Minnesota Legislature
SF 3346
2nd Unofficial Engrossment - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
1.1 A bill for an act 1.2 relating to human services; changing provisions for 1.3 health insurance, health programs, and health 1.4 professions; providing for recording and providing of 1.5 abortion data; prohibiting partial-birth abortions; 1.6 changing provisions in long-term care, MA, GAMC, 1.7 MinnesotaCare, welfare provisions, Work First 1.8 assistance programs, child support licensing, and 1.9 tribal child care assistance; providing for the 1.10 conveyance of state land; providing for criminal 1.11 penalties; appropriating money; amending Minnesota 1.12 Statutes 1996, sections 62A.65, subdivision 5; 1.13 62D.042, subdivision 2; 62E.16; 144.701, subdivisions 1.14 1, 2, and 4; 144.702, subdivisions 1, 2, and 8; 1.15 144.9501, subdivisions 1, 17, 18, 20, 23, 30, 32, and 1.16 by adding subdivisions; 144.9502, subdivisions 3, 4, 1.17 and 9; 144.9503, subdivisions 4, 6, and 7; 144.9504, 1.18 subdivisions 1, 3, 4, 5, 6, 7, 8, 9, and 10; 144.9505, 1.19 subdivisions 1, 4, and 5; 144.9506, subdivision 2; 1.20 144.9507, subdivisions 2, 3, and 4; 144.9508, 1.21 subdivisions 1, 3, 4, and by adding a subdivision; 1.22 144.9509, subdivision 2; 144.99, subdivision 1; 1.23 144A.04, subdivision 5; 144A.09, subdivision 1; 1.24 144A.44, subdivision 2; 145.411, by adding a 1.25 subdivision; 145A.15, subdivision 2; 148.66; 148.67; 1.26 148.70; 148.705; 148.71; 148.72, subdivisions 1, 2, 1.27 and 4; 148.73; 148.74; 148.75; 148.76; 148.78; 214.01, 1.28 subdivision 2; 214.03; 245.462, subdivisions 4 and 8; 1.29 245.4871, subdivision 4; 245A.03, by adding 1.30 subdivisions; 245A.14, subdivision 4; 254A.17, 1.31 subdivision 1, and by adding a subdivision; 256.014, 1.32 subdivision 1; 256.969, subdivisions 16, 17, and by 1.33 adding a subdivision; 256B.03, subdivision 3; 1.34 256B.055, by adding a subdivision; 256B.057, 1.35 subdivision 3a, and by adding subdivisions; 256B.0625, 1.36 subdivisions 20, 34, 38, and by adding a subdivision; 1.37 256B.0911, subdivision 4; 256B.41, subdivision 1; 1.38 256B.431, subdivisions 2b, 2i, 11, and by adding 1.39 subdivisions; 256B.501, subdivision 2; 256B.69, by 1.40 adding a subdivision; 256D.03, subdivision 4, and by 1.41 adding a subdivision; 256D.051, by adding a 1.42 subdivision; 256D.46, subdivision 2; 268.88; and 1.43 268.92, subdivision 4; Minnesota Statutes 1997 1.44 Supplement, sections 60A.15, subdivision 1; 62D.11, 1.45 subdivision 1; 62J.69, subdivisions 1, 2, and by 1.46 adding a subdivision; 62J.70, subdivision 3; 62J.71, 2.1 subdivisions 1, 3, and 4; 62J.72, subdivision 1; 2.2 62Q.105, subdivision 1; 62Q.30; 103I.208, subdivision 2.3 2; 119B.01, subdivision 16; 119B.02; 144.1494, 2.4 subdivision 1; 144.9504, subdivision 2; 144.9506, 2.5 subdivision 1; 144A.071, subdivision 4a; 144A.46, 2.6 subdivision 2; 144A.4605, subdivision 4; 171.29, 2.7 subdivision 2; 214.32, subdivision 1; 256.01, 2.8 subdivision 2; 256.031, subdivision 6; 256.741, by 2.9 adding a subdivision; 256.9657, subdivision 3; 2.10 256.9685, subdivision 1; 256.9864; 256B.04, 2.11 subdivision 18; 256B.06, subdivision 4; 256B.062; 2.12 256B.0625, subdivision 31a; 256B.0627, subdivisions 5 2.13 and 8; 256B.0635, by adding a subdivision; 256B.0645; 2.14 256B.0911, subdivisions 2 and 7; 256B.0915, 2.15 subdivision 1d; 256B.0951, by adding a subdivision; 2.16 256B.431, subdivisions 3f and 26; 256B.69, 2.17 subdivisions 2 and 3a; 256B.692, subdivisions 2 and 5; 2.18 256B.77, subdivisions 3, 7a, 10, and 12; 256D.03, 2.19 subdivision 3; 256D.05, subdivision 8; 256F.05, 2.20 subdivision 8; 256J.02, subdivision 4; 256J.03; 2.21 256J.08, subdivisions 11, 26, 28, 40, 60, 68, 73, 83, 2.22 and by adding subdivisions; 256J.09, subdivisions 6 2.23 and 9; 256J.11, subdivision 2, as amended; 256J.12; 2.24 256J.14; 256J.15, subdivision 2; 256J.20, subdivisions 2.25 2 and 3; 256J.21; 256J.24, subdivisions 1, 2, 3, 4, 2.26 and by adding subdivisions; 256J.26, subdivisions 1, 2.27 2, 3, and 4; 256J.28, subdivisions 1, 2, and by adding 2.28 a subdivision; 256J.30, subdivisions 10 and 11; 2.29 256J.31, subdivisions 5, 10, and by adding a 2.30 subdivision; 256J.32, subdivisions 4, 6, and by adding 2.31 a subdivision; 256J.33, subdivisions 1 and 4; 256J.35; 2.32 256J.36; 256J.37, subdivisions 1, 2, 9, and by adding 2.33 subdivisions; 256J.38, subdivision 1; 256J.39, 2.34 subdivision 2; 256J.395; 256J.42; 256J.43; 256J.44, by 2.35 adding a subdivision; 256J.45, subdivisions 1, 2, and 2.36 by adding a subdivision; 256J.46, subdivisions 1 and 2.37 2; 256J.47, subdivision 4; 256J.48, subdivisions 2 and 2.38 3; 256J.50, subdivision 5, and by adding a 2.39 subdivision; 256J.515; 256J.52, subdivisions 2, 3, 4, 2.40 and by adding subdivisions; 256J.54, subdivisions 2, 2.41 3, 4, and 5; 256J.55, subdivision 5; 256J.56; 256J.57, 2.42 subdivision 1; 256J.74, subdivision 2, and by adding a 2.43 subdivision; 256K.03, subdivision 5; 256L.01; 256L.02, 2.44 subdivision 3, and by adding a subdivision; 256L.03, 2.45 subdivisions 1, 3, 4, 5, and by adding subdivisions; 2.46 256L.04, subdivisions 1, 2, 7, 8, 9, 10, and by adding 2.47 subdivisions; 256L.05, subdivisions 2, 3, 4, and by 2.48 adding subdivisions; 256L.06, subdivision 3; 256L.07, 2.49 subdivisions 2 and 3; 256L.09, subdivisions 2, 4, and 2.50 6; 256L.11, subdivision 6; 256L.12, subdivision 5; 2.51 256L.15; and 256L.17, by adding a subdivision; Laws 2.52 1997, chapter 195, section 5; chapter 203, article 1, 2.53 section 2, subdivisions 5 and 12; article 4, section 2.54 64; chapter 207, section 7; chapter 225, article 2, 2.55 section 64; chapter 248, section 46, as amended; 2.56 proposing coding for new law in Minnesota Statutes, 2.57 chapters 62J; 62Q; 144; 145; 148; 256; 256B; 256D; 2.58 256J; and 256L; proposing coding for new law as 2.59 Minnesota Statutes, chapter 256M; repealing Minnesota 2.60 Statutes 1996, sections 144.0721, subdivision 3a; 2.61 144.491; 144.9501, subdivisions 12, 14, and 16; 2.62 144.9503, subdivisions 5, 8, and 9; 256.031, as 2.63 amended; 256.032; 256.033, as amended; 256.034; 2.64 256.035; 256.036; 256.0361; 256.047; 256.0475; 2.65 256.048; and 256.049; Minnesota Statutes 1997 2.66 Supplement, sections 62D.042, subdivision 3; 144.0721, 2.67 subdivision 3; 256B.057, subdivision 1a; 256B.062; 2.68 256B.0913, subdivision 15; 256J.25; 256J.28, 2.69 subdivision 4; 256J.32, subdivision 5; 256J.34, 2.70 subdivision 5; 256L.04, subdivisions 3, 4, 5, and 6; 2.71 256L.06, subdivisions 1 and 2; 256L.08; 256L.09, 3.1 subdivision 3; 256L.13; 256L.14; and 256L.15, 3.2 subdivision 3; Laws 1997, chapter 85, article 1, 3.3 sections 61 and 71; article 3, section 55; Minnesota 3.4 Rules (exempt), parts 2740.1600, subpart 1; and 3.5 9500.9100 to 9500.9220. 3.6 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.7 ARTICLE 1 3.8 APPROPRIATIONS 3.9 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 3.10 The sums in the columns headed "APPROPRIATIONS" are 3.11 appropriated or reductions from appropriations from the general 3.12 fund, or another named fund, to the agencies and for the 3.13 purposes specified to be available for the fiscal years 3.14 indicated for each purpose. 3.15 SUMMARY BY FUND 3.16 1998 1999 3.17 General $ (118,953,000)$ (110,073,000) 3.18 State Government Special 3.19 Revenue Fund 113,000 90,000 3.20 Special Revenue Fund -0- 400,000 3.21 Health Care Access 6,616,000 (1,161,000) 3.22 APPROPRIATIONS 3.23 Available for the Year 3.24 Ending June 30 3.25 1998 1999 3.26 Sec. 2. COMMISSIONER OF HUMAN SERVICES 3.27 Subdivision 1. Total 3.28 Appropriation (112,337,000) (130,101,000) 3.29 Summary by Fund 3.30 1998 1999 3.31 General (118,953,000) (129,081,000) 3.32 Special Revenue 3.33 Fund -0- 400,000 3.34 Health Care Access 6,616,000 (1,420,000) 3.35 Subd. 2. Children's Grants 3.36 General -0- 1,665,000 3.37 [CHILDREN'S MENTAL HEALTH SERVICES.] 3.38 (a) Of this appropriation, $200,000 in 3.39 fiscal year 1999 is from the general 3.40 fund for the commissioner to award 3.41 grants to counties that have a 3.42 relatively low net tax capacity to 3.43 provide children's mental health 3.44 services to children and families 3.45 residing outside of a metropolitan 4.1 statistical area, as that term is 4.2 defined by the United States Census 4.3 Bureau. Funds shall be used to provide 4.4 services according to an individual 4.5 family community support plan as 4.6 described in Minnesota Statutes, 4.7 section 245.4881, subdivision 4. The 4.8 plan must be developed using a process 4.9 that enhances consumer empowerment. 4.10 Counties with an approved children's 4.11 mental health collaborative may 4.12 integrate funds appropriated for fiscal 4.13 years 1998 and 1999 with existing funds 4.14 to meet the needs identified in the 4.15 child's individual family community 4.16 support plan. 4.17 (b) In awarding grants to counties 4.18 under this provision, the commissioner 4.19 shall follow the process established in 4.20 Minnesota Statutes, section 245.4886, 4.21 subdivision 2. The commissioner shall 4.22 give priority for funding to counties 4.23 that continued to spend for mental 4.24 health services specified in Minnesota 4.25 Statutes, sections 245.461 to 245.486 4.26 and 245.487 to 245.4888, according to 4.27 generally accepted accounting 4.28 principles, in an amount equal to the 4.29 total expenditures shown in the 4.30 county's approved 1987 CSSA plan for 4.31 services to persons with mental illness 4.32 plus the comparable figure for 4.33 facilities licensed under Minnesota 4.34 Rules, chapter 9545, for target 4.35 populations other than mental illness 4.36 in the county's approved 1989 CSSA 4.37 plan. The commissioner shall ensure 4.38 that grant funds are not used to 4.39 replace existing funds. 4.40 [TECHNICAL ASSISTANCE FOR CRISIS 4.41 NURSERIES.] Of this appropriation, 4.42 $200,000 in fiscal year 1999 is from 4.43 the general fund for the commissioner 4.44 to contract for technical assistance 4.45 with counties that are interested in 4.46 developing a crisis nursery program. 4.47 The technical assistance must be 4.48 designed to assist interested counties 4.49 in building capacity to develop and 4.50 maintain a crisis nursery program in 4.51 the county. The grant amount to a 4.52 county must range from $10,000 to 4.53 $20,000. To be eligible to receive a 4.54 grant under this program, the county 4.55 must not have an existing crisis 4.56 nursery program and must not be a 4.57 metropolitan county, as that term is 4.58 defined in Minnesota Statutes 1996, 4.59 section 473.121. This appropriation 4.60 shall not become part of the base for 4.61 the 2000-2001 biennial budget. 4.62 [PRIMARY SUPPORT TO IMPLEMENT THE 4.63 INDIAN FAMILY PRESERVATION ACT.] For 4.64 fiscal year 1998, $100,000 of federal 4.65 funds are transferred from the state's 4.66 federal TANF block grant and added to 4.67 the state's allocation of federal Title 4.68 XX block grant funds. Notwithstanding 5.1 the provisions of Minnesota Statutes 5.2 1997 Supplement, section 256E.07, the 5.3 commissioner shall use $100,000 of the 5.4 state's Title XX block grant funds for 5.5 a grant under Minnesota Statutes, 5.6 section 257.3571, subdivision 1, to an 5.7 Indian organization licensed as an 5.8 adoption agency. The grant must be 5.9 used to provide primary support for 5.10 implementation of the Minnesota Indian 5.11 Family Preservation Act and compliance 5.12 with the Indian Child Welfare Act. 5.13 This appropriation must be used 5.14 according to the requirements of the 5.15 amendments to section 404(d)(3)(B) of 5.16 Part A of Title IV of the Social 5.17 Security Act in Public Law Number 5.18 104-193. This appropriation is 5.19 available until June 30, 1999. 5.20 [ADOPTION ASSISTANCE CARRYFORWARD.] Of 5.21 the appropriation in Laws 1997, chapter 5.22 203, section 2, subdivision 3, for 5.23 children's grants for fiscal year 1998, 5.24 $600,000 of the amount appropriated for 5.25 the adoption assistance program is 5.26 available for the same purpose in 5.27 fiscal year 1999. The amount carried 5.28 forward shall become part of the base 5.29 for the adoption assistance program in 5.30 the 2000-2001 biennial budget. 5.31 [FAMILY PRESERVATION PROGRAM FUNDING.] 5.32 $10,000,000 is transferred in fiscal 5.33 year 1999 from the state's federal TANF 5.34 block grant to the state's federal 5.35 Title XX block grant. Notwithstanding 5.36 the provisions of Minnesota Statutes 5.37 1997 Supplement, section 256E.07, in 5.38 fiscal year 1999 the commissioner shall 5.39 transfer $10,000,000 of the state's 5.40 Title XX block grant funds to the 5.41 family preservation program under 5.42 Minnesota Statutes, chapter 256F. Of 5.43 the total amount transferred, the 5.44 commissioner shall allocate $8,800,000 5.45 to counties for the purposes of the 5.46 child protection assessments or 5.47 investigations community collaboration 5.48 pilot program under Minnesota Statutes, 5.49 section 626.5560. The commissioner 5.50 shall allocate $750,000 to counties for 5.51 the concurrent permanency planning 5.52 pilot program under Minnesota Statutes, 5.53 section 257.0711. The commissioner 5.54 shall transfer $200,000 to the 5.55 commissioner of health for the program 5.56 under Minnesota Statutes, section 5.57 145A.15, that funds home visiting 5.58 projects. The commissioner may retain 5.59 up to $250,000 of the total amount 5.60 transferred to conduct evaluations of 5.61 these pilot programs. The 5.62 commissioners shall ensure that money 5.63 allocated to counties under this 5.64 provision must be used in accordance 5.65 with the requirements of the amendments 5.66 to section 404(d)(3)(B) of Part A of 5.67 Title IV of the Social Security Act in 5.68 Public Law Number 104-193. This is a 5.69 one-time appropriation that shall not 6.1 be added to the base for the family 6.2 preservation program for the 2000-2001 6.3 biennial budget. 6.4 Subd. 3. Children's Services 6.5 Management 6.6 General -0- -0- 6.7 Special Revenue Fund -0- 400,000 6.8 [SOCIAL SERVICES INFORMATION SYSTEM.] 6.9 Of the appropriation authorized under 6.10 Minnesota Statutes, section 256.014, 6.11 subdivision 2, $400,000 in fiscal year 6.12 1999 is for the purposes of the 6.13 training and implementation costs 6.14 associated with the social services 6.15 information system project. 6.16 Subd. 4. Basic Health Care 6.17 Grants 6.18 General (74,679,000) (90,243,000) 6.19 Health Care Access 6,808,000 (4,278,000) 6.20 The amounts that may be spent from this 6.21 appropriation for each purpose are as 6.22 follows: 6.23 (a) MinnesotaCare Grants 6.24 Health Care Access 6,808,000 (4,278,000) 6.25 (b) MA Basic Health Care Grants; 6.26 Families and Children 6.27 General (23,231,000) (38,644,000) 6.28 Of this appropriation, $100,000 in 6.29 fiscal year 1999 is from the general 6.30 fund to the commissioner for the 6.31 post-kidney transplant drug program. 6.32 This appropriation shall not cancel, 6.33 but is available until expended. 6.34 [JANUARY 1, 1999 PROVIDER RATE INCREASE 6.35 FOR CERTAIN SERVICES.] (a) Effective 6.36 for services rendered on or after 6.37 January 1, 1999, the commissioner shall 6.38 increase reimbursement or allocation 6.39 rates by five percent, and county 6.40 boards shall adjust provider contracts 6.41 as needed, for mental health services 6.42 provided by community mental health 6.43 centers under Minnesota Statutes, 6.44 sections 245.62 and 256B.0625, 6.45 subdivision 5, and for community 6.46 support services for deaf and 6.47 hard-of-hearing adults with mental 6.48 illness who use or wish to use sign 6.49 language as their primary means of 6.50 communication. The commissioner shall 6.51 also increase prepaid medical 6.52 assistance program capitation rates as 6.53 appropriate to reflect the rate 6.54 increases in this provision. Section 6.55 10, sunset of uncodified language, does 6.56 not apply to this provision. 7.1 (b) It is the intention of the 7.2 legislature that the compensation 7.3 packages of staff within each service 7.4 be increased by five percent. 7.5 (c) MA Basic Health Care Grants; 7.6 Elderly and Disabled 7.7 General (23,819,000) (41,964,000) 7.8 [REGION 10 COMMISSION CARRYOVER 7.9 AUTHORITY.] Any unspent portion of the 7.10 appropriation to the commissioner of 7.11 human services in Laws 1997, chapter 7.12 203, article 1, section 2, subdivision 7.13 9, for the region 10 quality assurance 7.14 commission for fiscal year 1998 shall 7.15 not cancel but shall be available for 7.16 the commission for fiscal year 1999. 7.17 [DD CRISIS INTERVENTION PROJECT.] Of 7.18 this appropriation, $150,000 in fiscal 7.19 year 1999 is from the general fund to 7.20 the commissioner for start-up operating 7.21 and training costs for the action, 7.22 support, and prevention project of 7.23 southeastern Minnesota. This 7.24 appropriation is to provide crisis 7.25 intervention through community-based 7.26 services in the private sector to 7.27 persons with developmental disabilities 7.28 under Laws 1995, chapter 207, article 7.29 3, section 22. 7.30 [PRESCRIPTION DRUG BENEFIT.] (a) If, by 7.31 September 15, 1998, federal approval is 7.32 obtained to provide a prescription drug 7.33 benefit for qualified Medicare 7.34 beneficiaries at no less than 100 7.35 percent of the federal poverty 7.36 guidelines and service-limited Medicare 7.37 beneficiaries under Minnesota Statutes, 7.38 section 256B.057, subdivision 3a, at no 7.39 less than 120 percent of federal 7.40 poverty guidelines, the commissioner of 7.41 human services shall not implement the 7.42 senior citizen drug program under 7.43 Minnesota Statutes, section 256.955, 7.44 but shall implement a drug benefit in 7.45 accordance with the approved waiver. 7.46 Upon approval of this waiver, the total 7.47 appropriation for the senior citizen 7.48 drug program under Laws 1997, chapter 7.49 225, article 7, section 2, shall be 7.50 transferred to the medical assistance 7.51 account to fund the federally approved 7.52 coverage for eligible persons for 7.53 fiscal year 1999. 7.54 (b) The commissioner may seek approval 7.55 for a higher copayment for eligible 7.56 persons above 100 percent of the 7.57 federal poverty guidelines. 7.58 (c) The commissioner shall report by 7.59 October 15, 1998, to the chairs of the 7.60 health and human services policy and 7.61 fiscal committees of the house and 7.62 senate whether the waiver referred to 7.63 in paragraph (a) has been approved and 7.64 will be implemented or whether the 8.1 state senior citizen drug program will 8.2 be implemented. 8.3 (d) If the commissioner does not 8.4 receive federal waiver approval at or 8.5 above the level of eligibility defined 8.6 in paragraph (a), the commissioner 8.7 shall implement the program under 8.8 Minnesota Statutes, section 256.955. 8.9 (d) General Assistance 8.10 Medical Care 8.11 General (27,629,000) (9,635,000) 8.12 Subd. 5. Basic Health Care 8.13 Management 8.14 General -0- 261,000 8.15 Health Care Access (192,000) 1,774,000 8.16 The amounts that may be spent from this 8.17 appropriation for each purpose are as 8.18 follows: 8.19 (a) Health Care Policy 8.20 Administration 8.21 General -0- 173,000 8.22 Health Care Access (192,000) 37,000 8.23 [DELAY IN TRANSFERRING GAMC CLIENTS.] 8.24 Due to delaying the transfer of GAMC 8.25 clients to MinnesotaCare until January 8.26 1, 2000, $192,000 in fiscal year 1998 8.27 health care access fund administrative 8.28 funds, appropriated in Laws 1997, 8.29 chapter 225, article 7, section 2, 8.30 subdivision 1, are canceled. 8.31 [MINNESOTACARE OUTREACH.] Unexpended 8.32 money in fiscal year 1998 for 8.33 MinnesotaCare outreach activities 8.34 appropriated in Laws 1997, chapter 225, 8.35 article 7, section 2, subdivision 1, 8.36 does not cancel, but is available for 8.37 those purposes in fiscal year 1999. 8.38 [HEALTH CARE MANUAL PRODUCTION COSTS.] 8.39 For the biennium ending June 30, 1999, 8.40 the money difference between the cost 8.41 of producing and distributing the 8.42 department of human services health 8.43 care manual, and the fees paid by 8.44 individuals and private entities on 8.45 January 1, 1998, is appropriated to the 8.46 commissioner to defray manual 8.47 production and distribution costs. The 8.48 commissioner must provide the health 8.49 care manual to government agencies and 8.50 nonprofit agencies serving the legal 8.51 and social service needs of clients at 8.52 no cost to those agencies. 8.53 [TRANSFER.] For fiscal years 2000 and 8.54 2001, the commissioner of finance shall 8.55 transfer from the health care access 8.56 fund to the general fund an amount to 8.57 cover the expenditures associated with 9.1 the services provided to pregnant women 9.2 and children under the age of two 9.3 enrolled in the MinnesotaCare program. 9.4 Notwithstanding section 10, this 9.5 provision expires on July 1, 2001. 9.6 [FEDERAL CONTINGENCY RESERVE LIMIT.] 9.7 Notwithstanding Minnesota Statutes, 9.8 section 16A.76, subdivision 2, the 9.9 federal contingency reserve limit shall 9.10 be reduced for fiscal years 2000 and 9.11 2001 by the cumulative amount of the 9.12 expenditures associated with services 9.13 provided to pregnant women and children 9.14 enrolled in the MinnesotaCare program 9.15 in these fiscal years. Notwithstanding 9.16 section 10, this provision expires on 9.17 July 1, 2001. 9.18 (b) Health Care Operations 9.19 General -0- 88,000 9.20 Health Care Access -0- 1,737,000 9.21 Subd. 6. State-Operated 9.22 Services 9.23 General -0- 700,000 9.24 The amounts that may be spent from this 9.25 appropriation for each purpose are as 9.26 follows: 9.27 RTC Facilities 9.28 General -0- 700,000 9.29 [LEAVE LIABILITIES.] The accrued leave 9.30 liabilities of state employees 9.31 transferred to state-operated community 9.32 services programs may be paid from the 9.33 appropriation for state-operated 9.34 services in Laws 1997, chapter 203, 9.35 article 1, section 2, subdivision 7, 9.36 paragraph (a). Funds set aside for 9.37 this purpose shall not exceed the 9.38 amount of the actual leave liability 9.39 calculated as of June 30, 1999, and 9.40 shall be available until expended. 9.41 This provision is effective the day 9.42 following final enactment. 9.43 Subd. 7. Continuing Care and 9.44 Community Support Grants 9.45 General (35,100,000) (12,087,000) 9.46 The amounts that may be spent from this 9.47 appropriation for each purpose are as 9.48 follows: 9.49 (a) Community Services Block 9.50 Grant 9.51 General 130,000 -0- 9.52 [WILKIN COUNTY.] Of this appropriation, 9.53 $130,000 for fiscal year 1998 is to 9.54 reimburse Wilkin county for 9.55 flood-related human services and public 10.1 health costs which cannot be reimbursed 10.2 through any other source. 10.3 (b) Mental Health Grants 10.4 General 300,000 2,144,000 10.5 [PLANNING GRANT FOR PROSTITUTION 10.6 RECOVERY CENTER.] Of this 10.7 appropriation, $50,000 in fiscal year 10.8 1999 is from the general fund to the 10.9 commissioner for a planning grant to 10.10 enable an organization to develop a 10.11 long-term treatment program for women 10.12 escaping systems of prostitution. 10.13 [COMPULSIVE GAMBLING CARRYFORWARD.] 10.14 Unexpended funds appropriated to the 10.15 commissioner for compulsive gambling 10.16 programs for fiscal year 1998 do not 10.17 cancel but are available for these 10.18 purposes for fiscal year 1999. 10.19 [FLOOD COSTS.] Of this appropriation, 10.20 $300,000 in fiscal year 1998 and 10.21 $1,000,000 in fiscal year 1999 is from 10.22 the general fund to the commissioner 10.23 for the purpose of continuing 10.24 initiatives funded by Federal Emergency 10.25 Management Agency (FEMA) mental health 10.26 care grants beyond April 15, 1998. 10.27 This appropriation is available until 10.28 June 30, 1999. This provision is 10.29 effective April 15, 1998, if FEMA does 10.30 not extend these mental health care 10.31 grants beyond April 15, 1998. 10.32 (c) Deaf and Hard-of-hearing 10.33 Grants 10.34 General -0- 81,000 10.35 [SERVICES TO DEAF PERSONS WITH MENTAL 10.36 ILLNESS.] Of this appropriation, 10.37 $65,000 in fiscal year 1999 is from the 10.38 general fund to the commissioner for a 10.39 grant to a nonprofit agency that 10.40 currently serves deaf and 10.41 hard-of-hearing adults with mental 10.42 illness through residential programs 10.43 and supported housing outreach 10.44 activities. The grant must be used to 10.45 continue or maintain community support 10.46 services for deaf and hard-of-hearing 10.47 adults with mental illness who use or 10.48 wish to use sign language as their 10.49 primary means of communication. This 10.50 appropriation is in addition to the 10.51 appropriation in Laws 1997, chapter 10.52 203, article 1, section 2, subdivision 10.53 8, paragraph (d), for a grant to this 10.54 nonprofit agency. 10.55 (d) DD Community Support Grants 10.56 General -0- 41,000 10.57 (e) Aging and Adult 10.58 Services 10.59 General -0- 100,000 11.1 (f) Medical Assistance Long-term 11.2 Care Waivers and Home Care 11.3 General (8,463,000) (13,096,000) 11.4 [JANUARY 1, 1999, PROVIDER RATE 11.5 INCREASE.] (a) Effective for services 11.6 rendered on or after January 1, 1999, 11.7 the commissioner shall increase 11.8 reimbursement or allocation rates by 11.9 1.25 percent, and county boards shall 11.10 adjust provider contracts as needed, 11.11 for home and community-based waiver 11.12 services for persons with mental 11.13 retardation or related conditions under 11.14 Minnesota Statutes, section 256B.501; 11.15 home and community-based waiver 11.16 services for the elderly under 11.17 Minnesota Statutes, section 256B.0915; 11.18 nursing services and home health 11.19 services under Minnesota Statutes, 11.20 section 256B.0625, subdivision 6a; 11.21 personal care services and nursing 11.22 supervision of personal care services 11.23 under Minnesota Statutes, section 11.24 256B.0625, subdivision 19a; private 11.25 duty nursing services under Minnesota 11.26 Statutes, section 256B.0625, 11.27 subdivision 7; day training and 11.28 habilitation services for adults with 11.29 mental retardation or related 11.30 conditions under Minnesota Statutes, 11.31 sections 252.40 to 252.47; physical 11.32 therapy services under Minnesota 11.33 Statutes, sections 256B.0625, 11.34 subdivision 8, and 256D.03, subdivision 11.35 4; occupational therapy services under 11.36 Minnesota Statutes, sections 256B.0625, 11.37 subdivision 8a, and 256D.03, 11.38 subdivision 4; speech-language therapy 11.39 services under Minnesota Statutes, 11.40 section 256D.03, subdivision 4, and 11.41 Minnesota Rules, part 9505.0390; 11.42 respiratory therapy services under 11.43 Minnesota Statutes, section 256D.03, 11.44 subdivision 4, and Minnesota Rules, 11.45 part 9505.0295; family community 11.46 support grants under Minnesota Rules, 11.47 parts 9535.1700 to 9535.1760; and 11.48 semi-independent living services under 11.49 Minnesota Statutes, section 252.275, 11.50 including SILS funding under county 11.51 social services grants formerly funded 11.52 under Minnesota Statutes, chapter 11.53 256I. The commissioner shall also 11.54 increase prepaid medical assistance 11.55 program capitation rates as appropriate 11.56 to reflect the rate increases in this 11.57 provision. Section 10, sunset of 11.58 uncodified language, does not apply to 11.59 this provision. 11.60 (b) It is the intention of the 11.61 legislature that the compensation 11.62 packages of staff within each service 11.63 be increased by 1.25 percent. 11.64 (g) Medical Assistance Long-term 11.65 Care Facilities 11.66 General (18,272,000) (6,477,000) 12.1 [ICF/MR DISALLOWANCES.] Of this 12.2 appropriation, $65,000 in fiscal year 12.3 1999 is from the general fund to the 12.4 commissioner for the purpose of 12.5 reimbursing a 12-bed ICF/MR in Stearns 12.6 county and a 12-bed ICF/MR in Sherburne 12.7 county for disallowances resulting from 12.8 field audit findings. The commissioner 12.9 shall exempt these facilities from the 12.10 provisions of Minnesota Statutes, 12.11 section 256B.501, subdivision 5b, 12.12 paragraph (d), clause (6), for the rate 12.13 years beginning October 1, 1997, and 12.14 October 1, 1998. Section 10, sunset of 12.15 uncodified language, does not apply to 12.16 this provision. 12.17 [NURSING HOME MORATORIUM EXCEPTIONS.] 12.18 Base level funding for medical 12.19 assistance long-term care facilities is 12.20 increased by $255,000 in fiscal year 12.21 2000 and by $278,000 in fiscal year 12.22 2001 for the additional medical 12.23 assistance costs of the nursing home 12.24 moratorium exceptions under Minnesota 12.25 Statutes 1997 Supplement, section 12.26 144A.071, subdivision 4a, paragraphs 12.27 (w) and (x). Notwithstanding the 12.28 provisions of section 10, sunset of 12.29 uncodified language, this provision 12.30 shall not expire. 12.31 [ICFs/MR AND NURSING FACILITY 12.32 FLOOD-RELATED REPORTING.] For the 12.33 reporting year ending December 31, 12.34 1997, for ICFs/MR that temporarily 12.35 admitted victims of the flood of 1997, 12.36 the resident days related to those 12.37 temporary placements (persons not 12.38 formally admitted which continued to be 12.39 billed under the evacuated facility's 12.40 provider number) shall not be counted 12.41 in the cost report submitted to 12.42 calculate October 1, 1998, rates, and 12.43 the additional expenditures shall be 12.44 considered nonallowable. 12.45 For the reporting year ending September 12.46 30, 1997, for nursing facilities that 12.47 temporarily admitted victims of the 12.48 flood of 1997, the resident days 12.49 related to those temporary placements 12.50 (persons not formally admitted which 12.51 continued to be billed under the 12.52 evacuated facility's provider number) 12.53 shall not be counted in the cost report 12.54 submitted to calculate July 1, 1998, 12.55 rates, and the additional expenditures 12.56 shall be considered nonallowable. 12.57 (h) Alternative Care Grants 12.58 General -0- 21,666,000 12.59 (i) Group Residential Housing 12.60 General (8,795,000) (9,447,000) 12.61 (j) Chemical Dependency 12.62 Entitlement Grants 13.1 General -0- (7,498,000) 13.2 (k) Chemical Dependency 13.3 Nonentitlement Grants 13.4 General -0- 400,000 13.5 [MATCHING GRANT FOR YOUTH ALCOHOL 13.6 TREATMENT.] Of this appropriation, 13.7 $400,000 in fiscal year 1999 is from 13.8 the general fund for the commissioner 13.9 to provide a grant to the board of 13.10 directors of the Minnesota Indian 13.11 Primary Residential Treatment Center, 13.12 Inc., to build a youth alcohol 13.13 treatment wing at the Mash-Ka-Wisen 13.14 Treatment Center. This appropriation 13.15 is available only if matched by a 13.16 $1,500,000 federal grant and a $100,000 13.17 grant from state Indian bands. 13.18 [MATCHING GRANT FOR PROJECT TURNABOUT.] 13.19 If money is appropriated in fiscal year 13.20 1999 to the commissioner from the 13.21 lottery prize fund, the money shall be 13.22 used to provide a grant for capital 13.23 improvements to Project Turnabout in 13.24 Granite Falls. A local match is 13.25 required before the commissioner may 13.26 release this appropriation to the 13.27 facility. The facility shall receive 13.28 state funds equal to the amount of 13.29 local matching funds provided, up to 13.30 the limit of this appropriation. 13.31 Subd. 8. Economic Support Grants 13.32 General (9,174,000) (29,413,000) 13.33 The amounts that may be spent from this 13.34 appropriation for each purpose are as 13.35 follows: 13.36 (a) Assistance to Families 13.37 Grants 13.38 General -0- (20,343,000) 13.39 [TRANSFER OF STATE MONEY FROM TANF 13.40 RESERVE.] For fiscal year 1999, 13.41 $10,220,000 is appropriated from the 13.42 state money in the TANF reserve to the 13.43 commissioner for the purposes of 13.44 funding the families-first distribution 13.45 of child support arrearages under 13.46 Minnesota Statutes, section 256.741, 13.47 subdivision 2a; the Minnesota food 13.48 assistance program under Minnesota 13.49 Statutes, section 256D.053; and the 13.50 MFIP-S noncitizen food portion under 13.51 Minnesota Statutes, section 256J.11, 13.52 subdivision 2. 13.53 [TRANSFER OF FEDERAL TANF FUNDS TO 13.54 CHILD CARE DEVELOPMENT FUND.] $406,000 13.55 is transferred in fiscal year 1999 from 13.56 the state's federal TANF block grant to 13.57 the state's child care development 13.58 fund, and is appropriated to the 13.59 commissioner of children, families, and 13.60 learning for the purposes of Minnesota 14.1 Statutes, section 119B.05. 14.2 (b) General Assistance 14.3 General (6,933,000) (6,321,000) 14.4 (c) Minnesota Supplemental 14.5 Aid 14.6 General (2,241,000) (2,749,000) 14.7 Subd. 9. Economic Support 14.8 Management 14.9 General -0- 35,000 14.10 Health Care Access -0- 1,084,000 14.11 [ASSESSMENT OF AFFORDABLE HOUSING 14.12 SUPPLY.] The commissioner of human 14.13 services shall assess the statewide 14.14 supply of affordable housing for all 14.15 MFIP-S and GA recipients, and report to 14.16 the legislature by January 15, 1999, on 14.17 the results of this assessment. 14.18 The amounts that may be spent from this 14.19 appropriation for each purpose are as 14.20 follows: 14.21 Economic Support 14.22 Operations 14.23 General -0- 35,000 14.24 Health Care Access -0- 1,084,000 14.25 Sec. 3. COMMISSIONER OF HEALTH 14.26 Subdivision 1. Total 14.27 Appropriation -0- 18,996,000 14.28 Summary by Fund 14.29 General -0- 18,730,000 14.30 State Government Special 14.31 Revenue -0- 7,000 14.32 Health Care 14.33 Access -0- 259,000 14.34 Subd. 2. Health Systems and 14.35 Special Populations -0- 13,759,000 14.36 Summary by Fund 14.37 General -0- 13,500,000 14.38 Health Care 14.39 Access -0- 259,000 14.40 [FETAL ALCOHOL SYNDROME.] (a) Of this 14.41 appropriation, $3,500,000 in fiscal 14.42 year 1999 is from the general fund to 14.43 the commissioner for the fetal alcohol 14.44 syndrome/fetal alcohol effect (FAS/FAE) 14.45 initiatives specified in paragraphs (b) 14.46 to (k). 14.47 (b) Of the amount in paragraph (a), 15.1 $100,000 is transferred to the 15.2 commissioner of children, families, and 15.3 learning for school-based pilot 15.4 programs to identify and implement 15.5 effective educational strategies for 15.6 individuals with FAS/FAE. 15.7 (c) Of the amount in paragraph (a), 15.8 $600,000 is for the public awareness 15.9 campaign under Minnesota Statutes, 15.10 section 145.9266, subdivision 1. 15.11 (d) Of the amount in paragraph (a), 15.12 $300,000 is to develop a statewide 15.13 network of regional FAS diagnostic 15.14 clinics under Minnesota Statutes, 15.15 section 145.9266, subdivision 2. 15.16 (e) Of the amount in paragraph (a), 15.17 $150,000 is for professional training 15.18 about FAS under Minnesota Statutes, 15.19 section 145.9266, subdivision 3. 15.20 (f) Of the amount in paragraph (a), 15.21 $200,000 is for the fetal alcohol 15.22 coordinating board under Minnesota 15.23 Statutes, section 145.9266, subdivision 15.24 6. 15.25 (g) Of the amount in paragraph (a), 15.26 $500,000 is transferred to the 15.27 commissioner of human services to 15.28 expand the maternal and child health 15.29 social service programs under Minnesota 15.30 Statutes, section 254A.17, subdivision 15.31 1. 15.32 (h) Of the amount in paragraph (a), 15.33 $200,000 is for the commissioner to 15.34 study the extent of fetal alcohol 15.35 syndrome in the state. 15.36 (i) Of the amount in paragraph (a), 15.37 $300,000 is transferred to the 15.38 commissioner of human services for the 15.39 intervention and advocacy program under 15.40 Minnesota Statutes, section 254A.17, 15.41 subdivision 1b. 15.42 (j) Of the amount in paragraph (a), 15.43 $700,000 is for the FAS community grant 15.44 program under Minnesota Statutes, 15.45 section 145.9266, subdivision 4. 15.46 (k) Of the amount in paragraph (a), 15.47 $450,000 is transferred to the 15.48 commissioner of human services to 15.49 expand treatment services and halfway 15.50 houses for pregnant women and women 15.51 with children who abuse alcohol during 15.52 pregnancy. 15.53 [RURAL PHYSICIAN LOAN FORGIVENESS 15.54 BUDGET REQUEST.] The budget request for 15.55 the rural physician loan forgiveness 15.56 program in the 2000-2001 biennial 15.57 budget shall detail the amount of funds 15.58 carried forward and obligations 15.59 canceled. 15.60 [GRANTS FROM HEALTH CARE ACCESS FUND.] 16.1 Of any grants made from the health care 16.2 access fund to the commissioner of 16.3 health for purposes of Minnesota 16.4 Statutes, section 145.925, priority 16.5 shall be given for grants to entities 16.6 providing natural family planning 16.7 services that did not receive funding 16.8 under Minnesota Statutes, section 16.9 145.925, in fiscal year 1998. 16.10 Subd. 3. Health Protection -0- 5,230,000 16.11 Summary by Fund 16.12 General -0- 5,230,000 16.13 State Government 16.14 Special Revenue -0- 7,000 16.15 [OCCUPATIONAL RESPIRATORY DISEASE 16.16 INFORMATION SYSTEM.] Of the general 16.17 fund appropriation, $300,000 in fiscal 16.18 year 1999 is to design an occupational 16.19 respiratory disease information 16.20 system. This appropriation is 16.21 available until expended. This 16.22 appropriation is added to the base for 16.23 the 2000-2001 biennial budget. 16.24 [INFECTION CONTROL.] Of the general 16.25 fund appropriation, $300,000 in fiscal 16.26 year 1999 is for infection control 16.27 activities, including training and 16.28 technical assistance of health care 16.29 personnel to prevent and control 16.30 disease outbreaks, and for hospital and 16.31 public health laboratory testing and 16.32 other activities to monitor trends in 16.33 drug-resistant infections. Start-up 16.34 costs shall not become part of the base 16.35 for the 2000-2001 biennial budget. 16.36 [CANCER SCREENING.] Of the general fund 16.37 appropriation, $989,000 in fiscal year 16.38 1999 is for increased cancer screening 16.39 and diagnostic services for women, 16.40 particularly underserved women, and to 16.41 improve cancer screening rates for the 16.42 general population. Of this amount, at 16.43 least $665,000 is for grants to support 16.44 local boards of health in providing 16.45 outreach and coordination and to 16.46 reimburse health care providers for 16.47 screening and diagnostic tests, and up 16.48 to $324,000 is for technical 16.49 assistance, consultation, and outreach. 16.50 [SEXUALLY TRANSMITTED DISEASE 16.51 PREVENTION INITIATIVES.] (a) Of this 16.52 appropriation, $300,000 in fiscal year 16.53 1999 is from the general fund to the 16.54 commissioner for the sexually 16.55 transmitted disease prevention 16.56 initiatives specified in paragraphs (b) 16.57 to (d). 16.58 (b) $100,000 is for the commissioner, 16.59 in consultation with the HIV/STD 16.60 prevention task force and the 16.61 commissioner of children, families, and 16.62 learning, to conduct a statewide 17.1 assessment of need and capacity to 17.3 prevent and treat sexually transmitted 17.4 diseases and to prepare a comprehensive 17.5 plan for how to prevent and treat 17.6 sexually transmitted diseases, 17.7 including strategies for reducing 17.8 infection and for increasing access to 17.9 treatment. This appropriation shall 17.10 not become part of the base level 17.11 funding for this activity for the 17.12 2000-2001 biennial budget. 17.13 (c) $100,000 is for the commissioner to 17.14 conduct research on the prevalence of 17.15 sexually transmitted diseases among 17.16 populations at highest risk for 17.17 infection. The research may be done in 17.18 collaboration with the University of 17.19 Minnesota and nonprofit community 17.20 health clinics. This appropriation 17.21 shall not become part of the base level 17.22 funding for this activity for the 17.23 2000-2001 biennial budget. 17.24 (d) $100,000 is for the commissioner to 17.25 conduct laboratory screenings for 17.26 sexually transmitted diseases and to 17.27 overcome barriers to diagnostic 17.28 screening and treatment services, 17.29 particularly in populations at highest 17.30 risk for acquiring a sexually 17.31 transmitted disease. 17.32 [LEAD-SAFE PROPERTY CERTIFICATION 17.33 PROGRAM.] Of this appropriation, 17.34 $100,000 in fiscal year 1999 is from 17.35 the general fund to the commissioner 17.36 for the purposes of the lead-safe 17.37 property certification program under 17.38 Minnesota Statutes, section 144.9511. 17.39 Sec. 4. HEALTH-RELATED BOARDS 17.40 Subdivision 1. Total 17.41 Appropriation 113,000 83,000 17.42 The appropriations in this section are 17.43 from the state government special 17.44 revenue fund. 17.45 Subd. 2. Board of Medical 17.46 Practice 80,000 (110,000) 17.47 This appropriation is added to the 17.48 appropriation in Laws 1997, chapter 17.49 203, article 1, section 5, subdivision 17.50 6, and is for the health professional 17.51 services activity. 17.52 Subd. 3. Board of Physical 17.53 Therapy -0- 160,000 17.54 Subd. 4. Board of 17.55 Veterinary Medicine 33,000 33,000 17.56 This appropriation is added to the 17.57 appropriation in Laws 1997, chapter 17.58 203, article 1, section 5, subdivision 17.59 14, and is for national examination 17.60 costs. 18.1 Sec. 5. EMERGENCY MEDICAL 18.2 SERVICES BOARD 18.3 General -0- 78,000 18.4 [EMERGENCY MEDICAL SERVICES 18.5 COMMUNICATIONS NEEDS ASSESSMENT.] (a) 18.6 Of this appropriation, $78,000 in 18.7 fiscal year 1999 is from the general 18.8 fund to the board to conduct an 18.9 emergency medical services needs 18.10 assessment for areas outside the 18.11 seven-county metropolitan area. The 18.12 assessment shall determine the current 18.13 status of and need for emergency 18.14 medical services communications 18.15 equipment. All regional emergency 18.16 medical services programs designated by 18.17 the board under Minnesota Statutes 1997 18.18 Supplement, section 144E.50, shall 18.19 cooperate in the preparation of the 18.20 assessment. 18.21 (b) The appropriation for this project 18.22 shall be distributed through the 18.23 emergency medical services system fund 18.24 under Minnesota Statutes, section 18.25 144E.50, through a request-for-proposal 18.26 process. The board must select a 18.27 regional EMS program that receives at 18.28 least 20 percent of its funding from 18.29 nonstate sources to conduct the 18.30 assessment. The request for proposals 18.31 must be issued by August 1, 1998. 18.32 (c) A final report with recommendations 18.33 shall be presented to the board and the 18.34 legislature by July 1, 1999. 18.35 (d) This appropriation shall not become 18.36 part of base level funding for the 18.37 2000-2001 biennium. 18.38 Sec. 6. OMBUDSMAN FOR MENTAL 18.39 HEALTH AND MENTAL RETARDATION 18.40 General -0- 200,000 18.41 Sec. 7. Laws 1997, chapter 203, article 1, section 2, 18.42 subdivision 5, is amended to read: 18.43 Subd. 5. Basic Health Care Grants 18.44 Summary by Fund 18.45 General 834,098,000 938,504,000 18.46 The amounts that may be spent from this 18.47 appropriation for each purpose are as 18.48 follows: 18.49 (a) MA Basic Health Care Grants- 18.50 Families and Children 18.51 General 322,970,000 367,726,000 18.52[NOTICE ON CHANGES IN ASSET TEST.] The18.53commissioner shall provide a notice by18.54July 15, 1997, to all recipients18.55affected by the changes in this act in19.1asset standards for families with19.2children notifying them:19.3(1) what asset limits will apply to19.4them;19.5(2) when the new limits will apply;19.6(3) what options they have to spenddown19.7assets; and19.8(4) what options they have to enroll in19.9MinnesotaCare, including an explanation19.10of the MinnesotaCare premium structure.19.11 (b) MA Basic Health Care Grants- 19.12 Elderly & Disabled 19.13 General 337,659,000 400,408,000 19.14 [PUBLIC HEALTH NURSE ASSESSMENT.] The 19.15 reimbursement for public health nurse 19.16 visits relating to the provision of 19.17 personal care services under Minnesota 19.18 Statutes, sections 256B.0625, 19.19 subdivision 19a, and 256B.0627, is 19.20 $204.36 for the initial assessment 19.21 visit and $102.18 for each reassessment 19.22 visit. 19.23 [SURCHARGE COMPLIANCE.] In the event 19.24 that federal financial participation in 19.25 the Minnesota medical assistance 19.26 program is reduced as a result of a 19.27 determination that Minnesota is out of 19.28 compliance with Public Law Number 19.29 102-234 or its implementing regulations 19.30 or with any other federal law designed 19.31 to restrict provider tax programs or 19.32 intergovernmental transfers, the 19.33 commissioner shall appeal the 19.34 determination to the fullest extent 19.35 permitted by law and may ratably reduce 19.36 all medical assistance and general 19.37 assistance medical care payments to 19.38 providers other than the state of 19.39 Minnesota in order to eliminate any 19.40 shortfall resulting from the reduced 19.41 federal funding. Any amount later 19.42 recovered through the appeals process 19.43 shall be used to reimburse providers 19.44 for any ratable reductions taken. 19.45 [BLOOD PRODUCTS LITIGATION.] To the 19.46 extent permitted by federal law, 19.47 Minnesota Statutes, sections 256.015, 19.48 256B.042, 256B.056, and 256B.15 are 19.49 waived as necessary for the limited 19.50 purpose of resolving the state's claims 19.51 in connection with In re Factor VIII or 19.52 IX Concentrate Blood Products 19.53 Litigation, MDL-986, No. 93-C7452 19.54 (N.D.III.). 19.55 [DISTRIBUTION TO MEDICAL ASSISTANCE 19.56 PROVIDERS.] (a) Of the amount 19.57 appropriated to the medical assistance 19.58 account in fiscal year 1998, $5,000,000 19.59 plus the federal financial 19.60 participation amount shall be 19.61 distributed to medical assistance 20.1 providers according to the distribution 20.2 methodology of the medical education 20.3 research trust fund established under 20.4 Minnesota Statutes, section 62J.69. 20.5 (b) In fiscal year 1999, the prepaid 20.6 medical assistance and prepaid general 20.7 assistance medical care capitation rate 20.8 reduction amounts under Minnesota 20.9 Statutes, section 256B.69, subdivision 20.10 5c, and the federal financial 20.11 participation amount associated with 20.12 the medical assistance reduction, shall 20.13 be distributed to medical assistance 20.14 providers according to the distribution 20.15 methodology of the trust fund. 20.16[AUGMENTATIVE AND ALTERNATIVE20.17COMMUNICATION SYSTEMS.] Augmentative20.18and alternative communication systems20.19and related components that are prior20.20authorized by the department through20.21pass through vendors during the period20.22from January 1, 1997, until the20.23augmentative and alternative20.24communication system purchasing program20.25or other alternatives are operational20.26shall be paid under the medical20.27assistance program at the actual price20.28charged the pass through vendor plus 2020.29percent to cover administrative costs20.30of prior authorization and billing and20.31shipping charges.20.32 (c) General Assistance Medical Care 20.33 General 173,469,000 170,370,000 20.34 [HEALTH CARE ACCESS TRANSFERS TO 20.35 GENERAL FUND.] Funds shall be 20.36 transferred from the health care access 20.37 fund to the general fund in an amount 20.38 equal to the projected savings to 20.39 general assistance medical care (GAMC) 20.40 that would result from the transition 20.41 of GAMC parents and adults without 20.42 children to MinnesotaCare. Based on 20.43 this projection, for state fiscal year 20.44 1998, the amount transferred from the 20.45 health care access fund to the general 20.46 fund shall be $13,700,000. The amount 20.47 of transfer, if any, necessary for 20.48 state fiscal year 1999 shall be 20.49determined on a pro rata20.50basis$2,659,000. 20.51 [TUBERCULOSIS COST OF CARE.] Of the 20.52 general fund appropriation, $89,000 for 20.53 the biennium is for the cost of care 20.54 that is required to be paid by the 20.55 commissioner under Minnesota Statutes, 20.56 section 144.4872, to diagnose or treat 20.57 tuberculosis carriers. 20.58 Sec. 8. Laws 1997, chapter 203, article 1, section 2, 20.59 subdivision 12, is amended to read: 20.60 Subd. 12. Federal TANF Funds 20.61 [FEDERAL TANF FUNDS.] (a) Federal 21.1 Temporary Assistance for Needy Families 21.2 block grant funds authorized under 21.3 title I of Public Law Number 104-193, 21.4 the Personal Responsibility and Work 21.5 Opportunity Reconciliation Act of 1996, 21.6 are appropriated to the commissioner in 21.7 amounts up to$276,741,000$240,936,000 21.8 in fiscal year 1998 21.9 and$265,795,000$272,083,000 in fiscal 21.10 year 1999. Additional TANF funds may 21.11 be expended, but only to the extent 21.12 that an equal amount of state funds 21.13 have been transferred to the TANF 21.14 reserve under Minnesota Statutes 1997 21.15 Supplement, section 256J.03. 21.16 (b) The commissioner may use TANF 21.17 reserve funds to offset any future 21.18 reductions in the amount of the state's 21.19 allocation of federal TANF block grant 21.20 funds. 21.21 Sec. 9. [CARRYOVER LIMITATION.] 21.22 The appropriations in this article which are allowed to be 21.23 carried forward from fiscal year 1998 to fiscal year 1999 shall 21.24 not become part of the base level funding for the 2000-2001 21.25 biennial budget, unless specifically directed by the legislature. 21.26 Sec. 10. [SUNSET OF UNCODIFIED LANGUAGE.] 21.27 All uncodified language contained in this article expires 21.28 on June 30, 1999, unless a different expiration date is 21.29 specified. 21.30 Sec. 11. [EFFECTIVE DATE.] 21.31 The amendments to Laws 1997, chapter 203, article 1, 21.32 section 2, subdivision 12, in section 8 are effective the day 21.33 following final enactment. 21.34 ARTICLE 2 21.35 HEALTH DEPARTMENT AND HEALTH PROFESSIONALS 21.36 Section 1. Minnesota Statutes 1997 Supplement, section 21.37 62D.11, subdivision 1, is amended to read: 21.38 Subdivision 1. [ENROLLEE COMPLAINT SYSTEM.] Every health 21.39 maintenance organization shall establish and maintain a 21.40 complaint system, as required under section 62Q.105 to provide 21.41 reasonable procedures for the resolution of written complaints 21.42 initiated by or on behalf of enrollees concerning the provision 21.43 of health care services. "Provision of health services" 21.44 includes, but is not limited to, questions of the scope of 21.45 coverage, quality of care, and administrative operations. The 22.1 health maintenance organization must inform enrollees that they 22.2 may choose to usealternative dispute resolutionarbitration to 22.3 appeal a health maintenance organization's internal appeal 22.4 decision. The health maintenance organization must also inform 22.5 enrollees that they have the right to use arbitration to appeal 22.6 a health maintenance organization's internal appeal decision not 22.7 to certify an admission, procedure, service, or extension of 22.8 stay under section 62M.06. If an enrollee chooses to usean22.9alternative dispute resolution processarbitration, the health 22.10 maintenance organization must participate. 22.11 Sec. 2. Minnesota Statutes 1997 Supplement, section 22.12 62J.70, subdivision 3, is amended to read: 22.13 Subd. 3. [HEALTH PLAN COMPANY.] "Health plan company" 22.14 means a health plan company as defined in section 62Q.01, 22.15 subdivision 4, the medical assistance program, the MinnesotaCare 22.16 program, the general assistance medical care program, the state 22.17 employee group insurance program, the public employees insurance 22.18 program under section 43A.316, and coverage provided by 22.19 political subdivisions under section 471.617. 22.20 Sec. 3. Minnesota Statutes 1997 Supplement, section 22.21 62J.71, subdivision 1, is amended to read: 22.22 Subdivision 1. [PROHIBITED AGREEMENTS AND DIRECTIVES.] The 22.23 following types of agreements and directives are contrary to 22.24 state public policy, are prohibited under this section, and are 22.25 null and void: 22.26 (1) any agreement or directive that prohibits a health care 22.27 provider from communicating with an enrollee with respect to the 22.28 enrollee's health status, health care, or treatment options, if 22.29 the health care provider is acting in good faith and within the 22.30 provider's scope of practice as defined by law; 22.31 (2) any agreement or directive that prohibits a health care 22.32 provider from making a recommendation regarding the suitability 22.33 or desirability of a health plan company, health insurer, or 22.34 health coverage plan for an enrollee, unless the provider has a 22.35 financial conflict of interest in the enrollee's choice of 22.36 health plan company, health insurer, or health coverage plan; 23.1 (3) any agreement or directive that prohibits a provider 23.2 from providing testimony, supporting or opposing legislation, or 23.3 making any other contact with state or federal legislators or 23.4 legislative staff or with state and federal executive branch 23.5 officers or staff; 23.6 (4) any agreement or directive that prohibits a health care 23.7 provider from disclosing accurate information about whether 23.8 services or treatment will be paid for by a patient's health 23.9 plan company or health insurer or health coverage plan; and 23.10 (5) any agreement or directive that prohibits a health care 23.11 provider from informing an enrollee about the nature of the 23.12 reimbursement methodology used by an enrollee's health plan 23.13 company, health insurer, or health coverage plan to pay the 23.14 provider. 23.15 Sec. 4. Minnesota Statutes 1997 Supplement, section 23.16 62J.71, subdivision 3, is amended to read: 23.17 Subd. 3. [RETALIATION PROHIBITED.] No person, health plan 23.18 company, or other organization may take retaliatory action 23.19 against a health care provider solely on the grounds that the 23.20 provider: 23.21 (1) refused to enter into an agreement or provide services 23.22 or information in a manner that is prohibited under this section 23.23 or took any of the actions listed in subdivision 1; 23.24 (2) disclosed accurate information about whether a health 23.25 care service or treatment is covered by an enrollee's health 23.26 plan company, health insurer, or health coverage plan;or23.27 (3) discussed diagnostic, treatment, or referral options 23.28 that are not covered or are limited by the enrollee's health 23.29 plan company, health insurer, or health coverage plan; 23.30 (4) criticized coverage of the enrollee's health plan 23.31 company, health insurer, or health coverage plan; or 23.32 (5) expressed personal disagreement with a decision made by 23.33 a person, organization, or health care provider regarding 23.34 treatment or coverage provided to a patient of the provider, or 23.35 assisted or advocated for the patient in seeking reconsideration 23.36 of such a decision, provided the health care provider makes it 24.1 clear that the provider is acting in a personal capacity and not 24.2 as a representative of or on behalf of the entity that made the 24.3 decision. 24.4 Sec. 5. Minnesota Statutes 1997 Supplement, section 24.5 62J.71, subdivision 4, is amended to read: 24.6 Subd. 4. [EXCLUSION.] (a) Nothing in this section 24.7 prohibitsa health planan entity that is subject to this 24.8 section from taking action against a provider if thehealth plan24.9 entity has evidence that the provider's actions are illegal, 24.10 constitute medical malpractice, or are contrary to accepted 24.11 medical practices. 24.12 (b) Nothing in this section prohibits a contract provision 24.13 or directive that requires any contracting party to keep 24.14 confidential or to not use or disclose the specific amounts paid 24.15 to a provider, provider fee schedules, provider salaries, and 24.16 other similar provider-specific proprietary information of a 24.17 specifichealth plan or health plan companyentity that is 24.18 subject to this section. 24.19 Sec. 6. Minnesota Statutes 1997 Supplement, section 24.20 62J.72, subdivision 1, is amended to read: 24.21 Subdivision 1. [WRITTEN DISCLOSURE.] (a) A health plan 24.22 company, as defined under section 62J.70, subdivision 3, a 24.23 health care network cooperative as defined under section 62R.04, 24.24 subdivision 3, and a health care provider as defined under 24.25 section 62J.70, subdivision 2, shall, during open enrollment, 24.26 upon enrollment, and annually thereafter, provide enrollees with 24.27 a description of the general nature of the reimbursement 24.28 methodologies used by the health plan company, health insurer, 24.29 or health coverage plan to pay providers. The description must 24.30 explain clearly any aspect of the reimbursement methodology that 24.31 in any way may tend to make it advantageous for the health care 24.32 provider to minimize or restrict the health care provided to 24.33 enrollees. This description may be incorporated into the member 24.34 handbook, subscriber contract, certificate of coverage, or other 24.35 written enrollee communication. The general reimbursement 24.36 methodology shall be made available to employers at the time of 25.1 open enrollment. 25.2 (b) Health plan companies, health care network 25.3 cooperatives, and providers must, upon request, provide an 25.4 enrollee with specific information regarding the reimbursement 25.5 methodology, including, but not limited to, the following 25.6 information: 25.7 (1) a concise written description of the provider payment 25.8 plan, including any incentive plan applicable to the enrollee; 25.9 (2) a written description of any incentive to the provider 25.10 relating to the provision of health care services to enrollees, 25.11 including any compensation arrangement that is dependent on the 25.12 amount of health coverage or health care services provided to 25.13 the enrollee, or the number of referrals to or utilization of 25.14 specialists; and 25.15 (3) a written description of any incentive plan that 25.16 involves the transfer of financial risk to the health care 25.17 provider. 25.18 (c) The disclosure statement describing the general nature 25.19 of the reimbursement methodologies must comply with the 25.20 Readability of Insurance Policies Act in chapter 72C.25.21Notwithstanding any other law to the contrary, the disclosure25.22statement may voluntarily be filed with the commissioner for25.23approvaland must be filed with and approved by the commissioner 25.24 prior to its use. 25.25 (d) A disclosure statement that hasvoluntarilybeen filed 25.26 with the commissioner for approval underchapter 72C or25.27voluntarily filed with the commissioner for approval for25.28purposes other than pursuant to chapter 72Cparagraph (c) is 25.29 deemed approved 30 days after the date of filing, unless 25.30 approved or disapproved by the commissioner on or before the end 25.31 of that 30-day period. 25.32 (e) The disclosure statement describing the general nature 25.33 of the reimbursement methodologies must be provided upon request 25.34 in English, Spanish, Vietnamese, and Hmong. In addition, 25.35 reasonable efforts must be made to provide information contained 25.36 in the disclosure statement to other non-English-speaking 26.1 enrollees. 26.2 (f) Health plan companies and providers may enter into 26.3 agreements to determine how to respond to enrollee requests 26.4 received by either the provider or the health plan 26.5 company. Health plan companies may also enter into agreements 26.6 to determine how to respond to enrollee requests. This 26.7 subdivision does not require disclosure of specific amounts paid 26.8 to a provider, provider fee schedules, provider salaries, or 26.9 other proprietary information of a specific health plan company 26.10 or health insurer or health coverage plan or provider. 26.11 Sec. 7. [62J.77] [DEFINITIONS.] 26.12 Subdivision 1. [APPLICABILITY.] For purposes of sections 26.13 62J.77 to 62J.80, the terms defined in this section have the 26.14 meanings given them. 26.15 Subd. 2. [ENROLLEE.] "Enrollee" means a natural person 26.16 covered by a health plan company, health insurance, or health 26.17 coverage plan and includes an insured, policyholder, subscriber, 26.18 contract holder, member, covered person, or certificate holder. 26.19 Subd. 3. [PATIENT.] "Patient" means a former, current, or 26.20 prospective patient of a health care provider. 26.21 Sec. 8. [62J.78] [ESTABLISHMENT; ORGANIZATION.] 26.22 Subdivision 1. [GENERAL.] The office of health care 26.23 consumer assistance, advocacy, and information is established to 26.24 provide assistance, advocacy, and information to all health care 26.25 consumers within the state. The office shall have no regulatory 26.26 power or authority and shall not provide legal representation in 26.27 a court of law. 26.28 Subd. 2. [EXECUTIVE DIRECTOR.] An executive director shall 26.29 be appointed by the governor, in consultation with the consumer 26.30 advisory board, for a three-year term and may be removed only 26.31 for just cause. The executive director must be selected without 26.32 regard to political affiliation and must be a person who has 26.33 knowledge and experience concerning the needs and rights of 26.34 health care consumers and must be qualified to analyze questions 26.35 of law, administrative functions, and public policy. No person 26.36 may serve as executive director while holding another public 27.1 office. The director shall serve in the unclassified service. 27.2 Subd. 3. [STAFF.] The executive director shall appoint at 27.3 least nine consumer advocates to discharge the responsibilities 27.4 and duties of the office. The executive director and full-time 27.5 staff shall be included in the Minnesota state retirement 27.6 association. 27.7 Subd. 4. [DELEGATION.] The executive director may delegate 27.8 to staff any of the authority or duties of the director, except 27.9 the duty of formally making recommendations to the legislature. 27.10 Subd. 5. [TRAINING.] The executive director shall ensure 27.11 that the consumer advocates are adequately trained. 27.12 Subd. 6. [STATEWIDE ADVOCACY.] The executive director 27.13 shall assign a consumer advocate to represent each regional 27.14 coordinating board's geographic area. 27.15 Subd. 7. [FINANCIAL INTEREST.] The executive director and 27.16 staff must not have any direct personal financial interest in 27.17 the health care system, except as an individual consumer of 27.18 health care services. 27.19 Subd. 8. [ADMINISTRATION.] The office of the ombudsman for 27.20 mental health and mental retardation shall coordinate and share 27.21 administrative services with the office of health care consumer 27.22 assistance, advocacy, and information. To the extent practical, 27.23 all ombudsman offices with health care responsibilities shall 27.24 have their telephone systems linked in order to facilitate 27.25 immediate referrals. 27.26 Sec. 9. [62J.79] [DUTIES AND POWERS OF THE OFFICE OF 27.27 HEALTH CARE CONSUMER ASSISTANCE, ADVOCACY, AND INFORMATION.] 27.28 Subdivision 1. [DUTIES.] (a) The executive director shall 27.29 provide information and assistance to all health care consumers 27.30 by: 27.31 (1) assisting patients and enrollees in understanding and 27.32 asserting their contractual and legal rights, including the 27.33 rights under an alternative dispute resolution process. This 27.34 assistance may include advocacy for enrollees in administrative 27.35 proceedings or other formal or informal dispute resolution 27.36 processes; 28.1 (2) assisting enrollees in obtaining health care referrals 28.2 under their health plan company, health insurance, or health 28.3 coverage plan; 28.4 (3) assisting patients and enrollees in accessing the 28.5 services of governmental agencies, regulatory boards, and other 28.6 state consumer assistance programs, ombudsman, or advocacy 28.7 services whenever appropriate so that the patient or enrollee 28.8 can take full advantage of existing mechanisms for resolving 28.9 complaints; 28.10 (4) referring patients and enrollees to governmental 28.11 agencies and regulatory boards for the investigation of health 28.12 care complaints and for enforcement action; 28.13 (5) educating and training enrollees about their health 28.14 plan company, health insurance, or health coverage plan in order 28.15 to enable them to assert their rights and to understand their 28.16 responsibilities; 28.17 (6) assisting enrollees in receiving a timely resolution of 28.18 their complaints; 28.19 (7) monitoring health care complaints addressed by the 28.20 office to identify specific complaint patterns or areas of 28.21 potential improvement; 28.22 (8) recommending to health plan companies ways to identify 28.23 and remove any barriers that might delay or impede the health 28.24 plan company's effort to resolve consumer complaints; and 28.25 (9) in performing the duties specified in clauses (1) to 28.26 (8), taking into consideration the special situations of 28.27 patients and enrollees who have unique culturally defined needs. 28.28 (b) The executive director shall prioritize the duties 28.29 listed in this subdivision within the appropriations allocated. 28.30 Subd. 2. [COMMUNICATION.] The executive director shall 28.31 meet at least six times per year with the consumer advisory 28.32 board. The executive director shall share all public 28.33 information obtained by the office of health care consumer 28.34 assistance, advocacy, and information with the consumer advisory 28.35 board in order to assist the consumer advisory board in its role 28.36 of advising the commissioners of health and commerce and the 29.1 legislature in accordance with section 62J.75. 29.2 Subd. 3. [REPORTS.] Beginning January 15, 1999, the 29.3 executive director, on at least a quarterly basis, shall provide 29.4 data from the health care complaints addressed by the office to 29.5 the commissioners of health and commerce, the consumer advisory 29.6 board, the Minnesota council of health plans, the Insurance 29.7 Federation of Minnesota, and the information clearinghouse. 29.8 Beginning January 15, 1999, the executive director must make an 29.9 annual written report to the legislature regarding activities of 29.10 the office, including recommendations on improving health care 29.11 consumer assistance and complaint resolution processes. 29.12 Sec. 10. [62J.80] [RETALIATION.] 29.13 A health plan company or health care provider shall not 29.14 retaliate or take adverse action against an enrollee or patient 29.15 who, in good faith, makes a complaint against a health plan 29.16 company or health care provider. If retaliation is suspected, 29.17 the executive director may report it to the appropriate 29.18 regulatory authority. 29.19 Sec. 11. Minnesota Statutes 1997 Supplement, section 29.20 62Q.105, subdivision 1, is amended to read: 29.21 Subdivision 1. [ESTABLISHMENT.] Each health plan company 29.22 shall establish and make available to enrollees, by July 1,199829.23 1999, an informal complaint resolution process that meets the 29.24 requirements of this section. A health plan company must make 29.25 reasonable efforts to resolve enrollee complaints, and must 29.26 inform complainants in writing of the company's decision within 29.27 30 days of receiving the complaint. The complaint resolution 29.28 process must treat the complaint and information related to it 29.29 as required under sections 72A.49 to 72A.505. 29.30 Sec. 12. [62Q.107] [PROHIBITED PROVISION; EFFECT OF DENIAL 29.31 OF CLAIM.] 29.32 No health plan, including the coverages described in 29.33 section 62A.011, subdivision 3, clauses (7) and (10), may 29.34 specify a standard of review upon which a court may review 29.35 denial of a claim or of any other decision made by a health plan 29.36 company with respect to an enrollee. This section prohibits 30.1 limiting court review to a determination of whether the health 30.2 plan company's decision is arbitrary and capricious, an abuse of 30.3 discretion, or any other standard less favorable to the enrollee 30.4 than a preponderance of the evidence. 30.5 Sec. 13. Minnesota Statutes 1997 Supplement, section 30.6 62Q.30, is amended to read: 30.7 62Q.30 [EXPEDITED FACT FINDING AND DISPUTE RESOLUTION 30.8 PROCESS.] 30.9 The commissioner shall establish an expedited fact finding 30.10 and dispute resolution process to assist enrollees of health 30.11 plan companies with contested treatment, coverage, and service 30.12 issues to be in effect July 1,19981999. If the disputed issue 30.13 relates to whether a service is appropriate and necessary, the 30.14 commissioner shall issue an order only after consulting with 30.15 appropriate experts knowledgeable, trained, and practicing in 30.16 the area in dispute, reviewing pertinent literature, and 30.17 considering the availability of satisfactory alternatives. The 30.18 commissioner shall take steps including but not limited to 30.19 fining, suspending, or revoking the license of a health plan 30.20 company that is the subject of repeated orders by the 30.21 commissioner that suggests a pattern of inappropriate 30.22 underutilization. 30.23 Sec. 14. Minnesota Statutes 1997 Supplement, section 30.24 103I.208, subdivision 2, is amended to read: 30.25 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 30.26 property owner is: 30.27 (1) for a well that is not in use under a maintenance 30.28 permit, $100 annually; 30.29 (2) for construction of a monitoring well, $120, which 30.30 includes the state core function fee; 30.31 (3) for a monitoring well that is unsealed under a 30.32 maintenance permit, $100 annually; 30.33 (4) for monitoring wells used as a leak detection device at 30.34 a single motor fuel retail outletor, a single petroleum bulk 30.35 storage site excluding tank farms, or a single agricultural 30.36 chemical facility site, the construction permit fee is $120, 31.1 which includes the state core function fee, per site regardless 31.2 of the number of wells constructed on the site, and the annual 31.3 fee for a maintenance permit for unsealed monitoring wells is 31.4 $100 per site regardless of the number of monitoring wells 31.5 located on site; 31.6 (5) for a groundwater thermal exchange device, in addition 31.7 to the notification fee for wells, $120, which includes the 31.8 state core function fee; 31.9 (6) for a vertical heat exchanger, $120; 31.10 (7) for a dewatering well that is unsealed under a 31.11 maintenance permit, $100 annually for each well, except a 31.12 dewatering project comprising more than five wells shall be 31.13 issued a single permit for $500 annually for wells recorded on 31.14 the permit; and 31.15 (8) for excavating holes for the purpose of installing 31.16 elevator shafts, $120 for each hole. 31.17 Sec. 15. Minnesota Statutes 1997 Supplement, section 31.18 144.1494, subdivision 1, is amended to read: 31.19 Subdivision 1. [CREATION OF ACCOUNT.] A rural physician 31.20 education account is established in the health care access 31.21 fund. The commissioner shall use money from the account to 31.22 establish a loan forgiveness program for medical residents 31.23 agreeing to practice in designated rural areas, as defined by 31.24 the commissioner. Appropriations made to this account do not 31.25 cancel and are available until expended, except that at the end 31.26 of each biennium the commissioner shall cancel to the health 31.27 care access fund any remaining unobligated balance in this 31.28 account. 31.29 Sec. 16. [144.6905] [OCCUPATIONAL RESPIRATORY DISEASE 31.30 INFORMATION SYSTEM ADVISORY GROUP.] 31.31 The commissioner of health shall convene an occupational 31.32 respiratory disease advisory group and shall consult with the 31.33 group on the development, implementation, and ongoing operation 31.34 of an occupational respiratory disease information system. 31.35 Membership in the group shall include representatives of 31.36 academia, government, industry, labor, medicine, and consumers 32.1 from areas of the state targeted by the information system. 32.2 From members of the advisory group, the commissioner shall form 32.3 a technical and medical committee to create information system 32.4 protocols and a legal and policy committee to address data 32.5 privacy issues. The advisory group is governed by section 32.6 15.059, except that members shall not receive per diem 32.7 compensation. 32.8 Sec. 17. Minnesota Statutes 1996, section 144.701, 32.9 subdivision 1, is amended to read: 32.10 Subdivision 1. [CONSUMER INFORMATION.] The commissioner of 32.11 health shall ensure that the total costs, total 32.12 revenues, overall utilization, and total services of each 32.13 hospital and each outpatient surgical center are reported to the 32.14 public in a form understandable to consumers. 32.15 Sec. 18. Minnesota Statutes 1996, section 144.701, 32.16 subdivision 2, is amended to read: 32.17 Subd. 2. [DATA FOR POLICY MAKING.] The commissioner of 32.18 health shall compile relevant financial and accounting, 32.19 utilization, and services data concerning hospitals and 32.20 outpatient surgical centers in order to have statistical 32.21 information available for legislative policy making. 32.22 Sec. 19. Minnesota Statutes 1996, section 144.701, 32.23 subdivision 4, is amended to read: 32.24 Subd. 4. [FILING FEES.] Each report which is required to 32.25 be submitted to the commissioner of health under sections 32.26 144.695 to 144.703 and which is not submitted to a voluntary, 32.27 nonprofit reporting organization in accordance with section 32.28 144.702 shall be accompanied by a filing fee in an amount 32.29 prescribed by rule of the commissioner of health.Fees received32.30pursuant to this subdivision shall be deposited in the general32.31fund of the state treasury.Upon the withdrawal of approval of 32.32 a reporting organization, or the decision of the commissioner to 32.33 not renew a reporting organization, fees collected under section 32.34 144.702 shall be submitted to the commissionerand deposited in32.35the general fund. Fees received under this subdivision shall be 32.36 deposited in a revolving fund and are appropriated to the 33.1 commissioner of health for the purposes of sections 144.695 to 33.2 144.703. The commissioner shall report the termination or 33.3 nonrenewal of the voluntary reporting organization to the chair 33.4 of the health and human services subdivision of the 33.5 appropriations committee of the house of representatives, to the 33.6 chair of the health and human services division of the finance 33.7 committee of the senate, and the commissioner of finance. 33.8 Sec. 20. Minnesota Statutes 1996, section 144.702, 33.9 subdivision 1, is amended to read: 33.10 Subdivision 1. [REPORTING THROUGH A REPORTING 33.11 ORGANIZATION.] A hospital or outpatient surgical center may 33.12 agree to submit its financial, utilization, and services reports 33.13 to a voluntary, nonprofit reporting organization whose reporting 33.14 procedures have been approved by the commissioner of health in 33.15 accordance with this section. Each report submitted to the 33.16 voluntary, nonprofit reporting organization under this section 33.17 shall be accompanied by a filing fee. 33.18 Sec. 21. Minnesota Statutes 1996, section 144.702, 33.19 subdivision 2, is amended to read: 33.20 Subd. 2. [APPROVAL OF ORGANIZATION'S REPORTING 33.21 PROCEDURES.] The commissioner of health may approve voluntary 33.22 reporting procedures consistent with written operating 33.23 requirements for the voluntary, nonprofit reporting organization 33.24 which shall be established annually by the commissioner. These 33.25 written operating requirements shall specify reports, analyses, 33.26 and other deliverables to be produced by the voluntary, 33.27 nonprofit reporting organization, and the dates on which those 33.28 deliverables must be submitted to the commissioner. These 33.29 written operating requirements shall specify deliverable dates 33.30 sufficient to enable the commissioner of health to process and 33.31 report health care cost information system data to the 33.32 commissioner of human services by August 15 of each year. The 33.33 commissioner of health shall, by rule, prescribe standards for 33.34 submission of data by hospitals and outpatient surgical centers 33.35 to the voluntary, nonprofit reporting organization or to the 33.36 commissioner. These standards shall provide for: 34.1 (a) The filing of appropriate financial, utilization, and 34.2 services information with the reporting organization; 34.3 (b) Adequate analysis and verification of that financial, 34.4 utilization, and services information; and 34.5 (c) Timely publication of the costs, revenues, and rates of 34.6 individual hospitals and outpatient surgical centers prior to 34.7 the effective date of any proposed rate increase. The 34.8 commissioner of health shall annually review the procedures 34.9 approved pursuant to this subdivision. 34.10 Sec. 22. Minnesota Statutes 1996, section 144.702, 34.11 subdivision 8, is amended to read: 34.12 Subd. 8. [TERMINATION OR NONRENEWAL OF REPORTING 34.13 ORGANIZATION.] The commissioner may withdraw approval of any 34.14 voluntary, nonprofit reporting organization for failure on the 34.15 part of the voluntary, nonprofit reporting organization to 34.16 comply with the written operating requirements under subdivision 34.17 2. Upon the effective date of the withdrawal, all funds 34.18 collected by the voluntary, nonprofit reporting organization 34.19 undersection 144.701,subdivision41, but not expended shall 34.20 be deposited inthe general funda revolving fund and are 34.21 appropriated to the commissioner of health for the purposes of 34.22 sections 144.695 to 144.703. 34.23 The commissioner may choose not to renew approval of a 34.24 voluntary, nonprofit reporting organization if the organization 34.25 has failed to perform its obligations satisfactorily under the 34.26 written operating requirements under subdivision 2. 34.27 Sec. 23. [144.7022] [ADMINISTRATIVE PENALTY ORDERS FOR 34.28 REPORTING ORGANIZATIONS.] 34.29 Subdivision 1. [AUTHORIZATION.] The commissioner may issue 34.30 an order to the voluntary, nonprofit reporting organization 34.31 requiring violations to be corrected and administratively 34.32 assessing monetary penalties for violations of sections 144.695 34.33 to 144.703 or rules, written operating requirements, orders, 34.34 stipulation agreements, settlements, or compliance agreements 34.35 adopted, enforced, or issued by the commissioner. 34.36 Subd. 2. [CONTENTS OF ORDER.] An order assessing an 35.1 administrative penalty under this section must include: 35.2 (1) a concise statement of the facts alleged to constitute 35.3 a violation; 35.4 (2) a reference to the section of law, rule, written 35.5 operating requirement, order, stipulation agreement, settlement, 35.6 or compliance agreement that has been violated; 35.7 (3) a statement of the amount of the administrative penalty 35.8 to be imposed and the factors upon which the penalty is based; 35.9 (4) a statement of the corrective actions necessary to 35.10 correct the violation; and 35.11 (5) a statement of the right to request a hearing pursuant 35.12 to sections 14.57 to 14.62. 35.13 Subd. 3. [CONCURRENT CORRECTIVE ORDER.] The commissioner 35.14 may issue an order assessing an administrative penalty and 35.15 requiring the violations cited in the order to be corrected 35.16 within 30 calendar days from the date the order is received. 35.17 Before the 31st day after the order was received, the voluntary, 35.18 nonprofit reporting organization that is subject to the order 35.19 shall provide the commissioner with information demonstrating 35.20 that the violation has been corrected or that a corrective plan, 35.21 acceptable to the commissioner, has been developed. The 35.22 commissioner shall determine whether the violation has been 35.23 corrected and notify the voluntary, nonprofit reporting 35.24 organization of the commissioner's determination. 35.25 Subd. 4. [PENALTY.] If the commissioner determines that 35.26 the violation has been corrected or an acceptable corrective 35.27 plan has been developed, the penalty may be forgiven, except 35.28 where there are repeated or serious violations, the commissioner 35.29 may issue an order with a penalty that will not be forgiven 35.30 after corrective action is taken. Unless there is a request for 35.31 review of the order under subdivision 6 before the penalty is 35.32 due, the penalty is due and payable: 35.33 (1) on the 31st calendar day after the order was received, 35.34 if the voluntary, nonprofit reporting organization fails to 35.35 provide information to the commissioner showing that the 35.36 violation has been corrected or that appropriate steps have been 36.1 taken toward correcting the violation; 36.2 (2) on the 20th day after the voluntary, nonprofit 36.3 reporting organization receives the commissioner's determination 36.4 that the information provided is not sufficient to show that 36.5 either the violation has been corrected or that appropriate 36.6 steps have been taken toward correcting the violation; or 36.7 (3) on the 31st day after the order was received where the 36.8 penalty is for repeated or serious violations and according to 36.9 the order issued, the penalty will not be forgiven after 36.10 corrective action is taken. 36.11 All penalties due under this section are payable to the 36.12 treasurer, state of Minnesota, and shall be deposited in the 36.13 general fund. 36.14 Subd. 5. [AMOUNT OF PENALTY; CONSIDERATIONS.] (a) The 36.15 maximum amount for an administrative penalty is $5,000 for each 36.16 specific violation identified in an inspection, investigation, 36.17 or compliance review, up to an annual maximum total for all 36.18 violations of ten percent of the fees collected by the 36.19 voluntary, nonprofit reporting organization under section 36.20 144.702, subdivision 1. The annual total is based upon the 36.21 reporting year. 36.22 (b) In determining the amount of the administrative 36.23 penalty, the commissioner shall consider the following: 36.24 (1) the willfulness of the violation; 36.25 (2) the gravity of the violation; 36.26 (3) the history of past violations; 36.27 (4) the number of violations; 36.28 (5) the economic benefit gained by the person allowing or 36.29 committing the violation; and 36.30 (6) other factors as justice may require, if the 36.31 commissioner specifically identifies the additional factors in 36.32 the commissioner's order. 36.33 (c) In determining the amount of a penalty for a violation 36.34 committed after an initial violation, the commissioner shall 36.35 also consider: 36.36 (1) the similarity of the most recent previous violation 37.1 and the current violation; 37.2 (2) the time elapsed since the last violation; and 37.3 (3) the response of the voluntary, nonprofit reporting 37.4 organization to the most recent previous violation. 37.5 Subd. 6. [REQUEST FOR HEARING; HEARING; AND FINAL 37.6 ORDER.] A request for hearing must be in writing, delivered to 37.7 the commissioner by certified mail within 20 calendar days after 37.8 the receipt of the order, and specifically state the reasons for 37.9 seeking review of the order. The commissioner must initiate a 37.10 hearing within 30 calendar days from the date of receipt of the 37.11 written request for hearing. The hearing shall be conducted 37.12 pursuant to the contested case procedures in sections 14.57 to 37.13 14.62. No earlier than ten calendar days after and within 30 37.14 calendar days of receipt of the presiding administrative law 37.15 judge's report, the commissioner shall, based on all relevant 37.16 facts, issue a final order modifying, vacating, or making the 37.17 original order permanent. If, within 20 calendar days of 37.18 receipt of the original order, the voluntary, nonprofit 37.19 reporting organization fails to request a hearing in writing, 37.20 the order becomes the final order of the commissioner. 37.21 Subd. 7. [REVIEW OF FINAL ORDER AND PAYMENT OF 37.22 PENALTY.] Once the commissioner issues a final order, any 37.23 penalty due under that order shall be paid within 30 calendar 37.24 days after the date of the final order, unless review of the 37.25 final order is requested. The final order of the commissioner 37.26 may be appealed in the manner prescribed in sections 14.63 to 37.27 14.69. If the final order is reviewed and upheld, the penalty 37.28 shall be paid 30 calendar days after the date of the decision of 37.29 the reviewing court. Failure to request an administrative 37.30 hearing pursuant to subdivision 6 shall constitute a waiver of 37.31 the right to further agency or judicial review of the final 37.32 order. 37.33 Subd. 8. [REINSPECTIONS AND EFFECT OF NONCOMPLIANCE.] If 37.34 upon reinspection, or in the determination of the commissioner, 37.35 it is found that any deficiency specified in the order has not 37.36 been corrected or an acceptable corrective plan has not been 38.1 developed, the voluntary, nonprofit reporting organization is in 38.2 noncompliance. The commissioner shall issue a notice of 38.3 noncompliance and may impose any additional remedy available 38.4 under sections 144.695 to 144.703. 38.5 Subd. 9. [ENFORCEMENT.] The attorney general may proceed 38.6 on behalf of the commissioner to enforce penalties that are due 38.7 and payable under this section in any manner provided by law for 38.8 the collection of debts. 38.9 Subd. 10. [TERMINATION OR NONRENEWAL OF REPORTING 38.10 ORGANIZATION.] The commissioner may withdraw or not renew 38.11 approval of any voluntary, nonprofit reporting organization for 38.12 failure on the part of the voluntary, nonprofit reporting 38.13 organization to pay penalties owed under this section. 38.14 Subd. 11. [CUMULATIVE REMEDY.] The authority of the 38.15 commissioner to issue an administrative penalty order is in 38.16 addition to other lawfully available remedies. 38.17 Subd. 12. [MEDIATION.] In addition to review under 38.18 subdivision 6, the commissioner is authorized to enter into 38.19 mediation concerning an order issued under this section if the 38.20 commissioner and the voluntary, nonprofit reporting organization 38.21 agree to mediation. 38.22 Sec. 24. Minnesota Statutes 1996, section 144.9501, 38.23 subdivision 1, is amended to read: 38.24 Subdivision 1. [CITATION.] Sections 144.9501 to 144.9509 38.25 may be cited as the "childhoodLead Poisoning Prevention Act." 38.26 Sec. 25. Minnesota Statutes 1996, section 144.9501, is 38.27 amended by adding a subdivision to read: 38.28 Subd. 4a. [ASSESSING AGENCY.] "Assessing agency" means the 38.29 commissioner or a board of health with authority and 38.30 responsibility to conduct lead risk assessments in response to 38.31 reports of children or pregnant women with elevated blood lead 38.32 levels. 38.33 Sec. 26. Minnesota Statutes 1996, section 144.9501, is 38.34 amended by adding a subdivision to read: 38.35 Subd. 6b. [CLEARANCE INSPECTION.] "Clearance inspection" 38.36 means a visual identification of deteriorated paint and bare 39.1 soil and a resampling and analysis of interior dust lead 39.2 concentrations in a residence to ensure that the lead standards 39.3 established in rules adopted under section 144.9508 are not 39.4 exceeded. 39.5 Sec. 27. Minnesota Statutes 1996, section 144.9501, 39.6 subdivision 17, is amended to read: 39.7 Subd. 17. [LEAD HAZARD REDUCTION.] "Lead hazard reduction" 39.8 means action undertakenin response to a lead orderto make a 39.9 residence, child care facility, school, or playground lead-safe 39.10 by complying with the lead standards and methods adopted under 39.11 section 144.9508, by: 39.12 (1) a property owner orlead contractor complyingpersons 39.13 hired by the property owner to comply with a lead order issued 39.14 under section 144.9504;or39.15 (2) a swab team service provided in response to a lead 39.16 order issued under section 144.9504; or 39.17 (3) a renter residing at a rental property or one or more 39.18 volunteers to comply with a lead order issued under section 39.19 144.9504. 39.20 Sec. 28. Minnesota Statutes 1996, section 144.9501, is 39.21 amended by adding a subdivision to read: 39.22 Subd. 17a. [LEAD HAZARD SCREEN.] "Lead hazard screen" 39.23 means visual identification of the existence and location of any 39.24 deteriorated paint, collection and analysis of dust samples, and 39.25 visual identification of the existence and location of bare soil. 39.26 Sec. 29. Minnesota Statutes 1996, section 144.9501, 39.27 subdivision 18, is amended to read: 39.28 Subd. 18. [LEAD INSPECTION.] "Lead inspection" means a 39.29qualitative orquantitativeanalytical inspection of a residence39.30for deteriorated paint or bare soil and the collection of39.31samples of deteriorated paint, bare soil, dust, or drinking39.32water for analysis to determine if the lead concentrations in39.33the samples exceed standards adopted under section 144.9508.39.34Lead inspection includes the clearance inspection after the39.35completion of a lead ordermeasurement of the lead content of 39.36 paint and a visual identification of the existence and location 40.1 of bare soil. 40.2 Sec. 30. Minnesota Statutes 1996, section 144.9501, 40.3 subdivision 20, is amended to read: 40.4 Subd. 20. [LEAD ORDER.] "Lead order" means a legal 40.5 instrument to compel a property owner to engage in lead hazard 40.6 reduction according to the specifications given by the 40.7inspectingassessing agency. 40.8 Sec. 31. Minnesota Statutes 1996, section 144.9501, is 40.9 amended by adding a subdivision to read: 40.10 Subd. 20a. [LEAD PROJECT DESIGNER.] "Lead project designer" 40.11 means an individual who is responsible for planning the 40.12 site-specific performance of lead abatement or lead hazard 40.13 reduction and who has been licensed by the commissioner under 40.14 section 144.9505. 40.15 Sec. 32. Minnesota Statutes 1996, section 144.9501, is 40.16 amended by adding a subdivision to read: 40.17 Subd. 20b. [LEAD RISK ASSESSMENT.] "Lead risk assessment" 40.18 means a quantitative measurement of the lead content of paint, 40.19 interior dust, and bare soil to determine compliance with the 40.20 standards established under section 144.9508. 40.21 Sec. 33. Minnesota Statutes 1996, section 144.9501, is 40.22 amended by adding a subdivision to read: 40.23 Subd. 20c. [LEAD RISK ASSESSOR.] "Lead risk assessor" 40.24 means an individual who performs lead risk assessments or lead 40.25 inspections and who has been licensed by the commissioner under 40.26 section 144.9506. 40.27 Sec. 34. Minnesota Statutes 1996, section 144.9501, is 40.28 amended by adding a subdivision to read: 40.29 Subd. 22a. [LEAD SUPERVISOR.] "Lead supervisor" means an 40.30 individual who is responsible for the on-site performance of 40.31 lead abatement or lead hazard reduction and who has been 40.32 licensed by the commissioner under section 144.9505. 40.33 Sec. 35. Minnesota Statutes 1996, section 144.9501, 40.34 subdivision 23, is amended to read: 40.35 Subd. 23. [LEAD WORKER.] "Lead worker" meansany person40.36who is certifiedan individual who performs lead abatement or 41.1 lead hazard reduction and who has been licensed by the 41.2 commissioner under section 144.9505. 41.3 Sec. 36. Minnesota Statutes 1996, section 144.9501, is 41.4 amended by adding a subdivision to read: 41.5 Subd. 25a. [PLAY AREA.] "Play area" means any established 41.6 area where children play, or on residential property, any 41.7 established area where children play or bare soil is accessible 41.8 to children. 41.9 Sec. 37. Minnesota Statutes 1996, section 144.9501, is 41.10 amended by adding a subdivision to read: 41.11 Subd. 28a. [STANDARD.] "Standard" means a quantitative 41.12 assessment of lead in any environmental media or consumer 41.13 product or a work practice or method that reduces the likelihood 41.14 of lead exposure. 41.15 Sec. 38. Minnesota Statutes 1996, section 144.9501, 41.16 subdivision 30, is amended to read: 41.17 Subd. 30. [SWAB TEAM WORKER.] "Swab team worker" meansa41.18person who is certifiedan individual who performs swab team 41.19 services and who has been licensed by the commissioner as a lead 41.20 worker under section 144.9505. 41.21 Sec. 39. Minnesota Statutes 1996, section 144.9501, 41.22 subdivision 32, is amended to read: 41.23 Subd. 32. [VOLUNTARY LEAD HAZARD REDUCTION.] "Voluntary 41.24 lead hazard reduction" meansaction undertaken by a property41.25owner with the intention to engage in lead hazard reduction or41.26abatementlead hazard reduction activities defined in 41.27 subdivision 17, but not undertaken in response to the issuance 41.28 of a lead order. 41.29 Sec. 40. Minnesota Statutes 1996, section 144.9502, 41.30 subdivision 3, is amended to read: 41.31 Subd. 3. [REPORTS OF BLOOD LEAD ANALYSIS REQUIRED.] (a) 41.32 Every hospital, medical clinic, medical laboratory,orother 41.33 facility, or individual performing blood lead analysis shall 41.34 report the results after the analysis of each specimen analyzed, 41.35 for both capillary and venous specimens, and epidemiologic 41.36 information required in this section to the commissioner of 42.1 health, within the time frames set forth in clauses (1) and (2): 42.2 (1) within two working days by telephone, fax, or 42.3 electronic transmission, with written or electronic confirmation 42.4 within one month, for a venous blood lead level equal to or 42.5 greater than 15 micrograms of lead per deciliter of whole blood; 42.6 or 42.7 (2) within one month in writing or by electronic 42.8 transmission, foraany capillary result or for a venous blood 42.9 lead level less than 15 micrograms of lead per deciliter of 42.10 whole blood. 42.11 (b) If a blood lead analysis is performed outside of 42.12 Minnesota and the facility performing the analysis does not 42.13 report the blood lead analysis results and epidemiological 42.14 information required in this section to the commissioner, the 42.15 provider who collected the blood specimen must satisfy the 42.16 reporting requirements of this section. For purposes of this 42.17 section, "provider" has the meaning given in section 62D.02, 42.18 subdivision 9. 42.19 (c) The commissioner shall coordinate with hospitals, 42.20 medical clinics, medical laboratories, and other facilities 42.21 performing blood lead analysis to develop a universal reporting 42.22 form and mechanism. 42.23The reporting requirements of this subdivision shall expire42.24on December 31, 1997. Beginning January 1, 1998, every42.25hospital, medical clinic, medical laboratory, or other facility42.26performing blood lead analysis shall report the results within42.27two working days by telephone, fax, or electronic transmission,42.28with written or electronic confirmation within one month, for42.29capillary or venous blood lead level equal to the level for42.30which reporting is recommended by the Center for Disease Control.42.31 Sec. 41. Minnesota Statutes 1996, section 144.9502, 42.32 subdivision 4, is amended to read: 42.33 Subd. 4. [BLOOD LEAD ANALYSES AND EPIDEMIOLOGIC 42.34 INFORMATION.] The blood lead analysis reports required in this 42.35 section must specify: 42.36 (1) whether the specimen was collected as a capillary or 43.1 venous sample; 43.2 (2) the date the sample was collected; 43.3 (3) the results of the blood lead analysis; 43.4 (4) the date the sample was analyzed; 43.5 (5) the method of analysis used; 43.6 (6) the full name, address, and phone number of the 43.7 laboratory performing the analysis; 43.8 (7) the full name, address, and phone number of the 43.9 physician or facility requesting the analysis; 43.10 (8) the full name, address, and phone number of the person 43.11 with theelevatedblood lead level, and the person's birthdate, 43.12 gender, and race. 43.13 Sec. 42. Minnesota Statutes 1996, section 144.9502, 43.14 subdivision 9, is amended to read: 43.15 Subd. 9. [CLASSIFICATION OF DATA.] Notwithstanding any law 43.16 to the contrary, including section 13.05, subdivision 9, data 43.17 collected by the commissioner of health about persons with 43.18elevatedblood lead levels, including analytic results from 43.19 samples of paint, soil, dust, and drinking water taken from the 43.20 individual's home and immediate property, shall be private and 43.21 may only be used by the commissioner of health, the commissioner 43.22 of labor and industry, authorized agents of Indian tribes, and 43.23 authorized employees of local boards of health for the purposes 43.24 set forth in this section. 43.25 Sec. 43. Minnesota Statutes 1996, section 144.9503, 43.26 subdivision 4, is amended to read: 43.27 Subd. 4. [SWAB TEAM SERVICES.] Primary prevention must 43.28 include the use of swab team services in census tracts 43.29 identified at high risk for toxic lead exposure as identified by 43.30 the commissioner under this section. The swab team services may 43.31 be provided based onvisual inspectionslead hazard screens 43.32 whenever possible and must at least include lead 43.33 hazardmanagementreduction for deteriorated interior lead-based 43.34 paint, bare soil, and dust. 43.35 Sec. 44. Minnesota Statutes 1996, section 144.9503, 43.36 subdivision 6, is amended to read: 44.1 Subd. 6. [VOLUNTARY LEAD ABATEMENT OR LEAD HAZARD 44.2 REDUCTION.] The commissioner shall monitor the lead abatement or 44.3 lead hazard reduction methods adopted under section 144.9508 in 44.4 cases of voluntary lead abatement or lead hazard reduction. All 44.5contractorspersons hired to do voluntary lead abatement or lead 44.6 hazard reduction must be licensedlead contractorsby the 44.7 commissioner under section 144.9505 or 144.9506. Renters and 44.8 volunteers performing lead abatement or lead hazard reduction 44.9 must be trained and licensed as lead supervisors or lead 44.10 workers. If a property owner does notuse a lead contractor44.11 hire a person for voluntary lead abatement or lead hazard 44.12 reduction, the property owner shall provide the commissioner 44.13 with a work plan for lead abatement or lead hazard reduction at 44.14 least ten working days before beginning the lead abatement or 44.15 lead hazard reduction. The work plan must include the details 44.16 required in section 144.9505, and notice as to when 44.17 lead abatement or lead hazard reduction activities will begin. 44.18 Within the limits of appropriations, the commissioner shall 44.19 review work plans and shall approve or disapprove them as to 44.20 compliance with the requirements in section 144.9505. No 44.21 penalty shall be assessed against a property owner for 44.22 discontinuing voluntary lead hazard reduction before completion 44.23 of the work plan, provided that the property owner discontinues 44.24 theplanlead hazard reduction in a manner that leaves the 44.25 property in a condition no more hazardous than its condition 44.26 before the work plan implementation. 44.27 Sec. 45. Minnesota Statutes 1996, section 144.9503, 44.28 subdivision 7, is amended to read: 44.29 Subd. 7. [LEAD-SAFE INFORMATIONAL DIRECTIVES.] (a) By July 44.30 1, 1995, and amended and updated as necessary, the commissioner 44.31 shall develop in cooperation with the commissioner of 44.32 administration provisions and procedures to define 44.33 lead-safe informational directives for residential remodeling, 44.34 renovation, installation, and rehabilitation activities that are 44.35 not lead hazard reduction, but may disrupt lead-based paint 44.36 surfaces. 45.1 (b) The provisions and procedures shall define lead-safe 45.2 directives for nonlead hazard reduction activities including 45.3 preparation, cleanup, and disposal procedures. The directives 45.4 shall be based on the different levels and types of work 45.5 involved and the potential for lead hazards. The directives 45.6 shall address activities including painting; remodeling; 45.7 weatherization; installation of cable, wire, plumbing, and gas; 45.8 and replacement of doors and windows. The commissioners of 45.9 health and administration shall consult with representatives of 45.10 builders, weatherization providers, nonprofit rehabilitation 45.11 organizations, each of the affected trades, and housing and 45.12 redevelopment authorities in developing the directives and 45.13 procedures. This group shall also make recommendations for 45.14 consumer and contractor education and training. The 45.15 commissioner of health shall report to the legislature by 45.16 February 15, 1996, regarding development of the provisions 45.17 required under thissubdivisionparagraph. 45.18 (c) By January 1, 1999, the commissioner, in cooperation 45.19 with interested and informed persons and using the meeting 45.20 structure and format developed in paragraph (b), shall develop 45.21 lead-safe informational directives on the following topics: 45.22 (1) maintaining floors, walls, and ceilings; 45.23 (2) maintaining and repairing porches; 45.24 (3) conducting a risk evaluation for lead; and 45.25 (4) prohibited practices when working with lead. 45.26 The commissioner shall report to the legislature by January 1, 45.27 1999, regarding development of the provisions required under 45.28 this paragraph. 45.29 Sec. 46. Minnesota Statutes 1996, section 144.9504, 45.30 subdivision 1, is amended to read: 45.31 Subdivision 1. [JURISDICTION.] (a) A board of health 45.32 serving cities of the first class must conduct leadinspections45.33 risk assessments for purposes of secondary prevention, according 45.34 to the provisions of this section. A board of health not 45.35 serving cities of the first class must conduct leadinspections45.36 risk assessments for the purposes of secondary prevention, 46.1 unless theycertifycertified in writing to the commissioner by 46.2 January 1, 1996, that theydesiredesired to relinquish these 46.3 duties back to the commissioner. At the discretion of the 46.4 commissioner, a board of health may relinquish the authority and 46.5 duty to perform lead risk assessments for secondary prevention 46.6 by so certifying in writing to the commissioner by December 31, 46.7 1999. At the discretion of the commissioner, a board of health 46.8 may, upon written request to the commissioner, resume these 46.9 duties. 46.10 (b)InspectionsLead risk assessments must be conducted by 46.11 a board of health serving a city of the first class. The 46.12 commissioner must conduct leadinspectionsrisk assessments in 46.13 any area not including cities of the first class where a board 46.14 of health has relinquished to the commissioner the 46.15 responsibility for leadinspectionsrisk assessments. The 46.16 commissioner shall coordinate with the board of health to ensure 46.17 that the requirements of this section are met. 46.18 (c) The commissioner may assist boards of health by 46.19 providing technical expertise, equipment, and personnel to 46.20 boards of health. The commissioner may provide laboratory or 46.21 field lead-testing equipment to a board of health or may 46.22 reimburse a board of health for direct costs associated with 46.23 leadinspectionsrisk assessments. 46.24 (d) The commissioner shall enforce the rules under section 46.25 144.9508 in cases of voluntary lead hazard reduction. 46.26 Sec. 47. Minnesota Statutes 1997 Supplement, section 46.27 144.9504, subdivision 2, is amended to read: 46.28 Subd. 2. [LEADINSPECTIONRISK ASSESSMENT.] (a) 46.29 Aninspectingassessing agency shall conduct a leadinspection46.30 risk assessment of a residence according to the venous blood 46.31 lead level and time frame set forth in clauses (1) to (5) for 46.32 purposes of secondary prevention: 46.33 (1) within 48 hours of a child or pregnant female in the 46.34 residence being identified to the agency as having a venous 46.35 blood lead level equal to or greater than 70 micrograms of lead 46.36 per deciliter of whole blood; 47.1 (2) within five working days of a child or pregnant female 47.2 in the residence being identified to the agency as having a 47.3 venous blood lead level equal to or greater than 45 micrograms 47.4 of lead per deciliter of whole blood; 47.5 (3) within ten working days of a child in the residence 47.6 being identified to the agency as having a venous blood lead 47.7 level equal to or greater than 20 micrograms of lead per 47.8 deciliter of whole blood; 47.9 (4) within ten working days of a child in the residence 47.10 being identified to the agency as having a venous blood lead 47.11 level that persists in the range of 15 to 19 micrograms of lead 47.12 per deciliter of whole blood for 90 days after initial 47.13 identification; or 47.14 (5) within ten working days of a pregnant female in the 47.15 residence being identified to the agency as having a venous 47.16 blood lead level equal to or greater than ten micrograms of lead 47.17 per deciliter of whole blood. 47.18 (b) Within the limits of available state and federal 47.19 appropriations, aninspectingassessing agency may also conduct 47.20 a leadinspectionrisk assessment for children with any elevated 47.21 blood lead level. 47.22 (c) In a building with two or more dwelling units, an 47.23inspectingassessing agency shall inspect the individual unit in 47.24 which the conditions of this section are met and shall also 47.25 inspect all common areas. If a child visits one or more other 47.26 sites such as another residence, or a residential or commercial 47.27 child care facility, playground, or school, theinspecting47.28 assessing agency shall also inspect the other sites. 47.29 Theinspectingassessing agency shall have one additional day 47.30 added to the time frame set forth in this subdivision to 47.31 complete the leadinspectionrisk assessment for each additional 47.32 site. 47.33 (d) Within the limits of appropriations, theinspecting47.34 assessing agency shall identify the known addresses for the 47.35 previous 12 months of the child or pregnant female with venous 47.36 blood lead levels of at least 20 micrograms per deciliter for 48.1 the child or at least ten micrograms per deciliter for the 48.2 pregnant female; notify the property owners, landlords, and 48.3 tenants at those addresses that an elevated blood lead level was 48.4 found in a person who resided at the property; and give them a 48.5 copy of the leadinspectionrisk assessment guide. The 48.6inspectingassessing agency shall provide the notice required by 48.7 this subdivision without identifying the child or pregnant 48.8 female with the elevated blood lead level. Theinspecting48.9 assessing agency is not required to obtain the consent of the 48.10 child's parent or guardian or the consent of the pregnant female 48.11 for purposes of this subdivision. This information shall be 48.12 classified as private data on individuals as defined under 48.13 section 13.02, subdivision 12. 48.14 (e) Theinspectingassessing agency shall conduct the lead 48.15inspectionrisk assessment according to rules adopted by the 48.16 commissioner under section 144.9508. Aninspectingassessing 48.17 agency shall have leadinspectionsrisk assessments performed by 48.18 leadinspectorsrisk assessors licensed by the commissioner 48.19 according to rules adopted under section 144.9508. If a 48.20 property owner refuses to allowan inspectiona lead risk 48.21 assessment, theinspectingassessing agency shall begin legal 48.22 proceedings to gain entry to the property and the time frame for 48.23 conducting a leadinspectionrisk assessment set forth in this 48.24 subdivision no longer applies.An inspectorA lead risk 48.25 assessor orinspectingassessing agency may observe the 48.26 performance of lead hazard reduction in progress and shall 48.27 enforce the provisions of this section under section 144.9509. 48.28 Deteriorated painted surfaces, bare soil, and dust, and drinking48.29watermust be tested with appropriate analytical equipment to 48.30 determine the lead content, except that deteriorated painted 48.31 surfaces or bare soil need not be tested if the property owner 48.32 agrees to engage in lead hazard reduction on those 48.33 surfaces. The lead content of drinking water must be measured 48.34 if a probable source of lead exposure is not identified by 48.35 measurement of lead in paint, bare soil, or dust. Within a 48.36 standard metropolitan statistical area, an assessing agency may 49.1 order lead hazard reduction of bare soil without measuring the 49.2 lead content of the bare soil if the property is in a census 49.3 tract in which soil sampling has been performed according to 49.4 rules established by the commissioner and at least 25 percent of 49.5 the soil samples contain lead concentrations above the standard 49.6 in section 144.9508. 49.7 (f) A leadinspectorrisk assessor shall notify the 49.8 commissioner and the board of health of all violations of lead 49.9 standards under section 144.9508, that are identified in a 49.10 leadinspectionrisk assessment conducted under this section. 49.11 (g) Eachinspectingassessing agency shall establish an 49.12 administrative appeal procedure which allows a property owner to 49.13 contest the nature and conditions of any lead order issued by 49.14 theinspectingassessing agency.InspectingAssessing agencies 49.15 must consider appeals that propose lower cost methods that make 49.16 the residence lead safe. 49.17 (h) Sections 144.9501 to 144.9509 neither authorize nor 49.18 prohibit aninspectingassessing agency from charging a property 49.19 owner for the cost of a leadinspectionrisk assessment. 49.20 Sec. 48. Minnesota Statutes 1996, section 144.9504, 49.21 subdivision 3, is amended to read: 49.22 Subd. 3. [LEAD EDUCATION STRATEGY.] At the time of a 49.23 leadinspectionrisk assessment or following a lead order, the 49.24inspectingassessing agency shall ensure that a family will 49.25 receive a visit at their residence by a swab team worker or 49.26 public health professional, such as a nurse, sanitarian, public 49.27 health educator, or other public health professional. The swab 49.28 team worker or public health professional shall inform the 49.29 property owner, landlord, and the tenant of the health-related 49.30 aspects of lead exposure; nutrition; safety measures to minimize 49.31 exposure; methods to be followed before, during, and after the 49.32 lead hazard reduction process; and community, legal, and housing 49.33 resources. If a family moves to a temporary residence during 49.34 the lead hazard reduction process, lead education services 49.35 should be provided at the temporary residence whenever feasible. 49.36 Sec. 49. Minnesota Statutes 1996, section 144.9504, 50.1 subdivision 4, is amended to read: 50.2 Subd. 4. [LEADINSPECTIONRISK ASSESSMENT GUIDES.] (a) The 50.3 commissioner of health shall develop or purchase leadinspection50.4 risk assessment guides that enable parents and other caregivers 50.5 to assess the possible lead sources present and that suggest 50.6 lead hazard reduction actions. The guide must provide 50.7 information on lead hazard reduction and disposal methods, 50.8 sources of equipment, and telephone numbers for additional 50.9 information to enable the persons to either selecta lead50.10contractorpersons licensed by the commissioner under section 50.11 144.9505 or 144.9506 to perform lead hazard reduction or perform 50.12 the lead hazard reduction themselves. The guides must explain: 50.13 (1) the requirements of this section and rules adopted 50.14 under section 144.9508; 50.15 (2) information on the administrative appeal procedures 50.16 required under this section; 50.17 (3) summary information on lead-safe directives; 50.18 (4) be understandable at an eighth grade reading level; and 50.19 (5) be translated for use by non-English-speaking persons. 50.20 (b) Aninspectingassessing agency shall provide the lead 50.21inspectionrisk assessment guides at no cost to: 50.22 (1) parents and other caregivers of children who are 50.23 identified as having blood lead levels of at least ten 50.24 micrograms of lead per deciliter of whole blood; 50.25 (2) all property owners who are issued housing code or lead 50.26 orders requiring lead hazard reduction of lead sources and all 50.27 occupants of those properties; and 50.28 (3) occupants of residences adjacent to the inspected 50.29 property. 50.30 (c) Aninspectingassessing agency shall provide the lead 50.31inspectionrisk assessment guides on request to owners or 50.32 occupants of residential property, builders, contractors, 50.33 inspectors, and the public within the jurisdiction of 50.34 theinspectingassessing agency. 50.35 Sec. 50. Minnesota Statutes 1996, section 144.9504, 50.36 subdivision 5, is amended to read: 51.1 Subd. 5. [LEAD ORDERS.] Aninspectingassessing agency, 51.2 after conducting a leadinspectionrisk assessment, shall order 51.3 a property owner to perform lead hazard reduction on all lead 51.4 sources that exceed a standard adopted according to section 51.5 144.9508. If leadinspectionsrisk assessments and lead orders 51.6 are conducted at times when weather or soil conditions do not 51.7 permit the leadinspectionrisk assessment or lead hazard 51.8 reduction, external surfaces and soil lead shall be inspected, 51.9 and lead orders complied with, if necessary, at the first 51.10 opportunity that weather and soil conditions allow. If the 51.11 paint standard under section 144.9508 is violated, but the paint 51.12 is intact, theinspectingassessing agency shall not order the 51.13 paint to be removed unless the intact paint is a known source of 51.14 actual lead exposure to a specific person. Before the 51.15inspectingassessing agency may order the intact paint to be 51.16 removed, a reasonable effort must be made to protect the child 51.17 and preserve the intact paint by the use of guards or other 51.18 protective devices and methods. Whenever windows and doors or 51.19 other components covered with deteriorated lead-based paint have 51.20 sound substrate or are not rotting, those components should be 51.21 repaired, sent out for stripping or be planed down to remove 51.22 deteriorated lead-based paint or covered with protective guards 51.23 instead of being replaced, provided that such an activity is the 51.24 least cost method. However, a property owner who has been 51.25 ordered to perform lead hazard reduction may choose any method 51.26 to address deteriorated lead-based paint on windows, doors, or 51.27 other components, provided that the method is approved in rules 51.28 adopted under section 144.9508 and that it is appropriate to the 51.29 specific property. Lead orders must require that any source of 51.30 damage, such as leaking roofs, plumbing, and windows, be 51.31 repaired or replaced, as needed, to prevent damage to 51.32 lead-containing interior surfaces. Theinspectingassessing 51.33 agency is not required to pay for lead hazard reduction. Lead 51.34 orders must be issued within 30 days of receiving the blood lead 51.35 level analysis. Theinspectingassessing agency shall enforce 51.36 the lead orders issued to a property owner under this section. 52.1 A copy of the lead order must be forwarded to the commissioner. 52.2 Sec. 51. Minnesota Statutes 1996, section 144.9504, 52.3 subdivision 6, is amended to read: 52.4 Subd. 6. [SWAB TEAM SERVICES.] After a leadinspection52.5 risk assessment or after issuing lead orders, theinspecting52.6 assessing agency, within the limits of appropriations and 52.7 availability, shall offer the property owner the services of a 52.8 swab team free of charge and, if accepted, shall send a swab 52.9 team within ten working days to the residence to perform swab 52.10 team services as defined in section 144.9501. If theinspecting52.11 assessing agency provides swab team services after a 52.12 leadinspectionrisk assessment, but before the issuance of a 52.13 lead order, swab team services do not need to be repeated after 52.14 the issuance of the lead order if the swab team services 52.15 fulfilled the lead order. Swab team services are not considered 52.16 completed until the clearance inspection required under this 52.17 section shows that the property is lead safe. 52.18 Sec. 52. Minnesota Statutes 1996, section 144.9504, 52.19 subdivision 7, is amended to read: 52.20 Subd. 7. [RELOCATION OF RESIDENTS.] (a) Within the limits 52.21 of appropriations, theinspectingassessing agency shall ensure 52.22 that residents are relocated from rooms or dwellings during a 52.23 lead hazard reduction process that generates leaded dust, such 52.24 as removal or disruption of lead-based paint or plaster that 52.25 contains lead. Residents shall not remain in rooms or dwellings 52.26 where the lead hazard reduction process is occurring. An 52.27inspectingassessing agency is not required to pay for 52.28 relocation unless state or federal funding is available for this 52.29 purpose. Theinspectingassessing agency shall make an effort 52.30 to assist the resident in locating resources that will provide 52.31 assistance with relocation costs. Residents shall be allowed to 52.32 return to the residence or dwelling after completion of the lead 52.33 hazard reduction process. Aninspectingassessing agency shall 52.34 use grant funds under section 144.9507 if available, in 52.35 cooperation with local housing agencies, to pay for moving costs 52.36 and rent for a temporary residence for any low-income resident 53.1 temporarily relocated during lead hazard reduction. For 53.2 purposes of this section, "low-income resident" means any 53.3 resident whose gross household income is at or below 185 percent 53.4 of federal poverty level. 53.5 (b) A resident of rental property who is notified by an 53.6inspectingassessing agency to vacate the premises during lead 53.7 hazard reduction, notwithstanding any rental agreement or lease 53.8 provisions: 53.9 (1) shall not be required to pay rent due the landlord for 53.10 the period of time the tenant vacates the premises due to lead 53.11 hazard reduction; 53.12 (2) may elect to immediately terminate the tenancy 53.13 effective on the date the tenant vacates the premises due to 53.14 lead hazard reduction; and 53.15 (3) shall not, if the tenancy is terminated, be liable for 53.16 any further rent or other charges due under the terms of the 53.17 tenancy. 53.18 (c) A landlord of rental property whose tenants vacate the 53.19 premises during lead hazard reduction shall: 53.20 (1) allow a tenant to return to the dwelling unit after 53.21 lead hazard reduction and clearance inspection, required under 53.22 this section, is completed, unless the tenant has elected to 53.23 terminate the tenancy as provided for in paragraph (b); and 53.24 (2) return any security deposit due under section 504.20 53.25 within five days of the date the tenant vacates the unit, to any 53.26 tenant who terminates tenancy as provided for in paragraph (b). 53.27 Sec. 53. Minnesota Statutes 1996, section 144.9504, 53.28 subdivision 8, is amended to read: 53.29 Subd. 8. [PROPERTY OWNER RESPONSIBILITY.] Property owners 53.30 shall comply with lead orders issued under this section within 53.31 60 days or be subject to enforcement actions as provided under 53.32 section 144.9509. For orders or portions of orders concerning 53.33 external lead hazards, property owners shall comply within 60 53.34 days, or as soon thereafter as weather permits. If the property 53.35 owner does notuse a lead contractorhire a person licensed by 53.36 the commissioner under section 144.9505 for compliance with the 54.1 lead orders, the property owner shall submit a work plan to 54.2 theinspectingassessing agency within 30 days after receiving 54.3 the orders. The work plan must include the details required in 54.4 section 144.9505 as to how the property owner intends to comply 54.5 with the lead orders and notice as to when lead hazard reduction 54.6 activities will begin. Within the limits of appropriations, the 54.7 commissioner shall review plans and shall approve or disapprove 54.8 them as to compliance with the requirements in section 144.9505, 54.9 subdivision 5. Renters and volunteers performing lead abatement 54.10 or lead hazard reduction must be trained and licensed as lead 54.11 supervisors or lead workers under section 144.9505. 54.12 Sec. 54. Minnesota Statutes 1996, section 144.9504, 54.13 subdivision 9, is amended to read: 54.14 Subd. 9. [CLEARANCE INSPECTION.] After completion of swab 54.15 team services and compliance with the lead orders by the 54.16 property owner, including any repairs ordered by a local housing 54.17 or building inspector, theinspectingassessing agency shall 54.18 conduct a clearance inspection byvisually inspecting the54.19residence forvisual identification of deteriorated paint and 54.20 bare soil and retest the dust lead concentration in the 54.21 residence to assure that violations of the lead standards under 54.22 section 144.9508 no longer exist. Theinspectingassessing 54.23 agency is not required to test a dwelling unit after lead hazard 54.24 reduction that was not ordered by theinspectingassessing 54.25 agency. 54.26 Sec. 55. Minnesota Statutes 1996, section 144.9504, 54.27 subdivision 10, is amended to read: 54.28 Subd. 10. [CASE CLOSURE.] A leadinspectionrisk 54.29 assessment is completed and the responsibility of theinspecting54.30 assessing agency ends when all of the following conditions are 54.31 met: 54.32 (1) lead orders are written on all known sources of 54.33 violations of lead standards under section 144.9508; 54.34 (2) compliance with all lead orders has been completed; and 54.35 (3) clearance inspections demonstrate that no deteriorated 54.36 lead paint, bare soil, or lead dust levels exist that exceed the 55.1 standards adopted under section 144.9508. 55.2 Sec. 56. Minnesota Statutes 1996, section 144.9505, 55.3 subdivision 1, is amended to read: 55.4 Subdivision 1. [LICENSING AND CERTIFICATION.] (a)Lead55.5contractorsA person shall, before performing abatement or lead 55.6 hazard reduction or providing planning services for lead 55.7 abatement or lead hazard reduction, obtain a license from the 55.8 commissioner as a lead supervisor, lead worker, or lead project 55.9 designer.Workers for lead contractors shall obtain55.10certification from the commissioner.The commissioner shall 55.11 specify training and testing requirements for licensure and 55.12 certification as required in section 144.9508 and shall charge a 55.13 fee for the cost of issuing a license or certificate and for 55.14 training provided by the commissioner.Fees collected under55.15this section shall be set in amounts to be determined by the55.16commissioner to cover but not exceed the costs of adopting rules55.17under section 144.9508, the costs of licensure, certification,55.18and training, and the costs of enforcing licenses and55.19certificates under this section.License fees shall be 55.20 nonrefundable and must be submitted with each application in the 55.21 amount of $50 for each lead supervisor, lead worker, or lead 55.22 inspector and $100 for each lead project designer, lead risk 55.23 assessor, or certified firm. All fees received shall be paid 55.24 into the state treasury and credited to the lead abatement 55.25 licensing and certification account and are appropriated to the 55.26 commissioner to cover costs incurred under this section and 55.27 section 144.9508. 55.28 (b)ContractorsPersons shall not advertise or otherwise 55.29 present themselves as leadcontractorssupervisors, lead 55.30 workers, or lead project designers unless they havelead55.31contractorlicenses issued by thedepartment of health55.32 commissioner under section 144.9505. 55.33 Sec. 57. Minnesota Statutes 1996, section 144.9505, 55.34 subdivision 4, is amended to read: 55.35 Subd. 4. [NOTICE OF LEAD ABATEMENT OR LEAD HAZARD 55.36 REDUCTION WORK.] (a) At least five working days before starting 56.1 work at each lead abatement or lead hazard reduction worksite, 56.2 the person performing the lead abatement or lead hazard 56.3 reduction work shall give written notice and an approved work 56.4 plan as required in this section to the commissioner and the 56.5 appropriate board of health. Within the limits of 56.6 appropriations, the commissioner shall review plans and shall 56.7 approve or disapprove them as to compliance with the 56.8 requirements in subdivision 5. 56.9 (b) This provision does not apply to swab team workers 56.10 performing work under an order of aninspectingassessing agency. 56.11 Sec. 58. Minnesota Statutes 1996, section 144.9505, 56.12 subdivision 5, is amended to read: 56.13 Subd. 5. [ABATEMENT OR LEAD HAZARD REDUCTION WORK PLANS.] 56.14 (a) Alead contractorperson who performs lead abatement or lead 56.15 hazard reduction shall present a lead abatement or lead hazard 56.16 reduction work plan to the property owner with each bid or 56.17 estimate for lead abatement or lead hazard reduction work. 56.18 The work plan does not replace or supersede more stringent 56.19 contractual agreements. A written lead abatement or lead hazard 56.20 reduction work plan must be prepared which describes the 56.21 equipment and procedures to be used throughout the lead 56.22 abatement or lead hazard reduction work project. At a minimum, 56.23 the work plan must describe: 56.24 (1) the building area and building components to be worked 56.25 on; 56.26 (2) the amount of lead-containing material to be removed, 56.27 encapsulated, or enclosed; 56.28 (3) the schedule to be followed for each work stage; 56.29 (4) the workers' personal protection equipment and 56.30 clothing; 56.31 (5) the dust suppression and debris containment methods; 56.32 (6) the lead abatement or lead hazard reduction methods to 56.33 be used on each building component; 56.34 (7) cleaning methods; 56.35 (8) temporary, on-site waste storage, if any; and 56.36 (9) the methods for transporting waste material and its 57.1 destination. 57.2 (b)A lead contractorThe work plan shall itemize the costs 57.3 for each item listed in paragraph (a) and for any other expenses 57.4 associated with the lead abatement or lead hazard reduction work 57.5 and shallpresent these costsbe presented to the property owner 57.6 with any bid or estimate for lead abatement or lead hazard 57.7 reduction work. 57.8 (c)A lead contractorThe person performing the lead 57.9 abatement or lead hazard reduction shall keep a copy of the work 57.10 plan readily available at the worksite for the duration of the 57.11 project and present it to theinspectingassessing agency on 57.12 demand. 57.13 (d)A lead contractorThe person performing the lead 57.14 abatement or lead hazard reduction shall keep a copy of the work 57.15 plan on record for one year after completion of the project and 57.16 shall present it to theinspectingassessing agency on demand. 57.17 (e) This provision does not apply to swab team workers 57.18 performing work under an order of aninspectingassessing agency 57.19 or providing services at no cost to a property owner with 57.20 funding under a state or federal grant. 57.21 Sec. 59. Minnesota Statutes 1997 Supplement, section 57.22 144.9506, subdivision 1, is amended to read: 57.23 Subdivision 1. [LICENSE REQUIRED.] (a) Alead57.24inspectorperson shall obtain a license as a lead inspector or a 57.25 lead risk assessor before performing lead inspections, lead 57.26 hazard screens, or lead risk assessments and shall renew 57.27 itannuallyas required in rules adopted under section 144.9508. 57.28 The commissioner shall charge a fee and requireannualrefresher 57.29 training, as specified in this section. A lead inspector or 57.30 lead risk assessor shall have the lead inspector's license or 57.31 lead risk assessor's license readily available at all times 57.32 atana lead inspection site or lead risk assessment site and 57.33 make it available, on request, forinspectionexamination by the 57.34inspectingassessing agency with jurisdiction over the site. A 57.35 license shall not be transferred. License fees shall be 57.36 nonrefundable and must be submitted with each application in the 58.1 amount of $50 for each lead inspector and $100 for each lead 58.2 risk assessor. 58.3 (b) Individuals shall not advertise or otherwise present 58.4 themselves as lead inspectors or lead risk assessors unless 58.5 licensed by the commissioner. 58.6 (c) An individual may use sodium rhodizonate to test paint 58.7 for the presence of lead without obtaining a lead inspector or 58.8 lead risk assessor license, but must not represent the test as a 58.9 lead inspection or lead risk assessment. 58.10 Sec. 60. Minnesota Statutes 1996, section 144.9506, 58.11 subdivision 2, is amended to read: 58.12 Subd. 2. [LICENSE APPLICATION.] An application for a 58.13 license or license renewal shall be on a form provided by the 58.14 commissioner and shall include: 58.15 (1) a$50nonrefundable fee, in a form approved by the 58.16 commissioner; and 58.17 (2) evidence that the applicant has successfully completed 58.18 a lead inspector training course approved under this section or 58.19 from another state with which the commissioner has established 58.20 reciprocity. The fee required in this section is waived for 58.21 federal, state, or local government employees within Minnesota. 58.22 Sec. 61. Minnesota Statutes 1996, section 144.9507, 58.23 subdivision 2, is amended to read: 58.24 Subd. 2. [LEADINSPECTIONRISK ASSESSMENT CONTRACTS.] The 58.25 commissioner shall, within available federal or state 58.26 appropriations, contract with boards of health to conduct 58.27 leadinspectionsrisk assessments to determine sources of lead 58.28 contamination and to issue and enforce lead orders according to 58.29 section 144.9504. 58.30 Sec. 62. Minnesota Statutes 1996, section 144.9507, 58.31 subdivision 3, is amended to read: 58.32 Subd. 3. [TEMPORARY LEAD-SAFE HOUSING CONTRACTS.] The 58.33 commissioner shall, within the limits of available 58.34 appropriations, contract with boards of health for temporary 58.35 housing, to be used in meeting relocation requirements in 58.36 section 144.9504, and award grants to boards of health for the 59.1 purposes of paying housing and relocation costs under section 59.2 144.9504. The commissioner may use up to 15 percent of the 59.3 available appropriations to provide temporary lead-safe housing 59.4 in areas of the state in which the commissioner has the duty 59.5 under section 144.9504 to perform secondary prevention. 59.6 Sec. 63. Minnesota Statutes 1996, section 144.9507, 59.7 subdivision 4, is amended to read: 59.8 Subd. 4. [LEAD CLEANUP EQUIPMENT AND MATERIALGRANTS TO 59.9 NONPROFIT ORGANIZATIONS.] (a) The commissioner shall, within the 59.10 limits of available state or federal appropriations, provide 59.11 funds for lead cleanup equipment and materials under a grant 59.12 program to nonprofit community-based organizations in areas at 59.13 high risk for toxic lead exposure, as provided for in section 59.14 144.9503. 59.15 (b) Nonprofit community-based organizations in areas at 59.16 high risk for toxic lead exposure may apply for grants from the 59.17 commissioner to purchase lead cleanup equipment and materials 59.18 and to pay for training for staff and volunteers for lead 59.19 licensure under sections 144.9505 and 144.9506. 59.20 (c) For purposes of this section, lead cleanup equipment 59.21 and materials means high efficiency particle accumulator (HEPA) 59.22 and wet vacuum cleaners, wash water filters, mops, buckets, 59.23 hoses, sponges, protective clothing, drop cloths, wet scraping 59.24 equipment, secure containers, dust and particle containment 59.25 material, and other cleanup and containment materials to remove 59.26 loose paint and plaster, patch plaster, control household dust, 59.27 wax floors, clean carpets and sidewalks, and cover bare soil. 59.28 (d) The grantee's staff and volunteers may make lead 59.29 cleanup equipment and materials available to residents and 59.30 property owners and instruct them on the proper use of the 59.31 equipment. Lead cleanup equipment and materials must be made 59.32 available to low-income households, as defined by federal 59.33 guidelines, on a priority basis at no fee. Other households may 59.34 be charged on a sliding fee scale. 59.35 (e) The grantee shall not charge a fee for services 59.36 performed using the equipment or materials. 60.1 (f) Any funds appropriated for purposes of this subdivision 60.2 that are not awarded, due to a lack of acceptable proposals for 60.3 the full amount appropriated, may be used for any purpose 60.4 authorized in this section. 60.5 Sec. 64. Minnesota Statutes 1996, section 144.9508, 60.6 subdivision 1, is amended to read: 60.7 Subdivision 1. [SAMPLING AND ANALYSIS.] The commissioner 60.8 shall adopt, by rule,visual inspection and sampling and60.9analysismethods for: 60.10 (1) lead inspectionsunder section 144.9504, lead hazard 60.11 screens, lead risk assessments, and clearance inspections; 60.12 (2) environmental surveys of lead in paint, soil, dust, and 60.13 drinking water to determine census tracts that are areas at high 60.14 risk for toxic lead exposure; 60.15 (3) soil sampling for soil used as replacement soil;and60.16 (4) drinking water sampling, which shall be done in 60.17 accordance with lab certification requirements and analytical 60.18 techniques specified by Code of Federal Regulations, title 40, 60.19 section 141.89; and 60.20 (5) sampling to determine whether at least 25 percent of 60.21 the soil samples collected from a census tract within a standard 60.22 metropolitan statistical area contain lead in concentrations 60.23 that exceed 100 parts per million. 60.24 Sec. 65. Minnesota Statutes 1996, section 144.9508, is 60.25 amended by adding a subdivision to read: 60.26 Subd. 2a. [LEAD STANDARDS FOR EXTERIOR SURFACES AND STREET 60.27 DUST.] The commissioner may, by rule, establish lead standards 60.28 for exterior horizontal surfaces, concrete or other impervious 60.29 surfaces, and street dust on residential property to protect the 60.30 public health and the environment. 60.31 Sec. 66. Minnesota Statutes 1996, section 144.9508, 60.32 subdivision 3, is amended to read: 60.33 Subd. 3. [LEAD CONTRACTORS AND WORKERSLICENSURE AND 60.34 CERTIFICATION.] The commissioner shall adopt rules to license 60.35 leadcontractors and to certifysupervisors, lead workersof60.36lead contractors who perform lead abatement or lead hazard61.1reduction, lead project designers, lead inspectors, and lead 61.2 risk assessors. The commissioner shall also adopt rules 61.3 requiring certification of firms that perform lead abatement, 61.4 lead hazard reduction, lead hazard screens, or lead risk 61.5 assessments. The commissioner shall require periodic renewal of 61.6 licenses and certificates and shall establish the renewal 61.7 periods. 61.8 Sec. 67. Minnesota Statutes 1996, section 144.9508, 61.9 subdivision 4, is amended to read: 61.10 Subd. 4. [LEAD TRAINING COURSE.] The commissioner shall 61.11 establish by rule a permit fee to be paid by a training course 61.12 provider on application for a training course permit or renewal 61.13 period for each lead-related training course required for 61.14 certification or licensure. The commissioner shall establish 61.15 criteria in rules for the content and presentation of training 61.16 courses intended to qualify trainees for licensure under 61.17 subdivision 3. Training course permit fees shall be 61.18 nonrefundable and must be submitted with each application in the 61.19 amount of $500 for an initial training course, $250 for renewal 61.20 of a permit for an initial training course, $250 for a refresher 61.21 training course, and $125 for renewal of a permit of a refresher 61.22 training course. 61.23 Sec. 68. Minnesota Statutes 1996, section 144.9509, 61.24 subdivision 2, is amended to read: 61.25 Subd. 2. [DISCRIMINATION.] A person who discriminates 61.26 against or otherwise sanctions an employee who complains to or 61.27 cooperates with theinspectingassessing agency in administering 61.28 sections 144.9501 to 144.9509 is guilty of a petty misdemeanor. 61.29 Sec. 69. [144.9511] [LEAD-SAFE PROPERTY CERTIFICATION.] 61.30 Subdivision 1. [LEAD-SAFE PROPERTY CERTIFICATION PROGRAM 61.31 ESTABLISHED.] (a) The commissioner shall establish, within the 61.32 limits of available appropriations, a voluntary lead-safe 61.33 property certification program for residential properties. This 61.34 program shall involve an initial property certification process, 61.35 a property condition report, and a lead-safe property 61.36 certification booklet. 62.1 (b) The commissioner shall establish an initial property 62.2 certification process composed of the following: 62.3 (1) a lead hazard screen, which shall include a visual 62.4 evaluation of a residential property for both deteriorated paint 62.5 and bare soil; and 62.6 (2) a quantitative measure of lead in dust within the 62.7 structure and in common areas as determined by rule adopted 62.8 under authority of section 144.9508. 62.9 (c) The commissioner shall establish forms and checklists 62.10 for conducting a property condition report. A property 62.11 condition report is an evaluation of property components, 62.12 without regard to aesthetic considerations, to determine whether 62.13 any of the following conditions are likely to occur within one 62.14 year of the report: 62.15 (1) paint will become chipped, flaked, or cracked; 62.16 (2) structural defects in the roof, windows, or plumbing 62.17 will fail and cause paint to deteriorate; 62.18 (3) window wells or window troughs will not be cleanable 62.19 and washable; 62.20 (4) windows will generate dust due to friction; 62.21 (5) cabinet, room, and threshold doors will rub against 62.22 casings or have repeated contact with painted surfaces; 62.23 (6) floors will not be smooth and cleanable and carpeted 62.24 floors will not be cleanable; 62.25 (7) soil will not remain covered; 62.26 (8) bare soil in vegetable and flower gardens will not (i) 62.27 be inaccessible to children or (ii) be tested to determine if it 62.28 is below the soil standard under section 144.9508; 62.29 (9) parking areas will not remain covered by an impervious 62.30 surface or gravel; 62.31 (10) covered soil will erode, particularly in play areas; 62.32 and 62.33 (11) gutters and down spouts will not function correctly. 62.34 (d) The commissioner shall develop a lead-safe property 62.35 certification booklet that contains the following: 62.36 (1) information on how property owners and their 63.1 maintenance personnel can perform essential maintenance 63.2 practices to correct any of the property component conditions 63.3 listed in paragraph (c) that may occur; 63.4 (2) the lead-safe work practices fact sheets created under 63.5 section 144.9503, subdivision 7; 63.6 (3) forms, checklists, and copies of recommended lead-safe 63.7 property certification certificates; and 63.8 (4) an educational sheet for landlords to give to tenants 63.9 on the importance of having tenants inform property owners or 63.10 designated maintenance staff of one or more of the conditions 63.11 listed in paragraph (c). 63.12 Subd. 2. [CONDITIONS FOR CERTIFICATION.] A property shall 63.13 be certified as lead-safe only if the following conditions are 63.14 met: 63.15 (1) the property passes the initial certification process 63.16 in subdivision 1; 63.17 (2) the property owner agrees in writing to perform 63.18 essential maintenance practices; 63.19 (3) the property owner agrees in writing to use lead-safe 63.20 work practices, as provided for under section 144.9503, 63.21 subdivision 7; 63.22 (4) the property owner performs essential maintenance as 63.23 the need arises or uses maintenance personnel who have completed 63.24 a United States Environmental Protection Agency- or Minnesota 63.25 department of health-approved maintenance training program or 63.26 course to perform essential maintenance; 63.27 (5) the lead-safe property certification booklet is 63.28 distributed to the property owner, maintenance personnel, and 63.29 tenants at the completion of the initial certification process; 63.30 and 63.31 (6) a copy of the lead-safe property certificate is filed 63.32 with the commissioner along with a $5 filing fee. 63.33 Subd. 3. [LEAD STANDARDS.] Lead standards used in this 63.34 section shall be those approved by the commissioner under 63.35 section 144.9508. 63.36 Subd. 4. [LEAD RISK ASSESSORS.] Lead-safe property 64.1 certifications shall only be performed by lead risk assessors 64.2 licensed by the commissioner under section 144.9506. 64.3 Subd. 5. [EXPIRATION.] Lead-safe property certificates are 64.4 valid for one year. 64.5 Subd. 6. [LIST OF CERTIFIED PROPERTIES.] Within the limits 64.6 of available appropriations, the commissioner shall maintain a 64.7 list of all properties certified as lead-safe under this section 64.8 and make it freely available to the public. 64.9 Subd. 7. [REAPPLICATION.] Properties failing the initial 64.10 property certification may reapply for a lead-safe property 64.11 certification by having a new initial certification process 64.12 performed and by correcting any condition listed by the licensed 64.13 lead risk assessor in the property condition report. Properties 64.14 that fail the initial property certification process must have 64.15 the condition corrected by the property owner, by trained 64.16 maintenance staff, or by a contractor with personnel licensed 64.17 for lead hazard reduction or lead abatement work by the 64.18 commissioner under section 144.9505, in order to have the 64.19 property certified. 64.20 Sec. 70. Minnesota Statutes 1996, section 144.99, 64.21 subdivision 1, is amended to read: 64.22 Subdivision 1. [REMEDIES AVAILABLE.] The provisions of 64.23 chapters 103I and 157 and sections 115.71 to 115.77; 144.12, 64.24 subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), 64.25 (14), and (15); 144.121; 144.1222; 144.35; 144.381 to 144.385; 64.26 144.411 to 144.417;144.491;144.495; 144.71 to 144.74; 144.9501 64.27 to 144.9509; 144.992; 326.37 to 326.45; 326.57 to 326.785; 64.28 327.10 to 327.131; and 327.14 to 327.28 and all rules, orders, 64.29 stipulation agreements, settlements, compliance agreements, 64.30 licenses, registrations, certificates, and permits adopted or 64.31 issued by the department or under any other law now in force or 64.32 later enacted for the preservation of public health may, in 64.33 addition to provisions in other statutes, be enforced under this 64.34 section. 64.35 Sec. 71. Minnesota Statutes 1996, section 144A.44, 64.36 subdivision 2, is amended to read: 65.1 Subd. 2. [INTERPRETATION AND ENFORCEMENT OF RIGHTS.] These 65.2 rights are established for the benefit of persons who receive 65.3 home care services. "Home care services" means home care 65.4 services as defined in section 144A.43, subdivision 3. A home 65.5 care provider may not require a person to surrender these rights 65.6 as a condition of receiving services. A guardian or conservator 65.7 or, when there is no guardian or conservator, a designated 65.8 person, may seek to enforce these rights. This statement of 65.9 rights does not replace or diminish other rights and liberties 65.10 that may exist relative to persons receiving home care services, 65.11 persons providing home care services, or providers licensed 65.12 under Laws 1987, chapter 378. A copy of these rights must be 65.13 provided to an individual at the time home care services are 65.14 initiated. The copy shall also contain the address and phone 65.15 number of the office of health facility complaints and the 65.16 office of the ombudsman for older Minnesotans and a brief 65.17 statement describing how to file a complaint withthat office65.18 these offices. Information about how to contact the office of 65.19 the ombudsman for older Minnesotans shall be included in notices 65.20 of change in client fees and in notices where home care 65.21 providers initiate transfer or discontinuation of services. 65.22 Sec. 72. Minnesota Statutes 1997 Supplement, section 65.23 144A.46, subdivision 2, is amended to read: 65.24 Subd. 2. [EXEMPTIONS.] The following individuals or 65.25 organizations are exempt from the requirement to obtain a home 65.26 care provider license: 65.27 (1) a person who is licensed as a registered nurse under 65.28 sections 148.171 to 148.285 and who independently provides 65.29 nursing services in the home without any contractual or 65.30 employment relationship to a home care provider or other 65.31 organization; 65.32 (2) a personal care assistant who provides services to only 65.33 one individual under the medical assistance program as 65.34 authorized under sections 256B.0625, subdivision 19, and 65.35 256B.04, subdivision 16; 65.36 (3) a person or organization that exclusively offers, 66.1 provides, or arranges for personal care assistant services to 66.2 only one individual under the medical assistance program as 66.3 authorized under sections 256B.0625, subdivision 19, and 66.4 256B.04, subdivision 16; 66.5 (4) a person who isregisteredlicensed under sections 66.6 148.65 to 148.78 and who independently provides physical therapy 66.7 services in the home without any contractual or employment 66.8 relationship to a home care provider or other organization; 66.9 (5) a provider that is licensed by the commissioner of 66.10 human services to provide semi-independent living services under 66.11 Minnesota Rules, parts 9525.0500 to 9525.0660 when providing 66.12 home care services to a person with a developmental disability; 66.13 (6) a provider that is licensed by the commissioner of 66.14 human services to provide home and community-based services 66.15 under Minnesota Rules, parts 9525.2000 to 9525.2140 when 66.16 providing home care services to a person with a developmental 66.17 disability; 66.18 (7) a person or organization that provides only home 66.19 management services, if the person or organization is registered 66.20 under section 144A.461; or 66.21 (8) a person who is licensed as a social worker under 66.22 sections 148B.18 to 148B.289 and who provides social work 66.23 services in the home independently and not through any 66.24 contractual or employment relationship with a home care provider 66.25 or other organization. 66.26 An exemption under this subdivision does not excuse the 66.27 individual from complying with applicable provisions of the home 66.28 care bill of rights. 66.29 Sec. 73. Minnesota Statutes 1997 Supplement, section 66.30 144A.4605, subdivision 4, is amended to read: 66.31 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 66.32 establishment registered under chapter 144D that is required to 66.33 obtain a home care license must obtain an assisted living home 66.34 care license according to this section or a class A or class E 66.35 license according to rule. A housing with services 66.36 establishment that obtains a class E license under this 67.1 subdivision remains subject to the payment limitations in 67.2 sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915, 67.3 subdivision 3, paragraph (g). 67.4 (b) A board and lodging establishment registered for 67.5 special services as of December 31, 1996, and also registered as 67.6 a housing with services establishment under chapter 144D, must 67.7 deliver home care services according to sections 144A.43 to 67.8 144A.49, and may apply for a waiver from requirements under 67.9 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 67.10 licensed agency under the standards of section 157.17. Such 67.11 waivers as may be granted by the department will expire upon 67.12 promulgation of home care rules implementing section 144A.4605. 67.13 (c) An adult foster care provider licensed by the 67.14 department of human services and registered under chapter 144D 67.15 may continue to provide health-related services under its foster 67.16 care license until the promulgation of home care rules 67.17 implementing this section. 67.18 Sec. 74. Minnesota Statutes 1996, section 145.411, is 67.19 amended by adding a subdivision to read: 67.20 Subd. 6. [COMMISSIONER.] "Commissioner" means the 67.21 commissioner of health. 67.22 Sec. 75. [145.4131] [RECORDING AND REPORTING ABORTION 67.23 DATA.] 67.24 Subdivision 1. [FORMS.] (a) Within 90 days of the 67.25 effective date of this section, the commissioner shall prepare a 67.26 reporting form for physicians performing abortions. A copy of 67.27 this section shall be attached to the form. A physician 67.28 performing an abortion shall obtain a form from the commissioner. 67.29 (b) The form shall require the following information: 67.30 (1) the number of abortions performed by the physician in 67.31 the previous calendar year, reported by month; 67.32 (2) the method used for each abortion; 67.33 (3) the approximate gestational age of each child subject 67.34 to abortion, expressed in one of the following increments: 67.35 (i) less than nine weeks; 67.36 (ii) nine to ten weeks; 68.1 (iii) 11 to 12 weeks; 68.2 (iv) 13 to 15 weeks; 68.3 (v) 16 to 20 weeks; 68.4 (vi) 21 to 24 weeks; 68.5 (vii) 25 to 30 weeks; 68.6 (viii) 31 to 36 weeks; or 68.7 (ix) 37 weeks to term; 68.8 (4) the age of the mother on whom the abortion was 68.9 performed at the time the abortion was performed; 68.10 (5) the specific reason for the abortion, including, but 68.11 not limited to, the following: 68.12 (i) the pregnancy was a result of rape; 68.13 (ii) the pregnancy was a result of incest; 68.14 (iii) the mother cannot afford the child; 68.15 (iv) the mother does not want the child; 68.16 (v) the mother's emotional health is at stake; 68.17 (vi) the mother will suffer substantial and irreversible 68.18 impairment of a major bodily function if the pregnancy 68.19 continues; or 68.20 (vii) other; 68.21 (6) the number of prior induced abortions; 68.22 (7) the number of prior spontaneous abortions; 68.23 (8) whether the abortion was paid for by: 68.24 (i) private insurance; 68.25 (ii) a public health plan; or 68.26 (iii) another form of payment; 68.27 (9) whether coverage was under: 68.28 (i) a fee-for-service insurance company; 68.29 (ii) a managed care company; or 68.30 (iii) another type of health carrier; 68.31 (10) complications, if any, for each abortion and for the 68.32 aftermath of each abortion. Space for a description of any 68.33 complications shall be available on the form; 68.34 (11) the fee collected for each abortion; 68.35 (12) the type of anesthetic used, if any, for each 68.36 abortion; 69.1 (13) the method used to dispose of fetal tissue and 69.2 remains; 69.3 (14) the medical specialty of the physician performing the 69.4 abortion; and 69.5 (15) whether the physician performing the abortion has had 69.6 a physician's license suspended or revoked or has had other 69.7 professional sanctions in this or another state. 69.8 Subd. 2. [SUBMISSION.] A physician performing an abortion 69.9 shall complete and submit the form to the commissioner no later 69.10 than April 1 for abortions performed in the previous calendar 69.11 year. 69.12 Subd. 3. [ADDITIONAL REPORTING.] Nothing in this section 69.13 shall be construed to preclude the voluntary or required 69.14 submission of other reports or forms regarding abortions. 69.15 Sec. 76. [145.4132] [RECORDING AND REPORTING ABORTION 69.16 COMPLICATION DATA.] 69.17 Subdivision 1. [FORMS.] (a) Within 90 days of the 69.18 effective date of this section, the commissioner shall prepare 69.19 an abortion complication reporting form for all physicians 69.20 licensed and practicing in the state. A copy of this section 69.21 shall be attached to the form. 69.22 (b) The board of medical practice shall ensure that the 69.23 abortion complication reporting form is distributed: 69.24 (1) to all physicians licensed to practice in the state, 69.25 within 120 days after the effective date of this section and by 69.26 December 1 of each subsequent year; and 69.27 (2) to a physician who is newly licensed to practice in the 69.28 state, at the same time as official notification to the 69.29 physician that the physician is so licensed. 69.30 Subd. 2. [REQUIRED REPORTING.] A physician licensed and 69.31 practicing in the state who encounters an illness or injury that 69.32 is related to an induced abortion shall complete and submit an 69.33 abortion complication reporting form to the commissioner. 69.34 Subd. 3. [SUBMISSION.] A physician required to submit an 69.35 abortion complication reporting form to the commissioner shall 69.36 do so as soon as practicable after the encounter with the 70.1 abortion related illness or injury, but in no case more than 60 70.2 days after the encounter. 70.3 Subd. 4. [ADDITIONAL REPORTING.] Nothing in this section 70.4 shall be construed to preclude the voluntary or required 70.5 submission of other reports or forms regarding abortion 70.6 complications. 70.7 Sec. 77. [145.4133] [REPORTING OUT-OF-STATE ABORTIONS.] 70.8 The commissioner of human services shall report to the 70.9 commissioner by April 1 each year the following information 70.10 regarding abortions paid for with state funds and performed out 70.11 of state in the previous calendar year: 70.12 (1) the total number of abortions performed out of state 70.13 and partially or fully paid for with state funds through the 70.14 medical assistance, general assistance medical care, or 70.15 MinnesotaCare program, or any other program; 70.16 (2) the total amount of state funds used to pay for the 70.17 abortions and expenses incidental to the abortions; and 70.18 (3) the gestational age of each unborn child at the time of 70.19 abortion. 70.20 Sec. 78. [145.4134] [COMMISSIONER'S PUBLIC REPORT.] 70.21 (a) By July 1 of each year, the commissioner shall issue a 70.22 public report providing statistics for the previous calendar 70.23 year compiled from the data submitted under sections 145.4131 to 70.24 145.4133. Each report shall provide the statistics for all 70.25 previous calendar years, adjusted to reflect any additional 70.26 information from late or corrected reports. The commissioner 70.27 shall ensure that none of the information included in the public 70.28 reports can reasonably lead to identification of an individual 70.29 having performed or having had an abortion. All data included 70.30 on the forms under sections 145.4131 to 145.4133 must be 70.31 included in the public report. The commissioner shall submit 70.32 the report to the senate health care committee and the house 70.33 health and human services committee. 70.34 (b) The commissioner may, by rules adopted under chapter 70.35 14, alter the submission dates established under sections 70.36 145.4131 to 145.4133 for administrative convenience, fiscal 71.1 savings, or other valid reason, provided that physicians and the 71.2 commissioner of health submit the required information once each 71.3 year and the commissioner issues a report once each year. 71.4 Sec. 79. [145.4135] [ENFORCEMENT; PENALTIES.] 71.5 (a) A physician who fails to submit the required forms 71.6 under sections 145.4131 and 145.4132 within 30 days following 71.7 the due date is subject to a late fee of $500 for each 30-day 71.8 period, or portion thereof, that the forms are overdue. A 71.9 physician required to report under this section who does not 71.10 submit a report, or submits only an incomplete report, more than 71.11 one year following the due date, may be fined and, in an action 71.12 brought by the commissioner, be directed by a court of competent 71.13 jurisdiction to submit a complete report within a period stated 71.14 by court order or be subject to sanctions for civil contempt. 71.15 (b) If the commissioner fails to issue the public report 71.16 required under this section, or fails in any way to enforce this 71.17 section, a group of ten or more citizens of the state may seek 71.18 an injunction in a court of competent jurisdiction against the 71.19 commissioner requiring that a complete report be issued within a 71.20 period stated by court order or requiring that enforcement 71.21 action be taken. Failure to abide by an injunction shall 71.22 subject the commissioner to sanctions for civil contempt. 71.23 (c) A physician who knowingly or recklessly submits a false 71.24 report under this section is guilty of a misdemeanor. 71.25 (d) The commissioner may take reasonable steps to ensure 71.26 compliance with sections 145.4131 to 145.4133 and to verify data 71.27 provided, including but not limited to, inspection of places 71.28 where abortions are performed in accordance with chapter 14. 71.29 Sec. 80. [145.4136] [SEVERABILITY.] 71.30 If any one or more provision, section, subdivision, 71.31 sentence, clause, phrase, or word in sections 145.4131 to 71.32 145.4135, or the application thereof to any person or 71.33 circumstance is found to be unconstitutional, the same is hereby 71.34 declared to be severable and the balance of sections 145.4131 to 71.35 145.4135 shall remain effective notwithstanding such 71.36 unconstitutionality. The legislature hereby declares that it 72.1 would have passed sections 145.4131 to 145.4135, and each 72.2 provision, section, subdivision, sentence, clause, phrase, or 72.3 word thereof, irrespective of the fact that any one or more 72.4 provision, section, subdivision, sentence, clause, phrase, or 72.5 word be declared unconstitutional. 72.6 Sec. 81. [145.4201] [PARTIAL-BIRTH ABORTION; DEFINITIONS.] 72.7 Subdivision 1. [TERMS.] As used in sections 145.4201 to 72.8 145.4206, the terms defined in this section have the meanings 72.9 given them. 72.10 Subd. 2. [ABORTION.] "Abortion" means the use of any means 72.11 to intentionally terminate the pregnancy of a female known to be 72.12 pregnant with knowledge that the termination with those means 72.13 will, with reasonable likelihood, cause the death of the fetus. 72.14 Subd. 3. [FETUS AND INFANT.] "Fetus" and "infant" are used 72.15 interchangeably to refer to the biological offspring of human 72.16 parents. 72.17 Subd. 4. [PARTIAL-BIRTH ABORTION.] "Partial-birth abortion" 72.18 means an abortion in which the person performing the abortion 72.19 partially vaginally delivers a living fetus before killing the 72.20 fetus and completing the delivery. 72.21 Sec. 82. [145.4202] [PARTIAL-BIRTH ABORTIONS PROHIBITED.] 72.22 No person shall knowingly perform a partial-birth abortion. 72.23 Sec. 83. [145.4203] [LIFE OF THE MOTHER EXCEPTION.] 72.24 The prohibition under section 145.4202 shall not apply to a 72.25 partial-birth abortion that is necessary to save the life of the 72.26 mother because her life is endangered by a physical disorder, 72.27 physical illness, or physical injury, including a 72.28 life-endangering condition caused by or arising from the 72.29 pregnancy itself, provided that no other medical procedure would 72.30 suffice for that purpose. 72.31 Sec. 84. [145.4204] [CIVIL REMEDIES.] 72.32 Subdivision 1. [STANDING.] The woman upon whom a 72.33 partial-birth abortion has been performed in violation of 72.34 section 145.4202, the father of the fetus or infant, and the 72.35 maternal grandparents of the fetus or infant if the mother has 72.36 not attained the age of 18 years at the time of the abortion, 73.1 may obtain appropriate relief in a civil action, unless the 73.2 pregnancy resulted from the plaintiff's criminal conduct or the 73.3 plaintiff consented to the abortion. 73.4 Subd. 2. [TYPE OF RELIEF.] Relief shall include: 73.5 (1) money damages for all injuries, psychological and 73.6 physical, occasioned by the violation of sections 145.4201 to 73.7 145.4206; and 73.8 (2) statutory damages equal to three times the cost of the 73.9 partial-birth abortion. 73.10 Subd. 3. [ATTORNEY'S FEE.] If judgment is rendered in 73.11 favor of the plaintiff in an action described in this section, 73.12 the court shall also render judgment for a reasonable attorney's 73.13 fee in favor of the plaintiff against the defendant. If the 73.14 judgment is rendered in favor of the defendant and the court 73.15 finds that the plaintiff's suit was frivolous and brought in bad 73.16 faith, the court shall also render judgment for a reasonable 73.17 attorney's fee in favor of the defendant against the plaintiff. 73.18 Sec. 85. [145.4205] [CRIMINAL PENALTY.] 73.19 Subdivision 1. [FELONY.] A person who performs a 73.20 partial-birth abortion in knowing or reckless violation of 73.21 sections 145.4201 to 145.4206 is guilty of a felony and may be 73.22 sentenced to imprisonment for not more than 15 years or to 73.23 payment of a fine of not more than $50,000. 73.24 Subd. 2. [PROSECUTION OF MOTHER PROHIBITED.] A woman upon 73.25 whom a partial-birth abortion is performed may not be prosecuted 73.26 under this section for violating sections 145.4201 to 145.4206, 73.27 or any provision thereof, or for conspiracy to violate sections 73.28 145.4201 to 145.4206, or any provision thereof. 73.29 Sec. 86. [145.4206] [SEVERABILITY.] 73.30 (a) If any provision, word, phrase, or clause of section 73.31 145.4203, or the application thereof to any person or 73.32 circumstance is found to be unconstitutional, the same is hereby 73.33 declared to be inseverable. 73.34 (b) If any provision, section, subdivision, sentence, 73.35 clause, phrase, or word in section 145.4201, 145.4202, 145.4204, 73.36 145.4205, or 145.4206 or the application thereof to any person 74.1 or circumstance is found to be unconstitutional, the same is 74.2 hereby declared to be severable and the balance of sections 74.3 145.4201 to 145.4206 shall remain effective notwithstanding such 74.4 unconstitutionality. The legislature hereby declares that it 74.5 would have passed sections 145.4201 to 145.4206, and each 74.6 provision, section, subdivision, sentence, clause, phrase, or 74.7 word thereto, with the exception of section 145.4203, 74.8 irrespective of the fact that a provision, section, subdivision, 74.9 sentence, clause, phrase, or word be declared unconstitutional. 74.10 Sec. 87. [145.9266] [FETAL ALCOHOL SYNDROME.] 74.11 Subdivision 1. [PUBLIC AWARENESS.] The commissioner of 74.12 health shall design and implement an ongoing statewide campaign 74.13 to raise public awareness about fetal alcohol syndrome and other 74.14 effects of prenatal alcohol exposure. The campaign shall 74.15 include messages directed to the general population as well as 74.16 culturally specific and community-based messages. A toll-free 74.17 resource and referral telephone line shall be included in the 74.18 messages. The commissioner of health shall conduct an 74.19 evaluation to determine the effectiveness of the campaign. 74.20 Subd. 2. [STATEWIDE NETWORK OF FAS DIAGNOSTIC CLINICS.] A 74.21 statewide network of regional fetal alcohol syndrome diagnostic 74.22 clinics shall be developed between the department of health and 74.23 the University of Minnesota. This collaboration shall be based 74.24 on a statewide needs assessment and shall include involvement 74.25 from consumers, providers, and payors. By the end of calendar 74.26 year 1998, a plan shall be developed for the clinic network, and 74.27 shall include a comprehensive evaluation component. Sites shall 74.28 be established in calendar year 1999. The commissioner shall 74.29 not access or collect individually identifiable data for the 74.30 statewide network of regional fetal alcohol syndrome diagnostic 74.31 clinics. Data collected at the clinics shall be maintained 74.32 according to applicable data privacy laws, including section 74.33 144.335. 74.34 Subd. 3. [PROFESSIONAL TRAINING ABOUT FAS.] (a) The 74.35 commissioner of health, in collaboration with the board of 74.36 medical practice, the board of nursing, and other professional 75.1 boards and state agencies, shall develop curricula and materials 75.2 about fetal alcohol syndrome for professional training of health 75.3 care providers, social service providers, educators, and 75.4 judicial and corrections systems professionals. The training 75.5 and curricula shall increase knowledge and develop practical 75.6 skills of professionals to help them address the needs of 75.7 at-risk pregnant women and the needs of individuals affected by 75.8 fetal alcohol syndrome or fetal alcohol effects and their 75.9 families. 75.10 (b) Training for health care providers shall focus on skill 75.11 building for screening, counseling, referral, and follow-up for 75.12 women using or at risk of using alcohol while pregnant. 75.13 Training for health care professionals shall include methods for 75.14 diagnosis and evaluation of fetal alcohol syndrome and fetal 75.15 alcohol effects. Training for education, judicial, and 75.16 corrections professionals shall involve effective education 75.17 strategies, methods to identify the behaviors and learning 75.18 styles of children with alcohol-related birth defects, and 75.19 methods to identify available referral and community resources. 75.20 (c) Training for social service providers shall focus on 75.21 resources for assessing, referring, and treating at-risk 75.22 pregnant women, changes in the mandatory reporting and 75.23 commitment laws, and resources for affected children and their 75.24 families. 75.25 Subd. 4. [FAS COMMUNITY GRANT PROGRAM.] The commissioner 75.26 of health shall administer a grant program to provide money to 75.27 community organizations and coalitions to collaborate on fetal 75.28 alcohol syndrome prevention and intervention strategies and 75.29 activities. The commissioner shall disburse grant money through 75.30 a request for proposal process or sole-source distribution where 75.31 appropriate, and shall include at least one grant award for 75.32 transitional skills and services for individuals with fetal 75.33 alcohol syndrome or fetal alcohol effects. 75.34 Subd. 5. [SCHOOL PILOT PROGRAMS.] (a) The commissioner of 75.35 children, families, and learning shall award up to four grants 75.36 to schools for pilot programs to identify and implement 76.1 effective educational strategies for individuals with fetal 76.2 alcohol syndrome and other alcohol-related birth defects. 76.3 (b) One grant shall be awarded in each of the following age 76.4 categories: 76.5 (1) birth to three years; 76.6 (2) three to five years; 76.7 (3) six to 12 years; and 76.8 (4) 13 to 18 years. 76.9 (c) Grant proposals must include an evaluation plan, 76.10 demonstrate evidence of a collaborative or multisystem approach, 76.11 provide parent education and support, and show evidence of a 76.12 child- and family-focused approach consistent with 76.13 research-based educational practices and other guidelines 76.14 developed by the department of children, families, and learning. 76.15 (d) Children participating in the pilot program sites may 76.16 be identified through child find activities or a diagnostic 76.17 clinic. No identification activity may be undertaken without 76.18 the consent of a child's parent or guardian. 76.19 Subd. 6. [FETAL ALCOHOL COORDINATING BOARD; DUTIES.] (a) 76.20 The fetal alcohol coordinating board consists of: 76.21 (1) the commissioners of health, human services, 76.22 corrections, public safety, economic security, and children, 76.23 families, and learning; 76.24 (2) the director of the office of strategic and long-range 76.25 planning; 76.26 (3) the chair of the maternal and child health advisory 76.27 task force established by section 145.881, or the chair's 76.28 designee; 76.29 (4) a representative of the University of Minnesota 76.30 academic health center, appointed by the provost; 76.31 (5) five members from the general public appointed by the 76.32 governor, one of whom must be a family member of an individual 76.33 with fetal alcohol syndrome or fetal alcohol effect; and 76.34 (6) one member from the judiciary appointed by the chief 76.35 justice of the supreme court. 76.36 Terms, compensation, removal, and filling of vacancies of 77.1 appointed members are governed by section 15.0575. The board 77.2 shall elect a chair from its membership to serve a one-year 77.3 term. The commissioner of health shall provide staff and 77.4 consultant support for the board. Support must be provided 77.5 based on an annual budget and work plan developed by the board. 77.6 The board shall contract with the department of health for 77.7 necessary administrative services. Administrative services 77.8 include personnel, budget, payroll, and contract 77.9 administration. The board shall adopt an annual budget and work 77.10 program. 77.11 (b) Board duties include: 77.12 (1) reviewing programs of state agencies that involve fetal 77.13 alcohol syndrome and coordinating those that are 77.14 interdepartmental in nature; 77.15 (2) providing an integrated and comprehensive approach to 77.16 fetal alcohol syndrome prevention and intervention strategies 77.17 both at a local and statewide level; 77.18 (3) approving on an annual basis the statewide public 77.19 awareness campaign as designed and implemented by the 77.20 commissioner of health under subdivision 1; 77.21 (4) reviewing fetal alcohol syndrome community grants 77.22 administered by the commissioner of health under subdivision 4; 77.23 and 77.24 (5) submitting a report to the governor on January 15 of 77.25 each odd-numbered year summarizing board operations, activities, 77.26 findings, and recommendations, and fetal alcohol syndrome 77.27 activities throughout the state. 77.28 (c) The board expires on January 1, 2001. 77.29 Subd. 7. [FEDERAL FUNDS; CONTRACTS; DONATIONS.] The fetal 77.30 alcohol coordinating board may apply for, receive, and disburse 77.31 federal funds made available to the state by federal law or 77.32 rules adopted for any purpose related to the powers and duties 77.33 of the board. The board shall comply with any requirements of 77.34 federal law, rules, and regulations in order to apply for, 77.35 receive, and disburse funds. The board may contract with or 77.36 provide grants to public and private nonprofit entities. The 78.1 board may accept donations or grants from any public or private 78.2 entity. Money received by the board must be deposited in a 78.3 separate account in the state treasury and invested by the state 78.4 board of investment. The amount deposited, including investment 78.5 earnings, is appropriated to the board to carry out its duties. 78.6 Money deposited in the state treasury shall not cancel. 78.7 Sec. 88. Minnesota Statutes 1996, section 145A.15, 78.8 subdivision 2, is amended to read: 78.9 Subd. 2. [GRANT RECIPIENTS.] (a) The commissioner is 78.10 authorized to award grants to programs that meet the 78.11 requirements of subdivision 3 and include a strong child abuse 78.12 and neglect prevention focus for families in need of services. 78.13 Priority will be given to families considered to be in need of 78.14 additional services. These families include, but are not 78.15 limited to, families with: 78.16 (1) adolescent parents; 78.17 (2) a history of alcohol and other drug abuse; 78.18 (3) a history of child abuse, domestic abuse, or other 78.19 types of violence in the family of origin; 78.20 (4) a history of domestic abuse, rape, or other forms of 78.21 victimization; 78.22 (5) reduced cognitive functioning; 78.23 (6) a lack of knowledge of child growth and development 78.24 stages; 78.25 (7) low resiliency to adversities and environmental 78.26 stresses; or 78.27 (8) lack of sufficient financial resources to meet their 78.28 needs. 78.29 (b) Grants made under this section shall be used to fund 78.30 existing home visiting programs and to establish new programs. 78.31 The commissioner shall award grants to home visiting programs 78.32 that meet the program requirements in subdivision 3, regardless 78.33 of the number of years an existing program has received grant 78.34 funds in the past. 78.35 Sec. 89. Minnesota Statutes 1996, section 148.66, is 78.36 amended to read: 79.1 148.66 [STATE BOARD OFMEDICAL PRACTICEPHYSICAL THERAPY, 79.2 DUTIES.] 79.3 The state board ofmedical practice, as now or hereafter79.4constituted, hereinafter termed "the board," in the manner79.5hereinafter provided,physical therapy established under section 79.6 148.67 shall administerthe provisions of this lawsections 79.7 148.65 to 148.78. As used in sections 148.65 to 148.78, "board" 79.8 means the state board of physical therapy. 79.9 The board shall: 79.10 (1) adopt rules necessary to administer and enforce 79.11 sections 148.65 to 148.78; 79.12 (2) administer, coordinate, and enforce sections 148.65 to 79.13 148.78; 79.14 (3) evaluate the qualifications of applicants; 79.15 (4) issue subpoenas, examine witnesses, and administer 79.16 oaths; 79.17 (5) conduct hearings and keep records and minutes necessary 79.18 to the orderly administration of sections 148.65 to 148.78; 79.19 (6) investigate persons engaging in practices that violate 79.20 sections 148.65 to 148.78; and 79.21 (7) adopt rules under chapter 14 prescribing a code of 79.22 ethics for licensees. 79.23 Sec. 90. Minnesota Statutes 1996, section 148.67, is 79.24 amended to read: 79.25 148.67 [STATE BOARD OF PHYSICAL THERAPYCOUNCIL; MEMBERSHIP 79.26 APPOINTMENTS, VACANCIES, REMOVALS.] 79.27 Subdivision 1. [BOARD OF PHYSICAL THERAPY APPOINTED.] The 79.28board of medical practicegovernor shall appoint a state board 79.29 of physical therapycouncil in carrying out the provisions of79.30this lawto administer sections 148.65 to 148.78, regarding the 79.31 qualifications and examination of physical therapists. 79.32 Thecouncilboard shall consist ofsevennine members, citizens 79.33 and residents of the state of Minnesota, composed ofthreefive 79.34 physical therapists,twoone licensed and registereddoctors79.35 doctor of medicineand surgery, one being a professor or79.36associate or assistant professor from a program in physical80.1therapy approved by the board of medical practice, one aide or80.2assistant to a physical therapist and one public member. The80.3council shall expire, and the terms, compensation and removal of80.4members shall be as provided in section 15.059., one physical 80.5 therapy assistant and two public members. The five physical 80.6 therapist members must be licensed physical therapists in this 80.7 state. Each of the five physical therapist members must have at 80.8 least five years experience in physical therapy practice, 80.9 physical therapy administration, or physical therapy education. 80.10 The five years experience must immediately precede appointment. 80.11 Membership terms, compensation of members, removal of members, 80.12 filling of membership vacancies, and fiscal year and reporting 80.13 requirements shall be as provided in sections 214.07 to 214.09. 80.14 The provision of staff, administrative services, and office 80.15 space; the review and processing of complaints; the setting of 80.16 board fees; and other provisions relating to board operations 80.17 shall be as provided in chapter 214. Each member of the board 80.18 shall file with the secretary of state the constitutional oath 80.19 of office before beginning the term of office. 80.20 Subd. 2. [REPLACEMENT OF PHYSICAL THERAPISTS AND PHYSICIAN 80.21 MEMBERS.] When a member's term expires and the member is a 80.22 licensed physical therapist, the governor may appoint a licensed 80.23 physical therapist from a list submitted by the Minnesota 80.24 chapter of the American Physical Therapy Association. When a 80.25 member who is a licensed physical therapist leaves the board 80.26 before the member's term expires, the governor may appoint a 80.27 member for the remainder of the term from a list submitted by 80.28 the Minnesota chapter of the American Physical Therapy 80.29 Association. When a member who is a physician leaves the board 80.30 before the member's term expires, the governor may appoint a 80.31 member for the remainder of the term from lists submitted by the 80.32 state board of medical practice or the Minnesota Medical 80.33 Association. 80.34 Sec. 91. [148.691] [OFFICERS; EXECUTIVE DIRECTOR.] 80.35 Subdivision 1. [OFFICERS OF THE BOARD.] The board shall 80.36 elect from its members a president, a vice-president, and a 81.1 secretary-treasurer. Each shall serve for one year or until a 81.2 successor is elected and qualifies. The board shall appoint and 81.3 employ an executive secretary. A majority of the board, 81.4 including one officer, constitutes a quorum at a meeting. 81.5 Subd. 2. [BOARD AUTHORITY TO HIRE.] The board may employ 81.6 persons needed to carry out its work. 81.7 Sec. 92. Minnesota Statutes 1996, section 148.70, is 81.8 amended to read: 81.9 148.70 [APPLICANTS, QUALIFICATIONS.] 81.10It shall be the duty ofThe board ofmedical practice with81.11the advice and assistance of the physical therapy council to81.12pass uponphysical therapy must: 81.13 (1) establish the qualifications of applicants for 81.14registration,licensing and continuing education requirements 81.15 forreregistration,relicensing; 81.16 (2) provide for and conduct all examinations following 81.17 satisfactory completion of all didactic requirements,; 81.18 (3) determine the applicants who successfully pass the 81.19 examination,; and 81.20 (4) dulyregister such applicantslicense an applicant 81.21 after the applicant has presented evidence satisfactory to the 81.22 board that the applicant has completedaan accredited physical 81.23 therapy educational program of education or continuing education 81.24 approved by the board. 81.25 The passing score for examinations taken after July 1, 81.26 1995, shall be based on objective, numerical standards, as 81.27 established by a nationally recognized board approved testing 81.28 service. 81.29 Sec. 93. Minnesota Statutes 1996, section 148.705, is 81.30 amended to read: 81.31 148.705 [APPLICATION.] 81.32 An applicant forregistrationlicensing as a physical 81.33 therapist shall file a written application on forms provided by 81.34 the board together with a fee in the amount set by the board, no81.35portion of which shall be returned. No portion of the fee is 81.36 refundable. 82.1 An approved program for physical therapists shall include 82.2 the following: 82.3(a)(1) a minimum of 60 academic semester credits or its 82.4 equivalent from an accredited college, including courses in the 82.5 biological and physical sciences; and 82.6(b)(2) an accredited course in physical therapy education 82.7 which has provided adequate instruction in the basic sciences, 82.8 clinical sciences, and physical therapy theory and procedures, 82.9 as determined by the board. In determining whether or not a 82.10 course in physical therapy is approved, the board may take into 82.11 consideration the accreditation of such schools by the 82.12 appropriate council of the American Medical Association, the 82.13 American Physical Therapy Association, or the Canadian Medical 82.14 Association. 82.15 Sec. 94. Minnesota Statutes 1996, section 148.71, is 82.16 amended to read: 82.17 148.71 [REGISTRATIONLICENSING.] 82.18 Subdivision 1. [QUALIFIED APPLICANT.] The state board 82.19 ofmedical practicephysical therapy shallregisterlicense as a 82.20 physical therapist and shall furnish acertificate of82.21registrationlicense toeachan applicant who successfully 82.22 passes an examination provided for in sections 148.65 to 148.78 82.23 forregistrationlicensing as a physical therapist and who is 82.24 otherwise qualified as requiredhereinin sections 148.65 to 82.25 148.78. 82.26 Subd. 2. [TEMPORARY PERMIT.] (a) The board may, upon 82.27 payment of a fee set by the board, issue a temporary permit to 82.28 practice physical therapy under supervision to a physical 82.29 therapist who is a graduate of an approved school of physical 82.30 therapy and qualified for admission to examination for 82.31registrationlicensing as a physical therapist. A temporary 82.32 permit to practice physical therapy under supervision may be 82.33 issued only once and cannot be renewed. It expires 90 days 82.34 after the next examination forregistrationlicensing given by 82.35 the board or on the date on which the board, after examination 82.36 of the applicant, grants or denies the applicant aregistration83.1 license to practice, whichever occurs first. A temporary permit 83.2 expires on the first day the board begins its next examination 83.3 forregistrationlicense after the permit is issued if the 83.4 holder does not submit to examination on that date. The holder 83.5 of a temporary permit to practice physical therapy under 83.6 supervision may practice physical therapy as defined in section 83.7 148.65 if the entire practice is under the supervision of a 83.8 person holding a validregistrationlicense to practice physical 83.9 therapy in this state. The supervision shall be direct, 83.10 immediate, and on premises. 83.11 (b) A physical therapist from another state who is licensed 83.12 or otherwise registered in good standing as a physical therapist 83.13 by that state and meets the requirements forregistration83.14 licensing under section 148.72 does not require supervision to 83.15 practice physical therapy while holding a temporary permit in 83.16 this state. The temporary permit remains valid only until the 83.17 meeting of the board at which the application forregistration83.18 licensing is considered. 83.19 Subd. 3. [FOREIGN-TRAINED PHYSICAL THERAPISTS; TEMPORARY 83.20 PERMITS.] (a) The board of medical practice may issue a 83.21 temporary permit to a foreign-trained physical therapist who: 83.22 (1) is enrolled in a supervised physical therapy 83.23 traineeship that meets the requirements under paragraph (b); 83.24 (2) has completed a physical therapy education program 83.25 equivalent to that under section 148.705 and Minnesota Rules, 83.26 part 5601.0800, subpart 2; 83.27 (3) has achieved a score of at least 550 on the test of 83.28 English as a foreign language or a score of at least 85 on the 83.29 Minnesota battery test; and 83.30 (4) has paid a nonrefundable fee set by the board. 83.31 A foreign-trained physical therapist must have the 83.32 temporary permit before beginning a traineeship. 83.33 (b) A supervised physical therapy traineeship must: 83.34 (1) be at least six months; 83.35 (2) be at a board-approved facility; 83.36 (3) provide a broad base of clinical experience to the 84.1 foreign-trained physical therapist including a variety of 84.2 physical agents, therapeutic exercises, evaluation procedures, 84.3 and patient diagnoses; 84.4 (4) be supervised by a physical therapist who has at least 84.5 three years of clinical experience and isregisteredlicensed 84.6 under subdivision 1; and 84.7 (5) be approved by the board before the foreign-trained 84.8 physical therapist begins the traineeship. 84.9 (c) A temporary permit is effective on the first day of a 84.10 traineeship and expires 90 days after the next examination for 84.11registrationlicensing given by the board following successful 84.12 completion of the traineeship or on the date on which the board, 84.13 after examination of the applicant, grants or denies the 84.14 applicant aregistrationlicense to practice, whichever occurs 84.15 first. 84.16 (d) A foreign-trained physical therapist must successfully 84.17 complete a traineeship to beregisteredlicensed as a physical 84.18 therapist under subdivision 1. The traineeship may be waived 84.19 for a foreign-trained physical therapist who is licensed or 84.20 otherwise registered in good standing in another state and has 84.21 successfully practiced physical therapy in that state under the 84.22 supervision of a licensed or registered physical therapist for 84.23 at least six months at a facility that meets the requirements 84.24 under paragraph (b), clauses (2) and (3). 84.25 (e) A temporary permit will not be issued to a 84.26 foreign-trained applicant who has been issued a temporary permit 84.27 for longer than six months in any other state. 84.28 Sec. 95. Minnesota Statutes 1996, section 148.72, 84.29 subdivision 1, is amended to read: 84.30 Subdivision 1. [ISSUANCE OFREGISTRATIONLICENSE WITHOUT 84.31 EXAMINATION.] On payment to the board of a fee in the amount set 84.32 by the board and on submission of a written application on forms 84.33 provided by the board, the board shall issueregistrationa 84.34 license without examination to a person who is licensed or 84.35 otherwise registered as a physical therapist by another state of 84.36 the United States of America, its possessions, or the District 85.1 of Columbia, if the board determines that the requirements for 85.2licensurelicensing or registration in the state, possession, or 85.3 District are equal to, or greater than, the requirementsset85.4forthin sections 148.65 to 148.78. 85.5 Sec. 96. Minnesota Statutes 1996, section 148.72, 85.6 subdivision 2, is amended to read: 85.7 Subd. 2. [CERTIFICATE OF REGISTRATIONLICENSE.] The board 85.8 may issue acertificate of registration to a physical therapist85.9 license without examination to an applicant who presents 85.10 evidence satisfactory to the board of having passed an 85.11 examination recognized by the board, if the board determines the 85.12 standards of the other state or foreign country aredetermined85.13by the board to be as high asequal to those of this state.At85.14the time of making anUpon application, the applicant shall pay 85.15 to the board a fee in the amount set by the board,. No portion 85.16 ofwhich shall be returnedthe fee is refundable. 85.17 Sec. 97. Minnesota Statutes 1996, section 148.72, 85.18 subdivision 4, is amended to read: 85.19 Subd. 4. [ISSUANCE OFREGISTRATIONLICENSE AFTER 85.20 EXAMINATION.] The board shall issue acertificate of85.21registrationlicense toeachan applicant who passes the 85.22 examinationin accordance withaccording to standards 85.23 established by the board and who is not disqualified to 85.24 receiveregistrationa license underthe provisions ofsection 85.25 148.75. 85.26 Sec. 98. Minnesota Statutes 1996, section 148.73, is 85.27 amended to read: 85.28 148.73 [RENEWALS.] 85.29 Everyregisteredlicensed physical therapist shall, during 85.30 each January, apply to the board for an extension 85.31 ofregistrationa license and pay a fee in the amount set by the 85.32 board. The extension ofregistrationthe license is contingent 85.33 upon demonstration that the continuing education requirements 85.34 set by the board under section 148.70 have been satisfied. 85.35 Sec. 99. Minnesota Statutes 1996, section 148.74, is 85.36 amended to read: 86.1 148.74 [RULES.] 86.2 The boardis authorized tomay adopt rulesas may be86.3necessaryneeded to carry outthe purposes ofsections 148.65 to 86.4 148.78. Thesecretarysecretary-treasurer of the board shall 86.5 keep a record of proceedings under these sections and a register 86.6 of all personsregisteredlicensed under it. The register shall 86.7 show the name, address, date and number ofregistrationthe 86.8 license, and the renewalthereofof the license. Any other 86.9 interested person in the state may obtain a copy ofsuchthe 86.10 list on request to the board uponpayment ofpaying an amountas86.11may befixed by the board, which. The amount shall not exceed 86.12 the cost of the listsofurnished. The board shall provide 86.13 blanks, books, certificates, and stationery and assistanceas is86.14 necessaryfor the transaction of theto transact business of the 86.15 boardand the physical therapy council hereunder, and. All 86.16 money received by the board under sections 148.65 to 148.78 86.17 shall be paid into the state treasury as provided for by law. 86.18 The board shall set by rule the amounts of the application fee 86.19 and the annualregistrationlicensing fee. The fees collected 86.20 by the board must be sufficient to cover the costs of 86.21 administering sections 148.65 to 148.78. 86.22 Sec. 100. Minnesota Statutes 1996, section 148.75, is 86.23 amended to read: 86.24 148.75 [CERTIFICATESLICENSES; DENIAL, SUSPENSION, 86.25 REVOCATION.] 86.26 (a) The state board ofmedical practicephysical therapy 86.27 may refuse to grantregistrationa license to any physical 86.28 therapist, or may suspend or revoke theregistrationlicense of 86.29 any physical therapist for any of the following grounds: 86.30(a)(1) using drugs or intoxicating liquors to an extent 86.31 which affects professional competence; 86.32(b) been convicted(2) conviction of a felony; 86.33(c)(3) conviction for violating any state or federal 86.34 narcotic law; 86.35(d) procuring, aiding or abetting a criminal abortion;86.36(e) registration(4) obtaining a license orattempted87.1registrationattempting to obtain a license by fraud or 87.2 deception; 87.3(f)(5) conduct unbecoming a personregisteredlicensed as 87.4 a physical therapist or conduct detrimental to the best 87.5 interests of the public; 87.6(g)(6) gross negligence in the practice of physical 87.7 therapy as a physical therapist; 87.8(h)(7) treating human ailments by physical therapy after 87.9 an initial 30-day period of patient admittance to treatment has 87.10 lapsed, except by the order or referral of a person licensed in 87.11 this statetoin the practice of medicine as defined in section 87.12 147.081, the practice of chiropractic as defined in section 87.13 148.01, the practice of podiatry as defined in section 153.01, 87.14 or the practice of dentistry as defined in section 150A.05 and 87.15 whose license is in good standing; or when a previous diagnosis 87.16 exists indicating an ongoing condition warranting physical 87.17 therapy treatment, subject to periodic review defined by board 87.18 ofmedical practicephysical therapy rule; 87.19(i)(8) treating human ailments, without referral, by 87.20 physical therapy treatment without first having practiced one 87.21 year under a physician's orders as verified by the board's 87.22 records; 87.23(j) failure(9) failing to consult with the patient's 87.24 health care provider who prescribed the physical therapy 87.25 treatment if the treatment is altered by the physical therapist 87.26 from the original written order. The provision does not include 87.27 written ordersspecifying ordersto "evaluate and treat"; 87.28(k)(10) treating human ailments other than by physical 87.29 therapy unless duly licensed or registered to do so under the 87.30 laws of this state; 87.31(l)(11) inappropriate delegation to a physical therapist 87.32 assistant or inappropriate task assignment to an aide or 87.33 inadequate supervision of either level of supportive personnel; 87.34(m) treating human ailments other than by performing87.35physical therapy procedures unless duly licensed or registered87.36to do so under the laws of this state;88.1(n)(12) practicing as a physical therapist performing 88.2 medical diagnosis, the practice of medicine as defined in 88.3 section 147.081, or the practice of chiropractic as defined in 88.4 section 148.01; 88.5(o) failure(13) failing to comply with a reasonable 88.6 request to obtain appropriate clearance for mental or physical 88.7 conditionswhichthat would interfere with the ability to 88.8 practice physical therapy, andwhichthat may be potentially 88.9 harmful to patients; 88.10(p)(14) dividing fees with, or paying or promising to pay 88.11 a commission or part of the fee to, any person who contacts the 88.12 physical therapist for consultation or sends patients to the 88.13 physical therapist for treatment; 88.14(q)(15) engaging in an incentive payment arrangement, 88.15 other than that prohibited by clause(p)(14), that tends to 88.16 promote physical therapyoverutilizationoveruse,wherebythat 88.17 allows the referring person or person who controls the 88.18 availability of physical therapy services to a clientprofitsto 88.19 profit unreasonably as a result of patient treatment; 88.20(r)(16) practicing physical therapy and failing to refer 88.21 to a licensed health care professionalanya patient whose 88.22 medical condition at the time of evaluation has been determined 88.23 by the physical therapist to be beyond the scope of practice of 88.24 a physical therapist; and 88.25(s) failure(17) failing to report to the board other 88.26registeredlicensed physical therapists who violate this section. 88.27 (b) Acertificate of registrationlicense to practice as a 88.28 physical therapist is suspended if (1) a guardian of the person 88.29 of the physical therapist is appointed by order of a court 88.30 pursuant to sections 525.54 to 525.61, for reasons other than 88.31 the minority of the physical therapist; or (2) the physical 88.32 therapist is committed by order of a court pursuant to chapter 88.33 253B. Thecertificate of registrationlicense remains suspended 88.34 until the physical therapist is restored to capacity by a court 88.35 and, upon petition by the physical therapist, the suspension is 88.36 terminated by the board ofmedical practicephysical therapy 89.1 after a hearing. 89.2 Sec. 101. Minnesota Statutes 1996, section 148.76, is 89.3 amended to read: 89.4 148.76 [PROHIBITED CONDUCT.] 89.5 Subdivision 1. No person shall: 89.6(a)(1) use the title of physical therapist without a 89.7certificate of registrationlicense as a physical therapist 89.8 issuedpursuant to the provisions ofunder sections 148.65 to 89.9 148.78; 89.10(b)(2) in any manner hold out as a physical therapist, or 89.11 use in connection with the person's name the words or letters 89.12 Physical Therapist, Physiotherapist, Physical Therapy 89.13 Technician, Registered Physical Therapist, Licensed Physical 89.14 Therapist, P.T., P.T.T., R.P.T., L.P.T., or any letters, words, 89.15 abbreviations or insignia indicating or implying that the person 89.16 is a physical therapist, without acertificate of89.17registrationlicense as a physical therapist issuedpursuant to89.18the provisions ofunder sections 148.65 to 148.78. To do so is 89.19 a gross misdemeanor; 89.20(c)(3) employ fraud or deception in applying for or 89.21 securing acertificate of registrationlicense as a physical 89.22 therapist. 89.23 Nothingcontainedin sections 148.65 to 148.78shall89.24prohibit anyprohibits a person licensed or registered in this 89.25 state under another law from carrying out the therapy or 89.26 practice for which the person is duly licensed or registered. 89.27 Subd. 2. No physical therapist shall: 89.28(a)(1) treat human ailments by physical therapy after an 89.29 initial 30-day period of patient admittance to treatment has 89.30 lapsed, except by the order or referral of a person licensed in 89.31 this state to practice medicine as defined in section 147.081, 89.32 the practice of chiropractic as defined in section 148.01, the 89.33 practice of podiatry as defined in section 153.01, or the 89.34 practice of dentistry as defined in section 150A.05 and whose 89.35 license is in good standing; or when a previous diagnosis exists 89.36 indicating an ongoing condition warranting physical therapy 90.1 treatment, subject to periodic review defined by board of 90.2medical practicephysical therapy rule; 90.3(b)(2) treat human ailments by physical therapy treatment 90.4 without first having practiced one year under a physician's 90.5 orders as verified by the board's records; 90.6(c) utilize(3) use any chiropractic manipulative technique 90.7 whose end is the chiropractic adjustment of an abnormal 90.8 articulation of the body; and 90.9(d)(4) treat human ailments other than by physical therapy 90.10 unless duly licensed or registered to do so under the laws of 90.11 this state. 90.12 Sec. 102. Minnesota Statutes 1996, section 148.78, is 90.13 amended to read: 90.14 148.78 [PROSECUTION, ALLEGATIONS.] 90.15 In the prosecution of any person for violation of sections 90.16 148.65 to 148.78 as specified in section 148.76, it shall not be 90.17 necessary to allege or prove want of a validcertificate of90.18registrationlicense as a physical therapist, but shall be a 90.19 matter of defense to be established by the accused. 90.20 Sec. 103. Minnesota Statutes 1996, section 214.01, 90.21 subdivision 2, is amended to read: 90.22 Subd. 2. [HEALTH-RELATED LICENSING BOARD.] "Health-related 90.23 licensing board" means the board of examiners of nursing home 90.24 administrators established pursuant to section 144A.19, the 90.25 board of medical practice created pursuant to section 147.01, 90.26 the board of nursing created pursuant to section 148.181, the 90.27 board of chiropractic examiners established pursuant to section 90.28 148.02, the board of optometry established pursuant to section 90.29 148.52, the board of physical therapy established pursuant to 90.30 section 148.67, the board of psychology established pursuant to 90.31 section 148.90, the board of social work pursuant to section 90.32 148B.19, the board of marriage and family therapy pursuant to 90.33 section 148B.30, the office of mental health practice 90.34 established pursuant to section 148B.61, the alcohol and drug 90.35 counselors licensing advisory council established pursuant to 90.36 section 148C.02, the board of dietetics and nutrition practice 91.1 established under section 148.622, the board of dentistry 91.2 established pursuant to section 150A.02, the board of pharmacy 91.3 established pursuant to section 151.02, the board of podiatric 91.4 medicine established pursuant to section 153.02, and the board 91.5 of veterinary medicine, established pursuant to section 156.01. 91.6 Sec. 104. Minnesota Statutes 1996, section 214.03, is 91.7 amended to read: 91.8 214.03 [STANDARDIZED TESTS.] 91.9 Subdivision 1. [STANDARDIZED TESTS USED.] All state 91.10 examining and licensing boards, other than the state board of 91.11 law examiners, the state board of professional responsibility or 91.12 any other board established by the supreme court to regulate the 91.13 practice of law and judicial functions, shall use national 91.14 standardized tests for the objective, nonpractical portion of 91.15 any examination given to prospective licensees to the extent 91.16 that such national standardized tests are appropriate, except 91.17 when the subject matter of the examination relates to the 91.18 application of Minnesota law to the profession or calling being 91.19 licensed. 91.20 Subd. 2. [HEALTH-RELATED BOARDS; SPECIAL ACCOUNT.] There 91.21 is established an account in the special revenue fund where a 91.22 health-related licensing board may deposit applicants' payments 91.23 for national or regional standardized tests. Money in the 91.24 account is appropriated to each board that has deposited monies 91.25 into the account, in an amount equal to the amount deposited by 91.26 the board, to pay for the use of national or regional 91.27 standardized tests. 91.28 Sec. 105. Minnesota Statutes 1997 Supplement, section 91.29 214.32, subdivision 1, is amended to read: 91.30 Subdivision 1. [MANAGEMENT.] (a) A health professionals 91.31 services program committee is established, consisting of one 91.32 person appointed by each participating board, with each 91.33 participating board having one vote. The committee shall 91.34 designate one board to provide administrative management of the 91.35 program, set the program budget and the pro rata share of 91.36 program expenses to be borne by each participating board, 92.1 provide guidance on the general operation of the program, 92.2 including hiring of program personnel, and ensure that the 92.3 program's direction is in accord with its authority. No more 92.4 than half plus one of the members of the committee may be of one 92.5 gender. If the participating boards change which board is 92.6 designated to provide administrative management of the program, 92.7 any appropriation remaining for the program shall transfer to 92.8 the newly designated board on the effective date of the change. 92.9 The participating boards must inform the appropriate legislative 92.10 committees and the commissioner of finance of any change in the 92.11 administrative management of the program, and the amount of any 92.12 appropriation transferred under this provision. 92.13 (b) The designated board, upon recommendation of the health 92.14 professional services program committee, shall hire the program 92.15 manager and employees and pay expenses of the program from funds 92.16 appropriated for that purpose. The designated board may apply 92.17 for grants to pay program expenses and may enter into contracts 92.18 on behalf of the program to carry out the purposes of the 92.19 program. The participating boards shall enter into written 92.20 agreements with the designated board. 92.21 (c) An advisory committee is established to advise the 92.22 program committee consisting of: 92.23 (1) one member appointed by each of the following: the 92.24 Minnesota Academy of Physician Assistants, the Minnesota Dental 92.25 Association, the Minnesota Chiropractic Association, the 92.26 Minnesota Licensed Practical Nurse Association, the Minnesota 92.27 Medical Association, the Minnesota Nurses Association, and the 92.28 Minnesota Podiatric Medicine Association; 92.29 (2) one member appointed by each of the professional 92.30 associations of the other professions regulated by a 92.31 participating board not specified in clause (1); and 92.32 (3) two public members, as defined by section 214.02. 92.33 Members of the advisory committee shall be appointed for two 92.34 years and members may be reappointed. 92.35 No more than half plus one of the members of the committee 92.36 may be of one gender. 93.1 The advisory committee expires June 30, 2001. 93.2 Sec. 106. Minnesota Statutes 1996, section 254A.17, 93.3 subdivision 1, is amended to read: 93.4 Subdivision 1. [MATERNAL AND CHILD SERVICE PROGRAMS.] (a) 93.5 The commissioner shall fund maternal and child health and social 93.6 service programs designed to improve the health and functioning 93.7 of children born to mothers using alcohol and controlled 93.8 substances. Comprehensive programs shall include immediate and 93.9 ongoing intervention, treatment, and coordination of medical, 93.10 educational, and social services through a child's preschool 93.11 years. Programs shall also include research and evaluation to 93.12 identify methods most effective in improving outcomes among this 93.13 high-risk population. The commissioner shall ensure that the 93.14 programs are available on a statewide basis to the extent 93.15 possible with available funds. 93.16 (b) The commissioner of human services shall develop models 93.17 for the treatment of children ages 6 to 12 who are in need of 93.18 chemical dependency treatment. The commissioner shall fund at 93.19 least two pilot projects with qualified providers to provide 93.20 nonresidential treatment for children in this age group. Model 93.21 programs must include a component to monitor and evaluate 93.22 treatment outcomes. 93.23 Sec. 107. Minnesota Statutes 1996, section 254A.17, is 93.24 amended by adding a subdivision to read: 93.25 Subd. 1b. [INTERVENTION AND ADVOCACY PROGRAM.] Within the 93.26 limits of money available, the commissioner of human services 93.27 shall fund voluntary hospital-based outreach programs targeted 93.28 at women who deliver children affected by prenatal alcohol or 93.29 drug use. The program shall help women obtain treatment, stay 93.30 in recovery, and plan any future pregnancies. An advocate shall 93.31 be assigned to each woman in the program to provide guidance and 93.32 advice with respect to treatment programs, child safety and 93.33 parenting, housing, family planning, and any other personal 93.34 issues that are barriers to remaining free of chemical 93.35 dependence. The commissioner shall develop an evaluation 93.36 component and provide centralized coordination of the evaluation 94.1 process. 94.2 Sec. 108. Minnesota Statutes 1997 Supplement, section 94.3 256B.692, subdivision 2, is amended to read: 94.4 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] 94.5 Notwithstanding chapters 62D and 62N, a county that elects to 94.6 purchase medical assistance and general assistance medical care 94.7 in return for a fixed sum without regard to the frequency or 94.8 extent of services furnished to any particular enrollee is not 94.9 required to obtain a certificate of authority under chapter 62D 94.10 or 62N. A county that elects to purchase medical assistance and 94.11 general assistance medical care services under this section must 94.12 satisfy the commissioner of health that the requirements of 94.13 chapter 62D, applicable to health maintenance organizations, or 94.14 chapter 62N, applicable to community integrated service 94.15 networks, will be met. A county must also assure the 94.16 commissioner of health that the requirements ofsectionsections 94.17 62J.041; 62J.48; 62J.71 to 62J.73; all applicable provisions of 94.18 chapter 62Q, including sections 62Q.07; 62Q.075; 62Q.105; 94.19 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 62Q.14; 62Q.145; 94.20 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 62Q.47; 62Q.50; 94.21 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 will be met. All 94.22 enforcement and rulemaking powers available under chapters 62D, 94.23 62J, and 62N are hereby granted to the commissioner of health 94.24 with respect to counties that purchase medical assistance and 94.25 general assistance medical care services under this section. 94.26 Sec. 109. Minnesota Statutes 1996, section 268.92, 94.27 subdivision 4, is amended to read: 94.28 Subd. 4. [LEADCONTRACTORSSUPERVISOR OR CERTIFIED FIRM.] 94.29 (a) Eligible organizations and leadcontractorssupervisors or 94.30 certified firms may participate in the swab team program. An 94.31 eligible organization receiving a grant under this section must 94.32 assure that all participating leadcontractorssupervisors or 94.33 certified firms are licensed and that all swab team workers are 94.34 certified by the department of health under section 144.9505. 94.35 Eligible organizations and leadcontractorssupervisors or 94.36 certified firms may distinguish between interior and exterior 95.1 services in assigning duties and may participate in the program 95.2 by: 95.3 (1) providing on-the-job training for swab team workers; 95.4 (2) providing swab team services to meet the requirements 95.5 of sections 144.9503, subdivision 4, and 144.9504, subdivision 95.6 6; 95.7 (3) providing a removal and replacement component using 95.8 skilled craft workers under subdivision 7; 95.9 (4) providing lead testing according to subdivision 7a; 95.10 (5) providing lead dust cleaning supplies, as described in 95.11 section144.9503144.9507, subdivision54, 95.12 paragraph(b)(c), to residents; or 95.13 (6) having a swab team worker instruct residents and 95.14 property owners on appropriate lead control techniques, 95.15 including the lead-safe directives developed by the commissioner 95.16 of health. 95.17 (b) Participating leadcontractorssupervisors or certified 95.18 firms must: 95.19 (1) demonstrate proof of workers' compensation and general 95.20 liability insurance coverage; 95.21 (2) be knowledgeable about lead abatement requirements 95.22 established by the Department of Housing and Urban Development 95.23 and the Occupational Safety and Health Administration and lead 95.24 hazard reduction requirements and lead-safe directives of the 95.25 commissioner of health; 95.26 (3) demonstrate experience with on-the-job training 95.27 programs; 95.28 (4) demonstrate an ability to recruit employees from areas 95.29 at high risk for toxic lead exposure; and 95.30 (5) demonstrate experience in working with low-income 95.31 clients. 95.32 Sec. 110. [COMPLAINT PROCESS STUDY.] 95.33 The complaint process work group established by the 95.34 commissioners of health and commerce as required under Laws 95.35 1997, chapter 237, section 20, shall continue to meet to develop 95.36 a complaint resolution process for health plan companies to make 96.1 available to enrollees as required under Minnesota Statutes, 96.2 sections 62Q.105, 62Q.11, and 62Q.30. The commissioners of 96.3 health and commerce shall submit a progress report to the 96.4 legislative commission on health care access by September 15, 96.5 1998, and shall submit final recommendations to the legislature, 96.6 including draft legislation on developing such a process by 96.7 November 15, 1998. The recommendations must also include, in 96.8 consultation with the work group, a permanent method of 96.9 financing the office of health care consumer assistance, 96.10 advocacy, and information. 96.11 Sec. 111. [RESIDENTIAL HOSPICE ADVISORY TASK FORCE.] 96.12 The commissioner of health shall convene an advisory task 96.13 force to study issues related to the building codes and safety 96.14 standards that residential hospice facilities must meet for 96.15 licensure and to make recommendations on changes to these 96.16 standards. Task force membership shall include representatives 96.17 of residential hospices, pediatric residential hospices, the 96.18 Minnesota hospice organization, the Minnesota department of 96.19 health, and other interested parties. The task force is 96.20 governed by Minnesota Statutes, section 15.059, subdivision 6. 96.21 The task force shall submit recommendations and any draft 96.22 legislation to the legislature by January 15, 1999. 96.23 Sec. 112. [TEMPORARY LICENSURE WAIVER FOR DIETITIANS.] 96.24 Until October 31, 1998, the board of dietetics and 96.25 nutrition practice may waive the requirements for licensure as a 96.26 dietitian established in Minnesota Statutes, section 148.624, 96.27 subdivision 1, clause (1), and may issue a license to an 96.28 applicant who meets the qualifications for licensure specified 96.29 in Minnesota Statutes, section 148.627, subdivision 1. A waiver 96.30 may be granted in cases in which unusual or extraordinary 96.31 job-related circumstances prevented an applicant from applying 96.32 for licensure during the transition period specified in 96.33 Minnesota Statutes, section 148.627, subdivision 1. An 96.34 applicant must request a waiver in writing and must explain the 96.35 circumstances that prevented the applicant from applying for 96.36 licensure during the transition period. 97.1 Sec. 113. [ADVICE AND RECOMMENDATIONS.] 97.2 The commissioners of health and commerce shall convene an 97.3 ad hoc advisory panel of selected representatives of health plan 97.4 companies, purchasers, and provider groups engaged in the 97.5 practice of health care in Minnesota, and interested 97.6 legislators. This advisory panel shall meet and assist the 97.7 commissioners in developing measures to prevent discrimination 97.8 against providers and provider groups in managed care in 97.9 Minnesota and clarify the requirements of Minnesota Statutes, 97.10 section 62Q.23, paragraph (c). Any such measures shall be 97.11 reported to the legislature prior to November 15, 1998. 97.12 Sec. 114. [AGREEMENT AUTHORIZED.] 97.13 In order to have a comprehensive program to protect the 97.14 public from radiation hazards, the governor may enter into an 97.15 agreement with the United States Nuclear Regulatory Commission, 97.16 under the Atomic Energy Act of 1954, United States Code, title 97.17 42, section 2021, paragraph (b). The agreement may allow the 97.18 state to assume regulation over nonpower plant radiation hazards 97.19 including certain by-product, source, and special nuclear 97.20 materials not sufficient to form a critical mass. The agreement 97.21 must be approved in law prior to being implemented. 97.22 Sec. 115. [HEALTH DEPARTMENT DESIGNATED LEAD.] 97.23 The department of health is designated as the lead agency 97.24 to pursue an agreement on behalf of the governor, and for any 97.25 assumption of specified licensing and regulatory authority from 97.26 the Nuclear Regulatory Commission under an agreement. The 97.27 department may enter into negotiations with the Nuclear 97.28 Regulatory Commission for that purpose. The commissioner of 97.29 health shall establish an advisory group to assist the 97.30 department in preparing the state to meet the requirements for 97.31 achieving an agreement. 97.32 Sec. 116. [RULES.] 97.33 The department of health may adopt rules for the state 97.34 assumption of regulation under an agreement under this act, 97.35 including the licensing and regulation of by-product, source, 97.36 and special nuclear material not sufficient to form a critical 98.1 mass. 98.2 Sec. 117. [TRANSITION.] 98.3 A person who, on the effective date of an agreement under 98.4 this act, possesses a Nuclear Regulatory Commission license that 98.5 is subject to the agreement shall be deemed to possess a similar 98.6 license issued by the department of health. Licenses shall 98.7 expire on the expiration date specified in the federal license. 98.8 Sec. 118. [STUDY OF EXTENT OF FETAL ALCOHOL SYNDROME.] 98.9 The commissioner of health shall conduct a study of the 98.10 incidence and prevalence of fetal alcohol syndrome in Minnesota. 98.11 The commissioner shall not collect individually identifiable 98.12 data for this study. 98.13 Sec. 119. [INITIAL APPOINTMENTS TO BOARD.] 98.14 Notwithstanding Minnesota Statutes, section 148.67, the 98.15 first physical therapist members appointed to the board may be 98.16 registered physical therapists. 98.17 Sec. 120. [SUNSET.] 98.18 An agreement entered into before August 2, 2002, shall 98.19 remain in effect until terminated or suspended under the Atomic 98.20 Energy Act of 1954, United States Code, title 42, section 2021, 98.21 paragraph (j). The governor may not enter into an initial 98.22 agreement with the Nuclear Regulatory Commission after August 1, 98.23 2002. If an agreement is not entered into, any rules adopted 98.24 under this act are repealed on that date. 98.25 Sec. 121. [REPEALER.] 98.26 Minnesota Statutes 1996, sections 144.491; 144.9501, 98.27 subdivisions 12, 14, and 16; and 144.9503, subdivisions 5, 8, 98.28 and 9, are repealed. 98.29 Sec. 122. [EFFECTIVE DATES.] 98.30 Sections 23 to 37, 39 to 58, 60 to 69, 103 (214.03), 104 98.31 (214.32, subdivision 1), 111 (temporary licensure), 112 (advice 98.32 and recommendations), and 120 (Repealer) are effective the day 98.33 following final enactment. 98.34 Sections 1 and 7 to 10 are effective January 1, 1999, and 98.35 apply to coverage issued, renewed, or continued as defined in 98.36 section 60A.02, subdivision 2a, on or after that date. 99.1 ARTICLE 3 99.2 LONG-TERM CARE 99.3 Section 1. Minnesota Statutes 1996, section 144A.04, 99.4 subdivision 5, is amended to read: 99.5 Subd. 5. [ADMINISTRATORS.] Except as otherwise provided by 99.6 this subdivision, a nursing home must have a full time licensed 99.7 nursing home administrator serving the facility. In any nursing 99.8 home of less than2531 beds, the director of nursing services 99.9 may also serve as the licensed nursing home administrator. Two 99.10 nursing homes under common ownership having a total of 150 beds 99.11 or less and located within 75 miles of each other may share the 99.12 services of a licensed administrator if the administrator 99.13 divides full-time work week between the two facilities in 99.14 proportion to the number of beds in each facility. Every 99.15 nursing home shall have a person-in-charge on the premises at 99.16 all times in the absence of the licensed administrator. The 99.17 name of the person in charge must be posted in a conspicuous 99.18 place in the facility. The commissioner of health shall by rule 99.19 promulgate minimum education and experience requirements for 99.20 persons-in-charge, and may promulgate rules specifying the times 99.21 of day during which a licensed administrator must be on the 99.22 nursing home's premises. In the absence of rules adopted by the 99.23 commissioner governing the division of an administrator's time 99.24 between two nursing homes, the administrator shall designate and 99.25 post the times the administrator will be on site in each home on 99.26 a regular basis. A nursing home may employ as its administrator 99.27 the administrator of a hospital licensed pursuant to sections 99.28 144.50 to 144.56 if the individual is licensed as a nursing home 99.29 administrator pursuant to section 144A.20 and the nursing home 99.30 and hospital have a combined total of 150 beds or less and are 99.31 located within one mile of each other. A nonproprietary 99.32 retirement home having fewer than 15 licensed nursing home beds 99.33 may share the services of a licensed administrator with a 99.34 nonproprietary nursing home, having fewer than 150 licensed 99.35 nursing home beds, that is located within 25 miles of the 99.36 retirement home. A nursing home which is located in a facility 100.1 licensed as a hospital pursuant to sections 144.50 to 144.56, 100.2 may employ as its administrator the administrator of the 100.3 hospital if the individual meets minimum education and long term 100.4 care experience criteria set by rule of the commissioner of 100.5 health. 100.6 Sec. 2. Minnesota Statutes 1997 Supplement, section 100.7 144A.071, subdivision 4a, is amended to read: 100.8 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 100.9 best interest of the state to ensure that nursing homes and 100.10 boarding care homes continue to meet the physical plant 100.11 licensing and certification requirements by permitting certain 100.12 construction projects. Facilities should be maintained in 100.13 condition to satisfy the physical and emotional needs of 100.14 residents while allowing the state to maintain control over 100.15 nursing home expenditure growth. 100.16 The commissioner of health in coordination with the 100.17 commissioner of human services, may approve the renovation, 100.18 replacement, upgrading, or relocation of a nursing home or 100.19 boarding care home, under the following conditions: 100.20 (a) to license or certify beds in a new facility 100.21 constructed to replace a facility or to make repairs in an 100.22 existing facility that was destroyed or damaged after June 30, 100.23 1987, by fire, lightning, or other hazard provided: 100.24 (i) destruction was not caused by the intentional act of or 100.25 at the direction of a controlling person of the facility; 100.26 (ii) at the time the facility was destroyed or damaged the 100.27 controlling persons of the facility maintained insurance 100.28 coverage for the type of hazard that occurred in an amount that 100.29 a reasonable person would conclude was adequate; 100.30 (iii) the net proceeds from an insurance settlement for the 100.31 damages caused by the hazard are applied to the cost of the new 100.32 facility or repairs; 100.33 (iv) the new facility is constructed on the same site as 100.34 the destroyed facility or on another site subject to the 100.35 restrictions in section 144A.073, subdivision 5; 100.36 (v) the number of licensed and certified beds in the new 101.1 facility does not exceed the number of licensed and certified 101.2 beds in the destroyed facility; and 101.3 (vi) the commissioner determines that the replacement beds 101.4 are needed to prevent an inadequate supply of beds. 101.5 Project construction costs incurred for repairs authorized under 101.6 this clause shall not be considered in the dollar threshold 101.7 amount defined in subdivision 2; 101.8 (b) to license or certify beds that are moved from one 101.9 location to another within a nursing home facility, provided the 101.10 total costs of remodeling performed in conjunction with the 101.11 relocation of beds does not exceed $750,000; 101.12 (c) to license or certify beds in a project recommended for 101.13 approval under section 144A.073; 101.14 (d) to license or certify beds that are moved from an 101.15 existing state nursing home to a different state facility, 101.16 provided there is no net increase in the number of state nursing 101.17 home beds; 101.18 (e) to certify and license as nursing home beds boarding 101.19 care beds in a certified boarding care facility if the beds meet 101.20 the standards for nursing home licensure, or in a facility that 101.21 was granted an exception to the moratorium under section 101.22 144A.073, and if the cost of any remodeling of the facility does 101.23 not exceed $750,000. If boarding care beds are licensed as 101.24 nursing home beds, the number of boarding care beds in the 101.25 facility must not increase beyond the number remaining at the 101.26 time of the upgrade in licensure. The provisions contained in 101.27 section 144A.073 regarding the upgrading of the facilities do 101.28 not apply to facilities that satisfy these requirements; 101.29 (f) to license and certify up to 40 beds transferred from 101.30 an existing facility owned and operated by the Amherst H. Wilder 101.31 Foundation in the city of St. Paul to a new unit at the same 101.32 location as the existing facility that will serve persons with 101.33 Alzheimer's disease and other related disorders. The transfer 101.34 of beds may occur gradually or in stages, provided the total 101.35 number of beds transferred does not exceed 40. At the time of 101.36 licensure and certification of a bed or beds in the new unit, 102.1 the commissioner of health shall delicense and decertify the 102.2 same number of beds in the existing facility. As a condition of 102.3 receiving a license or certification under this clause, the 102.4 facility must make a written commitment to the commissioner of 102.5 human services that it will not seek to receive an increase in 102.6 its property-related payment rate as a result of the transfers 102.7 allowed under this paragraph; 102.8 (g) to license and certify nursing home beds to replace 102.9 currently licensed and certified boarding care beds which may be 102.10 located either in a remodeled or renovated boarding care or 102.11 nursing home facility or in a remodeled, renovated, newly 102.12 constructed, or replacement nursing home facility within the 102.13 identifiable complex of health care facilities in which the 102.14 currently licensed boarding care beds are presently located, 102.15 provided that the number of boarding care beds in the facility 102.16 or complex are decreased by the number to be licensed as nursing 102.17 home beds and further provided that, if the total costs of new 102.18 construction, replacement, remodeling, or renovation exceed ten 102.19 percent of the appraised value of the facility or $200,000, 102.20 whichever is less, the facility makes a written commitment to 102.21 the commissioner of human services that it will not seek to 102.22 receive an increase in its property-related payment rate by 102.23 reason of the new construction, replacement, remodeling, or 102.24 renovation. The provisions contained in section 144A.073 102.25 regarding the upgrading of facilities do not apply to facilities 102.26 that satisfy these requirements; 102.27 (h) to license as a nursing home and certify as a nursing 102.28 facility a facility that is licensed as a boarding care facility 102.29 but not certified under the medical assistance program, but only 102.30 if the commissioner of human services certifies to the 102.31 commissioner of health that licensing the facility as a nursing 102.32 home and certifying the facility as a nursing facility will 102.33 result in a net annual savings to the state general fund of 102.34 $200,000 or more; 102.35 (i) to certify, after September 30, 1992, and prior to July 102.36 1, 1993, existing nursing home beds in a facility that was 103.1 licensed and in operation prior to January 1, 1992; 103.2 (j) to license and certify new nursing home beds to replace 103.3 beds in a facilitycondemnedacquired by the Minneapolis 103.4 community development agency as part ofan economic103.5 redevelopmentplanactivities in a city of the first class, 103.6 provided the new facility is located withinone milethree miles 103.7 of the site of the old facility. Operating and property costs 103.8 for the new facility must be determined and allowed 103.9 underexisting reimbursement rulessection 256B.431 or 256B.434; 103.10 (k) to license and certify up to 20 new nursing home beds 103.11 in a community-operated hospital and attached convalescent and 103.12 nursing care facility with 40 beds on April 21, 1991, that 103.13 suspended operation of the hospital in April 1986. The 103.14 commissioner of human services shall provide the facility with 103.15 the same per diem property-related payment rate for each 103.16 additional licensed and certified bed as it will receive for its 103.17 existing 40 beds; 103.18 (l) to license or certify beds in renovation, replacement, 103.19 or upgrading projects as defined in section 144A.073, 103.20 subdivision 1, so long as the cumulative total costs of the 103.21 facility's remodeling projects do not exceed $750,000; 103.22 (m) to license and certify beds that are moved from one 103.23 location to another for the purposes of converting up to five 103.24 four-bed wards to single or double occupancy rooms in a nursing 103.25 home that, as of January 1, 1993, was county-owned and had a 103.26 licensed capacity of 115 beds; 103.27 (n) to allow a facility that on April 16, 1993, was a 103.28 106-bed licensed and certified nursing facility located in 103.29 Minneapolis to layaway all of its licensed and certified nursing 103.30 home beds. These beds may be relicensed and recertified in a 103.31 newly-constructed teaching nursing home facility affiliated with 103.32 a teaching hospital upon approval by the legislature. The 103.33 proposal must be developed in consultation with the interagency 103.34 committee on long-term care planning. The beds on layaway 103.35 status shall have the same status as voluntarily delicensed and 103.36 decertified beds, except that beds on layaway status remain 104.1 subject to the surcharge in section 256.9657. This layaway 104.2 provision expires July 1, 1998; 104.3 (o) to allow a project which will be completed in 104.4 conjunction with an approved moratorium exception project for a 104.5 nursing home in southern Cass county and which is directly 104.6 related to that portion of the facility that must be repaired, 104.7 renovated, or replaced, to correct an emergency plumbing problem 104.8 for which a state correction order has been issued and which 104.9 must be corrected by August 31, 1993; 104.10 (p) to allow a facility that on April 16, 1993, was a 104.11 368-bed licensed and certified nursing facility located in 104.12 Minneapolis to layaway, upon 30 days prior written notice to the 104.13 commissioner, up to 30 of the facility's licensed and certified 104.14 beds by converting three-bed wards to single or double 104.15 occupancy. Beds on layaway status shall have the same status as 104.16 voluntarily delicensed and decertified beds except that beds on 104.17 layaway status remain subject to the surcharge in section 104.18 256.9657, remain subject to the license application and renewal 104.19 fees under section 144A.07 and shall be subject to a $100 per 104.20 bed reactivation fee. In addition, at any time within three 104.21 years of the effective date of the layaway, the beds on layaway 104.22 status may be: 104.23 (1) relicensed and recertified upon relocation and 104.24 reactivation of some or all of the beds to an existing licensed 104.25 and certified facility or facilities located in Pine River, 104.26 Brainerd, or International Falls; provided that the total 104.27 project construction costs related to the relocation of beds 104.28 from layaway status for any facility receiving relocated beds 104.29 may not exceed the dollar threshold provided in subdivision 2 104.30 unless the construction project has been approved through the 104.31 moratorium exception process under section 144A.073; 104.32 (2) relicensed and recertified, upon reactivation of some 104.33 or all of the beds within the facility which placed the beds in 104.34 layaway status, if the commissioner has determined a need for 104.35 the reactivation of the beds on layaway status. 104.36 The property-related payment rate of a facility placing 105.1 beds on layaway status must be adjusted by the incremental 105.2 change in its rental per diem after recalculating the rental per 105.3 diem as provided in section 256B.431, subdivision 3a, paragraph 105.4 (d). The property-related payment rate for a facility 105.5 relicensing and recertifying beds from layaway status must be 105.6 adjusted by the incremental change in its rental per diem after 105.7 recalculating its rental per diem using the number of beds after 105.8 the relicensing to establish the facility's capacity day 105.9 divisor, which shall be effective the first day of the month 105.10 following the month in which the relicensing and recertification 105.11 became effective. Any beds remaining on layaway status more 105.12 than three years after the date the layaway status became 105.13 effective must be removed from layaway status and immediately 105.14 delicensed and decertified; 105.15 (q) to license and certify beds in a renovation and 105.16 remodeling project to convert 12 four-bed wards into 24 two-bed 105.17 rooms, expand space, and add improvements in a nursing home 105.18 that, as of January 1, 1994, met the following conditions: the 105.19 nursing home was located in Ramsey county; had a licensed 105.20 capacity of 154 beds; and had been ranked among the top 15 105.21 applicants by the 1993 moratorium exceptions advisory review 105.22 panel. The total project construction cost estimate for this 105.23 project must not exceed the cost estimate submitted in 105.24 connection with the 1993 moratorium exception process; 105.25 (r) to license and certify up to 117 beds that are 105.26 relocated from a licensed and certified 138-bed nursing facility 105.27 located in St. Paul to a hospital with 130 licensed hospital 105.28 beds located in South St. Paul, provided that the nursing 105.29 facility and hospital are owned by the same or a related 105.30 organization and that prior to the date the relocation is 105.31 completed the hospital ceases operation of its inpatient 105.32 hospital services at that hospital. After relocation, the 105.33 nursing facility's status under section 256B.431, subdivision 105.34 2j, shall be the same as it was prior to relocation. The 105.35 nursing facility's property-related payment rate resulting from 105.36 the project authorized in this paragraph shall become effective 106.1 no earlier than April 1, 1996. For purposes of calculating the 106.2 incremental change in the facility's rental per diem resulting 106.3 from this project, the allowable appraised value of the nursing 106.4 facility portion of the existing health care facility physical 106.5 plant prior to the renovation and relocation may not exceed 106.6 $2,490,000; 106.7 (s) to license and certify two beds in a facility to 106.8 replace beds that were voluntarily delicensed and decertified on 106.9 June 28, 1991; 106.10 (t) to allow 16 licensed and certified beds located on July 106.11 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 106.12 facility in Minneapolis, notwithstanding the licensure and 106.13 certification after July 1, 1995, of the Minneapolis facility as 106.14 a 147-bed nursing home facility after completion of a 106.15 construction project approved in 1993 under section 144A.073, to 106.16 be laid away upon 30 days' prior written notice to the 106.17 commissioner. Beds on layaway status shall have the same status 106.18 as voluntarily delicensed or decertified beds except that they 106.19 shall remain subject to the surcharge in section 256.9657. The 106.20 16 beds on layaway status may be relicensed as nursing home beds 106.21 and recertified at any time within five years of the effective 106.22 date of the layaway upon relocation of some or all of the beds 106.23 to a licensed and certified facility located in Watertown, 106.24 provided that the total project construction costs related to 106.25 the relocation of beds from layaway status for the Watertown 106.26 facility may not exceed the dollar threshold provided in 106.27 subdivision 2 unless the construction project has been approved 106.28 through the moratorium exception process under section 144A.073. 106.29 The property-related payment rate of the facility placing 106.30 beds on layaway status must be adjusted by the incremental 106.31 change in its rental per diem after recalculating the rental per 106.32 diem as provided in section 256B.431, subdivision 3a, paragraph 106.33 (d). The property-related payment rate for the facility 106.34 relicensing and recertifying beds from layaway status must be 106.35 adjusted by the incremental change in its rental per diem after 106.36 recalculating its rental per diem using the number of beds after 107.1 the relicensing to establish the facility's capacity day 107.2 divisor, which shall be effective the first day of the month 107.3 following the month in which the relicensing and recertification 107.4 became effective. Any beds remaining on layaway status more 107.5 than five years after the date the layaway status became 107.6 effective must be removed from layaway status and immediately 107.7 delicensed and decertified; 107.8 (u) to license and certify beds that are moved within an 107.9 existing area of a facility or to a newly constructed addition 107.10 which is built for the purpose of eliminating three- and 107.11 four-bed rooms and adding space for dining, lounge areas, 107.12 bathing rooms, and ancillary service areas in a nursing home 107.13 that, as of January 1, 1995, was located in Fridley and had a 107.14 licensed capacity of 129 beds; 107.15 (v) to relocate 36 beds in Crow Wing county and four beds 107.16 from Hennepin county to a 160-bed facility in Crow Wing county, 107.17 provided all the affected beds are under common ownership; 107.18 (w) to license and certify a total replacement project of 107.19 up to 49 beds located in Norman county that are relocated from a 107.20 nursing home destroyed by flood and whose residents were 107.21 relocated to other nursing homes. The operating cost payment 107.22 rates for the new nursing facility shall be determined based on 107.23 the interim and settle-up payment provisions of Minnesota Rules, 107.24 part 9549.0057, and the reimbursement provisions of section 107.25 256B.431, except that subdivision 26, paragraphs (a) and (b), 107.26 shall not apply until the second rate year after the settle-up 107.27 cost report is filed. Property-related reimbursement rates 107.28 shall be determined under section 256B.431, taking into account 107.29 any federal or state flood-related loans or grants provided to 107.30 the facility; 107.31 (x) to license and certify a total replacement project of 107.32 up to 129 beds located in Polk county that are relocated from a 107.33 nursing home destroyed by flood and whose residents were 107.34 relocated to other nursing homes. The operating cost payment 107.35 rates for the new nursing facility shall be determined based on 107.36 the interim and settle-up payment provisions of Minnesota Rules, 108.1 part 9549.0057, and the reimbursement provisions of section 108.2 256B.431, except that subdivision 26, paragraphs (a) and (b), 108.3 shall not apply until the second rate year after the settle-up 108.4 cost report is filed. Property-related reimbursement rates 108.5 shall be determined under section 256B.431, taking into account 108.6 any federal or state flood-related loans or grants provided to 108.7 the facility;or108.8 (y) to license and certify beds in a renovation and 108.9 remodeling project to convert 13 three-bed wards into 13 two-bed 108.10 rooms and 13 single-bed rooms, expand space, and add 108.11 improvements in a nursing home that, as of January 1, 1994, met 108.12 the following conditions: the nursing home was located in 108.13 Ramsey county, was not owned by a hospital corporation, had a 108.14 licensed capacity of 64 beds, and had been ranked among the top 108.15 15 applicants by the 1993 moratorium exceptions advisory review 108.16 panel. The total project construction cost estimate for this 108.17 project must not exceed the cost estimate submitted in 108.18 connection with the 1993 moratorium exception process.; 108.19 (z) to allow a 285-bed nursing facility in St. Paul that 108.20 provides for the special dietary needs of its residents under 108.21 the requirements in section 31.651 to undertake a construction 108.22 project that will improve some of the existing structures, 108.23 create new buildings, and reduce the licensed and certified beds 108.24 to 150; or 108.25 (aa) to allow the commissioner of human services to license 108.26 an additional 36 beds to provide residential services for the 108.27 physically handicapped under Minnesota Rules, parts 9570.2000 to 108.28 9570.3400, in a 198-bed nursing home located in Red Wing, 108.29 provided that the total number of licensed and certified beds at 108.30 the facility does not increase. 108.31 Sec. 3. Minnesota Statutes 1996, section 144A.09, 108.32 subdivision 1, is amended to read: 108.33 Subdivision 1. [SPIRITUAL MEANS FOR HEALING.]No rule108.34establishedSections 144A.04, subdivision 5, and 144A.18 to 108.35 144A.27, and rules adopted under sections 144A.01 to 144A.16 108.36 other than a rule relating to sanitation and safety of premises, 109.1 to cleanliness of operation, or to physical equipmentshalldo 109.2 not apply to a nursing home conducted by and for the adherents 109.3 of any recognized church or religious denomination for the 109.4 purpose of providing care and treatment for those who select and 109.5 depend upon spiritual means through prayer alone, in lieu of 109.6 medical care, for healing. 109.7 Sec. 4. Minnesota Statutes 1997 Supplement, section 109.8 256B.0951, is amended by adding a subdivision to read: 109.9 Subd. 7. [WAIVER OF RULES.] The commissioner of health may 109.10 exempt residents of intermediate care facilities for persons 109.11 with mental retardation (ICFs/MR) who participate in the 109.12 three-year quality assurance pilot project established in 109.13 section 256B.095 from the requirements of Minnesota Rules, 109.14 chapter 4665, upon approval by the federal government of a 109.15 waiver of federal certification requirements for ICFs/MR. The 109.16 commissioners of health and human services shall apply for any 109.17 necessary waivers as soon as practicable and shall submit the 109.18 concept paper to the federal government by June 1, 1998. 109.19 Sec. 5. Minnesota Statutes 1996, section 256B.431, 109.20 subdivision 2i, is amended to read: 109.21 Subd. 2i. [OPERATING COSTS AFTER JULY 1, 1988.] (a) 109.22 [OTHER OPERATING COST LIMITS.] For the rate year beginning July 109.23 1, 1988, the commissioner shall increase the other operating 109.24 cost limits established in Minnesota Rules, part 9549.0055, 109.25 subpart 2, item E, to 110 percent of the median of the array of 109.26 allowable historical other operating cost per diems and index 109.27 these limits as in Minnesota Rules, part 9549.0056, subparts 3 109.28 and 4. The limits must be established in accordance with 109.29 subdivision 2b, paragraph (d). For rate years beginning on or 109.30 after July 1, 1989, the adjusted other operating cost limits 109.31 must be indexed as in Minnesota Rules, part 9549.0056, subparts 109.32 3 and 4. For the rate period beginning October 1, 1992, and for 109.33 rate years beginning after June 30, 1993, the amount of the 109.34 surcharge under section 256.9657, subdivision 1, shall be 109.35 included in the plant operations and maintenance operating cost 109.36 category. The surcharge shall be an allowable cost for the 110.1 purpose of establishing the payment rate. 110.2 (b) [CARE-RELATED OPERATING COST LIMITS.] For the rate 110.3 year beginning July 1, 1988, the commissioner shall increase the 110.4 care-related operating cost limits established in Minnesota 110.5 Rules, part 9549.0055, subpart 2, items A and B, to 125 percent 110.6 of the median of the array of the allowable historical case mix 110.7 operating cost standardized per diems and the allowable 110.8 historical other care-related operating cost per diems and index 110.9 those limits as in Minnesota Rules, part 9549.0056, subparts 1 110.10 and 2. The limits must be established in accordance with 110.11 subdivision 2b, paragraph (d). For rate years beginning on or 110.12 after July 1, 1989, the adjusted care-related limits must be 110.13 indexed as in Minnesota Rules, part 9549.0056, subparts 1 and 2. 110.14 (c) [SALARY ADJUSTMENT PER DIEM.]For the rate period110.15 EffectiveOctoberJuly 1,19881998, to June 30,1990110.16 2000, the commissioner shalladd the appropriatemake available 110.17 the salary adjustment per diem calculated in clause (1) or (2) 110.18 to the total operating cost payment rate of each nursing 110.19 facility reimbursed under this section or section 256B.434. The 110.20 salary adjustment per diem for each nursing facility must be 110.21 determined as follows: 110.22 (1) For each nursing facility that reports salaries for 110.23 registered nurses, licensed practical nurses, and aides, 110.24 orderlies and attendants separately, the commissioner shall 110.25 determine the salary adjustment per diem by multiplying the 110.26 total salaries, payroll taxes, and fringe benefits allowed in 110.27 each operating cost category, except management fees and 110.28 administrator and central office salaries and the related 110.29 payroll taxes and fringe benefits, by3.54.25 percent and then 110.30 dividing the resulting amount by the nursing facility's actual 110.31 resident days; and. 110.32 (2) For each nursing facility that does not report salaries 110.33 for registered nurses, licensed practical nurses, aides, 110.34 orderlies, and attendants separately, the salary adjustment per 110.35 diem is the weighted average salary adjustment per diem increase 110.36 determined under clause (1). 111.1Each nursing facility that receives a salary adjustment per111.2diem pursuant to this subdivision shall adjust nursing facility111.3employee salaries by a minimum of the amount determined in111.4clause (1) or (2). The commissioner shall review allowable111.5salary costs, including payroll taxes and fringe benefits, for111.6the reporting year ending September 30, 1989, to determine111.7whether or not each nursing facility complied with this111.8requirement. The commissioner shall report the extent to which111.9each nursing facility complied with the legislative commission111.10on long-term care by August 1, 1990.111.11 (3) A nursing facility may apply for the salary adjustment 111.12 per diem calculated under clauses (1) and (2). The application 111.13 must be made to the commissioner and contain a plan by which the 111.14 nursing facility will distribute the salary adjustment to 111.15 employees of the nursing facility. For nursing facilities in 111.16 which the employees are represented by an exclusive bargaining 111.17 representative, an agreement negotiated and agreed to by the 111.18 employer and the exclusive bargaining representative, after July 111.19 1, 1998, may constitute the plan for the salary distribution. 111.20 The commissioner shall review the plan to ensure that the salary 111.21 adjustment per diem is used solely to increase the compensation 111.22 of nursing home facility employees. 111.23 (4) Additional costs incurred by nursing facilities as a 111.24 result of this salary adjustment are not allowable costs for 111.25 purposes of the September 30, 1998, cost report. 111.26 (d) [NEW BASE YEAR.] The commissioner shall establish new 111.27 base years for both the reporting year ending September 30, 111.28 1989, and the reporting year ending September 30, 1990. In 111.29 establishing new base years, the commissioner must take into 111.30 account: 111.31 (1) statutory changes made in geographic groups; 111.32 (2) redefinitions of cost categories; and 111.33 (3) reclassification, pass-through, or exemption of certain 111.34 costs such as public employee retirement act contributions. 111.35 (e) [NEW BASE YEAR.] The commissioner shall establish a 111.36 new base year for the reporting years ending September 30, 1991, 112.1 and September 30, 1992. In establishing a new base year, the 112.2 commissioner must take into account: 112.3 (1) statutory changes made in geographic groups; 112.4 (2) redefinitions of cost categories; and 112.5 (3) reclassification, pass-through, or exemption of certain 112.6 costs. 112.7 Sec. 6. Minnesota Statutes 1996, section 256B.431, is 112.8 amended by adding a subdivision to read: 112.9 Subd. 2s. [NONALLOWABLE COST.] Costs incurred for any 112.10 activities which are directed at or are intended to influence or 112.11 dissuade employees in the exercise of their legal rights to 112.12 freely engage in the process of selecting an exclusive 112.13 representative for the purpose of collective bargaining with 112.14 their employer shall not be allowable for purposes of setting 112.15 payment rates. 112.16 Sec. 7. Minnesota Statutes 1997 Supplement, section 112.17 256B.431, subdivision 3f, is amended to read: 112.18 Subd. 3f. [PROPERTY COSTS AFTER JULY 1, 1988.] (a) [ 112.19 INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 112.20 1988, the replacement-cost-new per bed limit must be $32,571 per 112.21 licensed bed in multiple bedrooms and $48,857 per licensed bed 112.22 in a single bedroom. For the rate year beginning July 1, 1989, 112.23 the replacement-cost-new per bed limit for a single bedroom must 112.24 be $49,907 adjusted according to Minnesota Rules, part 112.25 9549.0060, subpart 4, item A, subitem (1). Beginning January 1, 112.26 1990, the replacement-cost-new per bed limits must be adjusted 112.27 annually as specified in Minnesota Rules, part 9549.0060, 112.28 subpart 4, item A, subitem (1). Beginning January 1, 1991, the 112.29 replacement-cost-new per bed limits will be adjusted annually as 112.30 specified in Minnesota Rules, part 9549.0060, subpart 4, item A, 112.31 subitem (1), except that the index utilized will be the Bureau 112.32 of the Census: Composite fixed-weighted price index as 112.33 published in the C30 Report, Value of New Construction Put in 112.34 Place. 112.35 (b) [RENTAL FACTOR.] For the rate year beginning July 1, 112.36 1988, the commissioner shall increase the rental factor as 113.1 established in Minnesota Rules, part 9549.0060, subpart 8, item 113.2 A, by 6.2 percent rounded to the nearest 100th percent for the 113.3 purpose of reimbursing nursing facilities for soft costs and 113.4 entrepreneurial profits not included in the cost valuation 113.5 services used by the state's contracted appraisers. For rate 113.6 years beginning on or after July 1, 1989, the rental factor is 113.7 the amount determined under this paragraph for the rate year 113.8 beginning July 1, 1988. 113.9 (c) [OCCUPANCY FACTOR.] For rate years beginning on or 113.10 after July 1, 1988, in order to determine property-related 113.11 payment rates under Minnesota Rules, part 9549.0060, for all 113.12 nursing facilities except those whose average length of stay in 113.13 a skilled level of care within a nursing facility is 180 days or 113.14 less, the commissioner shall use 95 percent of capacity days. 113.15 For a nursing facility whose average length of stay in a skilled 113.16 level of care within a nursing facility is 180 days or less, the 113.17 commissioner shall use the greater of resident days or 80 113.18 percent of capacity days but in no event shall the divisor 113.19 exceed 95 percent of capacity days. 113.20 (d) [EQUIPMENT ALLOWANCE.] For rate years beginning on 113.21 July 1, 1988, and July 1, 1989, the commissioner shall add ten 113.22 cents per resident per day to each nursing facility's 113.23 property-related payment rate. The ten-cent property-related 113.24 payment rate increase is not cumulative from rate year to rate 113.25 year. For the rate year beginning July 1, 1990, the 113.26 commissioner shall increase each nursing facility's equipment 113.27 allowance as established in Minnesota Rules, part 9549.0060, 113.28 subpart 10, by ten cents per resident per day. For rate years 113.29 beginning on or after July 1, 1991, the adjusted equipment 113.30 allowance must be adjusted annually for inflation as in 113.31 Minnesota Rules, part 9549.0060, subpart 10, item E. For the 113.32 rate period beginning October 1, 1992, the equipment allowance 113.33 for each nursing facility shall be increased by 28 percent. For 113.34 rate years beginning after June 30, 1993, the allowance must be 113.35 adjusted annually for inflation. 113.36 (e) [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND 114.1 INTEREST EXPENSE.] For rate years beginning on or after July 1, 114.2 1990, Minnesota Rules, part 9549.0060, subpart 5, item E, shall 114.3 not apply to outstanding related organization debt incurred 114.4 prior to May 23, 1983, provided that the debt was an allowable 114.5 debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the 114.6 debt is subject to repayment through annual principal payments, 114.7 and the nursing facility demonstrates to the commissioner's 114.8 satisfaction that the interest rate on the debt was less than 114.9 market interest rates for similar arms-length transactions at 114.10 the time the debt was incurred. If the debt was incurred due to 114.11 a sale between family members, the nursing facility must also 114.12 demonstrate that the seller no longer participates in the 114.13 management or operation of the nursing facility. Debts meeting 114.14 the conditions of this paragraph are subject to all other 114.15 provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. 114.16 (f) [BUILDING CAPITAL ALLOWANCE FOR NURSING FACILITIES 114.17 WITH OPERATING LEASES.] For rate years beginning on or after 114.18 July 1, 1990, a nursing facility with operating lease costs 114.19 incurred for the nursing facility's buildings shall receive its 114.20 building capital allowance computed in accordance with Minnesota 114.21 Rules, part 9549.0060, subpart 8. If an operating lease 114.22 provides that the lessee's rent is adjusted to recognize 114.23 improvements made by the lessor and related debt, the costs for 114.24 capital improvements and related debt shall be allowed in the 114.25 computation of the lessee's building capital allowance, provided 114.26 that reimbursement for these costs under an operating lease 114.27 shall not exceed the rate otherwise paid. 114.28 Sec. 8. Minnesota Statutes 1996, section 256B.431, 114.29 subdivision 11, is amended to read: 114.30 Subd. 11. [SPECIAL PROPERTY RATE SETTING PROCEDURES FOR 114.31 CERTAIN NURSING FACILITIES.] (a) Notwithstanding Minnesota 114.32 Rules, part 9549.0060, subpart 13, item H, to the contrary, for 114.33 the rate year beginning July 1, 1990, a nursing facility leased 114.34 prior to January 1, 1986, and currently subject to adverse 114.35 licensure action under section 144A.04, subdivision 4, paragraph 114.36 (a), or section 144A.11, subdivision 2, and whose ownership 115.1 changes prior to July 1, 1990, shall be allowed a 115.2 property-related payment equal to the lesser of its current 115.3 lease obligation divided by its capacity days as determined in 115.4 Minnesota Rules, part 9549.0060, subpart 11, as modified by 115.5 subdivision 3f, paragraph (c), or the frozen property-related 115.6 payment rate in effect for the rate year beginning July 1, 115.7 1989. For rate years beginning on or after July 1, 1991, the 115.8 property-related payment rate shall be its rental rate computed 115.9 using the previous owner's allowable principal and interest 115.10 expense as allowed by the department prior to that prior owner's 115.11 sale and lease-back transaction of December 1985. 115.12 (b) Notwithstanding other provisions of applicable law, a 115.13 nursing facility licensed for 122 beds on January 1, 1998, and 115.14 located in Columbia Heights shall have its property-related 115.15 payment rate set under this subdivision. The commissioner shall 115.16 make a rate adjustment by adding $2.41 to the facility's July 1, 115.17 1997, property-related payment rate. The adjusted 115.18 property-related payment rate shall be effective for rate years 115.19 beginning on or after July 1, 1998. The adjustment in this 115.20 paragraph shall remain in effect so long as the facility's rates 115.21 are set under this section. If the facility participates in the 115.22 alternative payment system under section 256B.434, the 115.23 adjustment in this paragraph shall be included in the facility's 115.24 contract payment rate. If historical rates or property costs 115.25 recognized under this section become the basis for future 115.26 medical assistance payments to the facility under a managed 115.27 care, capitation, or other alternative payment system, the 115.28 adjustment in this paragraph shall be included in the 115.29 computation of the facility's payments. 115.30 Sec. 9. Minnesota Statutes 1997 Supplement, section 115.31 256B.431, subdivision 26, is amended to read: 115.32 Subd. 26. [CHANGES TO NURSING FACILITY REIMBURSEMENT 115.33 BEGINNING JULY 1, 1997.] The nursing facility reimbursement 115.34 changes in paragraphs (a) to (f) shall apply in the sequence 115.35 specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 115.36 this section, beginning July 1, 1997. 116.1 (a) For rate years beginning on or after July 1, 1997, the 116.2 commissioner shall limit a nursing facility's allowable 116.3 operating per diem for each case mix category for each rate year. 116.4 The commissioner shall group nursing facilities into two groups, 116.5 freestanding and nonfreestanding, within each geographic group, 116.6 using their operating cost per diem for the case mix A 116.7 classification. A nonfreestanding nursing facility is a nursing 116.8 facility whose other operating cost per diem is subject to the 116.9 hospital attached, short length of stay, or the rule 80 limits. 116.10 All other nursing facilities shall be considered freestanding 116.11 nursing facilities. The commissioner shall then array all 116.12 nursing facilities in each grouping by their allowable case mix 116.13 A operating cost per diem. In calculating a nursing facility's 116.14 operating cost per diem for this purpose, the commissioner shall 116.15 exclude the raw food cost per diem related to providing special 116.16 diets that are based on religious beliefs, as determined in 116.17 subdivision 2b, paragraph (h). For those nursing facilities in 116.18 each grouping whose case mix A operating cost per diem: 116.19 (1) is at or below the median of the array, the 116.20 commissioner shall limit the nursing facility's allowable 116.21 operating cost per diem for each case mix category to the lesser 116.22 of the prior reporting year's allowable operating cost per diem 116.23 as specified in Laws 1996, chapter 451, article 3, section 11, 116.24 paragraph (h), plus the inflation factor as established in 116.25 paragraph (d), clause (2), increased by two percentage points, 116.26 or the current reporting year's corresponding allowable 116.27 operating cost per diem; or 116.28 (2) is above the median of the array, the commissioner 116.29 shall limit the nursing facility's allowable operating cost per 116.30 diem for each case mix category to the lesser of the prior 116.31 reporting year's allowable operating cost per diem as specified 116.32 in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 116.33 plus the inflation factor as established in paragraph (d), 116.34 clause (2), increased by one percentage point, or the current 116.35 reporting year's corresponding allowable operating cost per diem. 116.36 For purposes of paragraph (a), for rate years beginning on 117.1 or after July 1, 1998, if a nursing facility reports on its cost 117.2 report a reduction in cost due to a refund or credit, the 117.3 commissioner shall increase that facility's spend-up limit for 117.4 the rate year following the current rate year by the amount of 117.5 the cost reduction divided by its resident days for the 117.6 reporting year preceding the rate year in which the adjustment 117.7 is to be made. 117.8 (b) For rate years beginning on or after July 1, 1997, the 117.9 commissioner shall limit the allowable operating cost per diem 117.10 for high cost nursing facilities. After application of the 117.11 limits in paragraph (a) to each nursing facility's operating 117.12 cost per diem, the commissioner shall group nursing facilities 117.13 into two groups, freestanding or nonfreestanding, within each 117.14 geographic group. A nonfreestanding nursing facility is a 117.15 nursing facility whose other operating cost per diem are subject 117.16 to hospital attached, short length of stay, or rule 80 limits. 117.17 All other nursing facilities shall be considered freestanding 117.18 nursing facilities. The commissioner shall then array all 117.19 nursing facilities within each grouping by their allowable case 117.20 mix A operating cost per diem. In calculating a nursing 117.21 facility's operating cost per diem for this purpose, the 117.22 commissioner shall exclude the raw food cost per diem related to 117.23 providing special diets that are based on religious beliefs, as 117.24 determined in subdivision 2b, paragraph (h). For those nursing 117.25 facilities in each grouping whose case mix A operating cost per 117.26 diem exceeds 1.0 standard deviation above the median, the 117.27 commissioner shall reduce their allowable operating cost per 117.28 diem by three percent. For those nursing facilities in each 117.29 grouping whose case mix A operating cost per diem exceeds 0.5 117.30 standard deviation above the median but is less than or equal to 117.31 1.0 standard deviation above the median, the commissioner shall 117.32 reduce their allowable operating cost per diem by two percent. 117.33 However, in no case shall a nursing facility's operating cost 117.34 per diem be reduced below its grouping's limit established at 117.35 0.5 standard deviations above the median. 117.36 (c) For rate years beginning on or after July 1, 1997, the 118.1 commissioner shall determine a nursing facility's efficiency 118.2 incentive by first computing the allowable difference, which is 118.3 the lesser of $4.50 or the amount by which the facility's other 118.4 operating cost limit exceeds its nonadjusted other operating 118.5 cost per diem for that rate year. The commissioner shall 118.6 compute the efficiency incentive by: 118.7 (1) subtracting the allowable difference from $4.50 and 118.8 dividing the result by $4.50; 118.9 (2) multiplying 0.20 by the ratio resulting from clause 118.10 (1), and then; 118.11 (3) adding 0.50 to the result from clause (2); and 118.12 (4) multiplying the result from clause (3) times the 118.13 allowable difference. 118.14 The nursing facility's efficiency incentive payment shall 118.15 be the lesser of $2.25 or the product obtained in clause (4). 118.16 (d) For rate years beginning on or after July 1, 1997, the 118.17 forecasted price index for a nursing facility's allowable 118.18 operating cost per diem shall be determined under clauses (1) 118.19 and (2) using the change in the Consumer Price Index-All Items 118.20 (United States city average) (CPI-U) as forecasted by Data 118.21 Resources, Inc. The commissioner shall use the indices as 118.22 forecasted in the fourth quarter of the calendar year preceding 118.23 the rate year, subject to subdivision 2l, paragraph (c). 118.24 (1) The CPI-U forecasted index for allowable operating cost 118.25 per diem shall be based on the 21-month period from the midpoint 118.26 of the nursing facility's reporting year to the midpoint of the 118.27 rate year following the reporting year. 118.28 (2) For rate years beginning on or after July 1, 1997, the 118.29 forecasted index for operating cost limits referred to in 118.30 subdivision 21, paragraph (b), shall be based on the CPI-U for 118.31 the 12-month period between the midpoints of the two reporting 118.32 years preceding the rate year. 118.33 (e) After applying these provisions for the respective rate 118.34 years, the commissioner shall index these allowable operating 118.35 cost per diem by the inflation factor provided for in paragraph 118.36 (d), clause (1), and add the nursing facility's efficiency 119.1 incentive as computed in paragraph (c). 119.2 (f) For rate years beginning on or after July 1, 1997, the 119.3 total operating cost payment rates for a nursing facility shall 119.4 be the greater of the total operating cost payment rates 119.5 determined under this section or the total operating cost 119.6 payment rates in effect on June 30, 1997, subject to rate 119.7 adjustments due to field audit or rate appeal resolution. This 119.8 provision shall not apply to subsequent field audit adjustments 119.9 of the nursing facility's operating cost rates for rate years 119.10 beginning on or after July 1, 1997. 119.11 (g) For the rate years beginning on July 1, 1997,andJuly 119.12 1, 1998, and July 1, 1999, a nursing facility licensed for 40 119.13 beds effective May 1, 1992, with a subsequent increase of 20 119.14 Medicare/Medicaid certified beds, effective January 26, 1993, in 119.15 accordance with an increase in licensure is exempt from 119.16 paragraphs (a) and (b). 119.17 (h) For a nursing facility whose construction project was 119.18 authorized according to section 144A.073, subdivision 5, 119.19 paragraph (g), the operating cost payment rates for the third 119.20 location shall be determined based on Minnesota Rules, part 119.21 9549.0057. Paragraphs (a) and (b) shall not apply until the 119.22 second rate year after the settle-up cost report is filed. 119.23 Notwithstanding subdivision 2b, paragraph (g), real estate taxes 119.24 and special assessments payable by the third location, a 119.25 501(c)(3) nonprofit corporation, shall be included in the 119.26 payment rates determined under this subdivision for all 119.27 subsequent rate years. 119.28 (i) For the rate year beginning July 1, 1997, the 119.29 commissioner shall compute the payment rate for a nursing 119.30 facility licensed for 94 beds on September 30, 1996, that 119.31 applied in October 1993 for approval of a total replacement 119.32 under the moratorium exception process in section 144A.073, and 119.33 completed the approved replacement in June 1995, with other 119.34 operating cost spend-up limit under paragraph (a), increased by 119.35 $3.98, and after computing the facility's payment rate according 119.36 to this section, the commissioner shall make a one-year positive 120.1 rate adjustment of $3.19 for operating costs related to the 120.2 newly constructed total replacement, without application of 120.3 paragraphs (a) and (b). The facility's per diem, before the 120.4 $3.19 adjustment, shall be used as the prior reporting year's 120.5 allowable operating cost per diem for payment rate calculation 120.6 for the rate year beginning July 1, 1998. A facility described 120.7 in this paragraph is exempt from paragraph (b) for the rate 120.8 years beginning July 1, 1997, and July 1, 1998. 120.9 (j) For the purpose of applying the limit stated in 120.10 paragraph (a), a nursing facility in Kandiyohi county licensed 120.11 for 86 beds that was granted hospital-attached status on 120.12 December 1, 1994, shall have the prior year's allowable 120.13 care-related per diem increased by $3.207 and the prior year's 120.14 other operating cost per diem increased by $4.777 before adding 120.15 the inflation in paragraph (d), clause (2), for the rate year 120.16 beginning on July 1, 1997. 120.17 (k) For the purpose of applying the limit stated in 120.18 paragraph (a), a 117 bed nursing facility located in Pine county 120.19 shall have the prior year's allowable other operating cost per 120.20 diem increased by $1.50 before adding the inflation in paragraph 120.21 (d), clause (2), for the rate year beginning on July 1, 1997. 120.22 (l) For the purpose of applying the limit under paragraph 120.23 (a), a nursing facility in Hibbing licensed for 192 beds shall 120.24 have the prior year's allowable other operating cost per diem 120.25 increased by $2.67 before adding the inflation in paragraph (d), 120.26 clause (2), for the rate year beginning July 1, 1997. 120.27 (m) For the purpose of applying the limit stated in 120.28 paragraph (a), a nursing facility in Hennepin county licensed 120.29 for 181 beds on September 30, 1996, shall have the prior year's 120.30 allowable care-related per diem increased by $1.455 and the 120.31 prior year's other operating cost per diem increased by $0.439 120.32 before adding the inflation in paragraph (d), clause (2), for 120.33 the rate year beginning on July 1, 1998. 120.34 (n) For the purpose of applying the limit stated in 120.35 paragraph (a), a nursing facility in Hennepin county licensed 120.36 for 161 beds on September 30, 1996, shall have the prior year's 121.1 allowable care-related per diem increased by $1.154 and the 121.2 prior year's other operating cost per diem increased by $0.256 121.3 before adding the inflation in paragraph (d), clause (2), for 121.4 the rate year beginning on July 1, 1998. 121.5 (o) For the purpose of applying the limit stated in 121.6 paragraph (a), a nursing facility in Ramsey county licensed for 121.7 176 beds on September 30, 1996, shall have the prior year's 121.8 allowable care-related per diem increased by $0.803 and the 121.9 prior year's other operating cost per diem increased by $0.272 121.10 before adding the inflation in paragraph (d), clause (2), for 121.11 the rate year beginning on July 1, 1998. 121.12 (p) For the purpose of applying the limit stated in 121.13 paragraph (a), a nursing facility in Brown county licensed for 121.14 86 beds on September 30, 1996, shall have the prior year's 121.15 allowable care-related per diem increased by $0.850 and the 121.16 prior year's other operating cost per diem increased by $0.275 121.17 before adding the inflation in paragraph (d), clause (2), for 121.18 the rate year beginning on July 1, 1998. 121.19 (q) For the rate year beginning July 1, 1998, the 121.20 commissioner shall compute the payment rate for a nursing 121.21 facility, which was licensed for 110 beds on May 1, 1997, was 121.22 granted approval in January 1994 for a replacement and 121.23 remodeling project under the moratorium exception process in 121.24 section 144A.073, and completed the approved replacement and 121.25 remodeling project on March 14, 1997, by increasing the other 121.26 operating cost spend-up limit under paragraph (a) by $1.64. 121.27 After computing the facility's payment rate for the rate year 121.28 beginning July 1, 1998, according to this section, the 121.29 commissioner shall make a one-year positive rate adjustment of 121.30 48 cents for increased real estate taxes resulting from 121.31 completion of the moratorium exception project, without 121.32 application of paragraphs (a) and (b). 121.33 Sec. 10. Minnesota Statutes 1996, section 256B.431, is 121.34 amended by adding a subdivision to read: 121.35 Subd. 27. [RULE 80 LIMITED EXEMPTION.] For the rate year 121.36 beginning July 1, 1998, the commissioner shall compute the 122.1 payment rate for a nursing facility exempted from care-related 122.2 limits under subdivision 2b, paragraph (d), clause (2), with a 122.3 minimum of three-quarters of its beds licensed to provide 122.4 residential services for the physically handicapped under 122.5 Minnesota Rules, parts 9570.2000 to 9570.3400, with the care 122.6 related spend-up limit under subdivision 26, paragraph (a), 122.7 increased by $13.21 for the rate year beginning July 1, 1998, 122.8 without application of subdivision 26, paragraph (b). For rate 122.9 years beginning on or after July 1, 1999, the commissioner shall 122.10 exclude that amount in calculating the facility's operating cost 122.11 per diem for purposes of applying subdivision 26, paragraph (b). 122.12 Sec. 11. Minnesota Statutes 1996, section 256B.431, is 122.13 amended by adding a subdivision to read: 122.14 Subd. 28. [CHANGES TO NURSING FACILITY REIMBURSEMENT 122.15 BEGINNING JULY 1, 1998.] The nursing facility reimbursement 122.16 changes in paragraphs (a) and (b) shall apply in the sequence 122.17 specified in this section and Minnesota Rules, parts 9549.0010 122.18 to 9549.0080, beginning July 1, 1998. 122.19 (a) For rate years beginning on or after July 1, 1998, the 122.20 operating cost limits established in subdivisions 2, 2b, 2i, 3c, 122.21 and 22, paragraph (d), and any previously effective 122.22 corresponding limits in law or rule shall not apply, except that 122.23 these cost limits shall still be calculated for purposes of 122.24 determining efficiency incentive per diems. For rate years 122.25 beginning on or after July 1, 1998, the total operating cost 122.26 payment rates for a nursing facility shall be the greater of the 122.27 total operating cost payment rates determined under this section 122.28 or the total operating cost payment rates in effect on June 30, 122.29 1998, subject to rate adjustments due to field audit or rate 122.30 appeal resolution. 122.31 (b) For rate years beginning on or after July 1, 1998, the 122.32 operating cost per diem referred to in subdivision 26, paragraph 122.33 (a), clauses (1) and (2), is the sum of the care related and 122.34 other operating per diems for a given case mix class. Any 122.35 reductions to the combined operating per diem shall be divided 122.36 proportionately between the care related and other operating per 123.1 diems. 123.2 Sec. 12. [256B.435] [NURSING FACILITY REIMBURSEMENT SYSTEM 123.3 EFFECTIVE JULY 1, 2000.] 123.4 Subdivision 1. [IN GENERAL.] Effective July 1, 2000, the 123.5 commissioner shall implement a performance-based contracting 123.6 system to replace the current method of setting operating cost 123.7 payment rates under sections 256B.431 and 256B.434 and Minnesota 123.8 Rules, parts 9549.0010 to 9549.0080. A nursing facility in 123.9 operation on May 1, 1998, with payment rates not established 123.10 under section 256B.431 or 256B.434 on that date, is ineligible 123.11 for this performance-based contracting system. In determining 123.12 prospective payment rates of nursing facility services, the 123.13 commissioner shall distinguish between operating costs and 123.14 property-related costs. The operating cost portion of the 123.15 payment rates shall be indexed annually by an inflation factor 123.16 as specified in subdivision 3, and in accordance with section 123.17 256B.431, subdivision 21, paragraph (c). Property related 123.18 payment rates, including real estate taxes and special 123.19 assessments, shall be determined under section 256B.431 or 123.20 256B.434. 123.21 Subd. 2. [CONTRACT PROVISIONS.] (a) The performance-based 123.22 contract with each nursing facility must include provisions that: 123.23 (1) apply the resident case mix assessment provisions of 123.24 Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 123.25 another assessment system, with the goal of moving to a single 123.26 assessment system; 123.27 (2) monitor resident outcomes through various methods, such 123.28 as quality indicators based on the minimum data set and other 123.29 utilization and performance measures; 123.30 (3) require the establishment and use of a continuous 123.31 quality improvement process that integrates information from 123.32 quality indicators and regular resident and family satisfaction 123.33 interviews; 123.34 (4) require annual reporting of facility statistical 123.35 information, including resident days by case mix category, 123.36 productive nursing hours, wages and benefits, and raw food costs 124.1 for use by the commissioner in the development of facility 124.2 profiles that include trends in payment and service utilization; 124.3 (5) require from each nursing facility an annual certified 124.4 audited financial statement consisting of a balance sheet, 124.5 income and expense statements, and an opinion from either a 124.6 licensed or certified public accountant, if a certified audit 124.7 was prepared, or unaudited financial statements if no certified 124.8 audit was prepared; and 124.9 (6) establish additional requirements and penalties for 124.10 nursing facilities not meeting the standards set forth in the 124.11 performance-based contract. 124.12 (b) The commissioner may develop additional incentive-based 124.13 payments for achieving outcomes specified in each contract. The 124.14 specified facility-specific outcomes must be measurable and 124.15 approved by the commissioner. 124.16 (c) The commissioner may also contract with nursing 124.17 facilities in other ways through requests for proposals, 124.18 including contracts on a risk or nonrisk basis, with nursing 124.19 facilities or consortia of nursing facilities, to provide 124.20 comprehensive long-term care coverage on a premium or capitated 124.21 basis. 124.22 Subd. 3. [PAYMENT RATE PROVISIONS.] (a) For rate years 124.23 beginning on or after July 1, 2000, the commissioner shall 124.24 determine operating cost payment rates for each licensed and 124.25 certified nursing facility by indexing its operating cost 124.26 payment rates in effect on June 30, 2000, for inflation. The 124.27 inflation factor to be used must be based on the change in the 124.28 Consumer Price Index-All Items, United States city average 124.29 (CPI-U) as forecasted by Data Resources, Inc. in the fourth 124.30 quarter preceding the rate year. The CPI-U forecasted index for 124.31 operating cost payment rates shall be based on the 12-month 124.32 period from the midpoint of the nursing facility's prior rate 124.33 year to the midpoint of the rate year for which the operating 124.34 payment rate is being determined. 124.35 (b) Beginning July 1, 2000, each nursing facility subject 124.36 to a performance-based contract under this section shall choose 125.1 one of two methods of payment for property related costs: 125.2 (1) the method established in section 256B.434; or 125.3 (2) the method established in section 256B.431. 125.4 Once the nursing facility has made the election in paragraph 125.5 (b), that election shall remain in effect for at least four 125.6 years or until an alternative property payment system is 125.7 developed. 125.8 Sec. 13. [256B.5011] [ICF/MR REIMBURSEMENT SYSTEM 125.9 EFFECTIVE OCTOBER 1, 2000.] 125.10 Subdivision 1. [PERFORMANCE-BASED CONTRACTING SYSTEM.] (a) 125.11 Effective October 1, 2000, the commissioner shall implement a 125.12 performance-based contracting system to replace the current 125.13 method of setting total cost payment rates under section 125.14 256B.501 and Minnesota Rules, parts 9553.0010 to 9553.0080. In 125.15 determining prospective payment rates of intermediate care 125.16 facilities for persons with mental retardation or related 125.17 conditions, the commissioner shall index each facility's total 125.18 payment rate by an inflation factor as described in subdivision 125.19 3. The commissioner of finance shall include annual inflation 125.20 adjustments in operating costs for intermediate care facilities 125.21 for persons with mental retardation and related conditions as a 125.22 budget change request in each biennial detailed expenditure 125.23 budget submitted to the legislature under section 16A.11. 125.24 Subd. 2. [CONTRACT PROVISIONS.] The performance-based 125.25 contract with each intermediate care facility must include 125.26 provisions for: 125.27 (1) modifying payments when significant changes occur in 125.28 the needs of the consumers; 125.29 (2) monitoring service quality using performance indicators 125.30 that measure consumer outcomes; 125.31 (3) the establishment and use of continuous quality 125.32 improvement processes using the results attained through service 125.33 quality monitoring; 125.34 (4) the annual reporting of facility statistical 125.35 information on all supervisory personnel, direct care personnel, 125.36 specialized support personnel, hours, wages and benefits, 126.1 staff-to-consumer ratios, and staffing patterns; 126.2 (5) annual aggregate facility financial information or an 126.3 annual certified audited financial statement, including a 126.4 balance sheet and income and expense statements for each 126.5 facility, if a certified audit was prepared; and 126.6 (6) additional requirements and penalties for intermediate 126.7 care facilities not meeting the standards set forth in the 126.8 performance-based contract. 126.9 Subd. 3. [PAYMENT RATE PROVISIONS.] For rate years 126.10 beginning on or after October 1, 2000, the commissioner shall 126.11 determine the total payment rate for each licensed and certified 126.12 intermediate care facility by indexing the total payment rate in 126.13 effect on September 30, 2000, for inflation. The inflation 126.14 factor to be used must be based on the change in the Consumer 126.15 Price Index-All Items, United States city average (CPI-U) as 126.16 forecasted by Data Resources, Inc. in the first quarter of the 126.17 calendar year during which the rate year begins. The CPI-U 126.18 forecasted index for total payment rates shall be based on the 126.19 12-month period from the midpoint of the ICFs/MR prior rate year 126.20 to the midpoint of the rate year for which the operating payment 126.21 rate is being determined. 126.22 Sec. 14. [RECOMMENDATIONS TO IMPLEMENT NEW REIMBURSEMENT 126.23 SYSTEM.] 126.24 (a) By January 15, 1999, the commissioner shall make 126.25 recommendations to the chairs of the health and human services 126.26 policy and fiscal committees on the repeal of specific statutes 126.27 and rules as well as any other additional recommendations 126.28 related to implementation of sections 11 and 12. 126.29 (b) In developing recommendations for nursing facility 126.30 reimbursement, the commissioner shall consider making each 126.31 nursing facility's total payment rates, both operating and 126.32 property rate components, prospective. The commissioner shall 126.33 involve nursing facility industry and consumer representatives 126.34 in the development of these recommendations. 126.35 (c) In making recommendations for ICF/MR reimbursement, the 126.36 commissioner may consider methods of establishing payment rates 127.1 that take into account individual client costs and needs, 127.2 include provisions to establish links between performance 127.3 indicators and reimbursement and other performance incentives, 127.4 and allow local control over resources necessary for local 127.5 agencies to set rates and contract with ICF/MR facilities. In 127.6 addition, the commissioner may establish methods that provide 127.7 information to consumers regarding service quality as measured 127.8 by performance indicators. The commissioner shall involve 127.9 ICF/MR industry and consumer representatives in the development 127.10 of these recommendations. 127.11 Sec. 15. [APPROVAL EXTENDED.] 127.12 Minnesota Statutes, section 144A.073, subdivision 3, 127.13 notwithstanding, the commissioner of health shall grant an 127.14 additional 18 months of approval for a proposed exception to the 127.15 nursing home licensure and certification moratorium, if the 127.16 proposal is to replace a 96-bed nursing home facility in Carlton 127.17 county and if initial approval for the proposal was granted in 127.18 November 1996. 127.19 Sec. 16. [EFFECTIVE DATE.] 127.20 Sections 4 (256B.0951, subd. 7), 9 (256B.431, subd. 26), 127.21 and 14 (approval extended) are effective the day following final 127.22 enactment. 127.23 ARTICLE 4 127.24 HEALTH CARE PROGRAMS, INCLUDING MA AND GAMC 127.25 Section 1. Minnesota Statutes 1997 Supplement, section 127.26 62J.69, subdivision 1, is amended to read: 127.27 Subdivision 1. [DEFINITIONS.] For purposes of this 127.28 section, the following definitions apply: 127.29 (a) "Medical education" means the accredited clinical 127.30 training of physicians (medical students and residents), doctor 127.31 of pharmacy practitioners, dentists, advanced practice nurses 127.32 (clinical nurse specialist, certified registered nurse 127.33 anesthetists, nurse practitioners, and certified nurse 127.34 midwives), and physician assistants. 127.35 (b) "Clinical training" means accredited training for the 127.36 health care practitioners listed in paragraph (a) that is funded 128.1and was historically fundedin part byinpatientpatient care 128.2 revenues and that occurs inbotheither an inpatientandor 128.3 ambulatory patient caresettingstraining site. 128.4 (c) "Trainee" means students involved in an accredited 128.5 clinical training program for medical education as defined in 128.6 paragraph (a). 128.7 (d) "Eligible trainee" means a student involved in an 128.8 accredited training program for medical education as defined in 128.9 paragraph (a), which meets the definition of clinical training 128.10 in paragraph (b), who is in a training site that is located in 128.11 Minnesota and which has a medical assistance provider number. 128.12 (e) "Health care research" means approved clinical, 128.13 outcomes, and health services investigations that are funded by 128.14 patient out-of-pocket expenses or a third-party payer. 128.15(e)(f) "Commissioner" means the commissioner of health. 128.16(f)(g) "Teaching institutions" means any hospital, medical 128.17 center, clinic, or other organization that currently sponsors or 128.18 conducts accredited medical education programs or clinical 128.19 research in Minnesota. 128.20 (h) "Accredited training" means training provided by a 128.21 program that is accredited through an organization recognized by 128.22 the department of education or the health care financing 128.23 administration as the official accrediting body for that program. 128.24 (i) "Sponsoring institution" means a hospital, school, or 128.25 consortium located in Minnesota that sponsors and maintains 128.26 primary organizational and financial responsibility for an 128.27 accredited medical education program in Minnesota and which is 128.28 accountable to the accrediting body. 128.29 Sec. 2. Minnesota Statutes 1997 Supplement, section 128.30 62J.69, subdivision 2, is amended to read: 128.31 Subd. 2. [ALLOCATION AND FUNDING FOR MEDICAL EDUCATION AND 128.32 RESEARCH.] (a) The commissioner may establish a trust fund for 128.33 the purposes of funding medical education and research 128.34 activities in the state of Minnesota. 128.35 (b) By January 1, 1997, the commissioner may appoint an 128.36 advisory committee to provide advice and oversight on the 129.1 distribution of funds from the medical education and research 129.2 trust fund. If a committee is appointed, the commissioner 129.3 shall: (1) consider the interest of all stakeholders when 129.4 selecting committee members; (2) select members that represent 129.5 both urban and rural interest; and (3) select members that 129.6 include ambulatory care as well as inpatient perspectives. The 129.7 commissioner shall appoint to the advisory committee 129.8 representatives of the following groups: medical researchers, 129.9 public and private academic medical centers, managed care 129.10 organizations, Blue Cross and Blue Shield of Minnesota, 129.11 commercial carriers, Minnesota Medical Association, Minnesota 129.12 Nurses Association, medical product manufacturers, employers, 129.13 and other relevant stakeholders, including consumers. The 129.14 advisory committee is governed by section 15.059, for membership 129.15 terms and removal of members and will sunset on June 30, 1999. 129.16 (c) Eligible applicants for funds are accredited medical 129.17 education teaching institutions, consortia, and programs 129.18 operating in Minnesota. Applications must be submitted by the 129.19 sponsoring institution on behalf of the teaching program, and 129.20 must be received by September 30 of each year for distribution 129.21 in January of the following year. An application for funds must 129.22 include the following: 129.23 (1) the official name and address of the sponsoring 129.24 institution and the official name and address of the facility or 129.25programprograms on whose behalf the institution is applying for 129.26 funding; 129.27 (2) the name, title, and business address of those persons 129.28 responsible for administering the funds; 129.29 (3)the total number, type, and specialty orientation of129.30eligible Minnesota-based trainees infor each accredited medical 129.31 education program for which funds are being sought the type and 129.32 specialty orientation of trainees in the program, the name, 129.33 address, and medical assistance provider number of each training 129.34 site used in the program, the total number of trainees at each 129.35 site, and the total number of eligible trainees at each training 129.36 site; 130.1 (4) audited clinical training costs per trainee for each 130.2 medical education program where available or estimates of 130.3 clinical training costs based on audited financial data; 130.4 (5) a description of current sources of funding for medical 130.5 education costs including a description and dollar amount of all 130.6 state and federal financial support, including Medicare direct 130.7 and indirect payments; 130.8 (6) other revenue received for the purposes of clinical 130.9 training; and 130.10 (7)a statement identifying unfunded costs; and130.11(8)other supporting information the commissioner, with 130.12 advice from the advisory committee, determines is necessary for 130.13 the equitable distribution of funds. 130.14 (d) The commissioner shall distribute medical education 130.15 funds to all qualifying applicants based on the following basic 130.16 criteria: (1) total medical education funds available; (2) 130.17 total eligible trainees in each eligible education program; and 130.18 (3) the statewide average cost per trainee, by type of trainee, 130.19 in each medical education program. Funds distributed shall not 130.20 be used to displace current funding appropriations from federal 130.21 or state sources. Funds shall be distributed to the sponsoring 130.22 institutions indicating the amount to be paid to each of the 130.23 sponsor's medical education programs based on the criteria in 130.24 this paragraph. Sponsoring institutions which receive funds 130.25 from the trust fund must distribute approved funds to the 130.26 medical education program according to the commissioner's 130.27 approval letter. Further, programs must distribute funds among 130.28 the sites of trainingbased on the percentage of total program130.29training performed at each site.as specified in the 130.30 commissioner's approval letter. Any funds not distributed as 130.31 directed by the commissioner's approval letter shall be returned 130.32 to the medical education and research trust fund within 30 days 130.33 of a notice from the commissioner. The commissioner shall 130.34 distribute returned funds to the appropriate entities in 130.35 accordance with the commissioner's approval letter. 130.36 (e) Medical education programs receiving funds from the 131.1 trust fund must submitannual cost and program reportsa medical 131.2 education and research grant verification report (GVR) through 131.3 the sponsoring institution based on criteria established by the 131.4 commissioner. If the sponsoring institution fails to submit the 131.5 GVR by the stated deadline, or to request and meet the deadline 131.6 for an extension, the sponsoring institution is required to 131.7 return the full amount of the medical education and research 131.8 trust fund grant to the medical education and research trust 131.9 fund within 30 days of a notice from the commissioner. The 131.10 commissioner shall distribute returned funds to the appropriate 131.11 entities in accordance with the commissioner's approval letter. 131.12 The reports must include: 131.13 (1) the total number of eligible trainees in the program; 131.14 (2) the programs and residencies funded, the amounts of 131.15 trust fund payments to each program, and within each program, 131.16 thepercentagedollar amount distributed to each training site; 131.17 and 131.18 (3)the average cost per trainee and a detailed breakdown131.19of the components of those costs;131.20(4) other state or federal appropriations received for the131.21purposes of clinical training;131.22(5) other revenue received for the purposes of clinical131.23training; and131.24(6)other information the commissioner, with advice from 131.25 the advisory committee, deems appropriate to evaluate the 131.26 effectiveness of the use of funds for clinical training. 131.27 The commissioner, with advice from the advisory committee, 131.28 will provide an annual summary report to the legislature on 131.29 program implementation due February 15 of each year. 131.30 (f) The commissioner is authorized to distribute funds made 131.31 available through: 131.32 (1) voluntary contributions by employers or other entities; 131.33 (2) allocations for the department of human services to 131.34 support medical education and research; and 131.35 (3) other sources as identified and deemed appropriate by 131.36 the legislature for inclusion in the trust fund. 132.1 (g) The advisory committee shall continue to study and make 132.2 recommendations on: 132.3 (1) the funding of medical research consistent with work 132.4 currently mandated by the legislature and under way at the 132.5 department of health; and 132.6 (2) the costs and benefits associated with medical 132.7 education and research. 132.8 Sec. 3. Minnesota Statutes 1997 Supplement, section 132.9 62J.69, is amended by adding a subdivision to read: 132.10 Subd. 4. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 132.11 SERVICES.] (a) The amount transferred according to section 132.12 256B.69, subdivision 5c, shall be distributed to qualifying 132.13 applicants based on a distribution formula that reflects a 132.14 summation of two factors: 132.15 (1) an education factor, which is determined by the total 132.16 number of eligible trainees and the total statewide average 132.17 costs per trainee, by type of trainee, in each program; and 132.18 (2) a public program volume factor, which is determined by 132.19 the total volume of public program revenue received by each 132.20 training site as a percentage of all public program revenue 132.21 received by all training sites in the trust fund pool. 132.22 In this formula, the education factor shall be weighted at 132.23 50 percent and the public program volume factor shall be 132.24 weighted at 50 percent. 132.25 (b) Public program revenue for the formula in paragraph (a) 132.26 shall include revenue from medical assistance, prepaid medical 132.27 assistance, general assistance medical care, and prepaid general 132.28 assistance medical care. 132.29 (c) Training sites that receive no public program revenue 132.30 shall be ineligible for payments from the prepaid medical 132.31 assistance program transfer pool. 132.32 Sec. 4. Minnesota Statutes 1996, section 245.462, 132.33 subdivision 4, is amended to read: 132.34 Subd. 4. [CASE MANAGER.] "Case manager" means an 132.35 individual employed by the county or other entity authorized by 132.36 the county board to provide case management services specified 133.1 in section 245.4711. A case manager musthave a bachelor's133.2degree in one of the behavioral sciences or related fields from133.3an accredited college or university and have at least 2,000133.4hours of supervised experience in the delivery of services to133.5adults with mental illness, mustbe skilled in the process of 133.6 identifying and assessing a wide range of client needs,andmust 133.7 be knowledgeable about local community resources and how to use 133.8 those resources for the benefit of the client, and must meet the 133.9 qualifications for mental health practitioners in subdivision 133.10 17. The case manager shall meet in person with a mental health 133.11 professional at least once each month to obtain clinical 133.12 supervision of the case manager's activities. Case managers 133.13 with a bachelor's degree but without 2,000 hours of supervised 133.14 experience in the delivery of services to adults with mental 133.15 illness must complete 40 hours of training approved by the 133.16 commissioner of human services in case management skills and in 133.17 the characteristics and needs of adults with serious and 133.18 persistent mental illness and must receive clinical supervision 133.19 regarding individual service delivery from a mental health 133.20 professional at least once each week until the requirement of 133.21 2,000 hours of supervised experience is met. Case managers 133.22 without a bachelor's degree but with 6,000 hours of supervised 133.23 experience in the delivery of services to adults with mental 133.24 illness must complete 40 hours of training approved by the 133.25 commissioner of human services in case management skills and in 133.26 the characteristics and needs of adults with serious and 133.27 persistent mental illness. Clinical supervision must be 133.28 documented in the client record. 133.29 Until June 30, 1999,a refugeean immigrant who does not 133.30 have the qualifications specified in this subdivision may 133.31 provide case management services to adultrefugeesimmigrants 133.32 with serious and persistent mental illness who are members of 133.33 the same ethnic group as the case manager if the person: (1) is 133.34 actively pursuing credits toward the completion of a bachelor's 133.35 degree in one of the behavioral sciences or a related field from 133.36 an accredited college or university; (2) completes 40 hours of 134.1 training as specified in this subdivision; and (3) receives 134.2 clinical supervision at least once a week until the requirements 134.3 ofobtaining a bachelor's degree and 2,000 hours of supervised134.4experiencethis subdivision are met. 134.5 Sec. 5. Minnesota Statutes 1996, section 245.462, 134.6 subdivision 8, is amended to read: 134.7 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 134.8 treatment services," or "day treatment program" means a 134.9 structured program of treatment and care provided to an adult in 134.10 or by: (1) a hospital accredited by the joint commission on 134.11 accreditation of health organizations and licensed under 134.12 sections 144.50 to 144.55; (2) a community mental health center 134.13 under section 245.62; or (3) an entity that is under contract 134.14 with the county board to operate a program that meets the 134.15 requirements of section 245.4712, subdivision 2, and Minnesota 134.16 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 134.17 group psychotherapy and other intensive therapeutic services 134.18 that are provided at least one day a weekfor a minimum134.19three-hour time blockby a multidisciplinary staff under the 134.20 clinical supervision of a mental health professional. The 134.21 services are aimed at stabilizing the adult's mental health 134.22 status, providing mental health services, and developing and 134.23 improving the adult's independent living and socialization 134.24 skills. The goal of day treatment is to reduce or relieve 134.25 mental illness and to enable the adult to live in the 134.26 community. Day treatment services are not a part of inpatient 134.27 or residential treatment services. Day treatment services are 134.28 distinguished from day care by their structured therapeutic 134.29 program of psychotherapy services. The commissioner may limit 134.30 medical assistance reimbursement for day treatment to 15 hours 134.31 per week per person instead of the three hours per day per 134.32 person specified in Minnesota Rules, part 9505.0323, subpart 15. 134.33 Sec. 6. Minnesota Statutes 1996, section 245.4871, 134.34 subdivision 4, is amended to read: 134.35 Subd. 4. [CASE MANAGER.] (a) "Case manager" means an 134.36 individual employed by the county or other entity authorized by 135.1 the county board to provide case management services specified 135.2 in subdivision 3 for the child with severe emotional disturbance 135.3 and the child's family. A case manager must have experience and 135.4 training in working with children. 135.5 (b) A case manager must meet the qualifications for a 135.6 mental health practitioner in subdivision 26: 135.7 (1)have at least a bachelor's degree in one of the135.8behavioral sciences or a related field from an accredited135.9college or university;135.10(2) have at least 2,000 hours of supervised experience in135.11the delivery of mental health services to children;135.12(3)have experience and training in identifying and 135.13 assessing a wide range of children's needs; and 135.14(4)(2) be knowledgeable about local community resources 135.15 and how to use those resources for the benefit of children and 135.16 their families. 135.17 (c) The case manager may be a member of any professional 135.18 discipline that is part of the local system of care for children 135.19 established by the county board. 135.20 (d) The case manager must meet in person with a mental 135.21 health professional at least once each month to obtain clinical 135.22 supervision. 135.23 (e) Case managers with a bachelor's degree but without 135.24 2,000 hours of supervised experience in the delivery of mental 135.25 health services to children with emotional disturbance must: 135.26 (1) begin 40 hours of training approved by the commissioner 135.27 of human services in case management skills and in the 135.28 characteristics and needs of children with severe emotional 135.29 disturbance before beginning to provide case management 135.30 services; and 135.31 (2) receive clinical supervision regarding individual 135.32 service delivery from a mental health professional at least once 135.33 each week until the requirement of 2,000 hours of experience is 135.34 met. 135.35 (f) Clinical supervision must be documented in the child's 135.36 record. When the case manager is not a mental health 136.1 professional, the county board must provide or contract for 136.2 needed clinical supervision. 136.3 (g) The county board must ensure that the case manager has 136.4 the freedom to access and coordinate the services within the 136.5 local system of care that are needed by the child. 136.6 (h) Until June 30, 1999,a refugeean immigrant who does 136.7 not have the qualifications specified in this subdivision may 136.8 provide case management services to childrefugeesimmigrants 136.9 with severe emotional disturbance of the same ethnic group as 136.10 therefugeeimmigrant if the person: 136.11 (1) is actively pursuing credits toward the completion of a 136.12 bachelor's degree in one of the behavioral sciences or related 136.13 fields at an accredited college or university; 136.14 (2) completes 40 hours of training as specified in this 136.15 subdivision; and 136.16 (3) receives clinical supervision at least once a week 136.17 until the requirements ofobtaining a bachelor's degree and136.182,000 hours of supervised experiencethis subdivision are met. 136.19 (i) Case managers without a bachelor's degree but with 136.20 6,000 hours of supervised experience in the delivery of mental 136.21 health services to children with emotional disturbance must 136.22 begin 40 hours of training approved by the commissioner of human 136.23 services in case management skills and in the characteristics 136.24 and needs of children with severe emotional disturbance before 136.25 beginning to provide case management services. 136.26 Sec. 7. [256.9364] [POST-KIDNEY TRANSPLANT DRUG PROGRAM.] 136.27 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 136.28 services shall establish and administer a program to pay for 136.29 costs of drugs prescribed exclusively for post-kidney transplant 136.30 maintenance when those costs are not otherwise reimbursed by a 136.31 third-party payer. The commissioner may contract with a 136.32 nonprofit entity to administer this program. 136.33 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 136.34 the program, an applicant must satisfy the following 136.35 requirements: 136.36 (1) the applicant's family gross income must not exceed 275 137.1 percent of the federal poverty level; and 137.2 (2) the applicant must be a Minnesota resident who has 137.3 resided in Minnesota for at least 12 months. 137.4 An applicant shall not be excluded because the applicant 137.5 received the transplant outside the state of Minnesota, so long 137.6 as the other requirements are met. 137.7 Subd. 3. [PAYMENT AMOUNTS.] (a) The amount of the payments 137.8 made for each eligible recipient shall be based on the following: 137.9 (1) available funds; and 137.10 (2) the cost of the post-kidney transplant maintenance 137.11 drugs. 137.12 (b) The payment rate under this program must be no greater 137.13 than the medical assistance reimbursement rate for the 137.14 prescribed drug. 137.15 (c) Payments shall be made to or on behalf of an eligible 137.16 recipient for the cost of the post-kidney transplant maintenance 137.17 drugs that is not covered, reimbursed, or eligible for 137.18 reimbursement by any other third party or government entity, 137.19 including, but not limited to, private or group health 137.20 insurance, medical assistance, Medicare, the Veterans 137.21 Administration, the senior citizen drug program established 137.22 under section 256.955, or under any waiver arrangement received 137.23 by the state to provide a prescription drug benefit for 137.24 qualified Medicare beneficiaries or service-limited Medicare 137.25 beneficiaries. 137.26 (d) The commissioner may restrict or categorize payments to 137.27 meet the appropriation allocated for this program. 137.28 (e) Any cost of the post-kidney transplant maintenance 137.29 drugs that is not reimbursed under this program is the 137.30 responsibility of the program recipient. 137.31 Subd. 4. [DRUG FORMULARY.] The commissioner shall maintain 137.32 a drug formulary that includes all drugs eligible for 137.33 reimbursement by the program. The commissioner may use the drug 137.34 formulary established under section 256B.0625, subdivision 13. 137.35 The commissioner shall establish an internal review procedure 137.36 for updating the formulary that allows for the addition and 138.1 deletion of drugs to the formulary. The drug formulary must be 138.2 reviewed at least quarterly per fiscal year. 138.3 Subd. 5. [PRIVATE DONATIONS.] The commissioner may accept 138.4 funding from other public or private sources. 138.5 Subd. 6. [SUNSET.] This program expires on July 1, 2000. 138.6 Sec. 8. Minnesota Statutes 1997 Supplement, section 138.7 256.9657, subdivision 3, is amended to read: 138.8 Subd. 3. [HEALTH MAINTENANCE ORGANIZATION; COMMUNITY 138.9 INTEGRATED SERVICE NETWORK SURCHARGE.] (a) Effective October 1, 138.10 1992, each health maintenance organization with a certificate of 138.11 authority issued by the commissioner of health under chapter 62D 138.12 and each community integrated service network licensed by the 138.13 commissioner under chapter 62N shall pay to the commissioner of 138.14 human services a surcharge equal to six-tenths of one percent of 138.15 the total premium revenues of the health maintenance 138.16 organization or community integrated service network as reported 138.17 to the commissioner of health according to the schedule in 138.18 subdivision 4. 138.19 (b) For purposes of this subdivision, total premium revenue 138.20 means: 138.21 (1) premium revenue recognized on a prepaid basis from 138.22 individuals and groups for provision of a specified range of 138.23 health services over a defined period of time which is normally 138.24 one month, excluding premiums paid to a health maintenance 138.25 organization or community integrated service network from the 138.26 Federal Employees Health Benefit Program; 138.27 (2) premiums from Medicare wrap-around subscribers for 138.28 health benefits which supplement Medicare coverage; 138.29 (3) Medicare revenue, as a result of an arrangement between 138.30 a health maintenance organization or a community integrated 138.31 service network and the health care financing administration of 138.32 the federal Department of Health and Human Services, for 138.33 services to a Medicare beneficiary, excluding Medicare revenue 138.34 that states are prohibited from taxing under sections 4001 and 138.35 4002 of Public Law Number 105-33 received by a health 138.36 maintenance organization or community integrated service network 139.1 through risk sharing or Medicare Choice + contracts; and 139.2 (4) medical assistance revenue, as a result of an 139.3 arrangement between a health maintenance organization or 139.4 community integrated service network and a Medicaid state 139.5 agency, for services to a medical assistance beneficiary. 139.6 If advance payments are made under clause (1) or (2) to the 139.7 health maintenance organization or community integrated service 139.8 network for more than one reporting period, the portion of the 139.9 payment that has not yet been earned must be treated as a 139.10 liability. 139.11 (c) When a health maintenance organization or community 139.12 integrated service network merges or consolidates with or is 139.13 acquired by another health maintenance organization or community 139.14 integrated service network, the surviving corporation or the new 139.15 corporation shall be responsible for the annual surcharge 139.16 originally imposed on each of the entities or corporations 139.17 subject to the merger, consolidation, or acquisition, regardless 139.18 of whether one of the entities or corporations does not retain a 139.19 certificate of authority under chapter 62D or a license under 139.20 chapter 62N. 139.21 (d) Effective July 1 of each year, the surviving 139.22 corporation's or the new corporation's surcharge shall be based 139.23 on the revenues earned in the second previous calendar year by 139.24 all of the entities or corporations subject to the merger, 139.25 consolidation, or acquisition regardless of whether one of the 139.26 entities or corporations does not retain a certificate of 139.27 authority under chapter 62D or a license under chapter 62N until 139.28 the total premium revenues of the surviving corporation include 139.29 the total premium revenues of all the merged entities as 139.30 reported to the commissioner of health. 139.31 (e) When a health maintenance organization or community 139.32 integrated service network, which is subject to liability for 139.33 the surcharge under this chapter, transfers, assigns, sells, 139.34 leases, or disposes of all or substantially all of its property 139.35 or assets, liability for the surcharge imposed by this chapter 139.36 is imposed on the transferee, assignee, or buyer of the health 140.1 maintenance organization or community integrated service network. 140.2 (f) In the event a health maintenance organization or 140.3 community integrated service network converts its licensure to a 140.4 different type of entity subject to liability for the surcharge 140.5 under this chapter, but survives in the same or substantially 140.6 similar form, the surviving entity remains liable for the 140.7 surcharge regardless of whether one of the entities or 140.8 corporations does not retain a certificate of authority under 140.9 chapter 62D or a license under chapter 62N. 140.10 (g) The surcharge assessed to a health maintenance 140.11 organization or community integrated service network ends when 140.12 the entity ceases providing services for premiums and the 140.13 cessation is not connected with a merger, consolidation, 140.14 acquisition, or conversion. 140.15 Sec. 9. Minnesota Statutes 1997 Supplement, section 140.16 256.9685, subdivision 1, is amended to read: 140.17 Subdivision 1. [AUTHORITY.] The commissioner shall 140.18 establish procedures for determining medical assistance and 140.19 general assistance medical care payment rates under a 140.20 prospective payment system for inpatient hospital services in 140.21 hospitals that qualify as vendors of medical assistance. The 140.22 commissioner shall establish, by rule, procedures for 140.23 implementing this section and sections 256.9686, 256.969, and 140.24 256.9695.The medical assistance payment rates must be based on140.25methods and standards that the commissioner finds are adequate140.26to provide for the costs that must be incurred for the care of140.27recipients in efficiently and economically operated hospitals.140.28 Services must meet the requirements of section 256B.04, 140.29 subdivision 15, or 256D.03, subdivision 7, paragraph (b), to be 140.30 eligible for payment. 140.31 Sec. 10. Minnesota Statutes 1996, section 256.969, is 140.32 amended by adding a subdivision to read: 140.33 Subd. 9c. [COUNTY BILLING.] Hospitals that have a 140.34 disproportionate population adjustment greater than eight 140.35 percent shall be eligible for a special payment for 140.36 uncompensated care. These hospitals may bill a county of 141.1 residence for services provided to a resident of that county 141.2 provided: 141.3 (1) the patient is from a county other than that in which 141.4 the hospital resides; and 141.5 (2) the hospital has made a preliminary determination at 141.6 the delivery of service that the patient was indigent based on 141.7 current medical assistance guidelines. 141.8 Counties that are billed under this program must pay 141.9 eligible hospitals at the rates established under the medical 141.10 assistance program. If the county can establish eligibility for 141.11 medical assistance after the service has been delivered, the 141.12 state shall reimburse the county for any funds paid to the 141.13 eligible hospital. 141.14 Sec. 11. Minnesota Statutes 1996, section 256.969, 141.15 subdivision 16, is amended to read: 141.16 Subd. 16. [INDIAN HEALTH SERVICE FACILITIES.]Indian141.17health serviceFacilities of the Indian health service and 141.18 facilities operated by a tribe or tribal organization under 141.19 funding authorized by title III of the Indian Self-Determination 141.20 and Education Assistance Act, Public Law Number 93-638, or by 141.21 United States Code, title 25, chapter 14, subchapter II, 141.22 sections 450f to 450n, are exempt from the rate establishment 141.23 methods required by this section and shall bereimbursed at141.24charges as limited to the amount allowed under federal lawpaid 141.25 according to the rate published by the United States assistant 141.26 secretary for health under authority of United States Code, 141.27 title 42, sections 248A and 248B. 141.28 Sec. 12. Minnesota Statutes 1996, section 256.969, 141.29 subdivision 17, is amended to read: 141.30 Subd. 17. [OUT-OF-STATE HOSPITALS IN LOCAL TRADE AREAS.] 141.31 Out-of-state hospitals that are located within a Minnesota local 141.32 trade area and that have more than 20 admissions in the base 141.33 year shall have rates established using the same procedures and 141.34 methods that apply to Minnesota hospitals. For this subdivision 141.35 and subdivision 18, local trade area means a county contiguous 141.36 to Minnesota and located in a metropolitan statistical area as 142.1 determined by Medicare for October 1 prior to the most current 142.2 rebased rate year. Hospitals that are not required by law to 142.3 file information in a format necessary to establish rates shall 142.4 have rates established based on the commissioner's estimates of 142.5 the information. Relative values of the diagnostic categories 142.6 shall not be redetermined under this subdivision until required 142.7 by rule. Hospitals affected by this subdivision shall then be 142.8 included in determining relative values. However, hospitals 142.9 that have rates established based upon the commissioner's 142.10 estimates of information shall not be included in determining 142.11 relative values. This subdivision is effective for hospital 142.12 fiscal years beginning on or after July 1, 1988. A hospital 142.13 shall provide the information necessary to establish rates under 142.14 this subdivision at least 90 days before the start of the 142.15 hospital's fiscal year. 142.16 Sec. 13. Minnesota Statutes 1996, section 256B.03, 142.17 subdivision 3, is amended to read: 142.18 Subd. 3. [AMERICAN INDIAN HEALTH FUNDING.] (a) 142.19 Notwithstanding subdivision 1 and sections 256B.0625 and 142.20 256D.03, subdivision 4, paragraph(f)(i), the commissioner may 142.21 make payments to federally recognized Indian tribes with a 142.22 reservation in the state to provide medical assistance and 142.23 general assistance medical care to Indians, as defined under 142.24 federal law, who reside on or near the reservation. The 142.25 payments may be made in the form of a block grant or other 142.26 payment mechanism determined in consultation with the tribe. 142.27 Any alternative payment mechanism agreed upon by the tribes and 142.28 the commissioner under this subdivision is not dependent upon 142.29 county agreement but is intended to create a direct payment 142.30 mechanism between the state and the tribe for the administration 142.31 of the medical assistanceprogramand general assistance medical 142.32 care programs, and for covered services. 142.33 (b) A tribe that implements a purchasing model under this 142.34 subdivision shall report to the commissioner at least annually 142.35 on the operation of the model. The commissioner and the tribe 142.36 shall cooperatively determine the data elements, format, and 143.1 timetable for the report. 143.2 (c) For purposes of this subdivision, "Indian tribe" means 143.3 a tribe, band, or nation, or other organized group or community 143.4 of Indians that is recognized as eligible for the special 143.5 programs and services provided by the United States to Indians 143.6 because of their status as Indians and for which a reservation 143.7 exists as is consistent with Public Law Number 100-485, as 143.8 amended. 143.9 (d) Payments under this subdivision may not result in an 143.10 increase in expenditures that would not otherwise occur in the 143.11 medical assistance program under this chapter or the general 143.12 assistance medical care program under chapter 256D. 143.13 Sec. 14. Minnesota Statutes 1996, section 256B.055, is 143.14 amended by adding a subdivision to read: 143.15 Subd. 7a. [SPECIAL CATEGORY FOR DISABLED 143.16 CHILDREN.] Medical assistance may be paid for a person who is 143.17 under age 18 and who meets income and asset eligibility 143.18 requirements of the Supplemental Security Income program if the 143.19 person was receiving Supplemental Security Income payments on 143.20 the date of enactment of section 211(a) of Public Law Number 143.21 104-193, the Personal Responsibility and Work Opportunity Act of 143.22 1996, and the person would have continued to receive the 143.23 payments except for the change in the childhood disability 143.24 criteria in section 211(a) of Public Law Number 104-193. 143.25 Sec. 15. Minnesota Statutes 1996, section 256B.057, 143.26 subdivision 3a, is amended to read: 143.27 Subd. 3a. [ELIGIBILITY FOR PAYMENT OF MEDICARE PART B 143.28 PREMIUMS.] A person who would otherwise be eligible as a 143.29 qualified Medicare beneficiary under subdivision 3, except the 143.30 person's income is in excess of the limit, is eligible for 143.31 medical assistance reimbursement of Medicare Part B premiums if 143.32 the person's income is less than110120 percent of the official 143.33 federal poverty guidelines for the applicable family size.The143.34income limit shall increase to 120 percent of the official143.35federal poverty guidelines for the applicable family size on143.36January 1, 1995.144.1 Sec. 16. Minnesota Statutes 1996, section 256B.057, is 144.2 amended by adding a subdivision to read: 144.3 Subd. 3b. [QUALIFIED INDIVIDUALS.] Beginning July 1, 1998, 144.4 to the extent of the federal allocation to Minnesota, a person, 144.5 who would otherwise be eligible as a qualified Medicare 144.6 beneficiary under subdivision 3, except that the person's income 144.7 is in excess of the limit, is eligible as a qualified individual 144.8 according to the following criteria: 144.9 (1) if the person's income is greater than 120 percent, but 144.10 less than 135 percent of the official federal poverty guidelines 144.11 for the applicable family size, the person is eligible for 144.12 medical assistance reimbursement of Medicare Part B premiums; or 144.13 (2) if the person's income is greater than 135 percent but 144.14 less than 175 percent of the official federal poverty guidelines 144.15 for the applicable family size, the person is eligible for 144.16 medical assistance reimbursement of that portion of the Medicare 144.17 Part B premium attributable to an increase in Part B 144.18 expenditures which resulted from the shift of home care services 144.19 from Medicare Part A to Medicare Part B under section 4732 of 144.20 Public Law Number 105-33, the Balanced Budget Act of 1997. 144.21 The commissioner shall limit enrollment of qualifying 144.22 individuals under this subdivision according to the requirements 144.23 of section 4732 of Public Law Number 105-33. 144.24 Sec. 17. Minnesota Statutes 1997 Supplement, section 144.25 256B.06, subdivision 4, is amended to read: 144.26 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 144.27 medical assistance is limited to citizens of the United States, 144.28 qualified noncitizens as defined in this subdivision, and other 144.29 persons residing lawfully in the United States. 144.30 (b) "Qualified noncitizen" means a person who meets one of 144.31 the following immigration criteria: 144.32 (1) admitted for lawful permanent residence according to 144.33 United States Code, title 8; 144.34 (2) admitted to the United States as a refugee according to 144.35 United States Code, title 8, section 1157; 144.36 (3) granted asylum according to United States Code, title 145.1 8, section 1158; 145.2 (4) granted withholding of deportation according to United 145.3 States Code, title 8, section 1253(h); 145.4 (5) paroled for a period of at least one year according to 145.5 United States Code, title 8, section 1182(d)(5); 145.6 (6) granted conditional entrant status according to United 145.7 States Code, title 8, section 1153(a)(7);or145.8 (7) determined to be a battered noncitizen by the United 145.9 States Attorney General according to the Illegal Immigration 145.10 Reform and Immigrant Responsibility Act of 1996, title V of the 145.11 Omnibus Consolidated Appropriations Bill, Public Law Number 145.12 104-200; 145.13 (8) is a child of a noncitizen determined to be a battered 145.14 noncitizen by the United States Attorney General according to 145.15 the Illegal Immigration Reform and Immigrant Responsibility Act 145.16 of 1996, title V of the Omnibus Consolidated Appropriations 145.17 Bill, Public Law Number 104-200; or 145.18 (9) determined to be a Cuban or Haitian entrant as defined 145.19 in section 501(e) of Public Law Number 96-422, the Refugee 145.20 Education Assistance Act of 1980. 145.21 (c) All qualified noncitizens who were residing in the 145.22 United States before August 22, 1996, who otherwise meet the 145.23 eligibility requirements of chapter 256B, are eligible for 145.24 medical assistance with federal financial participation. 145.25 (d) All qualified noncitizens who entered the United States 145.26 on or after August 22, 1996, and who otherwise meet the 145.27 eligibility requirements of chapter 256B, are eligible for 145.28 medical assistance with federal financial participation through 145.29 November 30, 1996. 145.30 Beginning December 1, 1996, qualified noncitizens who 145.31 entered the United States on or after August 22, 1996, and who 145.32 otherwise meet the eligibility requirements of chapter 256B are 145.33 eligible for medical assistance with federal participation for 145.34 five years if they meet one of the following criteria: 145.35 (i) refugees admitted to the United States according to 145.36 United States Code, title 8, section 1157; 146.1 (ii) persons granted asylum according to United States 146.2 Code, title 8, section 1158; 146.3 (iii) persons granted withholding of deportation according 146.4 to United States Code, title 8, section 1253(h); 146.5 (iv) veterans of the United States Armed Forces with an 146.6 honorable discharge for a reason other than noncitizen status, 146.7 their spouses and unmarried minor dependent children; or 146.8 (v) persons on active duty in the United States Armed 146.9 Forces, other than for training, their spouses and unmarried 146.10 minor dependent children. 146.11 Beginning December 1, 1996, qualified noncitizens who do 146.12 not meet one of the criteria in items (i) to (v) are eligible 146.13 for medical assistance without federal financial participation 146.14 as described in paragraph (j). 146.15 (e) Noncitizens who are not qualified noncitizens as 146.16 defined in paragraph (b), who are lawfully residing in the 146.17 United States and who otherwise meet the eligibility 146.18 requirements of chapter 256B, are eligible for medical 146.19 assistance under clauses (1) to (3). These individuals must 146.20 cooperate with the Immigration and Naturalization Service to 146.21 pursue any applicable immigration status, including citizenship, 146.22 that would qualify them for medical assistance with federal 146.23 financial participation. 146.24 (1) Persons who were medical assistance recipients on 146.25 August 22, 1996, are eligible for medical assistance with 146.26 federal financial participation through December 31, 1996. 146.27 (2) Beginning January 1, 1997, persons described in clause 146.28 (1) are eligible for medical assistance without federal 146.29 financial participation as described in paragraph (j). 146.30 (3) Beginning December 1, 1996, persons residing in the 146.31 United States prior to August 22, 1996, who were not receiving 146.32 medical assistance and persons who arrived on or after August 146.33 22, 1996, are eligible for medical assistance without federal 146.34 financial participation as described in paragraph (j). 146.35 (f) Nonimmigrants who otherwise meet the eligibility 146.36 requirements of chapter 256B are eligible for the benefits as 147.1 provided in paragraphs (g) to (i). For purposes of this 147.2 subdivision, a "nonimmigrant" is a person in one of the classes 147.3 listed in United States Code, title 8, section 1101(a)(15). 147.4 (g) Payment shall also be made for care and services that 147.5 are furnished to noncitizens, regardless of immigration status, 147.6 who otherwise meet the eligibility requirements of chapter 256B, 147.7 if such care and services are necessary for the treatment of an 147.8 emergency medical condition, except for organ transplants and 147.9 related care and services and routine prenatal care. 147.10 (h) For purposes of this subdivision, the term "emergency 147.11 medical condition" means a medical condition that meets the 147.12 requirements of United States Code, title 42, section 1396b(v). 147.13 (i) Pregnant noncitizens who are undocumented or 147.14 nonimmigrants, who otherwise meet the eligibility requirements 147.15 of chapter 256B, are eligible for medical assistance payment 147.16 without federal financial participation for care and services 147.17 through the period of pregnancy, and 60 days postpartum, except 147.18 for labor and delivery. 147.19 (j) Qualified noncitizens as described in paragraph (d), 147.20 and all other noncitizens lawfully residing in the United States 147.21 as described in paragraph (e), who are ineligible for medical 147.22 assistance with federal financial participation and who 147.23 otherwise meet the eligibility requirements of chapter 256B and 147.24 of this paragraph, are eligible for medical assistance without 147.25 federal financial participation. Qualified noncitizens as 147.26 described in paragraph (d) are only eligible for medical 147.27 assistance without federal financial participation for five 147.28 years from their date of entry into the United States. 147.29 (k) The commissioner shall submit to the legislature by 147.30 December 31, 1998, a report on the number of recipients and cost 147.31 of coverage of care and services made according to paragraphs 147.32 (i) and (j). 147.33 Sec. 18. Minnesota Statutes 1996, section 256B.0625, is 147.34 amended by adding a subdivision to read: 147.35 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 147.36 services rendered on or after July 1, 1999, medical assistance 148.1 payments for ambulance services shall be increased by ten 148.2 percent. 148.3 Sec. 19. Minnesota Statutes 1996, section 256B.0625, 148.4 subdivision 20, is amended to read: 148.5 Subd. 20. [MENTALILLNESSHEALTH CASE MANAGEMENT.] (a) To 148.6 the extent authorized by rule of the state agency, medical 148.7 assistance covers case management services to persons with 148.8 serious and persistent mental illnessor subject to federal148.9approval,and children with severe emotional disturbance. 148.10 Services provided under this section must meet the relevant 148.11 standards in sections 245.461 to 245.4888, the Comprehensive 148.12 Adult and Children's Mental Health Acts, Minnesota Rules, parts 148.13 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10. 148.14 (b) Entities meeting program standards set out in rules 148.15 governing family community support services as defined in 148.16 section 245.4871, subdivision 17, are eligible for medical 148.17 assistance reimbursement for case management services for 148.18 children with severe emotional disturbance when these services 148.19 meet the program standards in Minnesota Rules, parts 9520.0900 148.20 to 9520.0926 and 9505.0322, excludingsubpart 6subparts 6 and 148.21 10. 148.22(b) In counties where fewer than 50 percent of children148.23estimated to be eligible under medical assistance to receive148.24case management services for children with severe emotional148.25disturbance actually receive these services in state fiscal year148.261995, community mental health centers serving those counties,148.27entities meeting program standards in Minnesota Rules, parts148.289520.0570 to 9520.0870, and other entities authorized by the148.29commissioner are eligible for medical assistance reimbursement148.30for case management services for children with severe emotional148.31disturbance when these services meet the program standards in148.32Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322,148.33excluding subpart 6.148.34 (c) Medical assistance and MinnesotaCare payment for mental 148.35 health case management shall be made on a monthly basis. In 148.36 order to receive payment for an eligible child, the provider 149.1 must document at least a face-to-face contact with the child, 149.2 the child's parents, or the child's legal representative. To 149.3 receive payment for an eligible adult, the provider must 149.4 document at least a face-to-face contact with the adult or the 149.5 adult's legal representative. 149.6 (d) Payment for mental health case management provided by 149.7 county or state staff shall be based on the monthly rate 149.8 methodology under section 256B.094, subdivision 6, paragraph 149.9 (b), with separate rates calculated for child welfare and mental 149.10 health, and within mental health, separate rates for children 149.11 and adults. 149.12 (e) Payment for mental health case management provided by 149.13 county-contracted vendors shall be based on a monthly rate 149.14 negotiated by the host county. The negotiated rate must not 149.15 exceed the rate charged by the vendor for the same service to 149.16 other payers. If the service is provided by a team of contracted 149.17 vendors, the county may negotiate a team rate with a vendor who 149.18 is a member of the team. The team shall determine how to 149.19 distribute the rate among its members. No reimbursement 149.20 received by contracted vendors shall be returned to the county, 149.21 except to reimburse the county for advance funding provided by 149.22 the county to the vendor. 149.23 (f) If the service is provided by a team which includes 149.24 contracted vendors and county or state staff, the costs for 149.25 county or state staff participation in the team shall be 149.26 included in the rate for county-provided services. In this 149.27 case, the contracted vendor and the county may each receive 149.28 separate payment for services provided by each entity in the 149.29 same month. In order to prevent duplication of services, the 149.30 county must document, in the recipient's file, the need for team 149.31 case management and a description of the roles of the team 149.32 members. 149.33 (g) The commissioner shall calculate the nonfederal share 149.34 of actual medical assistance and general assistance medical care 149.35 payments for each county, based on the higher of calendar year 149.36 1995 or 1996 by service date, trend that amount forward to 1999, 150.1 and transfer the result from medical assistance and general 150.2 assistance medical care to each county's mental health grants 150.3 under sections 245.4886 and 256E.12 for calendar year 1999. The 150.4 minimum amount added to each county's mental health grant shall 150.5 be $3,000 per year for children and $5,000 per year for adults. 150.6 The commissioner may reduce the statewide growth factor in order 150.7 to fund these minimums. The total amount transferred shall 150.8 become part of the base for future mental health grants for each 150.9 county. 150.10 (h) Any net increase in revenue to the county as a result 150.11 of the change in this section must be used to provide expanded 150.12 mental health services as defined in sections 245.461 to 150.13 245.4888, the Comprehensive Adult and Children's Mental Health 150.14 Acts, excluding inpatient and residential treatment. For 150.15 adults, increased revenue may also be used for services and 150.16 consumer supports which are part of adult mental health projects 150.17 approved under Laws 1997, chapter 203, article 7, section 25. 150.18 For children, increased revenue may also be used for respite 150.19 care and nonresidential individualized rehabilitation services 150.20 as defined in section 245.492, subdivisions 17 and 23. 150.21 "Increased revenue" has the meaning given in Minnesota Rules, 150.22 part 9520.0903, subpart 3. 150.23 (i) Notwithstanding section 256B.19, subdivision 1, the 150.24 nonfederal share of costs for mental health case management 150.25 shall be provided by the recipient's county of responsibility, 150.26 as defined in sections 256G.01 to 256G.12, from sources other 150.27 than federal funds or funds used to match other federal funds. 150.28 (j) The commissioner may suspend, reduce, or terminate the 150.29 reimbursement to a provider that does not meet the reporting or 150.30 other requirements of this section. The county of 150.31 responsibility, as defined in sections 256G.01 to 256G.12, is 150.32 responsible for any federal disallowances. The county may share 150.33 this responsibility with its contracted vendors. 150.34 (k) The commissioner shall set aside a portion of the 150.35 federal funds earned under this section to repay the special 150.36 revenue maximization account under section 256.01, subdivision 151.1 2, clause (15). The repayment is limited to: 151.2 (1) the costs of developing and implementing this section; 151.3 and 151.4 (2) programming the information systems. 151.5 (l) Notwithstanding section 256.025, subdivision 2, 151.6 payments to counties for case management expenditures under this 151.7 section shall only be made from federal earnings from services 151.8 provided under this section. Payments to contracted vendors 151.9 shall include both the federal earnings and the county share. 151.10 (m) Notwithstanding section 256B.041, county payments for 151.11 the cost of mental health case management services provided by 151.12 county or state staff shall not be made to the state treasurer. 151.13 For the purposes of mental health case management services 151.14 provided by county or state staff under this section, the 151.15 centralized disbursement of payments to counties under section 151.16 256B.041 consists only of federal earnings from services 151.17 provided under this section. 151.18 (n) Case management services under this subdivision do not 151.19 include therapy, treatment, legal, or outreach services. 151.20 (o) If the recipient is a resident of a nursing facility, 151.21 intermediate care facility, or hospital, and the recipient's 151.22 institutional care is paid by medical assistance, payment for 151.23 case management services under this subdivision is limited to 151.24 the last 30 days of the recipient's residency in that facility 151.25 and may not exceed more than two months in a calendar year. 151.26 (p) Payment for case management services under this 151.27 subdivision shall not duplicate payments made under other 151.28 program authorities for the same purpose. 151.29 (q) By July 1, 2000, the commissioner shall evaluate the 151.30 effectiveness of the changes required by this section, including 151.31 changes in number of persons receiving mental health case 151.32 management, changes in hours of service per person, and changes 151.33 in caseload size. 151.34 Sec. 20. Minnesota Statutes 1997 Supplement, section 151.35 256B.0625, subdivision 31a, is amended to read: 151.36 Subd. 31a. [AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 152.1 SYSTEMS.] (a) Medical assistance covers augmentative and 152.2 alternative communication systems consisting of electronic or 152.3 nonelectronic devices and the related components necessary to 152.4 enable a person with severe expressive communication limitations 152.5 to produce or transmit messages or symbols in a manner that 152.6 compensates for that disability. 152.7 (b)By January 1, 1998, the commissioner, in cooperation152.8with the commissioner of administration, shall establish an152.9augmentative and alternative communication system purchasing152.10program within a state agency or by contract with a qualified152.11private entity. The purpose of this service is to facilitate152.12ready availability of the augmentative and alternative152.13communication systems needed to meet the needs of persons with152.14severe expressive communication limitations in an efficient and152.15cost-effective manner. This program shall:152.16(1) coordinate purchase and rental of augmentative and152.17alternative communication systems;152.18(2) negotiate agreements with manufacturers and vendors for152.19purchase of components of these systems, for warranty coverage,152.20and for repair service;152.21(3) when efficient and cost-effective, maintain and152.22refurbish if needed, an inventory of components of augmentative152.23and alternative communication systems for short- or long-term152.24loan to recipients;152.25(4) facilitate training sessions for service providers,152.26consumers, and families on augmentative and alternative152.27communication systems; and152.28(5) develop a recycling program for used augmentative and152.29alternative communications systems to be reissued and used for152.30trials and short-term use, when appropriate.152.31The availability of components of augmentative and152.32alternative communication systems through this program is152.33subject to prior authorization requirements established under152.34subdivision 25The commissioner shall reimburse augmentative and 152.35 alternative communication manufacturers and vendors at the 152.36 manufacturer's suggested retail price for augmentative and 153.1 alternative communication systems and related components. The 153.2 commissioner shall separately reimburse providers for purchasing 153.3 and integrating individual communication systems which are 153.4 unavailable as a package from an augmentative and alternative 153.5 communication vendor. 153.6 (c) Reimbursement rates established by this purchasing 153.7 program are not subject to Minnesota Rules, part 9505.0445, item 153.8 S or T. 153.9 Sec. 21. Minnesota Statutes 1996, section 256B.0625, 153.10 subdivision 34, is amended to read: 153.11 Subd. 34. [AMERICAN INDIAN HEALTH SERVICES FACILITIES.] 153.12 Medical assistance payments toAmerican Indian health services153.13facilities for outpatient medical services billed after June 30,153.141990, must befacilities of the Indian health service and 153.15 facilities operated by a tribe or tribal organization under 153.16 funding authorized by United States Code, title 25, sections 153.17 450f to 450n, or title III of the Indian Self-Determination and 153.18 Education Assistance Act, Public Law Number 93-638, shall be at 153.19 the option of the facility in accordance with the rate published 153.20 by the United States Assistant Secretary for Health under the 153.21 authority of United States Code, title 42, sections 248(a) and 153.22 249(b). General assistance medical care payments to facilities 153.23 of the American Indian health services and facilities operated 153.24 by a tribe or tribal organization for the provision of 153.25 outpatient medical care services billed after June 30, 1990, 153.26 must be in accordance with the general assistance medical care 153.27 rates paid for the same services when provided in a facility 153.28 other thanan Americana facility of the Indian health 153.29 service or a facility operated by a tribe or tribal organization. 153.30 Sec. 22. Minnesota Statutes 1996, section 256B.0625, 153.31 subdivision 38, is amended to read: 153.32 Subd. 38. [PAYMENTS FOR MENTAL HEALTH SERVICES.] Payments 153.33 for mental health services covered under the medical assistance 153.34 program that are provided by masters-prepared mental health 153.35 professionals shall be 80 percent of the rate paid to 153.36 doctoral-prepared professionals. Payments for mental health 154.1 services covered under the medical assistance program that are 154.2 provided by masters-prepared mental health professionals 154.3 employed by community mental health centers shall be 100 percent 154.4 of the rate paid to doctoral-prepared professionals. For 154.5 purposes of reimbursement of mental health professionals under 154.6 the medical assistance program, all social workers who: 154.7 (1) have received a master's degree in social work from a 154.8 program accredited by the council on social work education; 154.9 (2) are licensed at the level of graduate social worker or 154.10 independent social worker; and 154.11 (3) are practicing clinical social work under appropriate 154.12 supervision, as defined by section 148B.18; meet all 154.13 requirements under Minnesota Rules, part 9505.0323, subpart 24, 154.14 and shall be paid accordingly. 154.15 Sec. 23. Minnesota Statutes 1997 Supplement, section 154.16 256B.0627, subdivision 5, is amended to read: 154.17 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 154.18 payments for home care services shall be limited according to 154.19 this subdivision. 154.20 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 154.21 recipient may receive the following home care services during a 154.22 calendar year: 154.23 (1) any initial assessment; 154.24 (2) up to two reassessments per year done to determine a 154.25 recipient's need for personal care services; and 154.26 (3) up to five skilled nurse visits. 154.27 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 154.28 services above the limits in paragraph (a) must receive the 154.29 commissioner's prior authorization, except when: 154.30 (1) the home care services were required to treat an 154.31 emergency medical condition that if not immediately treated 154.32 could cause a recipient serious physical or mental disability, 154.33 continuation of severe pain, or death. The provider must 154.34 request retroactive authorization no later than five working 154.35 days after giving the initial service. The provider must be 154.36 able to substantiate the emergency by documentation such as 155.1 reports, notes, and admission or discharge histories; 155.2 (2) the home care services were provided on or after the 155.3 date on which the recipient's eligibility began, but before the 155.4 date on which the recipient was notified that the case was 155.5 opened. Authorization will be considered if the request is 155.6 submitted by the provider within 20 working days of the date the 155.7 recipient was notified that the case was opened; 155.8 (3) a third-party payor for home care services has denied 155.9 or adjusted a payment. Authorization requests must be submitted 155.10 by the provider within 20 working days of the notice of denial 155.11 or adjustment. A copy of the notice must be included with the 155.12 request; 155.13 (4) the commissioner has determined that a county or state 155.14 human services agency has made an error; or 155.15 (5) the professional nurse determines an immediate need for 155.16 up to 40 skilled nursing or home health aide visits per calendar 155.17 year and submits a request for authorization within 20 working 155.18 days of the initial service date, and medical assistance is 155.19 determined to be the appropriate payer. 155.20 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 155.21 authorization will be evaluated according to the same criteria 155.22 applied to prior authorization requests. 155.23 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 155.24 section 256B.0627, subdivision 1, paragraph (a), shall be 155.25 conducted initially, and at least annually thereafter, in person 155.26 with the recipient and result in a completed service plan using 155.27 forms specified by the commissioner. Within 30 days of 155.28 recipient or responsible party request for home care services, 155.29 the assessment, the service plan, and other information 155.30 necessary to determine medical necessity such as diagnostic or 155.31 testing information, social or medical histories, and hospital 155.32 or facility discharge summaries shall be submitted to the 155.33 commissioner. For personal care services: 155.34 (1) The amount and type of service authorized based upon 155.35 the assessment and service plan will follow the recipient if the 155.36 recipient chooses to change providers. 156.1 (2) If the recipient's medical need changes, the 156.2 recipient's provider may assess the need for a change in service 156.3 authorization and request the change from the county public 156.4 health nurse. Within 30 days of the request, the public health 156.5 nurse will determine whether to request the change in services 156.6 based upon the provider assessment, or conduct a home visit to 156.7 assess the need and determine whether the change is appropriate. 156.8 (3) To continue to receive personal care serviceswhen the156.9recipient displays no significant change, the county public156.10health nurse has the option to review with the commissioner, or156.11the commissioner's designee, the service plan on record and156.12receive authorization for up to an additional 12 months at a156.13time for up to three years.after the first year, the recipient 156.14 or the responsible party, in conjunction with the public health 156.15 nurse, may complete a service update on forms developed by the 156.16 commissioner. The service update may substitute for the annual 156.17 reassessment described in subdivision 1. 156.18 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 156.19 commissioner's designee, shall review the assessment, the 156.20 service plan, and any additional information that is submitted. 156.21 The commissioner shall, within 30 days after receiving a 156.22 complete request, assessment, and service plan, authorize home 156.23 care services as follows: 156.24 (1) [HOME HEALTH SERVICES.] All home health services 156.25 provided by a licensed nurse or a home health aide must be prior 156.26 authorized by the commissioner or the commissioner's designee. 156.27 Prior authorization must be based on medical necessity and 156.28 cost-effectiveness when compared with other care options. When 156.29 home health services are used in combination with personal care 156.30 and private duty nursing, the cost of all home care services 156.31 shall be considered for cost-effectiveness. The commissioner 156.32 shall limit nurse and home health aide visits to no more than 156.33 one visit each per day. 156.34 (2) [PERSONAL CARE SERVICES.] (i) All personal care 156.35 services and registered nurse supervision must be prior 156.36 authorized by the commissioner or the commissioner's designee 157.1 except for the assessments established in paragraph (a). The 157.2 amount of personal care services authorized must be based on the 157.3 recipient's home care rating. A child may not be found to be 157.4 dependent in an activity of daily living if because of the 157.5 child's age an adult would either perform the activity for the 157.6 child or assist the child with the activity and the amount of 157.7 assistance needed is similar to the assistance appropriate for a 157.8 typical child of the same age. Based on medical necessity, the 157.9 commissioner may authorize: 157.10 (A) up to two times the average number of direct care hours 157.11 provided in nursing facilities for the recipient's comparable 157.12 case mix level; or 157.13 (B) up to three times the average number of direct care 157.14 hours provided in nursing facilities for recipients who have 157.15 complex medical needs or are dependent in at least seven 157.16 activities of daily living and need physical assistance with 157.17 eating or have a neurological diagnosis; or 157.18 (C) up to 60 percent of the average reimbursement rate, as 157.19 of July 1, 1991, for care provided in a regional treatment 157.20 center for recipients who have Level I behavior, plus any 157.21 inflation adjustment as provided by the legislature for personal 157.22 care service; or 157.23 (D) up to the amount the commissioner would pay, as of July 157.24 1, 1991, plus any inflation adjustment provided for home care 157.25 services, for care provided in a regional treatment center for 157.26 recipients referred to the commissioner by a regional treatment 157.27 center preadmission evaluation team. For purposes of this 157.28 clause, home care services means all services provided in the 157.29 home or community that would be included in the payment to a 157.30 regional treatment center; or 157.31 (E) up to the amount medical assistance would reimburse for 157.32 facility care for recipients referred to the commissioner by a 157.33 preadmission screening team established under section 256B.0911 157.34 or 256B.092; and 157.35 (F) a reasonable amount of time for the provision of 157.36 nursing supervision of personal care services. 158.1 (ii) The number of direct care hours shall be determined 158.2 according to the annual cost report submitted to the department 158.3 by nursing facilities. The average number of direct care hours, 158.4 as established by May 1, 1992, shall be calculated and 158.5 incorporated into the home care limits on July 1, 1992. These 158.6 limits shall be calculated to the nearest quarter hour. 158.7 (iii) The home care rating shall be determined by the 158.8 commissioner or the commissioner's designee based on information 158.9 submitted to the commissioner by the county public health nurse 158.10 on forms specified by the commissioner. The home care rating 158.11 shall be a combination of current assessment tools developed 158.12 under sections 256B.0911 and 256B.501 with an addition for 158.13 seizure activity that will assess the frequency and severity of 158.14 seizure activity and with adjustments, additions, and 158.15 clarifications that are necessary to reflect the needs and 158.16 conditions of recipients who need home care including children 158.17 and adults under 65 years of age. The commissioner shall 158.18 establish these forms and protocols under this section and shall 158.19 use an advisory group, including representatives of recipients, 158.20 providers, and counties, for consultation in establishing and 158.21 revising the forms and protocols. 158.22 (iv) A recipient shall qualify as having complex medical 158.23 needs if the care required is difficult to perform and because 158.24 of recipient's medical condition requires more time than 158.25 community-based standards allow or requires more skill than 158.26 would ordinarily be required and the recipient needs or has one 158.27 or more of the following: 158.28 (A) daily tube feedings; 158.29 (B) daily parenteral therapy; 158.30 (C) wound or decubiti care; 158.31 (D) postural drainage, percussion, nebulizer treatments, 158.32 suctioning, tracheotomy care, oxygen, mechanical ventilation; 158.33 (E) catheterization; 158.34 (F) ostomy care; 158.35 (G) quadriplegia; or 158.36 (H) other comparable medical conditions or treatments the 159.1 commissioner determines would otherwise require institutional 159.2 care. 159.3 (v) A recipient shall qualify as having Level I behavior if 159.4 there is reasonable supporting evidence that the recipient 159.5 exhibits, or that without supervision, observation, or 159.6 redirection would exhibit, one or more of the following 159.7 behaviors that cause, or have the potential to cause: 159.8 (A) injury to the recipient's own body; 159.9 (B) physical injury to other people; or 159.10 (C) destruction of property. 159.11 (vi) Time authorized for personal care relating to Level I 159.12 behavior in subclause (v), items (A) to (C), shall be based on 159.13 the predictability, frequency, and amount of intervention 159.14 required. 159.15 (vii) A recipient shall qualify as having Level II behavior 159.16 if the recipient exhibits on a daily basis one or more of the 159.17 following behaviors that interfere with the completion of 159.18 personal care services under subdivision 4, paragraph (a): 159.19 (A) unusual or repetitive habits; 159.20 (B) withdrawn behavior; or 159.21 (C) offensive behavior. 159.22 (viii) A recipient with a home care rating of Level II 159.23 behavior in subclause (vii), items (A) to (C), shall be rated as 159.24 comparable to a recipient with complex medical needs under 159.25 subclause (iv). If a recipient has both complex medical needs 159.26 and Level II behavior, the home care rating shall be the next 159.27 complex category up to the maximum rating under subclause (i), 159.28 item (B). 159.29 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 159.30 nursing services shall be prior authorized by the commissioner 159.31 or the commissioner's designee. Prior authorization for private 159.32 duty nursing services shall be based on medical necessity and 159.33 cost-effectiveness when compared with alternative care options. 159.34 The commissioner may authorize medically necessary private duty 159.35 nursing services in quarter-hour units when: 159.36 (i) the recipient requires more individual and continuous 160.1 care than can be provided during a nurse visit; or 160.2 (ii) the cares are outside of the scope of services that 160.3 can be provided by a home health aide or personal care assistant. 160.4 The commissioner may authorize: 160.5 (A) up to two times the average amount of direct care hours 160.6 provided in nursing facilities statewide for case mix 160.7 classification "K" as established by the annual cost report 160.8 submitted to the department by nursing facilities in May 1992; 160.9 (B) private duty nursing in combination with other home 160.10 care services up to the total cost allowed under clause (2); 160.11 (C) up to 16 hours per day if the recipient requires more 160.12 nursing than the maximum number of direct care hours as 160.13 established in item (A) and the recipient meets the hospital 160.14 admission criteria established under Minnesota Rules, parts 160.15 9505.0500 to 9505.0540. 160.16 The commissioner may authorize up to 16 hours per day of 160.17 medically necessary private duty nursing services or up to 24 160.18 hours per day of medically necessary private duty nursing 160.19 services until such time as the commissioner is able to make a 160.20 determination of eligibility for recipients who are 160.21 cooperatively applying for home care services under the 160.22 community alternative care program developed under section 160.23 256B.49, or until it is determined by the appropriate regulatory 160.24 agency that a health benefit plan is or is not required to pay 160.25 for appropriate medically necessary health care services. 160.26 Recipients or their representatives must cooperatively assist 160.27 the commissioner in obtaining this determination. Recipients 160.28 who are eligible for the community alternative care program may 160.29 not receive more hours of nursing under this section than would 160.30 otherwise be authorized under section 256B.49. 160.31 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 160.32 ventilator-dependent, the monthly medical assistance 160.33 authorization for home care services shall not exceed what the 160.34 commissioner would pay for care at the highest cost hospital 160.35 designated as a long-term hospital under the Medicare program. 160.36 For purposes of this clause, home care services means all 161.1 services provided in the home that would be included in the 161.2 payment for care at the long-term hospital. 161.3 "Ventilator-dependent" means an individual who receives 161.4 mechanical ventilation for life support at least six hours per 161.5 day and is expected to be or has been dependent for at least 30 161.6 consecutive days. 161.7 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 161.8 or the commissioner's designee shall determine the time period 161.9 for which a prior authorization shall be effective. If the 161.10 recipient continues to require home care services beyond the 161.11 duration of the prior authorization, the home care provider must 161.12 request a new prior authorization. Under no circumstances, 161.13 other than the exceptions in paragraph (b), shall a prior 161.14 authorization be valid prior to the date the commissioner 161.15 receives the request or for more than 12 months. A recipient 161.16 who appeals a reduction in previously authorized home care 161.17 services may continue previously authorized services, other than 161.18 temporary services under paragraph (h), pending an appeal under 161.19 section 256.045. The commissioner must provide a detailed 161.20 explanation of why the authorized services are reduced in amount 161.21 from those requested by the home care provider. 161.22 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 161.23 the commissioner's designee shall determine the medical 161.24 necessity of home care services, the level of caregiver 161.25 according to subdivision 2, and the institutional comparison 161.26 according to this subdivision, the cost-effectiveness of 161.27 services, and the amount, scope, and duration of home care 161.28 services reimbursable by medical assistance, based on the 161.29 assessment, primary payer coverage determination information as 161.30 required, the service plan, the recipient's age, the cost of 161.31 services, the recipient's medical condition, and diagnosis or 161.32 disability. The commissioner may publish additional criteria 161.33 for determining medical necessity according to section 256B.04. 161.34 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 161.35 The agency nurse, the independently enrolled private duty nurse, 161.36 or county public health nurse may request a temporary 162.1 authorization for home care services by telephone. The 162.2 commissioner may approve a temporary level of home care services 162.3 based on the assessment, and service or care plan information, 162.4 and primary payer coverage determination information as required. 162.5 Authorization for a temporary level of home care services 162.6 including nurse supervision is limited to the time specified by 162.7 the commissioner, but shall not exceed 45 days, unless extended 162.8 because the county public health nurse has not completed the 162.9 required assessment and service plan, or the commissioner's 162.10 determination has not been made. The level of services 162.11 authorized under this provision shall have no bearing on a 162.12 future prior authorization. 162.13 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 162.14 Home care services provided in an adult or child foster care 162.15 setting must receive prior authorization by the department 162.16 according to the limits established in paragraph (a). 162.17 The commissioner may not authorize: 162.18 (1) home care services that are the responsibility of the 162.19 foster care provider under the terms of the foster care 162.20 placement agreement and administrative rules. Requests for home 162.21 care services for recipients residing in a foster care setting 162.22 must include the foster care placement agreement and 162.23 determination of difficulty of care; 162.24 (2) personal care services when the foster care license 162.25 holder is also the personal care provider or personal care 162.26 assistant unless the recipient can direct the recipient's own 162.27 care, or case management is provided as required in section 162.28 256B.0625, subdivision 19a; 162.29 (3) personal care services when the responsible party is an 162.30 employee of, or under contract with, or has any direct or 162.31 indirect financial relationship with the personal care provider 162.32 or personal care assistant, unless case management is provided 162.33 as required in section 256B.0625, subdivision 19a; 162.34 (4) home care services when the number of foster care 162.35 residents is greater than four unless the county responsible for 162.36 the recipient's foster placement made the placement prior to 163.1 April 1, 1992, requests that home care services be provided, and 163.2 case management is provided as required in section 256B.0625, 163.3 subdivision 19a; or 163.4 (5) home care services when combined with foster care 163.5 payments, other than room and board payments that exceed the 163.6 total amount that public funds would pay for the recipient's 163.7 care in a medical institution. 163.8 Sec. 24. Minnesota Statutes 1997 Supplement, section 163.9 256B.0627, subdivision 8, is amended to read: 163.10 Subd. 8. [PERSONAL CARE ASSISTANT SERVICES; SHARED CARE.] 163.11 (a) Medical assistance payments for personal care assistance 163.12 shared care shall be limited according to this subdivision. 163.13 (b) Recipients of personal care assistant services may 163.14 share staff and the commissioner shall provide a rate system for 163.15 shared personal care assistant services. For two persons 163.16 sharing care, the ratesystemshall not exceed 1-1/2 times the 163.17 amount paid forproviding services toone person, andshall163.18increase incrementally by one-half the cost of serving a single163.19person, for each person served. A personal care assistant may163.20not serve more than three children in a single setting.for 163.21 three persons, the rate shall not exceed twice the rate for 163.22 serving a single individual. No more than three persons may 163.23 receive shared care from a personal care assistant in a single 163.24 setting. 163.25 (c) Shared care is the provision of personal care services 163.26 by a personal care assistant to two or three recipients at the 163.27 same time and in the same setting. For the purposes of this 163.28 subdivision, "setting" means: 163.29 (1) the home or foster care home of one of the individual 163.30 recipients; or 163.31 (2) a child care program in which all recipients served by 163.32 one personal care assistant are participating, which is licensed 163.33 under chapter 245A or operated by a local school district or 163.34 private school. 163.35 The provisions of this subdivision do not apply when a 163.36 personal care assistant is caring for multiple recipients in 164.1 more than one setting. 164.2 (d) The recipient or the recipient's responsible party, in 164.3 conjunction with the county public health nurse, shall determine: 164.4 (1) whether shared care is an appropriate option based on 164.5 the individual needs and preferences of the recipient; and 164.6 (2) the amount of shared care allocated as part of the 164.7 overall authorization of personal care services. 164.8 The recipient or the responsible party, in conjunction with 164.9 the supervising registered nurse, shall approve the setting, 164.10 grouping, and arrangement of shared care based on the individual 164.11 needs and preferences of the recipients. Decisions on the 164.12 selection of recipients to share care must be based on the ages 164.13 of the recipients, compatibility, and coordination of their care 164.14 needs. 164.15 (e) The following items must be considered by the recipient 164.16 or the responsible party and the supervising nurse, and 164.17 documented in the recipient's care plan: 164.18 (1) the additional qualifications needed by the personal 164.19 care assistant to provide care to several recipients in the same 164.20 setting; 164.21 (2) the additional training and supervision needed by the 164.22 personal care assistant to ensure that the needs of the 164.23 recipient are met appropriately and safely. The provider must 164.24 provide on-site supervision by a registered nurse within the 164.25 first 14 days of shared care, and monthly thereafter; 164.26 (3) the setting in which the shared care will be provided; 164.27 (4) the ongoing monitoring and evaluation of the 164.28 effectiveness and appropriateness of the service and process 164.29 used to make changes in service or setting; and 164.30 (5) a contingency plan which accounts for absence of the 164.31 recipient in a shared care setting due to illness or other 164.32 circumstances and staffing contingencies. 164.33 (f) The provider must offer the recipient or the 164.34 responsible party the option of shared or individual personal 164.35 care assistant care. The recipient or the responsible party can 164.36 withdraw from participating in a shared care arrangement at any 165.1 time. 165.2 (g) Notwithstanding provisions to the contrary, all other 165.3 statutory and regulatory provisions relating to personal care 165.4 services continue to be in effect. 165.5 Nothing in this subdivision shall be construed to reduce 165.6 the total number of hours authorized for an individual recipient. 165.7 Sec. 25. Minnesota Statutes 1997 Supplement, section 165.8 256B.0645, is amended to read: 165.9 256B.0645 [PROVIDER PAYMENTS; RETROACTIVE CHANGES IN 165.10 ELIGIBILITY.] 165.11 Payment to a provider for a health care service provided to 165.12 a general assistance medical care recipient who is later 165.13 determined eligible for medical assistance or MinnesotaCare 165.14 according to section 256L.14 for the period in which the health 165.15 care service was provided,shall be considered payment in full,165.16and shall notmay be adjusted due to the change in eligibility. 165.17 This sectionappliesdoes not apply toboth fee-for-service165.18payments andpayments made to health plans on a prepaid 165.19 capitated basis. 165.20 Sec. 26. Minnesota Statutes 1997 Supplement, section 165.21 256B.0911, subdivision 2, is amended to read: 165.22 Subd. 2. [PERSONS REQUIRED TO BE SCREENED; EXEMPTIONS.] 165.23 All applicants to Medicaid certified nursing facilities must be 165.24 screened prior to admission, regardless of income, assets, or 165.25 funding sources, except the following: 165.26 (1) patients who, having entered acute care facilities from 165.27 certified nursing facilities, are returning to a certified 165.28 nursing facility; 165.29 (2) residents transferred from other certified nursing 165.30 facilities located within the state of Minnesota; 165.31 (3) individuals who have a contractual right to have their 165.32 nursing facility care paid for indefinitely by the veteran's 165.33 administration; 165.34 (4) individuals who are enrolled in the Ebenezer/Group 165.35 Health social health maintenance organization project, or 165.36 enrolled in a demonstration project under section 256B.69, 166.1 subdivision188, at the time of application to a nursing home; 166.2 (5) individuals previously screened and currently being 166.3 served under the alternative care program or under a home and 166.4 community-based services waiver authorized under section 1915(c) 166.5 of the Social Security Act; or 166.6 (6) individuals who are admitted to a certified nursing 166.7 facility for a short-term stay, which, based upon a physician's 166.8 certification, is expected to be 14 days or less in duration, 166.9 and who have been screened and approved for nursing facility 166.10 admission within the previous six months. This exemption 166.11 applies only if the screener determines at the time of the 166.12 initial screening of the six-month period that it is appropriate 166.13 to use the nursing facility for short-term stays and that there 166.14 is an adequate plan of care for return to the home or 166.15 community-based setting. If a stay exceeds 14 days, the 166.16 individual must be referred no later than the first county 166.17 working day following the 14th resident day for a screening, 166.18 which must be completed within five working days of the 166.19 referral. Payment limitations in subdivision 7 will apply to an 166.20 individual found at screening to not meet the level of care 166.21 criteria for admission to a certified nursing facility. 166.22 Regardless of the exemptions in clauses (2) to (6), persons 166.23 who have a diagnosis or possible diagnosis of mental illness, 166.24 mental retardation, or a related condition must receive a 166.25 preadmission screening before admission unless the admission 166.26 prior to screening is authorized by the local mental health 166.27 authority or the local developmental disabilities case manager, 166.28 or unless authorized by the county agency according to Public 166.29 Law Number 101-508. 166.30 Before admission to a Medicaid certified nursing home or 166.31 boarding care home, all persons must be screened and approved 166.32 for admission through an assessment process. The nursing 166.33 facility is authorized to conduct case mix assessments which are 166.34 not conducted by the county public health nurse under Minnesota 166.35 Rules, part 9549.0059. The designated county agency is 166.36 responsible for distributing the quality assurance and review 167.1 form for all new applicants to nursing homes. 167.2 Other persons who are not applicants to nursing facilities 167.3 must be screened if a request is made for a screening. 167.4 Sec. 27. Minnesota Statutes 1996, section 256B.0911, 167.5 subdivision 4, is amended to read: 167.6 Subd. 4. [RESPONSIBILITIES OF THE COUNTY AND THE SCREENING 167.7 TEAM.] (a) The county shall: 167.8 (1) provide information and education to the general public 167.9 regarding availability of the preadmission screening program; 167.10 (2) accept referrals from individuals, families, human 167.11 service and health professionals, and hospital and nursing 167.12 facility personnel; 167.13 (3) assess the health, psychological, and social needs of 167.14 referred individuals and identify services needed to maintain 167.15 these persons in the least restrictive environments; 167.16 (4) determine if the individual screened needs nursing 167.17 facility level of care; 167.18 (5) assess specialized service needs based upon an 167.19 evaluation by: 167.20 (i) a qualified independent mental health professional for 167.21 persons with a primary or secondary diagnosis of a serious 167.22 mental illness; and 167.23 (ii) a qualified mental retardation professional for 167.24 persons with a primary or secondary diagnosis of mental 167.25 retardation or related conditions. For purposes of this clause, 167.26 a qualified mental retardation professional must meet the 167.27 standards for a qualified mental retardation professional in 167.28 Code of Federal Regulations, title 42, section 483.430; 167.29 (6) make recommendations for individuals screened regarding 167.30 cost-effective community services which are available to the 167.31 individual; 167.32 (7) make recommendations for individuals screened regarding 167.33 nursing home placement when there are no cost-effective 167.34 community services available; 167.35 (8) develop an individual's community care plan and provide 167.36 follow-up services as needed; and 168.1 (9) prepare and submit reports that may be required by the 168.2 commissioner of human services. 168.3 (b) The screener shall document that the most 168.4 cost-effective alternatives available were offered to the 168.5 individual or the individual's legal representative. For 168.6 purposes of this section, "cost-effective alternatives" means 168.7 community services and living arrangements that cost the same or 168.8 less than nursing facility care. 168.9 (c)Screeners shall adhere to the level of care criteria168.10for admission to a certified nursing facility established under168.11section 144.0721.168.12(d)For persons who are eligible for medical assistance or 168.13 who would be eligible within 180 days of admission to a nursing 168.14 facility and who are admitted to a nursing facility, the nursing 168.15 facility must include a screener or the case manager in the 168.16 discharge planning process for those individuals who the team 168.17 has determined have discharge potential. The screener or the 168.18 case manager must ensure a smooth transition and follow-up for 168.19 the individual's return to the community. 168.20 Screeners shall cooperate with other public and private 168.21 agencies in the community, in order to offer a variety of 168.22 cost-effective services to the disabled and elderly. The 168.23 screeners shall encourage the use of volunteers from families, 168.24 religious organizations, social clubs, and similar civic and 168.25 service organizations to provide services. 168.26 Sec. 28. Minnesota Statutes 1997 Supplement, section 168.27 256B.0911, subdivision 7, is amended to read: 168.28 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 168.29 (a) Medical assistance reimbursement for nursing facilities 168.30 shall be authorized for a medical assistance recipient only if a 168.31 preadmission screening has been conducted prior to admission or 168.32 the local county agency has authorized an exemption. Medical 168.33 assistance reimbursement for nursing facilities shall not be 168.34 provided for any recipient who the local screener has determined 168.35 does not meet the level of care criteria for nursing facility 168.36 placement or, if indicated, has not had a level II PASARR 169.1 evaluation completed unless an admission for a recipient with 169.2 mental illness is approved by the local mental health authority 169.3 or an admission for a recipient with mental retardation or 169.4 related condition is approved by the state mental retardation 169.5 authority.The county preadmission screening team may deny169.6certified nursing facility admission using the level of care169.7criteria established under section 144.0721 and deny medical169.8assistance reimbursement for certified nursing facility care.169.9Persons receiving care in a certified nursing facility or169.10certified boarding care home who are reassessed by the169.11commissioner of health according to section 144.0722 and169.12determined to no longer meet the level of care criteria for a169.13certified nursing facility or certified boarding care home may169.14no longer remain a resident in the certified nursing facility or169.15certified boarding care home and must be relocated to the169.16community if the persons were admitted on or after July 1, 1998.169.17 (b)Persons receiving services under section 256B.0913,169.18subdivisions 1 to 14, or 256B.0915 who are reassessed and found169.19to not meet the level of care criteria for admission to a169.20certified nursing facility or certified boarding care home may169.21no longer receive these services if persons were admitted to the169.22program on or after July 1, 1998.The commissioner shall make a 169.23 request to the health care financing administration for a waiver 169.24 allowing screening team approval of Medicaid payments for 169.25 certified nursing facility care. An individual has a choice and 169.26 makes the final decision between nursing facility placement and 169.27 community placement after the screening team's recommendation, 169.28 except as provided in paragraphs (b) and (c). 169.29 (c) The local county mental health authority or the state 169.30 mental retardation authority under Public Law Numbers 100-203 169.31 and 101-508 may prohibit admission to a nursing facility, if the 169.32 individual does not meet the nursing facility level of care 169.33 criteria or needs specialized services as defined in Public Law 169.34 Numbers 100-203 and 101-508. For purposes of this section, 169.35 "specialized services" for a person with mental retardation or a 169.36 related condition means "active treatment" as that term is 170.1 defined in Code of Federal Regulations, title 42, section 170.2 483.440(a)(1). 170.3 (d) Upon the receipt by the commissioner of approval by the 170.4 Secretary of Health and Human Services of the waiver requested 170.5 under paragraph (a), the local screener shall deny medical 170.6 assistance reimbursement for nursing facility care for an 170.7 individual whose long-term care needs can be met in a 170.8 community-based setting and whose cost of community-based home 170.9 care services is less than 75 percent of the average payment for 170.10 nursing facility care for that individual's case mix 170.11 classification, and who is either: 170.12 (i) a current medical assistance recipient being screened 170.13 for admission to a nursing facility; or 170.14 (ii) an individual who would be eligible for medical 170.15 assistance within 180 days of entering a nursing facility and 170.16 who meets a nursing facility level of care. 170.17 (e) Appeals from the screening team's recommendation or the 170.18 county agency's final decision shall be made according to 170.19 section 256.045, subdivision 3. 170.20 Sec. 29. Minnesota Statutes 1997 Supplement, section 170.21 256B.0915, subdivision 1d, is amended to read: 170.22 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 170.23 RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the 170.24 provisions of section 256B.056, the commissioner shall make the 170.25 following amendment to the medical assistance elderly waiver 170.26 program effective July 1,19971999, or upon federal approval, 170.27 whichever is later. 170.28 A recipient's maintenance needs will be an amount equal to 170.29 the Minnesota supplemental aid equivalent rate as defined in 170.30 section 256I.03, subdivision 5, plus the medical assistance 170.31 personal needs allowance as defined in section 256B.35, 170.32 subdivision 1, paragraph (a), when applying posteligibility 170.33 treatment of income rules to the gross income of elderly waiver 170.34 recipients, except for individuals whose income is in excess of 170.35 the special income standard according to Code of Federal 170.36 Regulations, title 42, section 435.236. Recipient maintenance 171.1 needs shall be adjusted under this provision each July 1. 171.2 (b) The commissioner of human services shall secure 171.3 approval of additional elderly waiver slots sufficient to serve 171.4 persons who will qualify under the revised income standard 171.5 described in paragraph (a) before implementing section 171.6 256B.0913, subdivision 16. 171.7 Sec. 30. Minnesota Statutes 1996, section 256B.41, 171.8 subdivision 1, is amended to read: 171.9 Subdivision 1. [AUTHORITY.] The commissioner shall 171.10 establish, by rule, procedures for determining rates for care of 171.11 residents of nursing facilities which qualify as vendors of 171.12 medical assistance, and for implementing the provisions of this 171.13 section and sections 256B.421, 256B.431, 256B.432, 256B.433, 171.14 256B.47, 256B.48, 256B.50, and 256B.502. The procedures shall 171.15be based on methods and standards that the commissioner finds171.16are adequate to provide for the costs that must be incurred for171.17the care of residents in efficiently and economically operated171.18nursing facilities and shallspecify the costs that are 171.19 allowable for establishing payment rates through medical 171.20 assistance. 171.21 Sec. 31. Minnesota Statutes 1996, section 256B.431, 171.22 subdivision 2b, is amended to read: 171.23 Subd. 2b. [OPERATING COSTS, AFTER JULY 1, 1985.] (a) For 171.24 rate years beginning on or after July 1, 1985, the commissioner 171.25 shall establish procedures for determining per diem 171.26 reimbursement for operating costs. 171.27 (b) The commissioner shall contract with an econometric 171.28 firm with recognized expertise in and access to national 171.29 economic change indices that can be applied to the appropriate 171.30 cost categories when determining the operating cost payment rate. 171.31 (c) The commissioner shall analyze and evaluate each 171.32 nursing facility's cost report of allowable operating costs 171.33 incurred by the nursing facility during the reporting year 171.34 immediately preceding the rate year for which the payment rate 171.35 becomes effective. 171.36 (d) The commissioner shall establish limits on actual 172.1 allowable historical operating cost per diems based on cost 172.2 reports of allowable operating costs for the reporting year that 172.3 begins October 1, 1983, taking into consideration relevant 172.4 factors including resident needs, geographic location, and size 172.5 of the nursing facility, and the costs that must be incurred for172.6the care of residents in an efficiently and economically172.7operated nursing facility. In developing the geographic groups 172.8 for purposes of reimbursement under this section, the 172.9 commissioner shall ensure that nursing facilities in any county 172.10 contiguous to the Minneapolis-St. Paul seven-county metropolitan 172.11 area are included in the same geographic group. The limits 172.12 established by the commissioner shall not be less, in the 172.13 aggregate, than the 60th percentile of total actual allowable 172.14 historical operating cost per diems for each group of nursing 172.15 facilities established under subdivision 1 based on cost reports 172.16 of allowable operating costs in the previous reporting year. 172.17 For rate years beginning on or after July 1, 1989, facilities 172.18 located in geographic group I as described in Minnesota Rules, 172.19 part 9549.0052, on January 1, 1989, may choose to have the 172.20 commissioner apply either the care related limits or the other 172.21 operating cost limits calculated for facilities located in 172.22 geographic group II, or both, if either of the limits calculated 172.23 for the group II facilities is higher. The efficiency incentive 172.24 for geographic group I nursing facilities must be calculated 172.25 based on geographic group I limits. The phase-in must be 172.26 established utilizing the chosen limits. For purposes of these 172.27 exceptions to the geographic grouping requirements, the 172.28 definitions in Minnesota Rules, parts 9549.0050 to 9549.0059 172.29 (Emergency), and 9549.0010 to 9549.0080, apply. The limits 172.30 established under this paragraph remain in effect until the 172.31 commissioner establishes a new base period. Until the new base 172.32 period is established, the commissioner shall adjust the limits 172.33 annually using the appropriate economic change indices 172.34 established in paragraph (e). In determining allowable 172.35 historical operating cost per diems for purposes of setting 172.36 limits and nursing facility payment rates, the commissioner 173.1 shall divide the allowable historical operating costs by the 173.2 actual number of resident days, except that where a nursing 173.3 facility is occupied at less than 90 percent of licensed 173.4 capacity days, the commissioner may establish procedures to 173.5 adjust the computation of the per diem to an imputed occupancy 173.6 level at or below 90 percent. The commissioner shall establish 173.7 efficiency incentives as appropriate. The commissioner may 173.8 establish efficiency incentives for different operating cost 173.9 categories. The commissioner shall consider establishing 173.10 efficiency incentives in care related cost categories. The 173.11 commissioner may combine one or more operating cost categories 173.12 and may use different methods for calculating payment rates for 173.13 each operating cost category or combination of operating cost 173.14 categories. For the rate year beginning on July 1, 1985, the 173.15 commissioner shall: 173.16 (1) allow nursing facilities that have an average length of 173.17 stay of 180 days or less in their skilled nursing level of care, 173.18 125 percent of the care related limit and 105 percent of the 173.19 other operating cost limit established by rule; and 173.20 (2) exempt nursing facilities licensed on July 1, 1983, by 173.21 the commissioner to provide residential services for the 173.22 physically handicapped under Minnesota Rules, parts 9570.2000 to 173.23 9570.3600, from the care related limits and allow 105 percent of 173.24 the other operating cost limit established by rule. 173.25 For the purpose of calculating the other operating cost 173.26 efficiency incentive for nursing facilities referred to in 173.27 clause (1) or (2), the commissioner shall use the other 173.28 operating cost limit established by rule before application of 173.29 the 105 percent. 173.30 (e) The commissioner shall establish a composite index or 173.31 indices by determining the appropriate economic change 173.32 indicators to be applied to specific operating cost categories 173.33 or combination of operating cost categories. 173.34 (f) Each nursing facility shall receive an operating cost 173.35 payment rate equal to the sum of the nursing facility's 173.36 operating cost payment rates for each operating cost category. 174.1 The operating cost payment rate for an operating cost category 174.2 shall be the lesser of the nursing facility's historical 174.3 operating cost in the category increased by the appropriate 174.4 index established in paragraph (e) for the operating cost 174.5 category plus an efficiency incentive established pursuant to 174.6 paragraph (d) or the limit for the operating cost category 174.7 increased by the same index. If a nursing facility's actual 174.8 historic operating costs are greater than the prospective 174.9 payment rate for that rate year, there shall be no retroactive 174.10 cost settle-up. In establishing payment rates for one or more 174.11 operating cost categories, the commissioner may establish 174.12 separate rates for different classes of residents based on their 174.13 relative care needs. 174.14 (g) The commissioner shall include the reported actual real 174.15 estate tax liability or payments in lieu of real estate tax of 174.16 each nursing facility as an operating cost of that nursing 174.17 facility. Allowable costs under this subdivision for payments 174.18 made by a nonprofit nursing facility that are in lieu of real 174.19 estate taxes shall not exceed the amount which the nursing 174.20 facility would have paid to a city or township and county for 174.21 fire, police, sanitation services, and road maintenance costs 174.22 had real estate taxes been levied on that property for those 174.23 purposes. For rate years beginning on or after July 1, 1987, 174.24 the reported actual real estate tax liability or payments in 174.25 lieu of real estate tax of nursing facilities shall be adjusted 174.26 to include an amount equal to one-half of the dollar change in 174.27 real estate taxes from the prior year. The commissioner shall 174.28 include a reported actual special assessment, and reported 174.29 actual license fees required by the Minnesota department of 174.30 health, for each nursing facility as an operating cost of that 174.31 nursing facility. For rate years beginning on or after July 1, 174.32 1989, the commissioner shall include a nursing facility's 174.33 reported public employee retirement act contribution for the 174.34 reporting year as apportioned to the care-related operating cost 174.35 categories and other operating cost categories multiplied by the 174.36 appropriate composite index or indices established pursuant to 175.1 paragraph (e) as costs under this paragraph. Total adjusted 175.2 real estate tax liability, payments in lieu of real estate tax, 175.3 actual special assessments paid, the indexed public employee 175.4 retirement act contribution, and license fees paid as required 175.5 by the Minnesota department of health, for each nursing facility 175.6 (1) shall be divided by actual resident days in order to compute 175.7 the operating cost payment rate for this operating cost 175.8 category, (2) shall not be used to compute the care-related 175.9 operating cost limits or other operating cost limits established 175.10 by the commissioner, and (3) shall not be increased by the 175.11 composite index or indices established pursuant to paragraph 175.12 (e), unless otherwise indicated in this paragraph. 175.13 (h) For rate years beginning on or after July 1, 1987, the 175.14 commissioner shall adjust the rates of a nursing facility that 175.15 meets the criteria for the special dietary needs of its 175.16 residents and the requirements in section 31.651. The 175.17 adjustment for raw food cost shall be the difference between the 175.18 nursing facility's allowable historical raw food cost per diem 175.19 and 115 percent of the median historical allowable raw food cost 175.20 per diem of the corresponding geographic group. 175.21 The rate adjustment shall be reduced by the applicable 175.22 phase-in percentage as provided under subdivision 2h. 175.23(i) For the cost report year ending September 30, 1996, and175.24for all subsequent reporting years, certified nursing facilities175.25must identify, differentiate, and record resident day statistics175.26for residents in case mix classification A who, on or after July175.271, 1996, meet the modified level of care criteria in section175.28144.0721. The resident day statistics shall be separated into175.29case mix classification A-1 for any resident day meeting the175.30high-function class A level of care criteria and case mix175.31classification A-2 for other case mix class A resident days.175.32 Sec. 32. Minnesota Statutes 1996, section 256B.431, is 175.33 amended by adding a subdivision to read: 175.34 Subd. 27. [SPEND-UP AND HIGH COST LIMITS INDEXED; NOT 175.35 REBASED.] (a) For rate years beginning on or after July 1, 1998, 175.36 the commissioner shall modify the determination of the spend-up 176.1 limits referred to in subdivision 26, paragraph (a), by indexing 176.2 each group's previous year's median value by the factor in 176.3 subdivision 26, paragraph (d), clause (2), plus one percentage 176.4 point. 176.5 (b) For rate years beginning on or after July 1, 1998, the 176.6 commissioner shall modify the determination of the high cost 176.7 limits referred to in subdivision 26, paragraph (b), by indexing 176.8 each group's previous year's high cost per diem limits at .5 and 176.9 one standard deviations above the median by the factor in 176.10 subdivision 26, paragraph (d), clause (2), plus one percentage 176.11 point. 176.12 Sec. 33. Minnesota Statutes 1996, section 256B.501, 176.13 subdivision 2, is amended to read: 176.14 Subd. 2. [AUTHORITY.] The commissioner shall establish 176.15 procedures and rules for determining rates for care of residents 176.16 of intermediate care facilities for persons with mental 176.17 retardation or related conditions which qualify as providers of 176.18 medical assistance and waivered services.Approved rates shall176.19be established on the basis of methods and standards that the176.20commissioner finds adequate to provide for the costs that must176.21be incurred for the quality care of residents in efficiently and176.22economically operated facilities and services.The procedures 176.23 shall specify the costs that are allowable for payment through 176.24 medical assistance. The commissioner may use experts from 176.25 outside the department in the establishment of the procedures. 176.26 Sec. 34. Minnesota Statutes 1997 Supplement, section 176.27 256B.69, subdivision 2, is amended to read: 176.28 Subd. 2. [DEFINITIONS.] For the purposes of this section, 176.29 the following terms have the meanings given. 176.30 (a) "Commissioner" means the commissioner of human services. 176.31 For the remainder of this section, the commissioner's 176.32 responsibilities for methods and policies for implementing the 176.33 project will be proposed by the project advisory committees and 176.34 approved by the commissioner. 176.35 (b) "Demonstration provider" means a health maintenance 176.36 organizationor, community integrated service network, or 177.1 accountable provider network authorized and operating under 177.2 chapter 62Dor, 62N, or 62T that participates in the 177.3 demonstration project according to criteria, standards, methods, 177.4 and other requirements established for the project and approved 177.5 by the commissioner. Notwithstanding the above, Itasca county 177.6 may continue to participate as a demonstration provider until 177.7 July 1, 2000. 177.8 (c) "Eligible individuals" means those persons eligible for 177.9 medical assistance benefits as defined in sections 256B.055, 177.10 256B.056, and 256B.06. 177.11 (d) "Limitation of choice" means suspending freedom of 177.12 choice while allowing eligible individuals to choose among the 177.13 demonstration providers. 177.14 (e) This paragraph supersedes paragraph (c) as long as the 177.15 Minnesota health care reform waiver remains in effect. When the 177.16 waiver expires, this paragraph expires and the commissioner of 177.17 human services shall publish a notice in the State Register and 177.18 notify the revisor of statutes. "Eligible individuals" means 177.19 those persons eligible for medical assistance benefits as 177.20 defined in sections 256B.055, 256B.056, and 256B.06. 177.21 Notwithstanding sections 256B.055, 256B.056, and 256B.06, an 177.22 individual who becomes ineligible for the program because of 177.23 failure to submit income reports or recertification forms in a 177.24 timely manner, shall remain enrolled in the prepaid health plan 177.25 and shall remain eligible to receive medical assistance coverage 177.26 through the last day of the month following the month in which 177.27 the enrollee became ineligible for the medical assistance 177.28 program. 177.29 Sec. 35. Minnesota Statutes 1997 Supplement, section 177.30 256B.69, subdivision 3a, is amended to read: 177.31 Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when 177.32 implementing the general assistance medical care, or medical 177.33 assistance prepayment program within a county, must include the 177.34 county board in the process of development, approval, and 177.35 issuance of the request for proposals to provide services to 177.36 eligible individuals within the proposed county. County boards 178.1 must be given reasonable opportunity to make recommendations 178.2 regarding the development, issuance, review of responses, and 178.3 changes needed in the request for proposals. The commissioner 178.4 must provide county boards the opportunity to review each 178.5 proposal based on the identification of community needs under 178.6 chapters 145A and 256E and county advocacy activities. If a 178.7 county board finds that a proposal does not address certain 178.8 community needs, the county board and commissioner shall 178.9 continue efforts for improving the proposal and network prior to 178.10 the approval of the contract. The county board shall make 178.11 recommendations regarding the approval of local networks and 178.12 their operations to ensure adequate availability and access to 178.13 covered services. The provider or health plan must respond 178.14 directly to county advocates and the state prepaid medical 178.15 assistance ombudsperson regarding service delivery and must be 178.16 accountable to the state regarding contracts with medical 178.17 assistance and general assistance medical care funds. The 178.18 county board may recommend a maximum number of participating 178.19 health plans after considering the size of the enrolling 178.20 population; ensuring adequate access and capacity; considering 178.21 the client and county administrative complexity; and considering 178.22 the need to promote the viability of locally developed health 178.23 plans. The county board or a single entity representing a group 178.24 of county boards and the commissioner shall mutually select 178.25 health plans for participation at the time of initial 178.26 implementation of the prepaid medical assistance program in that 178.27 county or group of counties and at the time of contract renewal. 178.28 The commissioner shall also seek input for contract requirements 178.29 from the county or single entity representing a group of county 178.30 boards at each contract renewal and incorporate those 178.31 recommendations into the contract negotiation process. The 178.32 commissioner, in conjunction with the county board, shall 178.33 actively seek to develop a mutually agreeable timetable prior to 178.34 the development of the request for proposal, but counties must 178.35 agree to initial enrollment beginning on or before January 1, 178.36 1999, in either the prepaid medical assistance and general 179.1 assistance medical care programs or county-based purchasing 179.2 under section 256B.692. At least 90 days before enrollment in 179.3 the medical assistance and general assistance medical care 179.4 prepaid programs begins in a county in which the prepaid 179.5 programs have not been established, the commissioner shall 179.6 provide a report to the chairs of senate and house committees 179.7 having jurisdiction over state health care programs which 179.8 verifies that the commissioner complied with the requirements 179.9 for county involvement that are specified in this subdivision. 179.10 (b) The commissioner shall seek a federal waiver to allow a 179.11 fee-for-service plan option to MinnesotaCare enrollees. The 179.12 commissioner shall develop an increase of the premium fees 179.13 required under section 256L.06 up to 20 percent of the premium 179.14 fees for the enrollees who elect the fee-for-service option. 179.15 Prior to implementation, the commissioner shall submit this fee 179.16 schedule to the chair and ranking minority member of the senate 179.17 health care committee, the senate health care and family 179.18 services funding division, the house of representatives health 179.19 and human services committee, and the house of representatives 179.20 health and human services finance division. 179.21 (c) At the option of the county board, the board may 179.22 develop contract requirements related to the achievement of 179.23 local public health goals to meet the health needs of medical 179.24 assistance and general assistance medical care enrollees. These 179.25 requirements must be reasonably related to the performance of 179.26 health plan functions and within the scope of the medical 179.27 assistance and general assistance medical care benefit sets. If 179.28 the county board and the commissioner mutually agree to such 179.29 requirements, the department shall include such requirements in 179.30 all health plan contracts governing the prepaid medical 179.31 assistance and general assistance medical care programs in that 179.32 county at initial implementation of the program in that county 179.33 and at the time of contract renewal. The county board may 179.34 participate in the enforcement of the contract provisions 179.35 related to local public health goals. 179.36 (d) For counties in which prepaid medical assistance and 180.1 general assistance medical care programs have not been 180.2 established, the commissioner shall not implement those programs 180.3 if a county board submits acceptable and timely preliminary and 180.4 final proposals under section 256B.692, until county-based 180.5 purchasing is no longer operational in that county. For 180.6 counties in which prepaid medical assistance and general 180.7 assistance medical care programs are in existence on or after 180.8 September 1, 1997, the commissioner must terminate contracts 180.9 with health plans according to section 256B.692, subdivision 5, 180.10 if the county board submits and the commissioner accepts 180.11 preliminary and final proposals according to that subdivision. 180.12 The commissioner is not required to terminate contracts that 180.13 begin on or after September 1, 1997, according to section 180.14 256B.692 until two years have elapsed from the date of initial 180.15 enrollment. 180.16 (e) In the event that a county board or a single entity 180.17 representing a group of county boards and the commissioner 180.18 cannot reach agreement regarding: (i) the selection of 180.19 participating health plans in that county; (ii) contract 180.20 requirements; or (iii) implementation and enforcement of county 180.21 requirements including provisions regarding local public health 180.22 goals, the commissioner shall resolve all disputes after taking 180.23 into account the recommendations of a three-person mediation 180.24 panel. The panel shall be composed of one designee of the 180.25 president of the association of Minnesota counties, one designee 180.26 of the commissioner of human services, and one designee of the 180.27 commissioner of health. 180.28 (f) If a county which elects to implement county-based 180.29 purchasing ceases to implement county-based purchasing, it is 180.30 prohibited from assuming the responsibility of county-based 180.31 purchasing for a period of five years from the date it 180.32 discontinues purchasing. 180.33 (g) Notwithstanding the requirement in paragraph (a) that a 180.34 county must agree to initial enrollment on or before January 1, 180.35 1999, the commissioner shall grant a delay of up to 12 months in 180.36 the implementation of the county-based purchasing authorized in 181.1 section 256B.692 if the county or group of counties has 181.2 submitted a preliminary proposal for county-based purchasing by 181.3 September 1, 1997, has not already implemented the prepaid 181.4 medical assistance program before January 1, 1998, and has 181.5 submitted a written request for the delay to the commissioner by 181.6 July 1, 1998. In order for the delay to be continued, the 181.7 county or group of counties must also submit to the commissioner 181.8 the following information by December 1, 1998: 181.9 (1) identify the proposed date of implementation, not later 181.10 than January 1, 2000; 181.11 (2) include copies of the county board resolutions which 181.12 demonstrate the continued commitment to the implementation of 181.13 county-based purchasing by the proposed date of implementation. 181.14 County board authorization may remain contingent on the 181.15 submission of a final proposal which meets the requirements of 181.16 section 256B.692, subdivision 5, paragraph (b); 181.17 (3) if more than one county is involved in the proposal, 181.18 demonstrate actions taken for the establishment of a governance 181.19 structure between the participating counties and describe how 181.20 the fiduciary responsibilities of county-based purchasing will 181.21 be allocated between the counties; 181.22 (4) describe actions taken to identify how the risk of a 181.23 deficit will be managed in the event expenditures are greater 181.24 than total capitation payments. This description must identify 181.25 how any of the following strategies will be assessed: 181.26 (i) risk contracts with licensed health plans; 181.27 (ii) risk arrangements with providers who are not licensed 181.28 health plans; 181.29 (iii) risk arrangements with other licensed insurance 181.30 entities; and 181.31 (iv) funding from other county resources; 181.32 (5) include, if county-based purchasing will not contract 181.33 with licensed health plans or provider networks, letters of 181.34 interest from local providers in at least the categories of 181.35 hospital, physician, mental health, and pharmacy which express 181.36 interest in contracting for services; and 182.1 (6) describe the options being considered to obtain the 182.2 administrative services required in section 256B.692, 182.3 subdivision 3, clauses (3) and (5). 182.4 For counties which receive a delay under this subdivision, 182.5 the final proposals required under section 256B.692, subdivision 182.6 5, paragraph (b), must be submitted at least six months prior to 182.7 the requested implementation date. Authority to implement 182.8 county-based purchasing remains contingent on approval of the 182.9 final proposal as required under section 256B.692. 182.10 Sec. 36. Minnesota Statutes 1996, section 256B.69, is 182.11 amended by adding a subdivision to read: 182.12 Subd. 25. [AMERICAN INDIAN RECIPIENTS.] (a) Beginning on 182.13 or after January 1, 1999, for American Indian recipients of 182.14 medical assistance who are required to enroll with a 182.15 demonstration provider under subdivision 4 or in a county-based 182.16 purchasing entity, if applicable, under section 256B.692, 182.17 medical assistance shall cover health care services provided at 182.18 Indian health services facilities and facilities operated by a 182.19 tribe or tribal organization under funding authorized by United 182.20 States Code, title 25, sections 450f to 450n, or title III of 182.21 the Indian Self-Determination and Education Assistance Act, 182.22 Public Law Number 93-638, if those services would otherwise be 182.23 covered under section 256B.0625. Payments for services provided 182.24 under this subdivision shall be made on a fee-for-service basis, 182.25 and may, at the option of the tribe or tribal organization, be 182.26 made in accordance with rates authorized under sections 256.969, 182.27 subdivision 16, and 256B.0625, subdivision 34. Implementation 182.28 of this subdivision is contingent on federal approval. 182.29 (b) The commissioner of human services, in consultation 182.30 with the tribal governments, shall develop a plan for tribes to 182.31 assist in the enrollment process for American Indian recipients 182.32 enrolled in the prepaid medical assistance program under this 182.33 section or the prepaid general assistance medical care program 182.34 under section 256D.03, subdivision 4, paragraph (d). This plan 182.35 also shall address how tribes will be included in ensuring the 182.36 coordination of care for American Indian recipients between 183.1 Indian health service or tribal providers and other providers. 183.2 (c) For purposes of this subdivision, "American Indian" has 183.3 the meaning given to persons to whom services will be provided 183.4 for in Code of Federal Regulations, title 42, section 36.12. 183.5 (d) This subdivision also applies to American Indian 183.6 recipients of general assistance medical care and to the prepaid 183.7 general assistance medical care program under section 256D.03, 183.8 subdivision 4, paragraph (d). 183.9 Sec. 37. Minnesota Statutes 1997 Supplement, section 183.10 256B.692, subdivision 2, is amended to read: 183.11 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] 183.12 Notwithstanding chapters 62D and 62N, a county that elects to 183.13 purchase medical assistance and general assistance medical care 183.14 in return for a fixed sum without regard to the frequency or 183.15 extent of services furnished to any particular enrollee is not 183.16 required to obtain a certificate of authority under chapter 62D 183.17 or 62N. A county that elects to purchase medical assistance and 183.18 general assistance medical care services under this section must 183.19 satisfy the commissioner of health that the requirements of 183.20 chapter 62D, applicable to health maintenance organizations, or 183.21 chapter 62N, applicable to community integrated service 183.22 networks, will be met. A county must also assure the 183.23 commissioner of health that the requirements ofsectionsections 183.24 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all 183.25 applicable provisions of chapter 62Q, including sections 62Q.07; 183.26 62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 183.27 62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 183.28 62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 183.29 will be met. All enforcement and rulemaking powers available 183.30 under chapters 62Dand, 62J, 62M, 62N, and 62Q are hereby 183.31 granted to the commissioner of health with respect to counties 183.32 that purchase medical assistance and general assistance medical 183.33 care services under this section. 183.34 Sec. 38. Minnesota Statutes 1997 Supplement, section 183.35 256B.692, subdivision 5, is amended to read: 183.36 Subd. 5. [COUNTY PROPOSALS.] (a) On or before September 1, 184.1 1997, a county board that wishes to purchase or provide health 184.2 care under this section must submit a preliminary proposal that 184.3 substantially demonstrates the county's ability to meet all the 184.4 requirements of this section in response to criteria for 184.5 proposals issued by the department on or before July 1, 1997. 184.6 Counties submitting preliminary proposals must establish a local 184.7 planning process that involves input from medical assistance and 184.8 general assistance medical care recipients, recipient advocates, 184.9 providers and representatives of local school districts, labor, 184.10 and tribal government to advise on the development of a final 184.11 proposal and its implementation. 184.12 (b) The county board must submit a final proposal on or 184.13 before July 1, 1998, that demonstrates the ability to meet all 184.14 the requirements of this section, including beginning enrollment 184.15 on January 1, 1999, unless a delay has been granted under 184.16 section 256B.69, subdivision 3a, paragraph (g). 184.17 (c) After January 1, 1999, for a county in which the 184.18 prepaid medical assistance program is in existence, the county 184.19 board must submit a preliminary proposal at least 15 months 184.20 prior to termination of health plan contracts in that county and 184.21 a final proposal six months prior to the health plan contract 184.22 termination date in order to begin enrollment after the 184.23 termination. Nothing in this section shall impede or delay 184.24 implementation or continuation of the prepaid medical assistance 184.25 and general assistance medical care programs in counties for 184.26 which the board does not submit a proposal, or submits a 184.27 proposal that is not in compliance with this section. 184.28 (d) The commissioner is not required to terminate contracts 184.29 for the prepaid medical assistance and prepaid general 184.30 assistance medical care programs that begin on or after 184.31 September 1, 1997, in a county for which a county board has 184.32 submitted a proposal under this paragraph, until two years have 184.33 elapsed from the date of initial enrollment in the prepaid 184.34 medical assistance and prepaid general assistance medical care 184.35 programs. 184.36 Sec. 39. Minnesota Statutes 1997 Supplement, section 185.1 256B.77, subdivision 3, is amended to read: 185.2 Subd. 3. [ASSURANCES TO THE COMMISSIONER OF HEALTH.] A 185.3 county authority that elects to participate in a demonstration 185.4 project for people with disabilities under this section is not 185.5 required to obtain a certificate of authority under chapter 62D 185.6 or 62N. A county authority that elects to participate in a 185.7 demonstration project for people with disabilities under this 185.8 section must assure the commissioner of health that the 185.9 requirements of chapters 62Dand, 62N, and section 256B.692, 185.10 subdivision 2, are met. All enforcement and rulemaking powers 185.11 available under chapters 62Dand, 62J, 62M, 62N, and 62Q are 185.12 granted to the commissioner of health with respect to the county 185.13 authorities that contract with the commissioner to purchase 185.14 services in a demonstration project for people with disabilities 185.15 under this section. 185.16 Sec. 40. Minnesota Statutes 1997 Supplement, section 185.17 256B.77, subdivision 7a, is amended to read: 185.18 Subd. 7a. [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 185.19 for the demonstration project as provided in this subdivision. 185.20 (b) "Eligible individuals" means those persons living in 185.21 the demonstration site who are eligible for medical assistance 185.22 and are disabled based on a disability determination under 185.23 section 256B.055, subdivisions 7 and 12, or who are eligible for 185.24 medical assistance and have been diagnosed as having: 185.25 (1) serious and persistent mental illness as defined in 185.26 section 245.462, subdivision 20; 185.27 (2) severe emotional disturbance as defined in section 185.28 245.487, subdivision 6; or 185.29 (3) mental retardation, or being a mentally retarded person 185.30 as defined in section 252A.02, or a related condition as defined 185.31 in section 252.27, subdivision 1a. 185.32 Other individuals may be included at the option of the county 185.33 authority based on agreement with the commissioner. 185.34 (c) Eligible individuals residing on a federally recognized 185.35 Indian reservation may be excluded from participation in the 185.36 demonstration project at the discretion of the tribal government 186.1 based on agreement with the commissioner, in consultation with 186.2 the county authority. 186.3 (d) Eligible individuals include individuals in excluded 186.4 time status, as defined in chapter 256G. Enrollees in excluded 186.5 time at the time of enrollment shall remain in excluded time 186.6 status as long as they live in the demonstration site and shall 186.7 be eligible for 90 days after placement outside the 186.8 demonstration site if they move to excluded time status in a 186.9 county within Minnesota other than their county of financial 186.10 responsibility. 186.11 (e) A person who is a sexual psychopathic personality as 186.12 defined in section 253B.02, subdivision 18a, or a sexually 186.13 dangerous person as defined in section 253B.02, subdivision 18b, 186.14 is excluded from enrollment in the demonstration project. 186.15 Sec. 41. Minnesota Statutes 1997 Supplement, section 186.16 256B.77, subdivision 10, is amended to read: 186.17 Subd. 10. [CAPITATION PAYMENT.] (a) The commissioner shall 186.18 pay a capitation payment to the county authority and, when 186.19 applicable under subdivision 6, paragraph (a), to the service 186.20 delivery organization for each medical assistance eligible 186.21 enrollee. The commissioner shall develop capitation payment 186.22 rates for the initial contract period for each demonstration 186.23 site in consultation with an independent actuary, to ensure that 186.24 the cost of services under the demonstration project does not 186.25 exceed the estimated cost for medical assistance services for 186.26 the covered population under the fee-for-service system for the 186.27 demonstration period. For each year of the demonstration 186.28 project, the capitation payment rate shall be based on 96 186.29 percent of the projected per person costs that would otherwise 186.30 have been paid under medical assistance fee-for-service during 186.31 each of those years. Rates shall be adjusted within the limits 186.32 of the available risk adjustment technology, as mandated by 186.33 section 62Q.03. In addition, the commissioner shall implement 186.34 appropriate risk and savings sharing provisions with county 186.35 administrative entities and, when applicable under subdivision 186.36 6, paragraph (a), service delivery organizations within the 187.1 projected budget limits. Capitation rates shall be adjusted at 187.2 least annually to include any rate increases and payments for 187.3 expanded or newly covered services for eligible individuals. 187.4 The initial demonstration project rate shall include an amount 187.5 in addition to the fee for service payments to adjust for 187.6 underutilization of dental services. Any savings beyond those 187.7 allowed for the county authority, county administrative entity, 187.8 or service delivery organization shall be first used to meet the 187.9 unmet needs of eligible individuals. Payments to providers 187.10 participating in the project are exempt from the requirements of 187.11 sections 256.966 and 256B.03, subdivision 2. 187.12 (b) The commissioner shall monitor and evaluate annually 187.13 the effect of the discount on consumers, the county authority, 187.14 and providers of disability services. Findings shall be 187.15 reported and recommendations made, as appropriate, to ensure 187.16 that the discount effect does not adversely affect the ability 187.17 of the county administrative entity or providers of services to 187.18 provide appropriate services to eligible individuals, and does 187.19 not result in cost shifting of eligible individuals to the 187.20 county authority. 187.21 Sec. 42. Minnesota Statutes 1997 Supplement, section 187.22 256B.77, subdivision 12, is amended to read: 187.23 Subd. 12. [SERVICE COORDINATION.] (a) For purposes of this 187.24 section, "service coordinator" means an individual selected by 187.25 the enrollee or the enrollee's legal representative and 187.26 authorized by the county administrative entity or service 187.27 delivery organization to work in partnership with the enrollee 187.28 to develop, coordinate, and in some instances, provide supports 187.29 and services identified in the personal support plan. Service 187.30 coordinators may only provide services and supports if the 187.31 enrollee is informed of potential conflicts of interest, is 187.32 given alternatives, and gives informed consent. Eligible 187.33 service coordinators are individuals age 18 or older who meet 187.34 the qualifications as described in paragraph (b). Enrollees, 187.35 their legal representatives, or their advocates are eligible to 187.36 be service coordinators if they have the capabilities to perform 188.1 the activities and functions outlined in paragraph (b). 188.2 Providers licensed under chapter 245A to provide residential 188.3 services, or providers who are providing residential services 188.4 covered under the group residential housing program may not act 188.5 as service coordinator for enrollees for whom they provide 188.6 residential services. This does not apply to providers of 188.7 short-term detoxification services. Each county administrative 188.8 entity or service delivery organization may develop further 188.9 criteria for eligible vendors of service coordination during the 188.10 demonstration period and shall determine whom it contracts with 188.11 or employs to provide service coordination. County 188.12 administrative entities and service delivery organizations may 188.13 pay enrollees or their advocates or legal representatives for 188.14 service coordination activities. 188.15 (b) The service coordinator shall act as a facilitator, 188.16 working in partnership with the enrollee to ensure that their 188.17 needs are identified and addressed. The level of involvement of 188.18 the service coordinator shall depend on the needs and desires of 188.19 the enrollee. The service coordinator shall have the knowledge, 188.20 skills, and abilities to, and is responsible for: 188.21 (1) arranging for an initial assessment, and periodic 188.22 reassessment as necessary, of supports and services based on the 188.23 enrollee's strengths, needs, choices, and preferences in life 188.24 domain areas; 188.25 (2) developing and updating the personal support plan based 188.26 on relevant ongoing assessment; 188.27 (3) arranging for and coordinating the provisions of 188.28 supports and services, including knowledgeable and skilled 188.29 specialty services and prevention and early intervention 188.30 services, within the limitations negotiated with the county 188.31 administrative entity or service delivery organization; 188.32 (4) assisting the enrollee and the enrollee's legal 188.33 representative, if any, to maximize informed choice of and 188.34 control over services and supports and to exercise the 188.35 enrollee's rights and advocate on behalf of the enrollee; 188.36 (5) monitoring the progress toward achieving the enrollee's 189.1 outcomes in order to evaluate and adjust the timeliness and 189.2 adequacy of the implementation of the personal support plan; 189.3 (6) facilitating meetings and effectively collaborating 189.4 with a variety of agencies and persons, including attending 189.5 individual family service plan and individual education plan 189.6 meetings when requested by the enrollee or the enrollee's legal 189.7 representative; 189.8 (7) soliciting and analyzing relevant information; 189.9 (8) communicating effectively with the enrollee and with 189.10 other individuals participating in the enrollee's plan; 189.11 (9) educating and communicating effectively with the 189.12 enrollee about good health care practices and risk to the 189.13 enrollee's health with certain behaviors; 189.14 (10) having knowledge of basic enrollee protection 189.15 requirements, including data privacy; 189.16 (11) informing, educating, and assisting the enrollee in 189.17 identifying available service providers and accessing needed 189.18 resources and services beyond the limitations of the medical 189.19 assistance benefit set covered services; and 189.20 (12) providing other services as identified in the personal 189.21 support plan. 189.22 (c) For the demonstration project, the qualifications and 189.23 standards for service coordination in this section shall replace 189.24 comparable existing provisions of existing statutes and rules 189.25 governing case management for eligible individuals. 189.26 (d) The provisions of this subdivision apply only to the 189.27 demonstration sitesthat begin implementation on July 1, 1998189.28 designated by the commissioner under subdivision 5. 189.29 All other demonstration sites must comply with laws and 189.30 rules governing case management services for eligible 189.31 individuals in effect when the site begins the demonstration 189.32 project. 189.33 Sec. 43. Minnesota Statutes 1997 Supplement, section 189.34 256D.03, subdivision 3, is amended to read: 189.35 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 189.36 (a) General assistance medical care may be paid for any person 190.1 who is not eligible for medical assistance under chapter 256B, 190.2 including eligibility for medical assistance based on a 190.3 spenddown of excess income according to section 256B.056, 190.4 subdivision 5, or MinnesotaCare as defined in clause(4)(5), 190.5 except as provided in paragraph (b); and: 190.6 (1) who is receiving assistance under section 256D.05, 190.7 except for families with children who are eligible under 190.8 Minnesota family investment program-statewide (MFIP-S), who is 190.9 having a payment made on the person's behalf under sections 190.10 256I.01 to 256I.06, or who resides in group residential housing 190.11 as defined in chapter 256I and can meet a spenddown using the 190.12 cost of remedial services received through group residential 190.13 housing; or 190.14 (2)(i) who is a resident of Minnesota; and whose equity in 190.15 assets is not in excess of $1,000 per assistance unit. Exempt 190.16 assets, the reduction of excess assets, and the waiver of excess 190.17 assets must conform to the medical assistance program in chapter 190.18 256B, with the following exception: the maximum amount of 190.19 undistributed funds in a trust that could be distributed to or 190.20 on behalf of the beneficiary by the trustee, assuming the full 190.21 exercise of the trustee's discretion under the terms of the 190.22 trust, must be applied toward the asset maximum; and 190.23 (ii) who has countable income not in excess of the 190.24 assistance standards established in section 256B.056, 190.25 subdivision 4, or whose excess income is spent down according to 190.26 section 256B.056, subdivision 5, using a six-month budget 190.27 period. The method for calculating earned income disregards and 190.28 deductions for a person who resides with a dependent child under 190.29 age 21 shall follow section 256B.056, subdivision 1a. However, 190.30 if a disregard of $30 and one-third of the remainder has been 190.31 applied to the wage earner's income, the disregard shall not be 190.32 applied again until the wage earner's income has not been 190.33 considered in an eligibility determination for general 190.34 assistance, general assistance medical care, medical assistance, 190.35 or MFIP-S for 12 consecutive months. The earned income and work 190.36 expense deductions for a person who does not reside with a 191.1 dependent child under age 21 shall be the same as the method 191.2 used to determine eligibility for a person under section 191.3 256D.06, subdivision 1, except the disregard of the first $50 of 191.4 earned income is not allowed;or191.5 (3) who would be eligible for medical assistance except 191.6 that the person resides in a facility that is determined by the 191.7 commissioner or the federal Health Care Financing Administration 191.8 to be an institution for mental diseases; or 191.9 (4) who is receiving care and rehabilitation services from 191.10 a nonprofit center established to serve victims of torture. 191.11 These individuals are eligible for general assistance medical 191.12 care only for the period during which they are receiving 191.13 services from the center. During this period of eligibility, 191.14 individuals eligible under this clause shall not be required to 191.15 participate in prepaid general assistance medical care. 191.16(4)(5) Beginning July 1, 1998, applicants or recipients 191.17 who meet all eligibility requirements of MinnesotaCare as 191.18 defined in sections 256L.01 to 256L.16, and are: 191.19 (i) adults with dependent children under 21 whose gross 191.20 family income is equal to or less than 275 percent of the 191.21 federal poverty guidelines; or 191.22 (ii) adults without children with earned income and whose 191.23 family gross income is between 75 percent of the federal poverty 191.24 guidelines and the amount set by section 256L.04, subdivision 7, 191.25 shall be terminated from general assistance medical care upon 191.26 enrollment in MinnesotaCare. 191.27 (b) For services rendered on or after July 1, 1997, 191.28 eligibility is limited to one month prior to application if the 191.29 person is determined eligible in the prior month. A 191.30 redetermination of eligibility must occur every 12 months. 191.31 Beginning July 1, 1998, Minnesota health care program 191.32 applications completed by recipients and applicants who are 191.33 persons described in paragraph (a), clause(4)(5), may be 191.34 returned to the county agency to be forwarded to the department 191.35 of human services or sent directly to the department of human 191.36 services for enrollment in MinnesotaCare. If all other 192.1 eligibility requirements of this subdivision are met, 192.2 eligibility for general assistance medical care shall be 192.3 available in any month during which a MinnesotaCare eligibility 192.4 determination and enrollment are pending. Upon notification of 192.5 eligibility for MinnesotaCare, notice of termination for 192.6 eligibility for general assistance medical care shall be sent to 192.7 an applicant or recipient. If all other eligibility 192.8 requirements of this subdivision are met, eligibility for 192.9 general assistance medical care shall be available until 192.10 enrollment in MinnesotaCare subject to the provisions of 192.11 paragraph (d). 192.12 (c) The date of an initial Minnesota health care program 192.13 application necessary to begin a determination of eligibility 192.14 shall be the date the applicant has provided a name, address, 192.15 and social security number, signed and dated, to the county 192.16 agency or the department of human services. If the applicant is 192.17 unable to provide an initial application when health care is 192.18 delivered due to a medical condition or disability, a health 192.19 care provider may act on the person's behalf to complete the 192.20 initial application. The applicant must complete the remainder 192.21 of the application and provide necessary verification before 192.22 eligibility can be determined. The county agency must assist 192.23 the applicant in obtaining verification if necessary. 192.24 (d) County agencies are authorized to use all automated 192.25 databases containing information regarding recipients' or 192.26 applicants' income in order to determine eligibility for general 192.27 assistance medical care or MinnesotaCare. Such use shall be 192.28 considered sufficient in order to determine eligibility and 192.29 premium payments by the county agency. 192.30 (e) General assistance medical care is not available for a 192.31 person in a correctional facility unless the person is detained 192.32 by law for less than one year in a county correctional or 192.33 detention facility as a person accused or convicted of a crime, 192.34 or admitted as an inpatient to a hospital on a criminal hold 192.35 order, and the person is a recipient of general assistance 192.36 medical care at the time the person is detained by law or 193.1 admitted on a criminal hold order and as long as the person 193.2 continues to meet other eligibility requirements of this 193.3 subdivision. 193.4 (f) General assistance medical care is not available for 193.5 applicants or recipients who do not cooperate with the county 193.6 agency to meet the requirements of medical assistance. General 193.7 assistance medical care is limited to payment of emergency 193.8 services only for applicants or recipients as described in 193.9 paragraph (a), clause(4)(5), whose MinnesotaCare coverage is 193.10 denied or terminated for nonpayment of premiums as required by 193.11 sections 256L.06 to 256L.08. 193.12 (g) In determining the amount of assets of an individual, 193.13 there shall be included any asset or interest in an asset, 193.14 including an asset excluded under paragraph (a), that was given 193.15 away, sold, or disposed of for less than fair market value 193.16 within the 60 months preceding application for general 193.17 assistance medical care or during the period of eligibility. 193.18 Any transfer described in this paragraph shall be presumed to 193.19 have been for the purpose of establishing eligibility for 193.20 general assistance medical care, unless the individual furnishes 193.21 convincing evidence to establish that the transaction was 193.22 exclusively for another purpose. For purposes of this 193.23 paragraph, the value of the asset or interest shall be the fair 193.24 market value at the time it was given away, sold, or disposed 193.25 of, less the amount of compensation received. For any 193.26 uncompensated transfer, the number of months of ineligibility, 193.27 including partial months, shall be calculated by dividing the 193.28 uncompensated transfer amount by the average monthly per person 193.29 payment made by the medical assistance program to skilled 193.30 nursing facilities for the previous calendar year. The 193.31 individual shall remain ineligible until this fixed period has 193.32 expired. The period of ineligibility may exceed 30 months, and 193.33 a reapplication for benefits after 30 months from the date of 193.34 the transfer shall not result in eligibility unless and until 193.35 the period of ineligibility has expired. The period of 193.36 ineligibility begins in the month the transfer was reported to 194.1 the county agency, or if the transfer was not reported, the 194.2 month in which the county agency discovered the transfer, 194.3 whichever comes first. For applicants, the period of 194.4 ineligibility begins on the date of the first approved 194.5 application. 194.6 (h) When determining eligibility for any state benefits 194.7 under this subdivision, the income and resources of all 194.8 noncitizens shall be deemed to include their sponsor's income 194.9 and resources as defined in the Personal Responsibility and Work 194.10 Opportunity Reconciliation Act of 1996, title IV, Public Law 194.11 Number 104-193, sections 421 and 422, and subsequently set out 194.12 in federal rules. 194.13 (i)(1) An undocumented noncitizen or a nonimmigrant is 194.14 ineligible for general assistance medical care other than 194.15 emergency services. For purposes of this subdivision, a 194.16 nonimmigrant is an individual in one or more of the classes 194.17 listed in United States Code, title 8, section 1101(a)(15), and 194.18 an undocumented noncitizen is an individual who resides in the 194.19 United States without the approval or acquiescence of the 194.20 Immigration and Naturalization Service. 194.21(j)(2) This paragraph does not apply to a child under age 194.22 18, to a Cuban or Haitian entrant as defined in Public Law 194.23 Number 96-422, section 501(e)(1) or (2)(a), or to a noncitizen 194.24 who is aged, blind, or disabled as defined in Code of Federal 194.25 Regulations, title 42, sections 435.520, 435.530, 435.531, 194.26 435.540, and 435.541, or to an individual eligible for general 194.27 assistance medical care under paragraph (a), clause (4), who 194.28 cooperates with the Immigration and Naturalization Service to 194.29 pursue any applicable immigration status, including citizenship, 194.30 that would qualify the individual for medical assistance with 194.31 federal financial participation. 194.32(k)(3) For purposes ofparagraphs (f) and (i)this 194.33 paragraph, "emergency services" has the meaning given in Code of 194.34 Federal Regulations, title 42, section 440.255(b)(1), except 194.35 that it also means services rendered because of suspected or 194.36 actual pesticide poisoning. 195.1(l)(j) Notwithstanding any other provision of law, a 195.2 noncitizen who is ineligible for medical assistance due to the 195.3 deeming of a sponsor's income and resources, is ineligible for 195.4 general assistance medical care. 195.5 Sec. 44. Minnesota Statutes 1996, section 256D.03, 195.6 subdivision 4, is amended to read: 195.7 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 195.8 For a person who is eligible under subdivision 3, paragraph (a), 195.9 clause (3), general assistance medical care covers, except as 195.10 provided in paragraph (c): 195.11 (1) inpatient hospital services; 195.12 (2) outpatient hospital services; 195.13 (3) services provided by Medicare certified rehabilitation 195.14 agencies; 195.15 (4) prescription drugs and other products recommended 195.16 through the process established in section 256B.0625, 195.17 subdivision 13; 195.18 (5) equipment necessary to administer insulin and 195.19 diagnostic supplies and equipment for diabetics to monitor blood 195.20 sugar level; 195.21 (6) eyeglasses and eye examinations provided by a physician 195.22 or optometrist; 195.23 (7) hearing aids; 195.24 (8) prosthetic devices; 195.25 (9) laboratory and X-ray services; 195.26 (10) physician's services; 195.27 (11) medical transportation; 195.28 (12) chiropractic services as covered under the medical 195.29 assistance program; 195.30 (13) podiatric services; 195.31 (14) dental services; 195.32 (15) outpatient services provided by a mental health center 195.33 or clinic that is under contract with the county board and is 195.34 established under section 245.62; 195.35 (16) day treatment services for mental illness provided 195.36 under contract with the county board; 196.1 (17) prescribed medications for persons who have been 196.2 diagnosed as mentally ill as necessary to prevent more 196.3 restrictive institutionalization; 196.4 (18)case management services for a person with serious and196.5persistent mental illness who would be eligible for medical196.6assistance except that the person resides in an institution for196.7mental diseases;196.8(19)psychological services, medical supplies and 196.9 equipment, and Medicare premiums, coinsurance and deductible 196.10 payments; 196.11(20)(19) medical equipment not specifically listed in this 196.12 paragraph when the use of the equipment will prevent the need 196.13 for costlier services that are reimbursable under this 196.14 subdivision; 196.15(21)(20) services performed by a certified pediatric nurse 196.16 practitioner, a certified family nurse practitioner, a certified 196.17 adult nurse practitioner, a certified obstetric/gynecological 196.18 nurse practitioner, or a certified geriatric nurse practitioner 196.19 in independent practice, if the services are otherwise covered 196.20 under this chapter as a physician service, and if the service is 196.21 within the scope of practice of the nurse practitioner's license 196.22 as a registered nurse, as defined in section 148.171; and 196.23(22)(21) services of a certified public health nurse or a 196.24 registered nurse practicing in a public health nursing clinic 196.25 that is a department of, or that operates under the direct 196.26 authority of, a unit of government, if the service is within the 196.27 scope of practice of the public health nurse's license as a 196.28 registered nurse, as defined in section 148.171. 196.29 (b) Except as provided in paragraph (c), for a recipient 196.30 who is eligible under subdivision 3, paragraph (a), clause (1) 196.31 or (2), general assistance medical care covers the services 196.32 listed in paragraph (a) with the exception of special 196.33 transportation services. 196.34 (c) Gender reassignment surgery and related services are 196.35 not covered services under this subdivision unless the 196.36 individual began receiving gender reassignment services prior to 197.1 July 1, 1995. 197.2 (d) In order to contain costs, the commissioner of human 197.3 services shall select vendors of medical care who can provide 197.4 the most economical care consistent with high medical standards 197.5 and shall where possible contract with organizations on a 197.6 prepaid capitation basis to provide these services. The 197.7 commissioner shall consider proposals by counties and vendors 197.8 for prepaid health plans, competitive bidding programs, block 197.9 grants, or other vendor payment mechanisms designed to provide 197.10 services in an economical manner or to control utilization, with 197.11 safeguards to ensure that necessary services are provided. 197.12 Before implementing prepaid programs in counties with a county 197.13 operated or affiliated public teaching hospital or a hospital or 197.14 clinic operated by the University of Minnesota, the commissioner 197.15 shall consider the risks the prepaid program creates for the 197.16 hospital and allow the county or hospital the opportunity to 197.17 participate in the program in a manner that reflects the risk of 197.18 adverse selection and the nature of the patients served by the 197.19 hospital, provided the terms of participation in the program are 197.20 competitive with the terms of other participants considering the 197.21 nature of the population served. Payment for services provided 197.22 pursuant to this subdivision shall be as provided to medical 197.23 assistance vendors of these services under sections 256B.02, 197.24 subdivision 8, and 256B.0625. For payments made during fiscal 197.25 year 1990 and later years, the commissioner shall consult with 197.26 an independent actuary in establishing prepayment rates, but 197.27 shall retain final control over the rate methodology. 197.28 Notwithstanding the provisions of subdivision 3, an individual 197.29 who becomes ineligible for general assistance medical care 197.30 because of failure to submit income reports or recertification 197.31 forms in a timely manner, shall remain enrolled in the prepaid 197.32 health plan and shall remain eligible for general assistance 197.33 medical care coverage through the last day of the month in which 197.34 the enrollee became ineligible for general assistance medical 197.35 care. 197.36 (e) The commissioner of human services may reduce payments 198.1 provided under sections 256D.01 to 256D.21 and 261.23 in order 198.2 to remain within the amount appropriated for general assistance 198.3 medical care, within the following restrictions.: 198.4 (i) For the period July 1, 1985 to December 31, 1985, 198.5 reductions below the cost per service unit allowable under 198.6 section 256.966, are permitted only as follows: payments for 198.7 inpatient and outpatient hospital care provided in response to a 198.8 primary diagnosis of chemical dependency or mental illness may 198.9 be reduced no more than 30 percent; payments for all other 198.10 inpatient hospital care may be reduced no more than 20 percent. 198.11 Reductions below the payments allowable under general assistance 198.12 medical care for the remaining general assistance medical care 198.13 services allowable under this subdivision may be reduced no more 198.14 than ten percent. 198.15 (ii) For the period January 1, 1986 to December 31, 1986, 198.16 reductions below the cost per service unit allowable under 198.17 section 256.966 are permitted only as follows: payments for 198.18 inpatient and outpatient hospital care provided in response to a 198.19 primary diagnosis of chemical dependency or mental illness may 198.20 be reduced no more than 20 percent; payments for all other 198.21 inpatient hospital care may be reduced no more than 15 percent. 198.22 Reductions below the payments allowable under general assistance 198.23 medical care for the remaining general assistance medical care 198.24 services allowable under this subdivision may be reduced no more 198.25 than five percent. 198.26 (iii) For the period January 1, 1987 to June 30, 1987, 198.27 reductions below the cost per service unit allowable under 198.28 section 256.966 are permitted only as follows: payments for 198.29 inpatient and outpatient hospital care provided in response to a 198.30 primary diagnosis of chemical dependency or mental illness may 198.31 be reduced no more than 15 percent; payments for all other 198.32 inpatient hospital care may be reduced no more than ten 198.33 percent. Reductions below the payments allowable under medical 198.34 assistance for the remaining general assistance medical care 198.35 services allowable under this subdivision may be reduced no more 198.36 than five percent. 199.1 (iv) For the period July 1, 1987 to June 30, 1988, 199.2 reductions below the cost per service unit allowable under 199.3 section 256.966 are permitted only as follows: payments for 199.4 inpatient and outpatient hospital care provided in response to a 199.5 primary diagnosis of chemical dependency or mental illness may 199.6 be reduced no more than 15 percent; payments for all other 199.7 inpatient hospital care may be reduced no more than five percent. 199.8 Reductions below the payments allowable under medical assistance 199.9 for the remaining general assistance medical care services 199.10 allowable under this subdivision may be reduced no more than 199.11 five percent. 199.12 (v) For the period July 1, 1988 to June 30, 1989, 199.13 reductions below the cost per service unit allowable under 199.14 section 256.966 are permitted only as follows: payments for 199.15 inpatient and outpatient hospital care provided in response to a 199.16 primary diagnosis of chemical dependency or mental illness may 199.17 be reduced no more than 15 percent; payments for all other 199.18 inpatient hospital care may not be reduced. Reductions below 199.19 the payments allowable under medical assistance for the 199.20 remaining general assistance medical care services allowable 199.21 under this subdivision may be reduced no more than five percent. 199.22 (f) There shall be no copayment required of any recipient 199.23 of benefits for any services provided under this subdivision. A 199.24 hospital receiving a reduced payment as a result of this section 199.25 may apply the unpaid balance toward satisfaction of the 199.26 hospital's bad debts. 199.27(f)(g) Any county may, from its own resources, provide 199.28 medical payments for which state payments are not made. 199.29(g)(h) Chemical dependency services that are reimbursed 199.30 under chapter 254B must not be reimbursed under general 199.31 assistance medical care. 199.32(h)(i) The maximum payment for new vendors enrolled in the 199.33 general assistance medical care program after the base year 199.34 shall be determined from the average usual and customary charge 199.35 of the same vendor type enrolled in the base year. 199.36(i)(j) The conditions of payment for services under this 200.1 subdivision are the same as the conditions specified in rules 200.2 adopted under chapter 256B governing the medical assistance 200.3 program, unless otherwise provided by statute or rule. 200.4 Sec. 45. Minnesota Statutes 1996, section 256D.03, is 200.5 amended by adding a subdivision to read: 200.6 Subd. 9. [PAYMENT FOR AMBULANCE SERVICES.] Effective July 200.7 1, 1999, general assistance medical care payments for ambulance 200.8 services shall be increased by ten percent. 200.9 Sec. 46. Minnesota Statutes 1997 Supplement, section 200.10 256L.07, subdivision 2, is amended to read: 200.11 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 200.12 COVERAGE.] (a) To be eligible for subsidized premium payments 200.13 based on a sliding scale, a family or individual must not have 200.14 access to subsidized health coverage through an employer, and 200.15 must not have had access to subsidized health coverage through 200.16 an employer for the 18 months prior to application for 200.17 subsidized coverage under the MinnesotaCare program. The 200.18 requirement that the family or individual must not have had 200.19 access to employer-subsidized coverage during the previous 18 200.20 months does not apply if: (1) employer-subsidized coverage was 200.21 lost due to the death of an employee or divorce; (2) 200.22 employer-subsidized coverage was lost because an individual 200.23 became ineligible for coverage as a child or dependent; or (3) 200.24 employer-subsidized coverage was lost for reasons that would not 200.25 disqualify the individual for unemployment benefits under 200.26 section 268.09 and the family or individual has not had access 200.27 to employer-subsidized coverage since the loss of coverage. If 200.28 employer-subsidized coverage was lost for reasons that 200.29 disqualify an individual for unemployment benefits under section 200.30 268.09, children of that individual are exempt from the 200.31 requirement of no access to employer subsidized coverage for the 200.32 18 months prior to application, as long as the children have not 200.33 had access to employer subsidized coverage since the 200.34 disqualifying event. The requirement that the family or 200.35 individual must not have had access to employer-subsidized 200.36 coverage during the previous 18 months does apply if 201.1 employer-subsidized coverage is lost due to an employer 201.2 terminating health care coverage as an employee benefit, unless 201.3 that coverage was provided under section 256M.03. 201.4 (b) For purposes of this requirement, subsidized health 201.5 coverage means health coverage for which the employer pays at 201.6 least 50 percent of the cost of coverage for the employee, 201.7 excluding dependent coverage, or a higher percentage as 201.8 specified by the commissioner. Children are eligible for 201.9 employer-subsidized coverage through either parent, including 201.10 the noncustodial parent. The commissioner must treat employer 201.11 contributions to Internal Revenue Code Section 125 plans as 201.12 qualified employer subsidies toward the cost of health coverage 201.13 for employees for purposes of this subdivision. 201.14 Sec. 47. Minnesota Statutes 1997 Supplement, section 201.15 256L.07, subdivision 3, is amended to read: 201.16 Subd. 3. [PERIOD UNINSURED.] To be eligible for subsidized 201.17 premium payments based on a sliding scale, families and 201.18 individuals initially enrolled in the MinnesotaCare program 201.19 under section 256L.04, subdivisions 5 and 7, must have had no 201.20 health coverage for at least four months prior to application. 201.21 The commissioner may change this eligibility criterion for 201.22 sliding scale premiums in order to remain within the limits of 201.23 available appropriations. The requirement of at least four 201.24 months of no health coverage prior to application for the 201.25 MinnesotaCare program does not apply to: 201.26 (1) families, children, and individuals who apply for the 201.27 MinnesotaCare program upon termination from or as required by 201.28 the medical assistance program, general assistance medical care 201.29 program, or coverage under a regional demonstration project for 201.30 the uninsured funded under section 256B.73, the Hennepin county 201.31 assured care program, or the Group Health, Inc., community 201.32 health plan; 201.33 (2) families and individuals initially enrolled under 201.34 section 256L.04, subdivisions 1, paragraph (a), and 3; 201.35 (3) children enrolled pursuant to Laws 1992, chapter 549, 201.36 article 4, section 17;or202.1 (4) individuals currently serving or who have served in the 202.2 military reserves, and dependents of these individuals, if these 202.3 individuals: (i) reapply for MinnesotaCare coverage after a 202.4 period of active military service during which they had been 202.5 covered by the Civilian Health and Medical Program of the 202.6 Uniformed Services (CHAMPUS); (ii) were covered under 202.7 MinnesotaCare immediately prior to obtaining coverage under 202.8 CHAMPUS; and (iii) have maintained continuous coverage; or 202.9 (5) children who lose coverage under section 256M.03 due to 202.10 an employer terminating health coverage as an employee benefit 202.11 or due to an employee layoff. 202.12 Sec. 48. [256M.01] [DEFINITIONS.] 202.13 Subdivision 1. [APPLICABILITY.] For purposes of this 202.14 chapter, the terms defined in this section have the meanings 202.15 given. 202.16 Subd. 2. [COMMISSIONER.] "Commissioner" means the 202.17 commissioner of human services. 202.18 Subd. 3. [EMPLOYER-SUBSIDIZED 202.19 INSURANCE.] "Employer-subsidized insurance" has the meaning 202.20 provided in section 256L.07, subdivision 2. 202.21 Sec. 49. [256M.03] [COVERAGE OF CHILDREN INELIGIBLE FOR 202.22 MINNESOTACARE.] 202.23 Subdivision 1. [PAYMENTS FOR EMPLOYER-SUBSIDIZED 202.24 COVERAGE.] A child who would otherwise be eligible for coverage 202.25 under MinnesotaCare, except for the availability of 202.26 employer-subsidized coverage, is eligible for payment of the 202.27 employee share of employer-subsidized coverage for the child 202.28 under the state children's health insurance program established 202.29 in title 21 of the Social Security Act, according to the sliding 202.30 scale in subdivision 2. In order to be eligible under this 202.31 subdivision, a child must not have employer-subsidized coverage 202.32 at the time of application for payment, and the 202.33 employer-subsidized coverage must qualify as benchmark coverage 202.34 or benchmark equivalent coverage under title 21 of the Social 202.35 Security Act, section 2103. Payments shall be made directly to 202.36 the employer providing employer-subsidized insurance. 203.1 Subd. 2. [SLIDING SCALE PAYMENTS.] Upon federal approval 203.2 of the plan, the commissioner shall pay the difference of the 203.3 MinnesotaCare sliding premium scale as specified in Minnesota 203.4 Statutes, section 256L.08, up to a maximum of five percent of 203.5 the qualifying family's income and the employee share of the 203.6 coverage. 203.7 Subd. 3. [LIMITATION.] The availability of payments under 203.8 this section is subject to the limits of available 203.9 appropriations. The commissioner may set limits on the number 203.10 of children receiving payments under this section, or modify 203.11 payment levels, in order to remain within the limits of 203.12 appropriations. 203.13 Subd. 4. [ADVISORY TASK FORCE.] The commissioner shall 203.14 convene an advisory task force comprised of representatives of 203.15 small businesses, health plan companies, and insurance agents in 203.16 order to develop a plan to implement this section. 203.17 Sec. 50. [256M.05] [MAINTENANCE OF EMPLOYER SUBSIDY.] 203.18 Employers providing employer-subsidized coverage to 203.19 employees who receive payments on behalf of an employee eligible 203.20 under section 256M.03, subdivision 1, shall maintain at least 203.21 the same percentage level of subsidy for employee and family 203.22 coverage that was in place on July 1, 1998, for a period of one 203.23 year following receipt of the initial payment for an eligible 203.24 employee. After the initial year, an employer may not decrease 203.25 the percentage level of subsidy to employee and family coverage 203.26 by more than five percentage points. 203.27 Sec. 51. Laws 1997, chapter 195, section 5, is amended to 203.28 read: 203.29 Sec. 5. [PERSONAL CARE ASSISTANT PROVIDERS.] 203.30 The commissioner of health shall create a unique category 203.31 of licensure as appropriate for providers offering, providing, 203.32 or arranging personal care assistant services to more than one 203.33 individual. The commissioner shall work with the department of 203.34 human services, providers, consumers, and advocates in 203.35 developing the licensure standards. The licensure standards 203.36 must include requirements for providers to provide consumers 204.1 advance written notice of service termination, a service 204.2 transition plan, and an appeal process. If the commissioner 204.3 determines there are costs related to rulemaking under this 204.4 section, the commissioner shall include a budget request for 204.5 this item in the 2000-2001 biennial budget. Prior to 204.6 promulgating the rule, the commissioner shall submit the 204.7 proposed rule to the legislature by January 15, 1999. 204.8 Sec. 52. Laws 1997, chapter 203, article 4, section 64, is 204.9 amended to read: 204.10 Sec. 64. [STUDY OF ELDERLY WAIVER EXPANSION.] 204.11 The commissioner of human services shall appoint a task 204.12 force that includes representatives of counties, health plans, 204.13 consumers, and legislators to study the impact of the expansion 204.14 of the elderly waiver program under section 4 and to make 204.15 recommendations for any changes in law necessary to facilitate 204.16 an efficient and equitable relationship between the elderly 204.17 waiver program and the Minnesota senior health options project. 204.18 Based on the results of the task force study, the commissioner 204.19 may seek any federal waivers needed to improve the relationship 204.20 between the elderly waiver and the Minnesota senior health 204.21 options project. The commissioner shall report the results of 204.22 the task force study to the legislature byJanuary 15, 1998July 204.23 1, 2000. 204.24 Sec. 53. Laws 1997, chapter 225, article 2, section 64, is 204.25 amended to read: 204.26 Sec. 64. [EFFECTIVE DATE.] 204.27 Section 8 is effective for payments made for MinnesotaCare 204.28 services on or after July 1, 1996. Section 23 is effective the 204.29 day following final enactment. Section 46 is effective January 204.30 1, 1998, and applies to high deductible health plans issued or 204.31 renewed on or after that date. 204.32 Sec. 54. [SUBMITTAL OF PLAN TO ACCESS STATE CHILDREN'S 204.33 HEALTH INSURANCE FUNDING.] 204.34 The commissioner of human services shall submit a plan to 204.35 implement Minnesota Statutes, sections 256M.01 to 256M.05, to 204.36 the secretary of health and human services, in order to obtain 205.1 funding through the state children's health insurance program 205.2 established in title 21 of the Social Security Act. The 205.3 commissioner shall also request a waiver to purchase family 205.4 coverage as specified in title 21 of the Social Security Act, 205.5 section 2105(c)(3). Upon approval of the waiver, the 205.6 commissioner shall expand the definition of those eligible for 205.7 coverage under Minnesota Statutes, section 256M.03, to include 205.8 all adults eligible for coverage under the employee's policy. 205.9 Sec. 55. [OFFSET OF HMO SURCHARGE.] 205.10 Beginning October 1, 1998, and ending December 31, 1998, 205.11 the commissioner of human services shall offset monthly charges 205.12 for the health maintenance organization surcharge by the monthly 205.13 amount the health maintenance organization overpaid from August 205.14 1, 1997, to September 30, 1998, due to taxation of Medicare 205.15 revenues prohibited by section 256.9657, subdivision 3. 205.16 Sec. 56. [MR/RC WAIVER PROPOSAL.] 205.17 By November 15, 1998, the commissioner of human services 205.18 shall provide to the chairs of the house health and human 205.19 services finance division and the senate health and family 205.20 security finance division a detailed budget proposal for 205.21 providing services under the home and community-based waiver for 205.22 persons with mental retardation or related conditions to those 205.23 individuals who are screened and waiting for services. 205.24 Sec. 57. [COVERAGE OF REHABILITATIVE AND THERAPEUTIC 205.25 SERVICES.] 205.26 (a) The threshold limits for fee-for-service medical 205.27 assistance rehabilitative and therapeutic services for January 205.28 1, 1998 through June 30, 1999, shall be the limits prescribed in 205.29 the department of human services health care programs provider 205.30 manual for calendar year 1997. Rehabilitative and therapeutic 205.31 services are: occupational therapy services provided to medical 205.32 assistance recipients pursuant to Minnesota Statutes, section 205.33 256B.0625, subdivision 8; physical therapy services provided to 205.34 medical assistance recipients pursuant to Minnesota Statutes, 205.35 section 256B.0625, subdivision 8a; and speech language pathology 205.36 services provided to medical assistance recipients pursuant to 206.1 Minnesota Rules, part 9505.0390. 206.2 (b) The commissioner of human services, in consultation 206.3 with the department of human services rehabilitative work group, 206.4 shall report to the chair of the senate health and family 206.5 security committee and the chair of the house health and human 206.6 services committee by January 15, 1999, recommendations and 206.7 proposed legislation for the appropriate level of rehabilitative 206.8 services delivered to medical assistance recipients before prior 206.9 authorization. The recommendations shall also include proposed 206.10 legislation to clarify the rehabilitative and therapeutic 206.11 benefit set for medical assistance, as well as the appropriate 206.12 response time for requests for prior authorization. 206.13 Sec. 58. [DISPROPORTIONATE SHARE ADJUSTMENT FOR DENTAL 206.14 SERVICES.] 206.15 The commissioner of human services shall develop a 206.16 disproportionate share adjustment for dental services provided 206.17 under the medical assistance, general assistance medical care, 206.18 and MinnesotaCare programs. The adjustment must provide 206.19 progressive increases above current fee-for-service rates for 206.20 dental providers whose medical assistance, general assistance 206.21 medical care, and MinnesotaCare caseloads in total comprise more 206.22 than specified percentages of their total caseloads. The 206.23 disproportionate share adjustment must also apply to managed 206.24 care capitation rates. 206.25 The commissioner shall present recommendations and proposed 206.26 legislation for a disproportionate share adjustment to the 206.27 legislature by December 15, 1998. 206.28 Sec. 59. [REPORT ON COUNTY ALLOCATIONS.] 206.29 Beginning August 1, 1998, the commissioner of human 206.30 services shall issue an annual report on the home and 206.31 community-based waiver for persons with mental retardation or a 206.32 related condition, which includes a list of the counties in 206.33 which less than 95 percent of the allocation provided, excluding 206.34 the county waivered services reserve, has been committed for two 206.35 or more quarters during the previous state fiscal year. For 206.36 each listed county, the report shall include the amount of funds 207.1 allocated but not used, the number and ages of individuals 207.2 screened and waiting for services, the services needed, a 207.3 description of the technical assistance provided by the 207.4 commissioner to assist the county in jointly planning with other 207.5 counties in order to serve more persons, and additional actions 207.6 which will be taken to serve those screened and waiting for 207.7 services. 207.8 Sec. 60. [DENTAL ACCESS.] 207.9 The commissioner of human services shall make 207.10 recommendations to the legislature by February 1, 1999, on how 207.11 access to dental services for medical assistance, general 207.12 assistance medical care, and MinnesotaCare enrollees could be 207.13 expanded. In preparing the recommendations, the commissioner 207.14 shall consult with consumers, the board of dentistry, dental 207.15 providers, the dental hygiene association, consumer advocates, 207.16 legislators, and other affected parties. 207.17 Sec. 61. [REPORT BY UNIVERSITY OF MINNESOTA ACADEMIC 207.18 HEALTH CENTER.] 207.19 The University of Minnesota academic health center, after 207.20 consultation with the health care community and the medical 207.21 education and research cost (MERC) advisory committee, is 207.22 requested to report to the commissioner of health and the 207.23 legislative commission on health care access by January 15, 207.24 1999, on plans for the strategic direction and vision of the 207.25 academic health center. The report shall address plans for the 207.26 ongoing assessment of health provider workforce needs; plans for 207.27 the ongoing assessment of the educational needs of health 207.28 professionals and the implications for their education and 207.29 training programs; and plans for ongoing, meaningful input from 207.30 the health care community on health-related research and 207.31 education programs administered by the academic health center. 207.32 Sec. 62. [COUNTY BILLING BY CLINICS.] 207.33 Clinics that (1) serve the primary health care needs of 207.34 low-income population groups; (2) use a sliding fee scale based 207.35 on ability to pay and do not limit access to care because of 207.36 financial limitations of the client; and (3) are nonprofit under 208.1 Minnesota Statutes, chapter 317, or are federally qualified 208.2 health centers, shall be eligible for a special payment for 208.3 uncompensated care. The clinics may bill a county of residence 208.4 for services provided to a resident of that county provided: 208.5 (1) the patient is from a county other than that in which 208.6 the clinic resides; and 208.7 (2) the clinic has made a preliminary determination at the 208.8 delivery of service that the patient was indigent based on 208.9 current medical assistance guidelines. 208.10 Counties that are billed under this program shall pay 208.11 eligible clinics at the rates established under the medical 208.12 assistance program. If the county can establish eligibility for 208.13 medical assistance after the service has been delivered, the 208.14 state shall reimburse the county for any funds paid to the 208.15 eligible clinic. 208.16 Sec. 63. [RECOMMENDATIONS FOR RECYCLING PROGRAM.] 208.17 The commissioner of human services shall develop 208.18 recommendations for a recycling program for used augmentative 208.19 and alternative communications systems that would allow these 208.20 systems to be reissued and used for trials and short-term use, 208.21 when appropriate. The commissioner shall present 208.22 recommendations to the legislature by December 15, 1998. 208.23 Sec. 64. [REPEALER.] 208.24 Minnesota Statutes 1996, section 144.0721, subdivision 3a; 208.25 and Minnesota Statutes 1997 Supplement, sections 144.0721, 208.26 subdivision 3; and 256B.0913, subdivision 15, are repealed. 208.27 Sec. 65. [EFFECTIVE DATES.] 208.28 (a) Section 8 (256.9657, subdivision 3) is effective 208.29 retroactive to August 1, 1997. 208.30 (b) Sections 14 (256B.055, subdivision 7a) and 17 (256B.06, 208.31 subdivision 4) are effective retroactive to July 1, 1997. 208.32 (c) Sections 12 (256.969, subdivision 17), 19 (256B.0625, 208.33 subdivision 20), and 44 (256D.03, subdivision 4) are effective 208.34 January 1, 1999. 208.35 (d) Section 25 (256B.0645) is effective for changes in 208.36 eligibility that occur on or after July 1, 1998. 209.1 (e) Sections 5 (245.462, subdivision 8) and 36 (256B.69, 209.2 subdivision 25) are effective 30 days after final enactment. 209.3 (f) Section 24 (256B.0627, subdivision 8), related to 209.4 shared care, and section 57 (coverage of rehab.) are effective 209.5 the day following final enactment. 209.6 (g) Sections 18 and 45 (256B.0625, subdivision 17a, and 209.7 256D.03, subdivision 9) are effective July 1, 1999. 209.8 (h) Sections 46 to 50 (256L.07, subdivision 2; 256L.07, 209.9 subdivision 3; 256M.01; 256M.03; 256M.05) are effective only if 209.10 federal funding under the state children's health insurance 209.11 program is made available to the state and legislative approval 209.12 has been obtained. If the funding is made available and 209.13 legislative approval has been obtained, sections 46 to 50 are 209.14 effective on the date specified in the state plan. The 209.15 commissioner of human services shall publish a notice in the 209.16 State Register if federal funding is made available to implement 209.17 sections 46 to 50 and shall notify the revisor of statutes. 209.18 Section 54 (Submittal of plan) is effective the day following 209.19 final enactment. 209.20 ARTICLE 5 209.21 MINNESOTACARE 209.22 Section 1. Minnesota Statutes 1997 Supplement, section 209.23 60A.15, subdivision 1, is amended to read: 209.24 Subdivision 1. [DOMESTIC AND FOREIGN COMPANIES.] (a) On or 209.25 before April 1, June 1, and December 1 of each year, every 209.26 domestic and foreign company, including town and farmers' mutual 209.27 insurance companies, domestic mutual insurance companies, marine 209.28 insurance companies, health maintenance organizations, community 209.29 integrated service networks, and nonprofit health service plan 209.30 corporations, shall pay to the commissioner of revenue 209.31 installments equal to one-third of the insurer's total estimated 209.32 tax for the current year. Except as provided in paragraphs (d), 209.33 (e), (h), and (i), installments must be based on a sum equal to 209.34 two percent of the premiums described in paragraph (b). 209.35 (b) Installments under paragraph (a), (d), or (e) are 209.36 percentages of gross premiums less return premiums on all direct 210.1 business received by the insurer in this state, or by its agents 210.2 for it, in cash or otherwise, during such year. 210.3 (c) Failure of a company to make payments of at least 210.4 one-third of either (1) the total tax paid during the previous 210.5 calendar year or (2) 80 percent of the actual tax for the 210.6 current calendar year shall subject the company to the penalty 210.7 and interest provided in this section, unless the total tax for 210.8 the current tax year is $500 or less. 210.9 (d) For health maintenance organizations, nonprofit health 210.10 service plan corporations, and community integrated service 210.11 networks, the installments must be based on an amount determined 210.12 under paragraph (h) or (i). 210.13 (e) For purposes of computing installments for town and 210.14 farmers' mutual insurance companies and for mutual property 210.15 casualty companies with total assets on December 31, 1989, of 210.16 $1,600,000,000 or less, the following rates apply: 210.17 (1) for all life insurance, two percent; 210.18 (2) for town and farmers' mutual insurance companies and 210.19 for mutual property and casualty companies with total assets of 210.20 $5,000,000 or less, on all other coverages, one percent; and 210.21 (3) for mutual property and casualty companies with total 210.22 assets on December 31, 1989, of $1,600,000,000 or less, on all 210.23 other coverages, 1.26 percent. 210.24 (f) If the aggregate amount of premium tax payments under 210.25 this section and the fire marshal tax payments under section 210.26 299F.21 made during a calendar year is equal to or exceeds 210.27 $120,000, all tax payments in the subsequent calendar year must 210.28 be paid by means of a funds transfer as defined in section 210.29 336.4A-104, paragraph (a). The funds transfer payment date, as 210.30 defined in section 336.4A-401, must be on or before the date the 210.31 payment is due. If the date the payment is due is not a funds 210.32 transfer business day, as defined in section 336.4A-105, 210.33 paragraph (a), clause (4), the payment date must be on or before 210.34 the funds transfer business day next following the date the 210.35 payment is due. 210.36 (g) Premiums under medical assistance, general assistance 211.1 medical care, the MinnesotaCare program, and the Minnesota 211.2 comprehensive health insurance plan and all payments, revenues, 211.3 and reimbursements received from the federal government for 211.4 Medicare-related coverage as defined in section 62A.31, 211.5 subdivision 3, paragraph (e), are not subject to tax under this 211.6 section. 211.7 (h) For calendar years 1997, 1998, and 1999, the 211.8 installments for health maintenance organizations, community 211.9 integrated service networks, and nonprofit health service plan 211.10 corporations must be based on an amount equal to one percent of 211.11 premiums described under paragraph (b). Health maintenance 211.12 organizations, community integrated service networks, and 211.13 nonprofit health service plan corporations that have met the 211.14 cost containment goals established under section 62J.04 in the 211.15 individual and small employer market for calendar year 1996 are 211.16 exempt from payment of the tax imposed under this section for 211.17 premiums paid after March 30, 1997, and before April 1, 1998. 211.18 Health maintenance organizations, community integrated service 211.19 networks, and nonprofit health service plan corporations that 211.20 have met the cost containment goals established under section 211.21 62J.04 in the individual and small employer market for calendar 211.22 year 1997 are exempt from payment of the tax imposed under this 211.23 section for premiums paid after March 30, 1998, and before April 211.24 1, 1999. Health maintenance organizations, community integrated 211.25 service networks, and nonprofit health service plan corporations 211.26 that have met the cost containment goals established under 211.27 section 62J.04 in the individual and small employer market for 211.28 calendar year 1998 are exempt from payment of the tax imposed 211.29 under this section for premiums paid after March 30, 1999, and 211.30 before January 1, 2000. 211.31 (i) For calendar years after 1999, the commissioner of 211.32 finance shall determine the balance of the health care access 211.33 fund on September 1 of each year beginning September 1, 1999. 211.34 If the commissioner determines that there is no structural 211.35 deficit for the next fiscal year, no tax shall be imposed under 211.36 paragraph (d) for the following calendar year. If the 212.1 commissioner determines that there will be a structural deficit 212.2 in the fund for the following fiscal year, then the 212.3 commissioner, in consultation with the commissioner of revenue, 212.4 shall determine the amount needed to eliminate the structural 212.5 deficit and a tax shall be imposed under paragraph (d) for the 212.6 following calendar year. The commissioner shall determine the 212.7 rate of the tax as either one-quarter of one percent, one-half 212.8 of one percent, three-quarters of one percent, or one percent of 212.9 premiums described in paragraph (b), whichever is the lowest of 212.10 those rates that the commissioner determines will produce 212.11 sufficient revenue to eliminate the projected structural 212.12 deficit. The commissioner of finance shall publish in the State 212.13 Register by October 1 of each year the amount of tax to be 212.14 imposed for the following calendar year. 212.15 (j) In approving the premium rates as required in sections 212.16 62L.08, subdivision 8, and 62A.65, subdivision 3, the 212.17 commissioners of health and commerce shall ensure that any 212.18 exemption from the tax as described in paragraphs (h) and (i) is 212.19 reflected in the premium rate. 212.20 Sec. 2. Minnesota Statutes 1997 Supplement, section 212.21 256B.04, subdivision 18, is amended to read: 212.22 Subd. 18. [APPLICATIONS FOR MEDICAL ASSISTANCE.] The state 212.23 agency may take applications for medical assistance and conduct 212.24 eligibility determinations for MinnesotaCare enrolleeswho are212.25required to apply for medical assistance according to section212.26256L.03, subdivision 3, paragraph (b). 212.27 Sec. 3. Minnesota Statutes 1996, section 256B.057, is 212.28 amended by adding a subdivision to read: 212.29 Subd. 7. [WAIVER OF MAINTENANCE OF EFFORT REQUIREMENT.] 212.30 Unless a federal waiver of the maintenance of effort requirement 212.31 of section 2105(d) of title XXI of the Balanced Budget Act of 212.32 1997, Public Law Number 105-33, Statutes at Large, volume 111, 212.33 page 251, is granted by the federal Department of Health and 212.34 Human Services by September 30, 1998, eligibility for children 212.35 under age 21 must be determined without regard to asset 212.36 standards established in section 256B.056, subdivision 3. The 213.1 commissioner of human services shall publish a notice in the 213.2 State Register upon receipt of a federal waiver. 213.3 Sec. 4. Minnesota Statutes 1996, section 256B.057, is 213.4 amended by adding a subdivision to read: 213.5 Subd. 8. [CHILDREN UNDER AGE TWO.] Medical assistance may 213.6 be paid for a child under two years of age whose countable 213.7 family income is above 275 percent of the federal poverty 213.8 guidelines for the same size family but less than or equal to 213.9 280 percent of the federal poverty guidelines for the same size 213.10 family. 213.11 Sec. 5. Minnesota Statutes 1997 Supplement, section 213.12 256D.03, subdivision 3, is amended to read: 213.13 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 213.14 (a) General assistance medical care may be paid for any person 213.15 who is not eligible for medical assistance under chapter 256B, 213.16 including eligibility for medical assistance based on a 213.17 spenddown of excess income according to section 256B.056, 213.18 subdivision 5, or MinnesotaCare as defined in clause (4), except 213.19 as provided in paragraph (b); and: 213.20 (1) who is receiving assistance under section 256D.05, 213.21 except for families with children who are eligible under 213.22 Minnesota family investment program-statewide (MFIP-S), who is 213.23 having a payment made on the person's behalf under sections 213.24 256I.01 to 256I.06, or who resides in group residential housing 213.25 as defined in chapter 256I and can meet a spenddown using the 213.26 cost of remedial services received through group residential 213.27 housing; or 213.28 (2)(i) who is a resident of Minnesota; and whose equity in 213.29 assets is not in excess of $1,000 per assistance unit. Exempt 213.30 assets, the reduction of excess assets, and the waiver of excess 213.31 assets must conform to the medical assistance program in chapter 213.32 256B, with the following exception: the maximum amount of 213.33 undistributed funds in a trust that could be distributed to or 213.34 on behalf of the beneficiary by the trustee, assuming the full 213.35 exercise of the trustee's discretion under the terms of the 213.36 trust, must be applied toward the asset maximum; and 214.1 (ii) who has countable income not in excess of the 214.2 assistance standards established in section 256B.056, 214.3 subdivision 4, or whose excess income is spent down according to 214.4 section 256B.056, subdivision 5, using a six-month budget 214.5 period. The method for calculating earned income disregards and 214.6 deductions for a person who resides with a dependent child under 214.7 age 21 shall follow section 256B.056, subdivision 1a. However, 214.8 if a disregard of $30 and one-third of the remainder has been 214.9 applied to the wage earner's income, the disregard shall not be 214.10 applied again until the wage earner's income has not been 214.11 considered in an eligibility determination for general 214.12 assistance, general assistance medical care, medical assistance, 214.13 or MFIP-S for 12 consecutive months. The earned income and work 214.14 expense deductions for a person who does not reside with a 214.15 dependent child under age 21 shall be the same as the method 214.16 used to determine eligibility for a person under section 214.17 256D.06, subdivision 1, except the disregard of the first $50 of 214.18 earned income is not allowed; or 214.19 (3) who would be eligible for medical assistance except 214.20 that the person resides in a facility that is determined by the 214.21 commissioner or the federal Health Care Financing Administration 214.22 to be an institution for mental diseases. 214.23 (4) BeginningJuly 1, 1998January 1, 2000, applicants or 214.24 recipients who meet all eligibility requirements of 214.25 MinnesotaCare as defined in sections 256L.01 to 256L.16, and are: 214.26 (i) adults with dependent children under 21 whose gross 214.27 family income is equal to or less than 275 percent of the 214.28 federal poverty guidelines; or 214.29 (ii) adults without children with earned income and whose 214.30 family gross income is between 75 percent of the federal poverty 214.31 guidelines and the amount set by section 256L.04, subdivision 7, 214.32 shall be terminated from general assistance medical care upon 214.33 enrollment in MinnesotaCare. 214.34 (b) For services rendered on or after July 1, 1997, 214.35 eligibility is limited to one month prior to application if the 214.36 person is determined eligible in the prior month. A 215.1 redetermination of eligibility must occur every 12 months. 215.2 BeginningJuly 1, 1998January 1, 2000, Minnesota health care 215.3 program applications completed by recipients and applicants who 215.4 are persons described in paragraph (a), clause (4), may be 215.5 returned to the county agency to be forwarded to the department 215.6 of human services or sent directly to the department of human 215.7 services for enrollment in MinnesotaCare. If all other 215.8 eligibility requirements of this subdivision are met, 215.9 eligibility for general assistance medical care shall be 215.10 available in any month during which a MinnesotaCare eligibility 215.11 determination and enrollment are pending. Upon notification of 215.12 eligibility for MinnesotaCare, notice of termination for 215.13 eligibility for general assistance medical care shall be sent to 215.14 an applicant or recipient. If all other eligibility 215.15 requirements of this subdivision are met, eligibility for 215.16 general assistance medical care shall be available until 215.17 enrollment in MinnesotaCare subject to the provisions of 215.18 paragraph (d). 215.19 (c) The date of an initial Minnesota health care program 215.20 application necessary to begin a determination of eligibility 215.21 shall be the date the applicant has provided a name, address, 215.22 and social security number, signed and dated, to the county 215.23 agency or the department of human services. If the applicant is 215.24 unable to provide an initial application when health care is 215.25 delivered due to a medical condition or disability, a health 215.26 care provider may act on the person's behalf to complete the 215.27 initial application. The applicant must complete the remainder 215.28 of the application and provide necessary verification before 215.29 eligibility can be determined. The county agency must assist 215.30 the applicant in obtaining verification if necessary. 215.31 (d) County agencies are authorized to use all automated 215.32 databases containing information regarding recipients' or 215.33 applicants' income in order to determine eligibility for general 215.34 assistance medical care or MinnesotaCare. Such use shall be 215.35 considered sufficient in order to determine eligibility and 215.36 premium payments by the county agency. 216.1 (e) General assistance medical care is not available for a 216.2 person in a correctional facility unless the person is detained 216.3 by law for less than one year in a county correctional or 216.4 detention facility as a person accused or convicted of a crime, 216.5 or admitted as an inpatient to a hospital on a criminal hold 216.6 order, and the person is a recipient of general assistance 216.7 medical care at the time the person is detained by law or 216.8 admitted on a criminal hold order and as long as the person 216.9 continues to meet other eligibility requirements of this 216.10 subdivision. 216.11 (f) General assistance medical care is not available for 216.12 applicants or recipients who do not cooperate with the county 216.13 agency to meet the requirements of medical assistance. General 216.14 assistance medical care is limited to payment of emergency 216.15 services only for applicants or recipients as described in 216.16 paragraph (a), clause (4), whose MinnesotaCare coverage is 216.17 denied or terminated for nonpayment of premiums as required by 216.18 sections 256L.06to 256L.08and 256L.07. 216.19 (g) In determining the amount of assets of an individual, 216.20 there shall be included any asset or interest in an asset, 216.21 including an asset excluded under paragraph (a), that was given 216.22 away, sold, or disposed of for less than fair market value 216.23 within the 60 months preceding application for general 216.24 assistance medical care or during the period of eligibility. 216.25 Any transfer described in this paragraph shall be presumed to 216.26 have been for the purpose of establishing eligibility for 216.27 general assistance medical care, unless the individual furnishes 216.28 convincing evidence to establish that the transaction was 216.29 exclusively for another purpose. For purposes of this 216.30 paragraph, the value of the asset or interest shall be the fair 216.31 market value at the time it was given away, sold, or disposed 216.32 of, less the amount of compensation received. For any 216.33 uncompensated transfer, the number of months of ineligibility, 216.34 including partial months, shall be calculated by dividing the 216.35 uncompensated transfer amount by the average monthly per person 216.36 payment made by the medical assistance program to skilled 217.1 nursing facilities for the previous calendar year. The 217.2 individual shall remain ineligible until this fixed period has 217.3 expired. The period of ineligibility may exceed 30 months, and 217.4 a reapplication for benefits after 30 months from the date of 217.5 the transfer shall not result in eligibility unless and until 217.6 the period of ineligibility has expired. The period of 217.7 ineligibility begins in the month the transfer was reported to 217.8 the county agency, or if the transfer was not reported, the 217.9 month in which the county agency discovered the transfer, 217.10 whichever comes first. For applicants, the period of 217.11 ineligibility begins on the date of the first approved 217.12 application. 217.13 (h) When determining eligibility for any state benefits 217.14 under this subdivision, the income and resources of all 217.15 noncitizens shall be deemed to include their sponsor's income 217.16 and resources as defined in the Personal Responsibility and Work 217.17 Opportunity Reconciliation Act of 1996, title IV, Public Law 217.18 Number 104-193, sections 421 and 422, and subsequently set out 217.19 in federal rules. 217.20 (i) An undocumented noncitizen or a nonimmigrant is 217.21 ineligible for general assistance medical care other than 217.22 emergency services. For purposes of this subdivision, a 217.23 nonimmigrant is an individual in one or more of the classes 217.24 listed in United States Code, title 8, section 1101(a)(15), and 217.25 an undocumented noncitizen is an individual who resides in the 217.26 United States without the approval or acquiescence of the 217.27 Immigration and Naturalization Service. 217.28 (j) This paragraph does not apply to a child under age 18, 217.29 to a Cuban or Haitian entrant as defined in Public Law Number 217.30 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 217.31 aged, blind, or disabled as defined in Code of Federal 217.32 Regulations, title 42, sections 435.520, 435.530, 435.531, 217.33 435.540, and 435.541, who cooperates with the Immigration and 217.34 Naturalization Service to pursue any applicable immigration 217.35 status, including citizenship, that would qualify the individual 217.36 for medical assistance with federal financial participation. 218.1 (k) For purposes of paragraphs (f) and (i), "emergency 218.2 services" has the meaning given in Code of Federal Regulations, 218.3 title 42, section 440.255(b)(1), except that it also means 218.4 services rendered because of suspected or actual pesticide 218.5 poisoning. 218.6 (l) Notwithstanding any other provision of law, a 218.7 noncitizen who is ineligible for medical assistance due to the 218.8 deeming of a sponsor's income and resources, is ineligible for 218.9 general assistance medical care. 218.10 Sec. 6. Minnesota Statutes 1997 Supplement, section 218.11 256L.01, is amended to read: 218.12 256L.01 [DEFINITIONS.] 218.13 Subdivision 1. [SCOPE.] For purposes of sections 256L.01 218.14 to256L.10256L.18, the following terms shall have the meanings 218.15 given them. 218.16 Subd. 1a. [CHILD.] "Child" means an individual under 21 218.17 years of age, including the unborn child of a pregnant woman, an 218.18 emancipated minor, and an emancipated minor's spouse. 218.19 Subd. 2. [COMMISSIONER.] "Commissioner" means the 218.20 commissioner of human services. 218.21 Subd. 3. [ELIGIBLE PROVIDERS.] "Eligible providers" means 218.22 those health care providers who provide covered health services 218.23 to medical assistance recipients under rules established by the 218.24 commissioner for that program. 218.25 Subd. 3a. [FAMILY WITH CHILDREN.] (a) "Family with 218.26 children" means: 218.27 (1) parents, their children, and dependent siblings 218.28 residing in the same household; or 218.29 (2) grandparents, foster parents, relative caretakers as 218.30 defined in the medical assistance program, or legal guardians; 218.31 their wards who are children; and dependent siblings residing in 218.32 the same household. 218.33 (b) The term includes children and dependent siblings who 218.34 are temporarily absent from the household in settings such as 218.35 schools, camps, or visitation with noncustodial parents. 218.36 (c) For purposes of this subdivision, a dependent sibling 219.1 means an unmarried child who is a full-time student under the 219.2 age of 25 years who is financially dependent upon a parent, 219.3 grandparent, foster parent, relative caretaker, or legal 219.4 guardian. Proof of school enrollment is required. 219.5 Subd. 4. [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] "Gross 219.6 individual or gross family income" for farm and nonfarm 219.7 self-employed means income calculated using as the baseline the 219.8 adjusted gross income reported on the applicant's federal income 219.9 tax form for the previous year and adding back in reported 219.10 depreciation, carryover loss, and net operating loss amounts 219.11 that apply to the business in which the family is currently 219.12 engaged. Applicants shall report the most recent financial 219.13 situation of the family if it has changed from the period of 219.14 time covered by the federal income tax form. The report may be 219.15 in the form of percentage increase or decrease. 219.16 Subd. 5. [INCOME.] "Income" has the meaning given for 219.17 earned and unearned income for families and children in the 219.18 medical assistance program, according to the state's aid to 219.19 families with dependent children plan in effect as of July 16, 219.20 1996. The definition does not include medical assistance income 219.21 methodologies and deeming requirements. The earned income of 219.22 full-time and part-time students under age 19 is not counted as 219.23 income. Public assistance payments and supplemental security 219.24 income are not excluded income. 219.25 Sec. 7. Minnesota Statutes 1997 Supplement, section 219.26 256L.02, subdivision 3, is amended to read: 219.27 Subd. 3. [FINANCIAL MANAGEMENT.] (a) The commissioner 219.28 shall manage spending for the MinnesotaCare program in a manner 219.29 that maintains a minimum reserve in accordance with section 219.30 16A.76. As part of each state revenue and expenditure forecast, 219.31 the commissioner must makea quarterlyan assessment of the 219.32 expected expenditures for the covered services for the remainder 219.33 of the current biennium and for the following biennium. The 219.34 estimated expenditure, including the reserve requirements 219.35 described in section 16A.76, shall be compared to an estimate of 219.36 the revenues that will bedepositedavailable in the health care 220.1 access fund. Based on this comparison, and after consulting 220.2 with the chairs of the house ways and means committee and the 220.3 senate finance committee, and the legislative commission on 220.4 health care access, the commissioner shall, as necessary, make 220.5 the adjustments specified in paragraph (b) to ensure that 220.6 expenditures remain within the limits of available revenues for 220.7 the remainder of the current biennium and for the following 220.8 biennium. The commissioner shall not hire additional staff 220.9 using appropriations from the health care access fund until the 220.10 commissioner of finance makes a determination that the 220.11 adjustments implemented under paragraph (b) are sufficient to 220.12 allow MinnesotaCare expenditures to remain within the limits of 220.13 available revenues for the remainder of the current biennium and 220.14 for the following biennium. 220.15 (b) The adjustments the commissioner shall use must be 220.16 implemented in this order: first, stop enrollment of single 220.17 adults and households without children; second, upon 45 days' 220.18 notice, stop coverage of single adults and households without 220.19 children already enrolled in the MinnesotaCare program; third, 220.20 upon 90 days' notice, decrease the premium subsidy amounts by 220.21 ten percent for families with gross annual income above 200 220.22 percent of the federal poverty guidelines; fourth, upon 90 days' 220.23 notice, decrease the premium subsidy amounts by ten percent for 220.24 families with gross annual income at or below 200 percent; and 220.25 fifth, require applicants to be uninsured for at least six 220.26 months prior to eligibility in the MinnesotaCare program. If 220.27 these measures are insufficient to limit the expenditures to the 220.28 estimated amount of revenue, the commissioner shall further 220.29 limit enrollment or decrease premium subsidies. 220.30 Sec. 8. Minnesota Statutes 1997 Supplement, section 220.31 256L.02, is amended by adding a subdivision to read: 220.32 Subd. 4. [FUNDING FOR PREGNANT WOMEN AND CHILDREN UNDER 220.33 AGE TWO.] For fiscal years beginning on or after July 1, 1999, 220.34 the state cost of health care services provided to MinnesotaCare 220.35 enrollees who are pregnant women or children under age two shall 220.36 be paid out of the general fund rather than the health care 221.1 access fund. If the commissioner of finance decides to pay for 221.2 these costs using a source other than the general fund, the 221.3 commissioner shall include the change as a budget initiative in 221.4 the biennial or supplemental budget, and shall not change the 221.5 funding source through a forecast modification. 221.6 Sec. 9. Minnesota Statutes 1997 Supplement, section 221.7 256L.03, subdivision 1, is amended to read: 221.8 Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health 221.9 services" means the health services reimbursed under chapter 221.10 256B, with the exception of inpatient hospital services, special 221.11 education services, private duty nursing services, adult dental 221.12 care services other than preventive services, orthodontic 221.13 services, nonemergency medical transportation services, personal 221.14 care assistant and case management services, nursing home or 221.15 intermediate care facilities services, inpatient mental health 221.16 services, and chemical dependency services. Effective July 1, 221.17 1998, adult dental care for nonpreventive services with the 221.18 exception of orthodontic services is available to persons who 221.19 qualify under section 256L.04, subdivisions 1 to 7,or 256L.13,221.20 with family gross income equal to or less than 175 percent of 221.21 the federal poverty guidelines. Outpatient mental health 221.22 services covered under the MinnesotaCare program are limited to 221.23 diagnostic assessments, psychological testing, explanation of 221.24 findings, medication management by a physician, day treatment, 221.25 partial hospitalization, and individual, family, and group 221.26 psychotherapy. 221.27 No public funds shall be used for coverage of abortion 221.28 under MinnesotaCare except where the life of the female would be 221.29 endangered or substantial and irreversible impairment of a major 221.30 bodily function would result if the fetus were carried to term; 221.31 or where the pregnancy is the result of rape or incest. 221.32 Covered health services shall be expanded as provided in 221.33 this section. 221.34 Sec. 10. Minnesota Statutes 1997 Supplement, section 221.35 256L.03, is amended by adding a subdivision to read: 221.36 Subd. 1a. [COVERED SERVICES FOR PREGNANT WOMEN AND 222.1 CHILDREN UNDER MINNESOTACARE HEALTH CARE REFORM WAIVER.] 222.2 Children and pregnant women are eligible for coverage of all 222.3 services that are eligible for reimbursement under the medical 222.4 assistance program according to chapter 256B, except that 222.5 abortion services under MinnesotaCare shall be limited as 222.6 provided under section 256L.03, subdivision 1. Pregnant women 222.7 and children are exempt from the provisions of subdivision 5, 222.8 regarding copayments. Pregnant women and children who are 222.9 lawfully residing in the United States but who are not 222.10 "qualified noncitizens" under title IV of the Personal 222.11 Responsibility and Work Opportunity Reconciliation Act of 1996, 222.12 Public Law Number 104-193, Statutes at Large, volume 110, page 222.13 2105, are eligible for coverage of all services provided under 222.14 the medical assistance program according to chapter 256B. 222.15 Sec. 11. Minnesota Statutes 1997 Supplement, section 222.16 256L.03, is amended by adding a subdivision to read: 222.17 Subd. 1b. [PREGNANT WOMEN; ELIGIBILITY FOR FULL MEDICAL 222.18 ASSISTANCE SERVICES.] A woman who is enrolled in MinnesotaCare 222.19 when her pregnancy is diagnosed is eligible for coverage of all 222.20 services provided under the medical assistance program according 222.21 to chapter 256B retroactive to the date the pregnancy is 222.22 medically diagnosed. Copayments totaling $30 or more, paid 222.23 after the date the pregnancy is diagnosed, shall be refunded. 222.24 Sec. 12. Minnesota Statutes 1997 Supplement, section 222.25 256L.03, subdivision 3, is amended to read: 222.26 Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a)Beginning July222.271, 1993,Covered health services shall include inpatient 222.28 hospital services, including inpatient hospital mental health 222.29 services and inpatient hospital and residential chemical 222.30 dependency treatment, subject to those limitations necessary to 222.31 coordinate the provision of these services with eligibility 222.32 under the medical assistance spenddown. Prior to July 1, 1997, 222.33 the inpatient hospital benefit for adult enrollees is subject to 222.34 an annual benefit limit of $10,000.Effective July 1, 1997,The 222.35 inpatient hospital benefit for adult enrollees who qualify under 222.36 section 256L.04, subdivision 7, or who qualify under section 223.1 256L.04, subdivisions 1to 6and 2,or 256L.13with family gross 223.2 income that exceeds 175 percent of the federal poverty 223.3 guidelines and who are not pregnant, is subject to an annual 223.4 limit of $10,000. 223.5 (b)Enrollees who qualify under section 256L.04,223.6subdivision 7, or who qualify under section 256L.04,223.7subdivisions 1 to 6, or 256L.13 with family gross income that223.8exceeds 175 percent of the federal poverty guidelines and who223.9are not pregnant, and are determined by the commissioner to have223.10a basis of eligibility for medical assistance shall apply for223.11and cooperate with the requirements of medical assistance by the223.12last day of the third month following admission to an inpatient223.13hospital. If an enrollee fails to apply for medical assistance223.14within this time period, the enrollee and the enrollee's family223.15shall be disenrolled from the plan and they may not reenroll223.16until 12 calendar months have elapsed. Enrollees and enrollees'223.17families disenrolled for not applying for or not cooperating223.18with medical assistance may not reenroll.223.19(c)Admissions for inpatient hospital services paid for 223.20 under section 256L.11, subdivision 3, must be certified as 223.21 medically necessary in accordance with Minnesota Rules, parts 223.22 9505.0500 to 9505.0540, except as provided in clauses (1) and 223.23 (2): 223.24 (1) all admissions must be certified, except those 223.25 authorized under rules established under section 254A.03, 223.26 subdivision 3, or approved under Medicare; and 223.27 (2) payment under section 256L.11, subdivision 3, shall be 223.28 reduced by five percent for admissions for which certification 223.29 is requested more than 30 days after the day of admission. The 223.30 hospital may not seek payment from the enrollee for the amount 223.31 of the payment reduction under this clause. 223.32(d) Any enrollee or family member of an enrollee who has223.33previously been permanently disenrolled from MinnesotaCare for223.34not applying for and cooperating with medical assistance shall223.35be eligible to reenroll if 12 calendar months have elapsed since223.36the date of disenrollment.224.1 Sec. 13. Minnesota Statutes 1997 Supplement, section 224.2 256L.03, subdivision 4, is amended to read: 224.3 Subd. 4. [COORDINATION WITH MEDICAL ASSISTANCE.] The 224.4 commissioner shall coordinate the provision of hospital 224.5 inpatient services under the MinnesotaCare program with enrollee 224.6 eligibility under the medical assistance spenddown, and shall224.7apply to the secretary of health and human services for any224.8necessary federal waivers or approvals. 224.9 Sec. 14. Minnesota Statutes 1997 Supplement, section 224.10 256L.03, subdivision 5, is amended to read: 224.11 Subd. 5. [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 224.12 benefit plan shall include the following copayments and 224.13 coinsurance requirements: 224.14 (1) ten percent of the paid charges for inpatient hospital 224.15 services for adult enrolleesnot eligible for medical224.16assistance, subject to an annual inpatient out-of-pocket maximum 224.17 of $1,000 per individual and $3,000 per family; 224.18 (2) $3 per prescription for adult enrollees; 224.19 (3) $25 for eyeglasses for adult enrollees; and 224.20 (4) effective July 1, 1998, 50 percent of the 224.21 fee-for-service rate for adult dental care services other than 224.22 preventive care services for persons eligible under section 224.23 256L.04, subdivisions 1 to 7,or 256L.13,with income equal to 224.24 or less than 175 percent of the federal poverty guidelines. 224.25Prior to July 1, 1997, enrollees who are not eligible for224.26medical assistance with or without a spenddown shall be224.27financially responsible for the coinsurance amount and amounts224.28which exceed the $10,000 benefit limit.Effective July 1, 1997, 224.29 adult enrolleeswho qualify under section 256L.04, subdivision224.307, or who qualify under section 256L.04, subdivisions 1 to 6, or224.31256L.13with family gross income that exceeds 175 percent of the 224.32 federal poverty guidelines and who are not pregnant, and who are224.33not eligible for medical assistance with or without a spenddown,224.34 shall be financially responsible for the coinsurance amount and 224.35 amounts which exceed the $10,000 inpatient hospital benefit 224.36 limit. 225.1 When a MinnesotaCare enrollee becomes a member of a prepaid 225.2 health plan, or changes from one prepaid health plan to another 225.3 during a calendar year, any charges submitted towards the 225.4 $10,000 annual inpatient benefit limit, and any out-of-pocket 225.5 expenses incurred by the enrollee for inpatient services, that 225.6 were submitted or incurred prior to enrollment, or prior to the 225.7 change in health plans, shall be disregarded. 225.8 Sec. 15. Minnesota Statutes 1997 Supplement, section 225.9 256L.04, subdivision 1, is amended to read: 225.10 Subdivision 1. [CHILDREN; EXPANSION AND CONTINUATION OF225.11ELIGIBILITYFAMILIES WITH CHILDREN.] (a)[CHILDREN.] Prior to225.12October 1, 1992, "eligible persons" means children who are one225.13year of age or older but less than 18 years of age who have225.14gross family incomes that are equal to or less than 185 percent225.15of the federal poverty guidelines and who are not eligible for225.16medical assistance without a spenddown under chapter 256B and225.17who are not otherwise insured for the covered services. The225.18period of eligibility extends from the first day of the month in225.19which the child's first birthday occurs to the last day of the225.20month in which the child becomes 18 years old.Families with 225.21 children with family income equal to or less than 275 percent of 225.22 the federal poverty guidelines for the applicable family size 225.23 shall be eligible for MinnesotaCare according to this section. 225.24 All other provisions of sections 256L.01 to 256L.18, including 225.25 the insurance-related barriers to enrollment under section 225.26 256L.07, shall apply unless otherwise specified. 225.27 (b)[EXPANSION OF ELIGIBILITY.] Eligibility for225.28MinnesotaCare shall be expanded as provided in subdivisions 3 to225.297, except children who meet the criteria in this subdivision225.30shall continue to be enrolled pursuant to this subdivision. The225.31enrollment requirements in this paragraph apply to enrollment225.32under subdivisions 1 to 7.Parents who enroll in the 225.33 MinnesotaCare program must also enroll their children and 225.34 dependent siblings, if the children and their dependent siblings 225.35 are eligible. Children and dependent siblings may be enrolled 225.36 separately without enrollment by parents. However, if one 226.1 parent in the household enrolls, both parents must enroll, 226.2 unless other insurance is available. If one child from a family 226.3 is enrolled, all children must be enrolled, unless other 226.4 insurance is available. If one spouse in a household enrolls, 226.5 the other spouse in the household must also enroll, unless other 226.6 insurance is available. Families cannot choose to enroll only 226.7 certain uninsured members.For purposes of this section, a226.8"dependent sibling" means an unmarried child who is a full-time226.9student under the age of 25 years who is financially dependent226.10upon a parent. Proof of school enrollment will be required.226.11(c) [CONTINUATION OF ELIGIBILITY.] Individuals who226.12initially enroll in the MinnesotaCare program under the226.13eligibility criteria in subdivisions 3 to 7 remain eligible for226.14the MinnesotaCare program, regardless of age, place of226.15residence, or the presence or absence of children in the same226.16household, as long as all other eligibility criteria are met and226.17residence in Minnesota and continuous enrollment in the226.18MinnesotaCare program or medical assistance are maintained. In226.19order for either parent or either spouse in a household to226.20remain enrolled, both must remain enrolled, unless other226.21insurance is available.226.22 Sec. 16. Minnesota Statutes 1997 Supplement, section 226.23 256L.04, subdivision 2, is amended to read: 226.24 Subd. 2. [COOPERATION IN ESTABLISHING THIRD PARTY 226.25 LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 226.26 eligible for MinnesotaCare, individuals and families must 226.27 cooperate with the state agency to identify potentially liable 226.28 third party payers and assist the state in obtaining third party 226.29 payments. "Cooperation" includes, but is not limited to, 226.30 identifying any third party who may be liable for care and 226.31 services provided under MinnesotaCare to the enrollee, providing 226.32 relevant information to assist the state in pursuing a 226.33 potentially liable third party, and completing forms necessary 226.34 to recover third party payments. 226.35 (b) A parent, guardian, or child enrolled in the 226.36 MinnesotaCare program must cooperate with the department of 227.1 human services and the local agency in establishing the 227.2 paternity of an enrolled child and in obtaining medical care 227.3 support and payments for the child and any other person for whom 227.4 the person can legally assign rights, in accordance with 227.5 applicable laws and rules governing the medical assistance 227.6 program. A child shall not be ineligible for or disenrolled 227.7 from the MinnesotaCare program solely because the child's parent 227.8 or guardian fails to cooperate in establishing paternity or 227.9 obtaining medical support. 227.10 Sec. 17. Minnesota Statutes 1997 Supplement, section 227.11 256L.04, subdivision 7, is amended to read: 227.12 Subd. 7. [ADDITION OFSINGLE ADULTS AND HOUSEHOLDS WITH NO 227.13 CHILDREN.](a) Beginning October 1, 1994, the definition of227.14"eligible persons" is expanded to include all individuals and227.15households with no children who have gross family incomes that227.16are equal to or less than 125 percent of the federal poverty227.17guidelines and who are not eligible for medical assistance227.18without a spenddown under chapter 256B.227.19(b) Beginning July 1, 1997,The definition of eligible 227.20 personsis expanded to includeincludes all individuals and 227.21 households with no children who have gross family incomes that 227.22 are equal to or less than 175 percent of the federal poverty 227.23 guidelinesand who are not eligible for medical assistance227.24without a spenddown under chapter 256B. 227.25(c) All eligible persons under paragraphs (a) and (b) are227.26eligible for coverage through the MinnesotaCare program but must227.27pay a premium as determined under sections 256L.07 and 256L.08.227.28Individuals and families whose income is greater than the limits227.29established under section 256L.08 may not enroll in the227.30MinnesotaCare program.227.31 Sec. 18. Minnesota Statutes 1997 Supplement, section 227.32 256L.04, is amended by adding a subdivision to read: 227.33 Subd. 7a. [INELIGIBILITY.] Applicants whose income is 227.34 greater than the limits established under this section may not 227.35 enroll in the MinnesotaCare program. 227.36 Sec. 19. Minnesota Statutes 1997 Supplement, section 228.1 256L.04, subdivision 8, is amended to read: 228.2 Subd. 8. [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 228.3 ASSISTANCE.] (a) Individuals whoapply for MinnesotaCarereceive 228.4 supplemental security income or retirement, survivors, or 228.5 disability benefits due to a disability, or other 228.6 disability-based pension, who qualify under section 256L.04, 228.7 subdivision 7, but who are potentially eligible for medical 228.8 assistance without a spenddown shall be allowed to enroll in 228.9 MinnesotaCare for a period of 60 days, so long as the applicant 228.10 meets all other conditions of eligibility. The commissioner 228.11 shall identify and refer the applications of such individuals to 228.12 their county social service agency. The county and the 228.13 commissioner shall cooperate to ensure that the individuals 228.14 obtain medical assistance coverage for any months for which they 228.15 are eligible. 228.16 (b) The enrollee must cooperate with the county social 228.17 service agency in determining medical assistance eligibility 228.18 within the 60-day enrollment period. Enrollees who do notapply228.19for andcooperate with medical assistance within the 60-day 228.20 enrollment period, and their other family members,shall be 228.21 disenrolled from the plan within one calendar month. Persons 228.22 disenrolled for nonapplication for medical assistance may not 228.23 reenroll until they have obtained a medical assistance 228.24 eligibility determinationfor the family member or members who228.25were referred to the county agency. Persons disenrolled for 228.26 noncooperation with medical assistance may not reenroll until 228.27 they have cooperated with the county agency and have obtained a 228.28 medical assistance eligibility determination. 228.29 (c) Beginning January 1, 2000, counties that choose to 228.30 become MinnesotaCare enrollment sites shall consider 228.31 MinnesotaCare applications of individuals described in paragraph 228.32 (a) to also be applications for medical assistance and shall 228.33 first determine whether medical assistance eligibility exists. 228.34 Adults with children with family income under 175 percent of the 228.35 federal poverty guidelines for the applicable family size, 228.36 pregnant women, and children who qualify under subdivision 1 who 229.1 are potentially eligible for medical assistance without a 229.2 spenddown may choose to enroll in either MinnesotaCare or 229.3 medical assistance. 229.4 (d) The commissioner shall redetermine provider payments 229.5 made under MinnesotaCare to the appropriate medical assistance 229.6 payments for those enrollees who subsequently become eligible 229.7 for medical assistance. 229.8 Sec. 20. Minnesota Statutes 1997 Supplement, section 229.9 256L.04, subdivision 9, is amended to read: 229.10 Subd. 9. [GENERAL ASSISTANCE MEDICAL CARE.] A person 229.11 cannot have coverage under both MinnesotaCare and general 229.12 assistance medical care in the same month. Eligibility for 229.13 MinnesotaCare cannot be replaced by eligibility for general 229.14 assistance medical care, and eligibility for general assistance 229.15 medical care cannot be replaced by eligibility for MinnesotaCare. 229.16 Sec. 21. Minnesota Statutes 1997 Supplement, section 229.17 256L.04, subdivision 10, is amended to read: 229.18 Subd. 10. [SPONSOR'S INCOME AND RESOURCES DEEMED 229.19 AVAILABLE; DOCUMENTATION.] When determining eligibility for any 229.20 federal or state benefits under sections 256L.01 to256L.16229.21 256L.18, the income and resources of all noncitizens whose 229.22 sponsor signed an affidavit of support as defined under United 229.23 States Code, title 8, section 1183a, shall be deemed to include 229.24 their sponsors' income and resources as defined in the Personal 229.25 Responsibility and Work Opportunity Reconciliation Act of 1996, 229.26 title IV, Public Law Number 104-193, sections 421 and 422, and 229.27 subsequently set out in federal rules. To be eligible for the 229.28 program, noncitizens must provide documentation of their 229.29 immigration status. 229.30 Sec. 22. Minnesota Statutes 1997 Supplement, section 229.31 256L.04, is amended by adding a subdivision to read: 229.32 Subd. 12. [PERSONS IN DETENTION.] An applicant residing in 229.33 a correctional or detention facility is not eligible for 229.34 MinnesotaCare. An enrollee residing in a correctional or 229.35 detention facility is not eligible at renewal of eligibility 229.36 under section 256L.05, subdivision 3b. 230.1 Sec. 23. Minnesota Statutes 1997 Supplement, section 230.2 256L.04, is amended by adding a subdivision to read: 230.3 Subd. 13. [FAMILIES WITH GRANDPARENTS, RELATIVE 230.4 CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] In families 230.5 that include a grandparent, relative caretaker as defined in the 230.6 medical assistance program, foster parent, or legal guardian, 230.7 the grandparent, relative caretaker, foster parent, or legal 230.8 guardian may apply as a family or may apply separately for the 230.9 child. If the grandparent, relative caretaker, foster parent, 230.10 or legal guardian applies with the family, their income is 230.11 included in the gross family income for determining eligibility 230.12 and premium amount. 230.13 Sec. 24. Minnesota Statutes 1997 Supplement, section 230.14 256L.05, is amended by adding a subdivision to read: 230.15 Subd. 1a. [PERSON AUTHORIZED TO APPLY ON APPLICANT'S 230.16 BEHALF.] A family member who is age 18 or over or who is an 230.17 authorized representative, as defined in the medical assistance 230.18 program, may apply on an applicant's behalf. 230.19 Sec. 25. Minnesota Statutes 1997 Supplement, section 230.20 256L.05, subdivision 2, is amended to read: 230.21 Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall 230.22 use individuals' social security numbers as identifiers for 230.23 purposes of administering the plan and conduct data matches to 230.24 verify income. Applicants shall submit evidence of individual 230.25 and family income, earned and unearned,includingsuch as the 230.26 most recent income tax return, wage slips, or other 230.27 documentation that is determined by the commissioner as 230.28 necessary to verify income eligibility. The commissioner shall 230.29 perform random audits to verify reported income and 230.30 eligibility. The commissioner may execute data sharing 230.31 arrangements with the department of revenue and any other 230.32 governmental agency in order to perform income verification 230.33 related to eligibility and premium payment under the 230.34 MinnesotaCare program. 230.35 Sec. 26. Minnesota Statutes 1997 Supplement, section 230.36 256L.05, subdivision 3, is amended to read: 231.1 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] The effective date 231.2 of coverage is the first day of the month following the month in 231.3 which eligibility is approved and the first premium payment has 231.4 been received. As provided in section 256B.057, coverage for 231.5 newborns is automatic from the date of birth and must be 231.6 coordinated with other health coverage. The effective date of 231.7 coverage foreligible newborns oreligible newly adoptive 231.8 children added to a family receiving covered health services is 231.9 the date of entry into the family. The effective date of 231.10 coverage for other new recipients added to the family receiving 231.11 covered health services is the first day of the month following 231.12 the month in which eligibility is approvedand the first premium231.13payment has been receivedor at renewal, whichever the family 231.14 receiving covered health services prefers. All eligibility 231.15 criteria must be met by the family at the time the new family 231.16 member is added. The income of the new family member is 231.17 included with the family's gross income and the adjusted premium 231.18 begins in the month the new family member is added. The premium 231.19 must be received eight working days prior to the end of the 231.20 month for coverage to begin the following month. Benefits are 231.21 not available until the day following discharge if an enrollee 231.22 is hospitalized on the first day of coverage. Notwithstanding 231.23 any other law to the contrary, benefits under sections 256L.01 231.24 to256L.10256L.18 are secondary to a plan of insurance or 231.25 benefit program under which an eligible person may have coverage 231.26 and the commissioner shall use cost avoidance techniques to 231.27 ensure coordination of any other health coverage for eligible 231.28 persons. The commissioner shall identify eligible persons who 231.29 may have coverage or benefits under other plans of insurance or 231.30 who become eligible for medical assistance. 231.31 Sec. 27. Minnesota Statutes 1997 Supplement, section 231.32 256L.05, is amended by adding a subdivision to read: 231.33 Subd. 3a. [RENEWAL OF ELIGIBILITY.] An enrollee's 231.34 eligibility must be renewed every 12 months. The 12-month 231.35 period begins in the month after the month the application is 231.36 approved. An enrollee must meet all applicable eligibility 232.1 criteria at the time of renewal. An enrollee whose income 232.2 exceeds the income limits specified in section 256L.04, 232.3 subdivision 1 or 7 is subject to section 256L.07, subdivision 1. 232.4 Sec. 28. Minnesota Statutes 1997 Supplement, section 232.5 256L.05, is amended by adding a subdivision to read: 232.6 Subd. 3b. [REAPPLICATION.] Families and individuals must 232.7 reapply after a lapse in coverage of one calendar month or more 232.8 and must meet all eligibility criteria. 232.9 Sec. 29. Minnesota Statutes 1997 Supplement, section 232.10 256L.05, subdivision 4, is amended to read: 232.11 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 232.12 human services shall determine an applicant's eligibility for 232.13 MinnesotaCare no more than 30 days from the date that the 232.14 application is received by the department of human services. 232.15 Beginning January 1, 2000, this requirement also applies to 232.16 local county human services agencies that determine eligibility 232.17 for MinnesotaCare. To prevent processing delays, applicants who 232.18 appear to meet eligibility requirements shall be enrolled. The 232.19 enrollee must provide all required verifications within 30 days 232.20 of enrollment or coverage from the program shall be terminated. 232.21 Enrollees who are determined to be ineligible when verifications 232.22 are provided shall be terminated. 232.23 Sec. 30. Minnesota Statutes 1997 Supplement, section 232.24 256L.06, subdivision 3, is amended to read: 232.25 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 232.26 Premiums are dedicated to the commissioner for MinnesotaCare. 232.27The commissioner shall make an annual redetermination of232.28continued eligibility and identify people who may become232.29eligible for medical assistance.232.30 (b) The commissioner shall develop and implement procedures 232.31 to: (1) require enrollees to report changes in income; (2) 232.32 adjust sliding scale premium payments, based upon changes in 232.33 enrollee income; and (3) disenroll enrollees from MinnesotaCare 232.34 for failure to pay required premiums. Failure to pay includes 232.35 payment with a dishonored check. The commissioner may demand a 232.36 guaranteed form of payment as the only means to replace a 233.1 dishonored check. 233.2 (c) Premiums are calculated on a calendar month basis and 233.3 may be paid on a monthly, quarterly, or annual basis, with the 233.4 first payment due upon notice from the commissioner of the 233.5 premium amount required. The commissioner shall inform 233.6 applicants and enrollees of these premium payment options. 233.7 Premium payment is required before enrollment is complete and to 233.8 maintain eligibility in MinnesotaCare. 233.9 (d) Nonpayment of the premium will result in disenrollment 233.10 from the plan within one calendar month after the due date. 233.11 Persons disenrolled for nonpayment or who voluntarily terminate 233.12 coverage from the program may not reenroll until four calendar 233.13 months have elapsed. Persons disenrolled for nonpayment or who 233.14 voluntarily terminate coverage from the program may not reenroll 233.15 for four calendar months unless the person demonstrates good 233.16 cause for nonpayment. Good cause does not exist if a person 233.17 chooses to pay other family expenses instead of the premium. 233.18 The commissioner shall define good cause in rule. 233.19 Sec. 31. Minnesota Statutes 1997 Supplement, section 233.20 256L.07, is amended to read: 233.21 256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON 233.22 SLIDING SCALE.] 233.23 Subdivision 1. [GENERAL REQUIREMENTS.]Families and233.24individuals who enroll on or after October 1, 1992, are eligible233.25for subsidized premium payments based on a sliding scale under233.26section 256L.08 only if the family or individual meets the233.27requirements in subdivisions 2 and 3. Children already enrolled233.28in the children's health plan as of September 30, 1992, eligible233.29under section 256L.04, subdivision 1, paragraph (a), children233.30who enroll in the MinnesotaCare program after September 30,233.311992, pursuant to Laws 1992, chapter 549, article 4, section 17,233.32and children who enroll under section 256L.04, subdivision 6,233.33are eligible for subsidized premium payments without meeting233.34these requirements, as long as they maintain continuous coverage233.35in the MinnesotaCare plan or medical assistance.233.36 Familiesand individuals who initiallyenrolled in 234.1 MinnesotaCare under section 256L.04,andsubdivision 1, whose 234.2 income increases abovethe limits established in section 256L.08234.3 275 percent of the federal poverty guidelines, may continue 234.4 enrollment and pay the full cost of coverage. Individuals 234.5 enrolled in MinnesotaCare under section 256L.04, subdivision 7, 234.6 whose income increases above 175 percent of the federal poverty 234.7 guidelines may continue enrollment and pay premiums according to 234.8 the sliding fee scale. These individuals must pay the full cost 234.9 of coverage when their income increases above 275 percent of the 234.10 federal poverty guidelines. 234.11 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 234.12 COVERAGE.] (a) To be eligible for subsidized premium payments 234.13 based on a sliding scale, a family or individual must not have 234.14 access to subsidized health coverage through an employer, and234.15must not have had access to subsidized health coverage through234.16an employer for the 18 months prior to application for234.17subsidized coverage under the MinnesotaCare program.The234.18requirement that the family or individual must not have had234.19access to employer-subsidized coverage during the previous 18234.20months does not apply if: (1) employer-subsidized coverage was234.21lost due to the death of an employee or divorce; (2)234.22employer-subsidized coverage was lost because an individual234.23became ineligible for coverage as a child or dependent; or (3)234.24employer-subsidized coverage was lost for reasons that would not234.25disqualify the individual for unemployment benefits under234.26section 268.09 and the family or individual has not had access234.27to employer-subsidized coverage since the loss of coverage. If234.28employer-subsidized coverage was lost for reasons that234.29disqualify an individual for unemployment benefits under section234.30268.09, children of that individual are exempt from the234.31requirement of no access to employer subsidized coverage for the234.3218 months prior to application, as long as the children have not234.33had access to employer subsidized coverage since the234.34disqualifying event. The requirement that the. A family or 234.35 individualmust not have had access to employer-subsidized234.36coverage during the previous 18 months does apply ifwhose 235.1 employer-subsidized coverage is lost due to an employer 235.2 terminating health care coverage as an employee benefit during 235.3 the previous 18 months is not eligible. 235.4 (b) For purposes of this requirement, subsidized health 235.5 coverage means health coverage for which the employer pays at 235.6 least 50 percent of the cost of coverage for the employee,235.7excluding dependent coverageor dependent, or a higher 235.8 percentage as specified by the commissioner. Children are 235.9 eligible for employer-subsidized coverage through either parent, 235.10 including the noncustodial parent. The commissioner must treat 235.11 employer contributions to Internal Revenue Code Section 125 235.12 plans and any other employer benefits intended to pay health 235.13 care costs as qualified employer subsidies toward the cost of 235.14 health coverage for employees for purposes of this subdivision. 235.15 Subd. 3. [PERIOD UNINSUREDOTHER HEALTH COVERAGE.]To be235.16eligible for subsidized premium payments based on a sliding235.17scale,(a) Families and individualsinitiallyenrolled in the 235.18 MinnesotaCare programunder section 256L.04, subdivisions 5 and235.197,must havehadno health coverage while enrolled or for at 235.20 least four months prior to application and renewal. A child in 235.21 a family with income equal to or less than 150 percent of the 235.22 federal poverty guidelines, who has other health coverage, is 235.23 eligible if the other health coverage meets the requirements of 235.24 Minnesota Rules, part 9506.0020, subpart 3, item B. The 235.25 commissioner may change this eligibility criterion for sliding 235.26 scale premiums in order to remain within the limits of available 235.27 appropriations. The requirement ofat least four months ofno 235.28 health coverageprior to application for the MinnesotaCare235.29programdoes not apply to:newborns. 235.30(1) families, children, and individuals who apply for the235.31MinnesotaCare program upon termination from or as required by235.32the medical assistance program, general assistance medical care235.33program, or coverage under a regional demonstration project for235.34the uninsured funded under section 256B.73, the Hennepin county235.35assured care program, or the Group Health, Inc., community235.36health plan;236.1(2) families and individuals initially enrolled under236.2section 256L.04, subdivisions 1, paragraph (a), and 3;236.3(3) children enrolled pursuant to Laws 1992, chapter 549,236.4article 4, section 17; or236.5(4) individuals currently serving or who have served in the236.6military reserves, and dependents of these individuals, if these236.7individuals: (i) reapply for MinnesotaCare coverage after a236.8period of active military service during which they had been236.9covered by the Civilian Health and Medical Program of the236.10Uniformed Services (CHAMPUS); (ii) were covered under236.11MinnesotaCare immediately prior to obtaining coverage under236.12CHAMPUS; and (iii) have maintained continuous coverage.236.13 (b) For purposes of this section, medical assistance, 236.14 general assistance medical care, and civilian health and medical 236.15 program of the uniformed service (CHAMPUS) are not considered 236.16 insurance or health coverage. 236.17 (c) For purposes of this section, Medicare part A or B 236.18 coverage under title XVIII of the Social Security Act, United 236.19 States Code, title 42, sections 1395c to 1395w-4, is considered 236.20 health coverage. An applicant or enrollee may not refuse 236.21 Medicare coverage to establish eligibility for MinnesotaCare. 236.22 Subd. 4. [EXEMPTION FOR PERSONS WITH CONTINUATION 236.23 COVERAGE.] (a) Families, children, and individuals who want to 236.24 apply for the MinnesotaCare program upon termination from 236.25 continuation coverage required under federal or state law are 236.26 exempt from the requirements of subdivisions 2 and 3. 236.27 (b) For purposes of paragraph (a), "termination from 236.28 continuation coverage" means involuntary termination for any 236.29 reason, other than nonpayment of premium by the family, child, 236.30 or individual. Involuntary termination includes termination of 236.31 coverage due to reaching the end of the maximum period for 236.32 continuation coverage required under federal or state law. 236.33 Sec. 32. Minnesota Statutes 1997 Supplement, section 236.34 256L.09, subdivision 2, is amended to read: 236.35 Subd. 2. [RESIDENCY REQUIREMENT.] (a)Prior to July 1,236.361997, to be eligible for health coverage under the MinnesotaCare237.1program, families and individuals must be permanent residents of237.2Minnesota.237.3(b) Effective July 1, 1997,To be eligible for health 237.4 coverage under the MinnesotaCare program, adults without 237.5 children must be permanent residents of Minnesota. 237.6(c) Effective July 1, 1997,(b) To be eligible for health 237.7 coverage under the MinnesotaCare program, pregnant women, 237.8 families, and children must meet the residency requirements as 237.9 provided by Code of Federal Regulations, title 42, section 237.10 435.403, except that the provisions of section 256B.056, 237.11 subdivision 1, shall apply upon receipt of federal approval. 237.12 Sec. 33. Minnesota Statutes 1997 Supplement, section 237.13 256L.09, subdivision 4, is amended to read: 237.14 Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 237.15 purposes of this section, a permanent Minnesota resident is a 237.16 person who has demonstrated, through persuasive and objective 237.17 evidence, that the person is domiciled in the state and intends 237.18 to live in the state permanently. 237.19 (b) To be eligible as a permanent resident,all applicants237.20 an applicant must demonstrate the requisite intent to live in 237.21 the state permanently by: 237.22 (1) showing that the applicant maintains a residence at a 237.23 verified address other than a place of public accommodation, 237.24 through the use of evidence of residence described in section 237.25 256D.02, subdivision 12a, clause (1); 237.26 (2) demonstrating that the applicant has been continuously 237.27 domiciled in the state for no less than 180 days immediately 237.28 before the application; and 237.29 (3) signing an affidavit declaring that (A) the applicant 237.30 currently resides in the state and intends to reside in the 237.31 state permanently; and (B) the applicant did not come to the 237.32 state for the primary purpose of obtaining medical coverage or 237.33 treatment. 237.34 (c) A person who is temporarily absent from the state does 237.35 not lose eligibility for MinnesotaCare. "Temporarily absent 237.36 from the state" means the person is out of the state for a 238.1 temporary purpose and intends to return when the purpose of the 238.2 absence has been accomplished. A person is not temporarily 238.3 absent from the state if another state has determined that the 238.4 person is a resident for any purpose. If temporarily absent 238.5 from the state, the person must follow the requirements of the 238.6 health plan in which he or she is enrolled to receive services. 238.7 Sec. 34. Minnesota Statutes 1997 Supplement, section 238.8 256L.09, subdivision 6, is amended to read: 238.9 Subd. 6. [12-MONTH PREEXISTING EXCLUSION.] If the 180-day 238.10 requirement in subdivision 4, paragraph (b), clause (2), is 238.11 determined by a court to be unconstitutional, the commissioner 238.12 of human services shall impose a 12-month preexisting condition 238.13 exclusion on coverage for persons who have been domiciled in the 238.14 state for less than 180 days. 238.15 Sec. 35. Minnesota Statutes 1997 Supplement, section 238.16 256L.11, subdivision 6, is amended to read: 238.17 Subd. 6. [ENROLLEES 18 OR OLDER.] Payment by the 238.18 MinnesotaCare program for inpatient hospital services provided 238.19 to MinnesotaCare enrollees eligible under section 256L.04, 238.20 subdivision 7, or who qualify under section 256L.04, 238.21 subdivisions 1to 6and 2,or 256L.13with family gross income 238.22 that exceeds 175 percent of the federal poverty guidelines and 238.23 who are not pregnant, who are 18 years old or older on the date 238.24 of admission to the inpatient hospital must be in accordance 238.25 with paragraphs (a) and (b). Payment for adults who are not 238.26 pregnant and are eligible under section 256L.04, subdivisions 238.27 1to 6and 2,or 256L.13,and whose incomes are equal to or less 238.28 than 175 percent of the federal poverty guidelines, shall be as 238.29 provided for under paragraph (c). 238.30 (a) If the medical assistance rate minus any copayment 238.31 required under section 256L.03, subdivision 4, is less than or 238.32 equal to the amount remaining in the enrollee's benefit limit 238.33 under section 256L.03, subdivision 3, payment must be the 238.34 medical assistance rate minus any copayment required under 238.35 section 256L.03, subdivision 4. The hospital must not seek 238.36 payment from the enrollee in addition to the copayment. The 239.1 MinnesotaCare payment plus the copayment must be treated as 239.2 payment in full. 239.3 (b) If the medical assistance rate minus any copayment 239.4 required under section 256L.03, subdivision 4, is greater than 239.5 the amount remaining in the enrollee's benefit limit under 239.6 section 256L.03, subdivision 3, payment must be the lesser of: 239.7 (1) the amount remaining in the enrollee's benefit limit; 239.8 or 239.9 (2) charges submitted for the inpatient hospital services 239.10 less any copayment established under section 256L.03, 239.11 subdivision 4. 239.12 The hospital may seek payment from the enrollee for the 239.13 amount by which usual and customary charges exceed the payment 239.14 under this paragraph. If payment is reduced under section 239.15 256L.03, subdivision 3, paragraph(c)(b), the hospital may not 239.16 seek payment from the enrollee for the amount of the reduction. 239.17 (c) For admissions occurring during the period of July 1, 239.18 1997, through June 30, 1998, for adults who are not pregnant and 239.19 are eligible under section 256L.04, subdivisions 1to 6and 239.20 2,or 256L.13,and whose incomes are equal to or less than 175 239.21 percent of the federal poverty guidelines, the commissioner 239.22 shall pay hospitals directly, up to the medical assistance 239.23 payment rate, for inpatient hospital benefits in excess of the 239.24 $10,000 annual inpatient benefit limit. 239.25 Sec. 36. Minnesota Statutes 1997 Supplement, section 239.26 256L.12, subdivision 5, is amended to read: 239.27 Subd. 5. [ELIGIBILITY FOR OTHER STATE PROGRAMS.] 239.28 MinnesotaCare enrollees who become eligible for medical 239.29 assistance or general assistance medical care will remain in the 239.30 same managed care plan if the managed care plan has a contract 239.31 for that population. Effective January 1, 1998, MinnesotaCare 239.32 enrollees who were formerly eligible for general assistance 239.33 medical care pursuant to section 256D.03, subdivision 3, within 239.34 six months of MinnesotaCare enrollment and were enrolled in a 239.35 prepaid health plan pursuant to section 256D.03, subdivision 4, 239.36 paragraph (d), must remain in the same managed care plan if the 240.1 managed care plan has a contract for that population.Contracts240.2between the department of human services and managed care plans240.3must include MinnesotaCare, and medical assistance and may, at240.4the option of the commissioner of human services, also include240.5general assistance medical care.Managed care plans must 240.6 participate in the MinnesotaCare and general assistance medical 240.7 care programs under a contract with the department of human 240.8 services in service areas where they participate in the medical 240.9 assistance program. 240.10 Sec. 37. Minnesota Statutes 1997 Supplement, section 240.11 256L.15, is amended to read: 240.12 256L.15 [PREMIUMS.] 240.13 Subdivision 1. [PREMIUM DETERMINATION.] Familiesandwith 240.14 childrenenrolled according to sections 256L.13 to 256L.16and 240.15 individuals shall pay an enrollment fee or a premium determined 240.16 according to a sliding fee based on the cost of coverage as a 240.17 percentage of the family's gross family income. Pregnant women 240.18 and children under age two are exempt from the provisions of 240.19 section 256L.06, subdivision 3, paragraph (b), clause (3), 240.20 requiring disenrollment for failure to pay premiums. For 240.21 pregnant women, this exemption continues until the first day of 240.22 the month following the 60th day postpartum. Women who remain 240.23 enrolled during pregnancy or the postpartum period, despite 240.24 nonpayment of premiums, shall be disenrolled on the first of the 240.25 month following the 60th day postpartum for the penalty period 240.26 that otherwise applies under section 256L.06, unless they begin 240.27 paying premiums. 240.28 Subd. 1a. [PAYMENT OPTIONS.] The commissioner may offer 240.29 the following payment options to an enrollee: 240.30 (1) payment by check; 240.31 (2) payment by credit card; 240.32 (3) payment by recurring automatic checking withdrawal; 240.33 (4) payment by one-time electronic transfer of funds; or 240.34 (5) payment by wage withholding with the consent of the 240.35 employer and the employee. 240.36 Subd. 1b. [PAYMENTS NONREFUNDABLE.] MinnesotaCare premiums 241.1 and enrollment fees are not refundable. 241.2 Subd. 2. [SLIDING SCALE TO DETERMINE PERCENTAGE OF GROSS 241.3 INDIVIDUAL OR FAMILY INCOME.] The commissioner shall establish a 241.4 sliding fee scale to determine the percentage of 241.5 gross individual or family income that households at different 241.6 income levels must pay to obtain coverage through the 241.7 MinnesotaCare program. The sliding fee scale must be based on 241.8 the enrollee's gross individual or family income during the 241.9 previous four months. The sliding fee scale begins with a 241.10 premium of 1.5 percent of gross individual or family income for 241.11 individuals or families with incomes below the limits for the 241.12 medical assistance program for families and children and 241.13 proceeds through the following evenly spaced steps: 1.8, 2.3, 241.14 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. These percentages are 241.15 matched to evenly spaced income steps ranging from the medical 241.16 assistance income limit for families and children to 275 percent 241.17 of the federal poverty guidelines for the applicable family 241.18 size. An adult without children whose income is equal to or 241.19 less than 175 percent of the federal poverty guidelines shall 241.20 pay premiums according to the sliding fee scale. When an 241.21 enrollee's income exceeds the eligibility limit established for 241.22 families with children under section 256L.04, subdivision 1, the 241.23 enrollee must pay the full cost of coverage as required under 241.24 section 256L.07, subdivision 1. The sliding fee scale and 241.25 percentages are not subject to the provisions of chapter 14. If 241.26 a family or individual reports increased income after 241.27 enrollment, premiums shall not be adjusted until eligibility 241.28 renewal. 241.29Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium241.30of $48 is required for all children who are eligible according241.31to section 256L.13, subdivision 4.241.32 Subd. 4. [CHILDREN IN FAMILIES WITH INCOME AT OR LESS THAN 241.33 150 PERCENT OF FEDERAL POVERTY GUIDELINES.] Children in families 241.34 with income at or below 150 percent of the federal poverty 241.35 guidelines, when only the children are enrolled, may pay an 241.36 annual enrollment fee of $48 per child. Payment of the $48 242.1 annual enrollment fee in families with only the children 242.2 enrolled guarantees eligibility for 12 months regardless of 242.3 changes in circumstances. If the entire family is enrolled, the 242.4 children are required to pay a monthly premium of $4. 242.5 Sec. 38. Minnesota Statutes 1997 Supplement, section 242.6 256L.17, is amended by adding a subdivision to read: 242.7 Subd. 6. [WAIVER OF MAINTENANCE OF EFFORT 242.8 REQUIREMENT.] Unless a federal waiver of the maintenance of 242.9 effort requirements of section 2105(d) of title XXI of the 242.10 Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 242.11 at Large, volume 111, page 251, is granted by the federal 242.12 Department of Health and Human Services by September 30, 1998, 242.13 this section does not apply to children. The commissioner shall 242.14 publish a notice in the State Register upon receipt of a federal 242.15 waiver. 242.16 Sec. 39. [256L.19] [STATE CHILDREN'S HEALTH INSURANCE 242.17 PROGRAM.] 242.18 Subdivision 1. [AUTHORITY.] The commissioner is authorized 242.19 to claim enhanced federal matching funds under sections 242.20 2105(a)(2) and 2110 of the Balanced Budget Act of 1997, Public 242.21 Law Number 105-33, for any and all state or local expenditures 242.22 eligible as child health assistance for targeted low income 242.23 children and health service initiatives for low income 242.24 children. If required by federal law or regulations, the 242.25 commissioner is authorized to establish accounts, make 242.26 appropriate payments, and receive reimbursement from state and 242.27 local entities providing child health assistance or health 242.28 services for low income children, in order to obtain enhanced 242.29 federal matching funds. Enhanced federal matching funds 242.30 received as a result of authority exercised under this section 242.31 shall be deposited in the general fund. 242.32 Subd. 2. [ENHANCED MATCHING FUNDS FOR CHILDREN'S HEALTH 242.33 CARE INITIATIVES.] The commissioner shall submit to the health 242.34 care financing administration all plans and waiver requests 242.35 necessary to obtain enhanced matching funds under the state 242.36 children's health insurance program established as Title 21 of 243.1 the Balanced Budget Act of 1997, Public Law Number 105-33, for: 243.2 (1) expenditures made under section 256B.057, subdivision 8; and 243.3 (2) expenditures made under the MinnesotaCare program. The 243.4 commissioner shall submit to the legislature, by January 15, 243.5 1999, all statutory changes to the MinnesotaCare program 243.6 necessary to receive enhanced federal matching funds. 243.7 Sec. 40. [UNCOMPENSATED CARE STUDY.] 243.8 The commissioner of health, in consultation with the 243.9 commissioner of human services, shall present to the legislative 243.10 commission on health care access, by January 15, 1999, a report 243.11 and recommendations on the provision and financing of 243.12 uncompensated care in Minnesota. The report must: 243.13 (1) document the extent of uncompensated care provided in 243.14 Minnesota; 243.15 (2) discuss options for financing uncompensated care; 243.16 (3) describe other state approaches to monitoring and 243.17 financing uncompensated care; and 243.18 (4) describe alternative approaches to encourage health 243.19 care coverage. 243.20 Sec. 41. [SPECIAL PREMIUM TAX PAYMENT.] 243.21 Health maintenance organizations, community integrated 243.22 service networks, and nonprofit health service plan corporations 243.23 that have met the cost containment goals established in 243.24 Minnesota Statutes, section 62J.04, in the individual and small 243.25 employer market for calendar year 1996 shall pay a special, 243.26 one-time 1999 premium tax payment. The tax payment must be 243.27 based on an amount equal to one percent of gross premiums less 243.28 return premiums on all direct business received by the insurer 243.29 in this state, or by its agents for it, in cash or otherwise 243.30 after March 30, 1997, and before January 1, 1998. Payment of 243.31 the tax under this section is due January 2, 1999. Provisions 243.32 relating to the payment, assessment, and collection of the tax 243.33 assessed under Minnesota Statutes, section 60A.15, shall apply 243.34 to the special tax payment assessed under this section. 243.35 Sec. 42. [REVISOR'S INSTRUCTION.] 243.36 In each section of Minnesota Statutes referred to in column 244.1 A, the revisor of statutes shall delete the reference in column 244.2 B and insert the reference in column C. 244.3 Column A Column B Column C 244.4 256B.057, subd. 1a 256L.08 256L.15 244.5 256B.0645 256L.14 256L.03, subd. 1a 244.6 256L.16 256L.14 256L.03, subd. 1a 244.7 Sec. 43. [REPEALER.] 244.8 Minnesota Statutes 1997 Supplement, sections 256B.057, 244.9 subdivision 1a; 256L.04, subdivisions 3, 4, 5, and 6; 256L.06, 244.10 subdivisions 1 and 2; 256L.08; 256L.09, subdivision 3; 256L.13; 244.11 256L.14; and 256L.15, subdivision 3, are repealed. 244.12 Sec. 44. [EFFECTIVE DATE.] 244.13 (a) Sections 2 (256B.04, subdivision 18), 5 to 7, 9 to 37, 244.14 42 (Revisor Instruction), and 43 (Repealer) are effective 244.15 January 1, 1999. 244.16 (b) Sections 3 (256B.057, subdivision 7), 4 (256B.057, 244.17 subdivision 8), 38 (256L.17, subdivision 6), and 39 (256L.19) 244.18 are effective September 30, 1998. 244.19 ARTICLE 6 244.20 WELFARE REFORM; WORK FIRST; ASSISTANCE PROGRAM 244.21 AND CHILD SUPPORT CHANGES; AND LICENSING 244.22 Section 1. Minnesota Statutes 1997 Supplement, section 244.23 119B.01, subdivision 16, is amended to read: 244.24 Subd. 16. [TRANSITION YEAR FAMILIES.] "Transition year 244.25 families" means families who have received AFDC, or who were 244.26 eligible to receive AFDC after choosing to discontinue receipt 244.27 of the cash portion of MFIP-S assistance under section 256J.31, 244.28 subdivision 12, for at least three of the last six months before 244.29 losing eligibility for AFDC due to increased hours of 244.30 employment, increased income from employment or child or spousal 244.31 support, or the loss of income disregards due to time 244.32 limitations. 244.33 Sec. 2. Minnesota Statutes 1996, section 245A.03, is 244.34 amended by adding a subdivision to read: 244.35 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 244.36 clause (2), does not apply to: 245.1 (1) a child care provider who as an applicant for licensure 245.2 or as a licenseholder has received a license denial under 245.3 section 245A.05, a fine under section 245A.06, or a sanction 245.4 under 245A.07 from the commissioner that has not been reversed 245.5 on appeal; or 245.6 (2) a child care provider, or a child care provider who has 245.7 a household member who, as a result of a licensing process, has 245.8 a disqualification under chapter 245A that has not been set 245.9 aside by the commissioner. 245.10 Sec. 3. Minnesota Statutes 1996, section 245A.03, is 245.11 amended by adding a subdivision to read: 245.12 Subd. 4. [EXCLUDED CHILD CARE PROGRAMS; RIGHT TO SEEK 245.13 LICENSURE.] Nothing in this section shall prohibit a child care 245.14 program that is excluded from licensure under subdivision 2, 245.15 clause (2), or under Laws 1997, chapter 248, section 46, as 245.16 amended by Laws 1997, First Special Session chapter 5, section 245.17 10, from seeking a license under this chapter. The commissioner 245.18 shall ensure that any application received from such an excluded 245.19 provider is processed in the same manner as all other 245.20 applications for licensed family day care. 245.21 Sec. 4. Minnesota Statutes 1996, section 245A.14, 245.22 subdivision 4, is amended to read: 245.23 Subd. 4. [SPECIAL FAMILY DAY CARE HOMES.] Nonresidential 245.24 child care programs serving 14 or fewer children that are 245.25 conducted at a location other than the license holder's own 245.26 residence shall be licensed under this section and the rules 245.27 governing family day care or group family day care if: 245.28 (a) the license holder is the primary provider of care;245.29(b)and the nonresidential child care program is conducted 245.30 in a dwelling that is located on a residential lot;andor 245.31(c) the license holder complies with all other requirements245.32of sections 245A.01 to 245A.15 and the rules governing family245.33day care or group family day care.245.34 (b) the license holder is an employer who may or may not be 245.35 the primary provider of care, and the purpose for the child care 245.36 program is to provide child care services to children of the 246.1 license holder's employees. 246.2 Sec. 5. Minnesota Statutes 1997 Supplement, section 246.3 256.01, subdivision 2, is amended to read: 246.4 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 246.5 section 241.021, subdivision 2, the commissioner of human 246.6 services shall: 246.7 (1) Administer and supervise all forms of public assistance 246.8 provided for by state law and other welfare activities or 246.9 services as are vested in the commissioner. Administration and 246.10 supervision of human services activities or services includes, 246.11 but is not limited to, assuring timely and accurate distribution 246.12 of benefits, completeness of service, and quality program 246.13 management. In addition to administering and supervising human 246.14 services activities vested by law in the department, the 246.15 commissioner shall have the authority to: 246.16 (a) require county agency participation in training and 246.17 technical assistance programs to promote compliance with 246.18 statutes, rules, federal laws, regulations, and policies 246.19 governing human services; 246.20 (b) monitor, on an ongoing basis, the performance of county 246.21 agencies in the operation and administration of human services, 246.22 enforce compliance with statutes, rules, federal laws, 246.23 regulations, and policies governing welfare services and promote 246.24 excellence of administration and program operation; 246.25 (c) develop a quality control program or other monitoring 246.26 program to review county performance and accuracy of benefit 246.27 determinations; 246.28 (d) require county agencies to make an adjustment to the 246.29 public assistance benefits issued to any individual consistent 246.30 with federal law and regulation and state law and rule and to 246.31 issue or recover benefits as appropriate; 246.32 (e) delay or deny payment of all or part of the state and 246.33 federal share of benefits and administrative reimbursement 246.34 according to the procedures set forth in section 256.017;and246.35 (f) make contracts with and grants to public and private 246.36 agencies and organizations, both profit and nonprofit, and 247.1 individuals, using appropriated funds; and 247.2 (g) enter into contractual agreements with federally 247.3 recognized Indian tribes with a reservation in Minnesota to the 247.4 extent necessary for the tribe to operate a federally approved 247.5 family assistance program or any other program under the 247.6 supervision of the commissioner. The commissioner may establish 247.7 necessary accounts for the purposes of receiving and disbursing 247.8 funds as necessary for the operation of the programs. 247.9 (2) Inform county agencies, on a timely basis, of changes 247.10 in statute, rule, federal law, regulation, and policy necessary 247.11 to county agency administration of the programs. 247.12 (3) Administer and supervise all child welfare activities; 247.13 promote the enforcement of laws protecting handicapped, 247.14 dependent, neglected and delinquent children, and children born 247.15 to mothers who were not married to the children's fathers at the 247.16 times of the conception nor at the births of the children; 247.17 license and supervise child-caring and child-placing agencies 247.18 and institutions; supervise the care of children in boarding and 247.19 foster homes or in private institutions; and generally perform 247.20 all functions relating to the field of child welfare now vested 247.21 in the state board of control. 247.22 (4) Administer and supervise all noninstitutional service 247.23 to handicapped persons, including those who are visually 247.24 impaired, hearing impaired, or physically impaired or otherwise 247.25 handicapped. The commissioner may provide and contract for the 247.26 care and treatment of qualified indigent children in facilities 247.27 other than those located and available at state hospitals when 247.28 it is not feasible to provide the service in state hospitals. 247.29 (5) Assist and actively cooperate with other departments, 247.30 agencies and institutions, local, state, and federal, by 247.31 performing services in conformity with the purposes of Laws 247.32 1939, chapter 431. 247.33 (6) Act as the agent of and cooperate with the federal 247.34 government in matters of mutual concern relative to and in 247.35 conformity with the provisions of Laws 1939, chapter 431, 247.36 including the administration of any federal funds granted to the 248.1 state to aid in the performance of any functions of the 248.2 commissioner as specified in Laws 1939, chapter 431, and 248.3 including the promulgation of rules making uniformly available 248.4 medical care benefits to all recipients of public assistance, at 248.5 such times as the federal government increases its participation 248.6 in assistance expenditures for medical care to recipients of 248.7 public assistance, the cost thereof to be borne in the same 248.8 proportion as are grants of aid to said recipients. 248.9 (7) Establish and maintain any administrative units 248.10 reasonably necessary for the performance of administrative 248.11 functions common to all divisions of the department. 248.12 (8) Act as designated guardian of both the estate and the 248.13 person of all the wards of the state of Minnesota, whether by 248.14 operation of law or by an order of court, without any further 248.15 act or proceeding whatever, except as to persons committed as 248.16 mentally retarded. For children under the guardianship of the 248.17 commissioner whose interests would be best served by adoptive 248.18 placement, the commissioner may contract with a licensed 248.19 child-placing agency to provide adoption services. A contract 248.20 with a licensed child-placing agency must be designed to 248.21 supplement existing county efforts and may not replace existing 248.22 county programs, unless the replacement is agreed to by the 248.23 county board and the appropriate exclusive bargaining 248.24 representative or the commissioner has evidence that child 248.25 placements of the county continue to be substantially below that 248.26 of other counties. 248.27 (9) Act as coordinating referral and informational center 248.28 on requests for service for newly arrived immigrants coming to 248.29 Minnesota. 248.30 (10) The specific enumeration of powers and duties as 248.31 hereinabove set forth shall in no way be construed to be a 248.32 limitation upon the general transfer of powers herein contained. 248.33 (11) Establish county, regional, or statewide schedules of 248.34 maximum fees and charges which may be paid by county agencies 248.35 for medical, dental, surgical, hospital, nursing and nursing 248.36 home care and medicine and medical supplies under all programs 249.1 of medical care provided by the state and for congregate living 249.2 care under the income maintenance programs. 249.3 (12) Have the authority to conduct and administer 249.4 experimental projects to test methods and procedures of 249.5 administering assistance and services to recipients or potential 249.6 recipients of public welfare. To carry out such experimental 249.7 projects, it is further provided that the commissioner of human 249.8 services is authorized to waive the enforcement of existing 249.9 specific statutory program requirements, rules, and standards in 249.10 one or more counties. The order establishing the waiver shall 249.11 provide alternative methods and procedures of administration, 249.12 shall not be in conflict with the basic purposes, coverage, or 249.13 benefits provided by law, and in no event shall the duration of 249.14 a project exceed four years. It is further provided that no 249.15 order establishing an experimental project as authorized by the 249.16 provisions of this section shall become effective until the 249.17 following conditions have been met: 249.18 (a) The secretary of health, education, and welfare of the 249.19 United States has agreed, for the same project, to waive state 249.20 plan requirements relative to statewide uniformity. 249.21 (b) A comprehensive plan, including estimated project 249.22 costs, shall be approved by the legislative advisory commission 249.23 and filed with the commissioner of administration. 249.24 (13) According to federal requirements, establish 249.25 procedures to be followed by local welfare boards in creating 249.26 citizen advisory committees, including procedures for selection 249.27 of committee members. 249.28 (14) Allocate federal fiscal disallowances or sanctions 249.29 which are based on quality control error rates for the aid to 249.30 families with dependent children, Minnesota family investment 249.31 program-statewide, medical assistance, or food stamp program in 249.32 the following manner: 249.33 (a) One-half of the total amount of the disallowance shall 249.34 be borne by the county boards responsible for administering the 249.35 programs. For the medical assistance, MFIP-S, and AFDC 249.36 programs, disallowances shall be shared by each county board in 250.1 the same proportion as that county's expenditures for the 250.2 sanctioned program are to the total of all counties' 250.3 expenditures for the AFDC, MFIP-S, and medical assistance 250.4 programs. For the food stamp program, sanctions shall be shared 250.5 by each county board, with 50 percent of the sanction being 250.6 distributed to each county in the same proportion as that 250.7 county's administrative costs for food stamps are to the total 250.8 of all food stamp administrative costs for all counties, and 50 250.9 percent of the sanctions being distributed to each county in the 250.10 same proportion as that county's value of food stamp benefits 250.11 issued are to the total of all benefits issued for all 250.12 counties. Each county shall pay its share of the disallowance 250.13 to the state of Minnesota. When a county fails to pay the 250.14 amount due hereunder, the commissioner may deduct the amount 250.15 from reimbursement otherwise due the county, or the attorney 250.16 general, upon the request of the commissioner, may institute 250.17 civil action to recover the amount due. 250.18 (b) Notwithstanding the provisions of paragraph (a), if the 250.19 disallowance results from knowing noncompliance by one or more 250.20 counties with a specific program instruction, and that knowing 250.21 noncompliance is a matter of official county board record, the 250.22 commissioner may require payment or recover from the county or 250.23 counties, in the manner prescribed in paragraph (a), an amount 250.24 equal to the portion of the total disallowance which resulted 250.25 from the noncompliance, and may distribute the balance of the 250.26 disallowance according to paragraph (a). 250.27 (15) Develop and implement special projects that maximize 250.28 reimbursements and result in the recovery of money to the 250.29 state. For the purpose of recovering state money, the 250.30 commissioner may enter into contracts with third parties. Any 250.31 recoveries that result from projects or contracts entered into 250.32 under this paragraph shall be deposited in the state treasury 250.33 and credited to a special account until the balance in the 250.34 account reaches $1,000,000. When the balance in the account 250.35 exceeds $1,000,000, the excess shall be transferred and credited 250.36 to the general fund. All money in the account is appropriated 251.1 to the commissioner for the purposes of this paragraph. 251.2 (16) Have the authority to make direct payments to 251.3 facilities providing shelter to women and their children 251.4 according to section 256D.05, subdivision 3. Upon the written 251.5 request of a shelter facility that has been denied payments 251.6 under section 256D.05, subdivision 3, the commissioner shall 251.7 review all relevant evidence and make a determination within 30 251.8 days of the request for review regarding issuance of direct 251.9 payments to the shelter facility. Failure to act within 30 days 251.10 shall be considered a determination not to issue direct payments. 251.11 (17) Have the authority to establish and enforce the 251.12 following county reporting requirements: 251.13 (a) The commissioner shall establish fiscal and statistical 251.14 reporting requirements necessary to account for the expenditure 251.15 of funds allocated to counties for human services programs. 251.16 When establishing financial and statistical reporting 251.17 requirements, the commissioner shall evaluate all reports, in 251.18 consultation with the counties, to determine if the reports can 251.19 be simplified or the number of reports can be reduced. 251.20 (b) The county board shall submit monthly or quarterly 251.21 reports to the department as required by the commissioner. 251.22 Monthly reports are due no later than 15 working days after the 251.23 end of the month. Quarterly reports are due no later than 30 251.24 calendar days after the end of the quarter, unless the 251.25 commissioner determines that the deadline must be shortened to 251.26 20 calendar days to avoid jeopardizing compliance with federal 251.27 deadlines or risking a loss of federal funding. Only reports 251.28 that are complete, legible, and in the required format shall be 251.29 accepted by the commissioner. 251.30 (c) If the required reports are not received by the 251.31 deadlines established in clause (b), the commissioner may delay 251.32 payments and withhold funds from the county board until the next 251.33 reporting period. When the report is needed to account for the 251.34 use of federal funds and the late report results in a reduction 251.35 in federal funding, the commissioner shall withhold from the 251.36 county boards with late reports an amount equal to the reduction 252.1 in federal funding until full federal funding is received. 252.2 (d) A county board that submits reports that are late, 252.3 illegible, incomplete, or not in the required format for two out 252.4 of three consecutive reporting periods is considered 252.5 noncompliant. When a county board is found to be noncompliant, 252.6 the commissioner shall notify the county board of the reason the 252.7 county board is considered noncompliant and request that the 252.8 county board develop a corrective action plan stating how the 252.9 county board plans to correct the problem. The corrective 252.10 action plan must be submitted to the commissioner within 45 days 252.11 after the date the county board received notice of noncompliance. 252.12 (e) The final deadline for fiscal reports or amendments to 252.13 fiscal reports is one year after the date the report was 252.14 originally due. If the commissioner does not receive a report 252.15 by the final deadline, the county board forfeits the funding 252.16 associated with the report for that reporting period and the 252.17 county board must repay any funds associated with the report 252.18 received for that reporting period. 252.19 (f) The commissioner may not delay payments, withhold 252.20 funds, or require repayment under paragraph (c) or (e) if the 252.21 county demonstrates that the commissioner failed to provide 252.22 appropriate forms, guidelines, and technical assistance to 252.23 enable the county to comply with the requirements. If the 252.24 county board disagrees with an action taken by the commissioner 252.25 under paragraph (c) or (e), the county board may appeal the 252.26 action according to sections 14.57 to 14.69. 252.27 (g) Counties subject to withholding of funds under 252.28 paragraph (c) or forfeiture or repayment of funds under 252.29 paragraph (e) shall not reduce or withhold benefits or services 252.30 to clients to cover costs incurred due to actions taken by the 252.31 commissioner under paragraph (c) or (e). 252.32 (18) Allocate federal fiscal disallowances or sanctions for 252.33 audit exceptions when federal fiscal disallowances or sanctions 252.34 are based on a statewide random sample for the foster care 252.35 program under title IV-E of the Social Security Act, United 252.36 States Code, title 42, in direct proportion to each county's 253.1 title IV-E foster care maintenance claim for that period. 253.2 (19) Be responsible for ensuring the detection, prevention, 253.3 investigation, and resolution of fraudulent activities or 253.4 behavior by applicants, recipients, and other participants in 253.5 the human services programs administered by the department. 253.6 (20) Require county agencies to identify overpayments, 253.7 establish claims, and utilize all available and cost-beneficial 253.8 methodologies to collect and recover these overpayments in the 253.9 human services programs administered by the department. 253.10 (21) Have the authority to administer a drug rebate program 253.11 for drugs purchased pursuant to the senior citizen drug program 253.12 established under section 256.955 after the beneficiary's 253.13 satisfaction of any deductible established in the program. The 253.14 commissioner shall require a rebate agreement from all 253.15 manufacturers of covered drugs as defined in section 256B.0625, 253.16 subdivision 13. For each drug, the amount of the rebate shall 253.17 be equal to the basic rebate as defined for purposes of the 253.18 federal rebate program in United States Code, title 42, section 253.19 1396r-8(c)(1). This basic rebate shall be applied to 253.20 single-source and multiple-source drugs. The manufacturers must 253.21 provide full payment within 30 days of receipt of the state 253.22 invoice for the rebate within the terms and conditions used for 253.23 the federal rebate program established pursuant to section 1927 253.24 of title XIX of the Social Security Act. The manufacturers must 253.25 provide the commissioner with any information necessary to 253.26 verify the rebate determined per drug. The rebate program shall 253.27 utilize the terms and conditions used for the federal rebate 253.28 program established pursuant to section 1927 of title XIX of the 253.29 Social Security Act. 253.30 Sec. 6. Minnesota Statutes 1996, section 256.014, 253.31 subdivision 1, is amended to read: 253.32 Subdivision 1. [ESTABLISHMENT OF SYSTEMS.] The 253.33 commissioner of human services shall establish and enhance 253.34 computer systems necessary for the efficient operation of the 253.35 programs the commissioner supervises, including: 253.36 (1) management and administration of the food stamp and 254.1 income maintenance programs, including the electronic 254.2 distribution of benefits; 254.3 (2) management and administration of the child support 254.4 enforcement program; and 254.5 (3) administration of medical assistance and general 254.6 assistance medical care. 254.7 The commissioner shall distribute the nonfederal share of 254.8 the costs of operating and maintaining the systems to the 254.9 commissioner and to the counties participating in the system in 254.10 a manner that reflects actual system usage, except that the 254.11 nonfederal share of the costs of the MAXIS computer system and 254.12 child support enforcement systems shall be borne entirely by the 254.13 commissioner. Development costs must not be assessed against 254.14 county agencies. 254.15 The commissioner may enter into contractual agreements with 254.16 federally recognized Indian tribes with a reservation in 254.17 Minnesota to participate in state-operated computer systems 254.18 related to the management and administration of the food stamp, 254.19 income maintenance, child support enforcement, medical 254.20 assistance, and general assistance medical care programs to the 254.21 extent necessary for the tribe to operate a federally approved 254.22 family assistance program or any other program under the 254.23 supervision of the commissioner. 254.24 Sec. 7. Minnesota Statutes 1997 Supplement, section 254.25 256.031, subdivision 6, is amended to read: 254.26 Subd. 6. [END OF FIELD TRIALS.] (a) Upon agreement with 254.27 the federal government, the field trials of the Minnesota family 254.28 investment plan will end June 30, 1998. 254.29 (b) Families in the comparison group under subdivision 3, 254.30 paragraph (d), clause (i), receiving aid to families with 254.31 dependent children under sections 256.72 to 256.87, and STRIDE 254.32 services under section 256.736 will continue in those programs 254.33 until June 30, 1998. After June 30, 1998, families who cease 254.34 receiving assistance under the Minnesota family investment plan 254.35 and comparison group families who cease receiving assistance 254.36 under AFDC and STRIDE who are eligible for the Minnesota family 255.1 investment program-statewide (MFIP-S), medical assistance, 255.2 general assistance medical care, or the food stamp program shall 255.3 be placed with their consent on the programs for which they are 255.4 eligible. 255.5 (c) Families who cease receiving assistance under the MFIP 255.6 and comparison families who cease receiving assistance under 255.7 AFDC and STRIDE who are ineligible for MFIP-S due to increased 255.8 income from employment, or increased child or spousal support or 255.9 a combination of employment income and child or spousal support, 255.10 shall be eligible for extended medical assistance under section 255.11 256B.0635. For the purpose of determining receipt of extended 255.12 medical assistance, receipt of AFDC and MFIP shall be considered 255.13 to be the same as receipt of MFIP-S. 255.14 Sec. 8. Minnesota Statutes 1997 Supplement, section 255.15 256.741, is amended by adding a subdivision to read: 255.16 Subd. 2a. [FAMILIES-FIRST DISTRIBUTION OF CHILD SUPPORT 255.17 ARREARAGES.] Child support collected on behalf of a family that 255.18 formerly received assistance under AFDC, MFIP, MFIP-R, MFIP-S, 255.19 or Work First must be distributed as follows: 255.20 (1) to the extent that the amount collected does not exceed 255.21 the amount required to be paid to the family for the month in 255.22 which collected, the state shall distribute the amount to the 255.23 family; and 255.24 (2) to the extent that the amount collected exceeds the 255.25 amount required to be paid to the family for the month in which 255.26 collected, the state shall distribute the amount as follows: 255.27 (i) the state shall first distribute the amount collected 255.28 to the family to the extent necessary to satisfy any support 255.29 arrearages accrued after the family ceased to receive assistance 255.30 from the state; and 255.31 (ii) the state shall then distribute the amount collected 255.32 to the family to the extent necessary to satisfy any support 255.33 arrearages with respect to the family that accrued before the 255.34 family received assistance from the state. 255.35 Sec. 9. Minnesota Statutes 1997 Supplement, section 255.36 256.9864, is amended to read: 256.1 256.9864 [REPORTS BY RECIPIENT.] 256.2 (a) An assistance unit with a recent work history or with 256.3 earned income shall report monthly to the county agency on 256.4 income received and other circumstances affecting eligibility or 256.5 assistance amounts. All other assistance units shall report on 256.6 income and other circumstances affecting eligibility and 256.7 assistance amounts, as specified by the state agency. 256.8 (b) An assistance unit required to submit a report on the 256.9 form designated by the commissioner and within ten days of the 256.10 due date or the date of the significant change, whichever is 256.11 later, or otherwise report significant changes which would 256.12 affect eligibility or assistance amounts, is considered to have 256.13 continued its application for assistance effective the date the 256.14 required report is received by the county agency, if a complete 256.15 report is received within a calendar month in which assistance 256.16 was received, except that no assistance shall be paid for the256.17period beginning with the end of the month in which the report256.18was due and ending with the date the report was received by the256.19county agency. 256.20 Sec. 10. Minnesota Statutes 1997 Supplement, section 256.21 256B.062, is amended to read: 256.22 256B.062 [CONTINUED ELIGIBILITY.] 256.23 Medical assistance may be paid for persons who received aid 256.24 to families with dependent children in at least three of the six 256.25 months preceding the month in which the person became ineligible 256.26 for aid to families with dependent children, if the 256.27 ineligibility was due to an increase in hours of employment or 256.28 employment income or due to the loss of an earned income 256.29 disregard. A person who is eligible for extended medical 256.30 assistance is entitled to six months of assistance without 256.31 reapplication, unless the assistance unit ceases to include a 256.32 dependent child. For a person under 21 years of age, medical 256.33 assistance may not be discontinued within the six-month period 256.34 of extended eligibility until it has been determined that the 256.35 person is not otherwise eligible for medical assistance. 256.36 Medical assistance may be continued for an additional six months 257.1 if the person meets all requirements for the additional six 257.2 months, according to Title XIX of the Social Security Act, as 257.3 amended by section 303 of the Family Support Act of 1988, Public 257.4 Law Number 100-485. This section is repealed effectiveMarch 31257.5 July 1, 1998. 257.6 Sec. 11. Minnesota Statutes 1997 Supplement, section 257.7 256B.0635, is amended by adding a subdivision to read: 257.8 Subd. 3. [EXTENDED MEDICAL ASSISTANCE FOR MFIP-S 257.9 PARTICIPANTS WHO OPT TO DISCONTINUE MONTHLY CASH 257.10 ASSISTANCE.] Upon federal approval, medical assistance is 257.11 available to persons who received MFIP-S in at least three of 257.12 the six months preceding the month in which the person opted to 257.13 discontinue receiving MFIP-S cash assistance under section 257.14 256J.31, subdivision 12. A person who is eligible for medical 257.15 assistance under this section may receive medical assistance 257.16 without reapplication as long as the person meets MFIP-S 257.17 eligibility requirements, unless the assistance unit does not 257.18 include a dependent child. Medical assistance may be paid 257.19 pursuant to subdivisions 1 and 2 for persons who are no longer 257.20 eligible for MFIP-S due to increased employment or child support. 257.21 Sec. 12. Minnesota Statutes 1997 Supplement, section 257.22 256D.05, subdivision 8, is amended to read: 257.23 Subd. 8. [CITIZENSHIP.] (a) Effective July 1, 1997, 257.24 citizenship requirements for applicants and recipients under 257.25 sections 256D.01 to 256D.03, subdivision 2, and 256D.04 to 257.26 256D.21 shall be determined the same as under section 256J.11,257.27except that legal noncitizens who are applicants or recipients257.28must have been residents of Minnesota on March 1, 1997. Legal257.29noncitizens who arrive in Minnesota after March 1, 1997, and257.30become elderly or disabled after that date, and are otherwise257.31eligible for general assistance can receive benefits under this257.32section. The income and assets of sponsors of noncitizens shall 257.33 be deemed available to general assistance applicants and 257.34 recipients according to the Personal Responsibility and Work 257.35 Opportunity Reconciliation Act of 1996, Public Law Number 257.36 104-193, title IV, sections 421 and 422, and subsequently set 258.1 out in federal rules. 258.2 (b) As a condition of eligibility, each legal adult 258.3 noncitizen in the assistance unit who has resided in the country 258.4 for four years or more and who is under 70 years of age must: 258.5 (1) be enrolled in a literacy class, English as a second 258.6 language class, or a citizen class; 258.7 (2) be applying for admission to a literacy class, English 258.8 as a second language class, and is on a waiting list; 258.9 (3) be in the process of applying for a waiver from the 258.10 Immigration and Naturalization Service of the English language 258.11 or civics requirements of the citizenship test; 258.12 (4) have submitted an application for citizenship to the 258.13 Immigration and Naturalization Service and is waiting for a 258.14 testing date or a subsequent swearing in ceremony; or 258.15 (5) have been denied citizenship due to a failure to pass 258.16 the test after two attempts or because of an inability to 258.17 understand the rights and responsibilities of becoming a United 258.18 States citizen, as documented by the Immigration and 258.19 Naturalization Service or the county. 258.20 If the county social service agency determines that a legal 258.21 noncitizen subject to the requirements of this subdivision will 258.22 require more than one year of English language training, then 258.23 the requirements of clause (1) or (2) shall be imposed after the 258.24 legal noncitizen has resided in the country for three years. 258.25 Individuals who reside in a facility licensed under chapter 258.26 144A, 144D, 245A, or 256I are exempt from the requirements of 258.27 this section. 258.28 Sec. 13. Minnesota Statutes 1996, section 256D.051, is 258.29 amended by adding a subdivision to read: 258.30 Subd. 18. [WAIVER OF SERVICE COST REIMBURSEMENT LIMIT FOR 258.31 PARTICIPANTS WITH SIGNIFICANT BARRIERS TO EMPLOYMENT.] 258.32 (a) To the extent of available resources, the commissioner 258.33 may waive the $400 service cost limit specified in subdivision 6 258.34 for county agencies who propose to provide enhanced services 258.35 under the food stamp employment and training program to 258.36 hard-to-employ individuals. A "hard-to-employ individual" is 259.1 defined as: 259.2 (1) a recipient of general assistance under chapter 256D; 259.3 or 259.4 (2) an individual with at least one of the following three 259.5 barriers to employment: 259.6 (i) the individual has not completed secondary school or 259.7 obtained a general equivalency development diploma or an adult 259.8 diploma, and has low skills in reading or mathematics; 259.9 (ii) the individual requires substance abuse treatment for 259.10 employment; and 259.11 (iii) the individual has a poor work history. 259.12 (b) To obtain a waiver, the county agency must submit a 259.13 waiver request to the commissioner. The request must specify: 259.14 (1) the number of hard-to-employ individuals the agency 259.15 plans to serve; 259.16 (2) the nature of the enhanced employment and training 259.17 services the agency will provide; and 259.18 (3) the agency's plan for providing referrals for substance 259.19 abuse assessment and treatment for hard-to-employ individuals 259.20 who require substance abuse treatment for employment. 259.21 Sec. 14. [256D.053] [MINNESOTA FOOD ASSISTANCE PROGRAM.] 259.22 Subdivision 1. [PROGRAM ESTABLISHED.] For the period from 259.23 July 1, 1998, to June 30, 1999, the Minnesota food assistance 259.24 program is established to provide food assistance to legal 259.25 noncitizens residing in this state who are ineligible to 259.26 participate in the federal food stamp program solely due to the 259.27 provisions of section 402 or 403 of Public Law Number 104-193, 259.28 as authorized by Title VII of the 1997 Emergency Supplemental 259.29 Appropriations Act, Public Law Number 105-18. 259.30 Subd. 2. [ELIGIBILITY REQUIREMENTS.] To be eligible for 259.31 the Minnesota food assistance program, all of the following 259.32 conditions must be met: 259.33 (1) the applicant must meet the initial and ongoing 259.34 eligibility requirements for the federal food stamp program, 259.35 except for the applicant's ineligible immigration status; 259.36 (2) the applicant must be either a qualified noncitizen as 260.1 defined in section 256J.08, subdivision 73, or a noncitizen 260.2 otherwise residing lawfully in the United States; 260.3 (3) the applicant must be a resident of the state; and 260.4 (4) the applicant must not be receiving assistance under 260.5 the Minnesota family investment program-statewide or the work 260.6 first program. 260.7 Subd. 3. [PROGRAM ADMINISTRATION.] (a) The rules for the 260.8 Minnesota food assistance program shall follow exactly the 260.9 regulations for the federal food stamp program, except for the 260.10 provisions pertaining to immigration status under section 402 or 260.11 403 of Public Law Number 104-193. 260.12 (b) The county agency shall use the income, budgeting, and 260.13 benefit allotment regulations of the federal food stamp program 260.14 to calculate an eligible recipient's monthly Minnesota food 260.15 assistance program benefit. Until September 30, 1998, eligible 260.16 recipients under this subdivision shall receive the average per 260.17 person food stamp issuance in Minnesota in the fiscal year 260.18 ending June 30, 1997. Beginning October 1, 1998, eligible 260.19 recipients shall receive the same level of benefits as those 260.20 provided by the federal food stamp program to similarly situated 260.21 citizen recipients. The monthly Minnesota food assistance 260.22 program benefits shall not exceed an amount equal to the amount 260.23 of federal food stamp benefits the household would receive if 260.24 all members of the household were eligible for the federal food 260.25 stamp program. 260.26 (c) Minnesota food assistance program benefits must be 260.27 disregarded as income in all programs that do not count food 260.28 stamps as income. 260.29 (d) The county agency must redetermine a Minnesota food 260.30 assistance program recipient's eligibility for the federal food 260.31 stamp program when the agency receives information that the 260.32 recipient's legal immigration status has changed in such a way 260.33 that would make the recipient potentially eligible for the 260.34 federal food stamp program. 260.35 (e) Until October 1, 1998, the commissioner may provide 260.36 benefits under this section in cash. 261.1 Subd. 4. [STATE PLAN REQUIRED.] The commissioner shall 261.2 submit a state plan to the secretary of agriculture to allow the 261.3 commissioner to purchase federal food stamp benefits for each 261.4 Minnesota food assistance program recipient who is ineligible to 261.5 participate in the federal food stamp program solely due to the 261.6 provisions of section 402 or 403 of Public Law Number 104-193, 261.7 as authorized by Title VII of the 1997 Emergency Supplemental 261.8 Appropriations Act, Public Law Number 105-18. The commissioner 261.9 shall enter into a contract as necessary with the secretary to 261.10 use the existing federal food stamp benefit delivery system for 261.11 the purposes of administering the Minnesota food assistance 261.12 program under this section. 261.13 Sec. 15. Minnesota Statutes 1996, section 256D.46, 261.14 subdivision 2, is amended to read: 261.15 Subd. 2. [INCOME AND RESOURCE TEST.] All income and 261.16 resources available to the recipient must be considered in 261.17 determining the recipient's ability to meet the emergency need. 261.18 Property that can be liquidated in time to resolve the emergency 261.19 and income,(excludingMinnesota supplemental aid issued for261.20current month's need)an amount equal to the Minnesota 261.21 supplemental aid standard of assistance, that is normally 261.22 disregarded or excluded under the Minnesota supplemental aid 261.23 program must be considered available to meet the emergency need. 261.24 Sec. 16. Minnesota Statutes 1997 Supplement, section 261.25 256J.02, subdivision 4, is amended to read: 261.26 Subd. 4. [AUTHORITY TO TRANSFER.] Subject to limitations 261.27 of title I of Public Law Number 104-193, the Personal 261.28 Responsibility and Work Opportunity Reconciliation Act of 261.29 1996, as amended, the legislature may transfer money from the 261.30 TANF block grant to the child care fund under chapter 119B, or 261.31 the Title XX block grant under section 256E.07. 261.32 Sec. 17. Minnesota Statutes 1997 Supplement, section 261.33 256J.03, is amended to read: 261.34 256J.03 [TANF RESERVE ACCOUNT.] 261.35 Subdivision 1. TheMinnesota family investment261.36program-statewide/TANFTANF reserve account is created in the 262.1 state treasury. Funds retained or deposited in the TANF reserve 262.2 shall include: (1) funds designated by the legislatureand; (2) 262.3 unexpended state funds resulting from the acceleration of TANF 262.4 expenditures under subdivision 2; (3) earnings available from 262.5 the federal TANF block grant appropriated to the commissioner 262.6 but not expended in the biennium beginning July 1, 1997, shall262.7be retained; and (4) TANF funds available in fiscal years 1998, 262.8 1999, 2000, and 2001 that are not spent or not budgeted to be 262.9 spent in those years. 262.10 Funds deposited in the reserve accounttomust be expended 262.11 for the Minnesota family investment program-statewidein fiscal262.12year 2000 and subsequent fiscal yearsand directly related state 262.13 programs for the purposes in subdivision 3. 262.14 Subd. 2. [AUTHORIZATION TO ACCELERATE EXPENDITURE OF TANF 262.15 FUNDS.] The commissioner may expend federal Temporary Assistance 262.16 to Needy Families block grant funds in excess of appropriated 262.17 levels for the purpose of accelerating federal funding of the 262.18 MFIP program. By the end of the fiscal year in which the 262.19 additional federal expenditures are made, the commissioner must 262.20 deposit into the reserve account an amount of unexpended state 262.21 funds appropriated for assistance to families grants, aid to 262.22 families with dependent children, and Minnesota family 262.23 investment plan equal to the additional federal expenditures. 262.24 Reserve funds may be spent as TANF appropriations if 262.25 insufficient TANF funds are available because of acceleration. 262.26 Subd. 3. [ALLOWED TRANSFER PURPOSE.] Funds from the 262.27 reserve account may be used for the following purposes: 262.28 (1) unanticipated Temporary Assistance to Needy Families 262.29 block grant maintenance of effort shortfalls; 262.30 (2) MFIP cost increases due to reduced federal revenues and 262.31 federal law changes; 262.32 (3) one-half of the MFIP general fund cost increase in 262.33 fiscal year 2000 and subsequent fiscal years due to caseload 262.34 increases over fiscal year 1999; and 262.35 (4) transfers allowed under section 256J.02, subdivision 4. 262.36 Sec. 18. Minnesota Statutes 1997 Supplement, section 263.1 256J.08, subdivision 11, is amended to read: 263.2 Subd. 11. [CAREGIVER.] "Caregiver" means a minor child's 263.3 natural or adoptive parent or parents and stepparent who live in 263.4 the home with the minor child. For purposes of determining 263.5 eligibility for this program, caregiver also means any of the 263.6 following individuals, if adults, who live with and provide care 263.7 and support to a minor child when the minor child's natural or 263.8 adoptive parent or parents or stepparent do not reside in the 263.9 same home: legalcustodianscustodian or guardian, grandfather, 263.10 grandmother, brother, sister,stepfather, stepmother,263.11 stepbrother, stepsister, uncle, aunt, first cousin, nephew, 263.12 niece, person of preceding generation as denoted by prefixes of 263.13 "great," "great-great," or "great-great-great," or a spouse of 263.14 any person named in the above groups even after the marriage 263.15 ends by death or divorce. 263.16 Sec. 19. Minnesota Statutes 1997 Supplement, section 263.17 256J.08, is amended by adding a subdivision to read: 263.18 Subd. 24a. [DISQUALIFIED.] "Disqualified" means being 263.19 ineligible to receive MFIP-S due to noncooperation with program 263.20 requirements. Except for persons whose disqualification is 263.21 based on fraud, a disqualified person can take action to correct 263.22 the reason for ineligibility. 263.23 Sec. 20. Minnesota Statutes 1997 Supplement, section 263.24 256J.08, subdivision 26, is amended to read: 263.25 Subd. 26. [EARNED INCOME.] "Earned income" means cash or 263.26 in-kind income earned through the receipt of wages, salary, 263.27 commissions, profit from employment activities, net profit from 263.28 self-employment activities, payments made by an employer for 263.29 regularly accrued vacation or sick leave, and any other profit 263.30 from activity earned through effort or labor. The income must 263.31 be in return for, or as a result of, legal activity. 263.32 Sec. 21. Minnesota Statutes 1997 Supplement, section 263.33 256J.08, subdivision 28, is amended to read: 263.34 Subd. 28. [EMERGENCY.] "Emergency" means a situation or a 263.35 set of circumstances that causes or threatens to cause 263.36 destitution to aminor childfamily with a child under age 21. 264.1 Sec. 22. Minnesota Statutes 1997 Supplement, section 264.2 256J.08, subdivision 40, is amended to read: 264.3 Subd. 40. [GROSS EARNED INCOME.] "Gross earned income" 264.4 means earned income from employment before mandatory and 264.5 voluntary payroll deductions. Gross earned income includes 264.6 salaries, wages, tips, gratuities, commissions, incentive 264.7 payments from work or training programs, payments made by an 264.8 employer for regularly accrued vacation or sick leave, and 264.9 profits from other activity earned by an individual's effort or 264.10 labor. Gross earned income includes uniform and meal allowances 264.11 if federal income tax is deducted from the allowance. Gross 264.12 earned income includes flexible work benefits received from an 264.13 employer if the employee has the option of receiving the benefit 264.14 or benefits in cash. For self-employment, gross earned income 264.15 is the nonexcluded income minus expenses for the business. 264.16 Sec. 23. Minnesota Statutes 1997 Supplement, section 264.17 256J.08, is amended by adding a subdivision to read: 264.18 Subd. 46a. [SHELTER COSTS.] "Shelter costs" means rent, 264.19 manufactured home lot rental costs, or monthly principal, 264.20 interest, insurance premiums, and property taxes due for 264.21 mortgages or contracts for deed. 264.22 Sec. 24. Minnesota Statutes 1997 Supplement, section 264.23 256J.08, is amended by adding a subdivision to read: 264.24 Subd. 50a. [INTERSTATE TRANSITIONAL STANDARD.] "Interstate 264.25 transitional standard" means a combination of the cash 264.26 assistance a family with no other income would have received in 264.27 the state of previous residence and the Minnesota food portion 264.28 for the appropriate size family. 264.29 Sec. 25. Minnesota Statutes 1997 Supplement, section 264.30 256J.08, is amended by adding a subdivision to read: 264.31 Subd. 51a. [LEGAL CUSTODIAN.] "Legal custodian" means any 264.32 person who is under a legal obligation to provide care and 264.33 support for a minor and who is in fact providing care and 264.34 support for a minor. For an Indian child, custodian means any 264.35 Indian person who has legal custody of an Indian child under 264.36 tribal law or custom or under state law or to whom temporary 265.1 physical care, custody, and control has been transferred by the 265.2 parent of the child, as provided in section 257.351, subdivision 265.3 8. 265.4 Sec. 26. Minnesota Statutes 1997 Supplement, section 265.5 256J.08, subdivision 60, is amended to read: 265.6 Subd. 60. [MINOR CHILD.] "Minor child" means a child who 265.7 is living in the same home of a parent or other caregiver, is 265.8 not the parent of a child in the home, and is either less than 265.9 18 years of age or is under the age of 19 years and isregularly265.10attending asa full-time studentand is expected to complete a265.11high school orin a secondary school or pursuing a full-time 265.12 secondary level course of vocational or technical training 265.13 designed to fit students for gainful employmentbefore reaching265.14age 19. 265.15 Sec. 27. Minnesota Statutes 1997 Supplement, section 265.16 256J.08, is amended by adding a subdivision to read: 265.17 Subd. 61a. [NONCUSTODIAL PARENT.] "Noncustodial parent" 265.18 means a minor child's parent who does not live in the same home 265.19 as the child. 265.20 Sec. 28. Minnesota Statutes 1997 Supplement, section 265.21 256J.08, subdivision 68, is amended to read: 265.22 Subd. 68. [PERSONAL PROPERTY.] "Personal property" means 265.23 an item of value that is not real property, including the value 265.24 of a contract for deed held by a seller, assets held in trust on 265.25 behalf of members of an assistance unit,cash surrender value of265.26life insurance,value of a prepaid burial, savings account, 265.27 value of stocks and bonds, and value of retirement accounts. 265.28 Sec. 29. Minnesota Statutes 1997 Supplement, section 265.29 256J.08, subdivision 73, is amended to read: 265.30 Subd. 73. [QUALIFIED NONCITIZEN.] "Qualified noncitizen" 265.31 means a person: 265.32 (1) who was lawfully admitted for permanent residence 265.33 pursuant to United States Code, title 8; 265.34 (2) who was admitted to the United States as a refugee 265.35 pursuant to United States Code, title 8; section 1157; 265.36 (3) whose deportation is being withheld pursuant to United 266.1 States Code, title 8, section 1253(h); 266.2 (4) who was paroled for a period of at least one year 266.3 pursuant to United States Code, title 8, section 1182(d)(5); 266.4 (5) who was granted conditional entry pursuant to United 266.5 State Code, title 8, section 1153(a)(7); 266.6 (6) who was granted asylum pursuant to United States Code, 266.7 title 8, section 1158;or266.8 (7) determined to be a battered noncitizen by the United 266.9 States Attorney General according to the Illegal Immigration 266.10 Reform and Immigrant Responsibility Act of 1996, Title V of the 266.11 Omnibus Consolidated Appropriations Bill, Public Law Number 266.12 104-208; or 266.13 (8) who was admitted as a Cuban or Haitian entrant. 266.14 Sec. 30. Minnesota Statutes 1997 Supplement, section 266.15 256J.08, subdivision 83, is amended to read: 266.16 Subd. 83. [SIGNIFICANT CHANGE.] "Significant change" means 266.17 a decline in gross income of3536 percent or more from the 266.18 income used to determine the grant for the current month. 266.19 Sec. 31. Minnesota Statutes 1997 Supplement, section 266.20 256J.09, subdivision 6, is amended to read: 266.21 Subd. 6. [INVALID REASON FOR DELAY.] A county agency must 266.22 not delay a decision on eligibility or delay issuing the 266.23 assistance payment except to establish state residence as 266.24 provided in section 256J.12 by: 266.25 (1) treating the 30-day processing period as a waiting 266.26 period; 266.27 (2) delaying approval or issuance of the assistance payment 266.28 pending the decision of the county board; or 266.29 (3) awaiting the result of a referral to a county agency in 266.30 another county when the county receiving the application does 266.31 not believe it is the county of financial responsibility. 266.32 Sec. 32. Minnesota Statutes 1997 Supplement, section 266.33 256J.09, subdivision 9, is amended to read: 266.34 Subd. 9. [ADDENDUM TO AN EXISTING APPLICATION.] (a) An 266.35 addendum to an existing application must be used to add persons 266.36 to an assistance unit regardless of whether the persons being 267.1 added are required to be in the assistance unit. When a person 267.2 is added by addendum to an assistance unit, eligibility for that 267.3 person begins on the first of the month the addendum was filed 267.4 except as provided in section 256J.74, subdivision 2, clause (1). 267.5 (b) An overpayment must be determined when a change in 267.6 household composition is not reported within the deadlines in 267.7 section 256J.30, subdivision 9. Any overpayment must be 267.8 calculated from the month of the change including the needs, 267.9 income, and assets of any individual who is required to be 267.10 included in the assistance unit under section 256J.24, 267.11 subdivision 2. Individuals not included in the assistance unit 267.12 who are identified in section 256J.37, subdivisions 1 to 2, must 267.13 have their income and assets considered when determining the 267.14 amount of the overpayment. 267.15 Sec. 33. Minnesota Statutes 1997 Supplement, section 267.16 256J.11, subdivision 2, as amended by Laws 1997, Third Special 267.17 Session chapter 1, section 1, is amended to read: 267.18 Subd. 2. [NONCITIZENS; FOOD PORTION.] (a) For the period 267.19 September 1, 1997, to October 31, 1997, noncitizens who do not 267.20 meet one of the exemptions in section 412 of the Personal 267.21 Responsibility and Work Opportunity Reconciliation Act of 1996, 267.22 but were residing in this state as of July 1, 1997, are eligible 267.23 for the 6/10 of the average value of food stamps for the same 267.24 family size and composition until MFIP-S is operative in the 267.25 noncitizen's county of financial responsibility and thereafter, 267.26 the 6/10 of the food portion of MFIP-S. However, federal food 267.27 stamp dollars cannot be used to fund the food portion of MFIP-S 267.28 benefits for an individual under this subdivision. 267.29 (b) For the period November 1, 1997, to June 30,19981999, 267.30 noncitizens who do not meet one of the exemptions in section 412 267.31 of the Personal Responsibility and Work Opportunity 267.32 Reconciliation Act of 1996,but were residing in this state as267.33of July 1, 1997,and are receiving cash assistance under the 267.34 AFDC, family general assistance, MFIP or MFIP-S programs are 267.35 eligible for the average value of food stamps for the same 267.36 family size and composition until MFIP-S is operative in the 268.1 noncitizen's county of financial responsibility and thereafter, 268.2 the food portion of MFIP-S. However, federal food stamp dollars 268.3 cannot be used to fund the food portion of MFIP-S benefits for 268.4 an individual under this subdivision. The assistance provided 268.5 under this subdivision, which is designated as a supplement to 268.6 replace lost benefits under the federal food stamp program, must 268.7 be disregarded as income in all programs that do not count food 268.8 stamps as income where the commissioner has the authority to 268.9 make the income disregard determination for the program. 268.10 (c) The commissioner shall submit a state plan to the 268.11 secretary of agriculture to allow the commissioner to purchase 268.12 federal food stamp benefits in an amount equal to the MFIP-S 268.13 food portion for each legal noncitizen receiving MFIP-S 268.14 assistance who is ineligible to participate in the federal food 268.15 stamp program solely due to the provisions of section 402 or 403 268.16 of Public Law Number 104-193, as authorized by Title VII of the 268.17 1997 Emergency Supplemental Appropriations Act, Public Law 268.18 Number 105-18. The commissioner shall enter into a contract as 268.19 necessary with the secretary to use the existing federal food 268.20 stamp benefit delivery system for the purposes of administering 268.21 the food portion of MFIP-S under this subdivision. 268.22 Sec. 34. Minnesota Statutes 1997 Supplement, section 268.23 256J.12, is amended to read: 268.24 256J.12 [MINNESOTA RESIDENCE.] 268.25 Subdivision 1. [SIMPLE RESIDENCY.] To be eligible for AFDC 268.26 or MFIP-S, whichever is in effect,a familyan assistance unit 268.27 must have established residency in this state which means 268.28 thefamilyassistance unit is present in the state and intends 268.29 to remain here. 268.30 Subd. 1a. [30-DAY RESIDENCY REQUIREMENT.]A familyAn 268.31 assistance unit is considered to have established residency in 268.32 this state only when a child or caregiver has resided in this 268.33 state for at least 30 days with the intention of making the 268.34 person's home here and not for any temporary purpose. The birth 268.35 of a child in Minnesota to a member of the assistance unit does 268.36 not automatically establish the residency in this state under 269.1 this subdivision of the other members of the assistance unit. 269.2 Time spent in a shelter for battered women shall count toward 269.3 satisfying the 30-day residency requirement. 269.4 Subd. 2. [EXCEPTIONS.] (a) A county shall waive the 30-day 269.5 residency requirement where unusual hardship would result from 269.6 denial of assistance. 269.7 (b) For purposes of this section, unusual hardship meansa269.8familyan assistance unit: 269.9 (1) is without alternative shelter; or 269.10 (2) is without available resources for food. 269.11 (c) For purposes of this subdivision, the following 269.12 definitions apply (1) "metropolitan statistical area" is as 269.13 defined by the U.S. Census Bureau; (2) "alternative shelter" 269.14 includes any shelter that is located within the metropolitan 269.15 statistical area containing the county and for which the family 269.16 is eligible, provided thefamilyassistance unit does not have 269.17 to travel more than 20 miles to reach the shelter and has access 269.18 to transportation to the shelter. Clause (2) does not apply to 269.19 counties in the Minneapolis-St. Paul metropolitan statistical 269.20 area. 269.21 (d) Applicants are considered to meet the residency 269.22 requirement under subdivision 1a if they once resided in 269.23 Minnesota and: 269.24 (1) joined the United States armed services, returned to 269.25 Minnesota within 30 days of leaving the armed services, and 269.26 intend to remain in Minnesota; or 269.27 (2) left to attend school in another state, paid 269.28 nonresident tuition or Minnesota tuition rates under a 269.29 reciprocity agreement, and returned to Minnesota within 30 days 269.30 of graduation with the intent to remain in Minnesota. 269.31 (e) The 30-day residence requirement is met when: 269.32 (1) a minor child or a minor caregiver moves from another 269.33 state to the residence of a relative caregiver; 269.34 (2) the minor caregiver applies for and receives family 269.35 cash assistance; 269.36 (3) the relative caregiver chooses not to be part of the 270.1 MFIP-S assistance unit; and 270.2 (4) the relative caregiver has resided in Minnesota for at 270.3 least 30 days prior to the date the assistance unit applies for 270.4 cash assistance. 270.5 (f) Ineligible mandatory unit members who have resided in 270.6 Minnesota for 12 months immediately before the unit's date of 270.7 application establish the other assistance unit members' 270.8 eligibility for the MFIP-S transitional standard. 270.9 Subd. 2a. [MIGRANT WORKERS.] Migrant workers, as defined 270.10 in section 256J.08, and their immediate families are exempt from 270.11 the requirements of subdivisions 1 and 1a, provided the migrant 270.12 worker provides verification that the migrant family worked in 270.13 this state within the last 12 months and earned at least $1,000 270.14 in gross wages during the time the migrant worker worked in this 270.15 state. 270.16 Subd. 3. [PAYMENT PLAN FOR NEW RESIDENTS.] Assistance paid 270.17 to an eligiblefamilyassistance unit in which all members have 270.18 resided in this state for fewer than 12 consecutive calendar 270.19 months immediately preceding the date of application shall be at 270.20 the standard and in the form specified in section 256J.43. 270.21 Subd. 4. [SEVERABILITY CLAUSE.] If any subdivision in this 270.22 section is enjoined from implementation or found 270.23 unconstitutional by any court of competent jurisdiction, the 270.24 remaining subdivisions shall remain valid and shall be given 270.25 full effect. 270.26 Sec. 35. Minnesota Statutes 1997 Supplement, section 270.27 256J.14, is amended to read: 270.28 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 270.29 (a) The definitions in this paragraph only apply to this 270.30 subdivision. 270.31 (1) "Household of a parent, legal guardian, or other adult 270.32 relative" means the place of residence of: 270.33 (i) a natural or adoptive parent; 270.34 (ii) a legal guardian according to appointment or 270.35 acceptance under section 260.242, 525.615, or 525.6165, and 270.36 related laws;or271.1 (iii) a caregiver as defined in section 256J.08, 271.2 subdivision 11; or 271.3 (iv) an appropriate adult relative designated by a county 271.4 agency. 271.5 (2) "Adult-supervised supportive living arrangement" means 271.6 a private family setting which assumes responsibility for the 271.7 care and control of the minor parent and minor child, or other 271.8 living arrangement, not including a public institution, licensed 271.9 by the commissioner of human services which ensures that the 271.10 minor parent receives adult supervision and supportive services, 271.11 such as counseling, guidance, independent living skills 271.12 training, or supervision. 271.13 (b) A minor parent and the minor child who is in the care 271.14 of the minor parent must reside in the household of a parent, 271.15 legal guardian, otherappropriateadult relative,or other271.16caregiver,or in an adult-supervised supportive living 271.17 arrangement in order to receive MFIP-S unless: 271.18 (1) the minor parent has no living parent, other 271.19appropriateadult relative, or legal guardian whose whereabouts 271.20 is known; 271.21 (2) no living parent, otherappropriateadult relative, or 271.22 legal guardian of the minor parent allows the minor parent to 271.23 live in the parent's,appropriateother adult relative's, or 271.24 legal guardian's home; 271.25 (3) the minor parent lived apart from the minor parent's 271.26 own parent or legal guardian for a period of at least one year 271.27 before either the birth of the minor child or the minor parent's 271.28 application for MFIP-S; 271.29 (4) the physical or emotional health or safety of the minor 271.30 parent or minor child would be jeopardized if the minor parent 271.31 and the minor child resided in the same residence with the minor 271.32 parent's parent, otherappropriateadult relative, or legal 271.33 guardian; or 271.34 (5) an adult supervised supportive living arrangement is 271.35 not available for the minor parent andthe dependentchild in 271.36 the county in which the minor parent and child currentlyresides272.1 reside. If an adult supervised supportive living arrangement 272.2 becomes available within the county, the minor parent and child 272.3 must reside in that arrangement. 272.4 (c) Minor applicants must be informed orally and in writing 272.5 about the eligibility requirements and their rights and 272.6 obligations under the MFIP-S program. The county must advise 272.7 the minor of the possible exemptions and specifically ask 272.8 whether one or more of these exemptions is applicable. If the 272.9 minor alleges one or more of these exemptions, then the county 272.10 must assist the minor in obtaining the necessary verifications 272.11 to determine whether or not these exemptions apply. 272.12 (d) If the county worker has reason to suspect that the 272.13 physical or emotional health or safety of the minor parent or 272.14 minor child would be jeopardized if they resided with the minor 272.15 parent's parent, other adult relative, or legal guardian, then 272.16 the county worker must make a referral to child protective 272.17 services to determine if paragraph (b), clause (4), applies. A 272.18 new determination by the county worker is not necessary if one 272.19 has been made within the last six months, unless there has been 272.20 a significant change in circumstances which justifies a new 272.21 referral and determination. 272.22 (e) If a minor parent is not living with a parentor, legal 272.23 guardian, or other adult relative due to paragraph (b), clause 272.24 (1), (2), or (4), the minor parent must reside, when possible, 272.25 in a living arrangement that meets the standards of paragraph 272.26 (a), clause (2). 272.27 (f) When a minor parent and minor childlivelives with 272.28anothera parent, other adult relative, legal guardian, or in an 272.29 adult-supervised supportive living arrangement, MFIP-S must be 272.30 paid, when possible, in the form of a protective payment on 272.31 behalf of the minor parent and minor childin accordance with272.32 according to section 256J.39, subdivisions 2 to 4. 272.33 Sec. 36. Minnesota Statutes 1997 Supplement, section 272.34 256J.15, subdivision 2, is amended to read: 272.35 Subd. 2. [ELIGIBILITY DURING LABOR DISPUTES.] To receive 272.36 assistanceunder MFIP-S,when a member of an assistance unitwho273.1 is on strike, or when an individual identified under section 273.2 256J.37, subdivisions 1 to 2, whose income and assets must be 273.3 considered when determining the unit's eligibility is on strike, 273.4 the assistance unit must have beenanreceiving MFIP-S 273.5participant on the day before the strike,or have been eligible 273.6 for MFIP-S on the day before the strike. 273.7 The county agency must count the striker's prestrike 273.8 earnings as current earnings.WhenA significant change cannot 273.9 be invoked when a member of an assistance unit, or an individual 273.10 identified under section 256J.37, subdivisions 1 to 2, is on 273.11 strike. A member of an assistance unitwho, or an individual 273.12 identified under section 256J.37, subdivisions 1 to 2, is not 273.13 considered a striker when that person is not in the bargaining 273.14 unit that voted for the strike and does not cross the picket 273.15 line for fear of personal injury, the assistance unit member is273.16not a striker. Except for a member of an assistance unit who is273.17not in the bargaining unit that voted for the strike and who273.18does not cross the picket line for fear of personal injury, a273.19significant change cannot be invoked as a result of a labor273.20dispute. 273.21 Sec. 37. Minnesota Statutes 1997 Supplement, section 273.22 256J.20, subdivision 2, is amended to read: 273.23 Subd. 2. [REAL PROPERTY LIMITATIONS.] Ownership of real 273.24 property by an applicant or participant is subject to the 273.25 limitations in paragraphs (a) and (b). 273.26 (a) A county agency shall exclude the homestead of an 273.27 applicant or participant according to clauses (1) to(4)(5): 273.28 (1) an applicant or participant who is purchasing real 273.29 property through a contract for deed and using that property as 273.30 a home is considered the owner of real property; 273.31 (2) the total amount of land that can be excluded under 273.32 this subdivision is limited to surrounding property which is not 273.33 separated from the home by intervening property owned by 273.34 others. Additional property must be assessed as to its legal 273.35 and actual availability according to subdivision 1; 273.36 (3) when real property that has been used as a home by a 274.1 participant is sold, the county agency must treat the cash 274.2 proceeds from the sale as excluded property for six months when 274.3 the participant intends to reinvest the proceeds in another home 274.4 and maintains those proceeds, unused for other purposes, in a 274.5 separate account;and274.6 (4) when the homestead is jointly owned, but the client 274.7 does not reside in it because of legal separation, pending 274.8 divorce, or battering or abuse by the spouse or partner, the 274.9 homestead is excluded.; and 274.10 (5) the homestead shall continue to be excluded if it is 274.11 temporarily unoccupied due to employment, illness, or as the 274.12 result of compliance with a county-approved employability plan. 274.13 The education, training, or job search must be within the state, 274.14 but can be outside the immediate geographic area. A homestead 274.15 temporarily unoccupied because it is not habitable due to a 274.16 casualty or natural disaster is excluded. The homestead is 274.17 excluded during periods only if the client intends to return to 274.18 it. 274.19 (b) The equity value of real property that is not excluded 274.20 under paragraph (a) and which is legally available must be 274.21 applied against the limits in subdivision 3. When the equity 274.22 value of the real property exceeds the limits under subdivision 274.23 3, the applicant or participant may qualify to receive 274.24 assistance when the applicant or participant continues to make a 274.25 good faith effort to sell the property and signs a legally 274.26 binding agreement to repay the amount of assistance, less child 274.27 support collected by the agency. Repayment must be made within 274.28 five working days after the property is sold. Repayment to the 274.29 county agency must be in the amount of assistance received or 274.30 the proceeds of the sale, whichever is less. 274.31 Sec. 38. Minnesota Statutes 1997 Supplement, section 274.32 256J.20, subdivision 3, is amended to read: 274.33 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 274.34 MFIP-S, the equity value of all nonexcluded real and personal 274.35 property of the assistance unit must not exceed $2,000 for 274.36 applicants and $5,000 for ongoingrecipientsparticipants. The 275.1 value of assets in clauses (1) to(18)(20) must be excluded 275.2 when determining the equity value of real and personal property: 275.3 (1) a licensedvehiclesvehicle up to atotal marketloan 275.4 value of less than or equal to $7,500. The county agency shall 275.5 apply any excessmarketloan value as if it were equity value to 275.6 the asset limit described in this section. If the assistance 275.7 unit owns more than one licensed vehicle, the county agency 275.8 shall determine the vehicle with the highestmarketloan value 275.9 and count only themarketloan value over $7,500. The county 275.10 agency shall count themarketloan value of all other vehicles 275.11 and apply this amount as if it were equity value to the asset 275.12 limit described in this section. The value of special equipment 275.13 for a handicapped member of the assistance unit is excluded. To 275.14 establish themarketloan value of vehicles, a county agency 275.15 must use the N.A.D.A. Official Used Car Guide, Midwest Edition, 275.16 for newer model cars.The N.A.D.A. Official Used Car Guide,275.17Midwest Edition, is incorporated by reference.When a vehicle 275.18 is not listed in the guidebook, or when the applicant or 275.19 participant disputes the loan value listed in the guidebook as 275.20 unreasonable given the condition of the particular vehicle, the 275.21 county agency may require the applicant or participantto275.22 document the loan value by securing a written statement from a 275.23 motor vehicle dealer licensed under section 168.27, stating the 275.24 amount that the dealer would pay to purchase the vehicle. The 275.25 county agency shall reimburse the applicant or participant for 275.26 the cost of a written statement that documents a lower loan 275.27 value; 275.28 (2) the value of life insurance policies for members of the 275.29 assistance unit; 275.30 (3) one burial plot per member of an assistance unit; 275.31 (4) the value of personal property needed to produce earned 275.32 income, including tools, implements, farm animals, inventory, 275.33 business loans, business checking and savings accounts used at 275.34 least annually and used exclusively for the operation of a 275.35 self-employment business, and any motor vehicles if the vehicles 275.36 are essential for the self-employment business; 276.1 (5) the value of personal property not otherwise specified 276.2 which is commonly used by household members in day-to-day living 276.3 such as clothing, necessary household furniture, equipment, and 276.4 other basic maintenance items essential for daily living; 276.5 (6) the value of real and personal property owned by a 276.6 recipient of Supplemental Security Income or Minnesota 276.7 supplemental aid; 276.8 (7) the value of corrective payments, but only for the 276.9 month in which the payment is received and for the following 276.10 month; 276.11 (8) a mobile home used by an applicant or participant as 276.12 the applicant's or participant's home; 276.13 (9) money in a separate escrow account that is needed to 276.14 pay real estate taxes or insurance and that is used for this 276.15 purpose; 276.16 (10) money held in escrow to cover employee FICA, employee 276.17 tax withholding, sales tax withholding, employee worker 276.18 compensation, business insurance, property rental, property 276.19 taxes, and other costs that are paid at least annually, but less 276.20 often than monthly; 276.21 (11) monthly assistanceand, emergency assistance, and 276.22 diversionary payments for the current month's needs; 276.23 (12) the value of school loans, grants, or scholarships for 276.24 the period they are intended to cover; 276.25 (13) payments listed in section 256J.21, subdivision 2, 276.26 clause (9), which are held in escrow for a period not to exceed 276.27 three months to replace or repair personal or real property; 276.28 (14) income received in a budget month through the end of 276.29 thebudgetpayment month; 276.30 (15) savings from earned income of a minor child or a minor 276.31 parent that are set aside in a separate account designated 276.32 specifically for future education or employment costs; 276.33 (16) the federal earned incometaxcreditand, Minnesota 276.34 working family credit, state and federal income tax refunds, 276.35 state homeowners and renters credits under chapter 290A, 276.36 property tax rebates under Laws 1997, chapter 231, article 1, 277.1 section 16, and other federal or state tax rebates in the month 277.2 received and the following month; 277.3 (17) payments excluded under federal law as long as those 277.4 payments are held in a separate account from any nonexcluded 277.5 funds;and277.6 (18) money received by a participant of the corps to career 277.7 program under section 84.0887, subdivision 2, paragraph (b), as 277.8 a postservice benefit under the federal Americorps Act; 277.9 (19) the assets of children ineligible to receive MFIP-S 277.10 benefits because foster care or adoption assistance payments are 277.11 made on their behalf; and 277.12 (20) the assets of persons whose income is excluded under 277.13 section 256J.21, subdivision 2, clause 43. 277.14 Sec. 39. Minnesota Statutes 1997 Supplement, section 277.15 256J.21, is amended to read: 277.16 256J.21 [INCOME LIMITATIONS.] 277.17 Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP-S 277.18 eligibility, the county agency must evaluate income received by 277.19 members of an assistance unit, or by other persons whose income 277.20 is considered available to the assistance unit, and only count 277.21 income that is available to the member of the assistance unit. 277.22 Income is available if the individual has legal access to the 277.23 income. The income of an unrelated adult living in the same 277.24 household as the assistance unit who contributes financially to 277.25 the household in any way that subsidizes the expenses for which 277.26 the assistance unit is receiving a grant is considered to be 277.27 available to the assistance unit. All payments, unless 277.28 specifically excluded in subdivision 2, must be counted as 277.29 income. 277.30 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 277.31 excluded in determining a family's available income: 277.32 (1) payments for basic care, difficulty of care, and 277.33 clothing allowances received for providing family foster care to 277.34 children or adults under Minnesota Rules, parts 9545.0010 to 277.35 9545.0260 and 9555.5050 to 9555.6265, and payments received and 277.36 used for care and maintenance of a third-party beneficiary who 278.1 is not a household member; 278.2 (2) reimbursements for employment training received through 278.3 the Job Training Partnership Act, United States Code, title 29, 278.4 chapter 19, sections 1501 to 1792b; 278.5 (3) reimbursement for out-of-pocket expenses incurred while 278.6 performing volunteer services, jury duty, or employment; 278.7 (4) all educational assistance, except the county agency 278.8 must count graduate student teaching assistantships, 278.9 fellowships, and other similar paid work as earned income and, 278.10 after allowing deductions for any unmet and necessary 278.11 educational expenses, shall count scholarships or grants awarded 278.12 to graduate students that do not require teaching or research as 278.13 unearned income; 278.14 (5) loans, regardless of purpose, from public or private 278.15 lending institutions, governmental lending institutions, or 278.16 governmental agencies; 278.17 (6) loans from private individuals, regardless of purpose, 278.18 provided an applicant or participant documents that the lender 278.19 expects repayment; 278.20 (7)(i) stateand federalincome tax refunds; 278.21 (ii) federal income tax refunds; 278.22 (8)(i)state andfederal earned income credits; 278.23 (ii) Minnesota working family credits; 278.24 (iii) state homeowners and renters credits under chapter 278.25 290A; 278.26 (iv) property tax rebates under Laws 1997, chapter 231, 278.27 article 1, section 16; and 278.28 (v) other federal or state tax rebates; 278.29 (9) funds received for reimbursement, replacement, or 278.30 rebate of personal or real property when these payments are made 278.31 by public agencies, awarded by a court, solicited through public 278.32 appeal, or made as a grant by a federal agency, state or local 278.33 government, or disaster assistance organizations, subsequent to 278.34 a presidential declaration of disaster; 278.35 (10) the portion of an insurance settlement that is used to 278.36 pay medical, funeral, and burial expenses, or to repair or 279.1 replace insured property; 279.2 (11) reimbursements for medical expenses that cannot be 279.3 paid by medical assistance; 279.4 (12) payments by a vocational rehabilitation program 279.5 administered by the state under chapter 268A, except those 279.6 payments that are for current living expenses; 279.7 (13) in-kind income, including any payments directly made 279.8 by a third party to a provider of goods and services; 279.9 (14) assistance payments to correct underpayments, but only 279.10 for the month in which the payment is received; 279.11 (15) emergency assistance payments; 279.12 (16) funeral and cemetery payments as provided by section 279.13 256.935; 279.14 (17) nonrecurring cash gifts of $30 or less, not exceeding 279.15 $30 per participant in a calendar month; 279.16 (18) any form of energy assistance payment made through 279.17 Public Law Number 97-35, Low-Income Home Energy Assistance Act 279.18 of 1981, payments made directly to energy providers by other 279.19 public and private agencies, and any form of credit or rebate 279.20 payment issued by energy providers; 279.21 (19) Supplemental Security Income, including retroactive 279.22 payments; 279.23 (20) Minnesota supplemental aid, including retroactive 279.24 payments; 279.25 (21) proceeds from the sale of real or personal property; 279.26 (22) adoption assistance payments under section 259.67; 279.27 (23) state-funded family subsidy program payments made 279.28 under section 252.32 to help families care for children with 279.29 mental retardation or related conditions; 279.30 (24) interest payments and dividends from property that is 279.31 not excluded from and that does not exceed the asset limit; 279.32 (25) rent rebates; 279.33 (26) income earned by a minor caregiver or minor child who 279.34 is at least a half-time student in an approved secondary 279.35 education program; 279.36 (27) income earned by a caregiver under age 20 who is at 280.1 least a half-time student in an approved secondary education 280.2 program; 280.3 (28) MFIP-S child care payments under section 119B.05; 280.4 (29) all other payments made through MFIP-S to support a 280.5 caregiver's pursuit of greater self-support; 280.6 (30) income a participant receives related to shared living 280.7 expenses; 280.8 (31) reverse mortgages; 280.9 (32) benefits provided by the Child Nutrition Act of 1966, 280.10 United States Code, title 42, chapter 13A, sections 1771 to 280.11 1790; 280.12 (33) benefits provided by the women, infants, and children 280.13 (WIC) nutrition program, United States Code, title 42, chapter 280.14 13A, section 1786; 280.15 (34) benefits from the National School Lunch Act, United 280.16 States Code, title 42, chapter 13, sections 1751 to 1769e; 280.17 (35) relocation assistance for displaced persons under the 280.18 Uniform Relocation Assistance and Real Property Acquisition 280.19 Policies Act of 1970, United States Code, title 42, chapter 61, 280.20 subchapter II, section 4636, or the National Housing Act, United 280.21 States Code, title 12, chapter 13, sections 1701 to 1750jj; 280.22 (36) benefits from the Trade Act of 1974, United States 280.23 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 280.24 (37) war reparations payments to Japanese Americans and 280.25 Aleuts under United States Code, title 50, sections 1989 to 280.26 1989d; 280.27 (38) payments to veterans or their dependents as a result 280.28 of legal settlements regarding Agent Orange or other chemical 280.29 exposure under Public Law Number 101-239, section 10405, 280.30 paragraph (a)(2)(E); 280.31 (39) income that is otherwise specifically excluded from 280.32 the MFIP-S program consideration in federal law, state law, or 280.33 federal regulation; 280.34 (40) security and utility deposit refunds; 280.35 (41) American Indian tribal land settlements excluded under 280.36 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 281.1 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 281.2 reservations and payments to members of the White Earth Band, 281.3 under United States Code, title 25, chapter 9, section 331, and 281.4 chapter 16, section 1407; 281.5 (42) all income of the minor parent's parent and stepparent 281.6 when determining the grant for the minor parent in households 281.7 that include a minor parent living with a parent or stepparent 281.8 on MFIP-S with otherdependentchildren; and 281.9 (43) income of the minor parent's parent and stepparent 281.10 equal to 200 percent of the federal poverty guideline for a 281.11 family size not including the minor parent and the minor 281.12 parent's child in households that include a minor parent living 281.13 with a parent or stepparent not on MFIP-S when determining the 281.14 grant for the minor parent. The remainder of income is deemed 281.15 as specified in section 256J.37, subdivision11b; 281.16 (44) payments made to children eligible for relative 281.17 custody assistance under section 257.85; 281.18 (45) vendor payments for goods and services made on behalf 281.19 of a client unless the client has the option of receiving the 281.20 payment in cash; and 281.21 (46) the principal portion of a contract for deed payment. 281.22 Subd. 3. [INITIAL INCOME TEST.] The county agency shall 281.23 determine initial eligibility by considering all earned and 281.24 unearned income that is not excluded under subdivision 2. To be 281.25 eligible for MFIP-S, the assistance unit's countable income 281.26 minus the disregards in paragraphs (a) and (b) must be below the 281.27 transitional standard of assistance according to section 256J.24 281.28 for that size assistance unit. 281.29 (a) The initial eligibility determination must disregard 281.30 the following items: 281.31 (1) the employment disregard is 18 percent of the gross 281.32 earned income whether or not the member is working full time or 281.33 part time; 281.34 (2) dependent care costs must be deducted from gross earned 281.35 income for the actual amount paid for dependent care up tothea 281.36 maximumdisregard allowedof $200 per month for each child less 282.1 than two years of age, and $175 per month for each child two 282.2 years of age and older under this chapter and chapter 119B;and282.3 (3) all payments made according to a court order 282.4 for spousal support or the support of children not living in the 282.5 assistance unit's household shall be disregarded from the income 282.6 of the person with the legal obligation to pay support, provided 282.7 that, if there has been a change in the financial circumstances 282.8 of the person with the legal obligation to pay support since the 282.9 support order was entered, the person with the legal obligation 282.10 to pay support has petitioned for a modification of the support 282.11 order; and 282.12 (4) an allocation for the unmet need of an ineligible 282.13 spouse or an ineligible child under the age of 21 for whom the 282.14 caregiver is financially responsible and who lives with the 282.15 caregiver according to section 256J.36. 282.16 (b) Notwithstanding paragraph (a), when determining initial 282.17 eligibility forapplicants who haveapplicant units when at 282.18 least one member has received AFDC, family general assistance, 282.19 MFIP, MFIP-R, work first, or MFIP-S in this state within four 282.20 months of the most recent application for MFIP-S, the employment 282.21 disregard for all unit members is 36 percent of the gross earned 282.22 income. 282.23 After initial eligibility is established, the assistance 282.24 payment calculation is based on the monthly income test. 282.25 Subd. 4. [MONTHLY INCOME TEST AND DETERMINATION OF 282.26 ASSISTANCE PAYMENT.] The county agency shall determine ongoing 282.27 eligibility and the assistance payment amount according to the 282.28 monthly income test. To be eligible for MFIP-S, the result of 282.29 the computations in paragraphs (a) to (e) must be at least $1. 282.30 (a) Apply a 36 percent income disregard to gross earnings 282.31 and subtract this amount from the family wage level. If the 282.32 difference is equal to or greater than the transitional 282.33 standard, the assistance payment is equal to the transitional 282.34 standard. If the difference is less than the transitional 282.35 standard, the assistance payment is equal to the difference. 282.36 The employment disregard in this paragraph must be deducted 283.1 every month there is earned income. 283.2 (b) All payments made according to a court order 283.3 for spousal support or the support of children not living in the 283.4 assistance unit's household must be disregarded from the income 283.5 of the person with the legal obligation to pay support, provided 283.6 that, if there has been a change in the financial circumstances 283.7 of the person with the legal obligation to pay support since the 283.8 support order was entered, the person with the legal obligation 283.9 to pay support has petitioned for a modification of the court 283.10 order. 283.11 (c) An allocation for the unmet need of an ineligible 283.12 spouse or an ineligible child under the age of 21 for whom the 283.13 caregiver is financially responsible and who lives with the 283.14 caregiver must be made according to section 256J.36. 283.15 (d) Subtract unearned income dollar for dollar from the 283.16 transitional standard to determine the assistance payment amount. 283.17(d)(e) When income is both earned and unearned, the amount 283.18 of the assistance payment must be determined by first treating 283.19 gross earned income as specified in paragraph (a). After 283.20 determining the amount of the assistance payment under paragraph 283.21 (a), unearned income must be subtracted from that amount dollar 283.22 for dollar to determine the assistance payment amount. 283.23(e)(f) When the monthly income is greater than the 283.24 transitional or family wage level standard after applicable 283.25 deductions and the income will only exceed the standard for one 283.26 month, the county agency must suspend the assistance payment for 283.27 the payment month. 283.28 Subd. 5. [DISTRIBUTION OF INCOME.] The income of all 283.29 members of the assistance unit must be counted. Income may also 283.30 be deemed from ineligible persons to the assistance unit. 283.31 Income must be attributed to the person who earns it or to the 283.32 assistance unit according to paragraphs (a) to (c). 283.33 (a) Funds distributed from a trust, whether from the 283.34 principal holdings or sale of trust property or from the 283.35 interest and other earnings of the trust holdings, must be 283.36 considered income when the income is legally available to an 284.1 applicant or participant. Trusts are presumed legally available 284.2 unless an applicant or participant can document that the trust 284.3 is not legally available. 284.4 (b) Income from jointly owned property must be divided 284.5 equally among property owners unless the terms of ownership 284.6 provide for a different distribution. 284.7 (c) Deductions are not allowed from the gross income of a 284.8 financially responsible household member or by the members of an 284.9 assistance unit to meet a current or prior debt. 284.10 Sec. 40. Minnesota Statutes 1997 Supplement, section 284.11 256J.24, subdivision 1, is amended to read: 284.12 Subdivision 1. [MFIP-S ASSISTANCE UNIT.] An MFIP-S 284.13 assistance unit is either a group of individuals with at least 284.14 one minor child who live together whose needs, assets, and 284.15 income are considered together and who receive MFIP-S 284.16 assistance, or a pregnant woman and her spouse whoreceives284.17 receive MFIP-S assistance. 284.18 Individuals identified in subdivision 2 must be included in 284.19 the MFIP-S assistance unit. Individuals identified in 284.20 subdivision 3must be excluded from the assistance unitare 284.21 ineligible to receive MFIP-S. Individuals identified in 284.22 subdivision 4 may be included in the assistance unit at their 284.23 option. Individuals not included in the assistance unit who are 284.24 identified in section 256J.37,subdivisionsubdivisions 1orto 284.25 2, must have their income and assets considered when determining 284.26 eligibility and benefits for an MFIP-S assistance unit. All 284.27 assistance unit members, whether mandatory or elective, who live 284.28 together and for whom one caregiver or two caregivers apply must 284.29 be included in a single assistance unit. 284.30 Sec. 41. Minnesota Statutes 1997 Supplement, section 284.31 256J.24, subdivision 2, is amended to read: 284.32 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 284.33 for minor caregivers and their children whoaremust be in a 284.34 separate assistance unit from the other persons in the 284.35 household, when the following individuals live together, they 284.36 must be included in the assistance unit: 285.1 (1) a minor child, including a pregnant minor; 285.2 (2) the minor child's siblings, half-siblings, and 285.3 step-siblings;and285.4 (3) the minor child's natural, adoptive parents, and 285.5 stepparents; and 285.6 (4) the spouse of a pregnant woman. 285.7 Sec. 42. Minnesota Statutes 1997 Supplement, section 285.8 256J.24, subdivision 3, is amended to read: 285.9 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 285.10 ASSISTANCE UNIT.] (a) The following individualsmust be excluded285.11from an assistance unitwho are part of the assistance unit 285.12 determined under subdivision 2 are ineligible to receive MFIP-S: 285.13 (1) individuals receiving Supplemental Security Income or 285.14 Minnesota supplemental aid; 285.15 (2) individuals living at home while performing 285.16 court-imposed, unpaid community service work due to a criminal 285.17 conviction; 285.18 (3) individuals disqualified from the food stamp program or 285.19 MFIP-S, until the disqualification ends; 285.20 (4) children on whose behalf federal, state or local foster 285.21 care paymentsunder title IV-E of the Social Security Actare 285.22 made, except as provided insectionsections 256J.13, 285.23 subdivision 2, and 256J.74, subdivision 2; and 285.24 (5) children receiving ongoing monthly adoption assistance 285.25 payments under section 269.67. 285.26 (b) The exclusion of a person under this subdivision does 285.27 not alter the mandatory assistance unit composition. 285.28 Sec. 43. Minnesota Statutes 1997 Supplement, section 285.29 256J.24, subdivision 4, is amended to read: 285.30 Subd. 4. [INDIVIDUALS WHO MAY ELECT TO BE INCLUDED IN THE 285.31 ASSISTANCE UNIT.] (a) The minor child's eligible caregiver may 285.32 choose to be in the assistance unit, if the caregiver is not 285.33 required to be in the assistance unit under subdivision 2. If 285.34 therelativeeligible caregiver chooses to be in the assistance 285.35 unit, that person's spouse must also be in the unit. 285.36 (b) Any minor child not related as a sibling, stepsibling, 286.1 or adopted sibling to the minor child in the unit, but for whom 286.2 there is an eligible caregiver may elect to be in the unit. 286.3 (c) A foster care provider of a minor child who is 286.4 receiving federal, state, or local foster care maintenance 286.5 payments may elect to receive MFIP-S if the provider meets the 286.6 definition of caregiver under section 256J.08, subdivision 11. 286.7 If the provider chooses to receive MFIP-S, the spouse of the 286.8 provider must also be included in the assistance unit with the 286.9 provider. The provider and spouse are eligible for assistance 286.10 even if the only minor child living in the provider's home is 286.11 receiving foster care maintenance payments. 286.12 (d) The adult caregiver or caregivers of a minor parent are 286.13 eligible to be a separate assistance unit from the minor parent 286.14 and the minor parent's child when: 286.15 (1) the adult caregiver or caregivers have no other minor 286.16 children in the household; 286.17 (2) the minor parent and the minor parent's child are 286.18 living together with the adult caregiver or caregivers; and 286.19 (3) the minor parent and the minor parent's child receive 286.20 MFIP-S, or would be eligible to receive MFIP-S, if they were not 286.21 receiving SSI benefits. 286.22 Sec. 44. Minnesota Statutes 1997 Supplement, section 286.23 256J.24, is amended by adding a subdivision to read: 286.24 Subd. 5a. [FOOD PORTION OF MFIP-S TRANSITIONAL 286.25 STANDARD.] The commissioner shall adjust the food portion of the 286.26 MFIP-S transitional standard by October 1 each year beginning 286.27 October 1998 to reflect the cost-of-living adjustments to the 286.28 Food Stamp Program. The commissioner shall annually publish in 286.29 the State Register the transitional standard for an assistance 286.30 unit of sizes 1 to 10. 286.31 Sec. 45. Minnesota Statutes 1997 Supplement, section 286.32 256J.24, is amended by adding a subdivision to read: 286.33 Subd. 8. [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE 286.34 UNITS.] For all applicants who are eligible for MFIP-S 286.35 assistance, payments for shelter and utilities up to the amount 286.36 of MFIP-S benefits for which the assistance unit is eligible 287.1 may, upon county option, be vendor paid for as many months as 287.2 the assistance unit is eligible or six months, whichever comes 287.3 first. The residual amount of the grant after vendor payment, 287.4 if any, must be paid to the MFIP-S caregiver. A county that 287.5 chooses this method of payment must use it for all eligible 287.6 applicants. 287.7 Sec. 46. Minnesota Statutes 1997 Supplement, section 287.8 256J.26, subdivision 1, is amended to read: 287.9 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 287.10 Applicants orrecipientsparticipants who have been convicted of 287.11 a drug offense after July 1, 1997, may, if otherwise eligible, 287.12 receive AFDC or MFIP-S benefits subject to the following 287.13 conditions: 287.14 (1) Benefits for the entire assistance unit must be paid in 287.15 vendor form for shelter and utilities during any time the 287.16 applicant is part of the assistance unit;. 287.17 (2) The convicted applicant orrecipientparticipant shall 287.18 be subject to random drug testing as a condition of continued 287.19 eligibility andis subject to sanctions under section 256J.46287.20 following any positive test for an illegal controlled substance,287.21except that the grant must continue to be vendor paid under287.22clause (1).287.23For purposes of this subdivision, section 256J.46 is287.24effective July 1, 1997.287.25This subdivision also applies to persons who receive food287.26stamps under section 115 of the Personal Responsibility and Work287.27Opportunity Reconciliation Act of 1996.is subject to the 287.28 following sanctions: 287.29 (i) for failing a drug test the first time, the 287.30 participant's grant shall be reduced by ten percent of the 287.31 MFIP-S transitional standard or the interstate transitional 287.32 standard, whichever is applicable prior to making vendor 287.33 payments for shelter and utility costs; or 287.34 (ii) for failing a drug test two or more times, the 287.35 residual amount of the participant's grant after making vendor 287.36 payments for shelter and utility costs, if any, must be reduced 288.1 by an amount equal to 30 percent of the MFIP-S transitional 288.2 standard or the interstate transitional standard, whichever is 288.3 applicable. 288.4 (b) Applicants or participants who have been convicted of a 288.5 drug offense after July 1, 1997, may, if otherwise eligible, 288.6 receive food stamps if the convicted applicant or participant is 288.7 subject to random drug testing as a condition of continued 288.8 eligibility. Following a positive test for an illegal 288.9 controlled substance, the applicant is subject to the following 288.10 sanctions: 288.11 (1) for failing a drug test the first time, food stamps 288.12 shall be reduced by ten percent of the applicable food stamp 288.13 allotment; and 288.14 (2) for failing a drug test two or more times, food stamps 288.15 shall be reduced by an amount equal to 30 percent of the 288.16 applicable food stamp allotment. 288.17(b)(c) For the purposes of this subdivision, "drug offense" 288.18 means a conviction that occurred after July 1, 1997, of sections 288.19 152.021 to 152.025, 152.0261, or 152.096. Drug offense also 288.20 means a conviction in another jurisdiction of the possession, 288.21 use, or distribution of a controlled substance, or conspiracy to 288.22 commit any of these offenses, if the offense occurred after July 288.23 1, 1997, and the conviction is a felony offense in that 288.24 jurisdiction, or in the case of New Jersey, a high misdemeanor. 288.25 Sec. 47. Minnesota Statutes 1997 Supplement, section 288.26 256J.26, subdivision 2, is amended to read: 288.27 Subd. 2. [PAROLE VIOLATORS.] An individual violating a 288.28 condition of probation or parole or supervised release imposed 288.29 under federal law or the law of any state isineligible to288.30receivedisqualified from receiving AFDC or MFIP-S. 288.31 Sec. 48. Minnesota Statutes 1997 Supplement, section 288.32 256J.26, subdivision 3, is amended to read: 288.33 Subd. 3. [FLEEING FELONS.] An individual who is fleeing to 288.34 avoid prosecution, or custody, or confinement after conviction 288.35 for a crime that is a felony under the laws of the jurisdiction 288.36 from which the individual flees, or in the case of New Jersey, 289.1 is a high misdemeanor, isineligible to receivedisqualified 289.2 from receiving AFDC or MFIP-S. 289.3 Sec. 49. Minnesota Statutes 1997 Supplement, section 289.4 256J.26, subdivision 4, is amended to read: 289.5 Subd. 4. [DENIAL OF ASSISTANCE FOR TEN YEARS TO A PERSON 289.6 FOUND TO HAVE FRAUDULENTLY MISREPRESENTED RESIDENCY.] An 289.7 individual who is convicted in federal or state court of having 289.8 made a fraudulent statement or representation with respect to 289.9 the place of residence of the individual in order to receive 289.10 assistance simultaneously from two or more states isineligible289.11to receivedisqualified from receiving AFDC or MFIP-S for ten 289.12 years beginning on the date of the conviction. 289.13 Sec. 50. Minnesota Statutes 1997 Supplement, section 289.14 256J.28, subdivision 1, is amended to read: 289.15 Subdivision 1. [EXPEDITED ISSUANCE OF FOOD STAMP 289.16 ASSISTANCE.] The following households are entitled to expedited 289.17 issuance of food stamp assistance: 289.18 (1) households with less than $150 in monthly gross income 289.19 provided their liquid assets do not exceed $100; 289.20 (2) migrant or seasonal farm worker households who are 289.21 destitute as defined in Code of Federal Regulations, title 7, 289.22 subtitle B, chapter 2, subchapter C, part 273, section 273.10, 289.23 paragraph (e)(3), provided their liquid assets do not exceed 289.24 $100; and 289.25 (3) eligible households whose combined monthly gross income 289.26 and liquid resources are less than the household's monthly rent 289.27 or mortgage and utilities. 289.28The benefits issued through expedited issuance of food289.29stamp assistance must be deducted from the amount of the full289.30monthly MFIP-S assistance payment and a supplemental payment for289.31the difference must be issued.For any month an individual 289.32 receives expedited food stamp benefits, the individual is not 289.33 eligible for the MFIP-S food portion of assistance. 289.34 Sec. 51. Minnesota Statutes 1997 Supplement, section 289.35 256J.28, subdivision 2, is amended to read: 289.36 Subd. 2. [FOOD STAMPS FOR HOUSEHOLD MEMBERS NOT IN THE 290.1 ASSISTANCE UNIT.] (a) For household members who purchase and 290.2 prepare food with the MFIP-S assistance unit but are not part of 290.3 the assistance unit, the county agency must determine a separate 290.4 food stamp benefit based on regulations agreed upon with the 290.5 United States Department of Agriculture. 290.6(b) This subdivision does not apply to optional members who290.7have chosen not to be in the assistance unit.290.8(c)(b) Fair hearing requirements for persons who receive 290.9 food stamps under this subdivision are governed by section 290.10 256.045, and Code of Federal Regulations, title 7, subtitle B, 290.11 chapter II, part 273, section 273.15. 290.12 Sec. 52. Minnesota Statutes 1997 Supplement, section 290.13 256J.28, is amended by adding a subdivision to read: 290.14 Subd. 5. [FOOD STAMPS FOR PERSONS RESIDING IN A BATTERED 290.15 WOMAN'S SHELTER.] Members of an MFIP-S assistance unit residing 290.16 in a battered woman's shelter may receive food stamps or the 290.17 food portion twice in a month if the unit that initially 290.18 received the food stamps or food portion included the alleged 290.19 abuser. 290.20 Sec. 53. Minnesota Statutes 1997 Supplement, section 290.21 256J.30, subdivision 10, is amended to read: 290.22 Subd. 10. [COOPERATION WITH HEALTH CARE BENEFITS.] (a) The 290.23 caregiver of a minor child must cooperate with the county agency 290.24 to identify and provide information to assist the county agency 290.25 in pursuing third-party liability for medical services. 290.26 (b) A caregiver must assign to the department any rights to 290.27 health insurance policy benefits the caregiver has during the 290.28 period of MFIP-S eligibility. 290.29 (c) A caregiver must identify any third party who may be 290.30 liable for care and services available under the medical 290.31 assistance program on behalf of the applicant or participant and 290.32 all other assistance unit members. 290.33 (d) When a participant refuses to identify any third party 290.34 who may be liable for care and services, the recipient must be 290.35 sanctioned as provided in section 256J.46, subdivision 1. The 290.36 recipient is also ineligible for medical assistancefor a291.1minimum of one month anduntil the recipient cooperates with the 291.2 requirements of this subdivision. 291.3 Sec. 54. Minnesota Statutes 1997 Supplement, section 291.4 256J.30, subdivision 11, is amended to read: 291.5 Subd. 11. [REQUIREMENT TO ASSIGN SUPPORT AND MAINTENANCE 291.6 RIGHTS.]To be eligibleAn assistance unit is ineligible for 291.7 MFIP-S,unless the caregivermust assignassigns all rights to 291.8 child support and spousal maintenance benefits according 291.9 tosections 256.74, subdivision 5, andsection 256.741, if291.10enacted. 291.11 Sec. 55. Minnesota Statutes 1997 Supplement, section 291.12 256J.31, subdivision 5, is amended to read: 291.13 Subd. 5. [MAILING OF NOTICE.] The notice of adverse action 291.14 shall be issued according to paragraphs (a) to (c). 291.15 (a) A county agency shall mail a notice of adverse action 291.16 at least ten days before the effective date of the adverse 291.17 action, except as provided in paragraphs (b) and (c). 291.18 (b) A county agency must mail a notice of adverse action at 291.19 least five days before the effective date of the adverse action 291.20 when the county agency has factual information that requires an 291.21 action to reduce, suspend, or terminate assistance based on 291.22 probable fraud. 291.23 (c) A county agency shall mail a notice of adverse action 291.24 before or on the effective date of the adverse action when the 291.25 county agency: 291.26 (1) receives the caregiver's signed monthly MFIP-S 291.27 household report form that includes information that requires 291.28 payment reduction, suspension, or termination; 291.29 (2) is informed of the death of a participant or the payee; 291.30 (3) receives a signed statement from the caregiver that 291.31 assistance is no longer wanted; 291.32 (4) receives a signed statement from the caregiver that 291.33 provides information that requires the termination or reduction 291.34 of assistance; 291.35 (5) verifies that a member of the assistance unit is absent 291.36 from the home and does not meet temporary absence provisions in 292.1 section 256J.13; 292.2 (6) verifies that a member of the assistance unit has 292.3 entered a regional treatment center or a licensed residential 292.4 facility for medical or psychological treatment or 292.5 rehabilitation; 292.6 (7) verifies that a member of an assistance unit has been 292.7 placed in foster care, and the provisions of section 256J.13, 292.8 subdivision 2, paragraph(b)(c), clause (2), do not apply; 292.9 (8) verifies that a member of an assistance unit has been 292.10 approved to receive assistance by another state; or 292.11 (9) cannot locate a caregiver. 292.12 Sec. 56. Minnesota Statutes 1997 Supplement, section 292.13 256J.31, subdivision 10, is amended to read: 292.14 Subd. 10. [PROTECTION FROM GARNISHMENT.] MFIP-S grants or 292.15 earnings of a caregiverwhile participating in full or part-time292.16employment or trainingshall be protected from garnishment. 292.17 This protection for earnings shall extend for a period of six 292.18 months from the date of termination from MFIP-S. 292.19 Sec. 57. Minnesota Statutes 1997 Supplement, section 292.20 256J.31, is amended by adding a subdivision to read: 292.21 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 292.22 participant may discontinue receipt of the cash assistance 292.23 portion of MFIP-S assistance and retain eligibility for child 292.24 care assistance under section 119B.05 and for medical assistance 292.25 under sections 256B.055, subdivision 3a, and 256B.0635. 292.26 Sec. 58. [256J.311] [PROCEDURES TO IDENTIFY DOMESTIC 292.27 VIOLENCE VICTIMS.] The commissioner shall develop procedures for 292.28 county agencies and their contractors under this chapter and 292.29 chapter 256K to identify victims of domestic violence from among 292.30 applicants and recipients of assistance. The procedures must 292.31 provide, at a minimum, universal notification to all applicants 292.32 and recipients of MFIP-S that: 292.33 (1) referrals to counseling and supportive services are 292.34 available for victims of domestic violence; 292.35 (2) nonpermanent resident battered individuals married to 292.36 United States citizens or permanent residents may be eligible to 293.1 petition for permanent residency under the federal Violence 293.2 Against Women Act, and referrals to appropriate legal services 293.3 are available; 293.4 (3) victims of domestic violence are exempt from the 293.5 60-month limit on assistance while the individual is complying 293.6 with an approved safety plan, as defined in section 256J.49, 293.7 subdivision 11; and 293.8 (4) victims of domestic violence may choose to be exempt or 293.9 deferred from MFIP-S work requirements for up to 12 months while 293.10 the individual is complying with an approved safety plan as 293.11 defined in section 256J.49, subdivision 11. 293.12 The procedures must require that the notification must be 293.13 given in writing and orally at the time of application and 293.14 recertification, when the individual is referred to the title 293.15 IV-D child support enforcement agency, and at the beginning of 293.16 any employment and training services program. 293.17 Sec. 59. Minnesota Statutes 1997 Supplement, section 293.18 256J.32, subdivision 4, is amended to read: 293.19 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 293.20 verify the following at application: 293.21 (1) identity of adults; 293.22 (2) presence of the minor child in the home, if 293.23 questionable; 293.24 (3) relationship of a minor child to caregivers in the 293.25 assistance unit; 293.26 (4) age, if necessary to determine MFIP-S eligibility; 293.27 (5) immigration status; 293.28 (6) social security numberin accordance withaccording to 293.29 the requirements of section 256J.30, subdivision 12; 293.30 (7) income; 293.31 (8) self-employment expenses used as a deduction; 293.32 (9) source and purpose of deposits and withdrawals from 293.33 business accounts; 293.34 (10) spousal support and child support payments made to 293.35 persons outside the household; 293.36 (11) real property; 294.1 (12) vehicles; 294.2 (13) checking and savings accounts; 294.3 (14) savings certificates, savings bonds, stocks, and 294.4 individual retirement accounts; 294.5 (15) pregnancy, if related to eligibility; 294.6 (16) inconsistent information, if related to eligibility; 294.7 (17) medical insurance; 294.8 (18) anticipated graduation date of an 18-year-old; 294.9 (19) burial accounts; 294.10 (20) school attendance, if related to eligibility;and294.11 (21) residence; 294.12 (22) a claim of domestic violence if used as a basis for a 294.13 deferral or exemption from the 60-month time limit in section 294.14 256J.42 or employment and training services requirements in 294.15 section 256J.56; and 294.16 (23) disability if used as an exemption from employment and 294.17 training services requirements under section 256J.56. 294.18 Sec. 60. Minnesota Statutes 1997 Supplement, section 294.19 256J.32, subdivision 6, is amended to read: 294.20 Subd. 6. [RECERTIFICATION.] (a) The county agency shall 294.21 recertify eligibility in an annual face-to-face interview with 294.22 the participant and verify the following: 294.23 (1) presence of the minor child in the home, if 294.24 questionable; 294.25 (2) income, unless excluded, including self-employment 294.26 expenses used as a deduction or deposits or withdrawals from 294.27 business accounts; 294.28 (3) assets when the value is within $200 of the asset 294.29 limit; and 294.30 (4) inconsistent information, if related to eligibility. 294.31 (b) As part of the recertification process, each recipient 294.32 must be asked if the applicant has symptoms of a drug or alcohol 294.33 dependency or substance abuse problems. 294.34 Sec. 61. Minnesota Statutes 1997 Supplement, section 294.35 256J.32, is amended by adding a subdivision to read: 294.36 Subd. 7. [NOTICE TO UNDOCUMENTED PERSONS; RELEASE OF 295.1 PRIVATE DATA.] County agencies in consultation with the 295.2 commissioner of human services shall provide notification to 295.3 undocumented persons regarding the release of personal data to 295.4 the immigration and naturalization service and develop protocol 295.5 regarding the release or sharing of data about undocumented 295.6 persons with the Immigration and Naturalization Service as 295.7 required under sections 404, 434, and 411A of the Personal 295.8 Responsibility and Work Opportunity Reconciliation Act of 1996. 295.9 Sec. 62. Minnesota Statutes 1997 Supplement, section 295.10 256J.33, subdivision 1, is amended to read: 295.11 Subdivision 1. [DETERMINATION OF ELIGIBILITY.] A county 295.12 agency must determine MFIP-S eligibility prospectively for a 295.13 payment month based on retrospectively assessing income and the 295.14 county agency's best estimate of the circumstances that will 295.15 exist in the payment month. 295.16 Except as described in section 256J.34, subdivision 1, when 295.17 prospective eligibility exists, a county agency must calculate 295.18 the amount of the assistance payment using retrospective 295.19 budgeting. To determine MFIP-S eligibility and the assistance 295.20 payment amount, a county agency must apply countable income, 295.21 described in section 256J.37, subdivisions 3 to 10, received by 295.22 members of an assistance unit or by other persons whose income 295.23 is counted for the assistance unit, described under sections 295.24 256J.21 and 256J.37, subdivisions 1andto 2. 295.25 This income must be applied to the transitional standard or 295.26 family wage standard subject to this section and sections 295.27 256J.34 to 256J.36. Income received in a calendar month and not 295.28 otherwise excluded under section 256J.21, subdivision 2, must be 295.29 applied to the needs of an assistance unit. 295.30 Sec. 63. Minnesota Statutes 1997 Supplement, section 295.31 256J.33, subdivision 4, is amended to read: 295.32 Subd. 4. [MONTHLY INCOME TEST.] A county agency must apply 295.33 the monthly income test retrospectively for each month of MFIP-S 295.34 eligibility. An assistance unit is not eligible when the 295.35 countable income equals or exceeds the transitional standard or 295.36 the family wage level for the assistance unit. The income 296.1 applied against the monthly income test must include: 296.2 (1) gross earned income from employment, prior to mandatory 296.3 payroll deductions, voluntary payroll deductions, wage 296.4 authorizations, and after the disregards in section 256J.21, 296.5 subdivision34, and the allocations in section 256J.36, unless 296.6 the employment income is specifically excluded under section 296.7 256J.21, subdivision 2; 296.8 (2) gross earned income from self-employment less 296.9 deductions for self-employment expenses in section 256J.37, 296.10 subdivision 5, but prior to any reductions for personal or 296.11 business state and federal income taxes, personal FICA, personal 296.12 health and life insurance, and after the disregards in section 296.13 256J.21, subdivision34, and the allocations in section 296.14 256J.36; 296.15 (3) unearned income after deductions for allowable expenses 296.16 in section 256J.37, subdivision 9, and allocations in section 296.17 256J.36, unless the income has been specifically excluded in 296.18 section 256J.21, subdivision 2; 296.19 (4) gross earned income from employment as determined under 296.20 clause (1) which is received by a member of an assistance unit 296.21 who is a minor child or minor caregiver and less than a 296.22 half-time student; 296.23 (5) child support and spousal support received or 296.24 anticipated to be received by an assistance unit; 296.25 (6) the income of a parent when that parent is not included 296.26 in the assistance unit; 296.27 (7) the income of an eligible relative and spouse who seek 296.28 to be included in the assistance unit; and 296.29 (8) the unearned income of a minor child included in the 296.30 assistance unit. 296.31 Sec. 64. Minnesota Statutes 1997 Supplement, section 296.32 256J.35, is amended to read: 296.33 256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 296.34 Except as provided in paragraphs (a) to(c)(d), the amount 296.35 of an assistance payment is equal to the difference between the 296.36 transitional standard or the Minnesota family wage level in 297.1 section 256J.24, whichever is less, and countable income. 297.2 (a) When MFIP-S eligibility exists for the month of 297.3 application, the amount of the assistance payment for the month 297.4 of application must be prorated from the date of application or 297.5 the date all other eligibility factors are met for that 297.6 applicant, whichever is later. This provision applies when an 297.7 applicant loses at least one day of MFIP-S eligibility. 297.8 (b) MFIP-S overpayments to an assistance unit must be 297.9 recouped according to section 256J.38, subdivision 4. 297.10 (c) An initial assistance payment must not be made to an 297.11 applicant who is not eligible on the date payment is made. 297.12 (d) An individual whose needs have been otherwise provided 297.13 for in another state, in whole or in part by county, state, or 297.14 federal dollars during a month, is ineligible to receive MFIP-S 297.15 for the month. 297.16 Sec. 65. Minnesota Statutes 1997 Supplement, section 297.17 256J.36, is amended to read: 297.18 256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 297.19 MEMBERS.] 297.20 Except as prohibited in paragraphs (a) and (b), an 297.21 allocation of income is allowed from the caregiver's income to 297.22 meet the unmet need of an ineligible spouse or an ineligible 297.23 child under the age of 21 for whom the caregiver is financially 297.24 responsible who also lives with the caregiver.An allocation is297.25allowed from the caregiver's income to meet the need of an297.26ineligible or excluded person.That allocation is allowed in an 297.27 amount up to the difference between the MFIP-Sfamily allowance297.28 transitional standard for the assistance unit when thatexcluded297.29orineligible person is included in the assistance unit and the 297.30 MFIP-S family allowance for the assistance unit when 297.31 theexcluded orineligible person is not included in the 297.32 assistance unit. These allocations must be deducted from the 297.33 caregiver's counted earnings and from unearned income subject to 297.34 paragraphs (a) and (b). 297.35 (a) Income of a minor child in the assistance unit must not 297.36 be allocated to meet the need ofaan ineligible personwho is298.1not a member of the assistance unit, including the child's 298.2 parent, even when that parent is the payee of the child's income. 298.3 (b) Income ofan assistance unita caregiver must not be 298.4 allocated to meet the needs of a disqualified personineligible298.5for failure to cooperate with program requirements including298.6child support requirements, a person ineligible due to fraud, or298.7a relative caregiver and the caregiver's spouse who opt out of298.8the assistance unit. 298.9 Sec. 66. Minnesota Statutes 1997 Supplement, section 298.10 256J.37, subdivision 1, is amended to read: 298.11 Subdivision 1. [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 298.12 MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 298.13 the income of ineligible household members must be deemed after 298.14 allowing the following disregards: 298.15 (1) the first 18 percent of theexcludedineligible family 298.16 member's gross earned income; 298.17 (2) amounts the ineligible person actually paid to 298.18 individuals not living in the same household but whom the 298.19 ineligible person claims or could claim as dependents for 298.20 determining federal personal income tax liability; 298.21 (3)child or spousal support paid to a person who lives298.22outside of the householdall payments made by the ineligible 298.23 person according to a court order for spousal support or the 298.24 support of children not living in the assistance unit's 298.25 household, provided that, if there has been a change in the 298.26 financial circumstances of the ineligible person since the 298.27 support order was entered, the ineligible person has petitioned 298.28 for a modification of the support order; and 298.29 (4) an amount for the needs of the ineligible person and 298.30 other persons who live in the household but are not included in 298.31 the assistance unit and are or could be claimed by an ineligible 298.32 person as dependents for determining federal personal income tax 298.33 liability. This amount is equal to the difference between the 298.34 MFIP-Sneedtransitional standard when theexcludedineligible 298.35 person is included in the assistance unit and the MFIP-Sneed298.36 transitional standard when theexcludedineligible person is not 299.1 included in the assistance unit. 299.2 Sec. 67. Minnesota Statutes 1997 Supplement, section 299.3 256J.37, is amended by adding a subdivision to read: 299.4 Subd. 1a. [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 299.5 income of disqualified members must be deemed after allowing the 299.6 following disregards: 299.7 (1) the first 18 percent of the disqualified member's gross 299.8 earned income; 299.9 (2) amounts the disqualified member actually paid to 299.10 individuals not living in the same household but whom the 299.11 disqualified member claims or could claim as dependents for 299.12 determining federal personal income tax liability; 299.13 (3) all payments made by the disqualified member according 299.14 to a court order for spousal support or the support of children 299.15 not living in the assistance unit's household, provided that, if 299.16 there has been a change in the financial circumstances of the 299.17 disqualified member's legal obligation to pay support since the 299.18 support order was entered, the disqualified member has 299.19 petitioned for a modification of the support order; and 299.20 (4) an amount for the needs of other persons who live in 299.21 the household but are not included in the assistance unit and 299.22 are or could be claimed by the disqualified member as dependents 299.23 for determining federal personal income tax liability. This 299.24 amount is equal to the difference between the MFIP-S 299.25 transitional standard when the ineligible person is included in 299.26 the assistance unit and the MFIP-S transitional standard when 299.27 the ineligible person is not included in the assistance unit. 299.28 An amount shall not be allowed for the needs of a disqualified 299.29 member. 299.30 Sec. 68. Minnesota Statutes 1997 Supplement, section 299.31 256J.37, is amended by adding a subdivision to read: 299.32 Subd. 1b. [DEEMED INCOME FROM PARENTS OF MINOR 299.33 CAREGIVERS.] In households where minor caregivers live with a 299.34 parent or parents who do not receive MFIP-S, the income of the 299.35 parents must be deemed after allowing the following disregards: 299.36 (1) income of the parents equal to 200 percent of the 300.1 federal poverty guideline for a family size not including the 300.2 minor parent and the minor parent's child in the household 300.3 according to section 256J.21, subdivision 2, clause (43); 300.4 (2) 18 percent of the parents' gross earned income; 300.5 (3) amounts the parents actually paid to individuals not 300.6 living in the same household but whom the parents claim or could 300.7 claim as dependents for determining federal personal income tax 300.8 liability; and 300.9 (4) all payments made by parents according to a court order 300.10 for spousal support or the support of children not living in the 300.11 parent's household, provided that, if there has been a change in 300.12 the financial circumstances of the parent's legal obligation to 300.13 pay support since the support order was entered, the parents 300.14 have petitioned for a modification of the support order. 300.15 Sec. 69. Minnesota Statutes 1997 Supplement, section 300.16 256J.37, subdivision 2, is amended to read: 300.17 Subd. 2. [DEEMED INCOME AND ASSETS OF SPONSOR OF 300.18 NONCITIZENS.]All income and assets of a sponsor, or sponsor's300.19spouse, who executed an affidavit of support for a noncitizen300.20must be deemed to be unearned income of the noncitizen as300.21specified in the Personal Responsibility and Work Opportunity300.22Reconciliation Act of 1996, title IV, Public Law Number 104-193,300.23sections 421 and 422, and subsequently set out in federal300.24rules.If a noncitizen applies for or receives MFIP-S, the 300.25 county must deem the income and assets of the noncitizen's 300.26 sponsor and the sponsor's spouse who have signed an affidavit of 300.27 support for the noncitizen as specified in sections 421 and 422 300.28 of the Personal Responsibility and Work Opportunity 300.29 Reconciliation Act of 1996, title IV, Public Law Number 300.30 104-193. The income of a sponsor and the sponsor's spouse is 300.31 considered unearned income of the noncitizen. The assets of a 300.32 sponsor and the sponsor's spouse are considered available assets 300.33 of the noncitizen. 300.34 Sec. 70. Minnesota Statutes 1997 Supplement, section 300.35 256J.37, subdivision 9, is amended to read: 300.36 Subd. 9. [UNEARNED INCOME.] (a) The county agency must 301.1 apply unearned income, including housing subsidies as in301.2paragraph (b),to the transitional standard. When determining 301.3 the amount of unearned income, the county agency must deduct the 301.4 costs necessary to secure payments of unearned income. These 301.5 costs include legal fees, medical fees, and mandatory deductions 301.6 such as federal and state income taxes. 301.7 (b) Effective July 1, 1998, the county agency shall count 301.8 $100 of the value of public and assisted rental subsidies 301.9 provided through the Department of Housing and Urban Development 301.10 (HUD) as unearned income. The full amount of the subsidy must 301.11 be counted as unearned income when the subsidy is less than $100. 301.12 (c) For the period from July 1, 1998, to June 30, 1999, the 301.13 provisions of paragraph (b) shall not apply to MFIP-S 301.14 participants who are exempt from the employment and training 301.15 services component because they are: 301.16 (i) individuals who are age 60 or older; 301.17 (ii) individuals who are suffering from a professionally 301.18 certified permanent or temporary illness, injury, or incapacity 301.19 which is expected to continue for more than 30 days and which 301.20 prevents the person from obtaining or retaining employment; or 301.21 (iii) caregivers whose presence in the home is required 301.22 because of the professionally certified illness or incapacity of 301.23 another member in the household which is expected to last for 301.24 more than 30 days and the caregiver's presence replaces other 301.25 specialized care arrangements. 301.26 Sec. 71. Minnesota Statutes 1997 Supplement, section 301.27 256J.38, subdivision 1, is amended to read: 301.28 Subdivision 1. [SCOPE OF OVERPAYMENT.] When a participant 301.29 or former participant receives an overpayment due to agency, 301.30 client, or ATM error, or due to assistance received while an 301.31 appeal is pending and the participant or former participant is 301.32 determined ineligible for assistance or for less assistance than 301.33 was received, the county agency must recoup or recover the 301.34 overpaymentunderusing theconditions of this301.35section.following methods: 301.36 (1) reconstruct each affected budget month and 302.1 corresponding payment month; 302.2 (2) use the policies and procedures that were in effect for 302.3 the payment month; and 302.4 (3) do not allow employment disregards in section 256J.21, 302.5 subdivision 3 or 4, in the calculation of the overpayment when 302.6 the unit has not reported within two calendar months following 302.7 the end of the month in which the income was received. 302.8 Sec. 72. Minnesota Statutes 1997 Supplement, section 302.9 256J.39, subdivision 2, is amended to read: 302.10 Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 302.11 paying assistance directly to a participant may be used when: 302.12 (1) a county agency determines that a vendor payment is the 302.13 most effective way to resolve an emergency situation pertaining 302.14 to basic needs; 302.15 (2) a caregiver makes a written request to the county 302.16 agency asking that part or all of the assistance payment be 302.17 issued by protective or vendor payments for shelter and utility 302.18 service only. The caregiver may withdraw this request in 302.19 writing at any time; 302.20 (3)a caregiver has exhibited a continuing pattern of302.21mismanaging funds as determined by the county agency;302.22(4)the vendor payment is part of a sanction under section 302.23 256J.46, subdivision 2;or302.24(5)(4) the vendor payment is required under section 302.25 256J.24, subdivision 8, 256J.26, or 256J.43; 302.26 (5) a protective payment is required for a minor parent 302.27 under section 256J.14; or 302.28 (6) a caregiver has exhibited a continuing pattern of 302.29 mismanaging funds as determined by the county agency. 302.30 The director of a county agency must approve a proposal for 302.31 protective or vendor payment for money mismanagement when there 302.32 is a pattern of mismanagement under clause (6). During the time 302.33 a protective or vendor payment is being made, the county agency 302.34 must provide services designed to alleviate the causes of the 302.35 mismanagement. 302.36 The continuing need for and method of payment must be 303.1 documented and reviewed every 12 months. The director of a 303.2 county agency must approve the continuation of protective or 303.3 vendor payments. When it appears that the need for protective 303.4 or vendor payments will continue or is likely to continue beyond 303.5 two years because the county agency's efforts have not resulted 303.6 in sufficiently improved use of assistance on behalf of the 303.7 minor child, judicial appointment of a legal guardian or other 303.8 legal representative must be sought by the county agency. 303.9 Sec. 73. Minnesota Statutes 1997 Supplement, section 303.10 256J.395, is amended to read: 303.11 256J.395 [VENDOR PAYMENT OFRENTSHELTER COSTS AND 303.12 UTILITIES.] 303.13 Subdivision 1. [VENDOR PAYMENT.] (a) Effective July 1, 303.14 1997, when a county is required to provide assistance to 303.15 arecipientparticipant in vendor form forrentshelter costs 303.16 and utilities under this chapter, or chapter 256, 256D, or 256K, 303.17 the cost of utilities for a given family may be assumed to be: 303.18 (1) the average of the actual monthly cost of utilities for 303.19 that family for the prior 12 months at the family's current 303.20 residence, if applicable; 303.21 (2) the monthly plan amount, if any, set by the local 303.22 utilities for that family at the family's current residence; or 303.23 (3) the estimated monthly utility costs for the dwelling in 303.24 which the family currently resides. 303.25 (b) For purposes of this section, "utility" means any of 303.26 the following: municipal water and sewer service; electric, 303.27 gas, or heating fuel service; or wood, if that is the heating 303.28 source. 303.29 (c) In any instance where a vendor payment for rent is 303.30 directed to a landlord not legally entitled to the payment, the 303.31 county social services agency shall immediately institute 303.32 proceedings to collect the amount of the vendored rent payment, 303.33 which shall be considered a debt under section 270A.03, 303.34 subdivision 5. 303.35 Subd. 2. [VENDOR PAYMENT NOTIFICATION.] (a) When a county 303.36 agency is required to provide assistance to a participant in 304.1 vendor payment form for shelter costs or utilities under 304.2 subdivision 1, and the participant does not give the agency the 304.3 information needed to pay the vendor, the county agency shall 304.4 notify the participant of the intent to terminate assistance by 304.5 mail at least ten days before the effective date of the adverse 304.6 action. 304.7 (b) The notice of action shall include a request for 304.8 information about: 304.9 (1) the amount of the participant's shelter costs or 304.10 utilities; 304.11 (2) the due date of the shelter costs or utilities; and 304.12 (3) the name and address of the landlord, contract for deed 304.13 holder, mortgage company, and utility vendor. 304.14 (c) If the participant fails to provide the requested 304.15 information by the effective date of the adverse action, the 304.16 county must terminate the MFIP-S grant. If the applicant or 304.17 participant verifies they do not have shelter costs or utility 304.18 obligations, the county shall not terminate assistance if the 304.19 assistance unit is otherwise eligible. 304.20 Sec. 74. Minnesota Statutes 1997 Supplement, section 304.21 256J.42, is amended to read: 304.22 256J.42 [60-MONTH TIME LIMIT.] 304.23 Subdivision 1. [TIME LIMIT.] (a) Except for the exemptions 304.24 in this section and in section 256J.11, subdivision 2, An 304.25 assistance unit in which any adult caregiver has received 60 304.26 months of cash assistance funded in whole or in part by the TANF 304.27 block grant in this or any other state or United States 304.28 territory, MFIP-S, AFDC, or family general assistance, funded in 304.29 whole or in part by state appropriations, is ineligible to 304.30 receive MFIP-S. Any cash assistance funded with TANF dollars in 304.31 this or any other state or United States territory, or MFIP-S 304.32 assistance funded in whole or in part by state appropriations, 304.33 that was received by the unit on or after the date TANF was 304.34 implemented, including any assistance received in states or 304.35 United States territories of prior residence, counts toward the 304.36 60-month limitation. The 60-month limit applies to a minor who 305.1 is the head of a household or who is married to the head of a 305.2 household except under subdivision 5. The 60-month time period 305.3 does not need to be consecutive months for this provision to 305.4 apply. 305.5 (b) Months before July 1998 in which individuals receive 305.6 assistance as part of an MFIP, MFIP-R, or MFIP or MFIP-R 305.7 comparison group family under sections 256.031 to 256.0361 or 305.8 sections 256.047 to 256.048 are not included in the 60-month 305.9 time limit. 305.10Subd. 2. [ASSISTANCE FROM ANOTHER STATE.] An individual305.11whose needs have been otherwise provided for in another state,305.12in whole or in part by the TANF block grant during a month, is305.13ineligible to receive MFIP-S for the month.305.14 Subd. 3. [ADULTS LIVING ON AN INDIAN RESERVATION.] In 305.15 determining the number of months for which an adult has received 305.16 assistance under MFIP-S, the county agency must disregard any 305.17 month during which the adult lived on an Indian reservation if,305.18 during the month:305.19(1) at least 1,000 individuals were living on the305.20reservation; and305.21(2)at least 50 percent of the adults living on the 305.22 reservation wereunemployednot employed. 305.23 Subd. 4. [VICTIMS OF DOMESTIC VIOLENCE.] Any cash 305.24 assistance received by an assistance unit in a month when a 305.25 caregiver is complying with a safety plan under the MFIP-S 305.26 employment and training component does not count toward the 305.27 60-month limitation on assistance. 305.28 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 305.29 assistance received by an assistance unit does not count toward 305.30 the 60-month limit on assistance during a month in which 305.31 theparentalcaregiver is in the category in section 256J.56, 305.32 clause (1). The exemption applies for the period of time the 305.33 caregiver belongs to one of the categories specified in this 305.34 subdivision. 305.35 (b) From July 1, 1997, until the date MFIP-S is operative 305.36 in the caregiver's county of financial responsibility, any cash 306.1 assistance received by a caregiver who is complying with 306.2 sections 256.73, subdivision 5a, and 256.736, if applicable, 306.3 does not count toward the 60-month limit on assistance. 306.4 Thereafter, any cash assistance received by a minor caregiver 306.5 who is complying with the requirements of sections 256J.14 and 306.6 256J.54, if applicable, does not count towards the 60-month 306.7 limit on assistance. 306.8 (c) Any diversionary assistance or emergency assistance 306.9 received does not count toward the 60-month limit. 306.10 (d) Any cash assistance received by an 18 or 19 year old 306.11 caregiver during a month when the caregiver is complying with 306.12 the requirements of section 256J.54 does not count toward the 306.13 60-month limit. 306.14 Sec. 75. Minnesota Statutes 1997 Supplement, section 306.15 256J.43, is amended to read: 306.16 256J.43 [INTERSTATE PAYMENT STANDARDS.] 306.17 Subdivision 1. [PAYMENT.] (a) Effective July 1, 1997, the 306.18 amount of assistance paid to an eligiblefamilyunit in which 306.19 all members have resided in this state for fewer than 12 306.20 consecutive calendar months immediately preceding the date of 306.21 application shall be the lesser of either thepaymentinterstate 306.22 transitional standard that would have been received by 306.23 thefamilyassistance unit from the state of immediate prior 306.24 residence, or the amount calculated in accordance with AFDC or 306.25 MFIP-S standards. The lesser payment must continue until 306.26 thefamilyassistance unit meets the 12-month requirement. An 306.27 assistance unit that has not resided in Minnesota for 12 months 306.28 from the date of application is not exempt from the interstate 306.29 payment provisions solely because a child is born in Minnesota 306.30 to a member of the assistance unit. Payment must be calculated 306.31 by applying this state's budgeting policies, and the unit's net 306.32 income must be deducted from the payment standard in the other 306.33 state or in this state, whichever is lower. Payment shall be 306.34 made in vendor form for rent and utilities, up to the limit of 306.35 the grant amount, and residual amounts, if any, shall be paid 306.36 directly to the assistance unit. 307.1 (b) During the first 12 monthsa familyan assistance unit 307.2 resides in this state, the number of months that afamilyunit 307.3 is eligible to receive AFDC or MFIP-S benefits is limited to the 307.4 number of months thefamilyassistance unit would have been 307.5 eligible to receive similar benefits in the state of immediate 307.6 prior residence. 307.7 (c) This policy applies whether or not thefamily307.8 assistance unit received similar benefits while residing in the 307.9 state of previous residence. 307.10 (d) Whena familyan assistance unit moves to this state 307.11 from another state where thefamilyassistance unit has 307.12 exhausted that state's time limit for receiving benefits under 307.13 that state's TANF program, thefamilyunit will not be eligible 307.14 to receive any AFDC or MFIP-S benefits in this state for 12 307.15 months from the date thefamilyassistance unit moves here. 307.16 (e) For the purposes of this section, "state of immediate 307.17 prior residence" means: 307.18 (1) the state in which the applicant declares the applicant 307.19 spent the most time in the 30 days prior to moving to this 307.20 state; or 307.21 (2) the state in which an applicant who is a migrant worker 307.22 maintains a home. 307.23 (f) The commissioner shall annually verify and update all 307.24 other states' payment standards as they are to be in effect in 307.25 July of each year. 307.26 (g) Applicants must provide verification of their state of 307.27 immediate prior residence, in the form of tax statements, a 307.28 driver's license, automobile registration, rent receipts, or 307.29 other forms of verification approved by the commissioner. 307.30 (h) Migrant workers, as defined in section 256J.08, and 307.31 their immediate families are exempt from this section, provided 307.32 the migrant worker provides verification that the migrant family 307.33 worked in this state within the last 12 months and earned at 307.34 least $1,000 in gross wages during the time the migrant worker 307.35 worked in this state. 307.36 Subd. 2. [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 308.1 assistance unit that has met the requirements of section 308.2 256J.12, the number of months that the assistance unit receives 308.3 benefits under the interstate payment standards in this section 308.4 is not affected by an absence from Minnesota for fewer than 30 308.5 consecutive days. 308.6 (b) For an assistance unit that has met the requirements of 308.7 section 256J.12, the number of months that the assistance unit 308.8 receives benefits under the interstate payment standards in this 308.9 section is not affected by an absence from Minnesota for more 308.10 than 30 consecutive days but fewer than 90 consecutive days, 308.11 provided the assistance unit continues to maintain a residence 308.12 in Minnesota during the period of absence. 308.13 Subd. 3. [EXCEPTIONS TO THE INTERSTATE PAYMENT 308.14 POLICY.] Applicants who lived in another state in the 12 months 308.15 prior to applying for assistance are exempt from the interstate 308.16 payment policy for the months that a member of the unit: 308.17 (1) served in the United States armed services, provided 308.18 the person returned to Minnesota within 30 days of leaving the 308.19 armed forces, and intends to remain in Minnesota; 308.20 (2) attended school in another state, paid nonresident 308.21 tuition or Minnesota tuition rates under a reciprocity 308.22 agreement, provided the person left Minnesota specifically to 308.23 attend school and returned to Minnesota within 30 days of 308.24 graduation with the intent to remain in Minnesota; or 308.25 (3) meets the following criteria: 308.26 (i) a minor child or a minor caregiver moves from another 308.27 state to the residence of a relative caregiver; 308.28 (ii) the minor caregiver applies for and receives family 308.29 cash assistance; 308.30 (iii) the relative caregiver chooses not to be part of the 308.31 MFIP-S assistance unit; and 308.32 (iv) the relative caregiver has resided in Minnesota for at 308.33 least 12 months from the date the assistance unit applies for 308.34 cash assistance. 308.35 Subd. 4. [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 308.36 mandatory unit members who have resided in Minnesota for 12 309.1 months immediately before the unit's date of application 309.2 establish the other assistance unit members' eligibility for the 309.3 MFIP-S transitional standard. 309.4 Sec. 76. Minnesota Statutes 1997 Supplement, section 309.5 256J.44, is amended by adding a subdivision to read: 309.6 Subd. 3. [INTERVIEW TO IDENTIFY APPLICANTS WITH DRUG OR 309.7 ALCOHOL DEPENDENCIES.] As part of the initial screening under 309.8 this section, each applicant must also be asked if the applicant 309.9 has symptoms of a drug or alcohol dependency or substance abuse 309.10 problems. If this interview indicates that the applicant may 309.11 have a drug or alcohol dependency, the applicant must be 309.12 referred for further assessment. If the further assessment 309.13 indicates that the applicant or recipient has a drug or alcohol 309.14 dependency or substance abuse problem that requires treatment, 309.15 and that the individual's dependency is amenable to treatment, 309.16 the county must offer the individual a referral to an 309.17 appropriate treatment option. 309.18 Sec. 77. Minnesota Statutes 1997 Supplement, section 309.19 256J.45, subdivision 1, is amended to read: 309.20 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 309.21 county agency must provide each MFIP-S caregiver with a 309.22 face-to-face orientation. The caregiver must attend the 309.23 orientation. The county agency must inform the caregiver that 309.24 failure to attend the orientation is considereda firstan 309.25 occurrence of noncompliance with program requirements, and will 309.26 result in the imposition of a sanction under section 309.27 256J.46. If the client complies with the orientation 309.28 requirement prior to the effective date of the sanction, the 309.29 orientation sanction shall be lifted. 309.30 Sec. 78. Minnesota Statutes 1997 Supplement, section 309.31 256J.45, subdivision 2, is amended to read: 309.32 Subd. 2. [GENERAL INFORMATION.] The MFIP-S orientation 309.33 must consist of a presentation that informs caregivers of: 309.34 (1) the necessity to obtain immediate employment; 309.35 (2) the work incentives under MFIP-S; 309.36 (3) the requirement to comply with the employment plan and 310.1 other requirements of the employment and training services 310.2 component of MFIP-S; 310.3 (4) the consequences for failing to comply with the 310.4 employment plan and other program requirements; 310.5 (5) the rights, responsibilities, and obligations of 310.6 participants; 310.7 (6) the types and locations of child care services 310.8 available through the county agency; 310.9 (7) the availability and the benefits of the early 310.10 childhood health and developmental screening under sections 310.11 123.701 to 123.74; 310.12 (8) the caregiver's eligibility for transition year child 310.13 care assistance under section 119B.05; 310.14 (9) the caregiver's eligibility for extended medical 310.15 assistance when the caregiver loses eligibility for MFIP-S due 310.16 to increased earnings or increased child or spousal support;and310.17 (10) the caregiver's option to choose an employment and 310.18 training provider and information about each provider, including 310.19 but not limited to, services offered, program components, job 310.20 placement rates, job placement wages, and job retention rates; 310.21 and 310.22 (11) the caregiver's option to request approval of an 310.23 education and training plan according to section 256J.52. 310.24 Sec. 79. Minnesota Statutes 1997 Supplement, section 310.25 256J.45, is amended by adding a subdivision to read: 310.26 Subd. 3. [GOOD CAUSE FOR NOT ATTENDING ORIENTATION.] (a) 310.27 The county agency shall not impose the sanction under section 310.28 256J.46 if it determines that the participant has good cause for 310.29 failing to attend orientation. Good cause exists when: 310.30 (1) appropriate child care is not available; 310.31 (2) the participant is ill or injured; 310.32 (3) a family member is ill and needs care by the 310.33 participant that prevents the participant from attending 310.34 orientation; 310.35 (4) the caregiver is unable to secure necessary 310.36 transportation; 311.1 (5) the caregiver is in an emergency situation that 311.2 prevents orientation attendance; 311.3 (6) the orientation conflicts with the caregiver's work, 311.4 training, or school schedule; or 311.5 (7) the caregiver documents other verifiable impediments to 311.6 orientation attendance beyond the caregiver's control. 311.7 (b) Counties must work with clients to provide child care 311.8 and transportation necessary to ensure a caregiver has every 311.9 opportunity to attend orientation. 311.10 Sec. 80. Minnesota Statutes 1997 Supplement, section 311.11 256J.46, subdivision 1, is amended to read: 311.12 Subdivision 1. [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 311.13 WITH PROGRAM REQUIREMENTS.] (a) The following participants are 311.14 subject to a sanction under this subdivision: 311.15 (1) a participant who fails without good cause to comply 311.16 with the requirements of this chapter, and who is not subject to 311.17 a sanction under subdivision 2, shall be subject to a sanction311.18as provided in this subdivision; and 311.19 (2) a participant who has not complied with the orientation 311.20 requirement before the effective date of the sanction. 311.21 A sanction under this subdivision becomes effective ten 311.22 days after the required notice is given. For purposes of this 311.23 subdivision, each month that a participant fails to comply with 311.24 a requirement of this chapter shall be considered a separate 311.25 occurrence of noncompliance. A participant who has had one or 311.26 more sanctions imposed must remain in compliance with the 311.27 provisions of this chapter for six months in order for a 311.28 subsequent occurrence of noncompliance to be considered a first 311.29 occurrence. 311.30 (b) Sanctions for noncompliance shall be imposed as follows: 311.31 (1) For the first occurrence of noncompliance by a 311.32 participant in a single-parent household or by one participant 311.33 in a two-parent household, theparticipant'sassistance unit's 311.34 grant shall be reduced by ten percent of theapplicableMFIP-S 311.35 transitional standard or the interstate transitional standard 311.36 for an assistance unit of the same size, whichever is 312.1 applicable, with the residual paid to the participant. The 312.2 reduction in the grant amount must be in effect for a minimum of 312.3 one month and shall be removed in the month following the month 312.4 that the participant returns to compliance or in the month 312.5 following the minimum one-month sanction, whichever is later. 312.6 (2) For a second or subsequent occurrence of noncompliance, 312.7 or when both participants in a two-parent household are out of 312.8 compliance at the same time, theparticipant's rentassistance 312.9 unit's shelter costs shall be vendor paid up to the amount of 312.10 the cash portion of the MFIP-S grant for which the participant's 312.11 assistance unit is eligible. At county option, 312.12 theparticipant'sassistance unit's utilities may also be vendor 312.13 paid up to the amount of the cash portion of the MFIP-S grant 312.14 remaining after vendor payment of theparticipant's rent312.15 assistance unit's shelter costs.The vendor payment of rent312.16and, if in effect, utilities, must be in effect for six months312.17from the date that a sanction is imposed under this clause.The 312.18 residual amount of the grant after vendor payment, if any, must 312.19 be reduced by an amount equal to 30 percent of theapplicable312.20 MFIP-S transitional standard, or the interstate transitional 312.21 standard for an assistance unit of the same size, whichever is 312.22 applicable, before the residual is paid to theparticipant312.23 assistance unit. The reduction in the grant amount must be in 312.24 effect for a minimum of one month and shall be removed in the 312.25 month following the month thatthea participant in a one-parent 312.26 household returns to compliance or in the month following the 312.27 minimum one-month sanction, whichever is later. In a two-parent 312.28 household, the grant reduction shall be removed in the month 312.29 following the month both participants return to compliance or in 312.30 the month following the minimum one-month sanction, whichever is 312.31 later. The vendor payment ofrentshelter costs and, if 312.32 applicable, utilities shall be removed six months after the 312.33 month in which the participantreturnsor participants return to 312.34 compliance. 312.35 (c) No later than during the second month that a sanction 312.36 under paragraph (b), clause (2), is in effect due to 313.1 noncompliance with employment services, the participant's case 313.2 file must be reviewed to determine if: 313.3 (i) the continued noncompliance can be explained and 313.4 mitigated by providing a needed preemployment activity, as 313.5 defined in section 256J.49, subdivision 13, clause (16); 313.6 (ii) the participant qualifies for a good cause exception 313.7 under section 256J.57; or 313.8 (iii) the participant qualifies for an exemption under 313.9 section 256J.56. 313.10 If the lack of an identified activity can explain the 313.11 noncompliance, the county must work with the participant to 313.12 provide the identified activity, and the county must restore the 313.13 participant's grant amount to the full amount for which the 313.14 assistance unit is eligible. The grant must be restored 313.15 retroactively to the first day of the month in which the 313.16 participant was found to lack preemployment activities or to 313.17 qualify for an exemption or good cause exception. 313.18 If the participant is found to qualify for a good cause 313.19 exception or an exemption, the county must restore the 313.20 participant's grant to the full amount for which the assistance 313.21 unit is eligible.If the participant's grant is restored under313.22this paragraph, the vendor payment of rent and if applicable,313.23utilities, shall be removed six months after the month in which313.24the sanction was imposed and the county must consider a313.25subsequent occurrence of noncompliance to be a first occurrence.313.26 Sec. 81. Minnesota Statutes 1997 Supplement, section 313.27 256J.46, subdivision 2, is amended to read: 313.28 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 313.29 REQUIREMENTS.] The grant of an MFIP-S caregiver who refuses to 313.30 cooperate, as determined by the child support enforcement 313.31 agency, with support requirements under section 256.741, if 313.32 enacted, shall be subject to sanction as specified in this 313.33 subdivision. The assistance unit's grant must be reduced by 25 313.34 percent of the applicable transitional standard. The residual 313.35 amount of the grant, if any, must be paid to the caregiver. A 313.36 sanction under this subdivision becomes effective ten days after 314.1 the required notice is given. The sanction must be in effect 314.2 for a minimum of one month and shall be removed only when the 314.3 caregiver cooperates with the support requirements or in the 314.4 month following the minimum one-month sanction, whichever is 314.5 later. Each month that an MFIP-S caregiver fails to comply with 314.6 the requirements of section 256.741 must be considered a 314.7 separate occurrence of noncompliance. An MFIP-S caregiver who 314.8 has had one or more sanctions imposed must remain in compliance 314.9 with the requirements of section 256.741 for six months in order 314.10 for a subsequent sanction to be considered a first occurrence. 314.11 Sec. 82. Minnesota Statutes 1997 Supplement, section 314.12 256J.47, subdivision 4, is amended to read: 314.13 Subd. 4. [INELIGIBILITY FOR MFIP-S; EMERGENCY ASSISTANCE; 314.14 AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of diversionary 314.15 assistance, the family is ineligible for MFIP-S, emergency 314.16 assistance, and emergency general assistance for a period of 314.17 time. To determine the period of ineligibility, the county 314.18 shall use the following formula: regardless of household 314.19 changes, the county agency must calculate the number of days of 314.20 ineligibility by dividing the diversionary assistance issued by 314.21 the transitional standard a family of the same size and 314.22 composition would have received under MFIP-S, or if applicable 314.23 the interstate transitional standard, multiplied by 30, 314.24 truncating the result. The ineligibility period begins the date 314.25 the diversionary assistance is issued. 314.26 Sec. 83. Minnesota Statutes 1997 Supplement, section 314.27 256J.48, subdivision 2, is amended to read: 314.28 Subd. 2. [ELIGIBILITY.] Notwithstanding other eligibility 314.29 provisions of this chapter, any family without resources 314.30 immediately available to meet emergency needs identified in 314.31 subdivision 3 shall be eligible for an emergency grant under the 314.32 following conditions: 314.33 (1) a family member has resided in this state for at least 314.34 30 days; 314.35 (2) the family is without resources immediately available 314.36 to meet emergency needs; 315.1 (3) assistance is necessary to avoid destitution or provide 315.2 emergency shelter arrangements;and315.3 (4) the family's destitution or need for shelter or 315.4 utilities did not arise because the child or relative caregiver 315.5 refused without good cause under section 256J.57 to accept 315.6 employment or training for employment in this state or another 315.7 state; and 315.8 (5) at least one child or pregnant woman in the emergency 315.9 assistance unit meets MFIP-S citizenship requirements in section 315.10 256J.11. 315.11 Sec. 84. Minnesota Statutes 1997 Supplement, section 315.12 256J.48, subdivision 3, is amended to read: 315.13 Subd. 3. [EMERGENCY NEEDS.] Emergency needs are limited to 315.14 the following: 315.15 (a) [RENT.] A county agency may deny assistance to prevent 315.16 eviction from rented or leased shelter of an otherwise eligible 315.17 applicant when the county agency determines that an applicant's 315.18 anticipated income will not cover continued payment for shelter, 315.19 subject to conditions in clauses (1) to (3): 315.20 (1) a county agency must not deny assistance when an 315.21 applicant can document that the applicant is unable to locate 315.22 habitable shelter, unless the county agency can document that 315.23 one or more habitable shelters are available in the community 315.24 that will result in at least a 20 percent reduction in monthly 315.25 expense for shelter and that this shelter will be cost-effective 315.26 for the applicant; 315.27 (2) when no alternative shelter can be identified by either 315.28 the applicant or the county agency, the county agency shall not 315.29 deny assistance because anticipated income will not cover rental 315.30 obligation; and 315.31 (3) when cost-effective alternative shelter is identified, 315.32 the county agency shall issue assistance for moving expenses as 315.33 provided in paragraph(d)(e). 315.34 (b) [DEFINITIONS.] For purposes of paragraph (a), the 315.35 following definitions apply (1) "metropolitan statistical area" 315.36 is as defined by the United States Census Bureau; (2) 316.1 "alternative shelter" includes any shelter that is located 316.2 within the metropolitan statistical area containing the county 316.3 and for which the applicant is eligible, provided the applicant 316.4 does not have to travel more than 20 miles to reach the shelter 316.5 and has access to transportation to the shelter. Clause (2) 316.6 does not apply to counties in the Minneapolis-St. Paul 316.7 metropolitan statistical area. 316.8 (c) [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 316.9 agency shall issue assistance for mortgage or contract for deed 316.10 arrearages on behalf of an otherwise eligible applicant 316.11 according to clauses (1) to (4): 316.12 (1) assistance for arrearages must be issued only when a 316.13 home is owned, occupied, and maintained by the applicant; 316.14 (2) assistance for arrearages must be issued only when no 316.15 subsequent foreclosure action is expected within the 12 months 316.16 following the issuance; 316.17 (3) assistance for arrearages must be issued only when an 316.18 applicant has been refused refinancing through a bank or other 316.19 lending institution and the amount payable, when combined with 316.20 any payments made by the applicant, will be accepted by the 316.21 creditor as full payment of the arrearage; 316.22 (4) costs paid by a family which are counted toward the 316.23 payment requirements in this clause are:principleprincipal 316.24 and interest payments on mortgages or contracts for deed, 316.25 balloon payments, homeowner's insurance payments, manufactured 316.26 home lot rental payments, and tax or special assessment payments 316.27 related to the homestead. Costs which are not counted include 316.28 closing costs related to the sale or purchase of real property. 316.29 To be eligible for assistance for costs specified in clause 316.30 (4) which are outstanding at the time of foreclosure, an 316.31 applicant must have paid at least 40 percent of the family's 316.32 gross income toward these costs in the month of application and 316.33 the 11-month period immediately preceding the month of 316.34 application. 316.35 When an applicant is eligible under clause (4), a county 316.36 agency shall issue assistance up to a maximum of four times the 317.1 MFIP-S transitional standard for a comparable assistance unit. 317.2 (d) [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 317.3 issue assistance for damage or utility deposits when necessary 317.4 to alleviate the emergency. The county may require that 317.5 assistance paid in the form of a damage depositor a utility317.6deposit, less any amount retained by the landlord to remedy a 317.7 tenant's default in payment of rent or other funds due to the 317.8 landlord under a rental agreement, or to restore the premises to 317.9 the condition at the commencement of the tenancy, ordinary wear 317.10 and tear excepted, be returned to the county when the individual 317.11 vacates the premises or be paid to the recipient's new landlord 317.12 as a vendor payment. The county may require that assistance 317.13 paid in the form of a utility deposit less any amount retained 317.14 to satisfy outstanding utility costs be returned to the county 317.15 when the person vacates the premises, or be paid for the 317.16 person's new housing unit as a vendor payment. The vendor 317.17 payment of returned funds shall not be considered a new use of 317.18 emergency assistance. 317.19 (e) [MOVING EXPENSES.] A county agency shall issue 317.20 assistance for expenses incurred when a family must move to a 317.21 different shelter according to clauses (1) to (4): 317.22 (1) moving expenses include the cost to transport personal 317.23 property belonging to a family, the cost for utility connection, 317.24 and the cost for securing different shelter; 317.25 (2) moving expenses must be paid only when the county 317.26 agency determines that a move is cost-effective; 317.27 (3) moving expenses must be paid at the request of an 317.28 applicant, but only when destitution or threatened destitution 317.29 exists; and 317.30 (4) moving expenses must be paid when a county agency 317.31 denies assistance to prevent an eviction because the county 317.32 agency has determined that an applicant's anticipated income 317.33 will not cover continued shelter obligation in paragraph (a). 317.34 (f) [HOME REPAIRS.] A county agency shall pay for repairs 317.35 to the roof, foundation, wiring, heating system, chimney, and 317.36 water and sewer system of a home that is owned and lived in by 318.1 an applicant. 318.2 The applicant shall document, and the county agency shall 318.3 verify the need for and method of repair. 318.4 The payment must be cost-effective in relation to the 318.5 overall condition of the home and in relation to the cost and 318.6 availability of alternative housing. 318.7 (g) [UTILITY COSTS.] Assistance for utility costs must be 318.8 made when an otherwise eligible family has had a termination or 318.9 is threatened with a termination of municipal water and sewer 318.10 service, electric, gas or heating fuel service, or lacks wood 318.11 when that is the heating source, subject to the conditions in 318.12 clauses (1) and (2): 318.13 (1) a county agency must not issue assistance unless the 318.14 county agency receives confirmation from the utility provider 318.15 that assistance combined with payment by the applicant will 318.16 continue or restore the utility; and 318.17 (2) a county agency shall not issue assistance for utility 318.18 costs unless a family paid at least eight percent of the 318.19 family's gross income toward utility costs due during the 318.20 preceding 12 months. 318.21 Clauses (1) and (2) must not be construed to prevent the 318.22 issuance of assistance when a county agency must take immediate 318.23 and temporary action necessary to protect the life or health of 318.24 a child. 318.25 (h) [SPECIAL DIETS.] Effective January 1, 1998, a county 318.26 shall pay for special diets or dietary items for MFIP-S 318.27 participants. Persons receiving emergency assistance funds for 318.28 special diets or dietary items are also eligible to receive 318.29 emergency assistance for shelter and utility emergencies, if 318.30 otherwise eligible. The need for special diets or dietary items 318.31 must be prescribed by a licensed physician. Costs for special 318.32 diets shall be determined as percentages of the allotment for a 318.33 one-person household under the Thrifty Food Plan as defined by 318.34 the United States Department of Agriculture. The types of diets 318.35 and the percentages of the Thrifty Food Plan that are covered 318.36 are as follows: 319.1 (1) high protein diet, at least 80 grams daily, 25 percent 319.2 of Thrifty Food Plan; 319.3 (2) controlled protein diet, 40 to 60 grams and requires 319.4 special products, 100 percent of Thrifty Food Plan; 319.5 (3) controlled protein diet, less than 40 grams and 319.6 requires special products, 125 percent of Thrifty Food Plan; 319.7 (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 319.8 (5) high residue diet, 20 percent of Thrifty Food Plan; 319.9 (6) pregnancy and lactation diet, 35 percent of Thrifty 319.10 Food Plan; 319.11 (7) gluten-free diet, 25 percent of Thrifty Food Plan; 319.12 (8) lactose-free diet, 25 percent of Thrifty Food Plan; 319.13 (9) antidumping diet, 15 percent of Thrifty Food Plan; 319.14 (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 319.15 (11) ketogenic diet, 25 percent of Thrifty Food Plan. 319.16 Sec. 85. Minnesota Statutes 1997 Supplement, section 319.17 256J.50, subdivision 5, is amended to read: 319.18 Subd. 5. [PARTICIPATION REQUIREMENTS FOR SINGLE-PARENT AND 319.19 TWO-PARENT CASES.] (a) A county must establish a uniform 319.20 schedule for requiring participation by single parents. 319.21 Mandatory participation must be required within six months of 319.22 eligibility for cash assistance. For two-parent cases, 319.23 participation is required concurrent with the receipt of MFIP-S 319.24 cash assistance. 319.25 (b) Beginning January 1, 1998, with the exception of 319.26 caregivers required to attend high school under the provisions 319.27 of section 256J.54, subdivision 5, MFIP caregivers, upon 319.28 completion of the secondary assessment, must develop an 319.29 employment plan and participate in work activities. 319.30 (c) Upon completion of the secondary assessment: 319.31 (1) In single-parent families with no children under six 319.32 years of age, the job counselor and the caregiver must develop 319.33 an employment plan that includes 20 to 35 hours per week of work 319.34 activities for the period January 1, 1998, to September 30, 319.35 1998; 25 to 35 hours of work activities per week in federal 319.36 fiscal year 1999; and 30 to 35 hours per week of work activities 320.1 in federal fiscal year 2000 and thereafter. 320.2 (2) In single-parent families with a child under six years 320.3 of age, the job counselor and the caregiver must develop an 320.4 employment plan that includes 20 to 35 hours per week of work 320.5 activities. 320.6 (3) In two-parent families, the job counselor and the 320.7 caregivers must develop employment plans which result in a 320.8 combined total of at least 55 hours per week of work activities. 320.9 Sec. 86. Minnesota Statutes 1997 Supplement, section 320.10 256J.50, is amended by adding a subdivision to read: 320.11 Subd. 10. [COORDINATION.] The county agency and the county 320.12 agency's employment and training providers must consult and 320.13 coordinate with other providers of employment and training 320.14 services to identify existing resources, in order to prevent 320.15 duplication of services, to assure that other programs' services 320.16 are available to enable participants to achieve 320.17 self-sufficiency, and to assure that costs for these other 320.18 services for which participants are eligible are not incurred by 320.19 MFIP-S. At a minimum, the county agency and its providers must 320.20 coordinate with Jobs Training and Partnership Act providers and 320.21 with any other relevant employment, training, and education 320.22 programs in the county. 320.23 Sec. 87. Minnesota Statutes 1997 Supplement, section 320.24 256J.515, is amended to read: 320.25 256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 320.26 During the first meeting with participants, job counselors 320.27 must ensure that an overview of employment and training services 320.28 is provided that: (1) stresses the necessity and opportunity of 320.29 immediate employment,; (2) outlines the job search resources 320.30 offered,; (3) outlines education or training opportunities 320.31 available; (4) describes the range of work activities that are 320.32 allowable under MFIP-S to meet the individual needs of 320.33 participants; (5) explains the requirements to comply with an 320.34 employment planand; (6) explains the consequences for failing 320.35 to comply,; and (7) explains the services that are available to 320.36 support job search and work and education. 321.1 Sec. 88. Minnesota Statutes 1997 Supplement, section 321.2 256J.52, subdivision 2, is amended to read: 321.3 Subd. 2. [INITIAL ASSESSMENT.] (a) The job counselor must, 321.4 with the cooperation of the participant, assess the 321.5 participant's ability to obtain and retain employment. This 321.6 initial assessment must include a review of the participant's 321.7 education level, prior employment or work experience, 321.8 transferable work skills, and existing job markets. The job 321.9 counselor must assess each participant's literacy and math 321.10 skills as part of an initial assessment. If a participant lacks 321.11 basic math or literacy skills at or below an eighth grade level, 321.12 the participant must be allowed to enroll in adult basic 321.13 education activities as part of the participant's job search 321.14 support plan or employment plan. A participant with low-level 321.15 math and literacy skills should not be categorically assumed to 321.16 be unemployable. 321.17 (b) In assessing the participant, the job counselor must 321.18 determine if the participant needs refresher courses for 321.19 professional certification or licensure, in which case, the job 321.20 search plan under subdivision 3 must include the courses 321.21 necessary to obtain the certification or licensure, in addition 321.22 to other work activities, provided the combination of the 321.23 courses and other work activities are at least for 40 hours per 321.24 week. 321.25 (c)If a participant can demonstrate to the satisfaction of321.26the county agency thatIf the job counselor determines that a 321.27 lack of proficiency in English is a barrier to obtaining 321.28 suitable employment, the job counselor must include 321.29 participation in an intensive English as a second language 321.30 program if available or otherwise a regular English as a second 321.31 language program in the individual's employment plan under 321.32 subdivision 5 for as long as the participant is making 321.33 satisfactory progress and the individual's lack of proficiency 321.34 in English remains a barrier to obtaining suitable employment. 321.35 Lack of proficiency in English is not necessarily a barrier to 321.36 employment. 322.1 (d) Understanding that education may provide the best 322.2 opportunity for unsubsidized employment, the job counselor may 322.3 approve an education or training plan as a first option, and 322.4 postpone the job search requirement, if the participant has a 322.5 proposal for an education program, including those that may lead 322.6 to a certificate, diploma, or degree and which: 322.7 (1) can be completed within 12 months or within 18 months 322.8 if remedial education courses are necessary; 322.9 (2) meets the criteria of section 256J.53, subdivisions 2, 322.10 3, and 5; and 322.11 (3) is likely, without additional training, to lead to 322.12 monthly employment earnings which, after subtraction of the 322.13 earnings disregard under section 256J.21, equal or exceed the 322.14 family wage level for the participant's assistance unit. 322.15 (e) A participant who, at the time of the initial 322.16 assessment, presents a plan that includes farming as a 322.17 self-employed work activity must have an employment plan 322.18 developed under subdivision 5 that includes the farming as an 322.19 approved work activity. 322.20 Sec. 89. Minnesota Statutes 1997 Supplement, section 322.21 256J.52, subdivision 3, is amended to read: 322.22 Subd. 3. [JOB SEARCH; JOB SEARCH SUPPORT PLAN.] (a) If, 322.23 after the initial assessment, the job counselor determines that 322.24 the participant possesses sufficient skills that the participant 322.25 is likely to succeed in obtaining suitable employment, the 322.26 participant must conduct job search for a period of up to eight 322.27 weeks, for at least 30 hours per week. The participant must 322.28 accept any offer of suitable employment. The job counselor and 322.29 participant must develop a job search support plan which 322.30 specifies, at a minimum: whether the job search is to be 322.31 supervised or unsupervised; the number of hours of job search 322.32 that will be required; support services that will be provided 322.33 while the participant conducts job search activities; the 322.34 courses necessary to obtain certification or licensure, if 322.35 applicable, and after obtaining the license or certificate, the 322.36 client must comply with subdivision 5; and how frequently the 323.1 participant must report to the job counselor on the status of 323.2 the participant's job search activities. The job counselor may 323.3 approve other work activities listed in section 256J.49, 323.4 subdivision 13, to be included in a job search support plan. 323.5 (b) During the eight-week job search period, either the job 323.6 counselor or the participant may request a review of the 323.7 participant's job search plan and progress towards obtaining 323.8 suitable employment. If a review is requested by the 323.9 participant, the job counselor must concur that the review is 323.10 appropriate for the participant at that time. If a review is 323.11 conducted, the job counselor may make a determination to conduct 323.12 a secondary assessment prior to the conclusion of the job search. 323.13 (c) Failure to conduct the required job search, to accept 323.14 any offer of suitable employment, to develop or comply with a 323.15 job search support plan, or voluntarily quitting suitable 323.16 employment without good cause results in the imposition of a 323.17 sanction under section 256J.46. If at the end of eight weeks 323.18 the participant has not obtained suitable employment, the job 323.19 counselor must conduct a secondary assessment of the participant 323.20 under subdivision 3. 323.21 Sec. 90. Minnesota Statutes 1997 Supplement, section 323.22 256J.52, subdivision 4, is amended to read: 323.23 Subd. 4. [SECONDARY ASSESSMENT.] (a) The job counselor 323.24 must conduct a secondary assessment for those participants who: 323.25 (1) in the judgment of the job counselor, have barriers to 323.26 obtaining employment that will not be overcome with a job search 323.27 support plan under subdivision 3; 323.28 (2) have completed eight weeks of job search under 323.29 subdivision 3 without obtaining suitable employment;or323.30 (3) have not received a secondary assessment, are working 323.31 at least 20 hours per week, and the participant, job counselor, 323.32 or county agency requests a secondary assessment; or 323.33 (4) have an existing plan or are already involved in 323.34 training or education activities under section 256J.55, 323.35 subdivision 5. 323.36 (b) In the secondary assessment the job counselor must 324.1 evaluate the participant's skills and prior work experience, 324.2 family circumstances, interests and abilities, need for 324.3 preemployment activities, supportive or educational services, 324.4 and the extent of any barriers to employment. The job counselor 324.5 must use the information gathered through the secondary 324.6 assessment to develop an employment plan under subdivision 5. 324.7 (c) The provider shall make available to participants 324.8 information regarding additional vendors or resources which 324.9 provide employment and training services that may be available 324.10 to the participant under a plan developed under this section. 324.11 The information must include a brief summary of services 324.12 provided and related performance indicators. Performance 324.13 indicators must include, but are not limited to, the average 324.14 time to complete program offerings, placement rates, entry and 324.15 average wages, and retention rates. To be included in the 324.16 information given to participants, a vendor or resource must 324.17 provide counties with relevant information in the format 324.18 required by the county. 324.19 Sec. 91. Minnesota Statutes 1997 Supplement, section 324.20 256J.52, is amended by adding a subdivision to read: 324.21 Subd. 8. [ADMINISTRATIVE SUPPORT FOR POSTEMPLOYMENT 324.22 EDUCATION AND TRAINING.] After a caregiver has been employed for 324.23 six consecutive months, or after the first month in which the 324.24 caregiver works on average more than 20 hours per week, the 324.25 caregiver's job counselor shall inform the caregiver that the 324.26 caregiver may request a secondary assessment and shall provide 324.27 information about: 324.28 (1) part-time education and training options available to 324.29 the caregiver; and 324.30 (2) child care and transportation resources available to 324.31 support postemployment education and training. 324.32 Sec. 92. Minnesota Statutes 1997 Supplement, section 324.33 256J.52, is amended by adding a subdivision to read: 324.34 Subd. 9. [TRAINING CONCURRENT WITH EMPLOYMENT.] An MFIP 324.35 caregiver who is meeting the minimum hourly work participation 324.36 requirements under the Personal Responsibility and Work 325.1 Opportunity Reconciliation Act of 1996 through employment must 325.2 be allowed to meet any additional MFIP-S hourly work 325.3 participation requirements through training or education that 325.4 meets the requirements of section 256J.53. 325.5 Sec. 93. Minnesota Statutes 1997 Supplement, section 325.6 256J.54, subdivision 2, is amended to read: 325.7 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 325.8 PLAN.] For caregivers who are under age 18 without a high school 325.9 diploma or its equivalent, the assessment under subdivision 1 325.10 and the employment plan under subdivision 3 must be completed by 325.11 the social services agency under section 257.33. For caregivers 325.12 who are age 18 or 19 without a high school diploma or its 325.13 equivalent, the assessment under subdivision 1 and the 325.14 employment plan under subdivision 3 must be completed by the job 325.15 counselor. The social services agency or the job counselor 325.16 shall consult with representatives of educational agencies that 325.17 are required to assist in developing educational plans under 325.18 section 126.235. 325.19 Sec. 94. Minnesota Statutes 1997 Supplement, section 325.20 256J.54, subdivision 3, is amended to read: 325.21 Subd. 3. [EDUCATIONAL OPTION DEVELOPED.] If the job 325.22 counselor or county social services agency identifies an 325.23 appropriate educational option for a caregiver under the age of 325.24 20 without a high school diploma or its equivalent,itthe 325.25 counselor or agency must develop an employment plan which 325.26 reflects the identified option. The plan must specify that 325.27 participation in an educational activity is required, what 325.28 school or educational program is most appropriate, the services 325.29 that will be provided, the activities the caregiver will take 325.30 part in, including child care and supportive services, the 325.31 consequences to the caregiver for failing to participate or 325.32 comply with the specified requirements, and the right to appeal 325.33 any adverse action. The employment plan must, to the extent 325.34 possible, reflect the preferences of the caregiver. 325.35 Sec. 95. Minnesota Statutes 1997 Supplement, section 325.36 256J.54, subdivision 4, is amended to read: 326.1 Subd. 4. [NO APPROPRIATE EDUCATIONAL OPTION.] If the job 326.2 counselor determines that there is no appropriate educational 326.3 option for a caregiver who is age 18 or 19 without a high school 326.4 diploma or its equivalent, the job counselor must develop an 326.5 employment plan, as defined in section 256J.49, subdivision 5, 326.6 for the caregiver. If the county social services agency 326.7 determines that school attendance is not appropriate for a 326.8 caregiver under age 18 without a high school diploma or its 326.9 equivalent, the county agency shall refer the caregiver to 326.10 social services for services as provided in section 257.33. 326.11 Sec. 96. Minnesota Statutes 1997 Supplement, section 326.12 256J.54, subdivision 5, is amended to read: 326.13 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 326.14 the provisions of section 256J.56, minor parents, or 18- or 326.15 19-year-old parents without a high school diploma or its 326.16 equivalent must attend school unless: 326.17 (1) transportation services needed to enable the caregiver 326.18 to attend school are not available; 326.19 (2) appropriate child care services needed to enable the 326.20 caregiver to attend school are not available; 326.21 (3) the caregiver is ill or incapacitated seriously enough 326.22 to prevent attendance at school; or 326.23 (4) the caregiver is needed in the home because of the 326.24 illness or incapacity of another member of the household. This 326.25 includes a caregiver of a child who is younger than six weeks of 326.26 age. 326.27 (b) The caregiver must be enrolled in a secondary school 326.28 and meeting the school's attendance requirements. The county, 326.29 social service agency, or job counselor must verify at least 326.30 once per quarter that the caregiver is meeting the school's 326.31 attendance requirements. An enrolled caregiver is considered to 326.32 be meeting the attendance requirements when the school is not in 326.33 regular session, including during holiday and summer breaks. 326.34 Sec. 97. Minnesota Statutes 1997 Supplement, section 326.35 256J.55, subdivision 5, is amended to read: 326.36 Subd. 5. [OPTION TO UTILIZE EXISTING PLAN.] With job 327.1 counselor approval, if a participant is already complying with a 327.2 job search support or employment plan that was developed for a 327.3 different program or is already involved in education or 327.4 training activities, the participant mayutilizecontinue that 327.5 planand that program's services, subject to the requirements of327.6subdivision 3,or activity to be in compliance with sections 327.7 256J.52 to 256J.57 so long as the plan meets, or is modified to 327.8 meet, the requirements of those sections. 327.9 Sec. 98. Minnesota Statutes 1997 Supplement, section 327.10 256J.56, is amended to read: 327.11 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 327.12 EXEMPTIONS.] 327.13 (a) An MFIP-S caregiver is exempt from the requirements of 327.14 sections 256J.52 to 256J.55 if the caregiver belongs to any of 327.15 the following groups: 327.16 (1) individuals who are age 60 or older; 327.17 (2) individuals who are suffering from a professionally 327.18 certified permanent or temporary illness, injury, or incapacity 327.19 which is expected to continue for more than 30 days and which 327.20 prevents the person from obtaining or retaining employment. 327.21 Persons in this category with a temporary illness, injury, or 327.22 incapacity must be reevaluated at least quarterly; 327.23 (3) caregivers whose presence in the home is required 327.24 because of the professionally certified illness or incapacity of 327.25 another member in the assistance unit, a relative in the 327.26 household, or a foster child in the household; 327.27 (4) women who are pregnant, if the pregnancy has resulted 327.28 in a professionally certified incapacity that prevents the woman 327.29 from obtaining or retaining employment; 327.30 (5) caregivers of a child under the age of one year who 327.31 personally provide full-time care for the child. This exemption 327.32 may be used for only 12 months in a lifetime. In two-parent 327.33 households, only one parent or other relative may qualify for 327.34 this exemption; 327.35 (6)individualssingle parents, or one parent in a 327.36 two-parent family, employed at least40 hours per week or at328.1least 30 hours per week and engaged in job search for at least328.2an additional ten35 hours per week; 328.3 (7) individuals experiencing a personal or family crisis 328.4 that makes them incapable of participating in the program, as 328.5 determined by the county agency. If the participant does not 328.6 agree with the county agency's determination, the participant 328.7 may seek professional certification, as defined in section 328.8 256J.08, that the participant is incapable of participating in 328.9 the program. 328.10 Persons in this exemption category must be reevaluated 328.11 every 60 days; or 328.12 (8) second parents in two-parent families, provided the328.13second parent isemployed for 20 or more hours per week, 328.14 provided the first parent is employed at least 35 hours per week. 328.15 A caregiver who is exempt under clause (5) must enroll in 328.16 and attend an early childhood and family education class, a 328.17 parenting class, or some similar activity, if available, during 328.18 the period of time the caregiver is exempt under this section. 328.19 Notwithstanding section 256J.46, failure to attend the required 328.20 activity shall not result in the imposition of a sanction. 328.21 (b) The county agency must provide employment and training 328.22 services to MFIP-S caregivers who are exempt under this section, 328.23 but who volunteer to participate. Exempt volunteers may request 328.24 approval for any work activity under section 256J.49, 328.25 subdivision 13. The hourly participation requirements for 328.26 nonexempt caregivers under section 256J.50, subdivision 5, do 328.27 not apply to exempt caregivers who volunteer to participate. 328.28 Sec. 99. Minnesota Statutes 1997 Supplement, section 328.29 256J.57, subdivision 1, is amended to read: 328.30 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 328.31 county agency shall not impose the sanction under section 328.32 256J.46 if it determines that the participant has good cause for 328.33 failing to comply with the requirements ofsection 256J.45 or328.34 sections 256J.52 to 256J.55. Good cause exists when: 328.35 (1) appropriate child care is not available; 328.36 (2) the job does not meet the definition of suitable 329.1 employment; 329.2 (3) the participant is ill or injured; 329.3 (4) afamilymember of the assistance unit, a relative in 329.4 the household, or a foster child in the household is ill and 329.5 needs care by the participant that prevents the participant from 329.6 complying with the job search support plan or employment plan; 329.7 (5) the parental caregiver is unable to secure necessary 329.8 transportation; 329.9 (6) the parental caregiver is in an emergency situation 329.10 that prevents compliance with the job search support plan or 329.11 employment plan; 329.12 (7) the schedule of compliance with the job search support 329.13 plan or employment plan conflicts with judicial proceedings; 329.14 (8) the parental caregiver is already participating in 329.15 acceptable work activities; 329.16 (9) the employment plan requires an educational program for 329.17 a caregiver under age 20, but the educational program is not 329.18 available; 329.19 (10) activities identified in the job search support plan 329.20 or employment plan are not available; 329.21 (11) the parental caregiver is willing to accept suitable 329.22 employment, but suitable employment is not available; or 329.23 (12) the parental caregiver documents other verifiable 329.24 impediments to compliance with the job search support plan or 329.25 employment plan beyond the parental caregiver's control. 329.26 Sec. 100. Minnesota Statutes 1997 Supplement, section 329.27 256J.74, subdivision 2, is amended to read: 329.28 Subd. 2. [CONCURRENT ELIGIBILITY, LIMITATIONS.] A county 329.29 agency must not count an applicant or participant as a member of 329.30 more than one assistance unit in a given payment month, except 329.31 as provided in clauses (1) and (2). 329.32 (1) A participant who is a member of an assistance unit in 329.33 this state is eligible to be included in a second assistance 329.34 unitinthe first full monththatafter the month the 329.35 participantleaves the first assistance unit and lives with329.36ajoins the secondassistanceunit. 330.1 (2) An applicant whose needs are met through foster care 330.2 that is reimbursed under title IV-E of the Social Security Act 330.3 for the first part of an application month is eligible to 330.4 receive assistance for the remaining part of the month in which 330.5 the applicant returns home. Title IV-E payments and adoption 330.6 assistance payments must be considered prorated payments rather 330.7 than a duplication of MFIP-S need. 330.8 Sec. 101. Minnesota Statutes 1997 Supplement, section 330.9 256J.74, is amended by adding a subdivision to read: 330.10 Subd. 5. [FOOD STAMPS.] For any month an individual 330.11 receives food stamp benefits, the individual is not eligible for 330.12 the MFIP-S food portion of assistance, except as provided under 330.13 section 256J.28, subdivision 5. 330.14 Sec. 102. [256J.77] [AGING OF CASH BENEFITS.] 330.15 Cash benefits under chapters 256D, 256J, and 256K by 330.16 warrants or electronic benefit transfer that have not been 330.17 accessed within 90 days of issuance, shall be canceled. Cash 330.18 benefits may be replaced after they are canceled, for up to one 330.19 year after the date of issuance, if failure to do so would place 330.20 the client or family at risk. For the purposes of this section, 330.21 "accessed" means cashing a warrant or making at least one 330.22 withdrawal from benefits deposited in an electronic benefit 330.23 account. 330.24 Sec. 103. Minnesota Statutes 1997 Supplement, section 330.25 256K.03, subdivision 5, is amended to read: 330.26 Subd. 5. [EXEMPTION CATEGORIES.] (a) The applicant will be 330.27 exempt from the job search requirements and development of a job 330.28 search plan and an employability development plan under 330.29 subdivisions 3, 4, and 8 if the applicant belongs to any of the 330.30 following groups: 330.31 (1)caregivers under age 20 who have not completed a high330.32school education and are attending high school on a full-time330.33basis;330.34(2)individuals who are age 60 or older; 330.35(3)(2) individuals who are suffering from a professionally 330.36 certified permanent or temporary illness, injury, or incapacity 331.1 which is expected to continue for more than 30 days and which 331.2 prevents the person from obtaining or retaining employment. 331.3 Persons in this category with a temporary illness, injury, or 331.4 incapacity must be reevaluated at least quarterly; 331.5(4)(3) caregivers whose presence in the home is needed 331.6 because of the professionally certified illness or incapacity of 331.7 another member in the assistance unit, a relative in the 331.8 household, or a foster child in the household; 331.9(5)(4) women who are pregnant, ifitthe pregnancy has 331.10been medically verifiedresulted in a professionally certified 331.11 incapacity thatthe child is expected to be born within the next331.12six monthsprevents the woman from obtaining and retaining 331.13 employment; 331.14(6)(5) caregiversor other caregiver relativesof a child 331.15 under the age ofthreeone year who personally provide full-time 331.16 care for the child. This exemption may be used for only 12 331.17 months in a lifetime. In two-parent households, only one parent 331.18 or other relative may qualify for this exemption; 331.19(7) individuals(6) single parents, or one parent in a 331.20 two-parent family, employed at least3035 hours per week; 331.21(8) individuals for whom participation would require a331.22round trip commuting time by available transportation of more331.23than two hours, excluding transporting of children for child331.24care;331.25(9) individuals for whom lack of proficiency in English is331.26a barrier to employment, provided such individuals are331.27participating in an intensive program which lasts no longer than331.28six months and is designed to remedy their language deficiency;331.29(10) individuals who, because of advanced age or lack of331.30ability, are incapable of gaining proficiency in English, as331.31determined by the county social worker, shall continue to be331.32exempt under this subdivision and are not subject to the331.33requirement that they be participating in a language program;331.34(11)(7) individualsunder such duress that they are331.35incapable of participating in the program, as determined by the331.36county social workerexperiencing a personal or family crisis 332.1 that makes them incapable of participating in the program, as 332.2 determined by the county agency. If the participant does not 332.3 agree with the county agency's determination, the participant 332.4 may seek professional certification, as defined in section 332.5 256J.08, that the participant is incapable of participating in 332.6 the program. Persons in this exemption category must be 332.7 reevaluated every 60 days; or 332.8(12) individuals in need of refresher courses for purposes332.9of obtaining professional certification or licensure.332.10(b) In a two-parent family, only one caregiver may be332.11exempted under paragraph (a), clauses (4) and (6).332.12 (8) second parents in two-parent families employed for 20 332.13 or more hours per week, provided the first parent is employed at 332.14 least 35 hours per week. 332.15 (b) A caregiver who is exempt under clause (5) must enroll 332.16 in and attend an early childhood and family education class, a 332.17 parenting class, or some similar activity, if available, during 332.18 the period of time the caregiver is exempt under this section. 332.19 Notwithstanding section 256J.46, failure to attend the required 332.20 activity shall not result in the imposition of a sanction. 332.21 Sec. 104. Minnesota Statutes 1996, section 268.88, is 332.22 amended to read: 332.23 268.88 [LOCAL SERVICE UNIT PLANS.] 332.24 (a) By April 15,19911999, and by April 15 of each second 332.25 year thereafter, local service units shall prepare and submit to 332.26 the commissioner a plan that covers the next two state fiscal 332.27 years. At least 30 days prior to submission of the plan, the 332.28 local service unit shall solicit comments from the public on the 332.29 contents of the proposed plan. The commissioner shall notify 332.30 each local service unit within 60 days of receipt of its plan 332.31 that the plan has been approved or disapproved. The plan must 332.32 include: 332.33 (1) a statement of objectives for the employment and 332.34 training services the local service unit administers; 332.35 (2) the establishment of job placement and job retention 332.36 goals, the establishment of public assistance caseload reduction 333.1 goals, and the strategies and programs that will be used to 333.2 achieve these goals; 333.3 (3) a statement of whether the goals from the preceding 333.4 year were met and an explanation if the local service unit 333.5 failed to meet the goals; 333.6 (4) the amount proposed to be allocated to each employment 333.7 and training service; 333.8 (5) the proposed types of employment and training services 333.9 the local service unit plans to utilize; 333.10 (6) a description of how the local service unit will use 333.11 funds provided undersection 256.736 to meet the requirements of333.12that section. The description must include the two work333.13programs required by section 256.736, subdivision 10, paragraph333.14(a), clause (13), what services will be provided, number of333.15clients served, per service expenditures, type of clients333.16served, and projected outcomeschapter 256J to meet the 333.17 requirements of that chapter. The description must include what 333.18 services will be provided, per service expenditures, how many 333.19 employment and training slots the local service unit will 333.20 provide, how slots will be allocated between providers, how many 333.21 dollars the local service unit will provide per slot per 333.22 provider, how many participants per slot, the ratio of 333.23 participants per job counselor, and an accounting of proposed 333.24 uses for any residual funds not included in slot allocations to 333.25 providers; 333.26 (7) a report on the use of wage subsidies, grant 333.27 diversions, community investment programs, and other services 333.28 administered under this chapter; 333.29 (8) a performance review of the employment and training 333.30 service providers delivering employment and training services 333.31 for the local service unit; 333.32 (9) a copy of any contract between the local service unit 333.33 and an employment and training service provider including 333.34 expected outcomes and service levels for public assistance 333.35 clients;and333.36 (10) a copy of any other agreements between educational 334.1 institutions, family support services, and child care providers; 334.2 and 334.3 (11) a description of how the local service unit ensures 334.4 compliance with section 256J.06, requiring community involvement 334.5 in the administration of MFIP-S. 334.6 (b) In counties with a city of the first class, the county 334.7 and the city shall develop and submit a joint plan. The plan 334.8 may not be submitted until agreed to by both the city and the 334.9 county. The plan must provide for the direct allocation of 334.10 employment and training money to the city and the county unless 334.11 waived by either. If the county and the city cannot concur on a 334.12 plan, the commissioner shall resolve their dispute. In counties 334.13 in which a federally recognized Indian tribe is operating an 334.14 employment and training program under an agreement with the 334.15 commissioner of human services, the plan must provide that the 334.16 county will coordinate its employment and training programs, 334.17 including developing a system for referrals, sanctions, and the 334.18 provision of supporting services such as access to child care 334.19 funds and transportation with programs operated by the Indian 334.20 tribe. The plan may not be given final approval by the 334.21 commissioner until the tribal unit and county have submitted 334.22 written agreement on these provisions in the plan. If the 334.23 county and Indian tribe cannot agree on these provisions, the 334.24 local service unit shall notify the commissioner of economic 334.25 security and the commissioners of economic security and human 334.26 services shall resolve the dispute. 334.27 (c) The commissioner may withhold the distribution of 334.28 employment and training money from a local service unit that 334.29 does not submit a plan to the commissioner by the date set by 334.30 this section, and shall withhold the distribution of employment 334.31 and training money from a local service unit whose plan has been 334.32 disapproved by the commissioner until an acceptable amended plan 334.33 has been submitted. 334.34 (d) Beginning April 15, 1992, and by April 15 of each 334.35 second year thereafter, local service units must prepare and 334.36 submit to the commissioner an interim year plan update that 335.1 deals with performance in that state fiscal year and changes 335.2 anticipated for the second year of the biennium. The update 335.3 must include information about employment and training programs 335.4 addressed in the local service unit's two-year plan and shall be 335.5 completed in accordance with criteria established by the 335.6 commissioner. 335.7 Sec. 105. [REPORT REQUIRED.] 335.8 Beginning January 1, 1999, the commissioner shall report 335.9 annually to the legislature on the percent, for each of the four 335.10 quarters of the immediate preceding year, of the MFIP-S caseload 335.11 participants who are exempt from work under the provisions of 335.12 Minnesota Statutes, section 256J.56, clause (2) or (3). 335.13 Sec. 106. [DEVELOPMENT OF REQUIRED ROUTINE INTERVIEW 335.14 TOOLS.] 335.15 The commissioner of human services shall develop a list of 335.16 no more than six questions to be used by county agencies and 335.17 their contractors under Minnesota Statutes, section 256J.44, 335.18 subdivision 3, to identify MFIP-S applicants and recipients who 335.19 have drug or alcohol dependencies or substance abuse problems. 335.20 Sec. 107. Laws 1997, chapter 248, section 46, as amended 335.21 by Laws 1997, First Special Session chapter 5, section 10, is 335.22 amended to read: 335.23 Sec. 46. [UNLICENSED CHILD CARE PROVIDERS; INTERIM 335.24 EXPANSION.] 335.25 (a) Notwithstanding Minnesota Statutes, section 245A.03, 335.26 subdivision 2, clause (2), until June 30, 1999, nonresidential 335.27 child care programs or services that are provided by an 335.28 unrelated individual to persons from two or three other 335.29 unrelated families are excluded from the licensure provisions of 335.30 Minnesota Statutes, chapter 245A, provided that: 335.31 (1) the individual provides services at any one time to no 335.32 more than four children who are unrelated to the individual; 335.33 (2) no more than two of the children are under two years of 335.34 age; and 335.35 (3) the total number of children being cared for at any one 335.36 time does not exceed five. 336.1 (b) Paragraph (a), clauses (1) to (3), do not apply to: 336.2 (1) nonresidential programs that are provided by an 336.3 unrelated individual to persons from a single related family; 336.4 (2) a child care provider whose child care services meet 336.5 the criteria in paragraph (a), clauses (1) to (3), but who 336.6 chooses to apply for licensure; 336.7 (3) a child care provider who, as an applicant for 336.8 licensure or as a licenseholder, has received a license denial 336.9 under Minnesota Statutes, section 245A.05, a fine under section 336.10 245A.06, or a sanction under section 245A.07 from the 336.11 commissioner that has not been reversed on appeal; or 336.12 (4) a child care provider, or a child care provider who has 336.13 a household member who, as a result of a licensing process, has 336.14 a disqualification under Minnesota Statutes, chapter 245A, that 336.15 has not been set aside by the commissioner. 336.16 Sec. 108. [TRANSFER OF STATE MONEY FROM TANF RESERVE.] 336.17 For fiscal year 1999, the commissioner of human services 336.18 may transfer to the general fund up to 100 percent of the state 336.19 money that remains in the TANF reserve account for the purposes 336.20 of sections 12, 14, 33, and 70 (256D.05, subdivision 8; 336.21 256D.053, subdivisions 1, 2, 3, and 4; 256J.11, subdivision 2; 336.22 and 256J.37, subdivision 9). 336.23 Sec. 109. [REPEALER.] 336.24 (a) Minnesota Statutes 1997 Supplement, section 256J.28, 336.25 subdivision 4, is repealed effective January 1, 1998. 336.26 (b) Minnesota Statutes 1997 Supplement, section 256B.062, 336.27 is repealed effective July 1, 1998. 336.28 (c) Minnesota Statutes 1997 Supplement, section 256J.25, is 336.29 repealed. 336.30 (d) Minnesota Statutes 1996, sections 256.031, as amended 336.31 by Laws 1997, chapter 85, article 3, section 1; article 4, 336.32 section 11; 256.032; 256.033, as amended by Laws 1997, chapter 336.33 85, article 3, sections 2 and 3; 256.034; 256.035; 256.036; 336.34 256.0361; 256.047; 256.0475; 256.048; and 256.049; Minnesota 336.35 Statutes 1997 Supplement, sections 256J.32, subdivision 5; and 336.36 256J.34, subdivision 5, are repealed effective July 1, 1998. 337.1 (e) Minnesota Rules (exempt), parts 9500.9100 to 9500.9220, 337.2 are repealed effective July 1, 1998. 337.3 (f) Laws 1997, chapter 85, article 1, sections 61 and 71, 337.4 and article 3, section 55, are repealed. 337.5 Sec. 110. [EFFECTIVE DATE.] 337.6 (a) Section 45 (256J.24, subdivision 8) is effective 337.7 October 1, 1998. 337.8 (b) Sections 2, 3, and 92 (245A.03, subdivision 2b; 337.9 245A.03, subdivision 4; Laws 1997, chapter 248, section 46) are 337.10 effective the day following final enactment. 337.11 (c) Sections 5, 6, and 17 (256.01, subdivision 2; 256.014, 337.12 subdivision 1; 256J.03, subdivision 1) are effective the day 337.13 following final enactment. 337.14 Section 12 (256D.05, subdivision 8) is effective the day 337.15 following final enactment. 337.16 ARTICLE 7 337.17 TRIBAL CHILD CARE ASSISTANCE 337.18 Section 1. Minnesota Statutes 1997 Supplement, section 337.19 119B.02, is amended to read: 337.20 119B.02 [DUTIES OF COMMISSIONER.] 337.21 Subdivision 1. [CHILD CARE SERVICES.] The commissioner 337.22 shall develop standards for county and human services boards to 337.23 provide child care services to enable eligible families to 337.24 participate in employment, training, or education programs. 337.25 Within the limits of available appropriations, the commissioner 337.26 shall distribute money to counties to reduce the costs of child 337.27 care for eligible families. The commissioner shall adopt rules 337.28 to govern the program in accordance with this section. The 337.29 rules must establish a sliding schedule of fees for parents 337.30 receiving child care services. The rules shall provide that 337.31 funds received as a lump sum payment of child support arrearages 337.32 shall not be counted as income to a family in the month received 337.33 but shall be prorated over the 12 months following receipt and 337.34 added to the family income during those months. In the rules 337.35 adopted under this section, county and human services boards 337.36 shall be authorized to establish policies for payment of child 338.1 care spaces for absent children, when the payment is required by 338.2 the child's regular provider. The rules shall not set a maximum 338.3 number of days for which absence payments can be made, but 338.4 instead shall direct the county agency to set limits and pay for 338.5 absences according to the prevailing market practice in the 338.6 county. County policies for payment of absences shall be 338.7 subject to the approval of the commissioner. The commissioner 338.8 shall maximize the use of federal money in section 256.736 and 338.9 other programs that provide federal or state reimbursement for 338.10 child care services for low-income families who are in 338.11 education, training, job search, or other activities allowed 338.12 under those programs. Money appropriated under this section 338.13 must be coordinated with the programs that provide federal 338.14 reimbursement for child care services to accomplish this 338.15 purpose. Federal reimbursement obtained must be allocated to 338.16 the county that spent money for child care that is federally 338.17 reimbursable under programs that provide federal reimbursement 338.18 for child care services. The counties shall use the federal 338.19 money to expand child care services. The commissioner may adopt 338.20 rules under chapter 14 to implement and coordinate federal 338.21 program requirements. 338.22 Subd. 2. [CONTRACTUAL AGREEMENTS WITH TRIBES.] The 338.23 commissioner may enter into contractual agreements with a 338.24 federally recognized Indian tribe with a reservation in 338.25 Minnesota to carry out the responsibilities of county human 338.26 service agencies to the extent necessary for the tribe to 338.27 operate child care assistance programs under the supervision of 338.28 the commissioner. Funding to support services under sections 338.29 119B.03 and 119B.05 may be transferred to the federally 338.30 recognized Indian tribe with a reservation in Minnesota from 338.31 allocations available to counties in which reservation 338.32 boundaries lie. When funding is transferred under section 338.33 119B.03, the amount shall be commensurate to estimates of the 338.34 proportion of reservation residents with characteristics 338.35 identified in section 119B.03, subdivision 6, to the total 338.36 population of county residents with those same characteristics. 339.1 Sec. 2. [EFFECTIVE DATE.] 339.2 Section 1 (119B.02, subdivision 1) is effective the day 339.3 following final enactment. 339.4 ARTICLE 8 339.5 MISCELLANEOUS 339.6 Section 1. Minnesota Statutes 1996, section 62A.65, 339.7 subdivision 5, is amended to read: 339.8 Subd. 5. [PORTABILITY OF COVERAGE.] (a) No individual 339.9 health plan may be offered, sold, issued, or with respect to 339.10 children age 18 or under renewed, to a Minnesota resident that 339.11 contains a preexisting condition limitation, preexisting 339.12 condition exclusion, or exclusionary rider, unless the 339.13 limitation or exclusion is permitted under this subdivision, 339.14 provided that, except for children age 18 or under, underwriting 339.15 restrictions may be retained on individual contracts that are 339.16 issued without evidence of insurability as a replacement for 339.17 prior individual coverage that was sold before May 17, 1993. 339.18 The individual may be subjected to an 18-month preexisting 339.19 condition limitation, unless the individual has maintained 339.20 continuous coverage as defined in section 62L.02. The 339.21 individual must not be subjected to an exclusionary rider. An 339.22 individual who has maintained continuous coverage may be 339.23 subjected to a one-time preexisting condition limitation of up 339.24 to 12 months, with credit for time covered under qualifying 339.25 coverage as defined in section 62L.02, at the time that the 339.26 individual first is covered under an individual health plan by 339.27 any health carrier. Credit must be given for all qualifying 339.28 coverage with respect to all preexisting conditions, regardless 339.29 of whether the conditions were preexisting with respect to any 339.30 previous qualifying coverage. The individual must not be 339.31 subjected to an exclusionary rider. Thereafter, the individual 339.32 must not be subject to any preexisting condition limitation, 339.33 preexisting condition exclusion, or exclusionary rider under an 339.34 individual health plan by any health carrier, except an 339.35 unexpired portion of a limitation under prior coverage, so long 339.36 as the individual maintains continuous coverage as defined in 340.1 section 62L.02. 340.2 (b) A health carrier must offer an individual health plan 340.3 to any individual previously covered under a group health plan 340.4 issued by that health carrier, regardless of the size of the 340.5 group, so long as the individual maintained continuous coverage 340.6 as defined in section 62L.02. If the individual has available 340.7 any continuation coverage provided under sections 62A.146; 340.8 62A.148; 62A.17, subdivisions 1 and 2; 62A.20; 62A.21; 62C.142; 340.9 62D.101; or 62D.105, or continuation coverage provided under 340.10 federal law, the health carrier need not offer coverage under 340.11 this paragraph until the individual has exhausted the 340.12 continuation coverage. The offer must not be subject to 340.13 underwriting, except as permitted under this paragraph. A 340.14 health plan issued under this paragraph must be a qualified plan 340.15 as defined in section 62E.02 and must not contain any 340.16 preexisting condition limitation, preexisting condition 340.17 exclusion, or exclusionary rider, except for any unexpired 340.18 limitation or exclusion under the previous coverage. The 340.19 individual health plan must cover pregnancy on the same basis as 340.20 any other covered illness under the individual health plan. The 340.21 initial premium rate for the individual health plan must comply 340.22 with subdivision 3. The premium rate upon renewal must comply 340.23 with subdivision 2. In no event shall the premium rate exceed 340.24 90 percent of the premium charged for comparable individual 340.25 coverage by the Minnesota comprehensive health association, and 340.26 the premium rate must be less than that amount if necessary to 340.27 otherwise comply with this section. An individual health plan 340.28 offered under this paragraph to a person satisfies the health 340.29 carrier's obligation to offer conversion coverage under section 340.30 62E.16, with respect to that person. Coverage issued under this 340.31 paragraph must provide that it cannot be canceled or nonrenewed 340.32 as a result of the health carrier's subsequent decision to leave 340.33 the individual, small employer, or other group market. Section 340.34 72A.20, subdivision 28, applies to this paragraph. 340.35 Sec. 2. Minnesota Statutes 1996, section 62D.042, 340.36 subdivision 2, is amended to read: 341.1 Subd. 2. [BEGINNING ORGANIZATIONSNET WORTH REQUIREMENTS.] 341.2 (a) Beginning organizations shall maintain net worth of at least 341.3 8-1/3 percent of the sum of all expenses expected to be incurred 341.4 in the 12 months following the date the certificate of authority 341.5 is granted, or $1,500,000, whichever is greater. 341.6 (b) After the first full calendar year of operation, 341.7 organizations shall maintain net worth of at least 8-1/3 percent 341.8 and at most16-2/325 percent of the sum of all expenses 341.9 incurred during the most recent calendar year, but in no case 341.10 shall net worth fall below $1,000,000. 341.11 (c) Notwithstanding paragraphs (a) and (b), any health 341.12 maintenance organization owned by a political subdivision of 341.13 this state, which has a higher than average percentage of 341.14 enrollees who are enrolled in medical assistance or general 341.15 assistance medical care, may exceed the maximum net worth limits 341.16 provided in paragraphs (a) and (b), with the advance approval of 341.17 the commissioner. 341.18 Sec. 3. Minnesota Statutes 1996, section 62E.16, is 341.19 amended to read: 341.20 62E.16 [POLICY CONVERSION RIGHTS.] 341.21 Every program of self-insurance, policy of group accident 341.22 and health insurance or contract of coverage by a health 341.23 maintenance organization written or renewed in this state, shall 341.24 include, in addition to the provisions required by section 341.25 62A.17, the right to convert to an individual coverage qualified 341.26 plan without the addition of underwriting restrictionsifafter 341.27 the individual insured has exhausted any continuation coverage 341.28 provided under section 62A.146; 62A.148; 62A.17, subdivisions 1 341.29 and 2; 62A.20; 62A.21; 62C.142; 62D.101; or 62D.105, or 341.30 continuation coverage provided under federal law, if any 341.31 continuation coverage is available to the individual, and then 341.32 leaves the group regardless of the reason for leaving the group 341.33 or if an employer member of a group ceases to remit payment so 341.34 as to terminate coverage for its employees, or upon cancellation 341.35 or termination of the coverage for the group except where 341.36 uninterrupted and continuous group coverage is otherwise 342.1 provided to the group. If the health maintenance organization 342.2 has canceled coverage for the group because of a loss of 342.3 providers in a service area, the health maintenance organization 342.4 shall arrange for other health maintenance or indemnity 342.5 conversion options that shall be offered to enrollees without 342.6 the addition of underwriting restrictions. The required 342.7 conversion contract must treat pregnancy the same as any other 342.8 covered illness under the conversion contract. The person may 342.9 exercise this right to conversion within 30 days of exhausting 342.10 any continuation coverage provided under section 62A.146; 342.11 62A.148; 62A.17, subdivisions 1 and 2; 62A.20; or 62A.21, or 342.12 continuation coverage provided under federal law, and then 342.13 leaving the group or within 30 days following receipt of due 342.14 notice of cancellation or termination of coverage of the group 342.15 or of the employer member of the group and upon payment of 342.16 premiums from the date of termination or cancellation. Due 342.17 notice of cancellation or termination of coverage for a group or 342.18 of the employer member of the group shall be provided to each 342.19 employee having coverage in the group by the insurer, 342.20 self-insurer or health maintenance organization canceling or 342.21 terminating the coverage except where reasonable evidence 342.22 indicates that uninterrupted and continuous group coverage is 342.23 otherwise provided to the group. Every employer having a policy 342.24 of group accident and health insurance, group subscriber or 342.25 contract of coverage by a health maintenance organization shall, 342.26 upon request, provide the insurer or health maintenance 342.27 organization a list of the names and addresses of covered 342.28 employees. Plans of health coverage shall also include a 342.29 provision which, upon the death of the individual in whose name 342.30 the contract was issued, permits every other individual then 342.31 covered under the contract to elect, within the period specified 342.32 in the contract, to continue coverage under the same or a 342.33 different contract without the addition of underwriting 342.34 restrictions until the individual would have ceased to have been 342.35 entitled to coverage had the individual in whose name the 342.36 contract was issued lived. An individual conversion contract 343.1 issued by a health maintenance organization shall not be deemed 343.2 to be an individual enrollment contract for the purposes of 343.3 section 62D.10. An individual health plan offered under section 343.4 62A.65, subdivision 5, paragraph (b), to a person satisfies the 343.5 health carrier's obligation to offer conversion coverage under 343.6 this section with respect to that person. 343.7 Sec. 4. [62Q.096] [CREDENTIALING OF PROVIDERS.] 343.8 If a health plan company has initially credentialed, as 343.9 providers in its provider network, individual providers employed 343.10 by or under contract with an entity that: (1) is authorized to 343.11 bill under section 256B.0625, subdivision 5; (2) meets the 343.12 requirements of Minnesota Rules, parts 9520.0750 to 9520.0870; 343.13 (3) is designated an essential community provider under section 343.14 62Q.19; and (4) is under contract with the health plan company 343.15 to provide mental health services, the health plan company must 343.16 continue to credential at least the same number of providers 343.17 from that entity, as long as those providers meet the health 343.18 plan company's credentialing standards. A health plan company 343.19 shall not refuse to credential these providers on the grounds 343.20 that their provider network has a sufficient number of providers 343.21 of that type. 343.22 Sec. 5. Minnesota Statutes 1997 Supplement, section 343.23 171.29, subdivision 2, is amended to read: 343.24 Subd. 2. [FEES, ALLOCATION.] (a) A person whose driver's 343.25 license has been revoked as provided in subdivision 1, except 343.26 under section 169.121 or 169.123, shall pay a $30 fee before the 343.27 driver's license is reinstated. 343.28 (b) A person whose driver's license has been revoked as 343.29 provided in subdivision 1 under section 169.121 or 169.123 shall 343.30 pay a $250 fee plus a $10 surcharge before the driver's license 343.31 is reinstated. The $250 fee is to be credited as follows: 343.32 (1) Twenty percent shall be credited to the trunk highway 343.33 fund. 343.34 (2) Fifty-five percent shall be credited to the general 343.35 fund. 343.36 (3) Eight percent shall be credited to a separate account 344.1 to be known as the bureau of criminal apprehension account. 344.2 Money in this account may be appropriated to the commissioner of 344.3 public safety and the appropriated amount shall be apportioned 344.4 80 percent for laboratory costs and 20 percent for carrying out 344.5 the provisions of section 299C.065. 344.6 (4) Twelve percent shall be credited to a separate account 344.7 to be known as the alcohol-impaired driver education account. 344.8 Money in the account is appropriated as follows: 344.9 (i) The first $200,000 in a fiscal year is to the 344.10 commissioner of children, families, and learning for programs in 344.11 elementary and secondary schools. 344.12 (ii) The remainder credited in a fiscal year is 344.13 appropriated to the commissioner of transportation to be spent 344.14 as grants to the Minnesota highway safety center at St. Cloud 344.15 State University for programs relating to alcohol and highway 344.16 safety education in elementary and secondary schools. 344.17 (5) Five percent shall be credited to a separate account to 344.18 be known as the traumatic brain injury and spinal cord injury 344.19 account.$100,000 is annually appropriated from the account to344.20the commissioner of human services for traumatic brain injury344.21case management services.Theremainingmoney in the account is 344.22 annually appropriated to the commissioner of health to be used 344.23 as follows: 35 percent for a contract with a qualified 344.24 community-based organization to provide information, resources, 344.25 and support to assist persons with traumatic brain injury and 344.26 their families to access services, and 65 percent toestablish344.27andmaintain the traumatic brain injury and spinal cord injury 344.28 registry created in section 144.662 and to reimburse the 344.29 commissioner of economic security for the reasonable cost of 344.30 services provided under section 268A.03, clause (o). For the 344.31 purposes of this clause, a "qualified community-based 344.32 organization" is a private, not-for-profit organization of 344.33 consumers of traumatic brain injury services and their family 344.34 members. The organization must be registered with the United 344.35 States Internal Revenue Service under the provisions of section 344.36 501(c)(3) as a tax exempt organization and must have as its 345.1 purposes: 345.2 (i) the promotion of public, family, survivor, and 345.3 professional awareness of the incidence and consequences of 345.4 traumatic brain injury; 345.5 (ii) the provision of a network of support for persons with 345.6 traumatic brain injury, their families, and friends; 345.7 (iii) the development and support of programs and services 345.8 to prevent traumatic brain injury; 345.9 (iv) the establishment of education programs for persons 345.10 with traumatic brain injury; and 345.11 (v) the empowerment of persons with traumatic brain injury 345.12 through participation in its governance. 345.13 (c) The $10 surcharge shall be credited to a separate 345.14 account to be known as the remote electronic alcohol monitoring 345.15 pilot program account. The commissioner shall transfer the 345.16 balance of this account to the commissioner of finance on a 345.17 monthly basis for deposit in the general fund. 345.18 Sec. 6. Minnesota Statutes 1997 Supplement, section 345.19 256F.05, subdivision 8, is amended to read: 345.20 Subd. 8. [USES OF FAMILY PRESERVATION FUND GRANTS.] (a) A 345.21 county which has not demonstrated that year that its family 345.22 preservation core services are developed as provided in 345.23 subdivision 1a, must use its family preservation fund grant 345.24 exclusively for family preservation services defined in section 345.25 256F.03, subdivision 5, paragraphs (a), (b), (c), and (e). 345.26 (b) A county which has demonstrated that year that its 345.27 family preservation core services are developed becomes eligible 345.28 either to continue using its family preservation fund grant as 345.29 provided in paragraph (a), or to exercise the expanded service 345.30 option under paragraph (c). 345.31 (c) The expanded service option permits an eligible county 345.32 to use its family preservation fund grant for child welfare 345.33 preventive services. For purposes of this section, child 345.34 welfare preventive services are those services directed toward a 345.35 specific child or family that further the goals of section 345.36 256F.01 and include assessments, family preservation services, 346.1 service coordination, community-based treatment, crisis nursery 346.2 services when the parents retain custody and there is no 346.3 voluntary placement agreement with a child-placing agency, 346.4 respite care except when it is provided under a medical 346.5 assistance waiver, home-based services, and other related 346.6 services. For purposes of this section, child welfare 346.7 preventive services shall not include shelter care or other 346.8 placement services under the authority of the court or public 346.9 agency to address an emergency. To exercise this option, an 346.10 eligible county must notify the commissioner in writing of its 346.11 intention to do so no later than 30 days into the quarter during 346.12 which it intends to begin or in its county plan, as provided in 346.13 section 256F.04, subdivision 2. Effective with the first day of 346.14 that quarter, the county must maintain its base level of 346.15 expenditures for child welfare preventive services and use the 346.16 family preservation fund to expand them. The base level of 346.17 expenditures for a county shall be that established under 346.18 section 256F.10, subdivision 7. For counties which have no such 346.19 base established, a comparable base shall be established with 346.20 the base year being the calendar year ending at least two 346.21 calendar quarters before the first calendar quarter in which the 346.22 county exercises its expanded service option. The commissioner 346.23 shall, at the request of the counties, reduce, suspend, or 346.24 eliminate either or both of a county's obligations to continue 346.25 the base level of expenditures and to expand child welfare 346.26 preventive services under extraordinary circumstances. 346.27 (d) Notwithstanding paragraph (a), a county that is 346.28 participating in the child protection assessments or 346.29 investigations community collaboration pilot program under 346.30 section 626.5560, or in the concurrent permanency planning pilot 346.31 program under section 257.0711, may use its family preservation 346.32 fund grant for those programs. 346.33 Sec. 7. Laws 1997, chapter 207, section 7, is amended to 346.34 read: 346.35 Sec. 7. [PRIVATE SALE OF TAX-FORFEITED LAND; CARLTON 346.36 COUNTY.] 347.1 (a) Notwithstanding Minnesota Statutes, sections 92.45 and 347.2 282.018, subdivision 1, and the public sale provisions of 347.3 Minnesota Statutes, chapter 282, Carlton county may sell by 347.4 private sale the tax-forfeited land described in paragraph (d) 347.5 under the remaining provisions of Minnesota Statutes, chapter 347.6 282. 347.7 (b) The land described in paragraph (d) may be sold by 347.8 private sale. The considerationfor the conveyance must include347.9the taxes due on the property and any penalties, interest, and347.10costsshall be the appraised value of the land. If the lands 347.11 are sold, the conveyance must reserve to the state a 347.12 conservation easement, in a form prescribed by the commissioner 347.13 of natural resources, for the land within 100 feet of the 347.14 ordinary high water level of Slaughterhouse creek for public 347.15 angler access and stream habitat protection and enhancement. 347.16 (c) The conveyance must be in a form approved by the 347.17 attorney general. 347.18 (d) The land to be conveyed is located in Carlton county 347.19 and is described as: 347.20 North 6.66 acres of the West Half of the Northeast Quarter 347.21 of the Southwest Quarter, subject to pipeline easement, Section 347.22 6, Township 48 North, Range 16 West, City of Carlton. 347.23 (e) Carlton county has determined that this sale best 347.24 serves the land management interests of Carlton county. 347.25 Sec. 8. [CONVEYANCE OF STATE LAND; ANOKA COUNTY.] 347.26 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 347.27 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 347.28 subdivision 3, or any other law to the contrary, the 347.29 commissioner of administration may convey all, or any part of, 347.30 the land and associated buildings described in subdivision 3 to 347.31 Anoka county after the commissioner of human services declares 347.32 said property surplus to its needs. 347.33 Subd. 2. [FORM.] (a) The conveyance shall be in a form 347.34 approved by the attorney general. 347.35 (b) The conveyance is subject to a scenic easement, as 347.36 defined in Minnesota Statutes, section 103F.311, subdivision 6, 348.1 to be under the custodial control of the commissioner of natural 348.2 resources, on that portion of the conveyed land that is 348.3 designated for inclusion in the wild and scenic river system 348.4 under Minnesota Statutes, section 103F.325. The scenic easement 348.5 shall allow for continued use of the structures located within 348.6 the easement and for development of a walking path within the 348.7 easement. 348.8 (c) The conveyance shall restrict use of the land to 348.9 governmental, including recreational, purposes and shall provide 348.10 that ownership of any portion of the land that ceases to be used 348.11 for such purposes shall revert to the state of Minnesota. 348.12 (d) The commissioner of administration may convey any part 348.13 of the property described in subdivision 3 any time after the 348.14 land is declared surplus by the commissioner of human services 348.15 and the execution and recording of the scenic easement under 348.16 paragraph (b) has been completed. 348.17 (e) Notwithstanding any law, regulation, or ordinance to 348.18 the contrary, the instrument of conveyance to Anoka county may 348.19 be recorded in the office of the Anoka county recorder without 348.20 compliance with any subdivision requirement. 348.21 Subd. 3. [LAND DESCRIPTION.] Subject to right-of-way for 348.22 Grant Street, Northview Lane, Garfield Street, 5th Avenue, and 348.23 State Trunk Highway No. 288, also known as 4th Avenue, the land 348.24 to be conveyed may include all, or part of, that which is 348.25 described as follows: 348.26 (1) all that part of Government Lots 3 and 4 and that part 348.27 of the Southeast Quarter of the Southwest Quarter, all in 348.28 Section 31, Township 32 North, Range 24 West, Anoka county, 348.29 Minnesota, described as follows: 348.30 Beginning at the southwest corner of said Southeast Quarter 348.31 of the Southwest Quarter of Section 31; thence North 13 348.32 degrees 16 minutes 11 seconds East, assumed bearing, 473.34 348.33 feet; thence North 07 degrees 54 minutes 43 seconds East 348.34 186.87 feet; thence North 14 degrees 08 minutes 33 seconds 348.35 West 154.77 feet; thence North 62 degrees 46 minutes 44 348.36 seconds West 526.92 feet; thence North 25 degrees 45 349.1 minutes 30 seconds East 74.43 feet; thence northerly 88.30 349.2 feet along a tangential curve concave to the west having a 349.3 radius of 186.15 feet and a central angle of 27 degrees 10 349.4 minutes 50 seconds; thence North 01 degrees 25 minutes 20 349.5 seconds West, tangent to said curve, 140.53 feet; thence 349.6 North 71 degrees 56 minutes 34 seconds West to the 349.7 southeasterly shoreline of the Rum river; thence 349.8 southwesterly along said shoreline to the south line of 349.9 said Government Lot 4; thence easterly along said south 349.10 line to the point of beginning. For the purpose of this 349.11 description the south line of said Southeast Quarter of the 349.12 Southwest Quarter of Section 31 has an assumed bearing of 349.13 North 89 degrees 08 minutes 19 seconds East; 349.14 (2) Government Lot 1, Section 6, Township 31 North, Range 349.15 24 West, Anoka county, Minnesota; EXCEPT that part platted as 349.16 Grant Properties, Anoka county, Minnesota; ALSO EXCEPT that part 349.17 lying southerly of the westerly extension of the south line of 349.18 Block 6, Woodbury's Addition to the city of Anoka, Anoka county, 349.19 Minnesota, and lying westerly of the west line of said plat of 349.20 Grant Properties, said line also being the centerline of 4th 349.21 Avenue; 349.22 (3) all that part of said Block 6, Woodbury's Addition to 349.23 the city of Anoka lying westerly of Northview 1st Addition, 349.24 Anoka county, Minnesota; 349.25 (4) all that part of said Northview 1st Addition lying 349.26 westerly of the east line of Lots 11 through 20, Block 1, 349.27 inclusive, thereof; and 349.28 (5) all that part of the Northeast Quarter of the Northwest 349.29 Quarter of said Section 6, Township 31 North, Range 24 West, 349.30 Anoka county, Minnesota, lying northerly of the centerline of 349.31 Grant Street as defined by said plat of Grant Properties and 349.32 lying westerly of said east line of Lots 11 through 20, Block 1, 349.33 inclusive, Northview 1st Addition and said line's extension 349.34 north and south. 349.35 Subd. 4. [DETERMINATION.] The commissioner of human 349.36 services has determined that the land described in subdivision 3 350.1 will no longer be needed for the Anoka metro regional treatment 350.2 center upon the completion of the state facilities currently 350.3 under construction, and the completion of renovation work to 350.4 state buildings that are not located on the land described in 350.5 subdivision 3. The state's land and building management 350.6 interests may best be served by conveying all, or part of, the 350.7 land and associated buildings located on the land described in 350.8 subdivision 3. 350.9 Sec. 9. [CONVEYANCE OF STATE LAND; CROW WING COUNTY.] 350.10 Subdivision 1. [CONVEYANCE AUTHORIZED.] Notwithstanding 350.11 Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 350.12 subdivision 3, or any other law to the contrary, the 350.13 commissioner of administration may convey, all or any part of, 350.14 the land, and the state building located on said land, described 350.15 in subdivision 3 to Crow Wing county after the commissioner of 350.16 human services declares said property surplus to its needs. 350.17 Subd. 2. [FORM.] (a) The conveyance shall be in a form 350.18 approved by the attorney general. 350.19 (b) The conveyance shall restrict use of the land to county 350.20 governmental purposes, including community corrections programs, 350.21 and shall provide that ownership of any portion of the land or 350.22 building that ceases to be used for such purposes shall revert 350.23 to the state of Minnesota. 350.24 Subd. 3. [LAND DESCRIPTION.] The land to be conveyed is 350.25 that part of the Northeast Quarter of Section 30, Township 45 350.26 North, Range 30 West, Crow Wing county, Minnesota, described as 350.27 follows: 350.28 Commencing at the southeast corner of said Northeast 350.29 Quarter; thence North 00 degrees 46 minutes 05 seconds 350.30 West, bearing based on the Crow Wing county coordinate 350.31 database NAD 83/94, 1520.06 feet along the east line of 350.32 said Northeast Quarter to the point of beginning; thence 350.33 continue North 00 degrees 46 minutes 05 seconds West 634.14 350.34 feet along said east line of the Northeast Quarter; thence 350.35 South 89 degrees 13 minutes 20 seconds West 550.00 feet; 350.36 thence South 18 degrees 57 minutes 23 seconds East 115.59 351.1 feet; thence South 42 degrees 44 minutes 39 seconds East 351.2 692.37 feet; thence South 62 degrees 46 minutes 19 seconds 351.3 East 20.24 feet; thence North 89 degrees 13 minutes 55 351.4 seconds East 33.00 feet to the point of beginning. 351.5 Containing 4.69 acres, more or less. Subject to the 351.6 right-of-way of the township road along the east side 351.7 thereof, subject to other easements, reservations, and 351.8 restrictions of record, if any. 351.9 Subd. 4. [DETERMINATION.] The commissioner of human 351.10 services has determined that the land described in subdivision 3 351.11 and the building on the land will not be needed for future 351.12 operations of the Brainerd regional human services center. The 351.13 state's land management interests would best be served by 351.14 conveying the land to Crow Wing county for governmental use. 351.15 Sec. 10. [TOWN OF WHITE, ST. LOUIS COUNTY.] 351.16 Subdivision 1. [TRANSFER.] Notwithstanding any provision 351.17 of Minnesota Statutes to the contrary, the town of White is 351.18 hereby authorized to transfer the following property and any 351.19 buildings, equipment, and other improvements located thereon to 351.20 the White community hospital corporation, a nonprofit 351.21 corporation organized and existing under Minnesota Statutes, 351.22 chapter 317: 351.23 That part of the southeast quarter of southwest quarter (SE 351.24 1/4 of SW 1/4), section 10, township 58 north of range 15 west 351.25 of the fourth principal meridian, according to the United States 351.26 government survey thereof, St. Louis county, Minnesota, 351.27 described as follows: 351.28 Commencing at the southeast corner of said SE 1/4 of SW 351.29 1/4, section 10, township 58, range 15, thence proceeding north 351.30 along the east line thereof for a distance of 550 feet; thence 351.31 west and parallel to the south line thereof for a distance of 351.32 800 feet; thence south and parallel to the east line thereof, 351.33 for a distance of 550 feet to the south line; thence east along 351.34 said south line thereof, for a distance of 800 feet to the point 351.35 of beginning. 351.36 Subd. 2. [NO CONSIDERATION OR ELECTION REQUIRED.] The 352.1 transfer authorized by subdivision 1 shall be without 352.2 consideration and no vote of the electors of the town of White 352.3 or city of Aurora shall be required. 352.4 Subd. 3. [USE; PUBLIC PROPERTY.] The property legally 352.5 described in subdivision 1 shall be used for health care and 352.6 related purposes and shall be considered public property for 352.7 purposes of Minnesota Statutes, section 16A.695. The activities 352.8 conducted on the property described in subdivision 1 by the 352.9 White community hospital corporation, its successors and assigns 352.10 shall be considered a governmental program as authorized by 352.11 Minnesota Statutes, chapter 447. 352.12 Subd. 4. [NAME.] The public name of the buildings and 352.13 improvements located on the real property legally described in 352.14 subdivision 1 shall always include the words "White community." 352.15 Sec. 11. [LOAN GUARANTEE.] 352.16 The director of the division of emergency management of the 352.17 department of public safety shall, as the governor's authorized 352.18 representative and on behalf of the state, agree to provide 352.19 security for and guarantee a promissory note or similar document 352.20 for a loan from the Federal Emergency Management Agency under 352.21 its community disaster loan program to the city of Ada in the 352.22 amount of approximately $1,200,000. The loan is to cover 352.23 operating losses for a publicly owned health care facility that 352.24 was damaged in the spring floods of 1997. 352.25 Sec. 12. [LICENSING MORATORIUM; JUVENILE FACILITIES.] 352.26 Subdivision 1. [MORATORIUM; COMMISSIONER OF 352.27 CORRECTIONS.] Except as provided in subdivision 4, the 352.28 commissioner of corrections may not: 352.29 (1) issue any license under Minnesota Statutes, section 352.30 241.021, to operate a new correctional facility for the 352.31 detention or confinement of juvenile offenders that will include 352.32 more than 25 beds for juveniles; or 352.33 (2) renew a license under Minnesota Statutes, section 352.34 241.021, to operate a correctional facility licensed before the 352.35 effective date of this moratorium, for the detention or 352.36 confinement of juvenile offenders, if the number of beds in the 353.1 facility will increase by more than 25 beds since the time the 353.2 most recent license was issued. 353.3 Subd. 2. [MORATORIUM; COMMISSIONER OF HUMAN 353.4 SERVICES.] Except as provided in subdivision 4, the commissioner 353.5 of human services may not: 353.6 (1) issue any license under Minnesota Rules, parts 353.7 9545.0905 to 9545.1125, for the residential placement of 353.8 juveniles at a facility that will include more than 25 beds for 353.9 juveniles; or 353.10 (2) renew a license under Minnesota Rules, parts 9545.0905 353.11 to 9545.1125, for the residential placement of juveniles at a 353.12 facility licensed before the effective date of this moratorium, 353.13 if the number of beds in the facility will increase by more than 353.14 25 beds since the time the most recent license was issued. 353.15 Subd. 3. [MORATORIUM; OTHER BEDS.] Except as provided in 353.16 subdivision 4, no state agency may: 353.17 (1) issue a license for any new facility that will provide 353.18 an out-of-home placement for more than 25 juveniles at one time; 353.19 or 353.20 (2) renew a license for any existing facility licensed 353.21 before the effective date of this moratorium, if the number of 353.22 beds in the facility will increase by more than 25 beds since 353.23 the time the most recent license was issued. 353.24 For the purposes of this subdivision, "juvenile" means a 353.25 delinquent child, as defined in Minnesota Statutes, section 353.26 260.015, subdivision 5; a juvenile petty offender, as defined in 353.27 Minnesota Statutes, section 260.015, subdivision 21; or a child 353.28 in need of protection or services, as defined in Minnesota 353.29 Statutes, section 260.015, subdivision 2a. 353.30 Subd. 4. [EXEMPTIONS.] The moratorium in this section does 353.31 not apply to: 353.32 (1) any secure juvenile detention and treatment facility, 353.33 which is funded in part through a grant under Laws 1994, chapter 353.34 643, section 79; 353.35 (2) the department of corrections' facilities at Red Wing 353.36 and Sauk Centre; 354.1 (3) the proposed department of corrections' facility at 354.2 Camp Ripley; 354.3 (4) any facility that submitted a formal request for 354.4 licensure under Minnesota Statutes, section 241.021, before 354.5 December 31, 1997; and 354.6 (5) any residential academy receiving state funding for 354.7 fiscal year 1998 or 1999 for capital improvements. 354.8 Subd. 5. [MORATORIUM; LENGTH.] The moratorium in this 354.9 section stays in effect until June 30, 1999. 354.10 Sec. 13. [JUVENILE PLACEMENT STUDY.] 354.11 The legislative audit commission is requested to direct the 354.12 legislative auditor to conduct a study of juvenile out-of-home 354.13 placements. The study must include: 354.14 (1) an evaluation of existing placements for juveniles, 354.15 including, but not limited to, the number of beds at each 354.16 facility, the average number of beds occupied each day at each 354.17 facility, and the location of each facility, and an analysis of 354.18 the projected need for an increased number of beds for juvenile 354.19 out-of-home placements, including the geographic area where beds 354.20 will be needed; 354.21 (2) an evaluation of existing services and programming 354.22 provided in juvenile out-of-home placements and an assessment of 354.23 the types of services and programming that are needed in 354.24 juvenile out-of-home placements, by geographic area; 354.25 (3) an evaluation of the utilization of continuum of care; 354.26 (4) an assessment of the reasons why juveniles are placed 354.27 outside their homes; 354.28 (5) a summary of the demographics of juveniles placed 354.29 outside their homes, by county, including information on race, 354.30 gender, age, and other relevant factors; 354.31 (6) a summary of the geographic distance between the 354.32 juvenile's home and the location of the out-of-home placement, 354.33 including observations for the reasons a juvenile was placed at 354.34 a particular location; 354.35 (7) a determination of the average length of time that a 354.36 juvenile in Minnesota spends in an out-of-home placement and a 355.1 determination of the average length of time that a juvenile 355.2 spends in each type of out-of-home placement, including, but not 355.3 limited to, residential treatment centers, correctional 355.4 facilities, and group homes; 355.5 (8) a determination of the completion rates of juveniles 355.6 participating in programming in out-of-home placements and an 355.7 analysis of the reasons for noncompletion of programming; 355.8 (9) a determination of the percentage of juveniles whose 355.9 out-of-home placement ends due to the juvenile's failure to meet 355.10 the rules and conditions of the out-of-home placement and an 355.11 analysis of the reasons the juvenile failed; 355.12 (10) an analysis of the effectiveness of the juvenile 355.13 out-of-home placement, including information on recidivism, 355.14 where applicable, and the child's performance after returning to 355.15 the child's home; 355.16 (11) an estimate of the cost each county spends on juvenile 355.17 out-of-home placements; 355.18 (12) a description and examination of the per diem 355.19 components per offender at state, local, and private facilities 355.20 providing placements for juveniles; and 355.21 (13) other issues that may affect juvenile out-of-home 355.22 placements. 355.23 If the commission directs the auditor to conduct this 355.24 study, the auditor shall report its findings to the chairs of 355.25 the house and senate committees and divisions with jurisdiction 355.26 over criminal justice and health and human services policy and 355.27 funding by January 15, 1999. 355.28 Sec. 14. [CITY OF EVELETH; LOAN FORGIVENESS.] 355.29 Notwithstanding the provisions of any other law or charter, 355.30 the city of Eveleth may, by resolution of its city council, 355.31 forgive all or any portion of the principal and interest due or 355.32 to become due to the city, pursuant to any loan or loans made by 355.33 the city, in an amount not exceeding $100,000, prior to January 355.34 1, 1998, to any hospital, nursing home, other health care 355.35 facility or corporation, partnership, or limited liability 355.36 company operating such a facility within the city of Eveleth. 356.1 Sec. 15. [REPEALER.] 356.2 (a) Minnesota Rules, part 2740.1600, subpart 1, is repealed. 356.3 (b) Minnesota Statutes 1997 Supplement, section 62D.042, 356.4 subdivision 3, is repealed. 356.5 Sec. 16. [EFFECTIVE DATE.] 356.6 (a) Section 2 (62D.042, subdivision 2) is effective January 356.7 1, 1999. 356.8 (b) Section 15, paragraph (b) (repealing section 62D.042, 356.9 subdivision 3) is effective the day following final enactment. 356.10 (c) Section 7 (Laws 1997, chapter 207, section 7) is 356.11 effective the day following final enactment. 356.12 (d) Section 10 (TOWN OF WHITE, ST. LOUIS COUNTY) is 356.13 effective upon compliance with Minnesota Statutes, section 356.14 645.021, subdivision 2. 356.15 (e) Sections 12 and 13 (licensing and juvenile placement) 356.16 are effective the day following final enactment. 356.17 (f) Section 14 (loan forgiveness by the city of Eveleth) is 356.18 effective the day following final enactment without local 356.19 approval according to Minnesota Statutes, section 645.023, 356.20 subdivision 1, clause (a).