and countable income. 245.36 (a) When MFIP-S eligibility exists for the month of 246.1 application, the amount of the assistance payment for the month 246.2 of application must be prorated from the date of application or 246.3 the date all other eligibility factors are met for that 246.4 applicant, whichever is later. This provision applies when an 246.5 applicant loses at least one day of MFIP-S eligibility. 246.6 (b) MFIP-S overpayments to an assistance unit must be 246.7 recouped according to section 256J.38, subdivision 4. 246.8 (c) An initial assistance payment must not be made to an 246.9 applicant who is not eligible on the date payment is made. 246.10 (d) An individual whose needs have been otherwise provided 246.11 for in another state, in whole or in part by county, state, or 246.12 federal dollars during a month, is ineligible to receive MFIP-S 246.13 for the month. 246.14 Sec. 61. Minnesota Statutes 1997 Supplement, section 246.15 256J.36, is amended to read: 246.16 256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 246.17 MEMBERS.] 246.18 Except as prohibited in paragraphs (a) and (b), an 246.19 allocation of income is allowed from the caregiver's income to 246.20 meet the unmet need of an ineligible spouse or an ineligible 246.21 child under the age of 21 for whom the caregiver is financially 246.22 responsible who also lives with the caregiver.An allocation is246.23allowed from the caregiver's income to meet the need of an246.24ineligible or excluded person.That allocation is allowed in an 246.25 amount up to the difference between the MFIP-Sfamily allowance246.26 transitional standard for the assistance unit when thatexcluded246.27orineligible person is included in the assistance unit and the 246.28 MFIP-S family allowance for the assistance unit when 246.29 theexcluded orineligible person is not included in the 246.30 assistance unit. These allocations must be deducted from the 246.31 caregiver's counted earnings and from unearned income subject to 246.32 paragraphs (a) and (b). 246.33 (a) Income of a minor child in the assistance unit must not 246.34 be allocated to meet the need ofaan ineligible personwho is246.35not a member of the assistance unit, including the child's 246.36 parent, even when that parent is the payee of the child's income. 247.1 (b) Income ofan assistance unita caregiver must not be 247.2 allocated to meet the needs of a disqualified personineligible247.3for failure to cooperate with program requirements including247.4child support requirements, a person ineligible due to fraud, or247.5a relative caregiver and the caregiver's spouse who opt out of247.6the assistance unit. 247.7 Sec. 62. Minnesota Statutes 1997 Supplement, section 247.8 256J.37, subdivision 1, is amended to read: 247.9 Subdivision 1. [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 247.10 MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 247.11 the income of ineligible household members must be deemed after 247.12 allowing the following disregards: 247.13 (1) the first 18 percent of theexcludedineligible family 247.14 member's gross earned income; 247.15 (2) amounts the ineligible person actually paid to 247.16 individuals not living in the same household but whom the 247.17 ineligible person claims or could claim as dependents for 247.18 determining federal personal income tax liability; 247.19 (3)child or spousal support paid to a person who lives247.20outside of the householdall payments made by the ineligible 247.21 person according to a court order for spousal support or the 247.22 support of children not living in the assistance unit's 247.23 household, provided that, if there has been a change in the 247.24 financial circumstances of the ineligible person since the 247.25 support order was entered, the ineligible person has petitioned 247.26 for a modification of the support order; and 247.27 (4) an amount for the needs of the ineligible person and 247.28 other persons who live in the household but are not included in 247.29 the assistance unit and are or could be claimed by an ineligible 247.30 person as dependents for determining federal personal income tax 247.31 liability. This amount is equal to the difference between the 247.32 MFIP-Sneedtransitional standard when theexcludedineligible 247.33 person is included in the assistance unit and the MFIP-Sneed247.34 transitional standard when theexcludedineligible person is not 247.35 included in the assistance unit. 247.36 Sec. 63. Minnesota Statutes 1997 Supplement, section 248.1 256J.37, is amended by adding a subdivision to read: 248.2 Subd. 1a. [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 248.3 income of disqualified members must be deemed after allowing the 248.4 following disregards: 248.5 (1) the first 18 percent of the disqualified member's gross 248.6 earned income; 248.7 (2) amounts the disqualified member actually paid to 248.8 individuals not living in the same household but whom the 248.9 disqualified member claims or could claim as dependents for 248.10 determining federal personal income tax liability; 248.11 (3) all payments made by the disqualified member according 248.12 to a court order for spousal support or the support of children 248.13 or a spouse not living in the assistance unit's household, 248.14 provided that, if there has been a change in the financial 248.15 circumstances of the disqualified member's legal obligation to 248.16 pay support since the support order was entered, the 248.17 disqualified member has petitioned for a modification of the 248.18 support order; and 248.19 (4) an amount for the needs of other persons who live in 248.20 the household but are not included in the assistance unit and 248.21 are or could be claimed by the disqualified member as dependents 248.22 for determining federal personal income tax liability. This 248.23 amount is equal to the difference between the MFIP-S 248.24 transitional standard when the ineligible person is included in 248.25 the assistance unit and the MFIP-S transitional standard when 248.26 the ineligible person is not included in the assistance unit. 248.27 An amount shall not be allowed for the needs of a disqualified 248.28 member. 248.29 Sec. 64. Minnesota Statutes 1997 Supplement, section 248.30 256J.37, is amended by adding a subdivision to read: 248.31 Subd. 1b. [DEEMED INCOME FROM PARENTS OF MINOR 248.32 CAREGIVERS.] In households where minor caregivers live with a 248.33 parent or parents who do not receive MFIP-S, the income of the 248.34 parents must be deemed after allowing the following disregards: 248.35 (1) income of the parents equal to 200 percent of the 248.36 federal poverty guideline for a family size not including the 249.1 minor parent and the minor parent's child in the household 249.2 according to section 256J.21, subdivision 2, clause (43); 249.3 (2) 18 percent of the parent's gross earned income; 249.4 (3) amounts the parents actually paid to individuals not 249.5 living in the same household but whom the parents claim or could 249.6 claim as dependents for determining federal personal income tax 249.7 liability; and 249.8 (4) all payments made by parents according to a court order 249.9 for spousal support or the support of children or spouse not 249.10 living in the parent's household, provided that, if there has 249.11 been a change in the financial circumstances of the parent's 249.12 legal obligation to pay support since the support order was 249.13 entered, the parents have petitioned for a modification of the 249.14 support order. 249.15 Sec. 65. Minnesota Statutes 1997 Supplement, section 249.16 256J.37, subdivision 2, is amended to read: 249.17 Subd. 2. [DEEMED INCOME AND ASSETS OF SPONSOR OF 249.18 NONCITIZENS.]All income and assets of a sponsor, or sponsor's249.19spouse, who executed an affidavit of support for a noncitizen249.20must be deemed to be unearned income of the noncitizen as249.21specified in the Personal Responsibility and Work Opportunity249.22Reconciliation Act of 1996, title IV, Public Law Number 104-193,249.23sections 421 and 422, and subsequently set out in federal249.24rules.If a noncitizen applies for or receives MFIP-S, the 249.25 county must deem the income and assets of the noncitizen's 249.26 sponsor and the sponsor's spouse who have signed an affidavit of 249.27 support for the noncitizen as specified in Public Law Number 249.28 104-193, title IV, sections 421 and 422, the Personal 249.29 Responsibility and Work Opportunity Reconciliation Act of 1996. 249.30 The income of a sponsor and the sponsor's spouse is considered 249.31 unearned income of the noncitizen. The assets of a sponsor and 249.32 the sponsor's spouse are considered available assets of the 249.33 noncitizen. 249.34 Sec. 66. Minnesota Statutes 1997 Supplement, section 249.35 256J.37, subdivision 9, is amended to read: 249.36 Subd. 9. [UNEARNED INCOME.] (a) The county agency must 250.1 apply unearned income, including housing subsidies as in250.2paragraph (b),to the transitional standard. When determining 250.3 the amount of unearned income, the county agency must deduct the 250.4 costs necessary to secure payments of unearned income. These 250.5 costs include legal fees, medical fees, and mandatory deductions 250.6 such as federal and state income taxes. 250.7 (b) Effective July 1,19981999, the county agency shall 250.8 count $100 of the value of public and assisted rental subsidies 250.9 provided through the Department of Housing and Urban Development 250.10 (HUD) as unearned income. The full amount of the subsidy must 250.11 be counted as unearned income when the subsidy is less than $100. 250.12 Sec. 67. Minnesota Statutes 1997 Supplement, section 250.13 256J.38, subdivision 1, is amended to read: 250.14 Subdivision 1. [SCOPE OF OVERPAYMENT.] When a participant 250.15 or former participant receives an overpayment due to agency, 250.16 client, or ATM error, or due to assistance received while an 250.17 appeal is pending and the participant or former participant is 250.18 determined ineligible for assistance or for less assistance than 250.19 was received, the county agency must recoup or recover the 250.20 overpaymentunderusing theconditions of this250.21section.following methods: 250.22 (1) reconstruct each affected budget month and 250.23 corresponding payment month; 250.24 (2) use the policies and procedures that were in effect for 250.25 the payment month; and 250.26 (3) do not allow employment disregards in section 256J.21, 250.27 subdivision 3 or 4, in the calculation of the overpayment when 250.28 the unit has not reported within two calendar months following 250.29 the end of the month in which the income was received. 250.30 Sec. 68. Minnesota Statutes 1997 Supplement, section 250.31 256J.39, subdivision 2, is amended to read: 250.32 Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 250.33 paying assistance directly to a participant may be used when: 250.34 (1) a county agency determines that a vendor payment is the 250.35 most effective way to resolve an emergency situation pertaining 250.36 to basic needs; 251.1 (2) a caregiver makes a written request to the county 251.2 agency asking that part or all of the assistance payment be 251.3 issued by protective or vendor payments for shelter and utility 251.4 service only. The caregiver may withdraw this request in 251.5 writing at any time; 251.6 (3)a caregiver has exhibited a continuing pattern of251.7mismanaging funds as determined by the county agency;251.8(4)the vendor payment is part of a sanction under section 251.9 256J.46, subdivision 2;or251.10(5)(4) the vendor payment is required under section 251.11256J.24256J.26 or 256J.43; 251.12 (5) protective payments are required for minor parents 251.13 under section 256J.14; or 251.14 (6) a caregiver has exhibited a continuing pattern of 251.15 mismanaging funds as determined by the county agency. 251.16 The director of a county agency must approve a proposal for 251.17 protective or vendor payment for money mismanagement when there 251.18 is a pattern of mismanagement under clause (6). During the time 251.19 a protective or vendor payment is being made, the county agency 251.20 must provide services designed to alleviate the causes of the 251.21 mismanagement. 251.22 The continuing need for and method of payment must be 251.23 documented and reviewed every 12 months. The director of a 251.24 county agency must approve the continuation of protective or 251.25 vendor payments. when it appears that the need for protective or 251.26 vendor payments will continue or is likely to continue beyond 251.27 two years because the county agency's efforts have not resulted 251.28 in sufficiently improved use of assistance on behalf of the 251.29 minor child, judicial appointment of a legal guardian or other 251.30 legal representative must be sought by the county agency. 251.31 Sec. 69. Minnesota Statutes 1997 Supplement, section 251.32 256J.395, is amended to read: 251.33 256J.395 [VENDOR PAYMENT OFRENTSHELTER COSTS AND 251.34 UTILITIES.] 251.35 Subdivision 1. [VENDOR PAYMENT.] (a) Effective July 1, 251.36 1997, when a county is required to provide assistance to 252.1 arecipientparticipant in vendor form forrentshelter costs 252.2 and utilities under this chapter, or chapter 256, 256D, or 256K, 252.3 the cost of utilities for a given family may be assumed to be: 252.4 (1) the average of the actual monthly cost of utilities for 252.5 that family for the prior 12 months at the family's current 252.6 residence, if applicable; 252.7 (2) the monthly plan amount, if any, set by the local 252.8 utilities for that family at the family's current residence; or 252.9 (3) the estimated monthly utility costs for the dwelling in 252.10 which the family currently resides. 252.11 (b) For purposes of this section, "utility" means any of 252.12 the following: municipal water and sewer service; electric, 252.13 gas, or heating fuel service; or wood, if that is the heating 252.14 source. 252.15 (c) In any instance where a vendor payment for rent is 252.16 directed to a landlord not legally entitled to the payment, the 252.17 county social services agency shall immediately institute 252.18 proceedings to collect the amount of the vendored rent payment, 252.19 which shall be considered a debt under section 270A.03, 252.20 subdivision 5. 252.21 Subd. 2. [VENDOR PAYMENT NOTIFICATION.] (a) When a county 252.22 agency is required to provide assistance to a participant in 252.23 vendor payment form for shelter costs or utilities under 252.24 subdivision 1, and the participant does not give the agency the 252.25 information needed to pay the vendor, the county agency shall 252.26 notify the participant of the intent to terminate assistance by 252.27 mail at least ten days before the effective date of the adverse 252.28 action. 252.29 (b) The notice of action shall include a request for 252.30 information about: 252.31 (1) the amount of the participant's shelter costs or 252.32 utilities; 252.33 (2) the due date of the shelter costs or utilities; and 252.34 (3) the name and address of the landlord, contract for deed 252.35 holder, mortgage company, and utility vendor. 252.36 (c) If the participant fails to provide the requested 253.1 information by the effective date of the adverse action, the 253.2 county must terminate the MFIP-S grant. If the applicant or 253.3 participant verifies they do not have shelter costs or utility 253.4 obligations, the county shall not terminate assistance if the 253.5 assistance unit is otherwise eligible. 253.6 Sec. 70. Minnesota Statutes 1997 Supplement, section 253.7 256J.42, is amended to read: 253.8 256J.42 [60-MONTH TIME LIMIT.] 253.9 Subdivision 1. [TIME LIMIT.] (a) Except for the exemptions 253.10 in this section and in section 256J.11, subdivision 2, an 253.11 assistance unit in which any adult caregiver has received 60 253.12 months of cash assistance funded in whole or in part by the TANF 253.13 block grant in this or any other state or United States 253.14 territory, MFIP-S, AFDC, or family general assistance, funded in 253.15 whole or in part by state appropriations, is ineligible to 253.16 receive MFIP-S. Any cash assistance funded with TANF dollars in 253.17 this or any other state or United States territory, or MFIP-S 253.18 assistance funded in whole or in part by state appropriations, 253.19 that was received by the unit on or after the date TANF was 253.20 implemented, including any assistance received in states or 253.21 United States territories of prior residence, counts toward the 253.22 60-month limitation. The 60-month limit applies to a minor who 253.23 is the head of a household or who is married to the head of a 253.24 household except under subdivision 5. The 60-month time period 253.25 does not need to be consecutive months for this provision to 253.26 apply. 253.27 (b) Months before July 1998 in which individuals receive 253.28 assistance as part of an MFIP, MFIP-R, or MFIP or MFIP-R 253.29 comparison group family under sections 256.031 to 256.0361 or 253.30 sections 256.047 to 256.048 are not included in the 60-month 253.31 time limit. 253.32Subd. 2. [ASSISTANCE FROM ANOTHER STATE.] An individual253.33whose needs have been otherwise provided for in another state,253.34in whole or in part by the TANF block grant during a month, is253.35ineligible to receive MFIP-S for the month.253.36 Subd. 3. [ADULTS LIVING ON AN INDIAN RESERVATION.] In 254.1 determining the number of months for which an adult has received 254.2 assistance under MFIP-S, the county agency must disregard any 254.3 month during which the adult lived on an Indian reservation if,254.4 during the month:254.5(1) at least 1,000 individuals were living on the254.6reservation; and254.7(2)at least 50 percent of the adults living on the 254.8 reservation wereunemployednot employed. 254.9 Subd. 4. [VICTIMS OF DOMESTIC VIOLENCE.] Any cash 254.10 assistance received by an assistance unit in a month when a 254.11 caregiver is complying with a safety plan under the MFIP-S 254.12 employment and training component does not count toward the 254.13 60-month limitation on assistance. 254.14 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 254.15 assistance received by an assistance unit does not count toward 254.16 the 60-month limit on assistance during a month in which 254.17 theparentalcaregiver is in the category in section 256J.56, 254.18 clause (1). The exemption applies for the period of time the 254.19 caregiver belongs to one of the categories specified in this 254.20 subdivision. 254.21 (b) From July 1, 1997, until the date MFIP-S is operative 254.22 in the caregiver's county of financial responsibility, any cash 254.23 assistance received by a caregiver who is complying with 254.24 sections 256.73, subdivision 5a, and 256.736, if applicable, 254.25 does not count toward the 60-month limit on assistance. 254.26 Thereafter, any cash assistance received by a minor caregiver 254.27 who is complying with the requirements of sections 256J.14 and 254.28 256J.54, if applicable, does not count towards the 60-month 254.29 limit on assistance. 254.30 (c) The receipt of diversionary assistance or emergency 254.31 assistance does not count toward the 60-month limit. 254.32 (d) Any cash assistance received by an 18- or 19-year-old 254.33 caregiver who is complying with the requirements of section 254.34 256J.54 does not count toward the 60-month limit. 254.35 Sec. 71. Minnesota Statutes 1997 Supplement, section 254.36 256J.43, is amended to read: 255.1 256J.43 [INTERSTATE PAYMENT STANDARDS.] 255.2 Subdivision 1. [PAYMENT.] (a) Effective July 1, 1997, the 255.3 amount of assistance paid to an eligiblefamilyunit in which 255.4 all members have resided in this state for fewer than 12 255.5 consecutive calendar months immediately preceding the date of 255.6 application shall be the lesser of either thepaymentinterstate 255.7 transitional standard that would have been received by 255.8 thefamilyassistance unit from the state of immediate prior 255.9 residence, or the amount calculated in accordance with AFDC or 255.10 MFIP-S standards. The lesser payment must continue until 255.11 thefamilyassistance unit meets the 12-month requirement. An 255.12 assistance unit that has not resided in Minnesota for 12 months 255.13 from the date of application is not exempt from the interstate 255.14 payment provisions solely because a child is born in Minnesota 255.15 to a member of the assistance unit. Payment must be calculated 255.16 by applying this state's budgeting policies, and the unit's net 255.17 income must be deducted from the payment standard in the other 255.18 state or in this state, whichever is lower. Payment shall be 255.19 made in vendor form forrentshelter and utilities, up to the 255.20 limit of the grant amount, and residual amounts, if any, shall 255.21 be paid directly to the assistance unit. 255.22 (b) During the first 12 monthsa familyan assistance unit 255.23 resides in this state, the number of months that afamilyunit 255.24 is eligible to receive AFDC or MFIP-S benefits is limited to the 255.25 number of months thefamilyassistance unit would have been 255.26 eligible to receive similar benefits in the state of immediate 255.27 prior residence. 255.28 (c) This policy applies whether or not thefamily255.29 assistance unit received similar benefits while residing in the 255.30 state of previous residence. 255.31 (d) Whena familyan assistance unit moves to this state 255.32 from another state where thefamilyassistance unit has 255.33 exhausted that state's time limit for receiving benefits under 255.34 that state's TANF program, thefamilyunit will not be eligible 255.35 to receive any AFDC or MFIP-S benefits in this state for 12 255.36 months from the date thefamilyassistance unit moves here. 256.1 (e) For the purposes of this section, "state of immediate 256.2 prior residence" means: 256.3 (1) the state in which the applicant declares the applicant 256.4 spent the most time in the 30 days prior to moving to this 256.5 state; or 256.6 (2) the state in which an applicant who is a migrant worker 256.7 maintains a home. 256.8 (f) The commissioner shall annually verify and update all 256.9 other states' payment standards as they are to be in effect in 256.10 July of each year. 256.11 (g) Applicants must provide verification of their state of 256.12 immediate prior residence, in the form of tax statements, a 256.13 driver's license, automobile registration, rent receipts, or 256.14 other forms of verification approved by the commissioner. 256.15 (h) Migrant workers, as defined in section 256J.08, and 256.16 their immediate families are exempt from this section, provided 256.17 the migrant worker provides verification that the migrant family 256.18 worked in this state within the last 12 months and earned at 256.19 least $1,000 in gross wages during the time the migrant worker 256.20 worked in this state. 256.21 Subd. 2. [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 256.22 assistance unit that has met the requirements of section 256.23 256J.12, the number of months that the assistance unit receives 256.24 benefits under the interstate payment standards in this section 256.25 is not affected by an absence from Minnesota for fewer than 30 256.26 consecutive days. 256.27 (b) For an assistance unit that has met the requirements of 256.28 section 256J.12, the number of months that the assistance unit 256.29 receives benefits under the interstate payment standards in this 256.30 section is not affected by an absence from Minnesota for more 256.31 than 30 consecutive days but fewer than 90 consecutive days, 256.32 provided the assistance unit continues to maintain a residence 256.33 in Minnesota during the period of absence. 256.34 Subd. 3. [EXCEPTIONS TO THE INTERSTATE PAYMENT 256.35 POLICY.] Applicants who lived in another state in the 12 months 256.36 previous to application for assistance are exempt from the 257.1 interstate payment policy for the months that a member of the 257.2 unit: 257.3 (1) served in the United States armed services, provided 257.4 the person returned to Minnesota within 30 days of leaving the 257.5 armed forces, and intends to remain in Minnesota; 257.6 (2) attended school in another state, paid nonresident 257.7 tuition or Minnesota tuition rates under a reciprocity 257.8 agreement, provided the person left Minnesota specifically to 257.9 attend school and returned to Minnesota within 30 days of 257.10 graduation with the intent to remain in Minnesota; or 257.11 (3) meets the following criteria: 257.12 (i) a minor child or a minor caregiver moves from another 257.13 state to the residence of a relative caregiver; 257.14 (ii) the minor caregiver applies for and receives family 257.15 cash assistance; 257.16 (iii) the relative caregiver chooses not to be part of the 257.17 MFIP-S assistance unit; and 257.18 (iv) the relative caregiver has resided in Minnesota for at 257.19 least 12 months from the date the assistance unit applies for 257.20 cash assistance. 257.21 Subd. 4. [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 257.22 mandatory unit members who have resided in Minnesota for 12 257.23 months immediately before the date of application meet 257.24 eligibility for the Minnesota payment standard for the other 257.25 assistance unit members. 257.26 Sec. 72. Minnesota Statutes 1997 Supplement, section 257.27 256J.45, subdivision 1, is amended to read: 257.28 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 257.29 county agency must provide each MFIP-S caregiver with a 257.30 face-to-face orientation. The caregiver must attend the 257.31 orientation. The county agency must inform the caregiver that 257.32 failure to attend the orientation is considereda firstan 257.33 occurrence of noncompliance with program requirements, and will 257.34 result in the imposition of a sanction under section 257.35 256J.46. If the client complies with the orientation 257.36 requirement prior to the effective date of the sanction, the 258.1 orientation sanction shall be lifted. 258.2 Sec. 73. Minnesota Statutes 1997 Supplement, section 258.3 256J.45, subdivision 2, is amended to read: 258.4 Subd. 2. [GENERAL INFORMATION.] The MFIP-S orientation 258.5 must consist of a presentation that informs caregivers of: 258.6 (1) the necessity to obtain immediate employment; 258.7 (2) the work incentives under MFIP-S; 258.8 (3) the requirement to comply with the employment plan and 258.9 other requirements of the employment and training services 258.10 component of MFIP-S; 258.11 (4) the consequences for failing to comply with the 258.12 employment plan and other program requirements; 258.13 (5) the rights, responsibilities, and obligations of 258.14 participants; 258.15 (6) the types and locations of child care services 258.16 available through the county agency; 258.17 (7) the availability and the benefits of the early 258.18 childhood health and developmental screening under sections 258.19 123.701 to 123.74; 258.20 (8) the caregiver's eligibility for transition year child 258.21 care assistance under section 119B.05; 258.22 (9) the caregiver's eligibility for extended medical 258.23 assistance when the caregiver loses eligibility for MFIP-S due 258.24 to increased earnings or increased child or spousal support;and258.25 (10) the caregiver's option to choose an employment and 258.26 training provider and information about each provider, including 258.27 but not limited to, services offered, program components, job 258.28 placement rates, job placement wages, and job retention rates; 258.29 (11) the caregiver's option to request approval of an 258.30 education and training plan pursuant to section 256J.52; and 258.31 (12) the work study programs available under the higher 258.32 educational system. 258.33 Sec. 74. Minnesota Statutes 1997 Supplement, section 258.34 256J.45, is amended by adding a subdivision to read: 258.35 Subd. 3. [GOOD CAUSE EXEMPTIONS FOR NOT ATTENDING 258.36 ORIENTATION.] (a) The county agency shall not impose the 259.1 sanction under section 256J.46 if it determines that the 259.2 participant has good cause for failing to attend orientation. 259.3 Good cause exists when: 259.4 (1) appropriate child care is not available; 259.5 (2) the participant is ill or injured; 259.6 (3) a family member is ill and needs care by the 259.7 participant that prevents the participant from attending 259.8 orientation; 259.9 (4) the caregiver is unable to secure necessary 259.10 transportation; 259.11 (5) the caregiver is in an emergency situation that 259.12 prevents orientation attendance; 259.13 (6) the orientation conflicts with the caregiver's work, 259.14 training, or school schedule; or 259.15 (7) the caregiver documents other verifiable impediments to 259.16 orientation attendance beyond the caregiver's control. 259.17 (b) Counties must work with clients to provide child care 259.18 and transportation necessary to ensure a caregiver has every 259.19 opportunity to attend orientation. 259.20 Sec. 75. Minnesota Statutes 1997 Supplement, section 259.21 256J.46, subdivision 1, is amended to read: 259.22 Subdivision 1. [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 259.23 WITH PROGRAM REQUIREMENTS.] (a) The following participants are 259.24 subject to a sanction under this subdivision: 259.25 (1) a participant who fails without good cause to comply 259.26 with the requirements of this chapter, and who is not subject to 259.27 a sanction under subdivision 2, shall be subject to a sanction259.28as provided in this subdivision; and 259.29 (2) a participant who has not complied with the orientation 259.30 requirement before the effective date of the sanction. 259.31 A sanction under this subdivision becomes effective ten 259.32 days after the required notice is given. For purposes of this 259.33 subdivision, each month that a participant fails to comply with 259.34 a requirement of this chapter shall be considered a separate 259.35 occurrence of noncompliance. A participant who has had one or 259.36 more sanctions imposed must remain in compliance with the 260.1 provisions of this chapter for six months in order for a 260.2 subsequent occurrence of noncompliance to be considered a first 260.3 occurrence. 260.4 (b) Sanctions for noncompliance shall be imposed as follows: 260.5 (1) For the first occurrence of noncompliance by a 260.6 participant in a single-parent household or by one participant 260.7 in a two-parent household, theparticipant'sfamily's grant 260.8 shall be reduced by ten percent of theapplicableMFIP-S 260.9 transitional standard or the interstate transitional standard 260.10 for an assistance unit of the same size, whichever is 260.11 applicable, with the residual paid to the participant. The 260.12 reduction in the grant amount must be in effect for a minimum of 260.13 one month and shall be removed in the month following the month 260.14 that the participant returns to compliance or in the month 260.15 following the minimum one-month sanction, whichever is later. 260.16 (2) For a second or subsequent occurrence of noncompliance, 260.17 or when both participants in a two-parent household are out of 260.18 compliance at the same time, theparticipant's rentfamily's 260.19 shelter costs shall be vendor paid up to the amount of the cash 260.20 portion of the MFIP-S grant for which the participant's 260.21 assistance unit is eligible. At county option, 260.22 theparticipant'sfamily's utilities may also be vendor paid up 260.23 to the amount of the cash portion of the MFIP-S grant remaining 260.24 after vendor payment of theparticipant's rentfamily's shelter 260.25 costs.The vendor payment of rent and, if in effect, utilities,260.26must be in effect for six months from the date that a sanction260.27is imposed under this clause.The residual amount of the grant 260.28 after vendor payment, if any, must be reduced by an amount equal 260.29 to 30 percent of theapplicableMFIP-S transitional standard, or 260.30 the interstate transitional standard for an assistance unit of 260.31 the same size, whichever is applicable, before the residual is 260.32 paid to theparticipantfamily. The reduction in the grant 260.33 amount must be in effect for a minimum of one month and shall be 260.34 removed in the month following the month thatthea participant 260.35 in a one-parent household returns to compliance or in the month 260.36 following the minimum one-month sanction, whichever is later. 261.1 In a two-parent household, the grant reduction shall be removed 261.2 in the month following the month both participants return to 261.3 compliance or in the month following the minimum one-month 261.4 sanction, whichever is later. The vendor payment of 261.5rentshelter costs and, if applicable, utilities shall be 261.6 removed six months after the month in which the 261.7 participantreturnsor participants return to compliance. 261.8 (c) No later than during the second month that a sanction 261.9 under paragraph (b), clause (2), is in effect due to 261.10 noncompliance with employment services, the participant's case 261.11 file must be reviewed to determine if: 261.12 (i) the continued noncompliance can be explained and 261.13 mitigated by providing a needed preemployment activity, as 261.14 defined in section 256J.49, subdivision 13, clause (16); 261.15 (ii) the participant qualifies for a good cause exception 261.16 under section 256J.57; or 261.17 (iii) the participant qualifies for an exemption under 261.18 section 256J.56. 261.19 If the lack of an identified activity can explain the 261.20 noncompliance, the county must work with the participant to 261.21 provide the identified activity, and the county must restore the 261.22 participant's grant amount to the full amount for which the 261.23 assistance unit is eligible. The grant must be restored 261.24 retroactively to the first day of the month in which the 261.25 participant was found to lack preemployment activities or to 261.26 qualify for an exemption or good cause exception. 261.27 If the participant is found to qualify for a good cause 261.28 exception or an exemption, the county must restore the 261.29 participant's grant to the full amount for which the assistance 261.30 unit is eligible.If the participant's grant is restored under261.31this paragraph, the vendor payment of rent and if applicable,261.32utilities, shall be removed six months after the month in which261.33the sanction was imposed and the county must consider a261.34subsequent occurrence of noncompliance to be a first occurrence.261.35 Sec. 76. Minnesota Statutes 1997 Supplement, section 261.36 256J.46, subdivision 2, is amended to read: 262.1 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 262.2 REQUIREMENTS.] The grant of an MFIP-S caregiver who refuses to 262.3 cooperate, as determined by the child support enforcement 262.4 agency, with support requirements under section 256.741, if 262.5 enacted, shall be subject to sanction as specified in this 262.6 subdivision. The assistance unit's grant must be reduced by 25 262.7 percent of the applicable transitional standard. The residual 262.8 amount of the grant, if any, must be paid to the caregiver. A 262.9 sanction under this subdivision becomes effective ten days after 262.10 the required notice is given. The sanction must be in effect 262.11 for a minimum of one month and shall be removed only when the 262.12 caregiver cooperates with the support requirements or in the 262.13 month following the minimum one-month sanction, whichever is 262.14 later. Each month that an MFIP-S caregiver fails to comply with 262.15 the requirements of section 256.741 must be considered a 262.16 separate occurrence of noncompliance. An MFIP-S caregiver who 262.17 has had one or more sanctions imposed must remain in compliance 262.18 with the requirements of section 256.741 for six months in order 262.19 for a subsequent sanction to be considered a first occurrence. 262.20 Sec. 77. Minnesota Statutes 1997 Supplement, section 262.21 256J.46, subdivision 2a, is amended to read: 262.22 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 262.23 provisions of subdivisions 1 and 2, for a participant subject to 262.24 a sanction for refusal to comply with child support requirements 262.25 under subdivision 2 and subject to a concurrent sanction for 262.26 refusal to cooperate with other program requirements under 262.27 subdivision 1, sanctions shall be imposed in the manner 262.28 prescribed in this subdivision. 262.29 A participant who has had one or more sanctions imposed 262.30 under this subdivision must remain in compliance with the 262.31 provisions of this chapter for six months in order for a 262.32 subsequent occurrence of noncompliance to be considered a first 262.33 occurrence. Any vendor payment ofrentshelter costs or 262.34 utilities under this subdivision must remain in effect for six 262.35 months after the month in which the participant is no longer 262.36 subject to sanction under subdivision 1. 263.1 (b) If the participant was subject to sanction for: 263.2 (i) noncompliance under subdivision 1 before being subject 263.3 to sanction for noncooperation under subdivision 2; or 263.4 (ii) noncooperation under subdivision 2 before being 263.5 subject to sanction for noncompliance under subdivision 1; 263.6 the participant shall be sanctioned as provided in subdivision 263.7 1, paragraph (b), clause (2), and the requirement that the 263.8 county conduct a review as specified in subdivision 1, paragraph 263.9 (c), remains in effect. 263.10 (c) A participant who first becomes subject to sanction 263.11 under both subdivisions 1 and 2 in the same month is subject to 263.12 sanction as follows: 263.13 (i) in the first month of noncompliance and noncooperation, 263.14 the participant's grant must be reduced by 25 percent of the 263.15 applicable transitional standard, with any residual amount paid 263.16 to the participant; 263.17 (ii) in the second and subsequent months of noncompliance 263.18 and noncooperation, the participant shall be sanctioned as 263.19 provided in subdivision 1, paragraph (b), clause (2). 263.20 The requirement that the county conduct a review as 263.21 specified in subdivision 1, paragraph (c), remains in effect. 263.22 (d) A participant remains subject to sanction under 263.23 subdivision 2 if the participant: 263.24 (i) returns to compliance and is no longer subject to 263.25 sanction under subdivision 1; or 263.26 (ii) has the sanction under subdivision 1, paragraph (b), 263.27 removed upon completion of the review under subdivision 1, 263.28 paragraph (c). 263.29 A participant remains subject to sanction under subdivision 263.30 1, paragraph (b), if the participant cooperates and is no longer 263.31 subject to sanction under subdivision 2. 263.32 Sec. 78. Minnesota Statutes 1997 Supplement, section 263.33 256J.47, subdivision 4, is amended to read: 263.34 Subd. 4. [INELIGIBILITY FOR MFIP-S; EMERGENCY ASSISTANCE; 263.35 AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of diversionary 263.36 assistance, the family is ineligible for MFIP-S, emergency 264.1 assistance, and emergency general assistance for a period of 264.2 time. To determine the period of ineligibility, the county 264.3 shall use the following formula: regardless of household 264.4 changes, the county agency must calculate the number of days of 264.5 ineligibility by dividing the diversionary assistance issued by 264.6 the transitional standard a family of the same size and 264.7 composition would have received under MFIP-S, or if applicable 264.8 the interstate transitional standard, multiplied by 30, 264.9 truncating the result. The ineligibility period begins the date 264.10 the diversionary assistance is issued. 264.11 Sec. 79. Minnesota Statutes 1997 Supplement, section 264.12 256J.48, subdivision 2, is amended to read: 264.13 Subd. 2. [ELIGIBILITY.] Notwithstanding other eligibility 264.14 provisions of this chapter, any family without resources 264.15 immediately available to meet emergency needs identified in 264.16 subdivision 3 shall be eligible for an emergency grant under the 264.17 following conditions: 264.18 (1) a family member has resided in this state for at least 264.19 30 days; 264.20 (2) the family is without resources immediately available 264.21 to meet emergency needs; 264.22 (3) assistance is necessary to avoid destitution or provide 264.23 emergency shelter arrangements;and264.24 (4) the family's destitution or need for shelter or 264.25 utilities did not arise because the child or relative caregiver 264.26 refused without good cause under section 256J.57 to accept 264.27 employment or training for employment in this state or another 264.28 state; and 264.29 (5) at least one child or pregnant woman in the emergency 264.30 assistance unit meets MFIP-S citizenship requirements in section 264.31 256J.11. 264.32 Sec. 80. Minnesota Statutes 1997 Supplement, section 264.33 256J.48, is amended by adding a subdivision to read: 264.34 Subd. 2a. [MIGRANT WORKER ELIGIBILITY.] Notwithstanding 264.35 other eligibility provisions of this chapter, migrant workers, 264.36 as defined in section 256J.08, and their immediate families, who 265.1 meet the eligibility requirements in subdivision 2, except the 265.2 30-day residency requirement, are eligible for emergency 265.3 assistance, if the migrant worker provides verification to the 265.4 county agency that the migrant worker worked in this state 265.5 within the last 12 months and earned at least $1,000 in gross 265.6 wages during the time the migrant worker worked in this state. 265.7 Sec. 81. Minnesota Statutes 1997 Supplement, section 265.8 256J.48, subdivision 3, is amended to read: 265.9 Subd. 3. [EMERGENCY NEEDS.] Emergency needs are limited to 265.10 the following: 265.11 (a) [RENT.] A county agency may deny assistance to prevent 265.12 eviction from rented or leased shelter of an otherwise eligible 265.13 applicant when the county agency determines that an applicant's 265.14 anticipated income will not cover continued payment for shelter, 265.15 subject to conditions in clauses (1) to (3): 265.16 (1) a county agency must not deny assistance when an 265.17 applicant can document that the applicant is unable to locate 265.18 habitable shelter, unless the county agency can document that 265.19 one or more habitable shelters are available in the community 265.20 that will result in at least a 20 percent reduction in monthly 265.21 expense for shelter and that this shelter will be cost-effective 265.22 for the applicant; 265.23 (2) when no alternative shelter can be identified by either 265.24 the applicant or the county agency, the county agency shall not 265.25 deny assistance because anticipated income will not cover rental 265.26 obligation; and 265.27 (3) when cost-effective alternative shelter is identified, 265.28 the county agency shall issue assistance for moving expenses as 265.29 provided in paragraph(d)(e). 265.30 (b) [DEFINITIONS.] For purposes of paragraph (a), the 265.31 following definitions apply (1) "metropolitan statistical area" 265.32 is as defined by the United States Census Bureau; (2) 265.33 "alternative shelter" includes any shelter that is located 265.34 within the metropolitan statistical area containing the county 265.35 and for which the applicant is eligible, provided the applicant 265.36 does not have to travel more than 20 miles to reach the shelter 266.1 and has access to transportation to the shelter. Clause (2) 266.2 does not apply to counties in the Minneapolis-St. Paul 266.3 metropolitan statistical area. 266.4 (c) [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 266.5 agency shall issue assistance for mortgage or contract for deed 266.6 arrearages on behalf of an otherwise eligible applicant 266.7 according to clauses (1) to (4): 266.8 (1) assistance for arrearages must be issued only when a 266.9 home is owned, occupied, and maintained by the applicant; 266.10 (2) assistance for arrearages must be issued only when no 266.11 subsequent foreclosure action is expected within the 12 months 266.12 following the issuance; 266.13 (3) assistance for arrearages must be issued only when an 266.14 applicant has been refused refinancing through a bank or other 266.15 lending institution and the amount payable, when combined with 266.16 any payments made by the applicant, will be accepted by the 266.17 creditor as full payment of the arrearage; 266.18 (4) costs paid by a family which are counted toward the 266.19 payment requirements in this clause are:principleprincipal 266.20 and interest payments on mortgages or contracts for deed, 266.21 balloon payments, homeowner's insurance payments, manufactured 266.22 home lot rental payments, and tax or special assessment payments 266.23 related to the homestead. Costs which are not counted include 266.24 closing costs related to the sale or purchase of real property. 266.25 To be eligible for assistance for costs specified in clause 266.26 (4) which are outstanding at the time of foreclosure, an 266.27 applicant must have paid at least 40 percent of the family's 266.28 gross income toward these costs in the month of application and 266.29 the 11-month period immediately preceding the month of 266.30 application. 266.31 When an applicant is eligible under clause (4), a county 266.32 agency shall issue assistance up to a maximum of four times the 266.33 MFIP-S transitional standard for a comparable assistance unit. 266.34 (d) [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 266.35 issue assistance for damage or utility deposits when necessary 266.36 to alleviate the emergency. The county may require that 267.1 assistance paid in the form of a damage depositor a utility267.2deposit, less any amount retained by the landlord to remedy a 267.3 tenant's default in payment of rent or other funds due to the 267.4 landlord under a rental agreement, or to restore the premises to 267.5 the condition at the commencement of the tenancy, ordinary wear 267.6 and tear excepted, be returned to the county when the individual 267.7 vacates the premises or be paid to the recipient's new landlord 267.8 as a vendor payment. The county may require that assistance 267.9 paid in the form of a utility deposit less any amount retained 267.10 to satisfy outstanding utility costs be returned to the county 267.11 when the person vacates the premises, or be paid for the 267.12 person's new housing unit as a vendor payment. The vendor 267.13 payment of returned funds shall not be considered a new use of 267.14 emergency assistance. 267.15 (e) [MOVING EXPENSES.] A county agency shall issue 267.16 assistance for expenses incurred when a family must move to a 267.17 different shelter according to clauses (1) to (4): 267.18 (1) moving expenses include the cost to transport personal 267.19 property belonging to a family, the cost for utility connection, 267.20 and the cost for securing different shelter; 267.21 (2) moving expenses must be paid only when the county 267.22 agency determines that a move is cost-effective; 267.23 (3) moving expenses must be paid at the request of an 267.24 applicant, but only when destitution or threatened destitution 267.25 exists; and 267.26 (4) moving expenses must be paid when a county agency 267.27 denies assistance to prevent an eviction because the county 267.28 agency has determined that an applicant's anticipated income 267.29 will not cover continued shelter obligation in paragraph (a). 267.30 (f) [HOME REPAIRS.] A county agency shall pay for repairs 267.31 to the roof, foundation, wiring, heating system, chimney, and 267.32 water and sewer system of a home that is owned and lived in by 267.33 an applicant. 267.34 The applicant shall document, and the county agency shall 267.35 verify the need for and method of repair. 267.36 The payment must be cost-effective in relation to the 268.1 overall condition of the home and in relation to the cost and 268.2 availability of alternative housing. 268.3 (g) [UTILITY COSTS.] Assistance for utility costs must be 268.4 made when an otherwise eligible family has had a termination or 268.5 is threatened with a termination of municipal water and sewer 268.6 service, electric, gas or heating fuel service, or lacks wood 268.7 when that is the heating source, subject to the conditions in 268.8 clauses (1) and (2): 268.9 (1) a county agency must not issue assistance unless the 268.10 county agency receives confirmation from the utility provider 268.11 that assistance combined with payment by the applicant will 268.12 continue or restore the utility; and 268.13 (2) a county agency shall not issue assistance for utility 268.14 costs unless a family paid at least eight percent of the 268.15 family's gross income toward utility costs due during the 268.16 preceding 12 months. 268.17 Clauses (1) and (2) must not be construed to prevent the 268.18 issuance of assistance when a county agency must take immediate 268.19 and temporary action necessary to protect the life or health of 268.20 a child. 268.21 (h) [SPECIAL DIETS.] Effective January 1, 1998, a county 268.22 shall pay for special diets or dietary items for MFIP-S 268.23 participants. Persons receiving emergency assistance funds for 268.24 special diets or dietary items are also eligible to receive 268.25 emergency assistance for shelter and utility emergencies, if 268.26 otherwise eligible. The need for special diets or dietary items 268.27 must be prescribed by a licensed physician. Costs for special 268.28 diets shall be determined as percentages of the allotment for a 268.29 one-person household under the Thrifty Food Plan as defined by 268.30 the United States Department of Agriculture. The types of diets 268.31 and the percentages of the Thrifty Food Plan that are covered 268.32 are as follows: 268.33 (1) high protein diet, at least 80 grams daily, 25 percent 268.34 of Thrifty Food Plan; 268.35 (2) controlled protein diet, 40 to 60 grams and requires 268.36 special products, 100 percent of Thrifty Food Plan; 269.1 (3) controlled protein diet, less than 40 grams and 269.2 requires special products, 125 percent of Thrifty Food Plan; 269.3 (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 269.4 (5) high residue diet, 20 percent of Thrifty Food Plan; 269.5 (6) pregnancy and lactation diet, 35 percent of Thrifty 269.6 Food Plan; 269.7 (7) gluten-free diet, 25 percent of Thrifty Food Plan; 269.8 (8) lactose-free diet, 25 percent of Thrifty Food Plan; 269.9 (9) antidumping diet, 15 percent of Thrifty Food Plan; 269.10 (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 269.11 (11) ketogenic diet, 25 percent of Thrifty Food Plan. 269.12 Sec. 82. Minnesota Statutes 1997 Supplement, section 269.13 256J.49, subdivision 4, is amended to read: 269.14 Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 269.15 "Employment and training service provider" means: 269.16 (1) a public, private, or nonprofit employment and training 269.17 agency certified by the commissioner of economic security under 269.18 sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 269.19 is approved under section 256J.51 and is included in the county 269.20 plan submitted under section 256J.50, subdivision 7;or269.21 (2) a public, private, or nonprofit agency that is not 269.22 certified by the commissioner under clause (1), but with which a 269.23 county has contracted to provide employment and training 269.24 services and which is included in the county's plan submitted 269.25 under section 256J.50, subdivision 7; or 269.26 (3) a county agency, if the countyis certified under269.27clause (1)has opted to provide employment and training services 269.28 and the county has indicated that fact in the plan submitted 269.29 under section 256J.50, subdivision 7. 269.30 Notwithstanding section 268.871, an employment and training 269.31 services provider meeting this definition may deliver employment 269.32 and training services under this chapter. 269.33 Sec. 83. Minnesota Statutes 1997 Supplement, section 269.34 256J.50, subdivision 5, is amended to read: 269.35 Subd. 5. [PARTICIPATION REQUIREMENTS FOR SINGLE-PARENT AND 269.36 TWO-PARENT CASES.] (a) A county must establish a uniform 270.1 schedule for requiring participation by single parents. 270.2 Mandatory participation must be required within six months of 270.3 eligibility for cash assistance. For two-parent cases, 270.4 participation is required concurrent with the receipt of MFIP-S 270.5 cash assistance. 270.6 (b) Beginning January 1, 1998, with the exception of 270.7 caregivers required to attend high school under the provisions 270.8 of section 256J.54, subdivision 5, MFIP caregivers, upon 270.9 completion of the secondary assessment, must develop an 270.10 employment plan and participate in work activities. 270.11 (c) In single-parent families with no children under six 270.12 years of age, the job counselor and the caregiver must develop 270.13 an employment plan that includes 20 to 35 hours per week of work 270.14 activities for the period January 1, 1998, to September 30, 270.15 1998; 25 to 35 hours of work activities per week in federal 270.16 fiscal year 1999; and 30 to 35 hours per week of work activities 270.17 in federal fiscal year 2000 and thereafter. 270.18 (d) In single-parent families with a child under six years 270.19 of age, the job counselor and the caregiver must develop an 270.20 employment plan that includes 20 to 35 hours per week of work 270.21 activities. 270.22 (e) In two-parent families, the job counselor and the 270.23 caregivers must develop employment plans. 270.24 (f) Notwithstanding paragraphs (c) to (e), an MFIP 270.25 caregiver who is meeting the hourly work participation 270.26 requirements under the Personal Responsibility and Work 270.27 Opportunity Reconciliation Act of 1996 through employment and is 270.28 enrolled in training or education that meets the requirements of 270.29 section 256J.53, subdivision 2, concurrent with employment, 270.30 cannot be required to work additional hours under this section. 270.31 Sec. 84. Minnesota Statutes 1997 Supplement, section 270.32 256J.50, is amended by adding a subdivision to read: 270.33 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OF DOMESTIC 270.34 VIOLENCE.] County agencies and their contractors must provide 270.35 universal notification to all applicants and recipients of 270.36 MFIP-S that: 271.1 (1) referrals to counseling and supportive services are 271.2 available for victims of domestic violence; 271.3 (2) nonpermanent resident battered individuals married to 271.4 United States citizens or permanent residents may be eligible to 271.5 petition for permanent residency under the Violence Against 271.6 Women Act, and that referrals to appropriate legal services are 271.7 available; 271.8 (3) victims of domestic violence are exempt from the 271.9 60-month limit on assistance while the individual is complying 271.10 with an approved safety plan, as defined in section 256J.49, 271.11 subdivision 11; and 271.12 (4) victims of domestic violence may choose to be exempt or 271.13 deferred from work requirements for up to 12 months while the 271.14 individual is complying with an approved safety plan as defined 271.15 in section 256J.49, subdivision 11. 271.16 Notification must be in writing and orally at the time of 271.17 application and recertification, when the individual is referred 271.18 to the title IV-D child support agency, and at the beginning of 271.19 any job training or work placement assistance program. 271.20 Sec. 85. Minnesota Statutes 1997 Supplement, section 271.21 256J.52, subdivision 4, is amended to read: 271.22 Subd. 4. [SECONDARY ASSESSMENT.] (a) The job counselor 271.23 must conduct a secondary assessment for those participants who: 271.24 (1) in the judgment of the job counselor, have barriers to 271.25 obtaining employment that will not be overcome with a job search 271.26 support plan under subdivision 3; 271.27 (2) have completed eight weeks of job search under 271.28 subdivision 3 without obtaining suitable employment;or271.29 (3) have not received a secondary assessment, are working 271.30 at least 20 hours per week, and the participant, job counselor, 271.31 or county agency requests a secondary assessment; or 271.32 (4) have an existing plan or are already involved in 271.33 training or education activities under section 256J.55, 271.34 subdivision 5. 271.35 (b) In the secondary assessment the job counselor must 271.36 evaluate the participant's skills and prior work experience, 272.1 family circumstances, interests and abilities, need for 272.2 preemployment activities, supportive or educational services, 272.3 and the extent of any barriers to employment. The job counselor 272.4 must use the information gathered through the secondary 272.5 assessment to develop an employment plan under subdivision 5. 272.6 (c) The provider shall make available to participants 272.7 information regarding additional vendors or resources which 272.8 provide employment and training services that may be available 272.9 to the participant under a plan developed under this section. 272.10 The information must include a brief summary of services 272.11 provided and related performance indicators. Performance 272.12 indicators must include, but are not limited to, the average 272.13 time to complete program offerings, placement rates, entry and 272.14 average wages, and retention rates. To be included in the 272.15 information given to participants, a vendor or resource must 272.16 provide counties with relevant information in the format 272.17 required by the county. 272.18 Sec. 86. Minnesota Statutes 1997 Supplement, section 272.19 256J.54, subdivision 2, is amended to read: 272.20 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 272.21 PLAN.] For caregivers who are under age 18 without a high school 272.22 diploma or its equivalent, the assessment under subdivision 1 272.23 and the employment plan under subdivision 3 must be completed by 272.24 the social services agency under section 257.33. For caregivers 272.25 who are age 18 or 19 without a high school diploma or its 272.26 equivalent, the assessment under subdivision 1 and the 272.27 employment plan under subdivision 3 must be completed by the job 272.28 counselor. The social services agency or the job counselor 272.29 shall consult with representatives of educational agencies that 272.30 are required to assist in developing educational plans under 272.31 section 126.235. 272.32 Sec. 87. Minnesota Statutes 1997 Supplement, section 272.33 256J.54, subdivision 3, is amended to read: 272.34 Subd. 3. [EDUCATIONAL OPTION DEVELOPED.] If the job 272.35 counselor or county social services agency identifies an 272.36 appropriate educational option for a caregiver under the age of 273.1 20 without a high school diploma or its equivalent,itthe job 273.2 counselor or agency must develop an employment plan which 273.3 reflects the identified option. The plan must specify that 273.4 participation in an educational activity is required, what 273.5 school or educational program is most appropriate, the services 273.6 that will be provided, the activities the caregiver will take 273.7 part in, including child care and supportive services, the 273.8 consequences to the caregiver for failing to participate or 273.9 comply with the specified requirements, and the right to appeal 273.10 any adverse action. The employment plan must, to the extent 273.11 possible, reflect the preferences of the caregiver. 273.12 Sec. 88. Minnesota Statutes 1997 Supplement, section 273.13 256J.54, subdivision 4, is amended to read: 273.14 Subd. 4. [NO APPROPRIATE EDUCATIONAL OPTION.] If the job 273.15 counselor determines that there is no appropriate educational 273.16 option for a caregiver who is age 18 or 19 without a high school 273.17 diploma or its equivalent, the job counselor must develop an 273.18 employment plan, as defined in section 256J.49, subdivision 5, 273.19 for the caregiver. If the county social services agency 273.20 determines that school attendance is not appropriate for a 273.21 caregiver under age 18 without a high school diploma or its 273.22 equivalent, the county agency shall refer the caregiver to 273.23 social services for services as provided in section 257.33. 273.24 Sec. 89. Minnesota Statutes 1997 Supplement, section 273.25 256J.54, subdivision 5, is amended to read: 273.26 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 273.27 the provisions of section 256J.56, minor parents, or 18- or 273.28 19-year-old parents without a high school diploma or its 273.29 equivalent must attend school unless: 273.30 (1) transportation services needed to enable the caregiver 273.31 to attend school are not available; 273.32 (2) appropriate child care services needed to enable the 273.33 caregiver to attend school are not available; 273.34 (3) the caregiver is ill or incapacitated seriously enough 273.35 to prevent attendance at school; or 273.36 (4) the caregiver is needed in the home because of the 274.1 illness or incapacity of another member of the household. This 274.2 includes a caregiver of a child who is younger than six weeks of 274.3 age. 274.4 (b) The caregiver must be enrolled in a secondary school 274.5 and meeting the school's attendance requirements. The county, 274.6 social service agency, or job counselor must verify that the 274.7 caregiver is meeting the school's attendance requirements at 274.8 least once per quarter. An enrolled caregiver is considered to 274.9 be meeting the attendance requirements when the school is not in 274.10 regular session, including during holiday and summer breaks. 274.11 Sec. 90. Minnesota Statutes 1997 Supplement, section 274.12 256J.55, subdivision 5, is amended to read: 274.13 Subd. 5. [OPTION TO UTILIZE EXISTING PLAN.] With job 274.14 counselor approval, if a participant is already complying with a 274.15 job search support or employment plan that was developed for a 274.16 different program or is already involved in education or 274.17 training activities, the participant may utilize that plan and 274.18 that program's services, subject to the requirements of 274.19 subdivision 3, to be in compliance with sections 256J.52 to 274.20 256J.57 so long as the plan meets, or is modified to meet, the 274.21 requirements of those sections. 274.22 Sec. 91. Minnesota Statutes 1997 Supplement, section 274.23 256J.56, is amended to read: 274.24 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 274.25 EXEMPTIONS.] 274.26 An MFIP-S caregiver is exempt from the requirements of 274.27 sections 256J.52 to 256J.55 if the caregiver belongs to any of 274.28 the following groups: 274.29 (1) individuals who are age 60 or older; 274.30 (2) individuals who are suffering from a professionally 274.31 certified permanent or temporary illness, injury, or incapacity 274.32 which is expected to continue for more than 30 days and which 274.33 prevents the person from obtaining or retaining employment. 274.34 Persons in this category with a temporary illness, injury, or 274.35 incapacity must be reevaluated at least quarterly; 274.36 (3) caregivers whose presence in the home is required 275.1 because of the professionally certified illness or incapacity of 275.2 another member in the assistance unit, a relative in the 275.3 household, or a foster child in the household; 275.4 (4) women who are pregnant, if the pregnancy has resulted 275.5 in a professionally certified incapacity that prevents the woman 275.6 from obtaining or retaining employment; 275.7 (5) caregivers of a child under the age of one year who 275.8 personally provide full-time care for the child. This exemption 275.9 may be used for only 12 months in a lifetime. In two-parent 275.10 households, only one parent or other relative may qualify for 275.11 this exemption; 275.12 (6) individuals who are single parents or one parent in a 275.13 two-parent family employed at least40 hours per week or at275.14least 30 hours per week and engaged in job search for at least275.15an additional ten35 hours per week; 275.16 (7) individuals experiencing a personal or family crisis 275.17 that makes them incapable of participating in the program, as 275.18 determined by the county agency. If the participant does not 275.19 agree with the county agency's determination, the participant 275.20 may seek professional certification, as defined in section 275.21 256J.08, that the participant is incapable of participating in 275.22 the program. 275.23 Persons in this exemption category must be reevaluated 275.24 every 60 days; or 275.25 (8) second parents in two-parent families, provided the275.26second parent isemployed for 20 or more hours per week provided 275.27 the first parent is employed at least 35 hours per week. 275.28 A caregiver who is exempt under clause (5) must enroll in 275.29 and attend an early childhood and family education class, a 275.30 parenting class, or some similar activity, if available, during 275.31 the period of time the caregiver is exempt under this section. 275.32 Notwithstanding section 256J.46, failure to attend the required 275.33 activity shall not result in the imposition of a sanction. 275.34 Sec. 92. Minnesota Statutes 1997 Supplement, section 275.35 256J.57, subdivision 1, is amended to read: 275.36 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 276.1 county agency shall not impose the sanction under section 276.2 256J.46 if it determines that the participant has good cause for 276.3 failing to comply with the requirements ofsection 256J.45 or276.4 sections 256J.52 to 256J.55. Good cause exists when: 276.5 (1) appropriate child care is not available; 276.6 (2) the job does not meet the definition of suitable 276.7 employment; 276.8 (3) the participant is ill or injured; 276.9 (4) afamilymember of the assistance unit, a relative in 276.10 the household, or a foster child in the household is ill and 276.11 needs care by the participant that prevents the participant from 276.12 complying with the job search support plan or employment plan; 276.13 (5) the parental caregiver is unable to secure necessary 276.14 transportation; 276.15 (6) the parental caregiver is in an emergency situation 276.16 that prevents compliance with the job search support plan or 276.17 employment plan; 276.18 (7) the schedule of compliance with the job search support 276.19 plan or employment plan conflicts with judicial proceedings; 276.20 (8) the parental caregiver is already participating in 276.21 acceptable work activities; 276.22 (9) the employment plan requires an educational program for 276.23 a caregiver under age 20, but the educational program is not 276.24 available; 276.25 (10) activities identified in the job search support plan 276.26 or employment plan are not available; 276.27 (11) the parental caregiver is willing to accept suitable 276.28 employment, but suitable employment is not available; or 276.29 (12) the parental caregiver documents other verifiable 276.30 impediments to compliance with the job search support plan or 276.31 employment plan beyond the parental caregiver's control. 276.32 Sec. 93. Minnesota Statutes 1997 Supplement, section 276.33 256J.645, subdivision 3, is amended to read: 276.34 Subd. 3. [FUNDING.] If the commissioner and an Indian 276.35 tribe are parties to an agreement under this subdivision, the 276.36 agreement may annually provide to the Indian tribe the funding 277.1 amount in clause (1) or (2): 277.2 (1) if the Indian tribe operated a tribal STRIDE program 277.3 during state fiscal year 1997, the amount to be provided is the 277.4 amount the Indian tribe received from the state for operation of 277.5 its tribal STRIDE program in state fiscal year 1997, except that 277.6 the amount provided for a fiscal year may increase or decrease 277.7 in the same proportion that the total amount of state and 277.8 federal funds available for MFIP-S employment and training 277.9 services increased or decreased that fiscal year; or 277.10 (2) if the Indian tribe did not operate a tribal STRIDE 277.11 program during state fiscal year 1997, the commissioner may 277.12 provide to the Indian tribe for the first year of operations the 277.13 amount determined by multiplying the state allocation for MFIP-S 277.14 employment and training services to each county agency in the 277.15 Indian tribe's service delivery area by the percentage of MFIP-S 277.16 recipients in that county who were members of the Indian tribe 277.17 during the previous state fiscal year. The resulting amount 277.18 shall also be the amount that the commissioner may provide to 277.19 the Indian tribe annually thereafter through an agreement under 277.20 this subdivision, except that the amount provided for a fiscal 277.21 year may increase or decrease in the same proportion that the 277.22 total amount of state and federal funds available for MFIP-S 277.23 employment and training services increased or decreased that 277.24 fiscal year. 277.25 Sec. 94. Minnesota Statutes 1997 Supplement, section 277.26 256J.74, subdivision 2, is amended to read: 277.27 Subd. 2. [CONCURRENT ELIGIBILITY, LIMITATIONS.] A county 277.28 agency must not count an applicant or participant as a member of 277.29 more than one assistance unit in a given payment month, except 277.30 as provided in clauses (1) and (2). 277.31 (1) A participant who is a member of an assistance unit in 277.32 this state is eligible to be included in a second assistance 277.33 unitinthe first full monththatafter the month the 277.34 participantleaves the first assistance unit and lives with277.35ajoins the secondassistanceunit. 277.36 (2) An applicant whose needs are met through foster care 278.1 that is reimbursed under title IV-E of the Social Security Act 278.2 for the first part of an application month is eligible to 278.3 receive assistance for the remaining part of the month in which 278.4 the applicant returns home. Title IV-E payments and adoption 278.5 assistance payments must be considered prorated payments rather 278.6 than a duplication of MFIP-S need. 278.7 Sec. 95. Minnesota Statutes 1997 Supplement, section 278.8 256J.74, is amended by adding a subdivision to read: 278.9 Subd. 5. [FOOD STAMPS.] For any month an individual 278.10 receives Food Stamp Program benefits, the individual is not 278.11 eligible for the MFIP-S food portion of assistance, except under 278.12 section 256J.28, subdivision 5. 278.13 Sec. 96. [256J.77] [AGING OF CASH BENEFITS.] 278.14 Cash benefits under chapters 256D, 256J, and 256K by 278.15 warrants or electronic benefit transfer that have not been 278.16 accessed within 90 days of issuance shall be canceled. Cash 278.17 benefits may be replaced after they are canceled, for up to one 278.18 year after the date of issuance, if failure to do so would place 278.19 the client or family at risk. For purposes of this section, 278.20 "accessed" means cashing a warrant or making at least one 278.21 withdrawal from benefits deposited in an electronic benefit 278.22 account. 278.23 Sec. 97. Minnesota Statutes 1997 Supplement, section 278.24 256K.03, subdivision 5, is amended to read: 278.25 Subd. 5. [EXEMPTION CATEGORIES.] (a) The applicant will be 278.26 exempt from the job search requirements and development of a job 278.27 search plan and an employability development plan under 278.28 subdivisions 3, 4, and 8 if the applicant belongs to any of the 278.29 following groups: 278.30 (1)caregivers under age 20 who have not completed a high278.31school education and are attending high school on a full-time278.32basis;278.33(2)individuals who are age 60 or older; 278.34(3)(2) individuals who are suffering from a professionally 278.35 certified permanent or temporary illness, injury, or incapacity 278.36 which is expected to continue for more than 30 days and which 279.1 prevents the person from obtaining or retaining employment. 279.2 Persons in this category with a temporary illness, injury, or 279.3 incapacity must be reevaluated at least quarterly; 279.4(4)(3) caregivers whose presence in the home is needed 279.5 because of the professionally certified illness or incapacity of 279.6 another member in the assistance unit, a relative in the 279.7 household, or a foster child in the household; 279.8(5)(4) women who are pregnant, ifitthe pregnancy has 279.9been medically verifiedresulted in a professionally certified 279.10 incapacity thatthe child is expected to be born within the next279.11six monthsprevents the woman from obtaining and retaining 279.12 employment; 279.13(6)(5) caregiversor other caregiver relativesof a child 279.14 under the age ofthreeone year who personally provide full-time 279.15 care for the child. This exemption may be used for only 12 279.16 months in a lifetime. In two-parent households, only one parent 279.17 or other relative may qualify for this exemption; 279.18(7)(6) individuals who are single parents or one parent in 279.19 a two-parent family employed at least3035 hours per week; 279.20(8) individuals for whom participation would require a279.21round trip commuting time by available transportation of more279.22than two hours, excluding transporting of children for child279.23care;279.24(9) individuals for whom lack of proficiency in English is279.25a barrier to employment, provided such individuals are279.26participating in an intensive program which lasts no longer than279.27six months and is designed to remedy their language deficiency;279.28(10) individuals who, because of advanced age or lack of279.29ability, are incapable of gaining proficiency in English, as279.30determined by the county social worker, shall continue to be279.31exempt under this subdivision and are not subject to the279.32requirement that they be participating in a language program;279.33(11)(7) individualsunder such duress that they are279.34incapable of participating in the program, as determined by the279.35county social workerexperiencing a personal or family crisis 279.36 that makes them incapable of participating in the program, as 280.1 determined by the county agency. If the participant does not 280.2 agree with the county agency's determination, the participant 280.3 may seek professional certification, as defined in section 280.4 256J.08, that the participant is incapable of participating in 280.5 the program. Persons in this exemption category must be 280.6 reevaluated every 60 days; or 280.7(12) individuals in need of refresher courses for purposes280.8of obtaining professional certification or licensure.280.9(b) In a two-parent family, only one caregiver may be280.10exempted under paragraph (a), clauses (4) and (6).280.11 (8) second parents in two-parent families employed for 20 280.12 or more hours per week provided the first parent is employed at 280.13 least 35 hours per week. 280.14 (b) A caregiver who is exempt under clause (5) must enroll 280.15 in and attend an early childhood and family education class, a 280.16 parenting class, or some similar activity, if available, during 280.17 the period of time the caregiver is exempt under this section. 280.18 Notwithstanding section 256J.46, failure to attend the required 280.19 activity shall not result in the imposition of a sanction. 280.20 Sec. 98. Laws 1997, chapter 203, article 9, section 21, is 280.21 amended to read: 280.22 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMSUNSPENT 280.23 STATE MONEY.] 280.24(a) Beginning July 1, 1999, the following persons will be280.25ineligible for general assistance and general assistance medical280.26care under Minnesota Statutes, chapter 256D, group residential280.27housing under Minnesota Statutes, chapter 256I, and MFIP-S280.28assistance under Minnesota Statutes, chapter 256J, funded with280.29state money:280.30(1) persons who are terminated from or denied Supplemental280.31Security Income due to the 1996 changes in the federal law280.32making persons whose alcohol or drug addiction is a material280.33factor contributing to the person's disability ineligible for280.34Supplemental Security Income, and are eligible for general280.35assistance under Minnesota Statutes, section 256D.05,280.36subdivision 1, paragraph (a), clause (17), general assistance281.1medical care under Minnesota Statutes, chapter 256D, or group281.2residential housing under Minnesota Statutes, chapter 256I;281.3(2) legal noncitizens who are ineligible for Supplemental281.4Security Income due to the 1996 changes in federal law making281.5certain noncitizens ineligible for these programs due to their281.6noncitizen status; and281.7(3) legal noncitizens who are eligible for MFIP-S281.8assistance, either the cash assistance portion or the food281.9assistance portion, funded entirely with state money.281.10(b)State money that remains unspenton June 30, 1999, due 281.11 to changes in federal law enacted after May 12, 1997, that 281.12 reduce state spending for legal noncitizens or for persons whose 281.13 alcohol or drug addiction is a material factor contributing to 281.14 the person's disability, or enacted after February 1, 1998, that 281.15 reduce state spending for food benefits for legal noncitizens 281.16 shall not cancel and shall be deposited in the TANF reserve 281.17 account. 281.18 Sec. 99. Laws 1997, chapter 248, section 46, as amended by 281.19 Laws 1997, First Special Session chapter 5, section 10, is 281.20 amended to read: 281.21 Sec. 46. [UNLICENSED CHILD CARE PROVIDERS; INTERIM 281.22 EXPANSION.] 281.23 (a) Notwithstanding Minnesota Statutes, section 245A.03, 281.24 subdivision 2, clause (2), until June 30, 1999, nonresidential 281.25 child care programs or services that are provided by an 281.26 unrelated individual to persons from two or three other 281.27 unrelated families are excluded from the licensure provisions of 281.28 Minnesota Statutes, chapter 245A, provided that: 281.29 (1) the individual provides services at any one time to no 281.30 more than four children who are unrelated to the individual; 281.31 (2) no more than two of the children are under two years of 281.32 age; and 281.33 (3) the total number of children being cared for at any one 281.34 time does not exceed five. 281.35 (b) Paragraph (a), clauses (1) to (3), do not apply to: 281.36 (1) nonresidential programs that are provided by an 282.1 unrelated individual to persons from a single related family.; 282.2 (2) a child care provider whose child care services meet 282.3 the criteria in paragraph (a), clauses (1) to (3), but who 282.4 chooses to apply for licensure; 282.5 (3) a child care provider who, as an applicant for 282.6 licensure or as a license holder, has received a license denial 282.7 under Minnesota Statutes, section 245A.05, a fine under 282.8 Minnesota Statutes, section 245A.06, or a sanction under 282.9 Minnesota Statutes, section 245A.07 from the commissioner that 282.10 has not been reversed on appeal; or 282.11 (4) a child care provider, or a child care provider who has 282.12 a household member who, as a result of a licensing process, has 282.13 a disqualification under Minnesota Statutes, chapter 245A, that 282.14 has not been set aside by the commissioner. 282.15 Sec. 100. [REPEALER.] 282.16 (a) Minnesota Statutes 1997 Supplement, section 256J.28, 282.17 subdivision 4, is repealed effective January 1, 1998. 282.18 (b) Minnesota Statutes 1997 Supplement, sections 256J.25; 282.19 and 256J.76; Laws 1997, chapter 85, article 1, sections 61 and 282.20 71, and article 3, section 55, are repealed. 282.21 (c) Minnesota Statutes 1996, sections 256.031, subdivisions 282.22 1, 2, 3, and 4; 256.032; 256.033, subdivisions 2, 3, 4, 5, and 282.23 6; 256.034; 256.035; 256.036; 256.0361; 256.047; 256.0475; 282.24 256.048; and 256.049; and Minnesota Statutes 1997 Supplement, 282.25 sections 256.031, subdivisions 5 and 6; 256.033, subdivisions 1 282.26 and 1a; 256B.062; 256J.32, subdivision 5; and 256J.34, 282.27 subdivision 5, are repealed effective July 1, 1998. 282.28 (d) Minnesota Rules (Exempt), parts 9500.9100; 9500.9110; 282.29 9500.9120; 9500.9130; 9500.9140; 9500.9150; 9500.9160; 282.30 9500.9170; 9500.9180; 9500.9190; 9500.9200; 9500.9210; and 282.31 9500.9220, are repealed effective July 1, 1998. 282.32 Sec. 101. [EFFECTIVE DATE.] 282.33 Sections 1, 2, 5, 6, 80, and 99 are effective the day 282.34 following final enactment. 282.35 Section 43 is effective for all applications for the 282.36 Minnesota family investment program-statewide made on or after 283.1 July 1, 1998. 283.2 ARTICLE 7 283.3 REGIONAL TREATMENT CENTERS 283.4 Section 1. [CONVEYANCE OF STATE LAND; ANOKA COUNTY.] 283.5 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 283.6 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 283.7 subdivision 3, or any other law to the contrary, the 283.8 commissioner of administration may convey all, or any part of, 283.9 the land and associated buildings described in subdivision 3 to 283.10 Anoka county after the commissioner of human services declares 283.11 said property surplus to its needs. 283.12 Subd. 2. [FORM.] (a) The conveyance shall be in a form 283.13 approved by the attorney general. 283.14 (b) The conveyance is subject to a scenic easement, as 283.15 defined in Minnesota Statutes, section 103F.311, subdivision 6, 283.16 to be under the custodial control of the commissioner of natural 283.17 resources, on that portion of the conveyed land that is 283.18 designated for inclusion in the wild and scenic river system 283.19 under Minnesota Statutes, section 103F.325. The scenic easement 283.20 shall allow for continued use of the structures located within 283.21 the easement and for development of a walking path within the 283.22 easement. 283.23 (c) The conveyance shall restrict use of the land to 283.24 governmental, including recreational, purposes and shall provide 283.25 that ownership of any portion of the land that ceases to be used 283.26 for such purposes shall revert to the state of Minnesota. 283.27 (d) The commissioner of administration may convey any part 283.28 of the property described in subdivision 3 any time after the 283.29 land is declared surplus by the commissioner of human services 283.30 and the execution and recording of the scenic easement under 283.31 paragraph (b) has been completed. 283.32 (e) Notwithstanding any law, regulation, or ordinance to 283.33 the contrary, the instrument of conveyance to Anoka county may 283.34 be recorded in the office of the Anoka county recorder without 283.35 compliance with any subdivision requirement. 283.36 Subd. 3. [LAND DESCRIPTION.] Subject to right-of-way for 284.1 Grant Street, Northview Lane, Garfield Street, 5th Avenue, and 284.2 state trunk highway No. 288, also known as 4th Avenue, the land 284.3 to be conveyed may include all, or part of, that which is 284.4 described as follows: 284.5 (1) all that part of Government Lots 3 and 4 and that part 284.6 of the Southeast Quarter of the Southwest Quarter, all in 284.7 Section 31, Township 32 North, Range 24 West, Anoka county, 284.8 Minnesota, described as follows: 284.9 Beginning at the southwest corner of said Southeast Quarter 284.10 of the Southwest Quarter of Section 31; thence North 13 284.11 degrees 16 minutes 11 seconds East, assumed bearing, 473.34 284.12 feet; thence North 07 degrees 54 minutes 43 seconds East 284.13 186.87 feet; thence North 14 degrees 08 minutes 33 seconds 284.14 West 154.77 feet; thence North 62 degrees 46 minutes 44 284.15 seconds West 526.92 feet; thence North 25 degrees 45 284.16 minutes 30 seconds East 74.43 feet; thence northerly 88.30 284.17 feet along a tangential curve concave to the west having a 284.18 radius of 186.15 feet and a central angle of 27 degrees 10 284.19 minutes 50 seconds; thence North 01 degrees 25 minutes 20 284.20 seconds West, tangent to said curve, 140.53 feet; thence 284.21 North 71 degrees 56 minutes 34 seconds West to the 284.22 southeasterly shoreline of the Rum river; thence 284.23 southwesterly along said shoreline to the south line of 284.24 said Government Lot 4; thence easterly along said south 284.25 line to the point of beginning. For the purpose of this 284.26 description the south line of said Southeast Quarter of the 284.27 Southwest Quarter of Section 31 has an assumed bearing of 284.28 North 89 degrees 08 minutes 19 seconds East; 284.29 (2) Government Lot 1, Section 6, Township 31 North, Range 284.30 24 West, Anoka county, Minnesota; EXCEPT that part platted as 284.31 Grant Properties, Anoka county, Minnesota; ALSO EXCEPT that part 284.32 lying southerly of the westerly extension of the south line of 284.33 Block 6, Woodbury's Addition to the city of Anoka, Anoka county, 284.34 Minnesota, and lying westerly of the west line of said plat of 284.35 Grant Properties, said line also being the centerline of 4th 284.36 Avenue; 285.1 (3) all that part of said Block 6, Woodbury's Addition to 285.2 the city of Anoka lying westerly of Northview 1st Addition, 285.3 Anoka county, Minnesota; 285.4 (4) all that part of said Northview 1st Addition lying 285.5 westerly of the east line of Lots 11 through 20, Block 1, 285.6 inclusive, thereof; and 285.7 (5) all that part of the Northeast Quarter of the Northwest 285.8 Quarter of said Section 6, Township 31 North, Range 24 West, 285.9 Anoka county, Minnesota, lying northerly of the centerline of 285.10 Grant Street as defined by said plat of Grant Properties and 285.11 lying westerly of said east line of Lots 11 through 20, Block 1, 285.12 inclusive, Northview 1st Addition and said line's extension 285.13 north and south. 285.14 Subd. 4. [DETERMINATION.] The commissioner of human 285.15 services has determined that the land described in subdivision 3 285.16 will no longer be needed for the Anoka metro regional treatment 285.17 center upon the completion of the state facilities currently 285.18 under construction and the completion of renovation work to 285.19 state buildings that are not located on the land described in 285.20 subdivision 3. The state's land and building management 285.21 interests may best be served by conveying all, or part of, the 285.22 land and associated buildings located on the land described in 285.23 subdivision 3. 285.24 Sec. 2. [CONVEYANCE OF STATE LAND; CROW WING COUNTY.] 285.25 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 285.26 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 285.27 subdivision 3, or any other law to the contrary, the 285.28 commissioner of administration may convey all, or any part of, 285.29 the land and the state building located on the land described in 285.30 subdivision 3, to Crow Wing county after the commissioner of 285.31 human services declares the property surplus to its needs. 285.32 Subd. 2. [FORM.] (a) The conveyance shall be in a form 285.33 approved by the attorney general. 285.34 (b) The conveyance shall restrict use of the land to county 285.35 governmental purposes, including community corrections programs, 285.36 and shall provide that ownership of any portion of the land or 286.1 building that ceases to be used for such purposes shall revert 286.2 to the state of Minnesota. 286.3 Subd. 3. [LAND DESCRIPTION.] That part of the Northeast 286.4 Quarter (NE l/4) of Section 30, Township 45 North, Range 30 286.5 West, Crow Wing county, Minnesota, described as follows: 286.6 Commencing at the southeast corner of said Northeast 286.7 quarter; thence North 00 degrees 46 minutes 05 seconds 286.8 West, bearing based on the Crow Wing county Coordinate 286.9 Database NAD 83/94, 1520.06 feet along the east line of 286.10 said Northeast quarter to the point of beginning; thence 286.11 continue North 00 degrees 46 minutes 05 seconds West 634.14 286.12 feet along said east line of the Northeast quarter; thence 286.13 South 89 degrees 13 minutes 20 seconds West 550.00 feet; 286.14 thence South 18 degrees 57 minutes 23 seconds East 115.59 286.15 feet; thence South 42 degrees 44 minutes 39 seconds East 286.16 692.37 feet; thence South 62 degrees 46 minutes 19 seconds 286.17 East 20.24 feet; thence North 89 degrees 13 minutes 55 286.18 seconds East 33.00 feet to the point of beginning. 286.19 Containing 4.69 acres, more or less. Subject to the 286.20 right-of-way of the Township road along the east side 286.21 thereof, subject to other easements, reservations, and 286.22 restrictions of record, if any. 286.23 Subd. 4. [DETERMINATION.] The commissioner of human 286.24 services has determined that the land, and the building on this 286.25 land, described in subdivision 3 will not be needed for future 286.26 operations of the Brainerd regional human services center. 286.27 ARTICLE 8 286.28 COMPULSIVE GAMBLING 286.29 Section 1. [245.982] [PROGRAM SUPPORT.] 286.30 In order to address the problem of gambling in this state, 286.31 the compulsive gambling fund should attempt to assess the 286.32 beneficiaries of gambling, on a percentage basis according to 286.33 the revenue they receive from gambling, for the costs of 286.34 programs to help problem gamblers and their families. In that 286.35 light, the governor is requested to contact the chairs of the 11 286.36 tribal governments in this state and request a contribution of 287.1 funds for the compulsive gambling program. The governor should 287.2 seek a total supplemental contribution of $643,000. Funds 287.3 received from the tribal governments in this state shall be 287.4 deposited in the Indian gaming revolving account to offset the 287.5 appropriations contained in section 9. 287.6 Sec. 2. [245.983] [PUBLIC AWARENESS.] 287.7 The commissioner of human services shall establish a public 287.8 service campaign using program funds and leveraging media 287.9 contributions to create public awareness of the problems 287.10 associated with gambling. This public service campaign should 287.11 operate in conjunction with other prevention efforts of the 287.12 compulsive gambling program. 287.13 Sec. 3. Minnesota Statutes 1996, section 609.115, 287.14 subdivision 9, is amended to read: 287.15 Subd. 9. [COMPULSIVE GAMBLING ASSESSMENT REQUIRED.] (a) If 287.16 a person is convicted ofa felony fortheft under section 287.17 609.52, embezzlement of public funds under section 609.54, or 287.18 forgery under section 609.625, 609.63, or 609.631, the probation 287.19 officer shall determine in the report prepared under subdivision 287.20 1 whether or not compulsive gambling contributed to the 287.21 commission of the offense. If so, the report shall contain the 287.22 results of a compulsive gambling assessment conducted in 287.23 accordance with this subdivision. The probation officer shall 287.24 make an appointment for the offender to undergo the assessment 287.25 if so indicated. 287.26 (b) The compulsive gambling assessment report must include 287.27 a recommended level of treatment for the offender if the 287.28 assessor concludes that the offender is in need of compulsive 287.29 gambling treatment. The assessment must be conducted by an 287.30 assessor qualified under section 245.98, subdivision 2a, to 287.31 perform these assessments or to provide compulsive gambling 287.32 treatment. An assessor providing a compulsive gambling 287.33 assessment may not have any direct or shared financial interest 287.34 or referral relationship resulting in shared financial gain with 287.35 a treatment provider. If an independent assessor is not 287.36 available, the probation officer may use the services of an 288.1 assessor with a financial interest or referral relationship as 288.2 authorized under rules adopted by the commissioner of human 288.3 services under section 245.98, subdivision 2a. 288.4 (c) The commissioner of human services shall reimburse the 288.5 assessor for the costs associated with a compulsive gambling 288.6 assessment at a rate established by the commissioner up to a 288.7 maximum of $100 for each assessment. The commissioner shall 288.8 reimburse these costs after receiving written verification from 288.9 the probation officer that the assessment was performed and 288.10 found acceptable. 288.11 Sec. 4. Laws 1994, chapter 633, article 7, section 3, is 288.12 amended to read: 288.13 Sec. 3. [INDIAN GAMING REVOLVING ACCOUNT.] 288.14 Funds received from theattorney generalIndian tribal 288.15 governments and the Minnesota state lottery shalldepositbe 288.16 deposited in a separate account in the state treasuryall money288.17received from Indian tribal governmentsfor the purpose of 288.18defraying the attorney general's costs in providing legal288.19services with respect to Indian gaming. Money in the account is288.20appropriated to the attorney general for that288.21purposecontributing to the compulsive gambling program. 288.22 Sec. 5. [PREVALENCE STUDY.] 288.23 The compulsive gambling program shall provide baseline 288.24 prevalence studies to identify those at highest risk of 288.25 developing a compulsive gambling problem, including a 288.26 replication in 1999 of the 1994 adult prevalence survey. 288.27 Sec. 6. [BANKRUPTCY STUDY.] 288.28 The commissioner of human services, in consultation with 288.29 the attorney general and commissioner of commerce, shall study 288.30 changes in financial, bankruptcy, and credit laws that would 288.31 protect innocent victims who are financially linked to a 288.32 compulsive gambler, and shall report to the legislature by 288.33 December 15, 1998. 288.34 Sec. 7. [EXTENDING ASSESSMENTS TO BANKRUPTCY AND FAMILY 288.35 COURT PROCEEDINGS.] 288.36 The commissioner of human services shall study whether 289.1 problem gambling assessments should be provided or required for 289.2 individuals involved in bankruptcy or family court proceedings, 289.3 and report to the legislature by December 15, 1998. 289.4 Sec. 8. [HEALTH CARE.] 289.5 The commissioners of health and commerce shall report to 289.6 the legislature by December 15, 1998, on whether compulsive 289.7 gambling treatment should be considered a addictive disorder 289.8 treatment under current health care statutes. 289.9 Sec. 9. [COMPULSIVE GAMBLING APPROPRIATIONS.] 289.10 In addition to any other appropriations, $332,000 is 289.11 appropriated in fiscal year 1999 from the Minnesota lottery 289.12 prize fund for the compulsive gambling program. In addition, up 289.13 to $643,000 is appropriated from the lottery prize fund to the 289.14 compulsive gambling program if funds required under Minnesota 289.15 Statutes, section 245.982, are not available. The funds are 289.16 appropriated from the Indian gaming revolving account to the 289.17 commissioner of human services, unless otherwise specified below. 289.18 Of the funds appropriated under this section, $670,000 in 289.19 fiscal year 1999 is appropriated to the commissioner of human 289.20 services for the establishment of fee-for-service projects. 289.21 Fee-for-service funds under this appropriation may be awarded on 289.22 a per-client basis to existing treatment centers and may be in 289.23 addition to grants the centers currently receive. Baseline 289.24 grants based on the last fiscal year client numbers and units of 289.25 services provided constitute minimum appropriations to existing 289.26 treatment centers, and upon meeting the contracted level of 289.27 services, the treatment centers are eligible for fee-for-service 289.28 funds on a per-client basis in addition to grants. 289.29 Of the funds appropriated under this section, $20,000 in 289.30 fiscal year 1999 is appropriated to the commissioner of human 289.31 services for purposes of the bankruptcy study under section 6 289.32 and the bankruptcy and family court assessment study under 289.33 section 7, and $10,000 in fiscal year 1999 is appropriated to 289.34 the commissioner of health for purposes of the health care study 289.35 under section 8. 289.36 Of the funds appropriated under this section, $225,000 in 290.1 fiscal year 1999 is appropriated for the operation of prevention 290.2 and education programs aimed at helping adult and adolescent 290.3 gamblers, and for the completion of a prevalence study 290.4 replication; of the appropriation under this paragraph, up to 290.5 $50,000 may be appropriated to the commissioner of human 290.6 services for purposes of the public awareness campaign under 290.7 section 2. 290.8 Of the funds appropriated under this section, $50,000 in 290.9 fiscal year 1999 is appropriated for operation of the hotline. 290.10 Sec. 10. [APPROPRIATION.] 290.11 Subdivision 1. [PROJECT TURNABOUT.] $500,000 is 290.12 appropriated for fiscal year 1999 to the commissioner of human 290.13 services from the Minnesota lottery prize fund to be used for 290.14 Project Turnabout in Granite Falls. This appropriation shall 290.15 not become part of the base appropriation for the 2000-2001 290.16 biennium. 290.17 Subd. 2. [LOCAL MATCH.] There must be a local match before 290.18 money appropriated is released by the commissioner to Project 290.19 Turnabout. The facility shall receive state funds equal to the 290.20 amount of local matching funds received.